Menu labeling and food choice: A systematic review of the literature concerning the effects of menu labeling on consumer food choices

Objective: To review published literature on the impact of restaurant menu labeling on consumer food choices.^ Method: To examine all relevant studies published on the topic from 2002 to 2012.^ Results: Sixteen studies were identified as relevant and suitable for review. These studies comprised of one systematic review, one health impact assessment, and fourteen research studies conducted at restaurants, cafeterias, and laboratories. Three of ten studies conducted at restaurants and cafeterias and two of four studies conducted at laboratories found positive effects of menu labeling on consumer food choices. Conversely, the systematic review identified for this review found that five out of six studies resulted in weakly positive effects. The health impact assessment estimated positive effects; however, the results of this assessment must be cautiously interpreted since the authors used simulated data.^ Conclusion: Overall, there is insufficient evidence to provide support for the majority of the types of menu labels identified in this review on consumer food choice.^

Risk of adult-onset asthma in Mexican-American women employed in food preparation or food service

Existing literature examining the association between occupation and asthma has not been adequately powered to address this question in the food preparation or food service industries. Few studies have addressed the possible link between occupational exposure to cooking fumes and asthma. This secondary analysis of cohort study data aimed to investigate the association between adult-onset asthma and exposure to: (a) cooking fumes at work or (b) longest-held employment in food preparation or food service (e.g. waiters and waitresses, food preparation workers, non-restaurant food servers, etc.). Participants arose from a cohort of Mexican-American women residing in Houston, TX, recruited between July 2001 and June 2007. This analysis used Cox proportional-hazards regression to estimate the hazard ratio of adult-onset asthma given the exposures of interest, adjusting for age, BMI, smoking status, acculturation, and birthplace. We found a strong association between adult-onset asthma and occupational exposure to cooking fumes (hazard ratio [HR] = 1.77; 95% confidence interval [CI], 1.15, 2.72), especially in participants whose longest-held occupation was not in the food-related industry (HR = 2.12; 95% CI, 1.21, 3.60). In conclusion, adult-onset asthma is a serious public health concern for food industry workers. ^

Foodborne illness, food inspection policy and restaurants in the U.S.

Objectives. The purpose of this paper is to conduct a literature review of research relating to foodborne illness, food inspection policy, and restaurants in the United States. Aim 1: To convey the public health importance of studying restaurant food inspection policies and suggest that more research is needed in this field, Aim 2: To conduct a systematic literature review of recent literature pertaining to this subject such that future researchers can understand the: (1) Public perception and expectations of restaurant food inspection policies; (2) Arguments in favor of a grade card policy; and, conversely; (3) Reasons why inspection policies may not work. ^ Data/methods. This paper utilizes a systematic review format to review articles relating to food inspections and restaurants in the U.S. Eight articles were reviewed. ^ Results. The resulting data from the literature provides no conclusive answer as to how, when, and in what method inspection policies should be carried out. The authors do, however, put forward varying solutions as to how to fix the problem of foodborne illness outbreaks in restaurants. These solutions include the implementation of grade cards in restaurants and, conversely, a complete overhaul of the inspection policy system.^ Discussion. The literature on foodborne disease, food inspection policy, and restaurants in the U.S. is limited and varied. But, from the research that is available, we can see that two schools of thought exist. The first of these calls for the implementation of a grade card system, while the second proposes a reassessment and possible overhaul of the food inspection policy system. It is still unclear which of these methods would best slow the increase in foodborne disease transmission in the U.S.^ Conclusion. In order to arrive at solutions to the problem of foodborne disease transmission as it relates to restaurants in this country, we may need to look at literature from other countries and, subsequently, begin incremental changes in the way inspection policies are developed and enforced.^

A critical review: Why isn't "cold pasteurization" being used widespread as a method to prevent food-related illnesses as a result of the consumption of ready-to-eat, fresh fruits, and vegetables

The Centers for Disease Control estimates that foodborne diseases cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. The American public is becoming more health conscious and there has been an increase in the dietary intake of fresh fruits and vegetables. Affluence and demand for convenience has allowed consumers to opt for pre-processed packaged fresh fruits and vegetables. These pre-processed foods are considered Ready-to-Eat. They have many of the advantages of fresh produce without the inconvenience of processing at home. After seeing a decline in food-related illnesses between 1996 and 2004, due to an improvement in meat and poultry safety, tainted produce has tilted the numbers back. This has resulted in none of the Healthy People 2010 targets for food-related illness reduction being reached. Irradiation has been shown to be effective in eliminating many of the foodborne pathogens. The application of irradiation as a food safety treatment has been widely endorsed by many of the major associations involved with food safety and public health. Despite these endorsements there has been very little use of this technology to date for reducing the disease burden associated with the consumption of these products. A review of the available literature since the passage of the 1996 Food Quality Protection Act was conducted on the barriers to implementing irradiation as a food safety process for fresh fruits and vegetables. The impediments to adopting widespread utilization of irradiation food processing as a food safety measure involve a complex array of legislative, regulatory, industry, and consumer issues. The FDA’s approval process limits the expansion of the list of foods approved for the application of irradiation as a food safety process. There is also a lack of capacity within the industry to meet the needs of a geographically dispersed industry.^

Globesity: Food marketing to children in Asia-Pacific A systematic review

Food advertising and promotion to children has been identified as one possible contributing factor to the childhood obesity pandemic. Food marketing to children in "western" society consists mainly of foods that are high in fat, sugar and salt (HFSS), such as pre-sugared breakfast cereals; sugar sweetened beverages (SSBs); confectionary; savory snacks; and fast food. Of these heavily marketed items consumption of, SSBs, savory snacks and fast foods have been found to contribute to the childhood obesity pandemic. A systematic review was conducted to determine what types of products are being promoted and what types of techniques food marketers are using to promote these foods throughout the Asia-Pacific region. The review of current literature, while not abundant, clearly showed marketing styles and content similar to those in western countries were being employed in the Asia-Pacific. Advertisements in this geographic region often took on a local flair to make them more identifiable to children and adolescents in their respective regions and countries, due to the numerous cultural and traditional differences. Children in these developing parts of the world may be just as, if not more, susceptible to these advertising techniques than their counterparts in the west.^

Legal regulation of the food industry as a public health measure

Background. The Food and Drug Administration (FDA) is an agency of the federal government that is responsible for monitoring and maintaining public health through the regulation of many industries, including food safety. Through the Nutrition Labeling and Education Act of 1990, the FDA was granted authority over the implementation and regulation of nutrition labeling on packaged foods. Many nutrients are printed on nutrition labels as well as their percent Daily Values. Research has been undertaken to examine the evidentiary basis the FDA relied upon in making its determinations regarding which nutrients to include on nutrition labels as well as their Daily Values. ^ Methods. Relevant legal policies, scientific studies, and other published literature (either in print or electronic form) were used to collect data. ^ Results. Results demonstrated that the FDA did not employ one single method in its determination of which nutrients to select for inclusion on food labels. The agency relied upon current public heath studies of that time as well as recommendations from the U.S. Surgeon General.^

Clinical trials, informed consent, & emergency medicine: A systematic literature review

Background: In the United States, the Food and Drug Administration (FDA) regulates clinical trials. These regulations address good clinical practices as well as human subject protection (FDA, 2012). One of the most important legal and ethical concerns in clinical trials is informed consent. 21 CFR 50 governs human subjects research. Part 50.24 provides an emergency research exception to the informed consent requirement. Research was conducted to determine the appropriateness of this exception, whether the benefit justifies the exception, and its public health significance.^ Methods: A systematic literature review was conducted and articles were identified from peer-reviewed journals.^ Results: There is some variance in opinions regarding the appropriateness of the exception, but the literature reviewed found the study results of these trials justified the waiver.^ Conclusion: The exception to the informed consent requirement is likely appropriate and justified in emergency research when implemented within the specified guidelines.^