What Do Microbiologists Eat? Or Not Eat?

During my teaching days, I taught a course in infectious disease for several years. As part of our lab sessions, we did some sampling to test some common areas in the cafeteria as well as some local food samples from a few local restaurants (salads) and other produce from the supermarket.

As a result in our lab, we found E.coli growing in the ice tea spouts in the cafeteria and growing in the alfalfa sprouts at the local supermarket. The presence of these types of bacteria suggest fecal contamination – need I say more? Raw sprout contamination is not new. Raw sprouts are not recommended for pregnant women, those with compromised immune systems, or the elderly. Keep in mind that the species of E. coli can range from “friendly bacteria” to dangerous pathogens (E. coli 157:H7.)

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Eating Leafy Greens Safely

EATING Leafy Greens Safely from Consumer Report, March 2020

Many nutritionists declare that eating leafy greens are one of the hallmarks of eating a healthy diet. This is true, but due to various environmental events this advice has been questioned. The main culprit in this story is romaine lettuce that has too many times been implicated with outbreaks of food borne illnesses caused by a bacterium called E. coli.

Take the case of Cheryl in 1992.

Her mother, Susan knew something was wrong when she found her 6-year old daughter, Cheryl doubled up in pain and moaning. Her husband, Tom took her to the hospital after they realized Cheryl was also suffering from severe bloody diarrhea. Susan and Tom spent the rest of the day wondering what was going on. Appendicitis was mentioned as a possibility. By the morning, Cheryl was transferred to the ICU and given powerful painkillers. The next afternoon more tests showed that Cheryl did not have appendicitis. Now what? New tubes were connected to Cheryl’s body, but her condition only worsened as the day wore on.

Cheryl continued to get worse which resulted in a heart attack and she was eventually put on life support; the damage to her heart and brain and kidneys were irreversible. The time had come to remove her ventilator. Susan sat there holding her six-year old daughter who five days previous had stayed home from school with a stomachache. Now she was gone.

The cause still remained a medical mystery until one physician had listed as a possible cause hemolytic-uremic syndrome (HUS), a rare disease leading to anemia and kidney failure. He had read that research identified E. coli as the primary cause of HUS. Most E. coli strains are harmless to humans, but one strain E. coli 0157:H7 can be deadly since this bacterium manufactures a toxin that attacks red blood cells. Stool cultures from Cheryl confirmed the presence of the E.coli O157:H7.

Soon other children had been infected and presented to emergency rooms over the Northwest U.S. “The headlines read: At least 45 people in Western Washington, most of them children, have fallen ill from an outbreak of a bacterial illness commonly linked to under-cooked beef, the state Department of Health officials said yesterday” The bacterium was identified as E. coli 0157:H7 and identified the source was hamburger meat served at a Jack in the Box restaurant that resulted in the death of four children and over seven hundred others who were gravely ill. These potentially lethal outbreaks have forever changed America’s relationship with food. Previously, most consumers thought of food poisoning as a short-lived nuisance, if they thought of it at all. Now it has become more of a threat to the public and the produce industry in addition to the meat-industry.

Outbreaks Continue: Consumer Reports, A Safety Guide to Leafy Greens, March 2020.

“According to the CDC, from 2006 and 2019 romaine and other leafy greens, such as bags of spinach and spring mix, have been involved in at least 46 multistate E. coli outbreaks. Some research shows that greens cause more cases of food poisoning than any other food, including beef.” According to the Centers for Disease Control and Prevention, 73,000 Americans become infected with this strain from all sources each year and about 60 people die as a result.

“Many victims of these outbreaks have had their lives seriously disrupted. Many have needed kidney transplants and hundreds of thousands of dollars in medical expenses because they chose to eat a presumably healthy food,” says Bill Marler, a food safety lawyer in Seattle who negotiated settlements for many victims.

For every reported case, there are many, many more cases that are not reported, says the CDC. Something has gone wrong with the processing practices we now employ and can occur during any of the steps required to grow, harvest, and package salad greens. Salad greens in the U.S. are primarily grown in two main areas: Salinas Valley, California and Yuma, Arizona, depending on the season.

However, leafy greens, especially romaine lettuce have consistently been found to be the culprit in a great majority of cases from all causes. Sales of romaine have plummeted from sales of $563 million in 2017 to $465 million presently. Still, growers are trying to figure out at what stage of the plant’s growth, a potentially deadly bacteria finds its way into and onto lettuce leaves. As bacteria are killed in products that are consumed after cooking, salads are usually eaten raw. In raw foods, this final “kill” step of cooking simply does not exist making it more difficult to contain any outbreaks. Even more simply, consumer demand for salad greens has increased significantly. Romaine became the trendy lettuce and popular for salads, burritos, wraps. Even most mixed greens bags contain some romaine.

How Greens Become Contaminated

Growing the Seeds

Bacteria such as E. coli are found in animal feces from cattle and sheep and the leaves of the growing plants can take up the microbes into their roots and thus the leaves. Many of these lettuce farms are unfortunately found close to animal feedlots and the runoff from the feedlot waste ends up into the water used to irrigate the growing crops. It also may be carried by the wind from feedlots onto the adjacent growing plants. Wild animals or birds can deposit bacteria onto the fields. One major outbreak was attributed to the presence of wild boar contaminating the fields.

Harvesting the Fields

Machinery that helps to harvest may carry bacteria onto the fields. Workers may not practice proper hand washing when harvesting crops (this is hard to maintain in the field setting. When plant leaves are cut during harvesting, the ends provide a reservoir of nutrients for the bacteria to thrive on and bacteria to enter the leaves.

Processing Plants

For bagged greens, plants from many sources are mixed together. If there is even one contaminated leaf in the mix, the rest will soon become contaminated as well. Equipment is not sanitized properly, and workers do not practice adequate hand washing procedures. Greens are washed in a sanitizing solution that may be recycled.

Triple-washed Greens

Most consumers feel reassured when buying bagged greens that state on the label, “Triple-washed, Ready to Eat. This creates a false sense of security since most bacteria are almost impossible to remove. It only takes 10 microscopic bacterial cells of E. coli, for example, to be considered an infectious dose. Therefore, this process may cut bacterial contamination, but it does not guarantee all the bacteria are “killed.”

Fifty-six percent of Americans rinse their lettuce before eating it, but mere water does little to remove harmful bacteria. Bagged lettuce contains greens from many farms and the leaves have all been cut. ” According to the results from a 2006 spinach outbreak, the tainted greens were eventually traced to one small section of just one small section of just one growers’ field.”

Prevention

Prevention is a complicated problem. More regulations are needed, but growers say they have already made most of the changes that are known to improve food safety. “There’s no such thing as zero risk” according to Channah Rock, Ph.D., a researcher. People need to be alerted to outbreaks and recalls more quickly to stop the contaminated food from reaching the market. In my opinion, feedlots should not be allowed to operate so close to produce fields – and stricter water testing is needed. As with all regulations, delays are inevitable. For example, stricter rules were implemented to take place in 2018. Now they have been pushed out to at least 2022. Delays like this are unacceptable when consumers’ lives are involved.

The Safest Ways to Eat Salad

Even though there are problems, in my opinion, consumers should know the facts of the hazards and make their own decisions as to whether to eat raw salad greens or not. 25% of Americans say they eat lettuce less often now than before. I personally avoid raw salads but find this unfortunate due to their high nutrient density and recommendations to eat more fruits and vegetables. Here Is what you can do until the industry can make greens less risky.

Cook sturdier greens until wilted: Use spinach, kale, collards, Swiss chard, bok choy
Consider buying whole head lettuce, not bagged. The heads are less processed, cut, and easier to wash before eating. Their inner leaves are more protected and are less likely to meet with sources of contamination.
Keep packaged lettuce cold and eat it soon. Bacteria grow more quickly at room temperatures. Watch the expiration dates. Do not use damaged or bruised leaves.
Look for hydroponic or green-house grown greens. These are more protected against animal droppings in soil or water. Cleanliness depends on the water source and hand hygiene of the workers.
Soak greens in white vinegar for 10 minutes, then rinse. This will only reduce bacteria levels, not kill all bacteria. Forget salad rinses that only will clean off dirt or chemicals. They do not kill bacteria.
Stay informed. You can follow recalls at FDAfood and USDAFoodSafety. On either sites, you can sign up for email alerts.

CBD: The Facts

CBD: WHAT YOU NEED to KNOW

You may have noticed that cannabidol (CBD) seems to be available almost everywhere you look. No single compound expanded its market in 2019 quite like CBD did. This cannabinoid has the bragging rights for new product diversity, after finding its way into water, lattes, jellybeans, hummus, cosmetics and even doggie treats.

CDB products have claimed to treat or even cure a plethora of ailments such PTSD, cancer, arthritis pain, anxiety, sleep disorders, depression, Crohn’s and opiod addiction to name a few. The question remains: how could a single family of molecules help so many different maladies? The most obvious response is that they might not; all of this research might not pan out.

The FDA has approved only one CBD product, a prescription drug product called Epidiolex to treat two, severe forms of epilepsy. It is currently illegal to market CBD by adding it to a food or labeling it as dietary supplement. Some CBD products are being marketed with unproven medical claims and are of unknown quality.

So far, the FDA has warned about some possible side effects:

CBD can cause liver injury.
CBD can affect the metabolism of other drugs, causing serious side effects.
Use of CBD can cause changes in alertness, drowsiness, especially with alcohol.
CBD can cause changes in mood as agitation and irritability.
GI distress, decreased appetite, abdominal pain.
There are also disturbing regulation issues like cumulative exposure and how much is actually in the various products? For example, the FDA has tested the chemical content of some cannabinoid compounds and many were found to NOT contain the levels they claimed. Some have been found to contain pesticides, heavy metals, infective agents, and the neuroactive compound THC, the euphoria -inducing compound in marijuana.
A study in JAMA documented that in 84 products sold online, 26% had less CBD than advertised and 43% had more.

In May, the FDA held a public hearing on the safety and efficacy of CBD products. In June, a bipartisan team of legislators introduced a bill aimed to streamline research, and in September, the NIH (National Institutes of Health) announced a $3 million research package to investigate the use of cannabinoids and other cannabis-based, non-THC compounds for pain management.

For a full comprehensive report from the FDA:

Disclaimer: Pop-up advertisements are appearing on this blog without permission, and Food, Facts, and Fads is not associated with any brand that appears. In my opinion, with the list of side effects that have been associated with these products, it would be prudent to be careful with their use until regulations can be put in place by the FDA. As with all supplements, inform your doctor if you are using any of these products due to interactions with regular prescriptionn medications.

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The Myths and Realities of Dietary Supplements

Dietary Supplements: The Myths and Realities

In 1994 Congress passed the Dietary Supplement Health and Education Act, which led to an explosion of manufactured compounds which are now number to more than 80,000 products on the market and the number continues to grow. Types of dietary supplements include:

Vitamins and minerals (Vitamin C and E, selenium)
Herbs (botanicals such as ginseng, ginkgo)
Proteins and amino acids (chondroitin sulfate, creatine)
Hormones, hormone precursors (DHEA, vitamin D)
Fats (fish oils, EPA, DHA)
Other Plant extracts (garlic capsules, fiber, echinacea, green tea)

A recent edition of Consumer Reports (December 2019) has provided a very comprehensive article by Kevin Loria entitled “Shop Smarter About Supplements” that everyone should read if you take any dietary supplements to fully understand why consumers should be aware of the realities, both positive and negative of these products. Americans place lot of trust in diet supplement safety even though they are largely unregulated.

Here are some FACTS: Source: Consumer Reports

Percentage of Americans who take a supplement at least once a week: 68%
Percentage of Americans who take a supplement once a day: 54%
Percentage of Americans who say “supplements are safe”: 71%
Percentage of Americans who think supplements are tested by the Food and Drug Administration (FDA): 48%
Percentage of Americans who think the term “natural” means a supplement is safe or wholesome: 33%
Percentage of Americans who think supplements are safer than Rx or over-the-counter drugs: 38%
Percentage of Americans who think supplements usually work as well as Rx drugs: 32%

However, under the Dietary Supplement Health and Education Act, diet supplements do not have to be tested prior to marketing or shown to be safe or effective. Although they are often advertised to relieve certain ailments, they are not considered to be drugs. They are not subjected to vigorous testing to prove safety or effectiveness, as drugs must be. The FDA largely relies on any claims from the manufacturers. It has been shown that many industry-funded studies only favor positive results and many negative effects never see the light of day. So when you read in a headline for a supplement, “clinical trials have shown…,” the bias of the manufacturer of the study results may be suspected.

In fact, each supplement label must include the following declaration of any claim:

“This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.”

To summarize the realities:

FDA does not approve, test, or regulate the manufacture or sale of dietary supplements.
The FDA has limited power to keep potentially harmful dietary supplements off the market.
Dietary supplements often do not list side effects, warnings, or drug or food interactions on product labels.
Ingredients list on dietary supplement labels may not include all active ingredients.
Dietary supplements may not relieve problems or promote health and performance as advertised.
Many products may remain on the market because “there’s a strong placebo effect.”
“People will feel better if they think they’re going to feel better.”

What Can You Do?

Purchase supplements labeled USP (U.S. Pharmacopeia) and Consumer Laboratories (CL). They are tested for purity, ingredients and dose but does not address product safety of effectiveness directly.
Terms such as release assured, laboratory tested, quality tested, and scientifically blended on supplement labels guarantee nothing.
Check expiration dates on supplements.
Choose supplements containing 100% of the Daily Value or less.
Take supplements with meals.
Avoid calcium supplements made from oyster shells, bone or coral calcium. They may contain lead or aluminum.
Store supplements where small children cannot get at them. A high incidence of trips to the ER involve overdosing of a certain supplement by young children. Taking a large dose of iron can be life-threatening that can damage the intestinal lining and and may cause liver damage.
Tell your health provider about the supplements you take. Consult your provider about health problems before you start taking supplements to try to treat health problems with herbal supplements.

Source: Judith E. Brown, Nutrition Now, 7^th Edition.