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

Original Link

The Food Safety Risk of Organic versus Conventional

The Food Safety Risk of Organic versus Conventional.jpeg

The stated principles of organic agriculture are "health, ecology, fairness, and care," but if you ask people why they buy organic, the strongest predictor is concern for their own health. People appear to spend more for organic foods for selfish reasons, rather than altruistic motives. Although organic foods may not have more nutrients per dollar (see my video Are Organic Foods More Nutritious?), consumption of organic foods may reduce exposure to pesticide residues and antibiotic-resistant bacteria.

Food safety-wise, researchers found no difference in the risk for contamination with food poisoning bacteria in general. Both organic and conventional animal products have been found to be commonly contaminated with Salmonella and Campylobacter, for example. Most chicken samples (organic and inorganic), were found to be contaminated with Campylobacter, and about a third with Salmonella, but the risk of exposure to multidrug-resistant bacteria was lower with the organic meat. They both may carry the same risk of making us sick, but food poisoning from organic meat may be easier for doctors to treat.

What about the pesticides? There is a large body of evidence on the relation between exposure to pesticides and elevated rate of chronic diseases such as different types of cancers, diabetes, neurodegenerative disorders like Parkinson's, Alzheimer's, and ALS, as well as birth defects and reproductive disorders--but these studies were largely on people who live or work around pesticides.

Take Salinas Valley California, for example, where they spray a half million pounds of the stuff. Daring to be pregnant in an agricultural community like that may impair childhood brain development, such that pregnant women with the highest levels running through their bodies (as measured in their urine) gave birth to children with an average deficit of about seven IQ points. Twenty-six out of 27 studies showed negative effects of pesticides on brain development in children. These included attention problems, developmental disorders, and short-term memory difficulties.

Even in urban areas, if you compare kids born with higher levels of a common insecticide in their umbilical cord blood, those who were exposed to higher levels are born with brain anomalies. And these were city kids, so presumably this was from residential pesticide use.

Using insecticides inside your house may also be a contributing risk factor for childhood leukemia. Pregnant farmworkers may be doubling the odds of their child getting leukemia and increase their risk of getting a brain tumor. This has lead to authorities advocating that awareness of the potentially negative health outcome for children be increased among populations occupationally exposed to pesticides, though I don't imagine most farmworkers have much of a choice.

Conventional produce may be bad for the pregnant women who pick them, but what about our own family when we eat them?

Just because we spray pesticides on our food in the fields doesn't necessarily mean it ends up in our bodies when we eat it, or at least we didn't know that until a study was published in 2006. Researchers measured the levels of two pesticides running through children's bodies by measuring specific pesticide breakdown products in their urine. In my video, Are Organic Foods Safer?, you can see the levels of pesticides flowing through the bodies of three to 11-year olds during a few days on a conventional diet. The kids then went on an organic diet for five days and then back to the conventional diet. As you can see, eating organic provides a dramatic and immediate protective effect against exposures to pesticides commonly used in agricultural production. The study was subsequently extended. It's clear by looking at the subsequent graph in the video when the kids were eating organic versus conventional. What about adults, though? We didn't know... until now.

Thirteen men and women consumed a diet of at least 80% organic or conventional food for seven days and then switched. No surprise, during the mostly organic week, pesticide exposure was significantly reduced by a nearly 90% drop.

If it can be concluded that consumption of organic foods provides protection against pesticides, does that also mean protection against disease? We don't know. The studies just haven't been done. Nevertheless, in the meantime, the consumption of organic food provides a logical precautionary approach.

For more on organic foods:

For more on the infectious disease implications of organic versus conventional, see Superbugs in Conventional vs. Organic Chicken. Organic produce may be safer too. See Norovirus Food Poisoning from Pesticides. Organic eggs may also have lower Salmonella risk, which is an egg-borne epidemic every year in the US. See my video Who Says Eggs Aren't Healthy or Safe?

More on Parkinson's and pesticides in Preventing Parkinson's Disease With Diet.

Those surprised by the California data might have missed my video California Children Are Contaminated.

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: IFPRI -IMAGES / Flickr. This image has been modified.

Original Link

The Food Safety Risk of Organic versus Conventional

The Food Safety Risk of Organic versus Conventional.jpeg

The stated principles of organic agriculture are "health, ecology, fairness, and care," but if you ask people why they buy organic, the strongest predictor is concern for their own health. People appear to spend more for organic foods for selfish reasons, rather than altruistic motives. Although organic foods may not have more nutrients per dollar (see my video Are Organic Foods More Nutritious?), consumption of organic foods may reduce exposure to pesticide residues and antibiotic-resistant bacteria.

Food safety-wise, researchers found no difference in the risk for contamination with food poisoning bacteria in general. Both organic and conventional animal products have been found to be commonly contaminated with Salmonella and Campylobacter, for example. Most chicken samples (organic and inorganic), were found to be contaminated with Campylobacter, and about a third with Salmonella, but the risk of exposure to multidrug-resistant bacteria was lower with the organic meat. They both may carry the same risk of making us sick, but food poisoning from organic meat may be easier for doctors to treat.

What about the pesticides? There is a large body of evidence on the relation between exposure to pesticides and elevated rate of chronic diseases such as different types of cancers, diabetes, neurodegenerative disorders like Parkinson's, Alzheimer's, and ALS, as well as birth defects and reproductive disorders--but these studies were largely on people who live or work around pesticides.

Take Salinas Valley California, for example, where they spray a half million pounds of the stuff. Daring to be pregnant in an agricultural community like that may impair childhood brain development, such that pregnant women with the highest levels running through their bodies (as measured in their urine) gave birth to children with an average deficit of about seven IQ points. Twenty-six out of 27 studies showed negative effects of pesticides on brain development in children. These included attention problems, developmental disorders, and short-term memory difficulties.

Even in urban areas, if you compare kids born with higher levels of a common insecticide in their umbilical cord blood, those who were exposed to higher levels are born with brain anomalies. And these were city kids, so presumably this was from residential pesticide use.

Using insecticides inside your house may also be a contributing risk factor for childhood leukemia. Pregnant farmworkers may be doubling the odds of their child getting leukemia and increase their risk of getting a brain tumor. This has lead to authorities advocating that awareness of the potentially negative health outcome for children be increased among populations occupationally exposed to pesticides, though I don't imagine most farmworkers have much of a choice.

Conventional produce may be bad for the pregnant women who pick them, but what about our own family when we eat them?

Just because we spray pesticides on our food in the fields doesn't necessarily mean it ends up in our bodies when we eat it, or at least we didn't know that until a study was published in 2006. Researchers measured the levels of two pesticides running through children's bodies by measuring specific pesticide breakdown products in their urine. In my video, Are Organic Foods Safer?, you can see the levels of pesticides flowing through the bodies of three to 11-year olds during a few days on a conventional diet. The kids then went on an organic diet for five days and then back to the conventional diet. As you can see, eating organic provides a dramatic and immediate protective effect against exposures to pesticides commonly used in agricultural production. The study was subsequently extended. It's clear by looking at the subsequent graph in the video when the kids were eating organic versus conventional. What about adults, though? We didn't know... until now.

Thirteen men and women consumed a diet of at least 80% organic or conventional food for seven days and then switched. No surprise, during the mostly organic week, pesticide exposure was significantly reduced by a nearly 90% drop.

If it can be concluded that consumption of organic foods provides protection against pesticides, does that also mean protection against disease? We don't know. The studies just haven't been done. Nevertheless, in the meantime, the consumption of organic food provides a logical precautionary approach.

For more on organic foods:

For more on the infectious disease implications of organic versus conventional, see Superbugs in Conventional vs. Organic Chicken. Organic produce may be safer too. See Norovirus Food Poisoning from Pesticides. Organic eggs may also have lower Salmonella risk, which is an egg-borne epidemic every year in the US. See my video Who Says Eggs Aren't Healthy or Safe?

More on Parkinson's and pesticides in Preventing Parkinson's Disease With Diet.

Those surprised by the California data might have missed my video California Children Are Contaminated.

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: IFPRI -IMAGES / Flickr. This image has been modified.

Original Link

Peeks Behind the Egg Industry Curtain

NF-Mar19 Who Says Eggs Aren't Healthy or Safe?.jpg

The American Egg Board is a promotional marketing board appointed by the U.S. government whose mission is to "increase demand for egg and egg products on behalf of U.S. egg producers." If an individual egg company wants to run an ad campaign, they can say pretty much whatever they want. But if an egg corporation wants to dip into the 10 million dollars the American Egg Board sets aside for advertising every year, because the board is overseen by the federal government, corporations are not allowed to lie with those funds. This leads to quite revealing exchanges between egg corporations that want to use that money and the USDA on what egg companies can and cannot say about eggs.

Thanks to the Freedom of Information Act I was able to get my hands on some of those emails. Of course a lot of what I got were pages with nearly all of the text blacked out (you can see these in my video, Who Says Eggs Aren't Healthy or Safe?). But I did find some illuminating correspondence. For example, one email shows an egg company trying to put out a brochure on healthy snacking for kids. But because of existing laws against false and misleading advertising, the head of the USDA's poultry research and promotion programs reminds the company that eggs or egg products cannot be couched as being healthy or nutritious. "The words nutritious and healthy carry certain connotations, and because eggs have the amount of cholesterol they do, plus the fact that they're not low in fat, [the words healthy and nutritious] are problematic." This is the United States Department of Agriculture saying this!

However, the USDA official helpfully suggests, "I believe you can say something that's just as strong if not stronger, that is 'naturally nutrient-dense.'" Why can we say eggs are nutrient-dense but not nutritious? Because there's no legal definition of nutrient-dense. We can say Twinkies and Coca Cola are nutrient dense, but legally, we can't say something is nutritious unless it's actually... nutritious.

For example, the egg industry wanted to run an ad calling eggs a nutritional powerhouse that aids in weight loss. The USDA had to remind the industry that they can't portray eggs as a diet food because of the fat and cholesterol content. In fact, eggs have nearly twice the calories of anything that can be called "low-calorie."

"Nutritional powerhouse" can't be used either. Fine, the industry said, they'll move to plan B, and headline the ad "Egg-ceptional Nutrition." They couldn't say that either because, again, given the saturated fat and cholesterol you can't legally call eggs nutritious. So the headline ended up as, "Find true satisfaction," and instead of weight loss they had to go with "can reduce hunger." The USDA congratulated them on their cleverness. Yes, a food that when eaten can reduce hunger--what a concept!

They can't even say eggs are "relatively" low in calories. Can't say eggs are low in saturated fat--they're not. Can't say they're relatively low in fat, they're not. Can't even call them a rich source of protein, because, according to the USDA, they're not.

It's illegal to advertise that eggs pack a nutritional wallop, or that they have a high nutritional content. Eggs have so much cholesterol, we can't even say they "contribute nutritionally." Can't say eggs are "healthful," certainly can't say they're "healthy." Can't even say eggs contribute "healthful components."

Since we can't say eggs are a healthy start to the day, the USDA suggests a "satisfying start." Egg corporations can't call eggs a healthy ingredient, but they can call eggs a "recognizable" ingredient. Can't truthfully say eggs are good for us, either. By law, according to the USDA, the egg industry "needs to steer clear of words like 'healthy' or 'nutritious.'"

For a food to be labeled "healthy" under FDA rules, it has to be low in saturated fat (eggs fail that criteria) and have less than 90mg of cholesterol per serving (even half an egg fails that test). For the same reason we can't tout ice cream for strong bones, we can't say eggs are healthy because they exceed the threshold for cholesterol.

Egg corporations aren't even allowed to say things like "Eggs are an important part of a well balanced, healthy diet" on an egg carton because it would be considered misleading according to the USDA's National Egg Supervisor, since eggs contain significant amounts of fat and cholesterol and therefore can contribute to the leading killer in the United States, heart disease.

The industry can't afford to tell the truth about the eggs, or even the hens that lay them. The industry crams five to ten birds in cages the size of a file cabinet their whole lives, but when providing footage to the media, the American Egg Board instructs, "do not show multiple birds in cages--they look too crowded and open us up to activist criticism."

Not only is the industry barred from saying eggs are healthy, they can't even refer to eggs as safe because more than a hundred thousand Americans are food poisoned by Salmonella from eggs every year.

The egg board's response to this egg-borne epidemic is that Salmonella is a naturally occurring bacterium. An internal egg industry memo didn't think that should necessarily be the key message, fearing that "it may be counterproductive by implying there is no avoiding Salmonella in eggs aside from avoiding eggs altogether."

The food poisoning risk is why the American Egg Board can't even mention anything but eggs cooked hard and dry. No soft-boiled, no over-easy, no sunny-side up--because of the Salmonella risk. The American Egg Board's own research showed that the sunny-side up cooking method should be considered "unsafe."

In light of bird flu viruses, both the white and yolk must be cooked firm. The VP of marketing for the Egg Board complained to the USDA saying they'd "really like to not have to dictate that the yolks are firm," and cites a Washington Post article saying runny yolks may be safe for everyone except pregnant women, infants, elderly, or those with chronic disease. It turns out it was a misquote--eggs can't be considered safe for anyone.

Instead of safe, they can call eggs "fresh," the USDA marketing service helpfully suggests. But they can't call eggs safe, and they can't say eggs are "safe to eat." They can't even mention safety at all.

Wait a second, not only can eggs not be called healthy they can't even be called safe? Says who? Says the United States Department of Agriculture.

For more peeks behind the egg industry curtain see:

-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: U.S. Department of Agriculture / Flickr

Original Link

Chicken Salmonella Outbreaks Show Food Safety Systems Failure

NF-Mar5 The Big Problem with Foster Farms Chicken.jpg

Salmonella causes more hospitalizations and more deaths than any other foodborne illness, and it's been on the rise. Salmonella causes a million cases of food poisoning every year in the U.S., and over the last decade or so the number of cases has increased by 44%, particularly among children and the elderly. And chicken is the number one cause of Salmonella poisoning.

Starting in Spring 2012, the Centers for Disease Control (CDC) documented more than 600 individuals infected across 29 states with a particularly virulent strain of Salmonella (one in three were hospitalized). Investigations pointed to Foster Farms--the sixth largest chicken producer in the US--as the most likely source of the outbreak. The CDC warned people, but nothing was done. Foster Farms apparently continued to pump out contaminated meat for 17 months.

Though there's only been a few hundred cases confirmed, for every confirmed case the CDC estimates 38 cases slip through the cracks. So Foster Farms chicken may have infected and sickened more than 15,000 people.

When USDA inspectors went to investigate, they found 25% of the chicken they sampled was contaminated with the outbreak strain of Salmonella, presumed to be because of all the fecal matter they found on the carcasses.

In their February 2014 issue, Consumer Reports published a study on the high cost of cheap chicken, finding 97% of retail chicken breast off store shelves was contaminated with bacteria that can make people sick. 38% of the salmonella they found was resistant to multiple antibiotics (considered a serious public health threat by the CDC). Consumer Reports suggested the cramped conditions on factory chicken farms may play a role, and indeed new research shows the stress of overcrowding can increase Salmonella invasion.

The Pew Commission released a special report on the Foster Farms outbreaks, concluding that the outbreaks bring into sharp focus the ineffectiveness of USDA's approach to minimizing Salmonella contamination in poultry products. The agency's response "was inadequate to protect public health," and to this day thousands of people are getting sick with this preventable foodborne illnesses. One of the Pew Commission's recommendations is to close facilities that are failing to produce safe food and keep them closed until their products stop sending people to the hospital.

What did Foster Farms have to say for itself? They said that their chicken was "safe to eat," that there's "no recall in effect," and that it is "Grade A wholesome." In the same breath, though, they say Salmonella on chicken happens all the time. Their chicken is "Grade A wholesome," but might kill us if we don't handle it right. (See Foster Farms Responds to Chicken Salmonella Outbreak).

As outspoken food safety advocate Bill Marler put it, the poultry industry's reaction to the presence of fecal contamination on chicken is that... sh*t happens.

Salmonella contamination is also a problem in the U.S. egg supply, sickening more than 100,000 people every year. See my video Total Recall.

Other pathogens in meat include Yersinia enterocolitica in pork (Yersinia in Pork), Staphylococcus (U.S. Meat Supply Flying at Half Staph), MRSA (MRSA in U.S. Retail Meat), Hepatitis E (Hepatitis E Virus in Pork), bladder-infecting E coli (Avoiding Chicken To Avoid Bladder Infections), Clostridium difficile (Toxic Megacolon Superbug), and Campylobacter, the most common bacterial chicken pathogen (Poultry and Paralysis).

Poultry appears to cause the most outbreaks, but is all chicken to blame equally? See my video Superbugs in Conventional vs. Organic Chicken.

How was it legal for Foster Farms to continue to ship our meat known to be contaminated with a dangerous pathogen? See my videos Why is selling Salmonella tainted chicken still legal? and Chicken Salmonella Thanks to Meat Industry Lawsuit.

-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: zoomar / Flickr

Original Link

Viral Food Poisoning from Pesticides?

NF-Mar3 Did Pesticides Cause Your Food Poisoning?.jpg

Although the most serious causes of food poisoning like Salmonella come largely from animal products (for example, most foodborne-related deaths have been attributed to poultry), millions of Americans are sickened by produce every year, thanks to noroviruses. Noroviruses can spread person-to-person via the fecal-oral route or by the ingestion of aerosolized vomit, which together may explain most norovirus food outbreaks. But a substantial proportion remained unexplained. How else can fecal viruses get on our fruits and veggies?

The pesticide industry may be spraying them on (See Norovirus Food Poisoning from Pesticides).

The water that's used to spray pesticides on crops may be dredged up from ponds contaminated with fecal pathogens. When you hear of people getting infected with a stomach bug like E. coli from something like spinach, it's important to realize that the pathogen didn't originate from the spinach. Intestinal bugs come from intestines. Greens don't have guts; plants don't poop.

"The application of pesticides may therefore not only be a chemical hazard, but also a microbiological hazard for public health." What is the industry's solution? To add more chemicals! "The inclusion of antiviral substances in reconstituted pesticides," researchers assert, "may be appropriate to reduce the virological health risk posed by the application of pesticides." Or we could just choose organic.

Likewise the Salmonella in alfalfa sprout seeds (See Don't Eat Raw Alfalfa Sprouts) likely came from manure run-off or contaminated irrigation water. But this pesticide angle adds a whole new route for fecal pathogens to pollute produce. Broccoli Sprouts are safer, and organic sprouts may therefore be safer still (See Broccoli Sprouts).

Organic foods may also be healthier (see Cancer Fighting Berries) and don't carry the potential chemical hazards associated with pesticides. See my videos:

-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: jetsandzeppelins / Flickr

Original Link

Superbugs on Retail Chicken

NF-Jan13 Superbugs in Conventional Vs. Organic Chicken.jpg

One of the most concerning developments in medicine is the emergence of bacterial super-resistance--resistance not just to one class of drugs, like penicillin, but to multiple classes of drugs (so-called multi-drug resistance). In the 2013 Retail Meat Report, the FDA found that more than a quarter of the Salmonella contaminating retail chicken breast were resistant to not one but five or more different classes of antibiotic treatment drugs.

Throughout history there has been a continual battle between humans and pathogens. For the last half century, this battle has taken the form of bugs versus drugs. When we developed penicillin, the U.S. Surgeon General declared, "The war against infectious diseases has been won." However, the euphoria over the potential conquest of infectious diseases was short lived.

In response to our offensive, bacteria developed an enzyme that ate penicillin for breakfast. In fact, bacteria can excrete such large quantities of the enzyme that they can destroy the drug before it even comes into contact. So we developed a drug that blocks the penicillin-eating enzyme. That's why you may see two drug names on an antibiotic like Augmentin--one is the actual antibiotic (amoxicillin), and the other is a drug that blocks the enzyme the bacteria tries to use to block the antibiotic (clavulanate). But the bacteria outsmarted us again by developing a blocker blocking blocker--and so it goes back and forth. However hard we try and however clever we are, there is no question that organisms that have "been around for three billion years, and have adapted to survive under the most extreme conditions, will always overcome whatever we decide to throw at them."

So we went from first generation antibiotics, to second generation antibiotics, to third generation antibiotics. We now have bacteria that have evolved the capacity to survive our big-gun third generation cephalosporins like ceftriaxone, which is what we rely on to treat life-threatening Salmonella infections in children.

Where are these super-duper-superbugs found? According to one study profiled in my video, Superbugs in Conventional vs. Organic Chicken, "almost 90% were isolated from chicken carcasses or retail chicken meat."

But what if we only ate antibiotic-free organic chicken? In the first such study ever published, researchers compared multidrug-resistant bacteria in organic and conventional retail chicken meat. All of the conventional chicken samples were contaminated; however, the majority (84%) of organic chicken meat samples was also contaminated. So 100% versus 84%. Organic is definitely better, but odds are we could still be buying something that could make our family sick.

Where do these antibiotic resistant bacteria come from if organic producers are not using antibiotics? A possible explanation is that day-old chicks come from the hatcheries already infected with these bacteria before they arrive at the farms. Or, they could become contaminated after they leave the farm in the slaughter plant. Organic chickens and conventionally raised chickens are typically all slaughtered at the same plants, so there may be cross-contamination between carcasses. Finally, factory farms are dumping antibiotics and antibiotic-resistant bacteria-laden chicken manure out into the environment. Researchers can pick up antibiotic-resistant genes right out of the soil around factory farms. So even meat raised without antibiotics may be contaminated with multi-drug resistant bacteria.

In a cover story in which Consumer Reports urged retailers to stop selling meat produced with antibiotics, the researchers noted some store employee confusion: "An assistant store manager at one grocery store, when asked by a shopper for meats raised without antibiotics, responded, 'Wait, you mean like veggie burgers?'" On second thought maybe the employees weren't so confused after all.

I addressed this issue previously in video such as:

Isn't it illegal to sell meat contaminated with dangerous bacteria? Unfortunately no. See why in my video Salmonella in Chicken & Turkey: Deadly But Not Illegal. Reminds me of the case I wrote about in Supreme Court case: meat industry sues to keep downed animals in food supply.

-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: Chilanga Cement / 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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Egg Industry Caught Making False Claims

 

 

 

 

 

 

 

 

Egg Industry Caught Making False Claims

On the basis of concerns from the American Heart Association and consumer groups, the Federal Trade Commission carried out successful legal action—upheld by the Supreme Court—to compel the egg industry to cease and desist from false and misleading advertising that eggs had no harmful effects on health.

Over the years, cholesterol concerns resulted in severe economic loss through a reduction in egg consumption, so the egg industry created a “National Commission on Egg Nutrition” to combat the public health warnings with ads that said things like “There is no scientific evidence whatsoever that eating eggs in any way increases the risk of heart attack.” The U.S. Court of Appeals found such outright deception patently false and misleading.

Even the tobacco industry wasn’t that brazen, trying only to introduce the element of doubt, arguing that the relationship between smoking and health remains an open question. In contrast, the egg ads made seven claims, each of which was determined by the courts to be blatantly false. The Court determined the egg industry ads were "false, misleading, and deceptive." Legal scholars note that, like Big Tobacco, the egg industry did more than just espouse one side of a genuine controversy, but flatly denied the existence of scientific evidence.

Over the last 36 years, the American Egg Board has spent hundreds of millions of dollars to convince people eggs are not going to kill them—and it’s working. From one of their internal strategy documents that I was able to get a hold of: “In combination with aggressive nutrition science and public relations efforts, research shows that the advertising has been effective in decreasing consumers concerns over eggs and cholesterol/heart health.”

Currently, they’re targeting moms. Their approach is to “surround moms wherever they are.” They pay integration fees for egg product placement in TV shows. To integrate eggs into The Biggest Loser, for example, could be a million dollars, according to their internal documents. Getting some kids storytime reading program to integrate eggs may only take half a million, though. The American Egg Board keeps track of who is, and is not, a “friend-of-eggs.” They even pay scientists $1500 to sit and answer questions like, “What studies can help disassociate eggs from cardiovascular disease?”

From the beginning, their arch nemesis was the American Heart Association, with whom they fought a major battle over cholesterol. In documents retrieved through the Freedom of Information Act featured in my 6-min video Eggs and Cholesterol: Patently False and Misleading Claims, you can see even the USDA repeatedly chastises the egg industry for misrepresenting the American Heart Association position. In a draft letter to magazine editors, the egg industry tried to say that the “American Heart Association changed its recommendations to approve an egg a day in 2000 and eventually eliminated its number restrictions on eggs in 2002,” to which the head of USDA’s poultry research and promotion programs had to explain that the “change” in 2000 wasn’t a change at all. Nothing in the guidelines or recommendations was changed. What happened was that in response to a question posed by someone planted in the audience, Heart Association reps acknowledged that even though eggs are among the most concentrated source of cholesterol in the diet, an individual egg has under 300mg of cholesterol and could technically fit under the 300 mg daily limit. In 2002, they eliminated the specific mention of eggs for consistency sake, but the American Heart Association insists that they haven’t changed their position and continue to warn consumers about eggs.

The guidelines on the AHA website at the time explained that since one egg has 213 and the limit for people with normal cholesterol is 300 you could fit an egg in if you cut down on all other animal products. If you have an egg for breakfast, for example, and some coffee, some skinless turkey breast for lunch, etc., you could end up at over 500 by the end of the day, nearly twice the recommended limit. So if you are going to eat an egg, the Heart Association instructed, we would need to "substitute vegetables for some of the meat, drink our coffee black, and watch for hidden eggs in baked goods." Furthermore, the limit for folks with high cholesterol is 200mg a day, which may not even allow a single egg a day.

This is how the senior director of nutrition education at the American Egg Board’s Egg Nutrition Center characterized the American Heart Association guidelines: “Maybe I’m being overly sensitive, but this reads like: ‘If you insist on having those deadly high cholesterol eggs your penalty will be to eat vegetables and you can’t even have the yummy steak and creamy coffee you love. Really it’s not worth eating eggs. Oh, and if you think you’ll be able to enjoy some delicious baked goods, forget it, the deadly eggs are there too!’”

I shared some of my other Freedom of Information Act finds in my other egg videos, Eggs vs. Cigarettes in Atherosclerosis, and my personal favorite, Who Says Eggs Aren’t Healthy or Safe?

I’ve also explored the presence of carcinogenic chemicals in eggs (Heterocyclic Amines in Eggs, Cheese, and Creatine?), carcinogenic viruses (Carcinogenic Retrovirus Found in Eggs), industrial pollutants (Food Sources of Perfluorochemicals and Food Sources of PCB Chemical Pollutants), the egg-borne annual epidemic of Salmonella (Total Recall), arachidonic acid (Chicken, Eggs, and Inflammation), misleading claims about eyesight nutrients (Egg Industry Blind Spot), and, of course, cholesterol (Egg Cholesterol in the Diet and What Women Should Eat to Live Longer).

To my surprise, though, eggs are actually not the most concentrated dietary source of cholesterol. See Avoiding Cholesterol Is a No Brainer.

-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: Nick Wheeler/ Flickr

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