Jennifer L. Pomeranz is with the Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, NY. Emily M. Broad Leib is with the Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, MA. Dariush Mozaffarian is with the Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA and the Tufts School of Medicine and Division of Cardiology, Tufts Medical Center, Boston, MA.
Am J Public Health. 2024 Oct;114(10):1061-1070. doi: 10.2105/AJPH.2024.307755. Epub 2024 Aug 8.
The US food supply is increasingly associated with diet-related diseases, toxicity, cancer, and other health harms. These public health concerns are partly attributable to a loophole in federal law. The Food and Drug Administration (FDA) evaluates the premarket safety of ingredients regulated as food additives but allows the food industry to self-regulate and determine which substances to classify as generally recognized as safe (GRAS) based on undisclosed data and conclusions that the FDA never sees. Furthermore, the FDA lacks a formal approach for reviewing food additives and GRAS substances already found in the food supply. Substances in the food supply thus include innocuous ingredients (e.g., black pepper), those that are harmful at high levels (e.g., salt), those that are of questionable safety (e.g., potassium bromate), and those that are unknown to the FDA and the public. A recent court decision codified these gaps in the FDA's current approach, leaving states to try to fill the regulatory void. The FDA and Congress should consider several policy options to ensure that the FDA is meeting its mission to ensure a safe food supply. (. 2024;114(10):1061-1070. https://doi.org/10.2105/AJPH.2024.307755).
美国的食物供应与饮食相关的疾病、毒性、癌症和其他健康危害越来越相关。这些公共卫生问题部分归因于联邦法律的一个漏洞。美国食品和药物管理局 (FDA) 评估作为食品添加剂监管的成分的上市前安全性,但允许食品行业自行监管,并根据 FDA 从未见过的未公开数据和结论,自行决定将哪些物质归类为“一般认为安全” (GRAS)。此外,FDA 缺乏审查已在食品供应中发现的食品添加剂和 GRAS 物质的正式方法。因此,食品供应中的物质包括无害成分(例如黑胡椒)、在高浓度下有害的成分(例如盐)、安全性存在疑问的成分(例如溴酸钾)以及 FDA 和公众都不了解的成分。最近的一项法院裁决将 FDA 当前方法中的这些差距编纂成法规,这使得各州不得不试图填补监管空白。FDA 和国会应该考虑几种政策选择,以确保 FDA 能够履行其确保食品安全供应的使命。(doi:10.2105/AJPH.2024.307755)。