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Top health issues of 2008 | Health & Fitness | Reuters

By Terri Coles

If 2007 was the year of the toy recall and mental gymnastics over what we eat, then what will 2008 hold? Raw milk, melting fat, the end of cheap food... the crystal ball is still a little cloudy but here are some of the stories to watch.

1. Raw Milk

People will go to extreme lengths to get it, farmers will risk their businesses to sell it, and most state governments want nothing to do with legalizing it. Raw milk -- milk that hasn't been pasteurized or homogenized -- was one of the most talked-about foods of the year.

Its fans say that pasteurization removes proteins, enzymes and healthy bacteria from milk, making it less nutritious, and that the taste of raw milk is incomparable. Those opposed to raw milk consumption -- including health agencies like the Centers for Disease Control -- argue that the harmful bacteria are of primary concern, and that the dangers posed by E. coli, salmonella and listeria are not worth the risk.

The debate is sure to continue in 2008 as raw milk goes mainstream, governments try to make it unappealing and people find more creative ways to get their hands on it.

2. Melting Fat

It sounds too good to be true: a non-surgical cosmetic treatment that can melt away fat. The verdict is still out on whether or not it is. Mesotherapy treatments like LipoDissolve involve the injection of a customized chemical cocktail just under the skin, with the aim of reducing fat by causing the cells to explode and be released through feces and urine. But the treatments are not approved by the Food and Drug Administration (FDA) for this use, which also means they aren't standardized.

They were outlawed in Kansas this year, with the exception of clinical trials, though the state then decided to regulate use of the injections instead. They are not allowed in Canada or Brazil. St. Louis-based fat-injection chain Fig recently filed for bankruptcy, but the FDA is studying the treatment's safety and effectiveness, with results expected this year.

An investigation by Allure magazine charged that the injections constitute "human experimentation" and featured interviews from patients who say they experienced serious side effects, such as swelling, numbness and nodule formation, from the treatments. The American Society for Aesthetic Plastic Surgery has warned against them. But rumors about celebrities slimming down quickly with fat-melting injections will likely keep interest high while the wait for the FDA's results continues.

3. Food and Farm Bill

The 2007 Food and Farm Bill narrowly avoided becoming the 2008 Food and Farm Bill, and it passed so late in this year that the impact won't be realized until the next. But the Farm Bill that got passed is not the Farm Bill some politicians, food activists and bloggers were hoping for, and the end result was criticized in several newspaper editorials. The Senate dropped the school nutrition standards -- actually backed by food manufacturers like Coca-Cola and Mars -- that would have pulled soft drinks out of elementary schools and forced cafeterias to offer meals lower in fat and sugar.

Subsidies to large farms were largely untouched, and small family farms didn't get the help they were hoping for. Other activists pointed to a few victories, including livestock reforms and funding for research into biofuels and organics. And proponents of cloned foods also got a surprise: an amendment that stopped the FDA from approving food from clones until more studies are done went through with the bill.

4. What's Natural?

Rules for the labeling of organically grown meat are pretty strict in the United States, but when it comes to naturally raised, it's something of a free-for-all.

As things stand, meat or poultry with a "natural" label must be minimally processed and mean what the marketer says it does. But nobody is really checking, and there is some debate over what constitutes "minimally processed". Should injecting chicken with sodium solution or binding agents take away its natural status, for example? What about treating red meat with carbon monoxide in order to make it look fresher? The FDA will attempt to settle these and other questions in 2008 as it reviews the use of the "natural" label for fresh meat. The public comment period on the review ends Jan. 28.

5. Food Labels

If you're already addled by the many labels and symbols on your food, prepare to be even more flummoxed in 2008. Dr. David Katz, director of the Yale-Griffin Prevention Research Center, created the Overall Nutritional Quality Index, which rates foods on a scale from one -- the least healthy -- to 100 -- the most healthy. It should start showing up on some grocery store shelves this coming summer. Grocery retailer Hannaford will begin licensing their Guiding Stars rating system to other grocery chains next year, which could see their starred rating system spread across the country. And University of Washington nutritionist Adam Drewnowski is also working on a food scoring system. It remains to be seen if one of these systems will really grab consumers and help them make healthier choices, or if they'll leave everyone even more confused.

6. Michael Pollan

It was difficult to discuss food this year without bringing up Michael Pollan, whose bestselling book "The Omnivore's Dilemma" hit a nerve in the debate about our food system. By the end of 2008, we could be saying the same of "In Defense of Food: An Eater's Manifesto". Set for release on Jan. 1, Pollan's newest book follows up on a New York Magazine article from 2007 and argues that we're focusing too much on individual nutrients and losing site of the value of -- and delight in -- real food. Pollan's American paradox -- "the more we worry about nutrition, the less healthy we seem to become" -- is made all the more interesting by the increasing popularity of functional foods, or foods that are said to have added health benefits, with consumers and the food industry.

7. The End of Cheap Food?

At the start of 2007, ethanol seemed like a great idea. By the end of the year, it was looking about as good as oil. The problem is that it's made with corn, a heavily subsidized monoculture crop that's so cheap it's found in everything -- and not just as the much-maligned high-fructose corn syrup either. Corn tied into what we eat in a new way when demand for ethanol increased crop prices, which increased tortilla prices in Mexico and, less directly, pasta prices in Italy. The Economist charged that the prices North Americans pay for foods at the supermarket -- not just the processed ones made with the crop, but also diet staples like milk and vegetables -- might also start going up. Americans spend only about 10 percent of the household income on food, according to the USDA -- a proportion that has steadily decreased over time -- and last week, The Today Show's food editor Phil Lemptert argued that an increase might not be unwarranted.

8. Fixing the FDA/USDA

This month, a Food and Drug Administration committee said in a report that funding shortages had put the FDA in crisis mode, to the point where public safety was at risk.

It pointed to hand-written safety inspection reports, food plant inspections occurring as infrequently as once a decade and a full-time pet-food safety staff of two as signs of a widespread, serious problem at the federal agency in charge of regulating 80 percent of the food sold in the United States, as well as cosmetics, drugs, vaccines and medical devices -- the products the agency oversees account for about a quarter of every consumer dollar spent by Americans, the FDA says. The agency has seen its responsibilities increase as its budget decreased, and the globalization of food has changed the playing field and added new concerns to its long list. To hear that the FDA is in trouble likely comes as little surprise: between contaminated pet food, meat recalls, warnings on the popular diabetes drug Avandia and accusations of politically motivated appointments, the agency has had a bad year in the court of public opinion. What remains to be seen for the year to come is whether the FDA will get the money it says it needs to fix itself -- and if that will be enough to do the job.

© Reuters 2008. All rights reserved.

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