Corporate Appetites: The Influential Committee Defining America's Diet
Corporate Appetites: The Influential Committee Defining America's Diet
How Hidden Industry Influences Shape U.S. Dietary Guidelines
The health of Americans has undergone significant changes since the 1950s, marked by evolving dietary habits, fluctuating disease rates, and shifts in overall health indicators. Notably, life expectancy and health insurance coverage have seen significant shifts. In the wake of the pandemic, life expectancy has declined, while health insurance coverage has improved following the Affordable Care Act.
Dietary trends have also transformed significantly. Since the 1970s, Americans have shifted from a diet heavy in beef and sugar to one more reliant on chicken, corn-derived sweeteners, and a higher overall calorie intake. This change is attributed to various factors, including evolving agricultural practices, changes in food processing, and shifts in dietary preferences. However, these dietary shifts have also contributed to increased obesity rates and related health issues. The U.S. Department of Health and Human Services Dietary Guidelines for Americans have played a crucial role in shaping the nation's dietary habits, providing recommendations that are supposed to be for a diet that can promote healthy growth and development, help prevent diet-related chronic diseases, and meet nutrient needs. Considering the overall negative trends in the health of Americans, these guidelines seem to have done the opposite of their mandate.
Cancer trends provide a mixed picture. While the absolute number of cancer cases has risen, likely due to an aging population and better detection methods, the age-adjusted rates of both new cancer cases and deaths have decreased. This decline can be attributed to advancements in medical technology, better screening processes, and increased awareness of cancer prevention methods. Markedly, survival rates for cancer patients have improved significantly since the 1970s.
In contrast, the incidence of autoimmune and neurological disorders appears to be on the rise. This increase could be linked to various factors, including environmental changes, better diagnostic capabilities, and possibly lifestyle factors. Particularly concerning is the rise in autoimmune disorders, which has been observed across various demographic groups and attributed to a combination of genetic and environmental factors. Autoimmune conditions occur when the immune system becomes excessively active and starts attacking and harming the body's own tissues. Normally, antibodies are produced by the immune system to defend against harmful substances like viruses, cancer cells, and toxins. However, in autoimmune disorders, the immune system fails to distinguish between invaders and healthy cells.
There are over 100 known autoimmune diseases that collectively impact more than 24 million individuals in the United States. The exact causes or triggers of these diseases remain unclear. Typically, treatment aims at reducing immune system activity.
Overall, these trends highlight the complex interplay of genetics, environment, lifestyle, and healthcare advancements in shaping the health landscape of Americans over the past several decades. While progress in some areas, like cancer treatment, is evident, challenges in others, such as managing chronic diseases and understanding the rise in autoimmune and neurological disorders, persist. I will focus on an often overlooked aspect of our health landscape – the dietary guidelines and their impact on Americans' well-being. In particular, the Dietary Guidelines Advisory Committee has played a significant role in shaping the dietary guidelines for Americans, but concerns about conflicts of interest and lack of transparency have raised questions about the committee's ability to provide unbiased and evidence-based recommendations.
Navigating Nutrition: Unveiling the Controversies Surrounding the 2025 Dietary Guidelines Advisory Committee
In the realm of public health and nutrition, few entities wield as much influence as the United States Dietary Guidelines Advisory Committee (DGAC). Tasked with shaping the dietary recommendations that inform everything from school lunches to nutritional advice given by health professionals, the DGAC stands at the forefront of America's battle against obesity, malnutrition, and chronic diseases which it is currently losing. Yet, as we navigate the complex intersection of health science and policy, the integrity and transparency of this influential body have come under scrutiny.
A recent thorough investigation spearheaded by U.S. Right to Know, a nonprofit group dedicated to transparency in public health matters has highlighted these issues. This report, entitled "Full Disclosure: Assessing Conflicts of Interest of the 2025 Dietary Guidelines Advisory Committee," does more than just shed light on the composition of the 2025 DGAC; it delves deep into the potential conflicts of interest that may sway the committee's recommendations. This exploration is not just a matter of bureaucratic interest; it holds profound implications for the credibility of the guidelines that shape the nation's dietary habits and, consequently, the health of millions.
The significance of this report cannot be overstated. It comes at a time when the nation grapples with dietary-related health issues and a growing awareness of the influence of major food and pharmaceutical industries on public health recommendations. By examining the intricate web of relationships between committee members and these powerful industries, the report raises crucial questions about the objectivity of the guidelines and the very nature of public health policy formation in the United States.
As we delve into the details of the committee's composition and the ensuing concerns, it's essential to understand the broader context: the DGAC's guidelines don't just influence what Americans eat; they shape the nation's understanding of nutrition itself. In this light, the revelations about potential conflicts of interest within the 2025 DGAC aren't just a matter of policy; they're a matter of public trust.
A Short History of the Dietary Guidelines Advisory Committee
The Genesis and Evolution of America's Nutritional Compass
The story of the Dietary Guidelines Advisory Committee (DGAC) is a fascinating chronicle of public health evolution, reflecting America's growing awareness and scientific understanding of nutrition. The DGAC's journey, spanning several decades, is a tale of changing dietary challenges and evolving scientific perspectives.
The Early Years: Setting the Stage
The origin of the DGAC dates back to the late 1970s, a period marked by rising health concerns, particularly around heart disease and obesity. In response to the growing need for standardized dietary advice, the United States Congress mandated the establishment of national dietary guidelines. The precursor to the Dietary Guidelines came in 1977 when the Select Committee on Nutrition and Human Needs, led by George McGovern published its "Dietary Goals for the United States". McGovern had this to say in the foreword of the report:
"This is the first comprehensive statement by any branch of the federal government on risk factors in the American diet. Too much fat is linked directly to heart disease, cancer, obesity, and stroke.. . . six out of the ten leading causes of death in the United States [heart disease, cancer, vascular disease, diabetes, arteriosclerosis, and cirrhosis of the liver] have been linked to our diet."
Here is what the subcommittee prescribed for Americans.
"1. Increase carbohydrate consumption to account for 55 to 60 percent of energy (caloric) intake.
2. Reduce overall fat consumption from approximately 40 to 30 percent of energy intake.
3. Reduce saturated fat consumption to account for about 10 percent of total energy intake.
4. Reduce cholesterol consumption to about 300 mg a day."
This kicked off the obsession with removing and demonizing animal fats and consuming high amounts of carbohydrates as well as processed foods in the American diet. This philosophy known as the "Keys’ Model" named after University of Minnesota Professor of Physiology Ancel Keys was adopted by the subcommittee. Simply put, he believed that dietary fats and cholesterol raised the blood levels and led to atherosclerosis which in turn led to heart failure.
The inaugural guidelines, released in 1980, were a collaborative effort by the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS). However, the need for a more systematic approach soon became apparent, leading to the formation of the DGAC.
Committee Emerges
The DGAC was officially established to provide scientific expertise and guidance in the development of subsequent editions of the Dietary Guidelines for Americans. Composed of prominent experts in nutrition, medicine, and public health, the committee's primary role was to review the latest scientific and medical knowledge and translate it into practical dietary recommendations.
Over the years, the focus of the DGAC has evolved in response to emerging health trends and nutritional science. Initially, the committee's recommendations emphasized reducing fat intake and controlling cholesterol levels, mirroring the health concerns of the time. However, as research expanded and new health challenges emerged, the DGAC's scope broadened.
The 1990s saw a shift towards a more holistic view of diet and health, with increased emphasis on whole grains, fruits, and vegetables. This period also marked the beginning of the committee's engagement with issues like dietary patterns and their relation to chronic diseases such as diabetes and hypertension.
The 21st Century: A New Nutritional Landscape
Entering the 21st century, the DGAC faced a more complex nutritional landscape. With rising rates of obesity and type 2 diabetes (some would say a direct result of the DGAC recommendations), the committee began to focus more on caloric balance and the quality of dietary fats rather than just their quantity. The guidelines started to incorporate more comprehensive advice, acknowledging the role of physical activity and the importance of overall dietary patterns rather than just individual nutrients. By this time the proverbial cake had been baked, loaded with sugar and carbohydrates, and eaten by the public who had suffered the health consequences.
Current Challenges and Critiques
Throughout its history, the DGAC has not been without its critics. Concerns have been raised about the influence of the food industry on the committee's recommendations, the evolving and sometimes conflicting nature of nutritional science, and the challenge of translating complex scientific findings into practical dietary advice.
The committee releases a report every 5 years and the last iteration of DGAC that proposed guidelines for 2020-2025 faced particular scrutiny for its conflicts of interest. A report published by Cambridge University Press in October 2022, "Conflicts of Interest for Members of the U.S. 2020 Dietary Guidelines Advisory Committee" revealed that 95% of the committee members had COIs with the food and/or pharmaceutical industries. Major industry actors like Kellogg, Abbott, Kraft, Mead Johnson, General Mills, Dannon, and International Life Sciences had connections with multiple committee members. Over 60% of the COIs were related to research funding and membership on advisory or executive boards.
The authors recommend enhancing transparency and managing COIs among committee members. They suggest that a robust examination of COIs and potential biases is essential for maintaining public trust in the Dietary Guidelines. This is just one of many reports that examined the 2020-2025 DGAC and highlighted the conflicts of interest among its members. However it has become evident that with the new DGAC announced, these recommendations have not been implemented, raising serious questions about the supposed objectivity of its members.
The Mandate and Methodology of the DGAC
At its core, the Dietary Guidelines Advisory Committee (DGAC) serves a singular yet monumental task: to distill the vast ocean of nutritional science into clear, actionable guidance for the American public. Understanding the DGAC's mandate and the intricate process behind the development of these guidelines is crucial to appreciating their impact and importance.
The Mandate
The primary mandate of the DGAC is to advise the United States Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) on the current state of scientific knowledge on nutrition and health. Every five years, this committee of experts is tasked with reviewing the latest research to update the Dietary Guidelines for Americans. These guidelines are not just recommendations; they are the backbone of federal nutrition policy and programs, influencing everything from school lunches to the advice given by health professionals nationwide.
The Process
The process of developing these dietary guidelines is exhaustive and multi-faceted, involving several critical steps:
Formation of the Committee: The DGAC comprises leading experts in nutrition, epidemiology, pediatrics, gerontology, and other relevant disciplines. Their selection is intended to ensure a diverse and comprehensive expertise reflective of the multifaceted nature of nutrition science.
Review of Current Science: The committee undertakes a thorough review of current scientific and medical research. This involves analyzing a vast array of studies, reports, and data to understand the latest findings in nutrition and health.
Public Engagement: Public involvement is a cornerstone of the DGAC's process. The committee holds public meetings, invites expert testimonies, and considers written comments from the public and stakeholders. This engagement ensures that the guidelines are responsive to public needs and concerns.
Drafting the Report: After extensive review and discussion, the committee drafts a scientific report. This report outlines their findings and forms the basis for the Dietary Guidelines for Americans. It is a comprehensive document that details the scientific evidence behind each recommendation.
Public and Agency Review: The draft report is subject to public and agency review. The USDA and HHS consider the report, public comments, and additional scientific evidence before finalizing the Dietary Guidelines for Americans.
Implementation: Once finalized, these guidelines inform federal nutrition programs and policies. They also serve as a reference for healthcare professionals, nutrition educators, and policymakers, impacting dietary advice and food choices across the country.
Impact of DGAC on U.S. Food Policy
The process, although seemingly robust, suffers from the same thing most public health-related issues face, which is that a relatively small group of individuals, in this case just 20 people, are dictating wide-reaching policies that affect the health and well-being of millions of Americans.
The influence of the Dietary Guidelines Advisory Committee (DGAC) extends far beyond the pages of its reports. As a cornerstone of U.S. food policy, the DGAC's recommendations ripple through various sectors, profoundly impacting national nutrition programs, public health initiatives, and even the broader food industry.
1. National Nutrition Programs and Policies
School Meals: The National School Lunch Program and School Breakfast Program, serving millions of children, are directly influenced by the DGAC's guidelines. These programs aim to provide nutritious meals to students, and the guidelines inform the types of foods offered, portion sizes, and nutritional balance.
Food Assistance Programs: The Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) also draw from the DGAC's recommendations. These guidelines help shape the food packages and education materials provided to participants.
Labeling and Food Safety: Nutritional labeling on food products, including the now ubiquitous Nutrition Facts label, is based on the DGAC's guidelines. This ensures consumers have access to accurate, science-based information about the foods they purchase.
2. Public Health Initiatives
Nutrition Education and Campaigns: Public health campaigns and nutrition education programs across the country use the DGAC's guidelines as a foundation for their messaging. This information helps individuals make informed dietary choices and understand the importance of balanced nutrition.
Healthcare Guidance: Healthcare providers, including dietitians and physicians, rely on the guidelines to offer dietary advice to patients. This advice is crucial in managing and preventing chronic diseases like diabetes, heart disease, and obesity.
3. Broader Implications for the Food Industry and Consumer Habits
Influence on the Food Industry: The food industry closely monitors the DGAC's guidelines, often reformulating products to align with the latest recommendations. This can lead to broader changes in food production, such as reducing added sugars or trans fats in processed foods.
Consumer Behavior: The guidelines play a significant role in shaping consumer behavior. Trends in health and wellness often reflect the DGAC's recommendations, influencing what consumers buy and how they perceive healthy eating.
Economic and Environmental Impact: The recommendations can also have economic and environmental implications. For instance, shifts in dietary patterns towards plant-based diets, as suggested in past guidelines, can influence agricultural practices and food supply chains.
A Far-Reaching Influence
The DGAC's impact is evident in every corner of the U.S. food system. From the breakfasts served in schools to the health advice given in clinics, the guidelines inform decisions that affect millions of Americans daily. This extensive influence underscores the importance of ensuring the DGAC's recommendations are based on sound science and free from conflicts of interest.
2025 DGAC: Composition and Controversy
A Closer Look at the Committee's Makeup and Emerging Concerns
The 2025 Dietary Guidelines Advisory Committee (DGAC) is composed of a group of experts, each bringing specialized knowledge and experience in various fields of nutrition, public health, and medicine. However, the composition of this committee has been the subject of intense scrutiny, particularly regarding potential conflicts of interest that could influence its recommendations.
Composition of the 2025 DGAC
The 2025 DGAC has 20 members who are experts in various fields such as chronic disease prevention, pediatric nutrition, epidemiology, and gerontology. These individuals come from where you'd expect, mostly prestigious universities and medical institutions across the United States. Their primary responsibility is to review scientific evidence on topics related to nutrition and health in order to update the Dietary Guidelines for Americans.
The Report on Conflicts of Interest
A recent report by U.S. Right to Know, a non-profit group advocating for transparency in public health, has cast a spotlight on the potential conflicts of interest among the 2025 DGAC members.
The report suggests that a significant number of committee members may have potential conflicts of interest due to their ties to the food, pharmaceutical, and other industries. These ties include research funding, consultancy roles, speaking engagements, and positions in organizations with industry connections. The current disclosure practices of the U.S. Department of Agriculture and the Department of Health and Human Services are criticized in the report for obfuscating individual members' industry ties through aggregated disclosures. It is argued that these conflicts could compromise the integrity of the dietary guidelines and undermine public trust in these important health recommendations. It found that 13 out of 20 members have significant conflicts of interest. Through aggregating the disclosures it makes it nearly impossible to know the true scope of the conflicts of interest among the committee members. In the supplemental disclosure document provided by the USDA which can be found here there is a veritable who's who of major associations, institutions, and corporations in the food, agriculture, and pharmaceutical industries. I encourage you to have a look at that document to truly understand the magnitude of the conflicts of interest in the DGAC. Through the investigation conducted by the USRTK, we can get a glimpse into the potential biases and influences that may be present within the committee. (USRTK Report)
Breakdown of Individual Conflicts of Interest
Committee Chair
Sarah Booth, PhD, Tufts University: Medium-risk COI due to research support from USDA, National Dairy Council, and the Gerber Foundation; decision-making role in the American Society of Nutrition (ASN). Possible COI for speaking at a conference sponsored by Bayer, Coca-Cola, and Abbott.
According to the October 2023 U.S. Right To Know report (USRTK):
"Dr. Booth has held leadership positions in the industry-funded professional group, the American Society of Nutrition (ASN). See Appendix B for description of ASN’s ties to industry. She is currently vice president of ASN,75 and was its treasurer (2021–2022)".
Vice Chair
Angela Odoms-Young, PhD, Cornell University: Possible COI due to her role as associate editor of Nutrition Reviews, a journal published on behalf of the International Life Sciences Institute (ILSI). Founded in 1978 by a former senior vice president of Coca-Cola, Alex Malaspina, ILSI is a corporate-funded nonprofit organization headquartered in Washington D.C. with chapters worldwide. ILSI is funded by corporate members and supporters, including major food and chemical companies. However, the specifics of these contributions are not publicly disclosed. ILSI has been involved in downplaying the health impacts of sugar and defending industry interests in tobacco policies.
A Shadowy Industry Group Shapes Food Policy Around the World
(An infographic showing the web of connections ILSI has in the world of food policy, nutrition research, and industry influence)
Steven Abrams, MD, University of Texas at Austin: High-risk COI for past consultancy with MilkPEP, research funding from Perrigo Nutrition, and speaker fees from Abbott Nutrition a major player in infant formula. Possible COI for research support from Nestlé Nutrition Institute and speaking at their conferences.
"Dr. Abrams has disclosed research funding from Perrigo Nutrition, the third largest manufacturer of infant formula in the U.S. and Canadian markets." (USRTK Full Disclosure Report)
Cheryl Anderson, PhD, University of California San Diego: High-risk COI for advisory board honoraria(a fancy way of saying payment) from WeightWatchers (WW) International and McCormick Science Institute. Possible COI for speaking at a symposium sponsored by Abbott Nutrition.
"Dr. Anderson was a keynote speaker for a symposium sponsored by Abbott, along with several other pharmaceutical companies. We note that the symposium’s subject matter—heart failure—was not directly related to nutrition or to the mandate of the DGAC." (USRTK Report)
Here is a link to the symposium which is sponsored by almost every major pharmaceutical company: The 28th Annual Heart Failure Symposium
Heather Eicher-Miller, Ph.D., Purdue University: High-risk COI for consultancy with Mead Johnson & Company, National Dairy Council, Indiana Dairy Association, and grant reviewer for American Egg Board and Dairy Management Inc. Medium-risk COI for a leadership role in ASN. Possible COI for prizes and conference speaking roles.
“Dr. Eicher-Miller has had at least four studies in the past five years funded by Eli Lilly and Company. One grant from Eli Lilly listed on Dr. Eicher-Miller’s CV totals $240,821. She is on the 2023–2024 board of directors for the American Society of Nutrition (ASN) as director-at-large of nutrition population science and has spoken at several national and regional conferences, invited by or sponsored by Eli Lilly and Company." (USRTK Report)
Jennifer Orlet Fisher, Ph.D., Temple University: Possible COI for speaking at a Nestlé Nutrition Institute-sponsored event.
Teresa Fung, ScD, RD, Simmons University: Possible COI for her role as associate editor for the Journal of Nutrition which is published by the American Society for Nutrition which bills itself as a leader in nutrition research but if you look at their "sustainable partners" list, it becomes apparent that they act as a front group for the most powerful food and pharmaceutical industry players.
Christopher Gardner, Ph.D., Stanford University: High-risk COI for research funding from Beyond Meat. Possible COI for advising Diet ID and Zoe.
“Dr. Gardner has received funding from the plant-based meat substitute company, Beyond Meat for research on the health effects of Beyond Meat plant-based meat alternatives.” (USRTK Report)
Valarie Blue Bird Jernigan, DrPH, MPH, Oklahoma State University: Possible COI for a donation from Novo Nordisk to her organization. They donated $3.5 million to the Center for Indigenous Health Research and Policy (CIHRP) at Oklahoma State University’s Center for Health Sciences, of which Dr. Jernigan is the director. (USRTK Report)
Hollie Raynor, PhD, RD, LDN, University of Tennessee, Knoxville: High-risk COI for compensation from Slimming World and research funding from Weight Watchers (WW) International. (USRTK Report)
Fatima Cody Stanford, MD, MPH, MPA, MBA, Harvard University: High-risk COI for consultancy with multiple drug manufacturers and advisory roles. Possible COI for advisory positions with various health platforms and programs.
“Dr. Stanford is advisor/consultant to the weight loss and diabetes drug manufacturers Novo Nordisk, Eli Lilly, Pfizer, Boehringer Ingelheim, Rhythm Pharmaceuticals, and Gelesis. She also advises GoodRX (prescription services).” (USRTK Report)
Dr. Stanford received a total of $68,880 in consulting fees from multinational weight loss drug manufacturers between 2018–2022, including Novo Nordisk ($47,605), Eli Lilly ($15,050), and Boehringer Ingelheim ($6,225). (Open Payments)
Chris Taylor, PhD, RDN, LD, FAND, Ohio State University: High-risk COI for multiple research studies funded by Abbott Nutrition and the Beef Checkoff. Possible COI for receiving honoraria and travel expenses.
“Dr. Taylor has authored at least 11 articles and abstracts in the past five years funded by Abbott Nutrition. He has also received speaker honoraria(payments) and travel expenses from Abbott Nutrition.” (USRTK Report)
Deirdre Tobias, ScD, Harvard University: High-risk COI for an article supported by Mars Edge and research funded by the California Walnut Commission and the Peanut Institute. Possible COI for editorial role in the American Journal of Clinical Nutrition.
“Dr. Tobias authored an article, part of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), supported by an investigator-initiated grant from Mars Edge, a segment of the chocolate and snack manufacturer Mars, Incorporated.” (USRTK Report)
“Design and baseline characteristics of participants in the COcoa Supplement and Multivitamin Outcomes Study”
Dr. Tobias is also the academic editor for the American Journal of Clinical Nutrition, published by the American Society for Nutrition (ASN), the aforementioned industry front group. (USRTK Report)
Again this is not a comprehensive list of the COIs because an individualized disclosure for each member is not required by the government, casting doubt on the decisions supposedly being made on behalf of the American people. The story of the Dietary Guidelines for Americans Committee is a familiar one at this point. It reveals the complex web of industry “non-profit” front groups masquerading around as impartial advocacy and research groups with profit motives veiled through their associations with academic institutions. This influence-peddling model is being employed in virtually every sector of society and unless it is somehow reigned in by Congress, the problem will continue to metastasize, undermining the health and well-being of millions of Americans. Some steps can be taken to start this process of reigning in if only we can create the will to implement the following measures.
Recommendations for Improving Transparency and Integrity
It is argued by advocates that comprehensive disclosures for each member of the DGAC, spanning at least the past five years, are crucial to have a clear understanding of potential conflicts. A major criticism lies with the USDA and HHS's practice of providing aggregated disclosures that lump together all conflicts without specifying which member they pertain to. This creates difficulties in accurately assessing individual biases. This limitation may result in significant information being overlooked. Another concern is that disclosure forms using Form 450 from the Office of Government Ethics are kept confidential, thus preventing public access and further obscuring members' industry connections. These practices undermine the transparency and integrity of the Dietary Guidelines Advisory Committee. An objective observer may ask themselves why are they seemingly trying to hide the various conflicts of interests of their committee members if they supposedly have nothing to hide. (USRTK Report, Pages 15,16)
To ensure transparency and integrity in the committee, it is important to adopt a publicly accessible disclosure form that provides transparent reporting on industry ties. This will help alleviate concerns about the potential influence of these ties. Additionally, individuals with significant conflicts of interest should be avoided when appointing members to the committee. Furthermore, expanding the criteria for disclosures to include ties to conflicted nutrition organizations can also enhance transparency and accountability within the committee. (USRTK Report, Pages 15,16).
How Conflicts of Interest Might Skew DGAC Recommendations
Conflicts of interest, particularly undisclosed ones, can have far-reaching implications on the objectivity of the DGAC's recommendations. When committee members have financial or professional ties to food and pharmaceutical industries, there's an inherent risk that these connections could subtly influence their interpretations of scientific data or policy suggestions. This influence may not always be overt or intentional but can manifest in nuanced ways, such as favoring certain food groups or underemphasizing the risks associated with specific dietary patterns. The concern is that such biases, however slight, could skew the guidelines away from purely science-based recommendations towards those that inadvertently reflect the interests of certain industry players.
Conclusion and Impact on Public Trust and Policy Effectiveness
The effectiveness of any public health policy is deeply rooted in the trust it garners from the population it aims to serve. When allegations of conflict of interest surface, they can erode this trust, casting doubt on the motivations behind the guidelines and the credibility of the advice given. This erosion of trust is not just a theoretical concern; it can have practical consequences. When a group of individuals is given such tremendous responsibility in shaping public health policy, any doubts or concerns about their impartiality and potential conflicts of interest can undermine the legitimacy of the guidelines themselves. In 2023, when the public's overall trust in institutions is at an all-time low you would think the DGAC would take up the recommendations from past reviews and prioritize transparency and accountability to restore and start building the public's trust. Congress needs to reassess the appointment process for DGAC members to ensure that conflicts of interest are adequately addressed and hold hearings with all the parties involved in an attempt to reign in outsized industry influence on these far-reaching guidelines that directly affect the lives of every American, young and old.