Over the past century, previously underrepresented international actors have increasingly enjoyed greater access to power, based partly on growing normative commitments to democratisation and egalitarianism. That these norms can take root even in an anarchic international system shows not only how deep these commitments have become but also provides a hard test for where their limits might be. Though previous literature has investigated drivers of increased participation in international organisations, comparatively little attention has been paid to its potential effects on other sources of global governance legitimacy. We root our investigation of the potential trade-off between the participation in and efficiency of the policy-making process on recent literature, which conceptualises each as important sources of international organisations’ perceived legitimacy. We argue that while increasing participation is associated with decreasing efficiency, it is conversely associated with increasing efficiency if it can encourage new coalition building. Empirically, we find support for these trade-offs using an original dataset we created documenting the Codex Alimentarius’s policy-making process for food safety standards (the default reference the World Trade Organization uses to settle relevant trade disputes). In total, we analyse more than 500 standards developed in almost 900 standard-setting meetings documented between 1963 and 2019.

Shiga toxin-producing Escherichia coli (STEC) are zoonotic, foodborne pathogens that cause outbreaks of infectious gastrointestinal disease, including haemolytic uraemic syndrome (HUS) which can be fatal. In November 2023, a foodborne outbreak of STEC serotype O26:H11 stx2a/eae, involving 40 cases (54% female and 76% aged 0–9 years old), including 19 children with HUS. Whole-genome sequencing analysis revealed the outbreak strain was multidrug resistant and likely originated from outside the United Kingdom. Epidemiological analysis showed greatest odds of exposure among cases for consumption of a dried fruit product, predominantly in multi-packs. Batch numbers of the packs consumed by cases were rarely available, and where recorded, other packs in the same the batch were unavailable for testing; therefore, targeted microbiological testing was not possible. Fruit for drying can become contaminated when the crop is exposed to irrigation water or rainwater run off containing animal faeces. For STEC, where detection of the causative agent in food is challenging, we recommend establishing multi-source weight of evidence frameworks that promote the application of epidemiological and food chain evidence for public health action and the expansion of global surveillance networks to enhance the detection of foodborne threats at home and abroad.

With more than sixty percent of U.S. adults struggling with at least one diet-related health condition, the relationship between nutrition and public health has never been clearer. Indeed, for the first time in over a century, food has a prominent place on the national political stage and is one of the exceedingly few issues that has garnered bipartisan support. The recent rise in popularity of “Food Is Medicine” initiatives, which seek to provide medically tailored or healthy meals to vulnerable populations, underscores the critical importance of food to public health. Yet, while “Food Is Medicine” is shifting the insurance, business, and nutritional landscape, the Food and Drug Administration (“FDA”) — the primary regulator in charge of both food and drug safety — treats food as anything but medicine. Known and unknown food additives, color dyes categorically banned in other countries, chemicals leaching from paper and plastic, and environmental toxins and pathogens all contaminate our food and sicken children and adults alike. All the while, the FDA acts as if it were powerless to fulfill its mission of protecting the public from unsafe food.

In a time when the political will to reform our food system and rid it of harmful chemicals and ingredients is high, this article offers a blueprint for how to do so in a scientifically grounded, legally consistent, and lasting manner. Starting from the basic premise that food can be medicine, the article explores ways to bring food safety review closer to the much more demanding safety process for pharmaceuticals. Part I defends the premise that food is every bit as important to human health as medicine — both for good and for ill — and posits that food safety should be regulated just as much as (even if not in identical ways to) the safety of medical drugs. Parts II and III offer a comparison between the rigors of drug safety review, albeit with its own set of problems, and the laxity and at times utter lack of food safety review. Finally, Part IV advances a comprehensive package of both legislative and regulatory reforms, all designed to shift the de facto burden of proving the safety of food ingredients from the overtaxed FDA and the overburdened consumers to food manufacturers.

Biofilm formation is a prevalent contamination source in the dairy processing industry. It enhances the tolerance of bacterial cells and elevates the risk of product spoilage. Moreover, biofilms can present significant challenges to dairy processing equipment, thereby threatening the safety and efficiency of operations. In the dairy product processing environment, biofilms typically appear as mixed biofilms. Compared to single-species biofilms, mixed biofilms are characterized by high diversity, complex spatial distribution, strong antibiotic resistance and high adaptability to environmental conditions. Consequently, it is essential to comprehensively understand the formation mechanisms and characteristics of mixed biofilms and develop effective control strategies. This review provides an overview of the formation of common microbial biofilms and their mixed biofilms during dairy processing, describes the cellular interactions and characteristics, and finally outlines current common biofilm control measures. All of these efforts aim to provide valuable insights for reducing risks associated with mixed biofilms in the dairy environment.

Previous research has highlighted several quality-related concerns regarding food supplements available on the market, which compromise their safe consumption. This study evaluates whether the adoption of the European Pharmacopoeia (Ph. Eur.) as a framework for improving supplement quality could enhance quality and safety control practices. The findings are derived from a comparative legal analysis of the Canadian and U.S. legal systems. The results suggest that its application in the Canadian market may serve as an illustration of the Brussels effect in practice. Simultaneously, the European Food Safety Authority (EFSA) already encourages EU Food Business Operators (FBOs) to utilise the Ph. Eur. when assessing food supplement ingredients. Nevertheless, careful consideration is necessary regarding the extent of regulatory compliance by FBOs to mitigate potential conflicts with existing EU legislation and to prevent delays in innovative developments within the supplement market.

In New Zealand, Māori and Pasifika have the lowest foodborne illness notification rates (per 100,000 people) for most foodborne illnesses(1); with underreporting of illness and differing food safety practices as possible factors. New Zealand Food Safety (NZFS) is responsible for regulating the New Zealand food safety system to make sure food is safe and suitable for all New Zealanders. Supporting consumers to make informed food choices and understand safe food preparation practices is a key priority for NZFS(2). As part of this, NZFS communicates food safety advice through various traditional channels including published material and campaigns.To better understand consumer attitudes, knowledge and behaviours around food safety and suitability, NZFS conducted an online survey of 1602 New Zealanders 15 years and over between 24 November and 17 December 2023. The survey used a quota sampling method and included booster samples for Māori and Pasifika. The margin of error was ±2.9% at a 95% confidence interval. The survey was available in English and Te Reo Māori.(3). The study highlighted key insights into food safety practices for Māori and Pasifika. For example, NZFS advises consumers not to wash raw chicken due to the potential for cross-contamination during food preparation. In the survey(3), we found that 67% of consumers who prepare chicken said they washed it either sometimes or always; further, 79% of consumers who prepare chicken believe they should. The most common reason for washing raw chicken was because of hygiene (23%). Even though NZFS messaging is clear to not wash raw chicken, it is concerning that the advice is not adhered to, and the risks are not recognised. In the survey, Pasifika who prepare chicken were more likely to say they wash raw chicken either sometimes or always (79% of Pasifika). As a food safety regulator, it is important to understand our Māori and Pasifika consumers and their perceptions, knowledge and behaviours around food safety practices, but also to consider how we can communicate effectively with them. For example, of the food safety information sources most trusted, Māori were more likely to trust friends, family and or whanau (49%), and Pasifika were most likely to trust health professionals (53%)(3). With a view of trying to better understand our Māori and Pasifika consumers models such as Te Whare Tapa Wha(4) (the Māori Health Model) provide an important and holistic view of health-based concepts of taha whanau (family and social wellbeing), taha tinana (physical wellbeing), taha hinengaro (mental and emotional wellbeing) and taha wairua (spiritual wellbeing). There are opportunities for NZFS to reflect on and use Te Whare Tapa Wha throughout the survey development and implementation process, through to the delivery of targeted food safety messages.

The objective of the food safety system is to provide safe and suitable food in New Zealand(1). This is of particular importance for our youngest members– infants and young children. During the first 2000 days of life, food and nutrition have crucial roles. Nutrient requirements are high, and children often have an increased vulnerability to hazards associated with chemical and microbiological contamination. Foods targeted to this age group typically have strict regulations, as the quality and safety of foods for infants and young children is of great concern to caregivers, public health authorities and regulatory bodies worldwide. The recent First Foods New Zealand Study (FFNZ) and Young Foods New Zealand (YFNZ) Study have provided important data into what, and how, we feed our infants and young children under four years of age(2). Insights from the dietary intakes and health of 925 infants and young children from these studies are being used by NZFS to inform its work on food monitoring surveillance and food policy. Currently New Zealand Food Safety (NZFS) is conducting the 2024 New Zealand Total Diet Study (NZTDS) (Infants and Toddlers)(3). The NZTDS is a food monitoring and surveillance programme which aims to evaluate the risk to New Zealanders from exposure to certain chemicals such as agricultural chemicals, contaminants (including from food packaging), and nutrients. The 2024 NZTDS will, for the first time, focus exclusively on infants and young children. The FFNZ and YFNZ studies informed the selection of 117 foods to be tested from four New Zealand regions throughout 2024/2025. The dietary intake data will then be used to estimate the dietary exposure to each of the 362 chemicals analysed. This monitoring programme informs policy decision-making and food standard setting and provides assurance on the safety of our food supply. Concerns around the nutrient quality and labelling of some commercial products for infants and young children have been identified in Australia and New Zealand. Within the joint food regulatory system, consultation is underway to consider regulatory and non-regulatory options for improving commercial foods for infants and young children(4). This presentation will discuss NZFS’s role in monitoring foods and diets of infants and young children in Aotearoa New Zealand, the importance of, and application of evidence to inform policy, food safety, and potential regulatory and non-regulatory options to ensure that the food safety system continues to deliver safe and suitable food in New Zealand.

Human toxocariasis is a worldwide parasitic disease caused by zoonotic roundworms of the genus Toxocara, which can cause blindness and epilepsy. The aim of this study was to estimate the risk of food-borne transmission of Toxocara spp. to humans in the UK by developing mathematical models created in a Bayesian framework. Parameter estimation was based on published experimental studies and field data from southern England, with qPCR Cq values used as a measure of eggs in spinach portions and ELISA optical density data as an indirect measure of larvae in meat portions. The average human risk of Toxocara spp. infection, per portion consumed, was estimated as 0.016% (95% CI: 0.000–0.100%) for unwashed leafy vegetables and 0.172% (95% CI: 0.000–0.400%) for undercooked meat. The average proportion of meat portions estimated positive for Toxocara spp. larvae was 0.841% (95% CI: 0.300–1.400%), compared to 0.036% (95% CI: 0.000–0.200%) of spinach portions containing larvated Toxocara spp. eggs. Overall, the models estimated a low risk of infection with Toxocara spp. by consuming these foods. However, given the potentially severe human health consequences of toxocariasis, intervention strategies to reduce environmental contamination with Toxocara spp. eggs and correct food preparation are advised.

The objective of this study was to explore the knowledge and attitudes regarding seafood safety and consumption, along with preferences and environmental issues in coastal Bangladesh. A cross-sectional, consumer-based survey was conducted in Bangladesh from September to November 2023, targeting 1100 participants aged 18 years and older across seven coastal districts. Convenience sampling and in-person interviews were used for the data collection. The average knowledge and attitude scores toward seafood safety and consumption were 48.2% and 63.5%, respectively. Several factors influenced seafood safety and consumption knowledge, including age, education level, family size, religion, and residence in coastal areas (all P < 0.05). In contrast, attitudes toward seafood safety and consumption were shaped by education level, family size, employment status, seafood allergies, and history of seafood poisoning (all P < 0.05). The most commonly consumed seafood was rupchanda, followed by shrimp. Most participants consumed seafood for its health benefits, with no significant seasonal impact on seafood consumption. Overfishing and climate change were recognised as the most alarming environmental dangers identified by the participants. Coastal communities in Bangladesh have demonstrated moderate attitudes, but relatively low knowledge of seafood safety and consumption. Targeted educational programmes, including community workshops on safe handling and storage, school-based programmes on marine conservation, and digital campaigns via SMS/social media, are needed to improve seafood safety knowledge, while promoting sustainable consumption practices is crucial for addressing environmental concerns like overfishing. Additionally, improving market accessibility and highlighting the health advantages of seafood can drive more informed and healthier consumption choices.

Foodborne illnesses are costly to society and have been associated with local produce. The affordable “3-step wash” cleaning procedure was designed to reduce pathogens on produce. We estimate consumer willingness to pay (WTP) for food safety (i.e. 3-step washed), prepackage, and sales location attributes in locally grown produce (e.g., lettuce). On average, consumers are willing to pay $1.46 more for 3-step washed and $0.30 more for prepackaged lettuce. Additionally, consumers are willing to pay $0.16 more for fresh produce sold in natural stores and farmers markets compared to supermarkets, but $0.22 less for produce sold in other direct-to-consumer locations such as roadside stands. Higher WTP for the food safety attribute is associated with consumers who have greater risk aversion, less knowledge of foodborne illness, and stricter food safety cleaning and handling practices. Consumers highly concerned about foodborne risks also show higher WTP for both food safety and prepackage attributes. These findings can guide local farmers in making decisions about adopting pathogen-reduction cleaning procedures, selecting sales locations, and developing effective marketing strategies.

Perfluorinated compounds (PFCs) are synthetic chemicals commonly used in various industries for their water-, grease-, and stain-repellent properties. These compounds are highly persistent in the environment and can be absorbed by farm animals, subsequently contaminating animal-derived products. This contamination poses a significant health risk to humans who consume these products. Previous studies have identified cow's milk as one of the primary animal products contaminated with PFCs. However, it remains unclear which specific PFCs increase in concentrations over time. In this study, we analysed data on the concentrations of 24 PFCs in cow's milk sourced from a milk processing plant in Taiyuan, Shanxi Province, China, over a three-year period, as provided by the National Agriculture Science Data Centre. Our analysis revealed that perfluoropentanoic acid (PFPeA) and perfluorobutanoic acid (PFBA) were the dominant PFCs that tended to accumulate in cow's milk over time. Consequently, consumers and milk producers should monitor the levels of PFPeA and PFBA in cow's milk to mitigate potential health risks associated with these pollutants.

This article draws on fieldwork among patients pursuing healing using macrobiotic diets at a Buddhist temple clinic not far from Ho Chi Minh City, Vietnam. It examines the (re-)emergence of macrobiotic diets as a movement for “nurturing life” (duõng sinh) in modeern Vietnam. By examining the use of macrobiotic diets among this temple's patients and followers, the article unravels popular discourses of food and health, and their intertwining relationships with conceptions of chronic diseases in contemporary Vietnamese society. The popularity of this temple as an alternative therapeutic centre for people with chronic conditions also sheds light on notions of illness, healing processes, and religious beliefs. The rise of macrobiotics as an alternative diet and lifestyle reveals people's uncertainties and mistrust amid many prevalent problems in contemporary Vietnam, such as food safety concerns. Altogether, “nurturing life” activities offer strategies for individuals to adapt to a rapidly changing social context.

The incredible growth of China's cattle, sheep and dairy production is a visible phenomenon of the past twenty years, but its foundations were laid decades earlier. Seeking to industrialize its hinterland, and exploit its vast wealth of grazing livestock, China created slaughtering and processing facilities across its northern grasslands during the 1950s. Since the 1980s, much of this infrastructure has been privatized by companies which, like their predecessors, seek efficiency through economies of scale. Brutal competition over price and constant arrival of new domestic and foreign players have encouraged the integration of processing chains, but also sidelined small operators, and created gaps in safety best epitomized by the 2008 tainted milk scandal. Despite steps taken to “green” the production chain, it remains to be seen if such gaps have been adequately filled.

We study the impact of endowments and expectations on reference point formation and measure the value of food safety certification in the context of fish trading on real markets in Nigeria. In our field experiment, consumers can trade a known food item for a novel food item that is superior in terms of food safety––or vice versa. Endowments matter for reference point formation, but we also document a reverse endowment effect for a subsample of respondents. The effect of expectations about future ownership is weak and mixed. While expectations seem to affect bidding behavior for subjects “trading up” to obtain the certified food product (a marginally significant effect), it does not affect bids for subjects “trading down” to give up this novel food item. Finally, willingness to pay for safety certified food is large for our respondents—our estimate of the premium is bounded between 37 and 53% of the price of conventional, uncertified food.

The European Food Safety Authority (EFSA) provides independent scientific advice to EU risk managers on a wide range of food safety issues and communicates on existing and emerging risks in the food chain. This advice helps to protect consumers, animals and the environment. Data are essential to EFSA’s scientific assessments. EFSA collects data from various sources including scientific literature, biological and chemical monitoring programmes, as well as food consumption and composition databases. EFSA also assesses data from authorisation dossiers for regulated products submitted by the industry. To continue delivering the highest value for society, EFSA keeps abreast of new scientific, technological and societal developments. EFSA also engages in partnerships as an essential means to address the growing complexity in science and society and to better connect and integrate knowledge, data and expertise across sectors. This paper provides insights into EFSA’s data-related activities and future perspectives in the following key areas of EFSA’s 2027 strategy: one substance-one assessment, combined exposure to multiple chemicals, environmental risk assessment, new approach methodologies, antimicrobial resistance and risk–benefit assessment. EFSA’s initiatives to integrate societal insights in its risk communication are also described.

In July 2022, a genetically linked and geographically dispersed cluster of 12 cases of Shiga toxin-producing Escherichia coli (STEC) O103:H2 was detected by the UK Health Security Agency using whole genome sequencing. Review of food history questionnaires identified cheese (particularly an unpasteurized brie-style cheese) and mixed salad leaves as potential vehicles. A case–control study was conducted to investigate exposure to these products. Case food history information was collected by telephone. Controls were recruited using a market research panel and self-completed an online questionnaire. Univariable and multivariable analyses were undertaken using Firth Logistic Regression. Eleven cases and 24 controls were included in the analysis. Consumption of the brie-style cheese of interest was associated with illness (OR 57.5, 95% confidence interval: 3.10–1,060). Concurrently, the production of the brie-style cheese was investigated. Microbiological sample results for the cheese products and implicated dairy herd did not identify the outbreak strain, but did identify the presence of stx genes and STEC, respectively. Together, epidemiological, microbiological, and environmental investigations provided evidence that the brie-style cheese was the vehicle for this outbreak. Production of unpasteurized dairy products was suspended by the business operator, and a review of practices was performed.