Regulatory Monitoring of Unapproved/unregulated Foods in the United States

Foods from unapproved/unregulated food sources (UFS) pose complex public health challenges, and their contribution to foodborne illness remains insufficiently quantified. We conducted a cross-sectional survey from April 4 to May 5, 2024, that queried food safety regulatory agencies responsible for implementing, monitoring, and overseeing food safety programs. We assessed jurisdictional differences in monitoring practices, enforcement actions, and inspector training across retail and food service operations. The survey yielded 58 responses (22.3% response rate). Among respondents, 72.2% reported oversight of both retail and food service operations. Jurisdictions exhibited substantial variability in allowances for raw milk, along with additional jurisdiction-specific requirements or exemptions. Differences were reported in regulatory monitoring, documentation, training, and enforcement activities related to UFS. State-level allowances for UFS could create gaps in preventive food safety measures and impose additional burdens on regulatory jurisdictions. Additionally, these allowances could create conditions that increase foodborne illness among consumers. UFS entry into intrastate commerce increasingly challenges regulatory jurisdictions, heightens oversight variability, and strains the capacity to protect public health.