A trans disciplinary and multi actor approach to develop high impact food safety messages to consumers: Time for a revision of the WHO - Five keys to safer food?

Background: A significant part of foodborne infections is caused by food eaten at home, and food safety messages are given to help consumers mitigate risk. The World Health Organisation “Five Keys to Safer Food”, developed about 20 years ago has been used with success worldwide to provide general advice on how to prepare food safely. Scope and approach: In this commentary, we discuss how food safety messages could be updated using a holistic approach built on implementation science, considering new food consumption patterns and insights from natural and social sciences. A stepwise approach for developing and evaluating food safety messages, performed in the European project SafeConsume, is presented. The top pathogen-food combinations associated with foodborne disease in Europe were combined with common consumer practices to identify risky behaviours. Food safety messages were suggested and assessed for understanding as well as capability, opportunity, and motivation in an expert survey. Key findings and conclusions: Overall, the food safety topics developed overlapped with those from WHO. The opportunity and motivation for changing behaviour, (e.g., choose pasteurised egg) were identified as important restrictions for uptake of messages. Also, understanding terminology, (e.g “thoroughly cooked”) was a challenge. Therefore, there is a need to be specific, without excluding other safe alternatives or make lengthy explanations. The food safety messages suggested by the expert group were considered as more likely to be implemented among domestic cooks, resulting in safer practice than corresponding WHO messages. WHO should reconsider the preventive risk communication based on new knowledge and challenges.