Ultraprocessed Food: Addictive, Toxic, and Ready for Regulation.

Past public health crises (e.g., tobacco, alcohol, opioids, cholera, human immunodeficiency virus (HIV), lead, pollution, venereal disease, even coronavirus (COVID-19) have been met with interventions targeted both at the individual and all of society. While the healthcare community is very aware that the global pandemic of non-communicable diseases (NCDs) has its origins in our Western ultraprocessed food diet, society has been slow to initiate any interventions other than public education, which has been ineffective, in part due to food industry interference. This article provides the rationale for such public health interventions, by compiling the evidence that added sugar, and by proxy the ultraprocessed food category, meets the four criteria set by the public health community as necessary and sufficient for regulation-abuse, toxicity, ubiquity, and externalities (How does your consumption affect me?). To their credit, some countries have recently heeded this science and have instituted sugar taxation policies to help ameliorate NCDs within their borders. This article also supplies scientific counters to food industry talking points, and sample intervention strategies, in order to guide both scientists and policy makers in instituting further appropriate public health measures to quell this pandemic.

Priority Actions to Advance Population Sodium Reduction.

High sodium intake is estimated to cause approximately 3 million deaths per year worldwide. The estimated average sodium intake of 3.95 g/day far exceeds the recommended intake. Population sodium reduction should be a global priority, while simultaneously ensuring universal salt iodization. This article identifies high priority strategies that address major sources of sodium: added to packaged food, added to food consumed outside the home, and added in the home. To be included, strategies needed to be scalable and sustainable, have large benefit, and applicable to one of four measures of effectiveness: (1) Rigorously evaluated with demonstrated success in reducing sodium; (2) suggestive evidence from lower quality evaluations or modeling; (3) rigorous evaluations of similar interventions not specifically for sodium reduction; or (4) an innovative approach for sources of sodium that are not sufficiently addressed by an existing strategy. We identified seven priority interventions. Four target packaged food: front-of-pack labeling, packaged food reformulation targets, regulating food marketing to children, and taxes on high sodium foods. One targets food consumed outside the home: food procurement policies for public institutions. Two target sodium added at home: mass media campaigns and population uptake of low-sodium salt. In conclusion, governments have many tools to save lives by reducing population sodium intake.

Nutritional Content According to the Presence of Front of Package Marketing Strategies: The Case of Ultra-Processed Snack Food Products Purchased in Costa Rica.

The industry uses nutrition and health claims, premium offers, and promotional characters as marketing strategies (MS). The inclusion of these MS on ultra-processed products may influence child and adolescent purchase behavior. This study determined the proportion of foods carrying claims and marketing strategies, also the proportion of products with critical nutrients declaration, and nutritional profile differences between products that carry or not claims and MS on the front-of-package (FoP) of ultra-processed food products sold in Costa Rica. Data were obtained from 2423 photographs of seven food groups consumed as snacks that were sold in one of the most widespread and popular hypermarket chains in Costa Rica in 2015. Ten percent of products lacked a nutrition facts panel. Sodium was the least reported critical nutrient. Energy and critical nutrients were significantly highest in products that did not include any nutrition or health claim and in products that included at least one MS. Forty-four percent and 10% of all products displayed at least one nutrition or at least one health claim, respectively, and 23% displayed at least one MS. In conclusion, regulations are needed to restrict claims and marketing on ultra-processed food packages to generate healthier food environments and contribute to the prevention of childhood and adolescent obesity in Costa Rica.

Avaliação das Boas Práticas de Fabricação do serviço de alimentaçâo em um supermercado localizado no shopping center na cidade de Maceió/AL / Assessment of good manufacturing practices of the food service in a supermarket located in the shopping center in the city of Maceió/AL

O objetivo deste estudo foi avaliar as Boas Práticas de Fabricação do serviço de alimentação de um supermercado. Para realização do diagnóstico foi utilizado um check list adaptado da legislação federal. Conforme os percentuais de itens atendidos o estabelecimento foi classificado de médio risco de contaminação com 68,26% de itens conformes. Os blocos que obtiveram menos conformidades foram edificação e instalações (33,3%), higienização de instalações, equipamentos, móveis e utensílios (33,3%), produção e transporte de alimentos (36,3%) e controle de saúde e hábitos de higiene dos manipuladores de alimentos (33,3%). Conclui-se que a verificação continua das Boas Práticas é uma ferramenta expressiva para diagnosticar não conformidades do serviço e conseqüentemente realizar a correção adequada para que o mesmo não comercialize alimentos que venham a ser uma fonte de contaminação biológica e passível de causar doenças transmitidas por alimentos gerando danos à saúde dos seus funcionários e clientes.

Microbiological criteria and ecology of commercially available processed cheeses according to the product specification and physicochemical characteristics.

Although global cheese manufacturers release a variety of products onto the market, research on the microbiological quality and safety of cheese has focused mainly on conventional cheeses made from milk. Here, this study aimed to investigate commercially processed cheese products produced by mixing conventional cheeses after melting. Two approaches were used: a summary and comparison of legal definitions and standards/regulations regarding the microbiological criteria used by major cheese traders in the global market (Australia/New Zealand, China, European Union, Japan, Mexico, Republic of Korea, and the United States) and a comprehensive microbiological analysis of commercial products (n = 800), along with an assessment of salinity, pH, water activity, and heating conditions. The results of the literature search showed that major importing countries (China, Japan, Mexico, and the Republic of Korea) have stricter microbiological criteria for commercially available cheese products than major exporters (Australia/New Zealand, EU, and the USA). The former set limits with respect to the number of total coliforms in the product. Microbiological analyses were designed according to global standards and recommendations. No test sample contained detectable levels of Clostridium perfringens, enterohemorrhagic Escherichia coli, Listeria monocytogenes, Salmonella, or Staphylococcus aureus. In addition, no coliform bacteria (including E. coli) were detected. Overall, 79.9% of the samples contained detectable aerobic plate counts (1.0-7.8 log CFU/g); these levels varied significantly according to product type (grated cheese > chunks; cream cheese > portions or sliced) (p < .05). There was no significant association between microbe levels and salinity, water activity, pH, and heating conditions. The results can be used to develop a comprehensive database about commercially processed cheese products available in the global market and, as such, may be helpful for both national authorities and cheese manufacturers when considering novel strategic management plans for microbiological quality and safety.

Changes in Consumer Attitudes toward Broad-Based and Environment-Specific Sodium Policies-SummerStyles 2012 and 2015.

We examined temporal changes in consumer attitudes toward broad-based actions and environment-specific policies to limit sodium in restaurants, manufactured foods, and school and workplace cafeterias from the 2012 and 2015 SummerStyle surveys. We used two online, national research panel surveys to conduct a cross-sectional analysis of 7845 U.S. adults. Measures included self-reported agreement with broad-based actions and environment-specific policies to limit sodium in restaurants, manufactured foods, school cafeterias, workplace cafeterias, and quick-serve restaurants. Wald Chi-square tests were used to examine the difference between the two survey years and multivariate logistic regression was used to obtain odds ratios. Agreement with broad-based actions to limit sodium in restaurants (45.9% agreed in 2015) and manufactured foods (56.5% agreed in 2015) did not change between 2012 and 2015. From 2012 to 2015, there was a significant increase in respondents that supported environment-specific policies to lower sodium in school cafeterias (80.0% to 84.9%; p < 0.0001), workplace cafeterias (71.2% to 76.6%; p < 0.0001), and quick-serve restaurants (70.8% to 76.7%; p < 0.0001). Results suggest substantial agreement and support for actions to limit sodium in commercially-processed and prepared foods since 2012, with most consumers ready for actions to lower sodium in foods served in schools, workplaces, and quick-serve restaurants.

Determining the health benefits of poultry industry compliance measures: the case of campylobacteriosis regulation in New Zealand.

I undertake a cost benefit analysis of the food safety regulation of production of poultry for the New Zealand domestic market and the reduction in foodborne illness following this. I take a societal perspective to demonstrate that regulation brings both benefits and costs. I derive a cost of illness (COI) estimate of foodborne campylobacteriosis from three previous studies. I apply a cost benefit analysis (CBA) to this estimate, combined with the cost data supplied by industry and the regulator. The benefit:cost ratio was remarkable, showing a good return from the combined efforts of industry and the regulator in reduction of campylobacteriosis; in dollar terms a gain of at least $57.4 million annually. In summary the study demonstrates the high value to the New Zealand economy of investment in food safety compliance at the primary industry level.

Trans-fatty acids, dangerous bonds for health? A background review paper of their use, consumption, health implications and regulation in France.

INTRODUCTION: Trans-fatty acids (TFAs) can be produced either from bio-hydrogenation in the rumen of ruminants or by industrial hydrogenation. While most of TFAs' effects from ruminants are poorly established, there is increasing evidence that high content of industrial TFAs may cause deleterious effects on human health and life span. MATERIAL AND METHODS: Indeed, several epidemiological and experimental studies strongly suggest that high content of most TFA isomers could represent a higher risk of developing cardiovascular diseases by a mechanism that lowers the "good HDL cholesterol" and raises the "bad LDL cholesterol." RESULTS: With respect to the general precautionary principle and considering the existence of an international policy consensus regarding the need for public health action, some industrialized countries, such as France, are still not sufficiently involved in preventive strategies that aim to efficiently reduce TFAs content and TFAs consumption and produce alternative healthier fat sources. CONCLUSION: In this manuscript, we provide an overview about TFAs origins, their use and consumption among French population. We also discuss their potential human health implications as well as the preventive and regulatory measures undertaken in France.

[Current aspects in risk assessment of allergen traces in foodstuffs]. / Aktuelle Aspekte zur Risikobewertung von Allergenspuren in Lebensmitteln.

In contrast to usual ingredients in processed packaged foodstuffs, there are no suitable and binding regulations for the labeling of unintentional allergen traces in these foods as yet. This situation is unsatisfactory in regard to the fact that even traces of undeclared "hidden" allergens can constitute a considerable health risk for food allergic consumers. Furthermore, the unintentional cross-contact (cross-contamination) of allergens is also an issue in regard to food manufacturer product liability and due diligence. Therefore, stakeholders consider imperative need for the scientific determination of maximum tolerable levels of allergen traces in order to establish thresholds for legally binding food labeling. In addition to conventional toxicological risk assessments, the risk assessment of allergen traces that would be necessary in this context nowadays also incorporates modern approaches such as benchmark procedures and probabilistic modeling and methods. The scientific debate concerning the establishment of safe threshold levels continues, and a consensus must still be reached.

[Risk management of soybean-related asthma: monitoring and surveillance]. / Gestión del riesgo de asma por haba de soja: monitorización y vigilancia.

OBJECTIVES: Allergen emissions during soybean unloading operations in the Barcelona harbor have caused asthma epidemics. The present article aimed to describe the surveillance and control measures carried out by the public health services. METHODS: Data were extracted from control systems from 1999 to 2009, with description of the surveillance schemes for allergen emissions, environmental concentrations (with defined reference levels) and for health. RESULTS: Of 95 studies of plant emission, four were above the reference levels, and filters were found to be the most likely cause. Mean environmental concentrations were low but were above the reference levels on 13 days; these levels were related to adverse meteorological conditions and incidents in the plants. No health effects were detected in the panel of patients nor epidemic asthma days. CONCLUSIONS: The system detects incidents and has shown its usefulness in protecting public health.

Shifting post production patterns: exploring changes in New Zealand's seafood processing industry.

This paper examines the changing nature of New Zealand's seafood companies' production practices. The past 15 years has seen the offshore outsourcing of post-harvest fish gain unprecedented momentum. The growth in offshore processing is a further stage in an increasingly globalised fisheries value chain. Fish is head and gutted, frozen and then transported to processing sites in China where it is thawed, value-added processed and refrozen for export to the original sourcing country or third country markets. Reasons advanced by the industry for this shift in production practices include quota reductions, increasing production costs and the sale of trawlers.

Evaluating the technical feasibility of aflatoxin risk reduction strategies in Africa.

Public health interventions must be readily accepted by their target populations to have any meaningful impact and must have financial and infrastructural support to be feasible in the parts of the world where they are most needed. At the same time, these interventions must be assessed for potential unintended consequences, either to the environment or to human health. In this paper, we evaluate the technical feasibility of interventions to control aflatoxin risk, to be potentially deployed in parts of Africa where aflatoxin exposure poses a significant public health concern. We have applied a conceptual framework for feasibility to four interventions, one associated with each of four different stages of aflatoxin risk: biocontrol (pre-harvest), a post-harvest intervention package (post-harvest), NovaSil clay (dietary), and hepatitis B vaccination (clinical). For each intervention, we have assessed the following four components of technical feasibility: (1) characteristics of the basic intervention, (2) characteristics of delivery, (3) requirements on government capacity, and (4) usage characteristics. We propose ways in which feasibility of each intervention is currently high or low from the perspective of adoption in Africa, how public education is crucial for each of these interventions to succeed, and how to align economic incentives to make the interventions more suitable for less developed countries.

The "natural" aversion: the FDA's reluctance to define a leading food-industry marketing claim, and the pressing need for a workable rule.

As of 2009, the "natural foods" industry has become a 22.3 billion dollar giant and "all-natural" is the second-leading marketing claim for all new food products. Even in such a flourishing market, the Food and Drug Administration (FDA) has never defined the term "natural" through rulemaking. FDA and the U.S. Department of Agriculture (USDA) have instead created separate, non-identical policy statements governing the use of the term "natural," and FDA has abandoned efforts to define "natural" through rulemaking in the face of more pressing priorities. In absence of any governing federal standard, consumer advocacy groups and warring food industries have attempted to define "natural" to fit their preferences through high-stakes litigation of state law claims, leaving courts free to apply diverging standards without the expertise of FDA. Recent case law from federal district courts and the Supreme Court leaves little hope that FDA's current policy statement will preempt state law causes of action. To prevent a potential patchwork of definitions varying by state, and to create a legitimate standard resting on informed scientific expertise rather than consumer whims, FDA should engage in rulemaking to define the term "natural." This paper concludes by sketching potential formulations for such a rule based on FDA's previous successful rule-making ventures and standards used by natural foods retailers.

Prevention of Salmonella enteritidis in shell eggs during production, storage, and transportation. Final rule.

The Food and Drug Administration (FDA) is issuing a final rule that requires shell egg producers to implement measures to prevent Salmonella Enteritidis (SE) from contaminating eggs on the farm and from further growth during storage and transportation, and requires these producers to maintain records concerning their compliance with the rule and to register with FDA. FDA is taking this action because SE is among the leading bacterial causes of foodborne illness in the United States, and shell eggs are a primary source of human SE infections. The final rule will reduce SE-associated illnesses and deaths by reducing the risk that shell eggs are contaminated with SE.

[Role of the EFSA in risk management system regarding food contact materials and articles]. / Rola EFSA w systemie zarzadzania ryzykiem w odniesieniu do materialów i wyrobów przeznaczonych do kontaktu z zywnoscia.

The role of the European Food Safety Authority (EFSA) in the risk management system regarding food contact materials and articles is related with the risk assessment of the substances for the European Commission. General rules for the authorisation of substances used in materials and articles intended to contact with food is established in the Regulation (EC) no 1935/2004. For the evaluation of substances their toxicological properties and magnitude of migration into food simulants is taken into account. Toxicological studies include the mutagenicity tests, oral toxicity studies, carcinogenicity, reproduction and also studies on absorption, distribution, metabolism and excretion of the substance and other studies when needed. The set of the relevant toxicological data for substance depends on the magnitude of migration. In the case of positive opinion by EFSA the substance appears on the Community list of authorised substances. Sometimes, the earlier evaluated and authorized substances must undergo re-evaluation due to their new toxicological properties or as a result of a presence in the food of their earlier unknown decomposition products. Examples of the selected substances which underwent re-evaluation by EFSA in the light of the current toxicological knowledge and the relevant activities undertaken by the European Commission have been presented.

Prior notice of imported food under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. Final rule.

The Food and Drug Administration (FDA) is issuing a final regulation that requires the submission to FDA of prior notice of food, including animal feed, that is imported or offered for import into the United States. The final rule implements the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act), which required prior notification of imported food to begin on December 12, 2003. The final rule requires that the prior notice be submitted to FDA electronically via either the U.S. Customs and Border Protection (CBP or Customs) Automated Broker Interface (ABI) of the Automated Commercial System (ACS) or the FDA Prior Notice System Interface (FDA PNSI). The information must be submitted and confirmed electronically as facially complete by FDA for review no less than 8 hours (for food arriving by water), 4 hours (for food arriving by air or land/rail), and 2 hours (for food arriving by land/road) before the food arrives at the port of arrival. Food imported or offered for import without adequate prior notice is subject to refusal and, if refused, must be held. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of a draft compliance policy guide (CPG) entitled "Sec. 110.310 Prior Notice of Imported Food Under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002."