Delegates to the 2026 AMA Interim Meeting took a strong stance on several public health measures, adopting policies to strengthen oversight of food additives, improve safety measures for electric bikes, modernize sunscreen regulation, and support more comprehensive research and education on deprescribing in clinical practice.
In one major policy action, the AMA House of Delegates (HOD) is calling for stronger federal food-additive regulations in the U.S., recommending a shift toward mandatory safety testing, greater oversight by the Food and Drug Administration (FDA), and independent scientific review of ingredients already in the food supply that are of public health concern on a regular basis.
An AMA Council on Science and Public Health report whose recommendations were adopted identified a weakness in the FDA's food-additive approval process: the Generally Recognized as Safe (GRAS) exemption. Under this provision, food manufacturers can assess for themselves that an ingredient is safe without submitting it to the FDA for formal review.
Even when companies voluntarily notify the FDA, they can still market an ingredient if the agency finds insufficient evidence to support its safety or if the company withdraws its notification, says the council’s report. This system has allowed thousands of chemicals into the food supply with little independent oversight, inadequate safety testing, and potential conflicts of interest, the council noted.
It is estimated that there are over 10,000 food additives in the U.S. food supply. Comparatively, the European Union (EU) permits a little over 300, and Canada about 390. Unlike the U.S., both the EU and Canada require safety evaluations before additives can be approved. Several ingredients the U.S. permits—including Yellow Dye No. 5, butylated hydroxyanisole and potassium bromate—are banned in Europe.
“For decades, a loophole in federal law has allowed companies to add chemicals to our nation’s food supply without independent safety review by the FDA. We have very little understanding about the health risks they may pose,” said AMA Trustee Amar H. Kelkar, MD, MPH.
“The current U.S. system for regulating food additives is not doing enough to protect public health and reforms are clearly needed. We need stronger oversight, greater transparency, and a more consistent science-based regulatory framework to ensure the safety of our food supply and better protect the health of all Americans,” said Dr. Kelkar, a hematologist, medical oncologist and stem-cell transplant physician in Boston.
The AMA council also reviewed emerging research into the potential health effects of several categories of additives, including synthetic food dyes, emulsifiers, artificial sweeteners and high-fructose corn syrup. Research has raised concerns about possible links to cancer, allergic reactions, obesity, diabetes, cardiovascular disease and other health problems.
Evidence varies by additive and more research is needed, particularly regarding long-term exposure and the cumulative effects of consuming multiple additives, the council suggested.
To strengthen oversight of food additives, the HOD adopted language to amend the AMA's existing policy.
The HOD voted in support of establishing “an independent, ongoing scientific committee whose members are selected through a transparent process based on demonstrated expertise relevant to the safety of food additives and their impact on human health.”
According to the new AMA policy, that committee’s responsibility should be to:
- Conduct regularly scheduled systematic reviews of food additives, including food colors, currently in use in the U.S., prioritizing review of those that have been banned in the U.S. states or in other countries and those with the most significant negative health impact.
- Evaluate the scientific evidence regarding health impacts of these substances, considering emerging evidence and potential cumulative impacts on new classes of diseases, including but not limited to certain cancers, endocrine-related effects, and neurobehavioral effects; the cumulative impact of such additives with other ingredients; and potential enhanced effects on certain vulnerable populations, such as those who are pregnant or breastfeeding and children.
- Develop a prioritized timeline for regulatory action on the most concerning additives.
- Create transition pathways for food manufacturers to adopt safer alternatives.
- Engage the AMA and other interested members of the medical and scientific community throughout this process.
The AMA’s updated policy also supports:
- Comprehensive scientific research and safety testing for all food additives, demonstrating that they cause no statistically or clinically significant harm to human health at doses comparable to daily consumption patterns, prior to their review and approval by federal regulators.
- Updating the Food Additives Amendment to ensure the safety of food additives through more stringent regulatory oversight, including but not limited to requiring all new “generally recognized as safe” (GRAS) determinations to be submitted to the FDA for active review.
- The FDA’s having adequate resources and staff capacity to review GRAS determinations and do retroactive reviews of food additives that were previously deemed GRAS as new scientific evidence emerges.
- Stronger criteria for making GRAS determinations, including improved transparency of evaluation methods, and forbidding conflicts of interest for those who serve on GRAS determination panels.
The AMA will continue to monitor and support efforts to advance the implementation of more rigorous food additive legislation and regulations and provide ongoing guidance to support meaningful public health improvements, including adequate funding for medical and scientific research.
Remove barriers of sunscreen innovation
Delegates also adopted policy aimed at expanding access to safe and effective sunscreen products by modernizing the FDA’s regulatory process for approving sunscreen ingredients.
“Ultraviolet radiation is a major preventable risk factor for skin cancer, including melanoma,” said AMA Trustee and board-certified radiation oncologist Sheila Rege, MD, FASTRO. “We should be able to modernize the way we evaluate new sunscreen ingredients without compromising safety. Giving Americans greater access to safe and effective broad-spectrum sunscreens is a practical step we can take to help prevent skin cancer.”
Skin cancer is the most common cancer in the U.S. and ultraviolet (UV) radiation is a major preventable risk factor. Regular use of broad-spectrum sunscreen, which protects against both UVA and UVB rays, is an important part of skin cancer prevention.
In June, the FDA approved bemotrizinol (BEMT), the first new active sunscreen ingredient added to the U.S. over-the-counter sunscreen monograph in more than two decades. However, there are longstanding barriers to sunscreen innovation in this country.
Although Congress passed the Sunscreen Innovation Act in 2014 and later modernized the over-the-counter drug review system through the CARES Act of 2020, the approval of new sunscreen ingredients remains limited. Meanwhile, the 2025 SAFE Sunscreen Standards Act directs the FDA to modernize its review process by allowing consideration of real-world evidence and other scientifically valid information.
Products must also be affordable, suitable for different skin types and tones, and available in formulations people are willing to use consistently. Expanding the range of approved sunscreen filters could encourage manufacturers to develop products with better broad-spectrum protection, tolerability and cosmetic appeal.
To boost skin safety in the U.S., the HOD adopted new policy to support:
- Clear and efficient regulatory pathways and other policies that promote the development, evaluation, availability, and adoption of safe and effective broad-spectrum sunscreens in the U.S.
- Continued postmarket surveillance and real-world safety monitoring of newly approved sunscreen active ingredients as an integral component of a modernized regulatory framework.
Delegates also directed the AMA to “advocate for timely implementation of federal reforms modernizing United States Food and Drug Administration review of new sunscreen active ingredient applications—including appropriate consideration of real-world evidence, international safety and postmarket experience, and scientifically validated alternative testing methods as they become accepted for relevant over-the-counter topical drug safety endpoints—while maintaining rigorous standards for safety and effectiveness and existing environmental review requirements."
Ramp up regulation of e-bikes, scooters
Delegates also tackled the issue of electric mobility devices, including e-bikes and scooters, which are rapidly increasing across the country. E-bikes are useful at appropriate speeds and when using safety equipment, but pose growing safety risks, notes a resolution introduced at the Interim Meeting.
E-bikes and scooters rarely require registration or licensing to operate. At the state level, California and other states have implemented age and speed restrictions and a universal helmet requirement for riders under 18. However, state and local laws governing electric mobility devices are inconsistent. This includes classification of e-bikes, age requirements, helmet use, speed and power limits, riding zones, and regulation of driving while intoxicated.
“As more people ride e-bikes and e-scooters, we’re seeing a significant increase in injuries and deaths associated with their use, particularly among children under age 12. To help address this growing public health issue, we must place a greater focus on improving safety regulations, and enforcing them, to prevent more injuries and deaths,” said AMA Trustee Ilse R. Levin, DO, MPH & TM.
To strengthen the AMA’s advocacy on this emerging health threat, delegates adopted policy to “recognize injuries and deaths from electric bikes, scooters and other micromobility devices as a public health issue that would benefit from focused safety and injury-prevention strategies.”
The HOD also expanded AMA policy to help improve safety for micromobility usage by endorsing the following positions:
The AMA also modified existing policy to advocate and encourage:
- Standardized injury surveillance and reporting of micromobility-related injuries at the state and national level, including integration into existing trauma registries and public health reporting systems.
- Accelerated research into the root causes and long-term health and functional consequences of e-bike and e-scooter related injuries in the United States, with the goal of defining actionable best practices to prevent or minimize serious injury associated with operation of various classes of such vehicles, as well as the relevant demographics of the operators thereof.
In addition, the AMA will advocate that Congress establish a task force to develop recommendations on how states should regulate e-bikes and e-scooters, including “classification and labeling of electric bikes and scooters, licensing and registration requirements, age restrictions, universal helmet use, required rider safety education and public education motor power limits and maximum assistance-speed capabilities, night visibility requirements including lighting and reflectors braking performance; battery and electrical safety; safeguards against tampering or modification that allows a device to exceed its permitted class, power, or performance limits.”
This task force would recommend minimum federal standards while allowing states to establish more stringent standards.
In other actions, the AMA will advocate:
- Roadway and transportation infrastructure improvements demonstrated to improve the safety of electric bike and scooter users, motorists, and pedestrians.
- Parity of enforcement of safety regulations for electric bikes and scooters including citations and other enforcement actions.
More research on deprescribing
Another report from the AMA Council on Science and Public Health addresses “deprescribing,” a process in which physicians reduce or stop medication doses that may no longer be beneficial, or possibly causing harm, or misaligned with the goal of care. The goals of deprescribing are to improve health outcomes, minimize adverse effects, and enhance patient quality of life.
In its report, the council noted that polypharmacy—the use of five or more medications daily—is increasingly common among older adults. According to federal data, 43% of patients 65 or older took five or more prescription medications in the past 30 days between 2017 and 2020, compared with 33% between 2001 and 2004.
“This level of medication use may not be needed or desired in all cases,” says the council’s report. Deprescribing, when conducted carefully and under medical supervision, can safely reduce medication burdens and may improve certain health outcomes. Studies have associated deprescribing with lower risks of falls, rehospitalization and mortality, as well as potential reductions in healthcare costs.
But the evidence remains limited. Studies vary in their methods, patient populations and outcome measurements, and many have relatively short follow-up periods, the council’s report says.
Other barriers prevent deprescribing from becoming a routine part of care. Physicians often get limited training in how to approach these conversations. Moreover, responsibility for optimizing medications through deprescribing can also become unclear when patients see multiple specialists or transition across care settings. Poor interoperability and communication between physicians, pharmacies, and healthcare systems can further complicate the process, sometimes resulting in the dispensation of discontinued medications.
Many tools exist to help physicians identify potentially inappropriate medications, but most of these lack sufficient validation or practical guidance for implementing and monitoring medication changes.
Delegates adopted new policy to recognize that:
- Deprescribing is the planned, supervised process of medication dose reduction or discontinuation when a medication’s continued use may no longer provide clinical benefit, may cause harm that exceeds the clinical benefit, or is misaligned with goals of care, particularly among older adults and during transitions of care.
- Deprescribing, as a component of medication optimization, includes medication reconciliation; identification and assessment of medication risks in accordance with patient characteristics; shared decision-making; and physician-led team-based care.
- Barriers to deprescribing include unclear professional roles, care fragmentation, and lack of clinical workflows and interoperability across healthcare entities.
With the new policy, the AMA also encourages:
- Broader understanding of deprescribing through further research on clinical outcomes and best practices.
- Educational initiatives on deprescribing for physicians, care teams and patients.
“It is important that we recognize deprescribing as an essential, routine component of medication optimization and high-quality clinical care,” said Dr. Levin, of the AMA Board of Trustees. “Deprescribing is not simply about taking patients off medications, but about ensuring medications continue to provide more benefit than harm over time.”
Read about the other highlights from the 2026 AMA Interim Meeting.
