A Science-Based Framework for Diet-Related Disease Risk

As global rates of diet-related chronic diseases continue to rise, the debate over how foods contribute to health risks is intensifying. Questions surrounding ultra-processed foods (UPFs), dietary patterns, and nutrition policy have become increasingly prominent in public health discussions around the world.

Against that backdrop, IFT has submitted a new scientific work proposal to Codex Alimentarius that aims to establish a science-based framework for evaluating how foods may contribute to diet-related noncommunicable diseases. Titled “Proposed Guidance on Risk Analysis Approaches for Diet-Related Non-communicable Diseases,” the proposal was submitted on June 1 and is now seeking sponsorship from a Codex member country to advance through the Codex process.

Rosemary Walzem, professor at Texas A&M University and IFT's Codex Team Leader for the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU), recently shared her thoughts on the proposal, its potential impact, and why it could help shape future global nutrition policy.

IFT submitted a new work proposal to Codex called “Proposed Guidance on Risk Analysis Approaches for Diet-Related Non-communicable Diseases.” Can you tell us more about this proposal and how the idea behind this work proposal came about?

For several years, diet-related chronic diseases like diabetes, cardiovascular disease, and obesity have been increasing and are plaguing the world. As countries look for ways that we can reduce these chronic diseases, the focus on how certain kinds of foods contribute to the disease risk has increased. Specifically, UPFs are being increasingly connected to chronic diseases with many identifying any food labeled UPF as being unhealthy. But UPF is a very vague term, so last year, the World Health Organization officially announced that they're going to start working on a UPF definition. (See IFT comments on WHO Guideline Development Group for UPFs.) While a UPF definition would be helpful, it would not encompass the range of variables that should be considered when evaluating the potential risk of some foods.

Codex already has very well-developed approaches to risk analysis for a variety of food-related concerns, such as microbes and chemical safety. In fact, going back to 1995, the CCNFSDU started adopting those methods to deal with nutritional risk analysis. Initially, it was vitamin deficiencies and mineral deficiencies, but then they started developing methods for doing risk analysis related to chronic diet-dependent disease for specific nutrients, such as sodium and saturated fat. There are now rules about sodium and saturated fat currently within Codex texts.

Building off this expertise, our team at IFT developed a proposal to expand the risk analysis expertise of Codex to food categories in such a way as to take in more than the individual nutrient content of foods to assess their risk of promoting diet-related chronic disease within the context of a dietary pattern of intake. This proposal builds on the strength of Codex in terms of their ability to do detailed risk analysis to capture multiple dimensions of individual foods.

Building on Codex's prior approaches, strengths, and definitions, this proposal would be a way that Codex could practically develop a framework to identify which foods are promoting chronic disease risk from those that are not, independent of just saying they were made in a factory as opposed to on your kitchen stove.

Codex work proposals typically come from a country, not an association. What inspired IFT to take this unusual route?

Usually, countries are the ones that propose new work, but it is not unheard of for observer organizations with specific expertise to suggest new work or work with a country to help move a proposal forward. Still, an observer-proposed item will not be taken up by the committee unless a country sees its value and agrees to sponsor it, so ultimately, we will need a country sponsor. We see this proposal as a very pragmatic way to really drill down and better understand what it is about certain foods that may contribute to disease risk—or, just as importantly, what does not. Because this is a topic with a lot of emotion, input, and even politics behind it across different countries, we felt it was important for a scientific observer organization to help guide and lead the proposal.

Why should a country throw its support behind this work proposal?

One of the main goals of Codex is to help prevent unnecessary trade barriers. Countries can use trade barriers to exert power, and that can limit access to needed food products, add costs, and slow economic growth when foods cannot move easily across borders. I think the strongest reason for a country to support this proposal is that it offers a practical path toward a shared, science-based approach. The final guidance would be developed by the Codex committee, not by IFT alone, but the goal is to help countries evaluate foods using a consistent global standard. That kind of common framework can support public health while also helping avoid trade barriers.

Other food classification systems currently exist or are in development. Would this be an alternative?

I see this as complementary. It builds on food categories that Codex has already defined and countries have already agreed to, but it would adapt those categories for estimating diet-related disease risk. Codex already uses food categories to look at different kinds of risk, including microbial risks for food safety, chemical risks, and risks related to specific nutrient deficiencies, such as vitamins and minerals. So, the basic structure is already there. The categories are highly detailed and may need some adaptation, including the description of new risk variables and methods to assess their risk, but this proposal would not replace what countries are already using. It would give them another science-based tool to use alongside their own systems.

Why is this work proposal so important to ensuring a healthier and more nutritious future for all?

We want to make sure people have enough food, but we also want that food to be nutritious and supportive of long-term health. One of the best outcomes of this work, if the committee takes it up, is that it could encourage deeper research into how foods interact with our bodies, both in ways that support health and in ways that may contribute to disease. That research can give food scientists, food technologists, and food processors clearer targets for improving product quality and developing foods that better support long-term health. Over time, that could also help reduce the health costs associated with diet-related chronic diseases. Most importantly, it would give us a more consistent and systematic way to understand which foods are beneficial, which may be problematic, and how we can make food better for everyone.

If someone wants to get involved, what would they have to do?

I would encourage anyone interested to reach out to IFT Codex Coordinator Steve Havlik (shavlik@ift.org). Being an IFT member and volunteer has given me a way to elevate the science I care so deeply about in a global forum like Codex, and I would love to see more food scientists bring their expertise into this work. Engagement does not have to happen only through Codex. There are many ways to get involved through IFT divisions, volunteer groups, and other opportunities where your expertise can make a difference.

Join The Community Conversation

IFT will host an interactive Community Conversation at 12 p.m. CT on Wednesday, July 29, inviting those who are interested in the topic to share their thoughts on the Codex proposal on risk analysis and diet-related diseases. The conversation is free and open to the public.  

Register

Understanding Codex

For background on Codex Alimentarius and IFT's role as a scientific observer, read “What Is Codex Alimentarius and Why Does It Matter?”

IFT Comments:

• New Work Proposal
• New Work Prioritization Rating
• Food Category Risk Analysis
• Codex Reference Documents
• Food Category System
• Discussion Paper