Minister of fitness

Worried about obesity trends, the UK has decided to create a position called the minister of fitness in their government, and the USDA FAS reports on the development here. From the report:

According to the Department of Health, figures due out this week are set to show that, if nothing changes, there will be a significant increase in adult obesity levels in England by 2010. As an example, obesity prevalence in men is currently forecast to rise from 22 per cent in 2003 to 33 per cent in 2010. In addition to the implications for the health of the nation, the cost of dealing with obesity and the diseases it causes, which already runs into billions of pounds each year, are clearly also of concern to the government.
"What is important is that people do recognize that there are some pretty small changes that they can make in their lifestyle in terms of physical activity that can start making a big difference to their health.
"And I think that that is important, because a lot of people think that they have to go to the gym five times a week and if they can't do that, they can't do anything - and that is just not true."


TK: Initiatives both here and abroad focusing on physical activity alone should be combined with messages about the importance of eating more fruits and vegetables - and less of some the sugary foods that doom our efforts to shed pounds by taking the stairs.

Rutgers spinach report: Conclusion

From the Rutgers Food Policy Institute:


CONCLUSIONS

The results of the survey show that the FDA’s main message to consumers warning that bagged fresh spinach had been contaminated and should not be eaten was heard by most Americans. Moreover, the data clearly indicate that the majority of consumers did stop eating spinach during the recall. As a result, the main public health goal of the recall was met. However, fewer Americans were aware of important details related to the recall. Many were confused about the types of spinach affected, the organism that caused the contamination, the symptoms of the resulting illness, and perhaps most significantly, whether or not the recall had ended.


TK: As surely FDA bears some credit for the effectiveness of the recall, it must take its share of culpability for the lack of consumer knowledge about the particulars of the recall and the end of the recall.


As a result, the data suggest that there were also some unintended consequences of the recall. While most consumers stopped eating spinach as a result of the recall, the data show that many stopped buying other bagged produce as well. This is reflected in the decline in sales of spinach and other produce reported by industry. However, our data are likely to underestimate the full effect of the recall on produce sales. All of the respondents to the survey were interviewed by November 29, 2006. Soon after, on December 6, 2006, the FDA announced that it was investigating E. coli O157:H7 infections associated with multiple Taco Bell restaurants in four states. This outbreak sickened 71 people, resulting in the hospitalization of 53, and in 8 cases of hemolytic uremic syndrome by the time it was considered over on December 14, 2006. Green onions contaminated with E. coli were originally suspected as the cause of the outbreak, and were voluntarily recalled from Taco Bell restaurants; however, the FDA narrowed its investigation by focusing its efforts on finding the sources of shredded iceberg lettuce served at the restaurants. The result of two serious, widely publicized E. coli contamination incidents occurring in rapid succession has likely amplified consumer awareness and concerns about the safety of eating fresh produce. In part, this may be due to a violation of consumer expectations regarding foods such as spinach and lettuce that have typically been viewed as healthy, and are often eaten as a way of maintaining one’s personal well-being. In addition, because these types of produce are often eaten in a raw form, consumers have little ability to make the products safer once they have been purchased. Indeed, the one post-purchase action consumers can take, thoroughly washing produce, was dismissed as ineffective in the case of the spinach contamination. Most food product recalls are limited in scope and are normally issued to recover the products of a single manufacturer or distributor, and are often restricted to the food manufactured or processed at a single location, to specific lot numbers, and distributed within a circumscribed area. Thus, the broad nature of the recall, suggesting that all fresh spinach across the country should be considered as potentially contaminated and therefore unsafe to eat, combined with a message that no amount of washing would make it safe, distinguished it from the more routine advisories and notice of recalls typically issued by the FDA.

TK: What a message to try to recover from: all spinach is unsafe and no amount of washing will do you any good!


The unusual nature of the spinach recall, suggesting that anyone who ate fresh spinach was vulnerable to becoming ill, that there was little that consumers could do to avoid getting sick other than to stop eating it, and the potentially serious consequences of being infected with E.coli O157:H7 likely lead to both the extensive media coverage it received and to the large number of conversations Americans report having had about it. In addition, there remains considerable ambiguity concerning the vector responsible for the presence of the E. coli on the contaminated spinach. Although a genetic match for the particular strain of E. coli O157:H7 responsible for making some people sick was found in samples taken from a stream and from feces of cattle and wild pigs present on ranches implicated in the outbreak19, it is unlikely that investigations will ever reveal the exact mechanism by which the
spinach was contaminated and speculations about its cause continue. The fact that a definitive cause of the outbreak has not been definitively identified or remediated may help to explain the reluctance of some consumers to resume eating spinach or other produce grown in the same way, or in the same geographic areas as the contaminated spinach.

TK Another consumer frustration: no bottom line answer as to what caused outbreak, leading to mistrust.


For some consumers, the spinach recall may be a type of “signal event” indicating a wider problem that they do not yet see as having been solved. This may have been reinforced by the lack of a definitive statement by the government indicating that spinach was now “safe” to eat. Instead, the FDA issued a press release on September 22, 2006 indicating that “the public can be confident that spinach grown in the non-implicated areas can be consumed.” This also likely generated much less press coverage than the original press releases warning consumers that they should not eat any fresh spinach.Whether due to a lack of a definitive statement, lack of press coverage, or lack of attention by consumers, it is clear that many Americans did not get or believe the message that spinach is now safe to eat. As of November 2006, nearly half of those who had heard about the spinach recall were not completely confident that it had ended.

TK: FDA is in a tough spot, no doubt, but their decision to accelerate and elevate news about foodborne illness outbreaks is apparently rife with muddy communication.

In addition, only a little more than half thought it definitely true that authorities had declared that at fresh spinach available in supermarkets “safe to eat.” The ambiguity regarding the end of the recall and lack of closure to the incident may explain why, though most people say they will go back to eating spinach, many said that they would wait an average of two months before doing so. In part, this waiting period would likely be used by consumers to make sure that the contamination problem was truly over. The E. coli O157:H7 infections associated with Taco Bell restaurants occurred during this “wait and see” period likely reinforced some consumers’ beliefs that contamination problems involving produce had not yet been resolved. The fact that produce sales have not yet recovered following these outbreaks supports this speculation. Finally, while purposeful contamination was not suspected in this incident, it may be possible to draw some applicable lessons. Since the probable goal of intentional contamination is to create maximum uncertainty about the safety of the food supply, had the spinach been purposefully adulterated, the ambiguity surrounding the cause, scope, and impacts of the contamination would likely have been significantly greater. Moreover, without apprehending the perpetrators accompanied by definitive information and action designed to prevent further contamination by others, it might not be possible for the government to give an “all clear” signal that would be accepted by consumers. In the absence of such a definitive signal, consumers would likely continue to mistrust the safety of the product and would likely generalize their concerns to other
products.

TK: Collateral damage in the produce aisle: the worst of all worlds. As bad as E. coli outbreak was, a terror attacks on U.S. fresh produce would be far worse.

Moreover, the length of the “wait and see” period imposed by consumers concerned with the safety of these products would likely be considerably longer.

Rutgers Spinach report: Part VI

From the Rutgers Food Policy Institute:


Some Americans say they will avoid specific brands of spinach and spinach grown in particular regions of the country While many Americans are clearly hesitant about eating spinach again, the results indicate that some may eat spinach more selectively in the future. As part of the recall, consumers were advised to discard packages of specific brands of spinach suspected of containing contaminated product, and investigations revealed that the contaminated spinach was grown in California. When respondents who eat spinach and were aware of the recall were asked if they would avoid specific brands of spinach, 15% said that they would. Similarly, 19% reported that they would avoid spinach grown in particular areas of the country.


Coming up: Conclusion

Rutgers Spinach report: Part V

More from the Rutgers Food Policy Institute:

Most Americans say they have or will eat fresh spinach again More than four-in-ten respondents (44%) who had heard about the recall and ate spinach say they have eaten spinach since the recall ended (see Table 5). These respondents reported that it took approximately two weeks after the recall ended for them to resume eating (M= 14.50 days, SD= 12.01; Mdn= 14.00). Those who had had not yet eaten spinach since the recall said it will take an average of about two months for them to start eating fresh spinach again (M= 56.98 days, SD= 74.81; Mdn= 30.00) and their estimates ranged from one day to one year. Only 5% of those who ate spinach and heard about the recall say they will never eat fresh spinach again.

Demographics related to who is eating spinach after the recall There are important demographic differences among those people who had already begun eating spinach again as of November and those who had not. As shown in Table 6, among those who were aware of the recall and ate spinach prior to the recall, older people (χ2 (4, 502)=14.99; p<.005)and those with lower incomes (χ2 (3, 430)=20.53; p<.001) were less likely to have eaten spinach since the recall ended. Conversely, whites were more likely to have eaten spinach since the end of the recall (χ2 (2, 487)=8.65; p<.05). Education and sex were not related to eating spinach after the recall.

Rutgers Spinach report: Part IV

More from the Rutgers Food Policy Institute:


AFTER THE RECALL
Many Americans were unsure whether the recall was still in effect as of November, 2006 More than six weeks after the FDA had issued its statement on September 22, 2006,advising consumers that they could be confident in eating spinach grown outside the three counties in California that had been implicated in the E. coli contamination, more than one-tenth (13%)reported incorrectly that “the spinach recall is still in effect” (7% said this was definitely “true”`and 6% said it was “likely true”) and nearly one-fifth (18%) said they were not sure. About half
(55%) said that it was definitely “false” that the spinach recall was still in effect and 14% said that it was “likely false.” This indicates that, at the time the survey was conducted, almost half of people who were aware of the spinach recall (45%) were not confident hat the recall had ended. Many Americans think they are less likely to get sick from eating spinach now than before the recall. To examine perceptions of the threat of contracting a foodborne illness, respondents were asked
to rate the likelihood of becoming infected from eating “uncooked fresh spinach” and “a food other than spinach” using a semantic differential scale where 0 represented “not at all likely” and 10 represented “extremely likely.” As represented in Figure 4, respondents who were aware of the recall, reported their likelihood of infection from eating fresh spinach before the recall to be
relatively low (M= 2.86, SD= 2.94). Not surprisingly, respondents reported their likelihood of infection from eating fresh spinach during the recall (M= 5.09, SD= 3.24) to be significantly higher than before the recall (t(954)= -21.71, p<0.001).

Rutgers Spinach report: Part III

More from Rutgers Food Policy Institute:


Nearly all (95%) the respondents correctly reported that it was true that “bagged fresh spinach” had been recalled. However, when asked whether other types of spinach had been recalled, the percentage of incorrect and “don’t know” responses increased substantially. For example, only two-thirds (68%) knew that “loose fresh spinach” had been recalled. There is variability in the frequency of “don’t know” responses, ranging from the 3% for bagged spinach to as high as 21% for frozen spinach. Thus, not only were a significant portion of Americans wrong about what was recalled, an almost equally sizeable portion did not know whether certain types of spinach were recalled.


Many Americans thought that washing contaminated produce would make it safe to eat In their September 15, 2006 update on the outbreak of E. coli O157:H7 infections from fresh
spinach, the CDC provided general advice to consumers that they should “wash produce with clean cool running water just before eating and cut away damaged areas.” However, they also noted that “bacteria stick to produce even when it is washed, and sometimes the acteria are inside the produce11.” In addition, Robert Brackett, Director of the FDA’s Center for Food Safety and Nutrition (CFSAN), was widely quoted advising consumers to discard any spinach they had already purchased, noting that simply washing the spinach would not make it safe to eat. Perhaps it was because of this contradictory advice, or because washing food is so often a recommended action for food safety12 that there was some confusion about the role of washing in eliminating possible contaminants. Yet, whether they had heard of the recall or not, 44% of Americans thought it true that properly washing contaminated food makes food safe to eat, and nearly half (48%) reported that the spinach recall caused them to wash their food more thoroughly. However, 64% recognized that the statement, “bagged spinach marked as ‘Triple washed’ is certain not to have any E. coli” is untrue.


Some Americans chose to eat fresh spinach despite the recall One of the key messages romoted by the FDA between September 14 and 22, 2006 was that all fresh spinach should be discarded. Yet, only 64% of those who were aware of the recall said that they had heard that “during the recall, no fresh spinach was considered safe to eat.” Of particular concern from a public health perspective is that more than one-in-eight Americans (13%) who were aware of the recall and ate spinach prior to the recall report having eaten fresh spinach during the recall. Moreover, nearly three-quarters of these (74%) said that they knew about the recall when they ate it (see Figure 3). Nearly one-third (30%) of those who eat spinach and were aware of the recall say that they had fresh spinach in their homes when they first learned about it. While more than three quarters (77%) reported ultimately discarding the spinach once they learned about the recall, more than one-quarter (27%) say they consumed some or all of the spinach they had at home and 72% of these say they knew about the recall at the time they ate it.



NEXT: After the recall

Rutgers Spinach report: Part II

From Rutgers Food Policy Institute:

Most Americans first learned about the spinach recall from reports on TV Nearly three-quarters (71%) of those aware of the recall reported that they first learned about it
through television broadcasts (see Figure 2). Eight percent reported that they first heard about the recall from another person. The remainder said that they first learned about the recall from the radio, or through the newspaper or Internet.



The spinach recall was on Americans’ agenda of things to talk about While only a small portion of the population first heard about the recall from someone else, almost everyone who was aware of the spinach recall did eventually speak about it with others. More than eight-in-ten (84%) respondents who were aware of the recall said they talked with others about it. Nearly one-third (31%) reported they spoke with others about the recall “frequently” or “occasionally.” One-quarter (25%) reported they had discussed the recall “a few times” and 29% said they did so “once or twice.” Only 16% reported having never discussed the spinach recall with someone else. Most Americans were interested in stories about the recall, but passive consumers of information about it Consistent with the finding that most Americans reported having first heard about the recall through reports on television, the majority of Americans appear to have been somewhat passive consumers of information on the topic. Overall, most people (59%) indicated that they had been interested in stories about the spinach recall. But, when asked about active types of information seeking, only 44% of Americans agreed that they had “closely followed news stories about the spinach recall,” 23% agreed that they had “watched the news specifically to hear about the recall,” and 12% agreed that they had “searched on the Internet to find more information about the spinach recall.”



It is not surprising, perhaps, that those who said that they ate fresh spinach before the recall were significantly more interested in and active seekers of information about the recall. Significantly more of those who ate spinach (73%) were interested in recall stories than those who did not eat spinach before the recall (44%; χ2 (1, 1034) = 25.72, p<0.001). More than half (52%) of those who ate fresh spinach before the recall said that they had closely followed the news stories about the recall vs. only one-third (36%) of those who had not eaten spinach (χ2 (1, 1019) = 92.30, p<0.001). Significantly more of those who ate spinach before the recall (14%) than those who had not eaten spinach (9%) reported that they had searched the Internet to find information about the recall (χ2 (1, 1037) = 7.07, p<0.01). However, there were no significant differences in the percentage of people who reported having watched the news to specifically hear about the recall. Americans were not sure about the types of spinach contaminated While it is clear that the majority of Americans had heard about the recall, and reported they had heard a fair amount about it, their knowledge of many of the details of the recall was
significantly less robust. One of the key messages during the spinach recall was that consumers should not eat any fresh spinach, whether sold loose or in a bag. However, neither frozen nor canned spinach were suspected of having been contaminated and were considered safe for consumers to eat. To test the extent to which consumers paid attention to these messages, respondents who were aware of the recall were asked a series of true/false questions about whether each of four types of spinach had been recalled (see Table 3).

Rutgers spinach report

I thought Rutgers was most famous for beating my alma mater K-State in the Texas Bowl, but as it turns out they do some heavy lifting on food research topics as well. Here is the link to the Rutgers Food Policy Institute home page which shows the PDF for the spinach study.

Here are some excerpts from the study:


PRIOR TO THE SPINACH RECALL
Almost half of all Americans ate spinach prior to the recall Nearly half of Americans (48%) report that they ate fresh spinach before the recall and most also did so relatively frequently. More than one-in-five (22%) of those who said they ate fresh spinach reported that they did so “a few times a week,” 18% did so “once a week,” 29% “a few times a month,” and 14% reported eating spinach “once a month.” The remainder said they ate fresh spinach ‘a few times a year’ (14%), ‘less than a few times a year’ (2%) or ‘only a few times in their life’ (1%). Thus, most (83%) of those who ate spinach before the recall did so at least once a month, and 40% did so at least once a week. Americans with more education (B= 1.491; CI=1.332, 1.669) and higher incomes (B= 1.114; CI=1.045, 1.188) were more likely to report having eaten fresh spinach before the recall than those with less education or lower incomes. However, there were no significant differences in age, race, or gender between those who reported that they did and did not eat spinach before the recall.

DURING THE RECALL
Americans’ awareness of the spinach recall was high The majority of Americans (87%) reported they were aware of the spinach recall. More than half (56%) of Americans knew that there had been a recent food recall and were able to volunteer that it had been a recall involving spinach. An additional one-third (31%) reported being aware of the spinach recall when asked specifically if they had heard about it. Only 13% of Americans said they were unaware of the spinach recall when asked specifically about it. Moreover, as shown in Figure 1, more than half (52%) of Americans report having heard “a lot” or ”a great deal” about the spinach recall and 86% report having heard at least “a little” about it.

Americans wanted to know how the contamination happened, what was affected, and when it would be safe to eat spinach again Those who were aware of the recall were asked what questions they had when they first heard about it. The responses to this open-ended question were then categorized based on content. Table 2 shows that 446 respondents (43%) of those who had heard of the recall volunteered one or more responses and that the majority of their questions focused on how the contamination happened, what products had been affected, and when the problem might end.

Florida's limits

Citrus leaders in Florida are active on a number of fronts, including advocating for a rule in expected in April that may allow Sunshine state growers to ship to other citrus states next fall. Also, leaders are lamenting a legislative casualty that could have cost growers a chance to benefit from a federal tariff on Brazilian orange juice concentrate imports.

Despite California's freeze, Florida can't ship fresh fruit there this season. Florida's canker problems caused the USDA to slap a quarantine on Florida''s fresh shipments last August that precludes sales to 10 states and U.S. territories.
From The Ledger:

The quarantine meant Florida packinghouses could not ship fruit to 10 other states and U.S. territories with citrus production, including California, the largest market. Together they accounted for 5 percent to 7 percent of Florida fresh fruit sales in a typical year.

Don't look for Joel Nelsen and other California leaders to help out Florida in this effort. It will be a test of wills and sound science to resolve this high stakes rulemaking.

Spinach study

A Rutgers study has found lingering consumer effects from the spinach foodborne illness outbreak.

The survey showed nearly 9 out of 10 consumers said they heard about the recall, but nearly 1 in 3 said they didn't know the recall was over when the survey was taken. About 1 in 5 who were aware of the recall also stopped eating other bagged produce, and 7 percent threw out fresh produce other than spinach during the recall. More than 75 percent of respondents with spinach in their home threw it out.


Tom Stenzel of United was quoted in the AP piece.

"We need to be in front of this to maintain consumer confidence,'' said Tom Stenzel, president of the United Fresh Produce Association, a leading trade group. "Consumers need to eat fresh produce and feel safe in their choices, he said.



Look for more details about this study in this space later.