Posts Tagged ‘medically-related food issues’

Arsenic Toxicity: Part One, history & worldwide impact

Tuesday, February 21st, 2012

It looks harmless here

I started to write a post on arsenic in baby food since there’s been a spate of recent articles on this issue appearing both in newspapers and online (the AMA Morning Rounds email I receive started me thinking of the subject). But, as usual, when I began to pursue a topic, I found there was both a long history I needed to cover and, in this case, a worldwide problem that should be discussed.

Human industrial use of arsenic dates back 5,000 years. I found the Harvard Arsenic Project has a thorough coverage of varying aspects of our utilization of this element, both beneficial and detrimental. It has been used as a poison for many centuries since it has little if any odor or taste, especially when mixed with food or wine. A Roman leader named Sulla outlawed arsenic poisoning in 82 B.C., to no avail. In Italy in the 15th and 16th centuries, the Borgias, especially Pope Alexander VI and his son, Cesare were said to have killed scores of bishops and cardinals by liberally lacing their wine with arsenic; then, by Church laws, they owned the property of their victims.

Roger Smith, a Dartmouth Medical School Emeritus Professor of Pharmacology and Toxicology has published an online discussion of the uses of the element with the gripping title, “Arsenic: A Murderous History.”

Scientifically it is classed as a “heavy metal.” Nowadays we think of that term as referring to a form of music. But from the chemistry pound of view it actually is one of a group of elements that, volume for volume, are at least five times as heavy as water. Iron, lead and mercury are in that group, but so is arsenic.

If you were to ingest arsenic, diluted in wine or water, at an incredibly small level, 60 parts per million, you would develop belly pain, nausea, diarrhea and then die. Until a few years ago the US drinking water limit was 50 parts per billion. Then in 2000 the EPA proposed all 54,000 community water systems in this country should cut their arsenic levels to no more than 10 parts per billion.

but it's a a plague here

Our local water lab just told me our Fort Collins levels are less than 1 part per billion. That’s clearly not true elsewhere in the world. Over 137 million people in 70 countries are exposed to toxic levels in their drinking water. Bangladesh has the most well-known problem. When more than eight million deeper wells were dug in the 1970s and beyond, as an attempt to lower the infant death rate from ineffective water purification, arsenic  replaced infectious diseases as a major threat. The drinking water for more than 30 million people had levels over 50 parts per billion.

So they potentially could develop chronic arsenic effects include skin, lung, kidney, liver or bladder cancers and perhaps a variety of cardiovascular and respiratory diseases.

We’ve a long, long ways to go before we solve the issues raised by arsenic.

 

 

Do our kids have a bleak future?

Saturday, November 19th, 2011

As close to a salad as he'll get

I’m taking a break today from my series of posts on greenhouse gases, alternative energy source, volcanoes and global warming. All of those will affect the generations to come and those now growing up, but I want to re-examine another side of their issues. This morning I read two articles and one newspaper report on the heart health prospects for our American kids (and, by extension, kids elsewhere in the developed/rapidly developing world). The initial article came from a section of the Wall Street Journal I hadn’t gotten around to reading yesterday and was about to recycle. Then I saw a title that caught my eye, “Kids’ Hearth Health Is Faulted.”

I found a CDC website with an explanation of the National Health and Nutrition Examination Survey, NHANES. This is a continuation of a US Public Health Service effort started 40 years ago and is updated annually. Medically-trained interviewers may well come to your town and even to your front door someday. The data they obtain is used in many ways (I’ll paste in a website that leads you to some comments on NHANES as well as to a link to a video).

Now a portion of the survey/study looked at 5,450 kids between 12 and 19, finding they were a long ways from matching the American Heart Association’s (AHA) seven criteria for idea cardiovascular health (see 2nd link below to Harvard’s Beth Israel Deaconess Medical Center’s article on the subject). The adult health measures, known as Life’s Simple 7, are: 1). Never smoked or quit more than a year ago; 2). Body Mass Index (a measure of height versus weight) <25; 3). Physical activity on a weekly basis for 75 minutes (vigorously) or 150 minutes (moderate intensity).; 4). a healthy diet (four or more components meeting AHA guidelines); 5). total cholesterol <200 mg/dL; 6). blood pressure (BP) <120/80; and fasting blood glucose (AKA blood sugar) <100 mg/dL. The original article was published in the journal Circulation January 20, 2010 and is available free online. The metrics are slightly different for kids.

So where do our kids stack up? If you exclude eating a healthy diet, only 16.4% of boys and 11.3% of girls meet the standards for the other six criteria; if you include diet, none of them do. They don’t eat four to five servings of fruits and vegetables a day; they also don’t get enough whole-grains or fish and they consume far to much salt and sugar-sweetened drinks. Only one fifth of them even eat “fairly well.”

drop that hamburger and run for an hour

Many of then also don’t exercise on a daily basis for at least sixty minutes (50% of the boys do and 40% of the girls). More than a third are overweight or obese.

There’s some hope: a just-published article in the New England Journal of Medicine, examining the data from four studies following 6328 kids, found that those who do manage to lose weight had lower risk for type 2 diabetes, hypertension, abnormal lipids and carotid artery disease.

So I’m heading to the health club and will read the 2010 Circulation tome on an exercise bike.

Thus far my one biologic grandson, about to be 12,  is physically active and slender. I’ll encourage him to stay that way and the non-biologic grandkids to follow his example.

More on this subject to come.

Check out these articles:

Survey Results and Products from the National Health and Nutrition Examination Survey

AHA Defines “Ideal” Cardiovascular Health

 

The Five-Second Rule revisited

Friday, October 21st, 2011

don't wind up here, or worse

When I was a kid, we often used the Five-Second Rule, that meant food falling on a relative clean surface could be eaten if it was picked up in less than that amount of time. In recent years I’ve heard jokes about this rule: when parents have their first child, they use five seconds as a safe time, with the second, it’s ten seconds and with later children, it’s wipe off the mud and let them eat whatever dropped.

I received the November issue of the Center for Science in the Public Interest’s Nutrition Action Healthletter several days ago  and noticed this month’s focus was “Safe at Home: How to keep your kitchen from making you sick.” I haven’t had time to read much of the issue, but leafed through it and saw a brief blurb titled “Ignore the five-second rule.”

So today I re-read that section, then went online and found the original article in the Journal of Applied Microbiology and Googled the lead author. Dr. Paul Dawson is a Professor of Food Science at Clemson, got his PhD at North Carolina State University, then did a two-year post-doctoral fellowship. Since joining the Clemson faculty he’s published over 80 research manuscripts.

He was on a CNN TV show in 2010 discussing the 5-second rule, double-dipping (chips into a cheese or salsa dip) and, most recently was working on a project on the bacteriologic safety of blowing out birthday candles (See link below).

I read the online 2006 version of the original article in the Journal of Applied Microbiology, which appeared in paper format in April of 2007. Some of the background data is of interest: over 75,000,000 cases of food-borne illness occur in the United States each year and 5,200 of these result in deaths. Dawson’s experiments were performed using Salmonella bacteria, which is found in a substantial percentage of poultry, roughly 10% in two studies by the USDA.

Every surface is a danger zone

My take on Dawson’s results is 1). bacteria excrete chemicals allowing them to adhere to nearly any kind of surface (e.g., tile, rugs, cutting boards); 2). once they do so they have “biofilms,” microscopic layers that allow them to survive for extended periods of time; 3). they can transfer from those surfaces to a variety of foods (Dawson used bread and bologna) very rapidly; so 4). the five-second rule is invalid and we all need to work on more effectively cleaning “food contact surfaces (counter tops and cutting boards come to mind).

I enjoyed watching the CNN interview with Dr. Dawson and will be intrigued to find out what his birthday candle research will show. In the meantime, I’ll quit picking up food that has fallen on what appear to be clean surfaces; they’re not.

http://newsroom.blogs.cnn.com/2010/08/01/five-second-rule-urban-myth-or-scientific-fact/

 

 

Turkey, anyone?

Thursday, August 4th, 2011

Delicious if cooked correctly; potentially deadly otherwise

Last evening I was reading The New York Times breaking news on my Kindle. I scanned several articles and then read “Linked to Outbreak.” This morning the same topic was reported on the second page of The Wall Street Journal.

In brief, the Cargill company has recalled 36 million pounds of ground turkey, both fresh and frozen, believed linked to 79 illnesses and one death (so far) from contamination with the bacteria salmonella, in this case a strain of the common organism that is markedly antibiotic resistant. They’ve shut down one of their plants, in Arkansas, and says that’s been the only one of their four turkey-producing plants involved.

That rang an alarm since I knew they had a plant in Fort Morgan, Colorado, roughly 80 miles east, where my in-laws live. I Googled Cargill and noticed there’s even a branch here in Fort Collins. I found out the local branch is a research organization developing new forms of canola oil, but the Fort Morgan branch is a meat processing entity.

So I found background information on salmonella. One helpful website is a USDA Q&A four-page Fact Sheet. It mentions that salmonella bacteria are among the most common causes of foodborne illness, what we often term as “food poisoning.” I’ll paste in the link below, but wanted to mention some interesting background facts.

In Federal testing ten to fifteen percent of ground turkey is contaminated with salmonella and more than three fourths of those bacteria are resistant to at least one kind of antibiotic, since our current practice in raising food animals is to routinely give them drugs to prevent illness and, supposedly, to promote growth.

www.fsis.usda.gov/factsheets/salmonella_questions…/index.asp

Katic Couric has a CBS News article online (see link below) where in February 2010 she explored the question Is “Animal Antibiotic Overuse Hurting Humans?” That story centered on MRSA, a drug-resistant staph strain that has become a major problem in and outside hospitals.

http://www.cbsnews.com/stories/2010/02/09/eveningnews/main6191530.shtml

But the discussion veered off to the routine antibiotic use in other factory farm animals. One veterinarian said not every animal gets antibiotics on these huge farms, but drug distributors and dozens of farm workers in four farm belt states -Iowa, Missouri, Arkansas, and Oklahoma – said antibiotic use to promote growth is widespread on factory farms.

So what can and should we be doing in our own kitchens?

First thing is to be aware that cross contamination can occur; in other words when you’re preparing raw turkey meat, your hands, utensils and cutting boards can help spread the bacteria to other foods.

learn to use this correctly

Then you need to thoroughly cook these meat products, an internal temperature of 165 degrees measured with an accurate meat thermometer should be sufficient to kill salmonella, according to several government sources.

Leftovers have to be properly stored, within an hour if the ambient temperature is 90 or above, in a refrigerator at 40 degrees or below. I leave a thermometer in our refrigerator and check the temp every time I open the door. I also make sure it’s fully shut after I put food in for storage.

That’s a brief overview; check the links for more information.

 

Drinking and driving

Wednesday, August 3rd, 2011

lots of choices, all with alcohol

Twenty-four years ago I was the brand new Deputy Chief of Staff at our largest Air Force medical center. My counterpart at the Army’s hospital across town called and asked if I’d like to attend a party. I said, “Sure, what’s the occasion?”

His commander had just gotten a second star and, as a new major general, would be moving to DC soon. His immediate boss was going to get the one-star job running the medical center. That never happened. I don’t know the exact details, but was told one drink too many led to an off-color comment to the wrong person and then to a lost opportunity.

I got sensitized, through this episode, to drinking at events and, of course, to drinking and driving. I was in a culture where wine and beer flowed freely at parties, but decided I’d be a one-drink person. My wife and I were outliers sometimes; a friend who was a fellow commander when I moved up to lead a small hospital once told me, “I got picked up CWI last night.”

“I know what DWI means; what’s CWI?”

He replied, “Crawling while intoxicated.” Actually he was joking, while telling his story of leaving a party at the commanding general’s home and feeling unsteady while slowly walking to his own quarters, two houses down.

The Wall Street Journal on July 2, 2011, had an article titled “Testing the Limits of Tipsy.” Our US legal limit for driving used to be a blood alcohol concentration (BAC) of 0.15%; now it’s 0.08%. In much of Europe it’s 0.05%; in India it’s 0,03% and in China it’s 0.02%. That exceedingly low BAC limit may turn out to be the most realistic, especially on crowded streets and roads.

But the results can be bad, even to metal bodies

Our alcohol-related traffic fatalities have fallen by 50% since 1980, but still account for one-third of all deaths on the highway. Your BAC after drinking depends on a number of factors: your weight, age, prior drinking history, rate of consumption, if you’re also eating (consuming food may slow absorption of alcohol, but some foods help more than others) and menstrual cycle (women apparently metabolize alcohol a little more rapidly just after ovulating).

Once you’ve absorbed alcohol, your BAC falls roughly 0.015% per hour (for either gender), so it may take a long time to reach a “safe” level, if there is such a thing. As you age your liver tends to metabolize alcohol more slowly; on the other hand, an elevated BAC may affect younger brains more adversely.

Having read this, I’ll plan to continue our long-standing policy: when we go to a function one of us is the “designated drinker,” and usually has only one drink at that. The other is the designated driver. We’ve occasionally each had a glass of wine…at an event where we’ll be eating and not driving for a number of hours. It may be time to re-evaluate that policy.

On holidays like New Years Eve, when we know others will be drinking more than we do, we get off the roads early.

 

Food Allergies: part two

Wednesday, July 20th, 2011

These may cause hives or much more serious reactions

I was intrigued by the MedicineNet.com comments on Food Allergy that I mentioned in my last post.I printed off a nine-page discussion, but then went back to check on the background of the article’s editor and author. The chief editor, who helped found this website fifteen years ago, is a rheumatologist with what appear to be impeccable credentials. The author is a pathologist, not an allergist, but also seems to have a very solid background.

She mentions that roughly 6-8% of kids have food allergies and 3% of adults. Her discussion is detailed, but crucial in it is the fact that true food allergies involve the immune system and may be life-threatening. Many who develop food allergies have relatives who are allergic to pollens or other non-food items (feathers or medicines, for instance). If both your parents have those kinds of allergic problems, you’re more likely to develop food allergies than someone from an allergy-free family.

True food allergic reactions happen soon after ingestion of the nuts or shellfish or whatever causes the problem in a particular person. They may cause mild symptoms (such as oral itching), skin reactions such as hives, gastrointestinal reactions (pain, nausea, vomiting, diarrhea) or led to an asthmatic attack).

I’ll copy in the Mayo Clinic website’s take on the most severe reaction, anaphylaxis.

“Anaphylaxis is a severe, potentially life-threatening allergic reaction. It can occur within seconds or minutes of exposure to something you’re allergic to, such as the venom from a bee sting or a peanut.

The flood of chemicals released by your immune system during anaphylaxis can cause you to go into shock; your blood pressure drops suddenly and your airways narrow, blocking normal breathing. Signs and symptoms of anaphylaxis include a rapid, weak pulse, a skin rash, and nausea and vomiting. Common triggers of anaphylaxis include certain foods, some medications, insect venom and latex.

Anaphylaxis requires an immediate trip to the emergency department and an injection of epinephrine. If anaphylaxis isn’t treated right away, it can lead to unconsciousness or even death.”

Here's another Epi-pen; it can keep you alive

I mentioned an Epi-pen in my previous post on this subject. We keep one in the house since I give my wife her allergy shots; If you’ve had food reactions that appear to be true food allergy your doctor may want you to have one available.

Adults and kids are more likely to react to those foods commonly served in their particular culture, e.g., rice in Japan, fish in Scandinavia.

And to add to the mix, there are several types of cross-reactivity, e.g., allergic reactions from a food similar to one a person has had a severe reaction to or allergies to fruits (especially melons and apples) during the “hay-fever season”  The latter is caused by uncooked foods and may occur in half of those affected by pollens. Typically they are mild, but a tenth of those affected may have more severe problems and 1 or 2% can even have anaphylaxis.

Similarly, some people, usually teens or young adults, can eat a particular food, then exercise and then develop an allergic reaction. Eating two or more hours before exercising seems to prevent this form of food allergy.

There’s lots more information, but suffice it to say food allergy should be taken seriously.