is america at risk? - jones & bartlett learning and nutrition at risk in americatakes a...

CHAPTER 1

IS AMERICA AT RISK?

Sari Edelstein, PhD, RD

Chapter ObjectivesAfter reading the chapter and reflecting on the contents, you shouldbe able to:

1. Identify the concern for food safety and the presence of food-borne illness in the United States.

2. Articulate an understanding of the term “biotechnology” as itrelates to genetically modified food.

3. Determine that food insecurity is a growing problem in theUnited States.

4. Recognize that the threat of agroterrorism/bioterrorism existsin the United States

Key Termsagroterrorism: Includes purposeful adulteration/poisoning of agri-

cultural crops and the food supply to cause illness or death.biotechnology: Includes a gene slicing technique that enables sci-

entists to insert genes into foods for the purpose of dealing withthe environmental stresses the world now poses.

bioterrorism: Includes purposeful adulteration/poisoning of food orfood sources to cause illness or death.

food insecurity: Relates to the access to wholesome, healthy foods.food safety: The pursuit of uncontaminated, unadulterated, clean,

wholesome food that is fit for healthy consumption.foodborne illness: A disease that is carried or transmitted to people

by food. Pathogens in food can generate infection, intoxication,or intoxification.

1

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© Jones and Bartlett Publishers, LLC. NOT FOR SALE OR DISTRIBUTION.

genetically modified foods: Foods that have undergone gene slic-ing or gene replacement.

IntroductionThis book, Food and Nutrition at Risk in America: Food Insecurity,Biotechnology, Food Safety, and Bioterrorism, addresses thestrengths and weaknesses of four paramount issues in America’sstruggle to provide safe and adequate food and nutrition for allthose living within its borders. As we leap into the second decade ofthe 21st century, we find that providing US inhabitants with “safeand adequate” food has become a daunting task. So daunting, infact, that we might be on the verge of “crisis management” in ourability to protect our population from pathogens and chemicals thatinvade our food supply as well as our capability to supply enoughaffordable food to feed our people.

Food and Nutrition at Risk in America takes a four-prongedapproach to expose those areas in the food and nutrition domainthat have become increasingly vulnerable to the provision of safeand adequate food and nutrition in the United States. These fourareas of concern are: food safety, biotechnology and geneticallymodified foods, food insecurity, and agro/bioterrorism.

Food SafetyFood safety includes the pursuit of uncontaminated, unadulterated,clean, wholesome food that is fit for healthy consumption. To feedthe population safe food, the food should not cause illness uponingestion or during the hours following ingestion. In short, safefood should not cause a foodborne illness, which is a disease that iscarried or transmitted to people by food (FDA, 2006). Food safetycan be threatened by biological, chemical, or physical hazards. InSection One of this book, biological foodborne pathogens, their eti-ology, and emerging pathogens in the US food system will be high-lighted for the reader. Disease-causing pathogens in food cangenerate infection, intoxication, or intoxification for unwitting con-sumers. These illnesses can cause morbidity and mortality at alarm-

2 Chapter 1: Is America at Risk?

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ing rates. Table 1.1 indicates illness rates from biological foodborneillness in the United States.

Table 1.2 gives an account of the current dollars spent by theUnited States in three of its major governmental offices—US Depart-ment of Agriculture (USDA), US Department of Health and HumanServices (HHS), and Environmental Protection Agency (EPA)—onfood safety programs. Table 1.3 lists the percentage of respondentswho identified various pathogens as the top three causes of food-borne illnesses and the estimated percentage of US foodborne ill-nesses that were actually caused by those pathogens.

Figure 1.1 depicts the surveillance rates from 1996 to 2004 offive major foodborne illnesses, and Figure 1.2 indicates the fivetypes of Salmonella infection rates from those years.

Chemical hazards in food are linked to paint, lubricants, clean-ing agents, and pesticides while physical hazards include brokenglass, metal shavings, and plastic ties. These hazards should not beminimized in their importance of control in the food supply. Foodand Nutrition at Risk in America will focus on biological hazards asthe major source of foodborne illness in the United States.

3Food Safety

Table 1.1 Average Annual Hospitalizations and Deaths for Gastrointestinal Illnessby Diagnostic Category, National Hospital Discharge Survey, 1992 to 1996

First diagnosis All diagnoses

Cause of enteritisa Hospitalizations Deaths Hospitalizations Deaths

Bacterial (001–005, 27,987 148b 54,953 1,139008–008.5)

Viral (008.6–008.8) 82,149 0b 132,332 194b

Parasitic (006–007) 2,806 82b 5,799 127b

Unknown etiology 186,537 868b 423,293 5,148(009, 558.9)

Total 299,479 1,098 616,377 6,608

aICD-9-CM code. bEstimate unreliable due to small sample size.

Source: Mead, P.S., Slutsker, L., Dietz, V., McCaig, L.F., Bresee, J.S., Shapiro C., et al. (1999).Food-related illness and death in the United States. Emerging Infectious Diseases Newsletter,Vol. 5, No. 5. Retrieved October 12, 2007, from http://www.cdc.gov/ncidod/eid/vol5no5/mead.htm.

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Biotechnology and Genetically Modified FoodsBiotechnology includes a gene slicing technique that enables scien-tists to insert genes into foods for the purpose of dealing with theenvironmental stresses the world now poses (Bren, 2003). Figure 1.3illustrates gene slicing. The result is a genetically modified food thatshould be better able to withstand environmental stresses and pro-vide people with higher quality and quantity of food. More than 50genetically modified food products have been evaluated by the FDAand were found to be as safe as conventional foods, including canolaoil, corn, cottonseed oil, papaya, potatoes, soybeans, squash, sugarbeets, sweet corn, and tomatoes. Figure 1.4 depicts the percentage of

5Biotechnology and Genetically Modified Foods

Table 1.3 Percentage of Respondents Identifying Each Pathogen as among the TopThree Causes of Foodborne Illness and Estimated Percentage of Foodborne Illnessesin the United States Actually Caused by Those Pathogens

Percentage of Estimated percentage of respondents listing it foodborne illness in United

Pathogen among top three causes States caused by pathogen

Salmonella 90 9.7Escherichia coli 56 1.3Staphylococcus 36 1.3Shigella 32 0.6Campylobacter 18 14.2Listeria 16 �0.1Hepatitis A virus 8 �0.1Clostridium 8 1.8

perfringensNorwalk-like virus 5 66.7Virusesa 4 67.2Giardia lamblia 3 1.4Streptococcus 2 0.4

aThis represents respondents who wrote in “viruses” only; it does not include thosewho specified Norwalk-like virus.

Source: Jones, T.F., & Gerber, D.E. (2001). Perceived etiology of foodborne illness amongpublic health personnel. Emerging Infectious Diseases Newsletter, Vol. 7, No. 5. RetrievedOctober 12, 2007, from http://www.cdc.gov/ncidod/eid/vol7no5/jones.htm.

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genetically modified soybeans, corn, and cotton that now exist inour crop supply.

Food InsecurityFood insecurity encompasses many categories of persons within theUnited States, which include those who are food insecure withouthunger and food insecure with hunger. Chapter 6 gives insight tothe differences between these terms and how they are determined inthe United States. As of 2002, the USDA reports that some 11% ofUS households experienced food insecurity (Nord, Andrews, & Carl-son, 2002). This is a rise from past years and represents a threat toUS health. Figure 1.5 depicts the percentage of food insecurity bytype in the United States.


Source: CDC. (2005). Preliminary FoodNet data on the incidence of infection with pathogenstransmitted commonly through food—10 sites, United States, 2004. (MMWR, Vol. 54, No. 14,pp. 352–356.) Retrieved September 20, 2007, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5414a2.htm#tab.

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FIGURE 1.1 Relative Rates Compared with 1996 to 1998 Baseline Periodof Laboratory-Diagnosed Cases of Infection with Campylobacter, Escherichiacoli O157, Listeria, Salmonella, and Vibrio, by Year—Foodborne DiseasesActive Surveillance Network, United States, 1996 to 2004

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Food and Nutrition at Risk in America will delineate some solu-tions for food insecurity through federal, state, and communityassistance programs. While these programs are vital to the health ofthe US people, cost and cause must be analyzed further.

Agro/BioterrorismAgro/bioterrorism includes purposeful adulteration/poisoning offood to cause illness or death. Although acts of aggression againstthe US food supply are not new, 9/11 made the potential a possiblereality both within the United States and from outside perpetrators.The United States established the Bioterrorism Act of 2002 to delin-eate where threats would occur and our preparedness (USDA, 2002).

7Agro/Bioterrorism

JavianaNewportHeidelbergEnteritidisTyphimurium

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Source: CDC. (2005). Preliminary FoodNet data on the incidence of infection with pathogenstransmitted commonly through food—10 Sites, United States, 2004. (MMWR, Vol. 54, No. 14,pp. 352–356.) Retrieved September 20, 2007, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5414a2.htm#tab.

FIGURE 1.2 Relative Rates Compared with 1996 to 1998 Baseline Period ofLaboratory-Diagnosed Cases of Infection with the Five Most Commonly IsolatedSalmonella Serotypes, by Year—Foodborne Diseases Active SurveillanceNetwork, United States, 1996 to 2004

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The act includes the following five titles and can be found in com-plete form at http://www.fda.gov/oc/bioterrorism/PL107-188.html:

Title I—National Preparedness for Bioterrorism and Other PublicHealth Emergencies

Title II—Enhancing Controls on Dangerous Biological Agentsand Toxins

Title III—Protecting Safety and Security of Food and DrugSupply


Source: Bren, L. (2003). Genetic engineering: The future of foods? FDA Consumer Magazine,November–December. Retrieved October 12, 2007, from http://www.fda.gov/fdac/features/2003/plantDNA.html.

FIGURE 1.3 Traditional Plant Breeding and Modern Plant Breeding(Genetic Engineering)

Traditional PlantBreeding

A chromosome contains thousands of genes. Traditional plantbreeding combines many genes at once.

Traditional Donor Recipient Variety New Variety(many genes are transferred)

Desired Gene

�(crosses)

�

Desired Gene

DN

A

Using traditional genetic modification methods, such as cross-fertilization, scientists canproduce a desired trait, such as a hardier plant. But in doing so, they mix thousands of genes,requiring many attempts over many years to remove the unwanted traits that occur.

Newer methods of genetic modification, in the form of genetic engineering, are more preciseand predictable—and faster. By controlling the insertion of one or two genes into a plant,scientists can give it a specific new characteristic without transferring undesirable traits.

Modern Plant Breeding(genetic engineering)

Using plant biotechnology, a singlegene may be added.

Donor RecipientVariety

DesiredGene

New Variety(only desired gene is transferred)

Desired Gene

IsolateGene

�

Desired Gene

DN

A

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Title IV—Drinking Water Security and Safety Title V—Additional Provisions

In addition to the policy making of the USDA, the FDA (n.d.) isworking to prevent acts of bioterrorism through:

• working with industry to reduce threats and contain out-breaks of foodborne illness

• increasing risk-based surveillance of domestic and importedfood

• developing PrepNet food safety network• implementing the Bioterrorism Act of 2002• increasing the ability to quickly identify outbreaks of food-

borne illness• increasing participation in the first Internet-based food

safety system

9Agro/Bioterrorism

Gen

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ally

eng

inee

red

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Soybeans(81% of total

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59.7

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10

Corn(40% of total

corn crop)

Cotton(73% of totalcotton crop)

20

40

60

80

Source: Bren, L. (2003). Genetic engineering: The future of foods? FDA Consumer Magazine,November–December. Retrieved October 12, 2007, from http://www.fda.gov/fdac/features/2003/603_food.html.

FIGURE 1.4 Top Three Genetically Engineered Crops in the United States(2003)

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Food and Nutrition at Risk in America will clarify the risk for thereader as well as the state of preparedness of the United States.

Issues to Debate1. How educated do you think the public is about these topics at

the present time?2. Why do you think that the public is or is not informed about

these topics?3. How important is each of these topics? 4. Is the US government doing enough to solve the food and

nutrition problems of the country?5. Rate the importance of each topic against one another and

place them in order of importance. Explain your results.

Web SitesUS FDA/Center for Food Safety and Applied Nutritionwww.cfsan.fda.gov/

FDA’s food biotechnology Web sitewww.cfsan.fda.gov/~lrd/biotechm.html


Food insecure, 11.1%

Food insecure withouthunger, 7.6%

Food insecure withhunger, 3.5%

Food secure,88.9%

Source: Calculated by ERS using data from the December 2002Current Population Survey Food Security Supplement.

Source: Nord, M., Andrews, M., & Carlson, S. (2002). Household food security in the UnitedStates, 2002. Retrieved October 12, 2007, from www.ers.usda.gov/Publications/FANRR35/.

FIGURE 1.5 US Households by Security Status, 2002

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List of bioengineered foods that have completed FDA consultationwww.cfsan.fda.gov

USDA’s report on household food securitywww.ers.usda.gov/Publications/FANRR35/

Bioterrorism and food safetywww.foodsafety.gov/~fsg/bioterr.html

Bioterrorism Act of 2002http://www.fda.gov/oc/bioterrorism/PL107-188.html

FDA’s role in bioterrorismhttp://www.fda.gov/oc/bioterrorism/role.html

US Department of Agriculture Food Safety and Inspection Servicehttp://www.fsis.usda.gov/PDF/Food_Defense_Plan.pdf

ReferencesBren, L. (2003). Genetic engineering: The future of foods? FDA Consumer

Magazine, November–December. Retrieved October 12, 2007, fromhttp://www.fda.gov/fdac/features/2003/603_food.html

Food and Drug Administration. (n.d.). FDA’s counterterrorism role. RetrievedOctober 12, 2007, from http://www.fda.gov/oc/bioterrorism/role.html

Food and Drug Administration, Center for Food Safety and Applied Nutri-tion. (2006, April 25). Foodborne pathogenic microorganisms and naturaltoxins handbook (Bad bug book). Retrieved September 20, 2007, fromhttp://vm.cfsan.fda.gov/~mow/intro.html

Nord, M., Andrews, M., & Carlson, S. (2002). Household food security in theUnited States, 2002. Retrieved October 12, 2007, from www.ers.usda.gov/Publications/FANRR35/

USDA. (2002). Bioterrorism act of 2002. Retrieved October 12, 2007, fromhttp://www.fda.gov/oc/bioterrorism/PL107-188.html

11References

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