To My Patients, 

This month’s eblast highlights a disturbing, but important concern.  While reviewing topics on Medscape, I came across this intriguing article from the Journal of Midwifery and Women’s Health.  Please read it.  You may never shop for groceries the same way again.

On a lighter subject, our medspa services are offering an exciting special for facial rejuvenation and discounts on future procedures.

Sincerely,

Randy A. Birken, MD

Pollutants, Toxins, and Food:  Cleaning up Your Dietary Environment

A recent article from the Journal of Midwifery and Women’s Health addresses the issue environmental contaminants in food and ways to avoid them in your diet.  Here are the highlights:

One of the cornerstones of a healthy lifestyle is a balanced, nutritious diet. However, there may be more to a healthy diet than just following US Department of Agriculture Dietary Guidelines. Food can be a source of a variety of contaminants or additives that can have adverse effects on human health. These include recombinant bovine growth hormone (rBGH), mercury, persistent organic pollutants (POPs), antibiotics, polybrominated diphenyl ethers (PBDE), and pesticides. In addition, some of the current methods of food production can have a negative effect on the environment, farm animals, farm workers, and consumers.

Because of the possible link between IGF-I and breast cancer, clinicians may decide to counsel patients at risk for breast cancer to use rBGH-free dairy products. Currently, dairy products that contain milk from cows given rBGH are not labeled as such, but many dairy producers who do not use rBGH state this on their label. Organic dairy products are not produced with rBGH.

Antibiotic resistance is of paramount concern to the health care community. In a 2003 report on microbial threats to health, the National Academy of Sciences stated, "the world is facing an imminent crisis in the control of infectious disease as the result of a gradual but steady increase in the resistance of a number of microbial agents to available therapeutic drugs."  Health care professionals have been advised to limit the use of antibiotics by being judicious in their prescribing practices, to lessen the chance of antibiotic resistance developing among bacteria. Unfortunately, the agricultural industry has not followed these same practices.

Patients can reduce the risk of contracting food borne illnesses through education about proper meat storage and preparation techniques, washing all fresh fruits and vegetables, and identifying foods that carry an increased risk of being contaminated with antibiotic-resistant bacteria, such as raw (nonpasteurized) milk products, meats, and fruits and vegetables. The US Department of Agriculture has developed fact sheets for consumers in English and Spanish on many of these risk-reducing strategies, which can be perused online. Continued advocacy is needed to encourage governmental agencies to enact laws limiting the use of antimicrobial agents for non therapeutic uses in livestock and requiring changes in livestock production practices to minimize the spread of infections.

The FDA and EPA have issued an advisory for women of childbearing age, pregnant women, nursing mothers, and young children. They recommend that these women and children do not eat fish having the highest mercury levels and only consume 12 ounces (two servings) of fish that are low in mercury per week, such as shrimp, canned light tuna, salmon, pollock, and catfish.  High levels of mercury are found in king mackerel, shark, tilefish, and swordfish.  A new area of concern is a possible association between mercury levels and an increased risk of cardiovascular disease. Fish and fish oil are major sources of n-3 fatty acids, which have been shown in some studies to have a protective effect on the cardiovascular system.  There is now evidence that mercury may counteract these protective effects.  The risks and benefits of fish consumption need to be weighed carefully, as well as the types of fish that contain the highest levels of methylmercury.

Persistent organic pollutants (POPs) include compounds such as dioxins, polychlorinated biphenyls (PCBs), and pentachlorophenol (PCP). Although some of these chemicals (e.g., PCBs, which were banned in 1977) are no longer used in the United States, they are resistant to biodegradation and are still found in the environment, and therefore, found in foods.  In the general population, exposure to these compounds occurs primarily through the ingestion of animal products, such as in meat, high-fat dairy products, and fish. Of special concern are females throughout their childbearing years and populations that consume a large amount of fish. Fetuses and young children appear to be the most susceptible to the deleterious effects of exposure. POPs have been associated with low birth weight and changes in the functioning of T-lymphocytes, which may have negative effects on the functioning of the immune system.

As POPs are found in animal fats, advising women to eat low-fat meat and dairy products will help reduce their intake of POPs. In addition, following the FDA guidelines for fish consumption will help decrease the intake of POPs as well. Current recommendations support breastfeeding, even in populations with high levels of POPs, as the benefits of breastfeeding have been shown to outweigh the potential negative effects of POPs.

Polybrominated Diphenyl Ethers (PBDEs) are used as flame retardants in textiles, home goods, and construction materials. Although there is no consensus on the effects of exposure to PBDEs on human health, rodent studies have found that PBDEs affect thyroid function, spontaneous motor function, learning, memory, and they can increase liver and kidney weight.  Exposure to PBDE may occur through intake of contaminated food, such as fatty meat and fish. Schecter et al. performed a market basket survey in Dallas, Texas, to determine PBDE levels in common food items, and found the highest levels of PBDE in fish, midrange levels in meat, and low levels in dairy products. No PBDEs were found in nonfat milk. As with mercury and POPs, it appears that encouraging a diet low in animal fat and large fish will decrease exposure to PBDE.

There are many routes through which a woman may be exposed to pesticides: through lawn applications, in the home, occupationally (e.g., with farm workers), and in residues on food. There have been numerous studies that have looked at the toxic effects of pesticide exposure. Pesticides have been shown to cause a myriad of negative health effects, such as cancer, infertility, birth defects, neurological problems, and respiratory ailments.  Exposure to pesticide residues can be decreased by eating organically produced foods. However, many people are unable to afford these items. Exposure can then be minimized by consuming fruits and vegetables that do not contain as many pesticide residues and avoiding foods with high levels of pesticides such as apples, bell peppers, celery, cherries, imported grapes, potatoes, strawberries, and raspberries, nectarines, peaches, and pears.  Foods low in pesticides includes asparagus, avocado, bananas, broccoli, cauliflower, sweet corn, kiwi, mangoes, onions, papaya, pineapples, and sweet peas.  Another alternative is to shop at farmers' markets. Many of the vendors tend to be organic farmers, and the food vouchers distributed by Women Infants and Children (WIC) can be used at many of these markets. Although not all pesticides are removed with washing, the washing, the peeling of skins off of high residue fruits and vegetables, and other preparation techniques may considerably reduce the amount of residues left on the food item.

Remember, a healthy diet can reduce the risk of developing many chronic diseases.  Please follow the above recommendations when purchasing and preparing foods.

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