NY Times on "Fortified Foods"

In the business section of today's New York Times, Melanie Warner writes about a new trend in the food industry: adding health supplements to foods. They call them fortified foods. Examples include yogurt with active cultures, orange juice with added fiber, soft drinks with vitamins, etc.

Here's the only part of the article where genuine nutrition was really assessed:

Alice H. Lichtenstein, a senior scientist at the nutrition research center at Tufts University, says she believes that people who may be in need of additional nutrients, cholesterol-lowering plant sterols or extra fiber should get them through a multivitamin or pill-based supplement.

"The danger with this is that people will add food to their diet, rather than substitute, and then they'll end up consuming more calories, which would not be good," Dr. Lichtenstein said.

Food companies say many people do not like to take pills and find it easier to get nutrients or supplements in a food or a beverage that they may be consuming anyway.


I'm not an expert or a doctor, but it seems a little irresponsible to me to not even mention the idea of getting the majority of your nutrition from food that's actually proven to be healthy, like vegetables, fruits, legumes, nuts, etc.

The article also includes this staggeringly terrible news:

How big is the functional foods market? According to some reports, it could be huge. A study by Gerard Anderson, a professor of health policy and management at the Johns Hopkins University Bloomberg School of Public Health, found that 48.4 percent of all Americans in 2002 suffered from at least one chronic health condition, from hypertension to asthma to heart disease, up from 44.7 percent in 1996.

What caused all that chronic disease? The same companies that go to great lengths making fat, sugar, salt, and other things so fun and prevelant--even in our schools--are now going to capitalize on our health problems and fears to sell us more of the same with a couple of fancy additives thrown in? Something about that leaves a bad taste in my mouth.

Cow's Milk and Kids Aren't Made for Each Other

In Dr. Fuhrman's book Disease-Proof Your Child, Dr. Fuhrman presents studies linking diseases to cow's milk that including: allergies, anal fissures, childhood-onset (Type 1) diabetes, chronic constipation, Crohn's disease, ear infections, heart attacks, multiple sclerosis, and prostate cancer. He explains:

The leading cause of digestive intolerance leading to stomach complaints is dairy products. Many kids have subtle allergies to cow's milk that perpetuate their nasal congestion, leading to ear infections.

Milk, which is designed by nature for the rapidly growing cow, has about half its calories supplied from fat. The fatty component is concentrated more to make cheese and butter. Milk and cheese are the foods Americans encourage their children to eat, believing them to be healthy foods. Fifty years of heavy advertising by an economically powerful industry has shaped the public's perception, illustrating the power of one-sided advertising, but the reality and true health effects on our children is a different story. Besides the link between high-saturated-fat foods (dairy fat) and cancer, there is a body of scientific literature linking the consumption of cow's milk to many other diseases. If we expect our children to resist many common illnesses, they simply must consume less milk, cheese, and butter. Dairy foods should be consumed in limited quantity or not at all.

Cow's milk contains the calcium people need, but other foods are rich in calcium, too, including vegetables, beans, nuts, and seeds. Today we do not need to rely on cows for our calcium. We can eat greens directly for calcium, the place where cows get it to begin with, and orange juice and soy milks are fortified with calcium and vitamin D, too. It is easy to meet our nutrient needs for these substances without the risks of cow's milk.

Dietary Fiber and Colon Cancer

In a Dec. 14 Journal of the American Medical Association (JAMA) report, Yikyung Park, ScD, et al. addresses the relation between dietary fiber intake and risk of colorectal cancer.1 The study examines the commercially accepted hypothesis that dietary fiber reduces the risk of colorectal cancer. The conclusion of the research revealed mixed results, including some instances where fiber supplementation did not decrease the risk of cancer:

The association between dietary fiber intake and risk of colorectal cancer has been inconsistent among observational studies and several factors may explain the disparity: potential biases in each study, the failure to adjust for covariates in the multivariate models, and the range of dietary fiber intake. Inconsistent results also have been reported from randomized clinical trials of dietary fiber supplementation on the recurrence of colorectal adenomas (precursors of colorectal cancer); most trials have found no reduced risk of adenoma recurrence with dietary fiber supplementation compared with placebo.2-5

A statistically significant reduction in risk of colorectal cancer with higher dietary fiber intake has been observed in most case-control studies.6 However, case-control studies are prone to recall bias because dietary assessments are obtained after cancer diagnosis and also are prone to selection bias because control participants who participate are likely to be particularly health-conscious. In addition, publication bias may contribute to the accumulation of literature with significant findings. On the other hand, the Pooling Project is less susceptible to these biases because diet was assessed prior to diagnosis and the studies were not required to have published on the association between dietary fiber intake and risk of colorectal cancer.


In Dr. Fuhrman's book Eat to Live he gives a reason why this connection is inconsistent and provides his recommendation for fiber intake:
It is not the fiber extracted from the plant package that has miraculous health properties. It is the entire plant package considered as a whole, containing nature's anti-cancer nutrients as well as being rich in fiber.

High-fiber foods offer significant protection against both cancer (including colon cancer) and heart disease. I didn't say fiber; I said high-fiber foods. We can't just add a high-fiber candy bar or sprinkle a little Metamucil on our doughnut and french fries and expect to reap the benefits of eating high-fiber foods.

The reality is that healthy, nutritious foods are also very rich in fiber and that those foods associated with disease risk are generally fiber-deficient. Meat and dairy products do not contain any fiber, and foods made from refined grains (such as white bread, white rice, and pasta) have had their fiber removed. Clearly, we must substantially reduce our consumption of these fiber-deficient foods if we expect to lose weight and live a long, healthy life.


Furthermore, in his book Disease-Proof Your Child Dr. Fuhrman tells how the changing Japanese diet demonstrates a connection between higher consumption of animal products and the incidence of colon cancer:
The intake of Total Dietary Fiber (TDF) was evaluated from data from the National Nutrition Survey in Japan for forty-one years beginning in 1947. TDF intake decreased rapidly from 27.4 grams per day in 1947 to 15.8 grams in 1963. Fat intake increased rapidly from 18 grams in 1950 to 56.6 grams in 1987. Of significance in this carefully done study was that the increased occurrence of colon cancer had a twenty-three-to-twenty-four-year lag after the heightened consumption of animal products began. Apparently what the Japanese people did twenty-five years earlier had the strongest effect on inducing cancer, not what they ate ten years or even twenty years earlier.7 Those with the highest consumption of plant fiber in their childhood had the lowest incidence of colon cancer.

Recent studies have also found that eating fruit during childhood had powerful effects to protect against cancer in later life. A sixty-year study of 4,999 participants found that those who consumed more fruit in their childhood (the highest quartile) were 38 percent less likely to develop cancer as adults.8

Diets rich in meat and dairy are powerfully implicated as cancer promoters. Processed, pickled, smoked, or barbequed meats are even more strongly linked to cancer. Separate studies from Europe and the United States found the same results; those who eat meat daily have a three- to four-fold increase incidence of colon, esophageal, and stomach cancers, and the risks are more severe the younger in age people begin these practices.9

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Fishing for the Truth

Michael Hawthorne and Sam Roe of the Chicago Tribune report that the United States safety net for safeguarding consumers against the increased mercury levels in fish is in tatters. In the article the reporters detail the fate of one particular piece of fish:

Shipped from Singapore, the swordfish entered the U.S. this year without being tested for the toxic metal mercury.

When a fillet from that fish reached a display case at a supermarket in suburban Des Plaines, it carried no government warning labels, even though federal officials know swordfish often is so contaminated that young children and pregnant women should never eat it.

The Chicago Tribune actually bought and tested a portion of this fish, which produced alarming results:

When the Tribune bought and tested this particular piece of fish, the results showed not just high amounts of mercury, but levels three times the legal limit.

Hawthorne and Roe point out the dangers lurking in the fish and in the actions of U.S. health officials:

Even though mercury can cause learning disabilities in children and neurological problems in adults, regulators do not even bother to routinely check fish for metal. This leaves consumers with little idea about which fish are most hazardous.

In some cases, regulators have ignored the advice of their own scientists who concluded that mercury was far more dangerous than what consumers were being told.

In other instances, regulators have made decisions that benefited the fishing industry at the expense of public health.

In his book Eat to Live Dr. Fuhrman explains that consumption of fish creates a parodox:

Fish contains omega-3 fatty acids (EPA and DHA) that interfere with blood clotting much the same way aspirin does. Once you have significant atherosclerosis, it is helpful to take such anti-clotting agents, especially if you continue a dangerous diet. These fish derived-fats also have some effect on protecting the arterial walls from damage from other fats.

However, the best way to prevent a heart attack or stroke is to follow a high-nutrient diet with little or no animal products, thereby ensuring that such blockages don't develop in the first place. Then eating fish won't matter. In fact, the reason fish-derived fats, EPA and DHA, are not considered essential fats is that almost all people have enzymes to convert the plant-derived omega-3 fat rapidly into EPA and DHA.1

Fish is a double-edged sword, especially because fish has been shown to increase heart attack risk if polluted with mercury.2 It seems that the cardioprotective effects of eating a little fish is lost when you eat lots of fish, most likely because lots of fish exposes you to high mercury levels, which can promote lipid peroxidation.3 Lipid peroxidation plays a major role in the development of diseases such as heart disease, diabetes, and arthritis.

Dr. Fuhrman provides important information to consider when deciding whether or not to consume fish:

Higher levels of mercury found in mothers who eat more fish have been associated with birth defects, seizures, mental retardation, developmental disabilities, and cerebral palsy.4 This is mostly the result of women having eaten fish when they were pregnant. Scientists believe that fetuses are much more sensitive to mercury exposure than adults, although adults do suffer from varying degrees of brain damage from fish consumption.5 Even the FDA, which normally ignores reports on the dangers of our dangerous food practices, acknowledges that large fish such as shark, swordfish, and yellowfin and bluefin tuna, are potentially dangerous. Researchers are also concerned about other toxins concentrated in fish that can cause brain damage way before the cancers caused by chemical-carrying fish appear.

Fish with Highest and Lowest Mercury Levels

Highest
  • tilefish
  • swordfish
  • mackerel
  • shark
  • white snapper
  • tuna

Lowest
  • salmon
  • flounder
  • sole
  • tilapia
  • trout

Source: Mercury levels in seafood species. U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition. Office of Seafood, May 2001.

The bottom line: Choose fish over other animal products, but be aware that the place where it was caught, and the type of fish, matters. Don't accept recreational fish from questionable waters. Farmed fish is safer. Never eat high-mercury-content fish. Don't eat fish more than twice a week, and if you have a family history of hemorrhagic stroke, limit it further to only once a month.

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The Plastic Predator: BPA

In work published in Endocrinology University of Cincinnati researchers have found that a chemical widely used in food cans, milk container linings, water pipes, and even dental sealants could disrupt important effects of estrogen in the developing brain.

In a press release, researcher Scott Belcher, PhD, says Bisphenol A (BPA) interferes with the vital role of estrogen in female and male brain development even at low doses.

"We have now shown that environmental estrogens like BPA appear to alter, in a very complicated fashion, the normal way estrogen communicates with immature nerve cells," Dr. Belcher explained. "The developmental effects that we studied are known to be important for brain development and also for normal function of the adult brain," he said...

In the face of more than 100 studies published in peer-reviewed journals showing the detrimental effects of BPA, Dr. Belcher said, the chemical industry and federal regulatory agencies have resisted banning BPA from plastics used as food and beverage containers, despite the fact that plastics free of BPA and other toxic chemicals are available.


In the discussion forum of his member center, Dr. Fuhrman discussed plastics with members in 2004. One presented research that #2 HDPE (high density polyethylene), used for "cloudy" milk and water jugs and opaque food bottles, may be one of the safer ones. Dr. Fuhrman responded that he wasn't convinced, based on two primary factors. First of all, he wrote, water from those jugs "tastes like plastic, so it can't be good." Dr. Fuhrman also cited this study as a sample of research showing leeching from plastic into food.

The blog Mindfully has examined plastic and food extensively. I was hoping to find some handy advice to pass along about how to recognize safer kinds of plastics, but instead found only that they conclude plastic should never touch food. I can't vouch for their conclusions, but it's something to consider.

Any plastic experts out there who can shed some more light on this for us? I bet a lot of us would like to know some steps we can take to try to reduce our exposure to these kinds of toxins. Please comment away.

(Thanks to Medical Informatics for the heads up on this story.)

Is Organic Food Safer?

From Dr. Fuhrman's book Disease-Proof Your Child.

Acute lymphoblastic leukemia is up 10.7 percent over the last twenty years. Brain cancer is up 30 percent; osteogenic sarcoma, a type of bone cancer, is up 50 percent; and testicular cancer is up 60 percent in men under thirty. No one can tell us why. Scientific studies provide clues that are difficult to ignore:

  • Children whose parents work with pesticides are more likely to suffer leukemia, brain cancer, and other afflictions.
  • Studies show that childhood leukemia is related to increased pesticide use around the house.
  • Nine studies reviewed by the National Cancer Institute showed a correlation between pesticide exposure and brain cancer.
  • Exposure to weed killers in childhood increases asthma risk by more than fourfold.
All the dangers stated above are not the result of eating pesticide-treated produce. This clear link between pesticides and cancer is a result of chemical use around the home and farm.1 Clearly, it is not logical to eat organic food to avoid pesticide residue and then spray our homes with carcinogenic insecticides and weed killers used liberally in and around homes, interior plants, lawns, gardens, and even schools.

Because young children are the ones most susceptible to toxic exposures, the National Academy of Science has issued warnings and position papers stating that exposure to pesticides in early life can increase cancer rates down the road as well as increasing the occurrence of mental and immune system disorders.2

We must be careful not to expose our children to chemical cleaners, insecticides, and weed killers on our lawns. Chemicals used in pressure-treated wood used to build lawn furniture, decks, fences, and swings sets have been shown to place children at risk. When children are around, we must be vigilant to maintain a chemical-free environment.

The Environmental Protection Agency reports that the majority of pesticides now in use are probable or possible cancer causers. Studies of farm workers who work with pesticides suggest a link between pesticide use and brain cancer, Parkinson's disease, multiple myloma, leukemia, lymphoma, and cancers of the stomach, prostate, and testes.3 But the question remains, does the low level of pesticides remaining on our food present much of a danger?

Some scientists argue that the extremely low level of pesticide residue remaining on produce is insignificant and that there are naturally occurring toxins in all natural foods that are more significant. The large amount of studies performed on the typical pesticide-treated produce have demonstrated that consumption of produce, whether organic or not, is related to lower rates of cancer and disease protection, not higher rates. Certainly, it is better to eat fruits and vegetables grown and harvested using pesticides than not eating them at all. The health benefits of eating phytochemical-rich produce greatly outweigh any risk pesticide residues might pose.

It has been shown that women with higher levels of pesticides in their bloodstream have a higher risk of breast cancer.4 However, the pesticide shown in these studies to be connected to cancer was DDT, which is no longer used in food production and was banned by the U.S. government in 1972. The problem is that DDT is still in the environment and finds its way back into our food supply, predominately via shellfish and fish consumption. So purchasing organic fruit and vegetables will not lower our exposure to DDT if we are eating fish and shellfish regularly.

Keep in mind, there is a significantly larger exposure to toxic chemicals in animal products compared to plant food. By eating lower on the food chain and reducing our intake of animal products, one automatically reduces exposure to toxic chemicals. Plants have the least fat-soluble pollutants, animals that eat plants have more, and animals that eat animals have the highest levels of these toxic compounds. Fish that eat smaller fish will store the toxic compounds from every fish it ever ate, including all the fish eaten by the fish it just made a meal of. It is important to avoid lobster, shellfish, catfish, and predator fish such as tuna, bluefish, striped bass, shark, and swordfish, where toxins such as PCB, DDT, dioxin, and mercury are likely to build up due to the compounding effects of eating lots of smaller fish. One gets larger doses of more toxic compounds from these contaminated animal products than would be possible to take in from produce.

Organic food is certainly your best bet, to further limit exposure to toxic chemicals. No one knows for sure how much risk exists from pesticide residue on produce, but here's what we do know: the younger you are, the more your cells are susceptible to damage from toxins. It seems wise to feed our young children organic food whenever possible.

Of course, wash your vegetables and fruit with water and when possible, use a drop of dishwashing detergent and then rinse well to remove all detergent residues for a little more efficient cleaning. Specialty pesticide removal products have not clearly demonstrated any more effectiveness than mild soap and water.

Besides the heightened exposure to chemicals and pesticides from animal products, the most hazardous pesticides are used on some plant foods responsible for the majority of the plant-food-related dietary risk. These foods with the most pesticide residue are: strawberries, peaches, raspberries, blackberries, grapes, cherries, apples, and celery. Imported produce is also more likely to contain higher levels of pesticides.5

There is another reason to feed our children organic food when possible. Organic food usually has more nutrients than conventional.6 One study performed at the University of California at Davis found that foods grown organically had higher amounts of flavonoids, which have protective effects against both heart disease and cancer. The researchers found flavonoids were more than 50 percent higher in organic corn and strawberries. They theorized that when plants are forced to deal with the stress of insects, they produce more of these compounds, which are beneficial to humans.7 Overall, organic foods taste better, and organic agriculture protects farmers and our environment.

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