What About Those Additives?

When was the last time you actually read a food label?  Not just the nutritional content label, but the list of ingredients?  It's a bit daunting to do so, even if you have abundant experience in chemistry and may really know what some of those things are.  What's become clear over the years is that some of additives in foods are not the best things to consume from a health standpoint; I'm thinking red dye #2, implicated in cancer and banned by the FDA in the late 1970s.  Today, however, you can't count on the FDA to have much say over what's in your food, as Rick and I reveal on PodMed this week, but you know who you can count on?  The manufacturers of said food, as described in a JAMA Internal Medicine study we discuss.   And it's my belief that's a lot like turning the fox loose in the henhouse.

Food manufacturers are empowered by the FDA to determine whether food additives fall into a category known as 'generally recognized as safe' or GRAS. Although the makers are not required to provide the agency with notification of a GRAS determination sometimes they voluntarily do so.  The authors of this study utilized Institute of Medicine criteria on conflict of interest to analyze 451 GRAS notifications provided to the FDA between 1997 and 2012.

The majority of GRAS determinations were made by an expert panel selected by a consulting firm or the manufacturer themselves (64.3%).  Almost a quarter of the determinations (22.4%) were made by an employee of the manufacturing firm (!) and the remainder by an employee of a consulting firm selected by the manufacturer.  Yikes.  Seems like a situation ripe for conflict of interest to me.

A 2011 review cited in this paper states that over 10,000 additives are currently allowed in foods, of which 43% have had a GRAS determination.  The federal Government Accounting Office (GAO) looked  at this issue of GRAS determinations in 2010 and concluded that the FDA should increase its oversight, citing a need for reducing the potential for conflicts of interest and also calling for substantiation of GRAS determinations to the FDA.

Disturbingly, this paper found that when IOM criteria were applied, ALL determinations of GRAS were suspect.  The problem is somewhat academic, of course, because no specific circumstances of food additives that were determined as GRAS by a manufacturer have been subsequently shown to be harmful, and as I point out in the podcast, food makers are not fond of lawsuits and are therefore vested in at least the appearance of safety and concern for public health.  Even so, the opinion of the authors and one with which Rick and I concur is that objective measures should be developed and employed so that the potential for conflict of interest is essentially eliminated, and if that takes a mandate for more oversight by the FDA, okay.  Let's provide them with the resources and let them do the regulation.

Other topics this week include the burden of peripheral arterial disease (PAD) worldwide in the Lancet, glucose levels and dementia in NEJM, and self monitoring of blood pressure in Annals of Internal Medicine.  Until next week, y'all live well.

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What About Those Additives? | jhublogs
August 12, 2013 at 1:10 pm

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