nutritionwonderland

Category: Posts Authored by John Serrao

  • Book Review: Safe Food by Marion Nestle

    Book Review: Safe Food by Marion Nestle

    What if this latest peanut-salmonella outbreak in 2009 was completely preventable?  What if the procedures to prevent it were already in place?  Even worse, what if we didn’t even have a food safety system at all?

    NOTE: This article is the 2nd part of a series about Food Safety in the United States. You may want to read the first part to better understand this article:

    Part 1: Food Safety – A Recent History

    After reading Marion Nestle’s Safe Food, you will see the world of irony and contradiction finds a comfortable home in food safety.  Or should we say, a lack of food safety.  For it becomes painfully obvious in Nestle’s work that, in fact, we do not have a food safety system in the United States and a wide array of interests are actively working to keep it that way.

    Going Down to Get Up

    But before Nestle’s takes us down that dark road, we are introduced to this dysfunctional world very quickly with the story of how Starlink genetically modified corn made its appearance throughout the food supply in countries with bans on GMO crops.

    Quick Facts about this Title

    Her treatment of the subject acts as an interesting twist on the typical introductions you generally see with non-fiction books.  We meet all the players, agencies and of course trickery in a haphazard fashion, instead of having it all methodically laid out.  The method is good – because if you are thirsty for facts, it prepares you for the coming Thanksgiving-like feast.  An avalanche of professional observations and research accompanies every point in this book.  For better or worse.

    This style immediately establishes credibility and you will not find yourself asking whether or not the author is qualified to speak on the subject.  With a Ph.D. in molecular biology form UC Berkeley, a spot on the FDA’s Food Advisory Committee and Science Board and the USDA/DHHS Dietary Guidelines Advisory Committee, Marion Nestle does not really need a formal introduction to remind the reader she knows what’s going on – her prose does the job for her.

    And it’s Nestle prose that sets up an interesting dichotomy around which the entire book spins.  She breaks the world of food safety into two what we would call observational positions:

    • Science Based – ‘Benefits and Costs’
    • Value Based – ‘Fear and Dread ‘

    As she explains throughout the later parts of the book, parties involved with actually making food safe tend to view the situation in a purely scientific sense – ie, the benefits of GMO far outweigh the risks – whereas consumers in the general public use value based judgements – ie, the fear of what GMO could be outweigh the benefits.

    One of her central tenets is that the food makers need to satisfy the public’s value based concerns with the same perniciousness they purportedly apply to the science side of the equation – if we want to feel as if we have a safe food supply.  She claims this would go a long way to assuaging many people’s fears – an slightly provocative argument that would be a radical departure from how risks are currently evaluated.

    After the three – yes three – introductions, we get that the book contains two prominent sections and smaller rejoinder about pathogens, GMO crops and food terrorism, respectively.  But before you think she adopts such a staid format to the detriment of the book, keep in mind how explosive and controversial the subject matter she is dealing with really is.  Billions of dollars are the scale agribusiness operates on and Nestle handles each topic with the proper respect.

    After you find Nestle’s rhythm – which admittedly is not the easiest thing to do – the structure of the book fades away and you won’t find yourself burdened by it.  Other heavy lifting, however, is mandatory.

    Novel Concepts, Descriptive Means

    The cover…

    The book’s first section rips right into the meat of the issue, literally.  We get a first-hand account of the history of efforts and interventions that have been tried to implement a known protocol for ‘pathogen reduction’ called HAACP.  You’ll get a real sense of how much resistance there is on the part of industry to implementing these new controls.  Particularly disheartening was the section dealing with the government’s efforts to test ground beef for e.coli immediately before the Jack-in-the-Box outbreak of the early 90s.  From Page 77:

    “On October 14, the day before the rule for ground meat was to take effect, the federal court in Austin, Texas, issued an injunction that blocked the labeling plan, saying that the Jack in the Box outbreak was insufficient to justify ‘any departure from the normal rule-making procedures.’  Industry groups hailed the injunction as ‘a victory of fairness over bureaucracy.’  That very week, however, three children in Texas died from eating ground meat contaminated with E. coli O157:H7…”

    Similar tales of false starts and questionable means plague the history of food safety and Nestle pulls the curtains back in a fashion that is even and balanced.  You get the sense throughout her work that she, as an educator and public health advocate, is indeed enraged – even disgusted with the ways in which the system works but she never belies herself into a sycophant-like rage.  Instead, Nestle beautifully walks the tight-rope, delivering an objective review of the facts – a rare event in the charged world of food.

    GMO as Savior or Satan?

    Nowhere is this sensibility more pronounced than in the second part of her book, where she covers GMO crops.  Nestle gives her audience a good background on the issue and again dives into the core of the issue.  This time she focuses on the disconnect between researchers who better understand the mechanics of biotech foods and the consumers – reintroducing her dichotomy of science and value based arguments.  Particularly good is her chapter covering the ‘Politics of Consumer Concern’ – where she feels more comfortable in giving her opinion on the issues.  From Page 225:

    “What seems more surprising [about the food industry] is how much the industry’s unyielding opposition to labeling damages its own cause.  If public trust is the key to successful marketing, biotechnology companies should freely disclose their methods, economic goals, and products.”

    While she does give opinion, her treatment of the subject is really great because it, again, is able to show an objective view of the facts.  Sure, Nestle peppers her texts with her observations and opinions but she gives a fair shake to an industry she is usually in direct opposition to.

    The conclusion of the text is an applied section about how the politics of food safety play into bio-terrorism.  The section has a real strapped-on type feeling, especially considering how closely this book was published to the 9/11 attacks on the World Trade Center, mere blocks from her NYU teaching post.  Still, the section comes off as half-baked, possibly a move suggested by publishers to include a terrorism-related topic to move a few more copies in the wake of 9/11.

    Take the Good with the Bad

    Nestle covers all subjects thoroughly, at times too thoroughly.  Often complex analysis of super specific issues creates a significant hurdle to understanding the issues for most people outside of the world of nutrition and health.  You are constantly reminded as a reader that Ms. Nestle is a first and foremost an academic.  Her brilliance is frequently on display but so are her verbose explanations.

    It’s not that any concept she includes is particularly challenging in and of itself but taken together with the enormity of her topics, the political nature of the issue and the alphabet soup of acronyms you’ll find, Safe Food makes for a challenging read.  Observe a paragraph here where Nestle tries to explain the difficulties in determining food allergies (from page 173):

    “The widespread use of soy proteins – transgenic or not – in foods such as infant formulas, meat extenders, baked goods, and dairy replacements might be expected to increase the prevalence of soy allergies, but the increase would be difficult to detect unless it affected large numbers of people.  Worse, because methods to diagnose food allergies are unavailable or imprecise, the allergenic potential of most genetically modified foods is uncertain, unpredictable, and not easily tested.”

    Any reader of Nestle’s previous books would quickly recognize her academic style – and have formed their own opinion no doubt – but new readers should be warned.  Nestle expects her audience to come to this book with a significant background on the topic.  If upon hearing ‘GMO’ you are reminded of failed automakers or little green men from Mars, you might want to look elsewhere for a book.

    (Re)visit This Work

    But also realize this book’s high barrier of entry is also what makes it so good.  The more you read it, the more you know you are dealing with one of, if not THE, authority on the subject.  Yes, the prose bends towards the tone of an academic journal at times but if you want to understand the world of food safety, this is the book.

    The exceptional insight into every dimension of this crisis, the balanced view from both sides of each issue and her ability to educate – even entertain – at times, makes this a great read for anybody with a background in health or food.  Therefore, we highly recommend Safe Food as it provides both acumen into the most pressing issues related to food safety as well as a detailed context for understanding the issues (purchase this work on Amazon to support Nutrition Wonderland).

  • Mailbag: Smart Balance versus Butter

    Mailbag: Smart Balance versus Butter

    Question:

    We are having a discussion about whether buttery spread – such as Smart Balance is better than using butter?!?!

    http://www.smartbalance.com/

    what do you think??

    Thank you!!
    Claire from Los Angeles

    ##################

    Smart Balance is not good for you in the relative scheme of things.  It is a chemical conglomeration of esterified oils – which means they take all these different oils, blast them apart, combine them with caking agents which come together to form this new age margarine.  Its WAAAY better than old fashioned margarine, made from trans fat, but still not a natural food.  That stuff about the flaxseed oil helping is really nonsense – processing destroys the bioavailabilty of omega-3s.

    Ideally, you want to eat your essential fats, that is Omega3 and Omega6, in a 1:1 ratio.  Most Americans get about 15-20X more Omega6 than Omega3, precisely because of this processing problem.  Omega3 is very sensitive – it will degrade at room temperature even – and only in a small number of foods (flax, walnuts, wild salmon).  Omega 6 is everywhere and stands up to heat and processing much better…so you can see where this goes.  Smart Balance will have a high Omega6:3 ratio – making it an inflammatory food.

    We would much rather see you eating butter, but realize the type of butter you are eating here is key.  You really want to find butter from grass fed cows.  This type of butter will tend to be a bright yellow orange – the more orange the better.  This is an outward indication the cows feed on grass, which is rich in beta-carrotene – an orange flavonoid that will tint your butter (it will be more orange in the spring, when grass first starts to grow).  This is an unrefined, real food that contains high amounts of omega3 fats along with a dizzying array of vitamins and minerals – all very bioavailable.  Try and find Raw, Grass Fed butter if you can – this is even better for you.

    People lament that butter is high in saturated fats, which have been linked to heart disease.  While this is true, that information is related to a more outdated view of heart disease.  Heart disease is truly an inflammatory disease, not one of cholesterol.  Its when cholesterol gets oxidized that we have problems and eating natural foods decreases inflammation in the body.  Additionally, there is no research to back up the idea that saturated fats even translate into cholesterol in the body – the mechanisms are very very complex and still not fully understood.

    The degree of processing in foods is always an indication of whether or not you should be eating them.  ALWAYS STAY AWAY FROM PROCESSED FOODS!  Ignore whatever the label says – you have no idea how bought and paid for those labels are.  Smart Balance is highly processed; if it was not, the oils would simply separate and youd have something along the lines of salad dressing.  Butter is clearly the winner here.

    ##################

    Follow-up:

    Ok – one more question
    Salted or unsalted butter??  – or is that an obvious one?

    Claire, LA

    ##################

    The salting is important but pretty irrelevant considering how little the amount of salt in your butter will contribute to your overall salt intake.  The big thing to pay attention to in all your food is the quality of inputs – by that I mean, how good was the stuff that went into making it?

    If you buy butter from factory farm cows – who eat crap corn product, it once again creates that high Omega6:Omega3 inflammatory fat ratio, much like Smart Balance.  If you get butter from pasture cows that eat grass and hay like they are supposed to (they have 2 stomachs for a reason!), the nutrient profile increases dramatically.

    This ideology extends into everything you eat.  If you put an organic carrot next to conventionally grown carrot, you probably wont see a difference – but your body will.  Organics come from soil not artificially enriched and not bathed in hormone disrupting pesticides – which is why they are always preferred.

    Of course finding these foods is always hard, not to mention their cost after you have found them.

    For cooking, the most readily available unrefined oil is extra virgin olive oil.  You want to use it in low heat cooking (steaming) because it can oxidize easily due to its monounsaturated fat chemical alignment.  For higher heat cooking (BBQ, Sauté), use raw coconut oil or the grass fed butter – they are saturated fats, which can take heat very well.  Both the oils are readily available if you have trouble finding grass fed butter.

  • Food Safety – The Recent History

    Food Safety – The Recent History

    he early part of 2009 has witnessed one of the largest food contamination cases in US history.  The Peanut Corporation of America had a salmonella outbreak in one of their factories, contaminating the majority of peanut-butter containing products in the United States.  Unfortunately, this outbreak is not an isolated incident across the industry.

    E.coli O157:H7, Listeria, Staph and Campylocbacter cause millions of bacterial infections every year.  The prevalence of these pathogens relates directly to how food arrives into your home today – a process that has radically changed over the last 20 years.   Here, we review the recent history of food borne illnesses and how they relate to the consolidation of the food industry.

    Food Borne Illness

    Contaminated foods are far more common than you probably think.  Estimates suggest as many as 1 in 4 Americans, about 75 million people, suffer from food borne illness once every year while another 350,000 less fortunate people are hospitalized and 5,000 die.  People typically associate food contamination with meat – and for good reason.  The frantic hand-washing after handling most meat products strikes some as reactionary but it makes more sense when you see the numbers.

    Chicken Contamination in 2007

    Consumer Reports ran a large study, testing 525 raw chickens in early 2007 and found a stunning 83% of all chickens were infected with salmonella or campylobacter bacteria.  Even more alarming, the majority of both bacteria’s tested were resistant to one or more antibiotics – largely resulting from the factory farm practice of giving their birds a constant, low level of antibiotics to retard hunger. [1]

    All this is made worse by the dramatic consolidation of poultry slaughterhouses in the last 20 years, pushing ever greater numbers of chickens into tight spaces – the ideal environment for disease.  We could spend all day making the connection between factory farming and pathogens in food but that’s for another article.  The problem of food contamination goes way beyond meat products – they are only part of this story.  Before, we really get going, here is a primer video with the food safety czar Dr. Marion Nestle:

    The most recent fiasco with peanut butter better explains many of the other issues involved.

    Peanut Butter Under the Microscope

    The speed with which the peanut butter fiasco unfolded speaks volumes as to what we are up against with the way our food system is put together and ensuring its safety.  On January 16th 2009, Kellogg’s recalled some of their Austin brand peanut butter sandwich crackers at the request of the government.  Within a week, 130 more products from all sorts of manufacturers had been recalled.  By the end of the month, 19,000 people in 43 states had been sickened and 8 had died from complications.

    No bacteria in the shell

    With a little investigation, the FDA and CDC found the entire outbreak could be traced to one plant in Georgia owned by the Peanut Corporation of America.  It may be hard to imagine that one single plant could contaminate a good majority of the entire nation’s supply of peanut butter in under a month but that seems to be what happened here.

    To better understand how this could happen, the Times ran a great piece last month that starts to scratch the surface into the realities of the modern food system.  This is an excerpt from that piece that talks about inspections briefly but you will get the idea (emphasis mine):

    “Plant employees said they typically had advance knowledge of state inspections and that last month, when they were tipped off that federal investigators were coming, the employees were told not to answer questions. Where the state had found no major problems, the federal team found many, like the leaky roof, and swab tests showed salmonella living on the plant floors. Plant managers had not decontaminated the peanut butter processing line after detecting salmonella, the federal report shows.

    In examining Peanut Corporation of America’s records, federal investigators discovered that company tests had found salmonella 12 times since 2007. The inspectors said they got the records by invoking a bioterrorism law.”

    Conflicting standards, a lack of funds, lax oversight and carelessness were all apart of this salmonella epidemic.  The Peanut Corporation of America may be the poster child for all of this but similar practices surely go on elsewhere due to the exact same circumstances that created this situation.   The reality is that it is very hard for any of us – including the safety regulators in charge of this operation – to know where the next firestorm will erupt.   Looking back shows us an almost identical set of circumstances that led to the last major outbreak prior to peanut butter – spinach.

    Spinach Is Food Safety in a Nutshell

    The e.coli O157:H7 outbreak in pre-washed spinach back in late 2006 was the last poster child for food safety reform.  The incident was widely covered in the media, excellent news pieces were authored about the problems – especially the eerily prophetic article published in the Washington Post, whose last line concluded “Unless something changes, we will have another outbreak.”

     

    Extent of Spinach Outbreak, CDC

    Tainted spinach fully captured the national spotlight when the CDC first made public the problem.  From their first bulletin (emphasis mine):

    “Public health officials in multiple states, with the assistance of the Centers for Disease Control and Prevention, are investigating a large outbreak of E. coli O157:H7 infections. Thus far, 50 cases…have been reported from CT (1), ID (3), IN (4), MI (3), OR (5), NM (2), UT (11), WI (20).  Eight patients developed the hemolytic uremic syndrome (HUS) and one patient died.  Most cases are recent: for those with known illness onset, the range of onset is 08/25/2006 to 09/03/2006.  The outbreak is likely ongoing.”

    What’s important to note here is that by the time the first bulletin was issued, we were already dealing with contamination from coast to coast.  Essentially, the problem was nationwide before anyone even started to do anything about it.

    A quick response by government agencies mitigated the damage but still almost 200 people feel ill and 3 died as a result of the outbreak according to the CDC.  Follow up reports on the incident get us even closer to understanding just how intertwined our food system is now.

    The CDC worked with local California officials and conducted their own investigation into the exact source of the contamination.  Their findings suggested a nearby cattle farm who leased part of their land out to a spinach farm had runoff that was contaminated with the same genetic strain of e.coli that sickened large parts of the country.  Also suggested was that maybe a single wild pig may have run through the cattle manure and then the spinach.

    Reused water likely spread e.coli across America

    How could a single pig contaminate the entire nation’s spinach crop?  Surprisingly, it was quite easy.  Prepared spinach is ‘washed’ in water that gets reused over and over and over again.  It is assumed that the equipment and water are sterile but if one pathogen gets in, it easily spreads through the entire system.  After the spinach was bagged and trucked away, you can easily see how just one little pig sickened 200 people from coast to coast.

    Understanding the Centralized Food System

    Food safety issues are more important now because the concentration of food production in the United States has increased substantially over the past 20 years.  The USDA published an insightful look at the US food production landscape back in May 2007 – and its results highlight just how concentrated most food related activities are today.

    The report mostly focused on consolidation in food retailers – like the move from traditional supermarkets into warehousers like Sam’s Club – but it also found that food production and distribution  consolidated at a remarkable clip.

    How food production has concentrated, USDA

    Just in the period from 1997-2002, nearly every major food industry saw its four largest firms grow far larger.  Cookie makers, water distributors, seafood purveyors and milk producers saw their rates of consolidation climb anywhere from 10-100%.  Additional consolidation was seen in both the cattle and hog industries mentioned further down in the report.   In short, agribusiness is slowly becoming the de facto method of food production – and that means new controls are urgently needed.

    Tying the Pieces Together

    With dramatic uptakes in food industry consolidation, more and more of our food is coming from fewer and fewer places.  As we saw with both the peanut butter and spinach incidents, just one plant or one field can now contaminate the entire country in mere days.  Consequently, food safety becomes a bigger issue because there is a greater likelihood for contamination at every step.  Higher density farms, big processing plants and warehouse food retailers put massive amounts of ingredients together in ways whose ramifications we are only beginning to comprehend.

    While smaller food brands, organics and farmer’s markets have grown at a strong clip, they are nowhere near offsetting the dramatic consolidation going on inside the agribusiness industry.  Stronger food safety measures, like the agreement the California Leafy Green growers instituted after the spinach ordeal, need to be put into place everywhere.  It should not take outbreaks in each food group for proper food safety measures to become the norm, but, without an overarching national food safety framework, massive liability has been the only successful tool in motivating agribusiness to secure the food supply.  Here’s hoping things are a bit different this time around.

    NOTE: This article is the 1st part of a series about Food Safety in the United States. You may want to read the first part to better understand this article:

    Part 1: Book Review: Safe Food by Marion Nestle

  • Integrative Medicine on Capitol Hill

    Integrative Medicine on Capitol Hill

    On Thursday, the US Senate Committee on Health, Education, Labor and Pensions held a hearing called, Integrative Care: A Pathway to a Healthier Nation to assess how complementary medicine will be incorporated into President Obama’s challenge for Congress to pass health care reform in 2009. Barbara Milkulski (D), Maryland and Tom Harkin (D), Iowa chaired the committee that invited a distinguished panel of famous complementary practitioners to report their findings from field work.

    The proceedings can be see in their entirety here:

    Dr. Mehmet C. Oz, Director, Cardiovascular Institute and Complementary Medicine Program, New York-Presbyterian Hospital, New York, NY was the first speaker (minutes 27-33). His speech to the committee was based upon the idea of movements where Oz advocated having patients become their own advocates in the health care system. His proposal included four points:

    • 1. Create a Smart Patient Movement, where people learn how to take of themselves before needing medical intervention
    • 2. Massively upgrade the information systems surrounding health care to be upgraded to systems like Microsoft HealthVault and Google Health – where patients store their medical records for all types of health professionals to see.
    • 3. Establish a ‘culture of wellness’ – defined as giving patients a more total platter of options in how they want to be healed. Physicians would be joined by ‘Health Coaches’ – people like physical therapists, social workers and acupuncturists – who help people become healthier before they need reactionary, Western medicine.
    • 4. Expand his ‘Health Corps Movement’ – a program is based upon the concepts of Peace Corps, whereby passionate young adults tutor their peers, in schools, on becoming more healthy.

    Following Dr. Oz was Dr. Mark Hyman, Founder and Medical Director of The UltraWellness Center in Lenox, MA – (watch minutes 68-74 in the video).

    Dr. Hyman

    Hyman’s major point was an affront to most of the medical community – that the entire system and approach to modern disease is completely wrong. Because most of the health crises in American revolve around chronic diseases, the reactionary, allopathic model of medicine is outdated. He wants a system that proactively addresses the debilitating symptoms of chronic disease before they ever form. From his speech [emphasis mine]:

    “We must address the underlying causes of illness and chronic disease. If we, give the wrong type of care, we will simply be doing the wrong thing – better. [We need to change not] only the way we do medicine but the medicine we do. This new paradigm of functional medicine is a system of personalized, patient-centered care based on how our environment and lifestyle choices impact on our genes to create imbalances in our genes and biologic systems….It is the best solution to our health care system.”

    Continuing with Dr. Oz’s point, Dr. Hyman hammered on the point of the need for health coaches to assist doctors in creating a healthy environment. He outlined three major initiatives he wanted to see in Obama’s upcoming health reform act:

    • 1. A radical shift in public investment towards training and research facilities that proactively address the needs of chronic disease, with the US creating a federal training center.
    • 2. Expand already existing and proven functional medicine projects, compromised of doctors and other health professionals, that demonstrate a new model of care.
    • 3. Create a White House cabinet position that coordinates all of these functions.

    Next up was Dr. Dean Ornish, Founder and President, Preventive Medicine Research Institute, Sausalito, CA (minutes 78-82) who mainly reinforced the points made by earlier speakers, adding that the systems he has implemented show impressive cost reductions. He stated that 75-80% of all medical costs are now related to chronic diseases – heart disease, obesity, diabetes – and that he was able to eliminate almost 95% of those costs with functional medicine approaches.

    Dr. Weil

    Finally, Dr. Andy Weil, Arizona Center for Integrative Medicine, University of Arizona, Vail, AZ (minutes 82 – 92) turned his focus onto why medical costs are so high in America. He made the point that our high tech medical system costs so much that there is no possible way to treat the numbers of sick people present without a different approach. He advocated low, very low tech medicine – simple breathing techniques and laughing – as examples of therapies he uses on a regular basis. He was adamant on changing the culture around alternative therapies with proper education.

    Thoughts…

    The Q&A afterwords between the doctors and senators involved the nagging question of how to make these changes happen. It was distressing to see just how little of an idea this important regulatory body had in terms of what they should be doing to improve health. Consistently, throughout this hearing, you would see the panel of health professionals imploring the senators to use the doctors’ collective talents.

    But it strikes us as so odd that – as these doctors talked with the exact group responsible for implementing these policies – yet none of the senators take notes or have drafts of the necessary legislation on hand to amend with new ideas. All of this genius is sitting before them, unloading mountains of brilliant – and often proven – ideas as these legislators just sit and watch when it is they who have the responsibility to act on this information.

    Hello? Is anybody home? Oh…you are busy with lobbyists. Sorry to interrupt.

    Each one of these CAM advocates made the case for prevention and better information preventing diseases before they happen, and they did it eloquently. Each outlined a path to this new world of health care, demonstrating the numbers and how this should be the way forward. They made concrete recommendations – a White House level voice for wellness, re-educating health professionals at medical schools, implementing health coaches and expanding the Health Corps – that could have immediate effects. Dr. Hyman’s presentation was one of the best speeches on the subject we have ever heard.

    Seeing as this conference was focused on helping craft the complementary medicine portion of health care reform, it is regrettable, if not inexcusable, that these senators – on the health subcommittee no less – could not even start to show how they will implement the wisdom bestowed upon them at this hearing. The time for discussing these issues has long passed and action is urgently needed. Functional medicine is used by millions every day but the American system of medicine discourages its use at every turn. It is our hope a few of the people on the government’s side watching this presentation could synthesize just 1% of what was being said to them and craft it into meaningful policy.

    Read each presenter’s official submitted statements to the committee:

  • Truvia and PureVia: The Controversy of Stevia

    In our final view of Truvia and PureVia, we take a look at the political history of stevia – the base of rebiana, opinions of some of the major players in this debate and offer our final views on the subject.

    NOTE: This article is the 3rd part of a series about Truvia and PureVia. You may want to read the first two parts to better understand this article:

    Part 1: Truvia and PureVia – A Window to the Past or the Future?
    Part 2: Truvia and PureVia – The Science

    A History Spent in the Shadows

    Stevia, before processing

    The plant stevia provides the rebiana sweetener found in both Truvia and PureVia.  Originally, stevia was used, in its whole leaf form, as a prized sweetener of the indigenous Guarani people throughout Paraguay in South America.  It did not find fame in the modern, western food supply until Japan began cultivating and using it in diet soft drinks (including Diet Coke) during the 1970s, a process that continues today.  Building on that success, stevia began to be sold throughout the world, including the United States, during the 1980s.  Its path from here has since become mired in controversy.

    Stevia was officially banned from sale in the US as a sweetener in 1991, driven from the market after an anonymous safety petition led the FDA to conclude that it was an unsafe food additive.  The FDA has declined to release the petitioner’s affiliation, although it is suspected to be someone with links to aspartame – a popular artificial sweetener that had just come to market in the 1990s.

    Because of the 1991 decision, an ‘Import Alert‘ was then issued by the FDA maintaining that information regarding stevia leaves – the same source of Truvia and PureVia – was [emphasis mine]:

    “…inadequate to demonstrate its safety as a food additive or to affirm its status as GRAS” (GRAS = Generally Recognized as Safe, FDA speak for labeling that recognizes a product’s safety).

    This position is at odds with just about every other natural food in existence.  Because the FDA has no mandate to test real foods, it makes little sense why this decision was made.  Any food ‘in common use’ before 1958 was automatically grandfathered into being deemed GRAS, and so – with stevia’s history of being safely used as a sweetener in South America for centuries – it clearly qualified.

    We contacted the FDA but they declined to comment on this position.

    A Change in Position

    Japan’s Truvia

    Stevia was completely banned from the United States until 1994, when the the Congress passed legislation that allowed stevia to be used solely as, ‘an herbal supplement’.   Interestingly though, the sweetener was still banned from being sold as a sweetener.  This contradictory stance established in 1994 – where stevia remained banned from sale as a sweetener but remained for sale as a supplement – continues clear into today.

    The closest we can get to a followup opinion from the FDA on the matter doesn’t come for another 8 years.  From the FDA’s now discontinued magazine named, appropriately enough, “FDA Consumer Magazine“, this was the only other mention of stevia on the FDA’s website for almost 15 years [emphasis mine]:

    Another product, stevia, is derived from a South American shrub. Though it can impart a sweet taste to foods, it cannot be sold as a sweetener because FDA considers it an unapproved food additive. “The safety of stevia has been questioned by published studies,” says Martha Peiperl, a consumer safety officer in FDA’s Office of Premarket Approval. “And no one has ever provided FDA with adequate evidence that the substance [stevia] is safe.” Under provisions of 1994 legislation, however, stevia can be sold as a “dietary supplement,” though it cannot be promoted as a sweetener.

    Ms. Peiperl of the FDA is referring to the idea that one of the two sweeteners in stevia called steviocide, might cause mutations in the DNA of people who eat it regularly.  As we reported in our scientific review of rebiana, the studies that suggested stevia was mutagenic were widely dismissed because the amount of stevia required to cause the defect was so far in excess of what anyone could ever possibly consume.

    They say OK to stevia

    Stranger still, after a large review of scientific literature, the World Health Organization declared in 2006 that stevia is completely safe and even potentially beneficial for people with hypertension (WHO).  That opinion was further codified at the 69th annual JEFCA (Joint FAO/WHO Expert Committee on Food Additives) conference (.pdf link), where stevia was recognized as being non-mutagenic.

    Clearly, quite a few scientists could have “provided FDA with adequate evidence that the substance [stevia] is safe” in Ms. Peiperl’s words.  The only problem was that the FDA never asked to reevaluate stevia, for what are likely political reasons from what we have seen so far.

    Another Policy Switch

    In December 2008. the FDA opened yet another chapter in this debate and declared that rebaudioside A (rebiana) – the other sweetener found in stevia – was GRAS.  Somehow, ABC News broke this story:

    From the official GRAS approval letter:

    The subject of the notice is rebaudioside A purified from Stevia rebaudiana (Bertoni) Bertoni. The notice informs FDA of the view of Cargill, Incorporated (Cargill) that rebaudioside A is GRAS, through scientific procedures, for use as a general-purpose sweetener in foods, excluding meat and poultry products, provided that food standards of identity do not preclude such use, at levels determined by current good manufacturing practices (cGMP).

    Obviously aware of yet another policy contradiction, the FDA puts out a one-line statement in the GRAS notice about stevia, the plant that remains banned as a sweetener [emphasis mine]:

    The rebaudioside A that is the subject of GRAS Notice No. GRN 000253 is a highly purified component of the stevia plant. As such, FDA notes that the GRAS notice for the use of a specific purified component of stevia, such as rebaudioside A, and FDA’s response do not necessarily apply to the uses of other stevia products.

    The wording of this final statement here is especially interesting because the FDA is leaving the door open for yet further interpretation.  If this decision ‘does not necessarily apply’ to other uses of Stevia, companies that want to use stevia in their products may be able to petition the FDA for yet another policy change. Regardless, despite rebiana being approved as GRAS, stevia can still only be sold as a dietary supplement, not as a sweetener.

    From the Peanut Gallery…

    Nutrition Wonderland repeatedly tried to get in touch with different offices inside of the FDA to clarify their contradictory positions regarding stevia and rebiana but our calls were never returned.  Without a direct comment from the FDA, we can only speculate as to what was happening with regard to their policy – but that position really isn’t that hard to ascertain from the evidence.

    How the mighty have fallen…

    Based on the financiers of the rebiana studies (Cargill and Coca-Cola), the speed with which this decision was made and the history of stevia, we are left to conclude that rebiana- and consequently Truvia and PureVia – were simply approved because of who petitioned the FDA.

    Now, the FDA’s ruling does not mean that rebiana is not safe – but then again we don’t know that it is completely safe.  It’s hard what to know here.  We do know one thing though – with giants like Coca-Cola, Cargill, PepsiCo and Merisant banging at the FDA’s door, it becomes pretty obvious that there was little chance rebiana would be kept out of the market, regardless of what the science said.  The FDA’s position on stevia has never (well, post 1991 at least) sided with science.  This decision brings into question many of the other food additives that the FDA has approved, namely aspartame – whose makers may have been active in getting stevia banned.

    Nutrition Wonderland also contacted the Center for Science in the Public Interest (CSPI), a reputable food watchdog, who was cautiously optimistic about Truvia back in June 2008 in a WebMD article.  They have since dramatically reversed their position based largely upon new information from a report put out by UCLA showing why rebiana and stevia in general is unsafe.  You can view it below:

    We read over its arguments as to why rebiana is unsafe in this report but they are not as convincing as CSPI would have you believe.  While rebiana is not fully tested, this report finds fault with nearly every study published to date on the subject of stevia.  Its hard to buy into the idea that this much bad science was performed.  Nutrition Wonderland has extreme doubts about the Truvia-sponsored science we thoroughly discussed in our earlier review but the safety of stevioside seems well proven, based on its use in Japan for over 30 years.  Additionally, this report may have been performed at the behest of CSPI itself, making us leery of its findings as much as we are leery of Cargill’s.

    We contacted the CSPI repeatedly to make sense of their changing positions but they have not made a public statement to us regarding this situation.

    Final Words about Stevia > Rebiana > Truvia/PureVia

    In general with food, we see a destructive pattern with each refined product brought onto the market place.  Whole grains reduce the risk of heart disease while refined grains increase it.  The fructose in honey helps the body, while the fructose in HFCS has been linked to obesity, diabetes and insulin resistance.  Cold pressed natural oils dramatically reduce inflammation, while heavily refined hydrogenated oils promote inflammation – and chronic disease.  Why refined rebiana would be better for us than the whole leaf stevia has not been explained.

    Cheers or Jeers?

    There is some reason to think extracts of stevia, specifically stevioside, could prove extremely beneficial in a refined form but Truvia and PureVia do not contain any of that material.  Both sweeteners are proprietary formulas containing the largely untested rebiana and large amounts of erythritol, another non-caloric sweetening agent.  In fact, by volume, Truvia and PureVia have more erythritol than they do rebiana.  There is still no science testing Truvia and PureVia themselves, which would show how these two sweeteners (rebiana and erythritol) metabolize together.

    More than anything, Nutrition Wonderland strongly believes these sweeteners were developed so that the companies involved, especially Cargill and Merisant, could own the intellectual property behind stevia – in effect owning the food.  Cargill released some justification for all this trouble, if you don’t mind very corporate video:

    It would have been far easier to just use stevia for commercial food production – but, since you cannot patent a natural food, this opportunity was overlooked in our opinion.  This pattern of using the intellectual property of food for profit is well established across the 21st century agribusiness industry, modeled after highly successful power plays by chemical giants in the sale of GMO seeds.

    We have doubts about the sponsored science involved, doubts about the motive of this product in general and deep suspicions as to why stevia remains banned from the marketplace.  Truvia and PureVia may in fact be perfectly safe – and preliminary science shows that to be the case – but far more research on these new sweeteners is required.  Even still, we will probably never know the truth.  It is now the American public’s turn to be the guinea pigs for another agribusiness experiment.  You can easily opt out of this debate – as we are – by enjoying any of these safe sweetening options:

    • regular stevia sweetener ‘supplements’
    • blackstrap molasses (unrefined)
    • organic agave nectar
    • brown “turbinado” cane sugar (avoid brown sugar from sugar beets as they are now GMO)

  • The Science Behind Truvia and PureVia Sweeteners (Rebiana)

    The FDA recently announced that they have cleared a new, zero calorie sweetener called rebaudioside A (rebiana) for sale in the US, calling it ‘safe for use in foods and beverages‘.

    NOTE: This article is the 2nd part of a series about Truvia and PureVia. You may want to read the first part to better understand this article:

    Part 1: Truvia and PureVia – A Window to the Past or the Future?

    As a result of this decision, two products featuring the new sweetener are coming to market – Truvia and PureVia.  Truvia was jointly developed between the soft drink maker Coca-Cola and agribusiness giant Cargill while PureVia was developed by PepsiCo in partnership with artificial sweetener industry veteran Merisant (under the proxy Whole Earth Sweetener Company).

    The Coca-Cola Company has already announced products, including Sprite Green and Odwalla Mojito Mambo and Pomegranate Strawberry Juices, that will be for sale in 2009 containing the additive Truvia.  Not to be outdone, PepsiCo will put PureVia in Sobe Zero Calorie Life Water and Trop50 – a new low calorie orange juice slated for March 2009 release.

    The idea of a real, zero calorie sweetener has been a goal of many agribusiness giants for some time but have Truvia and PureVia been adequately tested?   Nutrition Wonderland has gone through the science surrounding these new sweeteners and spoken with some major industry players to get the scoop.  We have found some positives and some serious negatives, which we will review here.

    Starting From the Beginning

    Truvia and PureVia contain mostly the same chemical formula, as you can see in our chart below.  Both are mostly made of two sweeteners, erythritol and rebiana (called Reb A in PureVia).  Erythritol is a substitute low calorie sugar-alcohol sweetener developed by the French company Cerestar who was later purchased by Cargill.  Sugar-alcohols are not really sugars; they require adding hydrogen to sugar molecules so the body ignores them.  Erythritol is a favorite because it supposedly does not cause as many stomach aches as other similar sweeteners.

    It was FDA approved back in 2001 based on contract science, some of which was sponsored by Cerestar itself [1,2].  The World Health Organization also reviewed erythritol and found it to be safe.  Little other science exists on the subject.

    We could spend more time on erythritol but there is not much new to report about it.  It has not been extensively used (up until now), it has not been extensively studied and it was approved quite awhile ago now.  It is a bit of a sweetener dark horse, if you will.

    PureVia vs. Truvia – Fight!

    PureVia, but not Truvia, adds in another sweetener called isomaltulose – another supposedly safe sweetener with just a little contract science behind it.  It is derived from regular sucrose to create a sweetener with a longer sustained energy release in the body.  The FDA gave this one a green light back in 2006 at the behest of German sugar giant Sudzucker AG.  Again, it has seen very little use in the American food supply and we just don’t know very much about it scientifically beyond the fact that it does not harm teeth and does not cause stomach aches.

    The Stevia Flower, photo by Ethel Aardvark

    The other major component of Truvia/PureVia, rebiana, comes from a small herb plant called stevia.  Stevia originally comes to us from South America – where it has been used medicinally for centuries by indigenous people.  Rebiana sweeteners represent the first commercial applications of stevia in the United States but not the first in the world.  Another sweetener derived from stevia – called stevioside – was developed by the Japanese in the late 1970s and now controls 40% of the sweetener market in Japan.  Consequently, what we scientifically know about stevia is mostly based on stevioside, not rebiana – a problem we will see throughout this discussion.

    The Concensus on Stevioside

    The science we do have about stevia has only come about recently – in the last 20 years or so.  Despite very few (if any) reports of adverse reactions in the Japanese population from stevioside, some studies found that it was mutagenic, that is it could mutate the DNA of rats.  These findings were later dismissed in scientific literature multiple times when it was shown only extremely large amounts – far larger than anyone could consume – created the mutation.

    Subsequent study of stevioside’s medical effects have found it confers significant health benefits to those who use it medicinally.  Improved immune system regulation [1,2,3] and improve glucose absorption in the body [1,2],  have led some researchers to suggest stevioside:

    “may have the potential of becoming a new antidiabetic drug for use in type 2 diabetes”

    Even further, stevioside helps regulate cholesterol and triglycerides [1,2], which means it may treat metabolic syndrome (also known as syndrome X).

    On the whole, these findings suggest stevioside has major benefits but what about rebiana?

    The Rouge Rebiana

    If you follow any of those study links above, they will dump you into the PubMed scientific database.  The US National Institute of Health (NIH) requires all studies they fund (which is a considerable number) to publish their studies into this database.  Logically, we first looked for Truvia and PureVia here.

    Pubmed, an amazing resource

    A search for either sweetener nets zero search results, as of February 2009 (feel free to try it yourself, click here) – despite all the stevioside research.  However, searching for rebiana nets us 49 very recent results, presumably the ones the FDA used to clear this product (compared to 181 for stevioside).

    Diving through the search results leads us to a special supplementary release in July 2008 by The Food and Chemical Toxicology Journal called “Rebaudioside A: An Assessment of Safety”.  As an aside, it should be noted this release perfectly coincided with Coca-Cola’s first PR campaign that released Truvia to the public with a lavish promotion at Rockefeller Center in New York City last summer.  Below is some footage of the event:

    As for the science in this tome, we find a total of 11 research articles published about rebiana.  One of them [#12] is a review of the toxicity of stevioside , which, as we covered above, we declared safe by a decent battery of tests.  Two others [#2, #11]  deal with the development of rebiana from the stevia plant, both casually suggesting the toxicology information of stevioside should equally apply to rebiana – a dubious claim at best considering how little research has been done on the later.

    However, another study in this group [#5] actually demonstrates that the two sweeteners are relatively similar.  They based this statement on how quickly they are absorbed by the body as you can see in this chart:

    Results from study #5 in the rebiana review

    While it seems convincing, this report did not use a control group or use any kind of statistical analysis to determine if the slight difference in absorption between the two sweeteners was statistically significant.  Further, the study used about 20% (.8 mg/kg) more rebiana than stevioside in its test, a factor that is sure to skew results.  Their observations also omitted an important data point when observing stevioside at the critical 1 hour mark.  Not to mention, the time schedule on the main graph in the report is misleadingly constructed to show each observation as having occurred in hourly succession (when in fact no observations were made in hours 2 or 3).  This science is very poor in quality and, not surprisingly, funded by Cargill.

    Another one of the studies [#4] dealt directly with the toxicity of rebiana by super-dosing rats and observing them.  Most rats ended up eating significantly less food and consequently attaining lower body weight as they aged, consistent with other megadose sweetener studies.  But, most importantly, the rats did not die from rebiana so we could count that as a good thing.  Methodology in this study was far more convincing than the previous study – controls were used and statistical significance was achieved.  Still, the result of this study – that rebiana produces appetite suppression, should be followed up with additional study, something the authors do not call for.  Again, you should note that this study was funded by Cargill which may have influenced the lack of a call for additional study, though this is a minor critique.

     

    Follow the money – its not hard

    Rebiana: The Human Studies

    Two of the remaining studies deal with people instead of mice, so they should carry the most weight in your mind.  The first, [#6] in rebiana study supplement] tested rebiana against blood pressure and found high dosed patients maintain the same blood pressure in a randomized, double-blind placebo trial, the best type to use.  We can say a few bad things about this study but nothing ridiculously major; it was only 4 weeks long, it did not test against people who already have high blood pressure (a substantial portion of the population), and, again, Cargill funded the study.  Overall, this is encouraging but it is only the first study of its kind so its hard to draw too much from it.

    Controversial little shrub, eh?

    The other human study deals with rebiana and how it effects people with type II diabetes..  The study uses a megadose, 7X what a heavy user would probably ingest, and followed a little more than 100 patients for about 4 months.  Results of this placebo study show no severe effects on blood pressure or blood sugar.  However, there was one case of hyperglycemia – that is too much glucose in the blood stream – but in a group of diabetics, something like this seems likely to happen during a 4 month period of time.  And let’s not forget to mention that some Cargill money managed to squeeze its way into the study.

    In a way, this particular finding was a bit of a disappointment.  There was hope that rebiana would treat diabetes much like it is suspected stevioside can but this is the second study to disprove that.  The first study on this topic showed that rebiana was not able to deliver any of the metabolic syndrome reducing effects of stevioside, so a consensus is forming.  A few others studies show rebiana helps regulate glucose, but there is still much more investigation necessary.

    First Thoughts

    The studies we have about rebiana – and consequently Truvia and PureVia – are a mixed bag.  As we showed, some demonstrate safety, some show risk.  None really deal with potential side effects, an issue with a product that will find its way deep into the food supply.  Most surprisingly though, absolutely no published studies have actually tested Truvia or PureVia themselves.  This is probably because the sweeteners themselves were not ready in advance to be tested but we must ask why the American public is being silently asked to bear that burden.

    It would appear rebiana (along with erythiritol and isomaltulose) present little risk to people with high blood pressure and type II diabetes but in the world of science, your opinions are an extension of the crowd.  In a sense, you are only as good as those that have come before you.  With rebiana, there is no concensus, no crowd – so there is no way we can give any type of authoritative opinion on it yet.  The crowds surrounding erythiritol and isomaltulose are even more sparse.

    That’s all a problem with a new product and one the makers of Truvia and PureVia have done very little to assuage.  While most of these studies appear to verify that rebiana et al., do not have toxic effects, they are all very short term and funded exclusively by industry.  It is beyond unlikely that any study funded by Cargill is going to show rebiana and Truvia to be anything but the safest sweetener ever to arrive on planet earth.  Having said that, some of their studies do appear to demonstrate safety of rebiana but it so hard for us to believe these results with so much of their own money on the table.

    Now, lets give Truvia and PureVia a little credit here.  This is the first sweetener product(s) developed by an agribusiness interest that is not purely a chemical.  A real plant is involved here and that is the first time that has ever happened.  Not only that, the stevia plant shows some rather amazing medical benefits.  So, for a brief moment, let us congratulate Cargill and Merisant for at least starting with something very beneficial found in nature.  That is a MAJOR step in the right direction.

    Still, major questions persist.  When will Truvia or PureVia actually be tested?  How can we trust science sponsored by the same people who will gain from its results? What makes this better than just using regular old stevia?

    In our next and final view of Truvia and PureVia, we will talk about how all of this science relates to stevia’s controversial past, discuss some of our conversations (and lack thereof) with government/NGO players and finally present our view on the best way forward with these sweeteners.

    Please read Part 3 of the Truvia/PureVia series:
    Part 3: Truvia and PureVia – The Controversy of Stevia
  • Mailbag: Clare Island Organic Salmon Omega-3s

    Mailbag: Clare Island Organic Salmon Omega-3s

    Credit, Steve 2.0 (flickr)

    Periodically, readers write into Nutrition Wonderland about issues we cover and we respond back to them.   This is a new column we will try to feature as we move forward – send all questions to [email protected] to be featured in the mailbag.

    Michelle from Virginia writes:

    I read with great interest your 12/08 article on the Nutrition Wonderland website entitled “Organic Fish Standards Announced by the USDA” – very informative and I learned some new and interesting facts regarding the subject.

    However I found your article while in search of a more specific question, and I’m hoping you can direct me to a source for answers.

    My local grocery store carries the Clare Island Organic Salmon from Ireland brand. I’ve learned from you and others that the level of omega 3 in wild vs farm raised salmon is largely based on the diet fed the fish. I’d like to know if the organic fish raised by this company are fed a diet that results in a higher level of omega 3s? Specifically, how does the level of omega 3s in this fish compare to that of wild caught Alaskan salmon?

    I went to the company’s website (https://mowi.com) and could not find any information about the omega 3 content of this particular product. Do you know of another, unbiased source of this information?

    Thank you so much. And keep doing what you do – we depend on folks like you!

    Michelle-

    Glad you found the organic fish information helpful.

    This statement from the parent company gives us some insight into the brand [emphasis mine]-

    Clare Island Organic Salmon are provided with special diets that contain only organic, natural ingredients and are free of genetically modified products. Phaffia, a yeast based pigment, ensures the salmon have that natural salmon-pink colour.

    There is an interesting way to look at this statement – only organic ingredients implies that these fish are only eating vegetables, not other fish and krill like wild fish would.  We know this because there still are no wild fish farms that produce smaller fish for the salmon to eat.   Clare island is part of a large firm called Marine Harvest, and large firms tend to cut corners on quality.  We also know they are probably using GMO-free corn probably and not using pink dyes.  Both of those are good steps but nutritionally, corn gives a higher omega 6:3 ratio so you are missing out there.

    Generally, salmon in colder waters will have more fat and better fat – which is logical if you think about it.  Its cold so they are trying to protect themselves from the cold with more fat by eating more krill – which is their main source of omega-3s naturally.  That’s why wild Alaskan salmon is your best bet.

    You probably aren’t hurting yourself with the farm raised product but a wild Alaskan salmon would do you better.  I find that trader joe’s offers a nice product as does whole foods.  You can also try to buy in bulk online straight from Alaska if you have a freezer to store it in.

    The Weston A. Price foundation publishes a great shopping guide that can help guide you to the right foods – they are only $1 each.  Unfortunately its not online but I have one and highly recommend it – there are fisheries listed in there.

    Here is the order form:
    https://www.westonaprice.org/get-involved/#gsc.tab=0

  • Truvia and PureVia – A Window to the Past or the Future?

    In the coming weeks, we will be examining two new sweeteners called Truvia and PureVia that are being released into the American food supply in the first half of 2009.  They are derivative of a naturally sweet plant called Stevia, which has been used around the world for quite some time now to sweeten drinks and native dishes.   But before we dig deeply into the science around the new Stevia-based sweeteners, we think it would instructive to learn the history of synthetic sweeteners in America – as the past is usually the best predictor of the future.

    Back to the Future

    Harvey Wiley

    To understand Truvia and PureVia, you need to wind back the clock – all the way back to the 1900s.  Here you will meet a man named Harvey Wiley, a sugar chemist with Germany ancestry and deep roots in the American academic system.  He came to Washington in 1906 to become the Chief Chemist at the Department of Agriculture shortly after famed author Upton Sinclair dropped “The Jungle“, a scathing of the meat packing industry, onto the American public.  These developments were creating an environment ripe for change.

    During that same time, physicians were starting to recommend reduced-sugar diets to help some of their patients.  This advice was based on an unexplainable (no longer) link between being overweight, inactive, having diabetes, and ‘debilitation’ in general.

    As it turns out, our former president Teddy Roosevelt was just such a patient.  His doctors recommended jumping onto the newest artificial sweetener of the day, saccharin (today – Sweet ‘n Low), to reduce his sugar intake, presumably to prevent diabetes.

    Realizing the President was regularly consuming the additive, Wiley, ever the scientist, took immediate issue.  Here is an exchange between the two as they discuss potential actions against the additive [emphasis mine]:

    “I immediately said to the President: “Everyone who ate [it] was deceived. He thought he was eating sugar, when in point of fact he was eating a coal tar product totally devoid of food value and extremely injurious to health.”
    “You tell me that saccharin is injurious to health?” Roosevelt retorted.
    “Yes, Mr. President, I do tell you that,” Wiley replied.
    “Anybody who says saccharin is injurious to health is an idiot,” Roosevelt sternly answered.

    Towards Regulation

    Wiley was quite obviously a man of a different sort.  Anyone brave enough to get in a President’s face is not short of courage.  That same courage caused Wiley to take a different route. He and a brave group of human guinea pigs, nicknamed the ‘Poison Squad’, went about testing food additives – including saccharine, borax and formaldehyde – by ingesting them and reporting on what happened.   This group of hardy souls was only allowed a controlled amount of water & food while they ingested chemicals (‘in a hygienic environment’ of the day) and collected all their excrement for examination.

    Crude as it was, Wiley’s Poison Squad were conducting the first food additive studies. These theatrical studies were reported widely across the media, especially in the Washington Post – building Wiley’s magnanimous character.  These events, coupled with ‘The Jungle‘ finally culminated in the passage of the Pure Food Act of 1906 that established the FDA and Wiley as the ‘Father of Pure Food‘.

    As Upton Sinclair, the ardent socialist, famously noted about his Jungle treatise intended to stoke a populist backlash against unsafe labor conditions,

    “I aimed at the public’s heart and, by accident, I hit it in the stomach.”

    Meat Packing, cerca 1906 – Sinclair’s target

    And The Lobbying Begins

    Passage of that act led to more professional research programs designed to test the food additives – namely saccharin.  Wiley’s work quickly identified food containing saccharin as ‘adulterated’ – akin to a modern-day FDA ‘not GRAS‘ labeling.  From his April 29th, 1911 Food Inspection Decision 135 [emphasis mine]:

    “At the request of the Secretary of Agriculture, the Referee Board of Consulting Scientific Experts has conducted an investigation as to the effect on health of the use of saccharin.  The investigation has been concluded, and the referee board reports that the continued use of saccharin for a long time in quantities over 3/10ths of a gram/day is liable to impair digestion; and that the addition of saccharin as a substitute for cane sugar or other forms of sugar reduces the food value of the sweetened product, and hence lowers its quality.

    Wiley, et al. continue:

    “If the use of saccharin be continued, it is evident that amounts of saccharin may readily be consumed which will, through continual use, produce digestive disturbances.  In every food in which saccharin is used, some other sweetening agent known to be harmless to health can be substituted, and there is not even a pretense that saccharin is a necessity in the manufacture of food products.”

    Shortly thereafter, a pattern familiar to all 21st century citizens began.  An attorney representing the saccharin manufacturing corporation, Sherman Brothers, published a threatening letter to the New York Times, emphasizing the cost benefits of saccharin while claiming that the amount of saccharin required to do damage was significantly higher than anyone would consume in a single bottle of soda.  From the Times piece [emphasis mine]:

    “Saccharin today is almost exclusively used in soft drinks, “pop,” soda water, etc., and reduces the cost of the same.  3/10ths of a gram of saccharin – the quantity declared by the Remsen board to be innocuous – will sweeten thirty bottles of pop or soda water; and it therefore appears to be a physical impossibility for any person to absorb a dangerous quantity.  With sugar advancing in price, with a saccharin in moderate quantity approved by the highest scientific authority in the land, I am at a loss to understand the animus of the editorial article above referred to.”

     

    How the mighty have fallen…

    Only a year later in 1912, the newly formed FDA reversed their position, claiming the sweetener was safe.  This pattern would play out many more times.

    The battle of saccharin would take a breather for awhile but resurface in the late 1960′s after a studies unearthed 1940′s era research from the FDA that showed how saccharin caused bladder cancer.  A flurry of research started up again and a move by the FDA to ban the substance gained momentum in 1977 after watching saccharin formally banned in Canada.  Instead, the US congress blocked the ban and a warning label was issued instead.  That lasted until 2000 when it too was dropped for unclear reasons.  Subsequent scientists have spoken out about the additive but as of February 2009, it remains readily available in the United States.

    What are we to think?

    This now common back and forth policy is attributable to the way in which money sways political fervor, not as if this revelation should be news to you.  It nonetheless bears repeating because we are about to welcome still two more additives, Truvia and PureVia, into our lives in the coming months.

    The saccharin debate has stretched nearly 100 years but it is just one of many chemicals to suffer such a tumultuous fate – rGBH, DDT, Aspartame and most recently the plastic additive Bisphenol A have all followed this similar path.  Each is worth their own story but the take home point is the same – additives come with consequences.  All of these wonder chemicals come with side effects, some of them quite severe.

    Cheers or Jeers?

    And that brings us back to Truvia and PureVia – and why they may finally break this cycle.  The hope with the newest agribusiness additives is that they are actually based on something in nature – Stevia – so the thinking goes that they may bring the promise of a reduced calorie sweetener that does not impair people’s health.  None of the artificial sweeteners currently for sale can legitimately make that claim today.

    The characters surrounding these various debates constantly changes but Wiley and Roosevelt would largely find the song remains the same – nearly 100 years later.

    NOTE: This article is the 1st part of a series about Truvia and PureVia. You may want to read the next two parts to better understand this issue:

    Part 2: Truvia and PureVia – The Science
    Part 3: Truvia and PureVia – The Controversy of Stevia

  • Book Review: The Cholesterol Myths by Uffe Ravnskov, MD

    Book Review: The Cholesterol Myths by Uffe Ravnskov, MD

    A recent study from the New England Journal of Medicine showed that the death rate from heart disease has fallen by over 50% during the period from 1980-2000.  The authors concluded that the dramatic drop can be equally attributed to medical advancements in treatment and better management of heart disease risk factors, respectively.

    Cholesterol Myths in Detail

    While this large decline is great news, the heart disease situation remains more mixed than it first appears.  Of the roughly 340,000 deaths avoided since 1980, only about 82,000, or 24%, can be attributed to cholesterol management (using the now standard IMPACT statistical model (pdf)), despite the relentless National Cholesterol Education Program that was begun in 1985 at the behest of the NHLBI.  More worrisome, another large study states that 70% of the decline in deaths came in people that still have heart disease.  Other doctors also point out that any drop in heart disease deaths does not mean there is a drop in new cases of heart disease.

    Translation: we still have a lot of work to do.

    Closer to the “Truth”

    The perception of reality can mean different things to different people.  To some, those numbers above mark an unbelievable success – a triumph of science over nature.  To other researchers, those same numbers reveal troubling contradictions about the actual causes of the disease.

    And that’s where the questions started for Uffe Ravnskov, MD.

    Does cholesterol cause heart disease or do they merely have an association with each other?  How do HDL and LDL relate?  What role do high fat foods really play?  What if all of those studies about cholesterol were wrong?

     

    The Heart Disease Decline since 1950

    Dr. Ravnskov, a founding member of  the International Network of Cholesterol Skeptics, takes all those positions and goes even further in his book, “The Cholesterol Myths” published by NewTrends Publishing.  One part detective mystery, one part conspiracy theory, Ravnskov tears through piles of medical studies digging towards the “truth.”  His thesis is rather simple: cholesterol does not cause heart disease.  We put emphasis on the word cause for good reason: Ravnskov’s entire argument hangs on tearing apart the correlation-versus-causation dichotomy.  For the most part, he succeeds but at a cost to his text.

    A Myth Unraveled?

    The Book

    Ravnskov lays out his attack into a series of myths he wants to dispel for readers.  Some myths are bold like “High-fat foods cause heart disease” while others are down right incendiary, especially when he claims to bust the myth that “the cholesterol campaign is based on good science.”  Putting down the entire research community is good way to get attention and attention he received.   This book was publicly burned on Finnish television upon publication.  So much for reasoned debate.

    Once you get past the burnings, you will see this work is undeniably strong on laying out a solid foundation in science for those who aren’t so inclined.  Ravnskov meticulously breaks down the correlation-versus-causation argument in a way that lends itself to being understood.  You will definitely understand the difference between the two, even if you only manage to make it twenty pages into the text.

    Cholesterol Myths really shines when it sticks to deeply interpreting studies findings within the scientific paradigm Ravnskov sets up.  His work goes to great lengths to uncover shoddy science in some of the landmark cholesterol-heart disease studies.  In some cases, Ravnskov uncovers pure gold for his readers.  Case in point, one of Ravnskov’s first myths deals with a study examining the Masai people, an indigenous people who did not consume a western diet, for a diet-heart disease connection.  From Page 36 [emphasis added my own]:

    “Professor Mann studied a much greater number of hearts and aortas from Masai individuals of all ages and found that the coronary vessels of the Masai were just as atherosclerotic as those of US citizens, perhaps even moreso.  But severe sclerotic changes [in Masai], so-called raise lesions, were rare; the sclerotic changes in the Masai were situated inside the vessel walls, leaving the inner surface of the vessels smooth.  And in the 50 hearts he studied there was no evidence that myocardial infarction has occurred in any of them.”

    Moments like this really let Ravnskov’s investigatory skills shine; he masterfully dissects the cannon of cholesterol research like few other authors we have ever read.  And during these infrequent moments in the text, you can see what this book could really be – a true guide to the future of heart disease research  – but ultimately that is not this text.

    At its best, Cholesterol Myths is a scathing review of literature instead of a gateway to where this literature should guide the national discussion.  Instead of using his knowledge to lead us into a more beneficial discussion on heart disease, Ravnskov exhausts his mental energy on tearing down cholesterol.  At times, I found myself hoping he would direct that massive brain of his towards constructing a new paradigm in which we could view heart disease.  Don’t hold your breath for that one.

    Instead, Ravnskov frequently leaves the reader to infer ulterior motives about each study he rips into, all without ever saying it explicitly, a sort of intellectual dishonesty that I did not appreciate as a reader.    Additionally, the book’s nine myth sections overlap and repeat each other often.  Invariably, he finds problems with about every major study that shows a relationship between cholesterol and heart disease.

    From the beginnings of Myth 6, you can see a familiar line of reasoning repeated throughout the book:

    “It is extremely difficult to design even the initial steps of a scientifically acceptable trial.  The standards of science are high, however.  In fact, they are so high that, even if we manage to select a test group and a control group with almost identical risk factors for heart disease, we must remember that almost identical and absolutely identical are not the same thing, and that we will never know all the factors that may, or may not, contribute to the development of the disease in these people.”

    While he is technically correct, studies that contain a control group mitigate these confounding factors.  No study will ever be perfect but we can’t use that as an excuse to dismiss significant research findings completely.  Ravnskov is wise to highlight study oversights but that does little to forward the heart disease dialogue.  Arguments like the above really dog this book in our opinion – and they appear far too often.

    Where we go from here

    Simply addressing heart disease as a cholesterol problem has not brought the world any closer to eradicating it.  Ravnskov’s arguments about the sometimes flimsy science surrounding cholesterol theory are an extremely valuable addition to this discussion.  His commendable goal of educating the public on the many problems with the singular cholesterol argument was accomplished ten times over in this volume.  Even a casual reader of this work comes away from it with a better understanding of the scientific method and heart disease in general – and that is a welcome development.

    Still, Cholesterol Myths misses the larger target in our opinion.  After destroying cholesterol in his book, Ravnskov does not forward any additional theories on the causes of heart disease.  This may not seem like much of a problem but it is in the scientific world.  The best theory ‘wins’ out in science because it can explain the most behavior present in a given situation; it need not explain all of the behavior.

    With a chronic disease like heart disease, it has already been well established in scientific literature that many factors, like stress and inactivity, contribute.  Only one of these factors, cholesterol, is ever considered in this text – and in that way this book is attempting to topple a myth that simply does not exist anymore.  Even, more, Ravnskov may thoroughly debunk cholesterol as a singular cause of heart disease but he freely admits there is a correlation between the two.

    From Myth 2 in his work:

    “Table 2B shows, in accordance with many other studies, that more heart attacks occurred among those with the highest cholesterol levels.  The differences were not impressive, however, considering that the figures were not adjusted for anything but age….”

    Major studies controlling for various factors show somewhere between 10-33% of the total heart disease death rate decline can be attributed to cholesterol reduction, depending on the country in question.  While this doesn’t prove cholesterol singularly causes heart disease, it definitely shows cholesterol is somehow involved.

     

    Heart Disease Decline Factors, Credit: NEJM

    And thats just the problem for us.  These conflicting facts often leave us in the lurch during Ravnskov’s elaborate presentations, knowing cholesterol plays some role with heart disease but not truly being the cause.  Admittedly, uncovering the cause of heart disease may be beyond the scope of his book but Ravnskov’s omission of a more comprehensive theory looms largely over this book.

    Overall, this book is a necessary addition in the discussion about heart disease.  Ravnskov’s book should be read by anyone with a critical eye and a curiosity about the origins of heart disease.  But it could have been so much more.

  • Piven Sickened by Sushi’s Mercury

    Piven Sickened by Sushi’s Mercury

    Actor Jeremy Piven announced yesterday that he will leave the David Mamet play Speed-the-Plow because he has a mercury level running almost six times that of a normal person.

    Piven complained of fatigue and exhaustion since the play’s opening, which was back in early October. His doctor, Dr. Carlon M. Colker of Peak Wellness in Connecticut, said that all of Mr. Piven’s routine medical tests came back at acceptable levels, but, after reviewing what he knew about Piven – who liked to consume sushi sometimes twice a day – Colker decided to check Piven’s mercury levels.

    Jeremy Piven

    The results showed Piven was suffering from fatigue related to significant mercury exposure. He apparently decided to push on and continue to perform in Speed-the-Plow but that decision proved too ambitious. Later in the week, Piven was hospitalized for severe exhaustion after which his condition and his removal from the play was relayed to the production staff.

    Tough Crowd

    Public reactions were quick and sharp. Piven’s history as a bit of a Hollywood playboy have haunted him as this situation has unfolded. Some claim his departure is merely an excuse to leave the rigorous schedule Broadway demands. The playwright Mamet had this to say about his former star:

    “I talked to Jeremy on the phone and he told me that he discovered that he had a very high level of mercury. So my understanding is that he is leaving show business to pursue a career as a thermometer.”

    With the Hollywood mud flying, Dr. Colker went on ABC’s Good Morning America to try and clear the air for Piven.

    “We were very transparent about the fact that [Piven] had a mercury level that was shockingly high. It was almost six times the upper limit of the allowable reference range. He had very severe symptoms of fatigue and exhaustion at the beginning of the run of the show. We were basically going to tough it out and see how it went. I [Colker] acquiesced and let him go ahead and do that as we initiated treatments that were trying to get his mercury levels down.”

    Colker continued:

    “His symptoms had progressed, the neuromuscular fatigue began to come into play and, at that point, I would be remiss if I didn’t say ‘I think you need to step away from this’. Keep in mind, Jeremy is known as an absolute iron-horse when it comes to Hollywood and acting….It was up to me to step in and pull the reigns back in.”

    Mercury Toxicity – The Larger Story

    So the big question everyone wants to know is whether or not Piven is telling the truth or lying about the severity of his condition. Admittedly, the preliminary stages of mercury poisoning would be one of the easiest conditions to fake because, initially, it only exhibits itself in very strange ways that could easily be dismissed. General neuropathy (numbness), profuse sweating, raised heart rate and general fatigue are the most likely outward manifestations. Any of those conditions by themselves or even taken together can be casually dismissed, but they shouldn’t.

    Recall that in Dr. Colker’s interview above he mentioned the condition of “neuromuscular fatigue” and how it was starting to take a toll on Piven. What the good doctor was really talking about is the way mercury disrupts brain-to-muscle signaling.

    A synapse, where mercury attacks

    When Piven is out on stage, his brain, like yours, fires incredibly specific signals to key muscle groups so that he can perform. Neuromuscular junctions are where the brain ‘hands off’ its commands to the muscles – and this is where mercury comes into play.

    Mercury inhibits a key, relay neurotransmitter called acetylcholine, disrupting the way it normally binds and signals brain-to-muscle messages throughout the body. Bad signaling means the body has to work much harder to perform basic functions, resulting in an exhausting and seemingly unexplainable fatigue from which Piven was likely suffering.

    Beyond this initial stage of damage, mercury also severely disrupts the foundation of thought – neurons. The brain operates much like the microprocessor in your computer by firing a rapid symphony of tiny, neuronal-electrical signals throughout your body. Mercury can lay waste to the machine of your mind by literally tearing apart the electrical signaling equipment in your brain.

    Specifically, mercury ions bond with tubulin, the protective coverings that surround the electrical impulse-generating neurofibrils of each neuron. Those mercury ions cause the tubulin to literally disintegrate. Any neuron close enough to the mercury exposure suffers this fate. Worse yet, mercury’s fat solubility means that it tends to settle in the brain because the brain is the fattiest thing in your body, believe it or not. This video below shows just how destructive mercury is inside the body:

    Left untreated, severe mercury exposure can cause far greater problems by narrowing the field of vision, completely stopping all muscle function and even driving the afflicted to insanity – resulting in a fatal, tortured paralysis called Minamata’s Disease. Lest we forget, mercury plays a role in neurological disorders like Parkinson’s, Alzheimer’s and likely autism.

    Minimata – The final stage (Credit W.E. Smith)

    Obviously, Piven was a long way from any of these diseases but his extremely elevated mercury body burden makes it completely plausible that his fatigue was caused by the mercury from his sushi habit. Piven’s conditions of extreme fatigue and exhaustion that required a hospital stay fit the profile of mercury exposure very well. It is also highly unlikely a credentialed doctor would go on national TV, risk his career and lie about his patient being hospitalized. Considering all this, there is a very good chance Piven is telling the truth.

    Where does all this mercury come from?

    Beyond the Hollywood finger pointing, Piven’s condition is important because it could have easily been anyone else who casually enjoys eating fish that finds themselves in this same position. The real question for you needs to be why fish have so much mercury in the first place. The answer has far less to do with Hollywood’s trendy sushi joints and far more to do with West Virginia’s coal mines.

    Coal, the enemy of every climatologist worried about global warming, also pollutes our environment with significant amounts of mercury. The exact amount is hard to calculate but a 2005 statement by the EPA suggests at least 48 tons are released into the US atmosphere annually. Remember, this doesn’t even count China, who is estimated to open one or two new coal power plants every week.

    The mercury flying out of all these coal power plants is chemically transformed by bacteria into methylmercury once it finally falls back to the ground, often many miles from where it was emitted. Mercury first creeps into the water supply where it is absorbed by aquatic microorganisms. From here mercury works its way up the food chain in a process known as bioaccumulation.

    Your source for mercury

    The smallest sea creatures, plankton, feed off the microorganisms, which are later swallowed by bottom dwelling fish. These smaller fish get eaten by larger fish which are eventually eaten by human beings, transferring mercury up the food chain. Not surprisingly predatory fish like shark, swordfish and tuna that sit atop the aquatic food chain have the highest mercury concentrations (see a full list here). When we eat these fish, our bodies rapidly absorb the methylmercury – and we all find ourselves in a situation not too dissimilar from Piven.

    This situation could be different. Many techniques and technologies currently exist that can take out 95%+ of the mercury emitted from coal power plants. Such a move would have dramatic, positive benefits across our society but regulatory agencies like the EPA have been extremely slow in promoting new standards for typical reasons like bureaucracy and corruption. Ironically, the EPA has recently been publicly criticizing the FDA for its lax guidance of mercury laden-fish, the pot calling the kettle black if ever such a situation existed.

    Still, the push for coal remains strong. Let’s hope Piven’s high-profile nature helps to create a real discussion about getting mercury out of the world’s coal plant’s, waterways, fish and our bodies.