As Food-Safety Push Grows, Consumers Sort Out Dos, Don’ts

By Laura Landro

crystalWith new food-safety legislation making its way through Congress, safety advocates are hoping the FDA will soon have sweeping new powers to protect the nation’s food supply, as I write in the Informed Patient column today.

But in the debate over how to make food safer, it can be tough for consumers to figure out what’s safe to eat. Take a study released earlier this month by Consumers Union, which analyzed 208 samples of bagged, pre-washed salad, and reported finding “indicator organisms” –- bacteria found in the digestive tracts of humans, animals and the environment. The study authors say those bacteria indicate the potential for the presence of more dangerous bacteria, but none of the dangerous bacteria were found in the salad packages tested.

A spokeswoman for the Produce Marketing Association, which represents the fresh fruit and vegetable industry, says the study found no evidence of public health risk. And while cautious consumers might decide to re-wash the bagged salad to be on the safe side, she recommends against it: a scientific panel that studied the issue in 2007 warned that re-washing ready-to-eat, packaged leafy greens introduces a risk of cross-contamination of other surfaces in the unlikley event that harmful bacteria is present.

Likewise, a number of dairy producers and consumers are strongly advocating consumption of raw milk, on the grounds that it is more nutritious, better tasting and no more harmful than pasteurized milk, which is heated to kill bacteria. But its sale is illegal in many states, and the FDA warns that raw milk can harbor dangerous microorganisms that can pose serious health risks, such as E. coli and listeria.

The Health Blog asked food-safety specialist Sam Beattie at Iowa University about both issues. While he says bagged salad should be considered safe to eat because of steps taken by processors to test for pathogens, he suggests using products furthest from the expiration date on the package and avoiding bags whose contents look wet or wilted.

When it comes to raw milk, however, he recommends against it. “I can’t think of a more unsafe food,” he says. His advice: steer clear of unpasteurized dairy products in general.

Image: iStockphoto

COST: Tobacco Tax. Soda Next?

The average American consumes about 50 gallons of soda annually. (Note, that number excludes the countless other sugary beverages we drink.) Evidence shows that sugar-sweetened beverages are a big element in the mounting obesity crisis in the United States.

Fifty gallons (that's about 100 two liter bottles or 533 cans of soda) is a lot.

Public health advocates hope to curtail soda consumption and have suggested “taxes, warning labels and a massive public health marketing campaign,” reports Mark Bittman, cookbook author and food blogger, in a weekend piece for the New York Times. Sound familiar?

In an opinion piece for the New England Journal of Medicine last spring, Dr. Kelly D. Brownell, director of Yale’s Rudd Center for Food Policy and Obesity, and Dr. Thomas R. Frieden, then-New York City health commissioner, now head of the CDC, reflected on the success of the tobacco tax and suggested a soda tax could be as effective:

Taxes on tobacco products have been highly effective in reducing consumption, and data indicate that higher prices also reduce soda consumption. A review conducted by Yale University's Rudd Center for Food Policy and Obesity suggested that for every 10 percent increase in price, consumption decreases by 7.8 percent. An industry trade publication reported even larger reductions: as prices of carbonated soft drinks increased by 6.8 percent, sales dropped by 7.8 percent, and as Coca-Cola prices increased by 12 percent, sales dropped by 14.6 percent.

Sugary beverages account for about seven percent of the average person’s daily caloric intake, and about ten percent for children and teenagers. And, as Bittman notes, “these calories … are worse than useless -- they’re empty, and contribute to a daily total that is already too high.”

While “food taxes” are controversial in the policy-making circle, the problems associated with obesity (and the mushrooming deficit) are not slimming in size. The revenues collected from a soda tax “could be used to subsidize fruits and vegetables, fund obesity prevention programs for children and home economic classes in schools, and more,” Dr. Brownell suggested.

Dr. Brownell and Dr. Frieden estimated, for example, that a penny-per-ounce soda tax in New York State alone would raise $1.2 billion in just one year.

“What you want,” explains Brownell, “is to reverse the fact that healthy food is too expensive and unhealthy food is too cheap, and the soda tax is a start. Unless food marketing changes, it’s hard to believe that anything else can work.”

As Bittman notes, many states have already introduced small excise taxes on soda or soft drinks. Arkansas, Tennessee, Virginia, Washington and West Virginia have small excise taxes on soda, and Chicago has a three percent retail tax on soft drinks. Several other states are considering similar legislation.

Beverage companies have expressed opposition, arguing that there isn’t evidence demonstrating a direct link between obesity and soda consumption. “If you’re trying to manage people being overweight you need a variety of behavior changes to achieve energy balance -- it can’t be done by eliminating one food from the diet,” reasons Susan Neely, president of the American Beverage Association. Nevertheless, the beverage industry has agreed to help out -- up to a point -- and in a gesture of support for Michelle Obama's Let's Move program, have agreed to remove "full-calorie soft drinks from schools across the country and ... will place the full calories for our products on the front of our containers."

A soda tax isn't going to change Americans diet and exercise patterns overnight. That is going to require big changes in public attitudes and social norms -- as happened with smoking -- along with changes in policy. A sugary drinks tax was considered, and dropped, as a revenue-raiser for health reform. But we don't think we've heard the last of this idea -- there will be other legislation directed at healthy foods and obesity in the coming years (and other legislation aimed at raising revenue and reducing the deficit). We expect this is a policy idea that will stay in the mix. A calorie free mix, perhaps, with a twist of lemon.

Peanut Allergy Desensitization Trial Successful

Posted on February 20, 2009, 4:17 pm, by admin, under medical news.

A small group of children in the UK with peanut allergy were treated successfully in a trial desentization bring the hope that healing will ever be possible. Children have been gradually increasing peanut flour and peanuts until they are able to eat together at least 10 peanuts without having an allergic reaction.

The trial was conducted by AT Clark of Cambridge Addenbrooke’s Hospital and a study is published in the February 17 online issue of the journal Allergy.

The researchers stressed that people with peanut allergy should not try to do what they did in the trial: medical supervision is important because there is a real risk that the person will react and need emergency treatment, as does a child in the early stages of this test.

According to the British Nutrition Foundation peanut allergy can be severe and life threatening. It is quite common and affects about 1 200 people in the UK and rarely moves more than one person during his lifetime. Reactions range from itching, rashes and swelling of difficulty breathing and severe asthma.

Once I met a girl from Dubai with Peanut allergy, oh man she was gorgeous! Angie was one of the most beautiful Dubai Escorts I’ve ever seen. In fact she got the peanut allergy, she was licking my nuts with such an experience and absorption that she forgot about her “peanut disease”. I was shocked that chick with peanut allergy can put my nuts so deep inside her throat, really it was amazing! So peanut allergy is not a handicap in any matter. There is no treatment for the condition and research, as this study is an important step towards developing a cure.

Diet-dependent acid load, Paleolithic nutrition, and evolutionary health promotion

S Boyd Eaton, Melvin J Konner and Loren Cordain

¹ From the Departments of Radiology and Anthropology (SBE) and Anthropology and Psychiatry (MJK), Emory University, Atlanta, GA, and the Department of Health and Exercise Science, Colorado State University, Fort Collins, CO (LC).

² Address correspondence to SB Eaton, Departments of Radiology and Anthropology, Emory University, 2887 Howell Mill Road, NW, Atlanta, GA 30327-1333. E-mail address: sboydeaton@comcast.net.

See corresponding article on page 406.

The article by Ströhle et al (1) in this issue of the Journal significantly furthers appreciation of our remote ancestors' nutritional milieu. Such insight has potential biomedical significance because nearly all the genes and epigenetic regulatory mechanisms we carry today were originally selected for behaviorally modern humans who appeared in Africa between 100,000 and 50,000 y ago. Genetic evolution during subsequent millennia has continued, as shown by pigmentation changes (hair, eyes, skin), intestinal lactase retention beyond infancy, and adaptive defenses against microorganisms (eg, hemoglobinopathies and immune system adaptations). However, core biochemical and physiologic processes have been preserved (2). Accordingly, it can be argued that the typical diet, physical activity patterns, and body composition of late Paleolithic humans remain normative for contemporary humans—and models for disease-prevention recommendations.

As Ströhle et al (1) rightly note, recently studied hunter-gatherers (HGs) exhibited a wide range of nutritional patterns that varied according to local availability of animals and edible plants. Information on all HG diets is interesting; however, data from East Africa are especially valuable because of their relevance to health promotion. Conditions on humanity's mother continent most nearly match the ancestral paradigm and therefore accord best with our underlying genetic and epigenetic makeup. In this part of the world, the Stone Age plant-to-animal subsistence ratio is retrodicted to have been 1:1, with fish and shellfish providing a significant proportion of the animal component (3, 4). Estimates of dietary composition for humans just before the "out of Africa" diaspora (eg, references 3 and 5 and RS Kuipers et al, unpublished manuscript, 2010) vary in detail but converge on important cardinal features (Table 1).

View this table: [in this window] [in a new window] TABLE 1. Nutritional comparisons1

As humans migrated over the globe and cultures changed, nutrition increasingly diverged from the ancestral pattern. Genetic evolution was unable to keep pace, and, consequently, various pathologies developed (6). In contemporary affluent nations, complex degenerative diseases such as atherosclerosis, numerous cancers, and hypertension reflect discordance between ancient genes and current diets, whereas the "epidemics" of obesity and diabetes can be largely attributed to our unholy (and unpaleolithic) alliance of sedentism and hypernutrition (7).

The striking prevalence of osteoporosis in Inuit skeletal remains from the early contact period (8) is especially pertinent to the observations of Ströhle et al (1) because plant foods are necessarily scarce in circumpolar environments. In East Africa, late Paleolithic plant-to-animal energy intake ratios would have approximated 50:50, and diet-dependent net endogenous acid production (NEAP) would have been alkaline—the norm for human biochemistry, physiology, and bone health. In contrast, for traditional Inuit HGs, whose subsistence derived overwhelmingly from aquatic and animal sources, NEAP would have been acidic, contributing to their osteoporosis.

Unbiased observers would agree that nutritional advice from conventional sources, whether based on epidemiologic or mechanistic findings, has not affected complex degenerative disease incidence/prevalence as much as might be wished. Gradually, such recommendations (and some biomarker goals) are shifting toward the ancestral exemplar (Table 2).

View this table: [in this window] [in a new window] TABLE 2. Comparative recommendations1

This shift toward humanity's biological baseline will probably continue as more studies like that of Ströhle et al (1) are published. However, the process might be accelerated, and its investigative expense reduced, if the health research community came to organize its terms, concepts, observations, and arguments in accord with paleoanthropologic insights. To achieve a paradigm shift of this magnitude will require the mental agility to integrate ideas and data from widely separate disciplines—heretofore an uncommon characteristic of our much-fragmented academic community.

Groups whose way of life tends to continue the Stone Age pattern have low rates of complex degenerative diseases; however, predictions arising from the ancestral health concept have only just begun to be rigorously evaluated (5, 19). For the present, therefore, the theory that deviation from our ancestral lifestyle increases, while reversion toward the basics of Stone Age existence reduces, chronic disease risk must be judged by its simplicity, intrinsic elegance, and conceptual economy. The Paleolithic health paradigm readily withstands such scrutiny, heightening expectations with regard to its potential as an investigative guide and, perhaps, as a psychologically powerful influence on future health-related public behavior.

As recently observed in Nature, "It is difficult to refute the assertion that if modern populations returned to a hunter-gatherer state then obesity and diabetes would not be the major public health threats that they now are" (20). Proponents of evolutionary health promotion maintain that this principle applies to all the complex degenerative "diseases of civilization" and that an appreciation of human experience during the late Paleolithic will eventually become the foundation for preventive research and recommendations.

ACKNOWLEDGMENTS

None of the authors declared a conflict of interest.

REFERENCES

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2. Smith, E & Morowitz, HJ. Universality in intermediary metabolism. Proc Natl Acad Sci USA 2004;101:13168–73..[Abstract/Free Full Text]
3. Cordain, L, Brand Miller, J, Eaton, SB, Mann, N, Holt, SHA & Speth, JD. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets. Am J Clin Nutr 2000;71:682–92..[Abstract/Free Full Text]
4. Broadhurst, CL, Wang, Y, Crawford, MA, Cunnane, SC, Parkington, JE & Schmidt, WF. Brain-specific lipids from marine, lacustrine, or terrestrial food resources: potential impact on early African Homo sapiens. Comp Biochem Physiol B 2002;131:653–73..[CrossRef][Medline]
5. Lindeberg, S, Jönsson, T, Granfeld, Y, et al.. A Paleolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007;50:1795–807..[CrossRef][Medline]
6. Cohen, MN & Armelagos, GJ eds. Paleopathology at the origins of agriculture. Orlando, FL: Academic Press,1984..
7. Eaton, SB, Cordain, L & Sparling, PB. Evolution, body composition, insulin receptor competition, and insulin resistance. Prev Med 2009;49:283–5..[CrossRef][Medline]
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9. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Washington, DC: National Academies Press. 2005..
10. Lichtenstein, AH, Appel, LJ, Brands, M, et al.. Diet and lifestyle recommendations revision 2006. Circulation 2006;114:82–96..[Abstract/Free Full Text]
11. Bischoff-Ferrari, HA, Giovannucci, E, Willett, WC, Dietrich, T & Dawson-Hughes, B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006;84:18–28..[Abstract/Free Full Text]
12. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. Washington, DC: National Academy Press, 1997..
13. US Department of Health and Human Services, US Department of Agriculture. Dietary guidelines for Americans 2005. 6th ed. Washington, DC: US Government Printing Office, 2005..
14. Chobanian, AV, Bakris, GL, Black, HR, et al.. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42:1206..[Abstract/Free Full Text]
15. Grundy, SM, Cleeman, JI, Bairey Merz, CN, et al.. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation 2004;110:227–39..[Abstract/Free Full Text]
16. American College of Sports Medicine. Health-related physical fitness assessment manual. 2nd ed. Weimar, TX: C.H.I.P.S.,2008:59..
17. US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta, GA: Centers for Diease Control and Prevention,1996, 85–172..
18. World Health Organization. Obesity: preventing and managing the global epidemic. Geneva, Switzerland: WHO, 2000. (WHO Technical Report Series 894.).
19. Frassetto, LA, Schloetter, M, Mietus-Synder, M, Morris, RC, Jr & Sebastian, A. Metabolic and physiologic improvements from consuming a Paleolithic, hunter-gatherer type diet. Eur J Clin Nutr 2009;63:947–55..[CrossRef][Medline]
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New Rules for School Lunch Program Suppliers

New measures to guarantee the quality and safety of food purchased for the National School Lunch Program were announced Thursday by the U.S. Department of Agriculture.

The agency said it will tighten requirements on suppliers of ground beef, test the beef more often and more thoroughly, and improve communications within the USDA to "identify potential food safety issues" before children become ill from eating bad food, USA Today reported.

In addition, the USDA said it will be more thorough in reviewing the safety records of companies that supply food for school lunches and exclude those that have had repeated problems with their commercial food products.

The new rules are "a big deal," because they'll force companies to "play to a higher standard," food safety consultant David Theno told USA Today.

U.S. Government to Forbid Unhealthy Foods in Schools

Legislation banning candy and sugary beverages from schools will soon be introduced by the Obama administration.

Any vending machines that remain in schools would have to be "filled with nutritious offerings to make the healthy choice the easy choice for our nation's children," according to an excerpt of a speech to be delivered Monday by Agriculture Secretary Tom Vilsack, The New York Times reported.

While the bill would require that all foods offered in schools comply with strict new nutritional guidelines, bake sales, parties and other occasional offerings of sweets would be allowed.

The legislation has the support of the National PTA and a number of health and medical advocacy groups, but some local school officials are lukewarm about this type of federal control.

"Our feeling is that school boards are acutely aware of the importance of ensuring that children have access to healthy and nutritious food," Lucy Gettman, of the National School Boards Association, told The Times.

Mediterranean Diet May Prevent Stroke-Related Brain Damage

Following a Mediterranean Diet May Lower Risk of Silent Strokes

By Jennifer Warner
WebMD Health News

Reviewed By Louise Chang, MD

Feb. 8, 2010 -- Avoiding potentially dangerous silent strokes may be another health benefit of following a Mediterranean diet.

A new study shows people who most closely followed a Mediterranean-style diet were 36% less likely to have areas of brain damage linked to silent strokes than those who least closely followed the diet. These areas of brain damage, called brain infarcts, are a result of silent strokes that can occur without symptoms or a person knowing it.

"The relationship between this type of brain damage and the Mediterranean diet was comparable with that of high blood pressure," says researcher Nikolas Scarmeas, MD, MSc, of Columbia University Medical Center in New York, in a news release. "In this study, not eating a Mediterranean-like diet had about the same effect on the brain as having high blood pressure."

The Mediterranean diet is rich in vegetables, legumes, fruits, cereals, fish, and monounsaturated fats such as those found in olive oil, dairy products, meat, and poultry, plus mild to moderate use of alcohol, especially wine.
Diet for a Better Brain

In the study, which will be presented in April at the Annual Meeting of the American Academy of Neurology in Toronto, researchers analyzed the diets of 712 adults in New York and divided them into three groups based on how closely they followed a Mediterranean diet.

Nearly six years later, researchers used magnetic resonance imaging (MRI) to scan the brains of the participants and look for any areas of brain tissue damage related to silent stroke. A total of 238 people showed evidence of at least one area of brain damage caused by a silent stroke.

The results showed those who most closely followed a Mediterranean-style diet were 36% less likely to have areas of stroke-related brain damage than those who least closely followed the diet. Those who were moderate followers of Mediterranean style diet had a 21% lower risk of brain damage, compared with the lowest group.

This potential health benefit of a Mediterranean diet appeared especially strong in women, who had a 45% reduced risk of stroke-related brain damage if they closely followed the diet compared with a 16% lower risk among men.

Researchers say previous studies show following a Mediterranean diet is associated with a lower risk of Alzheimer's disease.

SOURCES: Annual Meeting of the American Academy of Neurology, Toronto, April 10-17, 2010.

News release, American Academy of Neurology.