Currently browsing posts about: Food-safety

I received a couple of requests to define “public health” last week from readers Anthro and MA.  As MA puts it,

Maybe…we need a definition of “public health.”  I view my health as a private matter, my food choices as a private matter, and an expression of my freedom.  To me, public health is not an individual concern, it’s a corporate (group) concern – government, schools, companies, farms, etc.  Public health includes things like properly working sewer systems, sanitation, water quality, and air quality.   Marion – can we get a definition of ‘public health’ from you, as Anthro suggested?

My definition of public health isn’t much different from mainstream definitions.  But to me, public health is a critically important expression of democracy, and the antithesis of  a “corporate” concern.  Public health approaches promote good health for everyone, not just those who can afford it or are educated enough to make appropriate choices.

A standard definition such as the one given in Wikipedia, says that public health is about promoting health and preventing disease through societal choices and efforts.   Public health deals with health at the population level, rather than at the level of individual personal responsibility, and it emphasizes prevention rather than treatment.

In my experience teaching public health nutrition, the concept of public health is sometimes hard for people to grasp, especially since populations are made up of individuals. I like to explain it this way: public health makes it easier for individuals to make healthful food choices for themselves and their families. Or to put it another way, public health makes better food choices the default.

The classic example of a public health intervention is water chlorination.  As individuals, we could all boil our own drinking water to kill harmful organisms but this requires us to have stoves, pots, and fuel, and to know how to boil water.  For many people, having to do this would be an intolerable burden and responsibility.  Instead, some societies choose to take public health measures to ensure that drinking water is safe at the tap for everyone.

Other food examples: milk Pasteurization, banning of trans fats, food labeling.

The particular example that elicited the question has to do with food safety.   We, as a society, could insist that food producers take measures to ensure that their products are free of harmful microorganisms (public health), or we could teach individuals how to manage food safety in the home or restaurants and cook foods properly (personal responsibility).

Preventing obesity is another example: We could, as a society, take measures to make it easier for people to eat more healthfully and be more active (public health) or leave it up to individuals to do this for themselves (personal responsibility). Many of the arguments about suggested public health measures to prevent obesity are about how best to balance society’s needs with individual rights.  But as I see it, the proposals aim to tweak societal choices that have already been made: which crops receive farm subsidies, for example.

An exceptionally clear example is how to avoid toxic levels of methylmercury in fish.   We can teach pregnant women to recognize which fish are high in methylmercury and hope this works well enough so they will avoid buying such fish (personal responsibility) or we could–as a society–require coal-burning power plants to scrub their emissions so mercury doesn’t get into ocean or lake waters in the first place (public health).

Obviously, both public health and individual approaches are necessary, but the overall objective of public health is to make it much, much easier for individuals to make better health choices without having to think about them.

Because public health applies to everyone, it is essentially democratic.   And that’s one of the reasons why I think it matters so much.

My policy is to ignore snippy comments on this site but I recently received one that raises an issue worth attention.  In response to my most recent post about the endless—and to my mind, appalling—delays in passing S. 510, a bill that will give the FDA authority to require safe food production, a critical reader, Harry Hamil, writes:

Dr. Nestle, your statement, “What’s holding up this bill? Nothing but politics of the worst kind,” is absolutely false and you know it.  As you well know, there is broad, deep and large opposition to the industrial-size-only approach to food safety that S 510/HR 2749 will make the law of the land….And, once again, I challenge you to a debate of the actual provisions of the bill. Your previous blogs demonstrate a remarkable ignorance of the actual provisions and little understanding of the real world consequences.

As readers of this blog know, I believe that all food, no exceptions, from large producers and small, should be produced safely, meaning that producers should follow food safety plans that involve preventive controls.  But this comment raises another issue: the unhelpful tone of this debate.

Bill Marler, the Seattle lawyer who represents the victims of food poisonings, gets such comments all the time.  In a post on FoodSafetyNews.com, he deals with the tone issue in response to rather nasty comment about his views of raw milk.  Marler says:

Actually, I get more than a few emails like this.  Most do a bit better at spelling and punctuation, but nearly all are from raw milk proponents, producers, or consumers (although there are a few from the anti-S. 510 cabal).  Some, but not all, have a level of passion that borders on violence.  Perhaps not directed at me, but generally in the “do not tread on me”–“tea party” shouting that we have been subjected to over the last year.

Frankly, I was perplexed at the “yell fest” that passed for discussion of whether we should expand health care to the 40 million of our fellow citizens without health insurance.  I am shocked at how we scream at each other via email or blog comments about raw milk or honest differences about how food safety legislation should be modeled.  It is like screaming at and belittling each other at the dinner table–albeit, a very large table.

What is with all this anger over food?  I mean, honestly, it seems like there are bigger fish to fry.  What about the wars?  Global warming?  Energy policy?

But, folks are angry about their view of food–especially the proponents of raw milk (affectionately, “raw milkies”) and the anti-S. 510 folks (affectionately, “organic tea baggers”).  Both groups view themselves as victims of big government and big business bent on reducing them to servitude or extinction.  They cannot see that perhaps, just perhaps, people who see the dangers of raw milk or the value of S. 510, might simply have an honest disagreement with those that see raw milk as the nectar of the gods or S. 510 as more than a method of lining the pockets of Monsanto.  But, hey, that is just me.

So, do the yelling, threats and belittling of the anti raw milk/pro S. 510 crowd actually work?  Are some convinced that those that yell the loudest have the best arguments?  Or, do some simply shy away from their positions after being the target of a nasty blog post or scathing email or comment?  I think some do.  I know I have been tempted to simply focus on other pressing issues surrounding food safety–there are many–and let folks guzzle raw milk to their heart’s content and let S. 510 die a lingering death.

But, that is not my style.  Even as a child when told to do A I usually did B.  When the raw milk party calls me a tool of big dairy or an ambulance chaser, I come back with reasoned pros and cons of raw milk consumption, videos of raw milk consumers sickened, and a website–Real Raw Milk Facts–dedicated to having a reasoned discussion about raw milk.  I am also beginning to work on a raw milk retail sampling project to test its safety.

As for S. 510, the nastier the emails from small producers who want little or no food safety regulation, the more money I donate to political campaigns, the more trips I take to DC, and the more often I fund victim visits to their favorite senator.

And, to do the above, I hardly raise my voice.  Well, once in awhile I do.

Eric Schlosser has an excellent op-ed in today’s New York Times, “Unsafe at any meal.”

You would think, he points out, that a bill that passed the House nearly a year ago,

with such broad support, on a public health issue of such fundamental importance, would easily reach the floor of the Senate for a vote. But it has been languishing, stuck in some legislative limbo. Food processors reluctant to oppose the bill openly will be delighted if it dies a quiet death.

How come?

because, right now, very few cases of food poisoning are ever actually linked to what the person ate, and companies that sell contaminated products routinely avoid liability. The economic cost is instead imposed on society. …Without tough food safety rules, a perverse economic incentive guides the marketplace. Adulterated food is cheaper to produce than safe food. Since consumers cannot tell the difference between the two, companies that try to do the right thing are forced to compete with companies that couldn’t care less.

As for the concerns of small farmers:

For months, however, the Internet has been rife with wild rumors and accusations: that the bill is really a subterfuge cleverly designed to eliminate small farms and strengthen the grip of industrial agriculture; that it would outlaw organic production; that it would hand over the nation’s food supply to Monsanto.   Those arguments may be sincere. But the bill very clearly instructs the Food and Drug Administration to focus its enforcement efforts on plants that pose the greatest risk of causing large-scale outbreaks.

What’s holding up this bill?  Nothing but politics of the worst kind.  Lives are at stake here and everyone who cares about our food system should be urging the Senate to get moving.  Thanks Eric for writing this piece.  I hope it helps.

It’s a hot weekend and I’m feeling lazy, so I will do a bit of borrowing and reproduce Bill Marler’s summary of year-to-date illnesses caused by raw milk products (click on the chart to make it bigger and easier to read).

On his website devoted to the topic, www.realrawmilkfacts.com, Marler presents a litigator’s view of the issues related to raw milk, with plenty of documents to back of his position.

My view: everyone who produces food should produce safe food.  If I were producing raw milk, I’d be testing it like mad to make sure it didn’t harbor dangerous pathogens, but that’s just me.

I never cease to be amazed by the problems that food technologists worry about. 

A German chocolate company—and the state of Schleswig-Holstein—are funding $2 million worth of research to find a method to safely add chocolate pieces to yogurt.

Why is the safety of chocolate in yogurt a problem?  Yogurt is wet and dissolves the sugar crystals in chocolate, making it messy.  Worse, chocolate is not sterile and yogurt is an ideal bacterial growth medium.

Sterilizing chocolate, it seems, is not easy:

The constituents of the cocoa are very sensitive. Excessively high temperatures and incorrect cleaning, roasting, grinding or conching impair the quality of the finished chocolate pieces. All that has to be taken into account when you are developing new sterilisation techniques.

Researchers, get busy!  Please, please solve this problem right away.

And in the meantime, for those of you desperate for chocolate in your yogurt, how about tossing in a handful of M&Ms?

Britain has, as threatened, split up its Food Standards Agency (roughly equivalent to our FDA).  The split only applied to FSA in England.  Its role in Scotland, Northern Ireland and Wales remains the same for the moment.

As I mentioned in a previous post, the precipitating cause of the new government’s distress about the FSA was—incredible as it seems—the agency’s support of traffic-light front-of-package labeling. 

In its new configuration, FSA keeps its food safety functions.  Its nutrition and labeling functions go to the Department of Health.  Its country-of-origin and other non-labeling policies go to the Department for Environment, Food and Rural Affairs (Defra).

Surprise!  The UK Food and Drink Federation thinks this is a terrific move.

As the voice of the UK food and drink manufacturing sector, we believe it is important to maintain an independent food safety regulator and fully support today’s decision by the Government to retain the Food Standards Agency…We also support the decision to move responsibility for nutrition, and other food policy issues, back into Government departments…This should lead to clearer and more consistent policy making, while avoiding unnecessary duplication of effort across Whitehall.

FSA may be keeping its food safety responsibilities, but Food Safety News reports that the agency hasn’t been doing such a great job with them.  FSA’s most recent  Annual Report says that it did not achieve its target for reduction of Campylobacter infections.  It also failed to reach targets for reductions in salt and saturated fat.

Under the new division of responsibility, salt and fat are no longer FSA’s problem.  The Health Department will be dealing with them—or not.

Given the industry-friendly bent of the new new health minister, expect considerable backing off from previous FSA policies. 

England is not setting a good example for our FDA, alas.

As for what FDA can and cannot do, see Michael Taylor’s post on the Atlantic Food Channel.  In discussing why the FDA isn’t taking a more vigorous enforcement stance against unsubstantiated health claims on food products, Taylor says:

We have no pre-market review authority over such claims, and, under prevailing legal doctrines concerning “commercial free speech,” the evidentiary requirements placed on FDA to prove that such claims are misleading are significant and costly to meet. Moreover, meeting them requires tapping the same team of nutritionists, labeling experts, and lawyers who are working on our other nutrition initiatives.

If they go after health claims, he says, it’s a losing proposition:

We’re also conscious of the cleverness of marketing folks, who, once we prove today’s claim is misleading, can readily come up with another one tomorrow. Going after them one-by-one with the legal and resource restraints we work under is a little like playing Whac-a-Mole, with one hand tied behind your back.

What he doesn’t point out nearly strongly enough, in my opinion, is that doing something about health claims rests with Congress.  Congress passes laws.  The FDA’s job is to enforce them.  Congress needs to give the FDA the tools it needs to protect the public and promote public health. 

And that, of course, brings us back to the food safety bill that has been sitting in the Senate for the last 11 months.  If Congress can’t even get that passed, it’s hard to be optimistic about its doing anything reasonable about misleading health claims.

I’ve been collecting items on food safety for the last week or two. Here’s a roundup for a quiet Friday in July:

Antibiotics in animal agriculture

     USA Today does great editorial point/counterpoints and here is one from July 12 on use of antibiotics as growth promoters or as  prophylactics in farm animals and poultry.  This selects for antibiotic-resistant bacteria.   If we get infected with antibiotic-resistant bacteria, too bad for us. 

     The paper’s editors think that use of antibiotics for these purposes is irresponsible:  Our view on food safety: To protect humans, curb antibiotic use in animals.

     Dr. Howard Hill, a veterinarian who directs the National Pork Producers Council, defends these uses of antibiotics: Don’t bar animal antibiotics.

The source of the 2006 E. coli 0157:H7 outbreak in California spinach

     USDA and UC Davis investigators are still trying to figure out how the toxic E. coli O157:H7 got onto the spinach. Investigators did not find the bacteria on the spinach field itself, but they did find it in water, cattle, and cattle feces at a cattle crossing over a stream one mile away. Leading hypotheses: runoff from that stream or wild boar.

     Subsequent studies showed low levels of E. coli 0157:H7 in wild animals and birds.  A new study confirms that just under 4% of wild boar harbor the bacteria. 

     The investigators say the spinach outbreak of 2006 was the result of a combination of circumstances: “Everybody is starting to realize that maybe unusually heavy rainfall prior to planting could be an issue in terms of where water is routed.”

     Dairy farming is moving into California’s Central Valley in a big way.  Runoff from those farms will not be sterile and growing vegetables along water routes may be risky.  Compost, anyone?

The chemical behind Kellogg’s cereal recall

     Kellogg recalled 28 million packets of breakfast cereals last month because people reported funny smells and getting sick from something in the packaging.  At first, Kellogg would not say what the chemical contaminant might be.  

     Then it said the chemical is methylnaphthalene. Mothballs! (Are they still making mothballs?  Their smell is unforgettable)

     Tom Philpott’s comments on Grist.com point out what’s really at stake: “And of course, the real scandal is what Kellogg’s is marketing to kids: a tarted-up slurry consisting mainly of sugar, corn products, partially hydrogenated oil, and food colorings. But that’s a whole different story.”

Salsa and guacamole are sources of foodborne illness

     The CDC reports that salsa and guacamole are becoming more frequent sources of contaminants leading to illness.  CDC started collecting information on sources of outbreaks in 1973.  Its first outbreak due to salsa or guacamole occurred in 1984.  Since then, there have been 136 such outbreaks.  Restaurants and delis were responsible for 84%.  Between 1984 and 1997, salsa and guacamole outbreaks accounted for 1.5% of total foodborne outbreaks.  But the percentage rose to 3.9% from 1998 to 2008.

     Moral: make your own!

China deals with melamine in milk powder

     China is taking creative steps to prevent melamine from getting into milk powder and infant formula.  To discourage fraudulent producers from boosting up the apparent level of protein in milk with melamine, it simply reduced the amount of protein required.

The latest on food irradiation

     FoodSafetyNews.com presented a two-part series on food irradiation (part 1 and part 2), both of them quite favorable to the technology. As I discuss in my book, Safe Food, I don’t have any safety ojections to food irradiation, but I consider it a late-stage techno-fix for a problem that should never have occurred in the first place.

     I conclude with my favorite quote from former USDA official Carol Tucker Foreman: “sterilized poop is still poop.”

Enjoy a safe weekend!

Food Safety: FDA Has Begun to Take Action to Address Weaknesses in Food Safety Research, but Gaps Remain. GAO-10-182R, April 23, 2010 (23 pages).

Imported food makes up a substantial and growing portion of the U.S. food supply, with 60 percent of fresh fruits and vegetables and 80 percent of seafood coming from across our borders….In January 2007 GAO designated federal oversight of food safety as a high-risk area needing urgent attention and transformation because of the federal government’s fragmented oversight of food safety. The Food and Drug Administration (FDA) is responsible for ensuring the safety of roughly 80 percent of the U.S. food supply–virtually all domestic and imported foods except for meat, poultry, and processed egg products–valued at a total of $466 billion annually, as of June 2008.

Food Safety: FDA Could Strengthen Oversight of Imported Food by Improving Enforcement and Seeking Additional Authorities.  GAO-10-699T, May 6, 2010 (20 pages).

In 2008, FDA inspected 153 foreign food facilities out of an estimated 189,000 such facilities registered with FDA…. FDA estimated that it would conduct 200 inspections in 2009 and 600 in 2010. GAO previously identified several gaps in enforcement that could allow food products that violate safety laws to enter U.S. commerce. For example, FDA has limited authority to assess penalties on importers who introduce such food products, and the lack of a unique identifier for firms exporting food products may allow contaminated food to evade FDA’s review.

As it has been saying for years, GAO wants FDA to ask Congress to give it statutory authority to:

• Recall products identified as unsafe
• Require companies to demonstrate that food ingredients are safe before using them
• Require preventive controls (e.g. HACCP) by firms producing foods that have been associated with repeated instances of serious health problems or death.

Note that the FDA does not have this authority now and must seek it from Congress.  The food safety bill now before Congress does some of this, which is one reason why it should be passed.  Note: the House passed the bill last August.  Eleven months later, the Senate is still sitting on it.  Not helpful.

Addition: Consumers Union has produced a video—starring Eric Schlosser—on why the Senate must pass the food safety bill, and right away.

Update, July 8: President Obama states support of the Senate’s food safety bill.