POLICY AND PEOPLE
Europe tackles consumers fears over food safety
he choice of food available to the consumer has never been greater but recent European food safety scares and revelations about poor standards in farming and food production have rocked consumer confidence. “A succession of food scares culminating in the Bovine Spongiform Encephalopathy (BSE) crisis has damaged consumer confidence in the safety of the food”, says Patrick Wall, the head of Ireland’s Food Safety Authority. However, newspaper headlines have forced governments to act and have prompted international organisations to step up policy plans in an attempt to allay the public fears and restore confidence in food and drink. In November last year the European Union set up the European Food Authority (EFA) to oversee all aspects of food safety from farm to fork, which includes a rapid alert system. At the launch of the EFA, Health and Consumer Commissioner, David Byrne, reminded the public that “safety is the most important ingredient in our food”. The Codex Alimentaire, an international organisation that sets global food safety reference standards, has also intensified international discussions on food safety. The United Nations has started to issue regular food safety awareness bulletins and promised more action on food safety. However, recent news stories show that the concern over food safety, such as those raised by the BSE crisis, has not gone away. For example, earlier this year Spanish chefs were up in arms over the government’s decision to ban the consumption of the estimated 18 000 bulls killed in bullfights each year because mandatory BSE testing of the carcasses will cost too much. In Italy, schools will now only serve organic food to children in a reaction to consumer panic over BSE and concern about genetically-modified food. However, the quality of meat is one part of “farm to fork” food safety. EFA and others note that foodborne diseases are a widespread and increasing public health problem, which equally affects developed and developing countries. In industrialised countries, 30% of people have had a food-related illness. In USA, for example, there are 76 million cases of foodborne illness each 1276
year, resulting in 325 000 admissions to hospital and 5000 deaths. In Europe and central Asia, 130 million people are affected each year by foodborne illnesses. The main foodborne illness in the world is diarrhoea and in 1998, 2·2 million people, including 1·8 million children, died from diarrhoeal diseases.
Farms must have higher standards
“Foodborne illnesses are defined as diseases, usually either infectious or toxic in nature, caused by agents that enter the body through the ingestion of food. Every person is at risk of foodborne illness”, says WHO. Furthermore “the food production chain has become more complex, providing greater opportunities for contamination and growth of pathogens. Many outbreaks of foodborne diseases that were once contained within a small community may now take on global dimensions”, notes the UN agency. On the other side of the coin, a lack of food is causing equally serious problems. In fact malnutrition in Europe is such a concern that WHO’s European Region has launched the continent’s first food and nutrition plan. The major malnutrition-related problem is growth retardation. For example, 43% of children, particularly in former Soviet Union countries are affected by stunted growth. Iron-deficiency anaemia affects millions of people and impairs cognitive development in children and increases risks to pregnant women The food and nutrition action programme covers 50 European and central Asian countries. WHO will target paediatricians, policy-makers, and national governments, and provide them with scientific evidence to enable them to develop or update their current national recommendations on nutrition. “A large portion of the health care budget is used to treat preventable nutrition-related disorders, costs that could be substantially reduced if these disorders were prevented. Implementing these
guidelines will enable countries to develop their own national nutrition policies for infants and young children”, said Marc Danzon, WHO Regional Director for Europe. An key message from WHO and leading nutrition experts is that foodbourne illness and malnutrition are preventable. But eating a healthy balanced diet is important. Oncologists note that at least a third of cancers are food and nutrition related. “We have compelling evidence that what you eat is a major determinant of cancer and other chronic disease risk, but all too often [researchers] lack an adequate understanding of the molecular basis for established relationships”, says Peter Greenwald, director of the division of cancer prevention at the National Cancer Institute in Washington. “Basic nutritional science needs to be built into the mainstream [thinking] of our leading biomedical research institutions, and medical training needs greater emphasis on diet”, said Greenwald. Others have suggested that molecular biology and genetics will provide many of the answers to the role nutrition plays in disease development. EFA and others are making an effort to address food safety issues, but some clinicians and nutritionists have expressed concern that new types of functional foods —food genetically engineered to appeal to consumers with particular health concerns—may not be safe or effective. The modified foods appearing in European supermarket shelves include soup containing St John’s wort, which may help treat depression; cakes with psyllium, which can help lower cholesterol; eggs enriched with omega-3; and probiotic and prebiotic products to help alleviate bowel and cholesterol problems. More functional foods are in the pipeline and experts have called for more controlled trials and assurances about the long-term safety of such products. Myrtle Allen, a former head of Eurotoques, the international chefs organisation, well known for her stance on fresh and wholesome food echoes nutritionists and clinicians concerns. “People have lost the concept of healthy animals, healthy plants, healthy food and healthy people.” Karen Birchard
THE LANCET • Vol 357 • April 21, 2001