Public Health,Ethics, and Functional Foods

Functional foods aim to provide a positive impact on health and well-being beyond their nutritive content. As such, they are likely candidates to enhance the public health official’s tool kit. Or are they? Although a very small number of functional foods (e.g., phytosterol-enriched margarine) show such promise in improving individual health that Dutch health insurance companies reimburse their costs to consumers, one must not draw premature conclusions about functional foods as a group. A large number of questions about individual products’ safety, efficacy, and affordability need to be answered before they might become an important part of the public health agenda. More importantly, though, the costs and benefits of functional foods relative to alternative mechanisms of public health improvement need to be ascertained. Alternative scenarios that warrant investigation are mainly the supply of nutraceutical ingredients in pill form targeting “at risk” groups and consumer education on diet and lifestyle.     

Consensus Conferences – A Case Study: Publiforum in Switzerland with Special Respect to the Role of Lay Persons and Ethics

This paper focuses on experiences from a case study dealing with the Swiss type of a consensus conference called “PubliForum” concerning “Genetic Technology and Nutrition” (1999). Societal and ethical aspects of genetically modified food meanwhile can be seen as prototypes of topics depending on the involvement of the public through a participatory process. The important role of the lay perspective in this field seems to be accepted in practice. Nevertheless, there is still some theoretical controversy about the necessity and democratic legitimacy of participatory processes in general, and especially about those dealing with technological or environmental problems (sustainable development) concerning society. From an ethical point of view, a lot of heterogeneous problems concerning contents and procedures of public participation can be pointed out, not only on the theoretical level but also in practice, e.g., concerning the communication process between laypersons and experts. The intention of our paper is to give hints and to clarify criteria that support the communication process leading to a dialog of autonomous citizens and which especially consider ethical aspects in the field. One important result is that there must be an orientation for all members of a consensus conference having clear rules and knowing their different roles that support transparency, credibility, and fairness of the whole procedure and a “good product”: a substantial final document or citizens’ report. This paper presents results of the project Ethical Bio-TA Tools as funded by the European Commission, DG Research, under FP5, Quality of Life Programme.     

Trust,Food, and Health. Questions of Trust at the Interface between Food and Health

The food sector and health sector become more and more intertwined. This raises many possibilities, but also questions. One of them is the question of what the implication is for public trust in food and health issues. In this article, I argue that the products on the interface between food and health entails some serious questions of trust. Trust in food products and medical products is often based upon a long history of rather clear patterns of mutual expectations, yet these expectations are not similar in both sectors. As long as the food sector and health sector remain distinct, these differences will not lead to problems of trust, yet when new products are introduced, like functional foods or personalized dietary advices, trust can be threatened. To prevent this, we need clarity with regard to what we can expect of these new products and of whom to expect what in this situation. This requires not␣only adequate information on operating procedures, but also a profound debate␣on responsibilities and the explication and interpretation of moral values and norms.     

Accelerating progress on salt iodisation in Sudan: time for action

This paper uses a public health approach to examine briefly: (a) the progress of universal salt iodisation (USI) in Sudan; (b) the roles of the main actors involved; and (c) the main issues around accelerating USI. The literature, especially that coming from the UN agencies, is analysed and experiences from the recently revitalised USI programme, and related relevant meetings, are distilled. In Sudan the prevalence of goitre is 22 per cent. It is assumed that productivity among the people affected is reduced by 5–25 per cent. Little apparent progress has been made with USI. The Government of Sudan, UN multilateral agencies, international consultative groups, bilateral agencies, global and national non-governmental organisations and, increasingly, the private sector must work together to find innovative approaches to increase awareness of the broader social, public health and nutritional contexts, and to advocate for increased national nd international funding.     

An environmental assessment of food supply chains: a case study on dessert apples

The contemporary food system provides consumers with convenience, extensive choice, and the year-round availability of fresh produce. In this paper these achievements are recognized within the context of the associated environmental impacts. While many analyses have considered the energy and material efficiency of various options for food production and packaging, very few studies have investigated the environmental impacts of the transport components of food supply chains. This is surprising, given that the global sourcing of food produce, centralized distribution systems, and shopping by car have become prevalent in recent decades and have contributed to an increase in the distance between producer and consumer or “food miles.” In a case study the transport energy consumption is calculated for all possible ways in which dessert apples can be supplied to the UK consumer. The aim is to assess the environmental performance of the predominant fresh produce supply chains and to investigate claims that localized systems are more environmentally efficient. The main criteria used to compare the environmental efficiency in alternative food supply chains are the transport-related fossil-fuel energy consumption and associated carbon dioxide emissions. Analysis of the empirical data shows that transportation is now responsible for a considerable fraction of the total energy consumption in the life cycle of fresh apples, and in most cases exceeds the energy consumed in commercial apple cultivation. By developing local production and marketing systems for fresh products, transport demand can be reduced and many of the environmental impacts associated with existing supply chains can be avoided. The results of the study are then discussed in relation to the wider issues of transport policy, international trade, food security, and product-related environmental information for consumers.     

发展绿色产业开发有机食品

本文就有机食品这一新兴的绿色产业，从开发有机食品在实现农业产业结构调整战略中的作用、赤峰市有机食品资源现状及开发优势、开发有机食品的总体思路等方面探讨了赤峰市开发有机食品发展绿色产业的现状及前景。     

The Food Debate: Ethical versus Substantial Equivalence

Substantial equivalence (SE) has beenintroduced to assess novel foods, includinggenetically modified (GM) food, by means ofcomparison with traditional food. Besides anumber of objections concerning its scientificvalidity for risk assessment, the maindifficulty with SE is that it implies that foodcan be qualified on a purely substantial basis.SE embodies the assumption that only reductivescientific arguments are legitimate fordecision-making in public policy due to theemphasis on legal issues. However, the surge ofthe food debate clearly shows that thistechnocratic model is not accepted anymore.Food is more than physico-chemical substanceand encompasses values such as quality andethics. These values are legitimate in theirown right and require that new democraticprocesses are set up for transverse,transdisciplinary assessment in partnershipwith society. The notion of equivalence canprovide a reference scale in which to examinethe various legitimate factors involved:substance (SE), quality (QualitativeEquivalence: QE), and ethics (EthicalEquivalence: EE). QE requires that newqualitative methods of evaluation that are notbased on reductive principles are developed. EEcan provide a basis for the development of anEthical Assurance as a counterpart of QualityAssurance in the food sector. In France, asecond circle of expertise is being set up toaddress the social issues in food public policybeside classical risk assessment by the firstcircle of expertise. Since ethics is likely tobecome an organizing principle of the secondcircle, the equivalence ethical framework canprove instrumental in this context.     

Safety Assurance of Foods: Risk Management Depends on Good Science but it is not a Scientific Activity

We make many decisions in our livesand we weigh the benefits against thedrawbacks. Our decisions are based on whatbenefits are most important to us and whatdrawbacks we are willing to accept. Decisionsabout what we eat are made in the same way; butwhen it comes to safety, our decisions areusually made more carefully. Food containsnatural chemicals and it can come into contactwith many natural and artificial substancesduring harvest, production, processing, andpreparation. They include microorganisms,chemicals, either naturally present or producedby cooking, environmental contaminants, andpesticides. Since the chance of being harmed bythese potential hazards is called risk, riskanalysis might be better termed as the scienceof safety, because risk management is anessential part of it. It would, however, bedifficult and shortsighted to maintain thatquestions about risk and safety can have nomoral dimension. Risk and safety become mattersof moral concern when they raise furtherquestions about responsibility, accountability,and justifiability. The question of risk cannotbe ignored in any ethical investigation ofgenetic engineering, novel foods, animalwelfare, and individual choices. However, foodis more than metabolic fuel. It hasphysiological, psychological, social, cultural,and aesthetic associations that merge to form agestalt that people endanger and maintain. Thecontribution of any food towards anindividual's well being is as complex as theindividual himself. In this context, thebenefits of consuming food that containshazards may outweigh the risk.     

Ethical Issues Related to Food Sector Evolution in Developing Countries: About Sustainability and Equity

After a century of major technicaladvance, essentially achieved by and for theindustrialized countries, the evolution of thefood sector in southern countries should nolonger be thought of in terms of a ``headlongpursuit.'' In the present context of demographicgrowth, urbanization, poverty and disparities,environmental degradation, and globalization oftrade, new priorities have emerged, and newethical questions have been raised, mainlyrelated to sustainability and equity. Thispaper analyses these ethical concerns in thefollowing terms: can the model of food sectordevelopment initiated by the industrializedcountries be applied to the entire world on asustainable and equitable basis, given theeffects of this development with regard to theenergy consumed, the changes in dietarybehavior and related nutritional problems, thenew demands in terms of food safety, thequestions of biodiversity, ownership ofknowledge, cultural identities, gender issues,and Man's relationship to food and Nature?