Currently browsing posts about: Regulation

By the time the FDA posted this outbreak alert, the cucumbers had all been picked, shipped, and done their damage.

The outbreak

Total Illnesses: 449
Hospitalizations: 125
Deaths: 0
Last Illness Onset: June 4, 2024
States with Cases: AL, AR, CT, DE, DC, FL, GA, IL, IN, IA, KY, ME, MD, MA, MI, MN, MO, NV, NJ, NY, NC, OH, OK, PA, RI, SC, TN, TX, VA, VT, WA, WI [31 states]

The CDC investigation:  Of 188 people interviewed (69%) reported eating cucumbers.

The product

cucumbers distributed by Fresh Start Produce Sales, Inc. and grown by Bedner Growers, Inc., of Boynton Beach, FL. Recalled cucumbers are beyond shelf life and should no longer be available for sale to consumers in stores.  Bedner Growers, Inc.’s growing and harvesting seasons are over. There is no product from this farm on the market and likely no ongoing risk to the public.

The self-protective reaction

According to Food Safety News,

the Florida Department of Agriculture (FDOA) called the U.S. Food and Drug Administration’s (FDA) tracing of a Salmonella outbreak to a local cucumber grower “at best inaccurate, and at worst misleading.” Apparently, the head of food safety at the FDOA, who told the FDA in an email “We find the science inaccurate, unsubstantiated and unnecessarily damaging to the firm implicated.”

Comment

This outbreak is worth special attention, not least because so many people were affected in so many states, and the cucumbers were gone by the time investigators knew they were the most likely cause.

• Half the cases were due to a new kind of Salmonella, S. Braenderup.
• The FDA idenified S. Braenderup in untreated canal water used for irrigation.

Salmonella in the water?  This means there must be some kind of enormous CAFO (Confined Animal Feeding Operation) nearby, spilling its cattle, dairy, or poutry waste into local streams.

The regulatory issues

This brings me to law professor Timothy Lytton’s latest paper on precisely this issue:  Lytton, Timothy D., Known Unknowns: Unmeasurable Hazards and the Limits of Risk Regulation (July 02, 2024). Oklahoma Law Review, Vol. 76, No. 4, p. 857, 2024.

This Article develops general principles for addressing known unknowns using a case study of efforts to regulate agricultural water quality. Contaminated water used to cultivate fresh produce is a well-known cause of recurrent foodborne illness outbreaks. Unfortunately, it has, so far, proven impossible to reliably quantify the risk of human illness from any given source of agricultural water.

At least one problem here is the split in regulatory authority between FDA (cucumbers) and USDA (animals).  FDA has no authority over CAFOs.  Its authority stops at the farm.  How is the cucumber farmer supposed to stop toxic forms of Salmonella from getting onto cucumber fields?

That is the insoluble regulatory problem Lytton’s piece addresses.

Last month, the UK government announced guidance for the food industry on compliance with its new policies on dealing with foods High in Fat, Sugar, or Salt (HFSS): Restricting promotions of products high in fat, sugar or salt by location and by volume price: implementation guidance.  

The food industry is not happy about these policies.

Kellogg has launched a legal challenge.

Kellogg has launched a legal challenge against the Government’s upcoming restrictions on retail promotions for food and drink high in fat, salt and sugar (HFSS), claiming the rules unfairly represented breakfast cereals.

On what basis?

The manufacturer argued that the formula used tomeasure the nutritional value of food was wrong when it came to breakfast cereals, as the Nutrient Profiling Model (NPM) only accounted for portions of dry cereals and not for a bowl of cereal and milk…Breakfast cereals are dehydrated foods, that are intended to absorb milk to make the food more palatable and give the food its intended flavour and texture.  Hardly anyone sits down to a bowl of dry breakfast cereals in the morning – cereals are almost always eaten with milk.

What’s really at stake?

From October this year, new legislation will restrict retail promotion of HFSS products. The changes could lead to a reported loss of 1.1bn per year.

The food industry is also arguing that the new regulations will cause a consumer backlash.

These restrictions might escape public scrutiny, but consumers will get a horrible shock when they wake up one day and find their favourite brands have been ruined by regulation and cost more.  Unless manufacturers fight back, be it in the courts or out in the public square, it’ll be too late to do anything about it.

And that the HFSS regulations won’t do any good.

The soft drink industry, however, sees the regulations as no problem: “The soft drinks category will be affected by new HFSS legislation coming into force in England. But having already done plenty of work in reformulating and innovating for the UK sugar tax, the sector is well placed to turn a challenge into an opportunity.”

What’s all this about?  Here’s a quick review of the HFSS history:

2018: In Chapter 2 of the Childhood Obesity Plan,  the UK government set out its intention to end the promotion of high fat, sugar and salt (HFSS) products by location and by price.  It committed to consult on how this should be implemented.  This was based on evidence that food retail price promotions are widespread and effective at influencing food preferences and purchases (particularly for children), and on previous reports recommending reducing and rebalancing promotions towards healthier food and drink to help prevent obesity in children.

2019: The consultation on restricting the promotion of HFSS products was held.

2020:  The government theld a consultation on technical enforcement of the restrictions.  It announced in Tackling obesity: empowering adults and children to live healthier lives, that it would legislate to end promotion of HFSS products by volume (for example, “buy one get one free”) and location both online and in store in England.  It published a formal consultation response.

2021: The government introduced legislation to restrict the promotion of HFSS products by volume price both online and in store in England., based on the nutrient profiling technical guidance 2011.) These regulations will come into force on 1 October 2022.

2022: The new restrictions on HFAA promotion. 

JAMA Pediatrics has just published the online version of a study by Daniel Taber et al, Association Between State Laws Governing School Meal Nutrition Content and Student Weight Status: Implications for New USDA School Meal Standards.

I wrote the accompanying editorial: School meals: A starting point for countering childhood obesity.

In it, I review how researchers like Taber et al are demonstrating how regulations aimed at changing the environment of food choice seem to be helping children and adults eat more healthfully.

That is why regulation is worth consideration.

The food industry cannot make significant changes on its own.  Food companies are beholden to stockholders and returns to investors.

We can’t count on consumer demand.  It’s up against the billions of dollars spent on food marketing, advertising, and lobbying.

It’s government’s role to level the playing field.

Studies like this one are beginning to show positive results.

If you take junk food and sodas out of schools, kids don’t eat as much of them and are healthier.  If you have strict nutrition standards for school food, the food is healthier and so are the kids.

This may all seem self-evident, but now we have research to prove it.

Government agencies should pay close attention and figure out everything they can do to make the food environment healthier for children and adults.

As part of an interactive case study and point-counterpoint on regulation of sugar-sweetened beverages, the New England Journal of Medicine (NEJM) conducted a poll of its U.S. and international readers.  The poll elicited responses from 1290 readers from 75 countries.

Overall, 68% of respondents favored government regulation.

High as this percentage is, the average is much lower than percentages from most countries as a result of one outlier—the United States.

Only 58% of U.S. voters in the poll favored regulation.  Everywhere else in the world, the percent in favor averaged 84%.

These results reminded me of change-in-sales figures from a few years ago:

Americans have reduced soft drink consumption, causing soda companies to focus their marketing efforts overseas.  Trends like these explain Coca-Cola’s new obesity ad campaign and Pepsi’s $50 million deal with Beyoncé. 

In America these days, 58% is an impressive majority.  NEJM readers are likely to be physicians, scientists, and health and health policy professionals. I suspect we will be hearing more about this idea.  Stay tuned for this one too.