Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review

Abstract

BackgroundThe limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts.AimThe goal of this scoping review is to delineate and “map” the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise.MethodsA scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O’Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications.ResultsThe ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented.DiscussionThe ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues cannot be managed without a careful consideration for the complexity of contexts in which nutrition-related interventions are expected to be implemented. These interventions engage a variety of actors with diverse perspectives and interests. We discuss these challenges and also comment on the importance of considering ethical impacts in the monitoring and evaluation of such interventions.ConclusionGeneral ethical frameworks or recommendations–although useful–cannot be expected to provide policy makers, implementators and other public health personnel with sufficient practical ethical guidance as they cannot consider and anticipate the particularities of all specific nutrition-related public health interventions and the complexity of the contexts in which they are implemented. Further research is needed in order to develop more targeted ethical frameworks.

Research of Rational Concentration of Oilseed Crops Meals in the Sandy Dough Semi-Finished Product

“…Sandy dough, consisted of different ingredients (flour, eggs, sugar, salt, soda, ammonium (fluffier), cream butter) was added with 10 %, 20 % and 30 % of the composition of soya, sunflower and milk thistle meals instead of flour (experiment No. 1,experiment No. 2,experiment No.…”

“…It is urgent today to provide health of all people throughout the world. For this it is necessary to improve the ration at the expanse of consuming healthy and relatively cheap food [1]. This task is usually provided by different methods.…”

Calcium‐fortified foods in public health programs: considerations for implementation

“…97 In the literature, the main ethical aspects stated about food fortification are the accountability of states and/or other stakeholders and the benefits of this type of program. 98 Some of these aspects concerning calcium fortification are addressed below.…”

II. The Research Ethics Involving Vulnerable Groups

“…Intervention in individuals with excessive weight has been justified with the argument that doing so will have a positive effect not only on individuals but also on their families and public health in general while, at the same time, will improve socal costs and have a positive impact on the healthcare system. This is a sensitive matter since health promotion strategies that emphasize the responsibility to make healthy or accepted choices (being fitter, thinner, stronger, faster, and smarter), can lead to punitive consequences for those who make unhealthy, over-consumptive choices (of food, alcohol, etc.,) and can hinder the individual's autonomy 26,27 .…”