Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank

Original Link

Should Cancer Patients Avoid Raw Fruits and Vegetables?

Should Cancer Patients Avoid Raw Fruits and Vegetables?.jpeg

Back in the 1960s, a patient isolator unit was developed for cancer patients undergoing chemotherapy. Because our immune system cells were often caught in the friendly fire, up to 50% of cancer patients died of infections before they could even complete the chemo because their immune systems had become so compromised. So, a bubble boy-like contraption was developed. The patient was shaved, dipped in disinfectant, rinsed off with alcohol, rubbed with antibiotic ointment into every orifice, and placed on a rotating regimen of a dozen of the most powerful antibiotics they had. Procedures were performed through plastic sleeves on the sides of the unit, and everything in and out had to be sterilized and passed through airlocks. So, the patient wasn't allowed any fresh fruits or vegetables.

People went crazy cooped up in these bubble-like units, with 38% even experiencing hallucinations. Fifteen years later the results were in: it simply didn't work. People were still dying at the same rate, so the whole thing was scrapped--except the diet. The airlocks and alcohol baths were abandoned, but they continued to make sure no one got to eat a salad.

Neutrophils are white blood cells that serve as our front line of defense. When we're immunocompromised and don't have enough neutrophils, we're called "neutropenic." So, the chemotherapy patients were put on a so-called neutropenic diet without any fresh fruits and vegetables. The problem is there's a glaring lack of evidence that such a neutropenic diet actually helps (see my video Is a Neutropenic Diet Necessary for Cancer Patients?).

Ironically, the neutropenic diet is the one remaining component of those patient isolator unit protocols that's still practiced, yet it has the least evidence supporting its use. Why? The rationale is: there are bacteria in salads, bacteria cause infections, immunocompromised patients are at increased risk for infections, and therefore, no salad. What's more, they were actually glad there aren't any studies on this because it could be way too risky to give a cancer patient an apple or something. So, its continued use seems to be based on a ''better safe than sorry'' philosophy.

The problem is that kids diagnosed with cancer are already low in dietary antioxidants, so the last thing we should do is tell them they can't have any fresh fruit or veggies. In addition to the lack of clinical evidence for this neutropenic diet, there may be some drawbacks. Restricting fruits and vegetables may even increase the risk of infection and compromise their nutritional status.

So, are neutropenic diets for cancer patients "reasonable prudence" or "clinical superstition"? Starting in the 1990s, there was a resurgence of research when greater importance was placed on the need to "support clinical practice with evidence."

What a concept!

Three randomized controlled trials were published, and not one supported the neutropenic diet. In the biggest study, an all-cooked diet was compared to one that allowed raw fruits and veggies, and there was no difference in infection and death rates. As a result of the study, the principal investigator at the MD Anderson Cancer Center described how their practice has changed and now everyone is allowed to eat their vegetables--a far cry from "please don't eat the salads" 31 years earlier.

Today, neither the Food and Drug Administration, the Centers for Disease Control and Prevention, nor the American Cancer Society support the neutropenic diet. The real danger comes from pathogenic food-poisoning bacteria like Campylobacter, Salmonella, and E. coli. So we still have to keep patients away from risky foods like undercooked eggs, meat, dairy, and sprouts. At this point, though, there really shouldn't be a debate about whether cancer patients should be on a neutropenic diet. Nevertheless, many institutions still tell cancer patients they shouldn't eat fresh fruits and veggies. According to the latest survey, more than half of pediatric cancer doctors continue to prescribe these diets, though it's quite variable even among those at the same institution.

Why are doctors still reluctant to move away from the neutropenic diet? There are several reasons why physicians may be hesitant to incorporate evidence-based medicine into their practices. They may have limited time to review the literature. They'd like to dig deep into studies, but simply don't have the time to look at the evidence. Hmm, if only there was a website... :)

Bone marrow transplants are the final frontier. Sometimes it's our immune system itself that is cancerous, such as in leukemia or lymphoma. In these cases, the immune system is wiped out on purpose to rebuild it from scratch. So, inherent in the procedure is a profound immunodeficiency for which a neutropenic diet is often recommended. This has also had never been tested--until now.

Not only did it not work, a strict neutropenic diet was actually associated with an increased risk for infection, maybe because you don't get the good bugs from fruits and vegetables crowding out the bad guys in the gut. So not only was the neutropenic diet found to be unbeneficial; there was a suggestion that it has the potential to be harmful. This wouldn't be the first time an intervention strategy made good sense theoretically, but, when put to the test, was ultimately ineffective.

Unfortunately, there's an inertia in medicine that can result in medical practice that is at odds with the available evidence. Sometimes this disconnect can have devastating consequences. See, for example, Evidence-Based Medicine or Evidence-Biased? and The Tomato Effect.

The reason it is so important to straighten out the neutropenic diet myth is that fruits and vegetables may actually improve cancer survival:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank

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What is ‘Meat Glue’?

NF-Apr16 What is

The so-called "meat glue enzyme" transglutaminase is used by the meat industry to add value to meat by gluing together smaller scraps into a larger chunk. And it's not just used to make fake steak--the American Meat Institute estimates that it's used in about "eight million pounds of meat every year in the United States." Transglutaminase can be used to cross-link pieces of any type of meat, fish, or meat product, and hence can be used to produce large chunks of virtually intact looking meat or fish out of small meat or fish cuttings. When researchers actually tested for transglutaminase in 20 samples of meat from the supermarket, they found meat glue in only two of the samples--in a sample of salmon and a sample of turkey (See Is Meat Glue Safe?)

Where does meat glue come from? For decades, the sole commercial source of transglutaminase was from the livers of guinea pigs. Now it can be sourced much cheaper. However, the future of meat glue remains uncertain because of "communication difficulties."

One of the reasons the industry uses meat glue enzymes is because, "restructured meat can be made from underutilized portions of the carcasses." For example, you can get away with adding up to 5% tendons to beef, and some people can't tell the difference.

This has raised food safety concerns. There is a "risk that otherwise discarded leftovers of questionable microbial quality could find their way into the reconstituted meat."

One can actually take a microscope and see introduced E. coli O157:H7 along the glue lines where meat pieces were enzymatically attached, which shows that the restructuring process can translocate fecal matter surface contamination into the interior of the meat.

Furthermore, people who have problems with gluten may develop problems when ingesting meat treated with the meat glue enzyme, since it functions as an auto-antigen capable of inducing an autoimmune reaction. (Many gluten reactions may not actually be to gluten, though. See my video Is Gluten Sensitivity Real? and most need not worry about gluten sensitivity. See my video Is Gluten Bad For You?).

Some meat additives, however, may actually improve food safety. See Meat Additives to Diminish Toxicity, Viral Meat Spray and Maggot Meat Spray.

More on E. coli O157:H7 in my video, Meat May Exceed Daily Allowance of Irony. For those interested in the politics of this "Jack-in-the-Box" strain, see my blogs E. coli O145 Ban Opposed by Meat Industry and Supreme Court case: meat industry sues to keep downed animals in food supply. From a population perspective, the E. coli in chicken is more of a concern. See my video Avoiding Chicken To Avoid Bladder Infections.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Wheeler Cowperthwaite / Flickr

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Cayenne for Irritable Bowel

 

 

 

 

 

 

 

 

Cayenne for Irritable Bowel

Nearly 50 million Americans come down with food poisoning every year. Over a hundred thousand are hospitalized and thousands die every year just because of something they ate. If they had ordered something different on the menu or chosen something else at the grocery store, they or their loved one might be alive today. But in the vast majority of cases, food poisoning manifests itself as little more than a case of “stomach flu”—a few days of pain, vomiting, diarrhea, and then it’s gone. So what’s the big deal?

Well, as described in this recent editorial in the American Journal of Gastroenterology, in many cases, that acute infection can trigger a chronic “postinfectious functional gastrointestinal disorder” that can last for years or even forever. The two most common of which are irritable bowel syndrome and functional dyspepsia (chronic indigestion).

Up to 10% of people stricken with Salmonella, E. coli, or Campylobacter are left with irritable bowel syndrome. The thought is that the "transitory inflammation during the infection leads to subtle but permanent changes in the structure and function of the digestive system," causing the lining of the gut to become hyper-sensitized. How do they determine if someone’s rectum is hypersensitive?

Innovative Japanese researchers developed a device to deliver "repetitive painful rectal distention." Basically, the researchers hooked up a half-quart balloon to a fancy bicycle pump that was lubricated with olive oil, inserted it into the rectum and inflated it until the patients couldn’t stand the pain anymore. As you can see in my video, Cayenne Pepper for Irritable Bowel Syndrome and Chronic Indigestion, those with IBS had a significantly lower pain threshold, significantly less “rectal compliance.”

Healthy people felt the pain where we’d expect to feel the pain with, effectively, a balloon animal up their tush. But many with IBS also experienced abdominal pain, indicating a hypersensitivity of the entire gut wall. Well, if that’s the problem, how can we desensitize the gut?

In my video, Hot Sauce in the Nose for Cluster Headaches?, we learned about the ability of hot pepper compounds to deplete pain fibers of substance P, a neurotransmitter used for transmitting pain. It’s bad enough to have to rub hot peppers up our nose, where do we have to stick them for irritable bowel? Thankfully researchers chose the oral route.

The researchers concluded that “the chronic administration of red pepper powder in IBS patients with enteric-coated pills was significantly more effective than placebo in decreasing the intensity of abdominal pain and bloating, and was considered by the patients more effective than placebo," suggesting a "novel way of dealing with this frequent and distressing functional disease.”

After 48 million cases of annual food poisoning, 10% may end up with IBS. Even more may end up with chronic indigestion. How do peppers work against that? We can’t use whole peppers because then we couldn’t blind a placebo, but if we give capsules of red pepper powder to folks suffering from chronic indigestion—about one and a half teaspoons a day worth—and compare that to an identical-looking sugar pill, within a month their overall symptoms improved, including their stomach pain and their feelings of being bloated. They had less nausea, too. The frequently prescribed drug, Propulsid (cisapride), worked almost as well as the red pepper powder, and was considered generally well tolerated… that is, until it killed people. Propulsid was pulled from the market after causing dozens of deaths.

I explore another natural treatment for IBS in Kiwi Fruit for Irritable Bowel Syndrome.

I’ve covered some of the long-term consequences of food poisoning in videos such as Poultry and Paralysis, Fecal Bacteria Survey, and Amnesic Seafood Poisoning. The meat industry is all over it, though: Check out my videos  Viral Meat Spray and Maggot Meat Spray. Why is it legal to sell meat tainted with our leading foodborne killer? Find out in Salmonella in Chicken & Turkey: Deadly But Not Illegal and  

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Jennifer C. / Flickr

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Does Cranberry Juice Work Against Bladder Infections?

 

 

 

 

 

 

 

 

Can Cranberry Juice Treat Bladder Infections?

How could any bacteria cause a bladder infection without just getting flushed away—literally? Bladder infections may make sense if we’re not drinking enough or if we leave behind a stagnant pool because we can’t empty completely (as in men with enlarged prostates).  However, in most people there should be a constant flow of water. The way bladder infection-causing E. coli hold on is that they evolved  finger-like projections (fimbrae) they can use to stick to the walls of the bladder so they don’t get washed away.

Almost 30 years ago, it was demonstrated that if you drip cranberry juice on E. coli, their fimbrae aren’t able to stick as well. Grape juice doesn’t work, nor does orange or apple juice. Even white cranberry juice made from unripened berries doesn’t work, suggesting that it’s one of the red phytonutrients that’s the active ingredient. For more on these natural plant compounds, see Phytochemicals: The Nutrition Facts Missing From the Label and for those doubting the power of plants, Power Plants.

Even if it works in a petri dish, though, we don’t pee cranberry juice. How do we know that the anti-adherence phytonutrients are even absorbed through the gut and make it into the bladder? Subsequent studies have shown that if you drip the urine of someone who drank cranberry juice onto E. coli, they don’t stick as well either. Now we’re getting somewhere. If you check out my 4-min video Can Cranberry Juice Treat Bladder Infections?, you can see the stickiness of strains of E. coli wading in urine from someone drinking water, and the stickiness in the urine of someone drinking cranberry juice. Within hours of consumption there’s a drop in E. coli adherence that appears to last throughout much of the day. So might cranberries really help prevent bladder infections?

The best way to prevent infections is to not get infected in the first place, which may involve the avoidance of chicken so you’re not constantly re-infecting yourself (see my last video Avoiding Chicken to Avoid Bladder Infections).

If that doesn’t work, however—if your gut remains stubbornly colonized with these bad bladder bugs—various tested cranberry products appear to reduce the recurrence of bladder infections by about 35 percent. Not as effective as antibiotics, but cranberry juice doesn’t foster antibiotic resistance and has fewer side effects.

There’s no good evidence to suggest cranberries are an effective treatment, though, which makes sense. Cranberries prevent the initial adherence, but that occurs at the start of the infection. When the infection is present and already stuck, there’s no clinical data to suggest that cranberries are effective in the treatment of urinary tract infections, meaning it doesn’t work better than placebo—but placebos work! For example, ibuprofen seems to work just as well as antibiotics for the treatment of uncomplicated urinary tract infections.

Some people really do need antibiotics—pregnant women, children, men, those with kidney infections, and systemic symptoms like nausea and vomiting. For most healthy women, though, bladder infections just go away on their own without antibiotics. Women who drink cranberry juice and have their symptoms disappear may falsely attribute their recovery to the juice. However, when it comes to most UTIs, nothing works–as in nothing, a sugar pill, actually works!

I discuss the controversy around doctors giving placebos in The Lie That Heals: Should Doctors Give Placebos?

What else can cranberries do? Check out my recent videos Which Fruit Fights Cancer Better? and Cranberries Versus Cancer.

How can you consume cranberries palatably? Check out my recipe for Pink Juice with Green Foam.

If cranberries are so good at keeping bacteria from sticking to the wall of the bladder, what about keeping bacteria from sticking to other places like our teeth? I touch on that in my video Childhood Tea Drinking May Increase Fluorosis Risk.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: ztephen / Flickr

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How Avoiding Chicken Could Prevent Bladder Infections

 

 

 

 

 

 

 

 

How Avoiding Chicken Could Prevent Bladder Infections

Where do bladder infections come from? Back in the ’70s, longitudinal studies of women over time showed that the movement of rectal bacteria into the vaginal area preceded the appearance of the same types of bacteria in the urethra before they were able to infect the bladder. However, it would be another 25 years before genetic fingerprinting techniques were able to confirm this so-called fecal-perineal-urethral theory, indicating that E. coli strains residing in the rectal flora serve as a reservoir for urinary tract infections.

And it would be another 15 years still before we tracked it back another step and figured out where that rectal reservoir of bladder infecting E. coli was coming from—chicken. Researchers were able to capture these extraintestinal (meaning outside of the gut), pathogenic, disease-causing E. coli straight from the slaughterhouse, to the meat, to the urine specimens obtained from infected women. We now have “proof of a direct link between farm animals, meat, and bladder infections,” solid evidence that urinary tract infections can be a zoonosis (an animal-to-human disease). Millions of women are infected with bladder infections every year, at a cost of more than a billion dollars.

Even worse, researchers have detected multidrug resistant strains of E. coli in chicken meat resistant to some of our most powerful antibiotics.

The best way to prevent bladder infections is the same way we can prevent all types of infections, by not getting infected in the first place. It’s not in all meat equally—beef and pork, for example, appear significantly less likely to harbor bladder-infecting strains than chicken.

Can’t one just use a meat thermometer and cook the chicken thoroughly? We’ve known for 36 years that it’s not always the meat, but the cross-contamination, that causes the infection. If you give people frozen chickens naturally contaminated with antibiotic resistant E. coli and let people prepare and cook it in their own kitchen as they normally would, the bacteria ends up in their rectum even if they don’t actually consume the meat. That’s how they know it was cross-contamination, because the jump happened after the animal was prepared but before it was eaten. In one study five different strains of antibiotic resistant E. coli jumped from the chicken to the volunteer.

So not only did it not matter how well the chicken was cooked, it didn’t even matter if one eats any! It was the bringing of the contaminated carcass into the home and handling it. Within days, the drug resistant chicken bacteria had multiplied to the point of becoming a major part of the person’s fecal flora. If you check out my 6-min video Avoiding Chicken To Avoid Bladder Infections, you can see all this drug resistant bacteria colonizing this person’s colon, yet the person hadn’t taken any antibiotics—it’s the chickens who were given the drugs. That’s why the industry shouldn’t be routinely feeding chickens antibiotics by the millions of pounds a year. It can end up selecting for and amplifying superbugs that may end up in our bodies.

More on the threat of feeding antibiotics to farm animals by the ton in:

What if we’re really careful in the kitchen, though? The pivotal study in this area was entitled “The Effectiveness of Hygiene Procedures for Prevention of Cross-Contamination from Chicken Carcasses in the Domestic Kitchen.” Researchers went into five dozen homes, gave each family a chicken, and asked them to cook it. I expected to read that they inoculated the carcass with a specific number of bacteria to ensure everyone got a contaminated bird, but no. They realized that fecal contamination of chicken carcasses was so common that they just went to the store and bought any random chicken.

After the participants were done cooking it, there was bacteria from chicken feces (Salmonella and Campylobacter–both serious human pathogens) all over the kitchen—on the cutting board, the utensils, on their hands, on the fridge handle, on the cupboard,  the oven handle doorknob. Obviously people don’t know what proper handling and disinfection protocols entail. So the researchers took another group of people and gave them specific instructions. After they cooked the chicken they had to wash everything with hot water and detergent. They were told specifically to wash the cutting board, knobs on the sink, the faucet, the fridge, the doorknobs—everything. And the researchers still found pathogenic fecal bacteria all over.

Fine. Last group. This time they were going to insist that people bleach everything. The dishcloth used to wipe up was to be immersed in bleach disinfectant. Then they sprayed the bleach on all kitchen surfaces and let it sit there for 5 minutes. And… they still found Campylobacter and Salmonella on some utensils, a dishcloth, the counter around the sink, and the cupboard. Definitely better, but unless our kitchen is like some biohazard lab, the only way to guarantee we’re not going to leave infection around the kitchen is to not bring it into the house in the first place.

The good news is that if we eat chicken once, we’re not colonized for life. In the study I profile in Avoiding Chicken To Avoid Bladder Infections, the chicken bacteria only seemed to last about 10 days in peoples' guts before our good bacteria could muscle it out of the way. The problem is that people tend to eat chicken more than once every ten days, so they may be constantly re-introducing these chicken pathogens into their system. For example, a study found that if people are fed only sterilized meat that’s been boiled for an hour, within 3 weeks there’s a 500 fold drop in the number of antibiotic-resistant bacteria passing through their bodies.

I originally explored this topic in Chicken Out of UTIs, but decided I needed to take a much deeper dive, especially in light of the cross-contamination issue, which I also  touched on in Food Poisoning Bacteria Cross-Contamination and Fecal Contamination of Sushi.

Other videos about diseases that one might not initially associate with food include:

More on urinary tract health in:

What if you already have a urinary tract infection? See Can Cranberry Juice Treat Bladder Infections?

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: epSos.de / Flickr

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Why Is Selling Salmonella-Tainted Chicken Legal?

 

 

 

 

 

 

 

 

When researchers last year at the Emerging Pathogens Institute ranked foodborne pathogens to figure out which was the worst, Salmonella was number one on their list. Salmonella was ranked the food poisoning bacteria with the greatest public health burden on our country, the leading cause of food poisoning hospitalization, and the number one cause of food-related death. Where do you get it from?

In my video Total Recall I talked about the threat of eggs. According to the FDA, 142,000 Americans are sickened every year by eggs contaminated with Salmonella. That’s an egg-borne epidemic every year. But Salmonella in eggs was only ranked the tenth worst pathogen-food combination. Salmonella in poultry ranks even worse, the fourth worst contaminated food in the United States in terms of both cost and quality-adjusted years of life lost.  In terms of getting Salmonella poisoning from various U.S. foods, eating chicken may be eight times riskier than eating eggs.

Due to strengthening of food safety regulations under the Clinton administration, the number of Americans poisoned by chicken dropped every year from about 390,000 to 200,000. This was rightly hailed as a significant accomplishment. So now eating chicken only sickens 200,000 people in the U.S. every year. Isn’t that a bit like some toy company boasting that they’ve reduced the amount of lead in their toys and they’re now poisoning 40 percent fewer kids? Hundreds of thousands sickened isn’t exactly something to boast about, and the numbers have since rebounded upwards.

Since the late ’90s human Salmonella cases have increased by 44 percent. The rebound in incidence of Salmonella infection is likely a result of several factors, but one important risk factor singled out is eating chicken, since the proportion of chicken carrying infection has increased.  When people think manure in meat they typically think ground beef, but when you look at E. coli levels there’s fecal matter in about 65 percent of American beef, yet in more than 80 percent in poultry (chicken and turkey).

Why have we seen a decrease in the Jack-in-the-box E. coli O157 but not chicken-borne Salmonella? In the last decade or so, E. coli infected beef and children has dropped by about 30 percent. Salmonella, on the other hand, has actually increased over the last 15 years. One reason for the difference is that the O157:H7 was declared an “adulterant,” defined as any poisonous or deleterious substance that may render meat injurious to health. So selling E. coli laden beef is illegal.

Why is beef laced with E. coli contaminated fecal matter considered adulterated, but chicken laced with Salmonella contaminated fecal matter okay? Salmonella certainly kills more people than the banned E.coli. It all goes back to a famous case I detail in my video Salmonella in Chicken & Turkey: Deadly But Not Illegal, when the American Public Health Association sued the USDA for putting its stamp of approval on meat contaminated with Salmonella.

What could the USDA possibly say in meat’s defense? They pointed out that there have been Salmonella outbreaks linked to dairy and eggs, for example, too, so since “there are numerous sources of contamination which might contribute to the overall problem.” It would be “unjustified to single out the meat industry and ask that the Department require it to identify its raw products as being hazardous to health.” That’s like the tuna industry arguing there’s no need to label cans of tuna with mercury levels because you can also get exposed eating a thermometer.

The DC Circuit Court of Appeals upheld the meat industry position, arguing you can allow potentially deadly Salmonella in meat because, “American housewives are…normally are not ignorant or stupid and their methods of preparing and cooking of food do not ordinarily result in salmonellosis.” What?! That’s like saying oh, minivans don’t need seatbelts because soccer moms don’t ordinarily crash into things.

I’ve talked about this travesty before in my blog post Why is it Legal to Sell Unsafe Meat? and video Unsafe at Any Feed. Don’t worry, though, the meat industry is on it! See my videos Viral Meat Spray and Maggot Meat Spray (if you dare! :)

My video Food Poisoning Bacteria Cross-Contamination explains that raw meat can be dangerous no matter how long you cook it and Fecal Bacteria Survey features an industry trade journal explaining the difference between the attitude in Europe and The United States.

The Center for Science in the Public Interest has petitioned the USDA to bar the sale of Salmonella-contaminated meat, but so far to no avail.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit:  futureshape / Flickr

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