Food safety for the 21st century.

THROUGHOUT HISTORY, HUMAN HEALTH HAS DEpended on food supply. Recognition that food can pose a major threat to human health is also centuries old. Federal regulation to reduce food contamination in the United States began in the early 20th century, with the adoption of the Pure Food and Drug Act and the Meat Inspection Act of 1906 that regulated food purity and required content disclosure. Since then, additional regulatory measures and industrial improvements have further reduced contamination, although food-borne pathogens still cause the deaths of 5000 individuals a year in the United States. But the most rapidly growing food-related threat to health today is not microbes, but overconsumption of calories, sugar, salt, and unhealthy fat. In the United States, nearly a third of adults are obese, a proportion that has doubled in 20 years. Unhealthy diet and physical inactivity are second only to tobacco as underlying causes of death. Overweight and obesity currently account for more than 1 in 6 cancer deaths in the United States. Globally, the 10 leading underlying causes of disabilityadjusted life-years lost include high blood pressure (which is in large part diet-related), overweight, high cholesterol, and low intake of fruits and vegetables. Echoing the public outcry about food sanitation a century ago, there is increasing public distrust of food and the food industry, evidenced by books and films such as Fast Food Nation and Supersize Me. However, governments have been slow to use effective public policy to protect citizens from diet-related chronic diseases. Instead, efforts to promote healthy eating have generally been limited to guidelines and education, which are relatively weak interventions. To have a substantial effect on diet-related health problems, as did public health measures in response to microbial threats, stronger actions are needed.