An approach to conflicts of interest in UK food regulatory institutions.

The history of food is replete with examples of food scandals leading to institutional and procedural reforms intended to rebuild trust. For trust to be sustainable, systems need to be trustworthy. Food regulatory institutions are at the interface of science and policy, and they should have robust and reliable mechanisms for identifying and addressing commercial conflicts of interest (COIs) among the membership of their boards and advisory committees. Here we provide a detailed estimate, analysis and critique of COIs within the United Kingdom's food regulatory institutions. This exercise was facilitated by the United Kingdom's rule requiring declarations of COIs, which are published. Institutions that require and publish declarations of COIs are probably more trustworthy than those that do not, while institutions that exclude all individuals with COIs could be even more trustworthy.

Why did EFSA not reduce its ADI for aspartame or recommend its use should no longer be permitted?

On behalf of the European Food Safety Authority (EFSA), Kass and Lodi recently published a letter purporting to 'refute' our July 2019 analysis of EFSA's December 2013 assessment of the risks of aspartame. We had previously claimed inter alia that the EFSA panel had evaluated studies that had indicated that aspartame might be harmful far more sceptically than those that had not indicated harm. We reported that EFSA had deemed every one of 73 studies suggesting harm to have been unreliable. Kass and Lodi provided a tabulation with figures that differed from ours in every detail. This commentary shows that, while Kass and Lodi provided a response to our analysis, they have not come close to refuting it. Our analysis provided detailed characterisations of each of the studies and how the panel interpreted them, but Kass and Lodi provide no corresponding information at all. Kass and Lodi claim that EFSA deemed 21 of 35 studies that had indicated possible harm to have been reliable. But if that is so, we now ask: why did the EFSA panel not recommend that aspartame should be banned, or at least tightly restricted?

Policy options for obesity in Europe: a comparison of public health specialists with other stakeholders.

OBJECTIVE: To explore policy options that public health specialists (PHS) consider appropriate for combating obesity in Europe, and compare their preferences with those of other stakeholders (non-PHS). DESIGN: Structured interviews using multicriteria mapping, a computer-based, decision-support tool. SETTING: Nine European countries. SUBJECTS: A total of 189 stakeholders. Twenty-seven interviewees were PHS and non-PHS included food, sports and health sectors. MEASUREMENTS: A four-step approach was taken, i.e. selecting options, defining criteria, scoring options quantitatively and weighting the criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. RESULTS: The PHS concur with other stakeholders interviewed, as all emphasised the importance of educational initiatives in combating obesity, followed by policies to improve community sports facilities, introduce mandatory food labelling and controlling food and drink advertising. Further analyses revealed several significant differences. The non-PHS from the private sector ranked institutional reforms favourably; the PHS from non-Mediterranean countries supported the option of medicines to prevent obesity; and those PHS from Mediterranean countries endorsed the use of activity monitoring devices such as pedometers. As far as appraisal criteria were concerned, PHS considered efficacy and the economic impact on the public sector to be the most important. CONCLUSION: There is clear consensus among PHS and other stakeholders concerning the need for a package of policy options, which suggests that European-wide implementation could be successful. However, it would be advisable to avoid more contentious policy options such as taxation until future changes in public opinion.

EFSA's toxicological assessment of aspartame: was it even-handedly trying to identify possible unreliable positives and unreliable negatives?

BACKGROUND: A detailed appraisal is provided of the most recent (December 2013) assessment of the safety and/or toxicity of the artificial sweetener aspartame by the European Food Safety Authority's Panel on Food Additives and Nutrient Sources Added to Food. That appraisal is prefaced with a contextualising chronological account drawn from a documentary archive of the key highlights of the antecedent scientific and policy debates concerning this sweetener from the early 1970s onwards. The appraisal focuses specifically on Section 3.2 of the panel's review, which is headed 'Toxicological data of aspartame'. METHODS: The methodology of the appraisal focusses on the extent to which the panel was symmetrically alert to possible false positives and false negatives, which in toxicological terms denote misleading indications of possible toxicity or misleading indications of safety. The methodology involved identifying and tabulating the prima facie indications of each of 154 empirical studies, and then comparing them with the way in which the panel chose to interpret the studies' findings, by focussing primarily on whether the panel deemed those studies to be reliable or unreliable. If the panel had been even-handed, the criteria for assessing reliability should have been the same for both putative positive and negative studies. RESULTS: Eighty-one studies were identified that prima facie did not indicate any possible harm, and of those the panel deemed 62 to be reliable and 19 as unreliable. Seventy-three studies were identified that prima facie did indicate possible harm; of those the panel deemed all 73 to be unreliable; none were deemed reliable. A qualitative comparative review of the criteria of appraisal invoked by the panel to judge the reliability of putative negative and positive studies is also provided. CONCLUSION: The quantitative result indicate that the panel's appraisal of the available studies was asymmetrically more alert to putative false positives than to possible false negatives. The qualitative analysis shows that very demanding criteria were used to judge putative positive studies, while far more lax and forgiving criteria were applied to putative negative studies. DISCUSSION: That quantitative and qualitative patterns are very problematic for a body supposed to prioritise the protection of public health. Given the shortcomings of EFSA's risk assessment of aspartame, and the shortcomings of all previous official toxicological risk assessments of aspartame, it would be premature to conclude that it is acceptably safe. They also imply that the manner in which EFSA panels operate needs to be scrutinised and reformed.

The Introduction of Thousands of Tonnes of Glyphosate in the food Chain-An Evaluation of Glyphosate Tolerant Soybeans.

Glyphosate-tolerant (GT) soybeans dominate the world soybean market. These plants have triggered increased use of, as well as increased residues of, glyphosate in soybean products. We present data that show farmers have doubled their glyphosate applications per season (from two to four) and that residues of late season spraying of glyphosate (at full bloom of the plant) result in much higher residues in the harvested plants and products. GT soybeans produced on commercial farms in the USA, Brazil and Argentina accumulate in total an estimated 2500-10,000 metric tonnes of glyphosate per year, which enter global food chains. We also review studies that have compared the quality of GT soybeans with conventional and organic soybeans. Feeding studies in Daphnia magna have shown dose-related adverse effects (mortality, reduced fecundity and delayed reproduction) of glyphosate residues in soybeans, even at glyphosate concentrations below allowed residue levels. We argue that GT soybeans need to be tested in fully representative and realistic contexts. However, the current risk assessment system has only required and received data from field trials with beans that were sprayed with much lower doses of glyphosate as compared to contemporary commercial farms. This has left knowledge gaps and a potentially serious underestimation of health risks to consumers.

Carcinogenicity of saccharin in laboratory animals and humans: letter to Dr. Harry Conacher of Health Canada.

We appreciate this opportunity to provide input to the Health Protection Branch's (HPB's) review of the artificial sweetener saccharin. Concerns with regard to the safety of saccharin are of great public health significance and of great interest to the public because saccharin is consumed by tens of millions of people, including children and fetuses. Any evidence of carcinogenesis--and there is ample such evidence--of such a widely used chemical should spur health officials to minimize human exposure to it. It is worth noting that on October 31, 1997, the Board of Scientific Counselors of the National Toxicology Program, a unit of the National Institute of Environmental Health Sciences (NIEHS), voted not to delist saccharin from its Report on Carcinogens.

Developing national obesity policy in middle-income countries: a case study from North Africa.

BACKGROUND: The prevalence of overweight and obesity is a rapidly growing threat to public health in both Morocco and Tunisia, where it is reaching similar proportions to high-income countries. Despite this, a national strategy for obesity does not exist in either country. The aim of this study was to explore the views of key stakeholders towards a range of policies to prevent obesity, and thus guide policy makers in their decision making on a national level. METHODS: Using Multicriteria Mapping, data were gathered from 82 stakeholders (from 33 categories in Morocco and 36 in Tunisia) who appraised 12 obesity policy options by reference to criteria of their own choosing. RESULTS: The feasibility of policies in practical or political terms and their cost were perceived as more important than how effective they would be in reducing obesity. There was most consensus and preference for options targeting individuals through health education, compared with options that aimed at changing the environment, i.e. modifying food supply and demand (providing healthier menus/changing food composition/food sold in schools); controlling information (advertising controls/mandatory labelling) or improving access to physical activity. In Tunisia, there was almost universal consensus that at least some environmental-level options are required, but in Morocco, participants highlighted the need to raise awareness within the population and policy makers that obesity is a public health problem, accompanied by improving literacy before such measures would be accepted. CONCLUSION: Whilst there is broad interest in a range of policy options, those measures targeting behaviour change through education were most valued. The different socioeconomic, political and cultural contexts of countries need to be accounted for when prioritizing obesity policy. Obesity was not recognized as a major public health priority; therefore, convincing policy makers about the need to prioritize action to prevent obesity, particularly in Morocco, will be a crucial first step.

A collaboratively-derived science-policy research agenda.

The need for policy makers to understand science and for scientists to understand policy processes is widely recognised. However, the science-policy relationship is sometimes difficult and occasionally dysfunctional; it is also increasingly visible, because it must deal with contentious issues, or itself becomes a matter of public controversy, or both. We suggest that identifying key unanswered questions on the relationship between science and policy will catalyse and focus research in this field. To identify these questions, a collaborative procedure was employed with 52 participants selected to cover a wide range of experience in both science and policy, including people from government, non-governmental organisations, academia and industry. These participants consulted with colleagues and submitted 239 questions. An initial round of voting was followed by a workshop in which 40 of the most important questions were identified by further discussion and voting. The resulting list includes questions about the effectiveness of science-based decision-making structures; the nature and legitimacy of expertise; the consequences of changes such as increasing transparency; choices among different sources of evidence; the implications of new means of characterising and representing uncertainties; and ways in which policy and political processes affect what counts as authoritative evidence. We expect this exercise to identify important theoretical questions and to help improve the mutual understanding and effectiveness of those working at the interface of science and policy.

The potential role of taxes and subsidies on food in the prevention of obesity in Europe.

BACKGROUND: Obesity implies costs not only for the individual but also for society. The authors explore the opinions of stakeholders on the potential of taxes or subsidies, as measures for tackling obesity in Europe. METHODS: Structured interviews were conducted using Multicriteria Mapping, a computer-based, decision-support tool, with 189 interviewees drawn from 21 different stakeholder categories across nine members of the EU interviews, to appraise 20 predefined policy options aimed at reducing obesity, including 'taxing obesity-promoting foods' and 'subsidising healthy foods.' A four-step approach involved selecting options, defining criteria, scoring options quantitatively and weighting criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. RESULTS: Compared with other policy options appraised, taxation and subsidies were not favourably received, mainly because they were considered difficult to implement. Overall, trade unions rated both options more favourably than all other stakeholder groups. As anticipated, both options received their lowest scores from representatives of the farming, food processing and advertising industries. Nutritional/obesity advisory experts and public sector caterers gave the most positive ratings to subsidies overall. Along with public health professionals, large commercial retailers were most in favour of taxation. CONCLUSIONS: Taxation and subsidies were poorly appraised compared with other policy measures, with stakeholders expressing reservations mainly focussed on the practicalities and cost of introducing such measures. Although applying taxes/subsidies could be useful to combat obesity, the study suggests that most stakeholders still need to be convinced of their viability and acceptability when compared with other measures.

Policy councils on food, nutrition and physical activity: the UK as a case study.

International experience of Policy Councils on food and nutrition has developed over recent decades but they have not received the attention that is due to them. The 1992 International Conference on Nutrition recommended that governments create Food Policy Councils but few have been created. There has been more experience in local and sub-national policy councils, particularly in North America. Developing country experience of attempting to improve food policy integration stems from the 1970s. The UK's House of Commons' (Parliamentary) Health Committee, in its 2004 report on obesity, reviewed current policy determinants of the rise in obesity, concluding that national food and health policy lacked coherence, integration and effectiveness. To address this vacuum, it proposed the creation of a new 'Council of Nutrition and Physical Activity to improve co-ordination and inject independent thinking into strategy'. The case for creating such a Council in the UK is reviewed, as are possible organisational options, functions and remit. A Council could be created under the forthcoming Public Health Act. The purpose of the new Council would be to provide independent advice and strategic advice as well as monitor the linkages between policies on food, nutrition and physical activity, noting their environmental implications.