Precautionary Principle

The precautionary principle generally defines actions on issues considered to be uncertain, for instance applied in assessing risk management.[1] The principle is used by policy makers to justify discretionary decisions in situations where there is the possibility of harm from making a certain decision (e.g. taking a particular course of action) when extensive scientific knowledge on the matter is lacking. The principle implies that there is a social responsibility to protect the public from exposure to harm, when scientific investigation has found a plausible risk. These protections can be relaxed only if further scientific findings emerge that provide sound evidence that no harm will result.

In some legal systems, as in law of the European Union, the application of the precautionary principle has been made a statutory requirement in some areas of law.[2]

Regarding international conduct, the first endorsement of the principle was in 1982 when the World Charter for Nature was adopted by the United Nations General Assembly, while its first international implementation was in 1987 through the Montreal Protocol. Soon after, the principle integrated with many other legally binding international treaties such as the Rio Declaration and Kyoto Protocol.

Application

The application of the precautionary principle is hampered by both lack of political will, as well as the wide range of interpretations placed on it. One study identified 14 different formulations of the principle in treaties and nontreaty declarations.[12] R.B. Stewart (2002)[13] reduced the precautionary principle to four basic versions:

  1. Scientific uncertainty should not automatically preclude regulation of activities that pose a potential risk of significant harm (Non-Preclusion PP).
  2. Regulatory controls should incorporate a margin of safety; activities should be limited below the level at which no adverse effect has been observed or predicted (Margin of Safety PP).
  3. Activities that present an uncertain potential for significant harm should be subject to best technology available requirements to minimise the risk of harm unless the proponent of the activity shows that they present no appreciable risk of harm (BAT PP).
  4. Activities that present an uncertain potential for significant harm should be prohibited unless the proponent of the activity shows that it presents no appreciable risk of harm (Prohibitory PP).

In deciding how to apply the principle, one may use a cost-benefit analysis that factors in both the opportunity cost of not acting, and the option value of waiting for further information before acting. One of the difficulties of the application of the principle in modern policy-making is that there is often an irreducible conflict between different interests, so that the debate necessarily involves politics.

In the field of Medicine and Oncology

In 1982, a “landmark report on diet, nutrition, and cancer” was released by the National Academy of Sciences, “the first major, institutional, science-based report on this topic.” The report started out saying that yes, scientists must be careful in their choice of words, whenever they are not totally confident about their conclusions. But, for example, by that time, it had become “absolutely clear” that cigarettes were killing people. But, “[if] the population had been persuaded to stop smoking when the association with lung cancer was first reported, these cancer deaths would now not be occurring.” If you wait for absolute certainty, millions of people could die in the meantime. That’s why, sometimes, you have to invoke the “precautionary principle.”

 

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J Am Coll Nutr. 2014;33(3):239-46. doi: 10.1080/07315724.2013.866527. Epub 2014 May 28.

Applying the precautionary principle to nutrition and cancer.

Gonzales JF1, Barnard ND, Jenkins DJ, Lanou AJ, Davis B, Saxe G, Levin S.

Author information

Abstract

PRIMARY OBJECTIVE:

Research has identified certain foods and dietary patterns that are associated with reduced cancer risk and improved survival after cancer diagnosis. This research has formed the basis for dietary guidance issued by cancer organizations. Unfortunately, gaps within nutrition research have made it difficult to make recommendations in some areas. This review specifies suggested dietary guidance in which evidence of a dietary influence on cancer risk is substantial, even if not conclusive. Evidence summaries within the review are based on the 2007 report of the World Cancer Research Fund/American Institute for Cancer Research. This review also describes advantages and disadvantages of following the suggested dietary guidance and includes putative mechanisms involved in cancer progression.

MAIN OUTCOMES AND RESULTS:

Suggested dietary guidance where evidence is sufficiently compelling include (1) limiting or avoiding dairy products to reduce the risk of prostate cancer; (2) limiting or avoiding alcohol to reduce the risk of cancers of the mouth, pharynx, larynx, esophagus, colon, rectum, and breast; (3) avoiding red and processed meat to reduce the risk of cancers of the colon and rectum; (4) avoiding grilled, fried, and broiled meats to reduce the risk of cancers of the colon, rectum, breast, prostate, kidney, and pancreas; (5) consumption of soy products during adolescence to reduce the risk of breast cancer in adulthood and to reduce the risk of recurrence and mortality for women previously treated for breast cancer; and (6) emphasizing fruits and vegetables to reduce risk of several common forms of cancer.

CONCLUSION:

By adopting the precautionary principle for nutrition research, this review aims to serve as a useful tool for practitioners and patients.

KEYWORDS:

alcohol; cancer; dairy; diet; meat; milk; risk; soy

https://www.ncbi.nlm.nih.gov/pubmed/24870117

Text under construction

  1. ^ Rupert Read and Tim O’Riordan. “The Precautionary Principle Under Fire”. EnvironmentMagazine.org. Environment. Retrieved 25 September 2017.
    1. ^ Art. 191 (2) TFEU, Explanations Relating to the Charter of Fundamental Rights (2007/C 303/02, OJ EU C303/35 14.12.2007 explanation on article 52 (5) of the EU Charter of Fundamental Rights, T-13/99 Pfizer vs Council p.114-125
  1. ^ Foster, Kenneth R.; Vecchia, Paolo; Repacholi, Michael H. (12 May 2000). “Science and the Precautionary Principle”. Science. 288 (5468): 979–981. doi:10.1126/science.288.5468.979. ISSN 0036-8075. PMID 10841718
  2. ^ Stewart, R.B. (2002). “Environmental Regulatory Decision Making Under Uncertainty”. Research in Law and Economics. 20: 76.

 

Extra

 

 

In 1982, a “landmark report on diet, nutrition, and cancer” was released by the National Academy of Sciences, “the first major, institutional, science-based report on this topic.” The report started out saying that yes, scientists must be careful in their choice of words, whenever they are not totally confident about their conclusions. But, for example, by that time, it had become “absolutely clear” that cigarettes were killing people. But, “[if] the population had been persuaded to stop smoking when the association with lung cancer was first reported, these cancer deaths would now not be occurring.” If you wait for absolute certainty, millions of people could die in the meantime. That’s why, sometimes, you have to invoke the “precautionary principle.”

For example, emphasizing that “fruits and vegetables [may] reduce the risk of several common forms of cancer.” We’re not completely sure, but there’s good evidence, and what’s the downside of eating more fruits and vegetables? So, why not give it a try?

The 1982 National Academy of Sciences report continued: “The public is now asking about the causes of cancers that are not associated with smoking. What are these causes, and how can these cancers be avoided? Unfortunately, it is not yet possible to make firm scientific pronouncements about the association between diet and cancer. We are in an interim stage of knowledge similar to that for cigarettes 20 years ago. Therefore, in the judgment of the committee, it is now the time to offer some interim guidelines on diet and cancer.”

For example, they raised concern about processed meats. And, 30 years later, it was confirmed: processed meat was officially declared “carcinogenic to humans.” Maybe if we would have listened back then, maybe we would have been spared Lunchables, which, if taken apart, a CEO of Philip Morris describes reading, “the most healthy item in it is the napkin.”

“The findings of this [diet and cancer] report generated a striking level of disbelief from the cancer community and outright hostility from people and the industries whose livelihood depended on the foods…being questioned,” to the point of accusing one of the authors of the report of “killing people,” with formally organized petitions “to expel [the researchers] from their professional societies…clearly, a very sensitive nerve was touched.”

The American Meat Science Association and other members of the Council for Agricultural Science and Technology criticized the report. Yeah, maybe it would save lives, but the recommended “reductions in meat consumption would sharply reduce incomes to the livestock and meat processing industries.” “The fruit and vegetable industries would clearly benefit…if consumers were to implement the guidelines. However, fruits and vegetables account for less than 15 percent of cash receipts.” Most of the money is in “cattle, hogs, poultry products, feed grains, and oil crops.” That reminds me of the tobacco industry memos where Philip Morris spoke of the tobacco industry going “bankrupt.”

“Maybe it’s not the meat that’s causing cancer,” the industry critique continued, but all the “marihuana” people are smoking these days. “How…can one argue that such an abundant diet causes cancer?” Maybe you’re all just jealous of all the good food we’re eating, like the Puritans that “condemned bear baiting, not because of the pain for the bear but because of the pleasure of the spectators.” You can’t tell us to cut down on meat; “one of mankind’s few remaining pleasures is that of the table.”

The day the National Academy of Sciences report was published was “The Day That Food Was Declared a Poison,” declared Thomas Jukes, the guy who discovered you could speed up the growth of chickens by feeding them antibiotics. How dare the National Academy of Sciences recommend people eat fruits, vegetables, and whole grains daily, which were said to contain “as yet unidentified compounds that may protect us against certain cancers”? “How can one select foods that contain unidentified compounds? This is not a scientific recommendation; it sounds like ‘health food store’ literature.”

My favorite, though, was to think about the human breast. How can animal fat be bad for us if breastfeeding women create so much of it? Women are animals; their mammary glands make fat for breast milk. Therefore, we shouldn’t have to cut down on burgers. Huh?

So, anyway, what did the latest science tell us about nutrition and cancer? What were the other five recommendations? We talked about eating more fruits and vegetables. Consumption of soy products may not only reduce the risk of getting breast cancer, but also increase chances of surviving it. Then, in terms of dietary-guidance-suggestions-on-foods-to cut-down-on, where evidence is sufficiently compelling, recommendations included “limiting or avoiding dairy products to reduce the risk of prostate cancer; limiting or avoiding alcohol to reduce the risk of cancers of the mouth, [throat], esophagus, colon, rectum, and breast; avoiding red and processed meat to reduce the risk of cancers of the colon and rectum; and avoiding grilled, fried, and broiled meats to reduce the risk of cancers of the colon, rectum, breast, prostate, kidney, and pancreas.” In this context, they’re talking about all meat, including poultry and fish.

Look, we all have to make dietary decisions every day. We “cannot wait for the evolution of scientific consensus.” Until we know more, “to protect [ourselves and our families, all we can do is act on] the best available evidence [we have right now].”

 

The level of evidence required to make decisions depends on the level of risk. If we’re talking about some new drug, for example, given the fact that medications kill more than 100,000 Americans a year (Why Prevention Is Worth a Ton of Cure) you want to be darn sure that the benefits outweigh the risks before you prescribe it (or take it!). But what level of evidence do you need to eat broccoli? Do you need randomized double-blind placebo-controlled trials? (How would you even design a placebo vegetable?) Even if all the evidence suggesting how powerful broccoli is turned out to be some crazy cruciferous conspiracy, what’s the worst that could have happened? It’s healthy anyway. That’s the beauty of safe, simple, side effect-free solutions provided by the lifestyle medicine approach. It can only help.

 

Campbell TC. Nutrition and Cancer: An Historical Perspective.-The Past, Present, and Future of Nutrition and Cancer. Part 2. Misunderstanding and Ignoring Nutrition. Nutr Cancer. 2017;69(6):962-968.

National Research Council (US) Committee on Diet, Nutrition, and Cancer. Diet, Nutrition, and Cancer. National Academy Press (US). 1982.

Council for Agricultural Science and Technology. Diet, Nutrition, and Cancer: A Critique. CAST Special Publication No. 13. 1982.

Campbell TC. The Past, Present, and Future of Nutrition and Cancer: Part 1-Was A Nutritional Association Acknowledged a Century Ago?. Nutr Cancer. 2017;69(5):811-817.

Gonzales JF, Barnard ND, Jenkins DJ, et al. Applying the precautionary principle to nutrition and cancer. J Am Coll Nutr. 2014;33(3):239-46.

Bouvard V, Loomis D, Guyton KZ, et al. Carcinogenicity of consumption of red and processed meat. Lancet Oncol. 2015;16(16):1599-600.

Moss M. The Extraordinary Science of Addictive Junk Food. New York Times Magazine. Feb 20, 2013.

Jukes TH: The Day that Food was Declared a Poison. Ames, IO: Council for Agricultural Science and Technology, 1982, pp. 42–45

 

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Nutr Cancer. 2017 Jul;69(5):811-817. doi: 10.1080/01635581.2017.1317823. Epub 2017 Jun 8.

The Past, Present, and Future of Nutrition and Cancer: Part 1-Was A Nutritional Association Acknowledged a Century Ago?

Campbell TC1.

Author information

Abstract

Professional interest in the association of diet and nutrition with cancer first appeared in the early 1800s, if not before. Yet, progress in understanding this association over the past two centuries has been exceedingly slow and confusing. Without addressing this confusion, progress in using diet and nutrition information to prevent and even to treat cancer, will remain uncertain. To better understand this issue, the present paper is the first of two to explore the history of the diet and cancer relationship prior to a 1982 National Academy of Sciences (NAS) report on Diet, Nutrition and Cancer. This report was a milestone in the nutrition and cancer history because it was the first science-based, institutional report on this topic. But, based on the evidence cited in that report, it could be inferred that this topic was relatively new, perhaps beginning around 1940. While it attracted great public interest, it also generated great controversy, some of which was a natural response from affected industries. Exploring the history prior to 1940, therefore, might provide clues on the present-day confusion concerning the relationship between diet and cancer. This investigation asks three questions. First (the subject of this paper), was the relationship of nutrition to cancer even considered prior to 1940 and, if so, what was said? Second (the subject of the upcoming paper), assuming that nutrition was seriously considered, why then was it ignored or forgotten? Third, has the forgotten information contributed to the contemporary confusion surrounding the relationship to cancer? The answer to the first question, considered here, is that, yes, nutrition as a possible cause of cancer was not only hypothesized, it was a major topic for discussion in some quarters. But it also was a topic struggling to be heard among the authorities who had most of the power and influence in the professional cancer community. This paper documents that history and the corresponding struggle for this message to be heard. One figure, Frederick Hoffman, founder of the American Cancer Society and prodigious researcher, led much of that effort during the period of 1913-1943, but his contributions have remained almost totally unknown.

PMID: 28594590 DOI: 10.1080/01635581.2017.1317823

[Indexed for MEDLINE]

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https://www.ncbi.nlm.nih.gov/pubmed/28594590

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Nutr Cancer. 2017 Aug-Sep;69(6):962-968. doi: 10.1080/01635581.2017.1339094. Epub 2017 Jul 25.

Nutrition and Cancer: An Historical Perspective.-The Past, Present, and Future of Nutrition and Cancer. Part 2. Misunderstanding and Ignoring Nutrition.

Campbell TC1.

Author information

Abstract

The role that nutrition plays in cancer development and treatment has received considerable attention in recent decades, but it still engenders considerable controversy. Within the cancer research and especially the clinical community, for example, nutritional factors are considered to play, at best, a secondary role. The role of nutrition in cancer development was noted by authorities as far back as the early 1800s, generally under the theory that cancer is “constitutional” in its origin, implying a complex, multifactorial, multistage etiology. Opponents of this idea insisted, rather vigorously, that cancer is a local unifactorial disease, best treated through surgery, with little attention paid to the etiology and possible prevention of cancer. This “local” theory, developed during the late 1700s and early 1800s, gradually included, in the late 1800s and early 1900s, chemotherapy and radiotherapy as treatment modalities, which now remain, along with surgery, as the basis of present-day cancer treatment. This highly reductionist paradigm left in its wake unfortunate consequences for the present day, which is the subject of this perspective.

PMID: 28742399 DOI: 10.1080/01635581.2017.1339094

[Indexed for MEDLINE]

https://www.ncbi.nlm.nih.gov/pubmed/28742399

 

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