Development of a risk-ranking framework to evaluate potential high-threat microorganisms, toxins, and chemicals in food.

Through a cooperative agreement with the U.S. Food and Drug Administration, the Institute of Food Technologists developed a risk-ranking framework prototype to enable comparison of microbiological and chemical hazards in foods and to assist policy makers, risk managers, risk analysts, and others in determining the relative public health impact of specific hazard-food combinations. The prototype is a bottom-up system based on assumptions that incorporate expert opinion/insight with a number of exposure and hazard-related risk criteria variables, which are propagated forward with food intake data to produce risk-ranking determinations. The prototype produces a semi-quantitative comparative assessment of food safety hazards and the impacts of hazard control measures. For a specific hazard-food combination the prototype can produce a single metric: a final risk value expressed as annual pseudo-disability adjusted life years (pDALY). The pDALY is a harmonization of the very different dose-response relationships observed for chemicals and microbes. The prototype was developed on 2 platforms, a web-based user interface and an Analytica(R) model (Lumina Decision Systems, Los Gatos, Calif., U.S.A.). Comprising visual basic language, the web-based platform facilitates data input and allows use concurrently from multiple locations. The Analytica model facilitates visualization of the logic flow, interrelationship of input and output variables, and calculations/algorithms comprising the prototype. A variety of sortable risk-ranking reports and summary information can be generated for hazard-food pairs, showing hazard and dose-response assumptions and data, per capita consumption by population group, and annual p-DALY.

Putting things in perspective: building on our experience.

The science and policy underlying food labeling and food fortification have evolved over the past 30 years to a point where dietary guidance and nutrition labeling now provide consumers with highly sophisticated, very specific information about links between diet and health. The focus was once on prevention of nutrient deficiency diseases, but today it is on reducing the risk of chronic diseases and health-related conditions. The Nutrition Labeling and Education Act of 1990, with its provisions for authorization of health claims on food labels, has provided a gateway through which a broader realm of nutrition and health information can be made available to consumers. However, the interpretation and implementation of the health claim provisions must evolve, based on a strong foundation of supporting science, so that industry may more readily make health information available to consumers in a form that is easily understood and effectively used in making their dietary choices. We must develop a database to support claims of beneficial effects of food components. We must be assured that the beneficial effects are not outweighed by safety concerns. And we must develop an environment that is conducive to conducting the research to develop these data. This can only be accomplished through the collaborative efforts of industry, academia, consumers and public health agencies.

The regulatory environment past and future--incentive or impediment to developments in food science and technology: a perspective from FDA.

The best system for protecting public health is one that involves two layers of control before food reaches the consumer. The first layer of control is the industry's clear responsibility to prepare food that is safe. The second layer of control is the monitoring that is provided by government to ensure that the industry is doing its job and is in fact producing safe food. While some may view this "second layer" as an impediment in the development and marketing of new technologies, there is another way to look at the "regulatory environment". The regulatory environment itself, is not an impediment to the development of food science and technology. The regulatory environment, with all its components--scientists, consumers, industry, and Congress--defines "safety" within the context of today's technology, scientific capability, and tolerance level of the lay public. The entire regulatory environment serves to guide the development of food science and technology by providing signposts, in the form of scientifically sound regulatory decisions. The scientific basis of these decisions becomes building blocks on which to rest further refinement of the technology, product, ingredient, or packaging material or on which research in related technologies or research in innovative directions can build. This scientific groundwork becomes very important as more and more companies move away from having self-contained research laboratories toward using commercial laboratories and academic institutions, as well as participating in cooperative research endeavors to meet food safety and product development research needs.(ABSTRACT TRUNCATED AT 250 WORDS)

Improving continuity of care by evaluation of post-discharge outcomes.

Evaluation of nursing care is being expanded to identify and assure attainment of patient outcomes. Ideally, evaluation of care will occur throughout all phases of treatment and include perceptions of the patient and/or significant others. A framework for patient outcomes as proposed by Marek (1989) was useful in defining outcomes for newly injured and chronically skin-compromised patients with spinal cord injury. Guidelines established by the Joint Commission for Accreditation of Health Organizations also influenced development of the nursing quality assurance approach. A pilot program demonstrated attainment of expected patient outcomes for high-risk and problem-prone aspects of nursing care.

Perspective of Food and Drug Administration on Dietary sodium.

The sodium and potassium content of typical American diets of infants, toddlers, and adults was determined, both for total content and for content at the commodity group level, by chemical analysis of representative diets from 1977 through 1980. In recent years the scientific community has reached a consensus that high sodium intake is positively associated with hypertension. Various professional groups urge the American public to reduce their sodium intake. Several monitoring initiatives of the Food and Drug Administration relative to sodium in the national food supply are discussed.

Estimation of dietary iodine intake of Americans in recent years.

The iodine content of diets of typical American infants, toddlers, and adults in recent years was found to be far in excess of the amount necessary for adequate nutrition. Dairy products were the major contributor. Other large contributors were grain and cereal products, sugars and adjuncts, and meat, fish, and poultry in adult diets and grain and cereal products and meat, fish, and poultry in infant and toddler diets. A statistical evaluation of the data and a discussion of possible sources of iodine are presented.