No One Should Die from Eating Salad

Julia Belluz wrote . . . . . . .

No one should die from eating a salad. But over the past four months, five people have died and 197 have fallen ill across the country as a result of E. coli infections linked to romaine lettuce, most of it sold chopped and bagged.

According to a June 1 update on the outbreak from the Centers for Disease Control and Prevention, nearly half of these food poisoning patients had to be hospitalized, including 26 people who developed a severe form of kidney failure. All told, the outbreak hit 35 states, with the five deaths occurring in Arkansas, California, Minnesota, and New York.

Eerily, almost the exact same scenario played out in the US a dozen years ago. In 2006, a giant E. coli outbreak linked to bagged fresh spinach sickened more than 200 people and killed three in 26 states. It also involved convenient packaged salad.

As I’ve reported, a 2013 analysis by CDC of food poisoning cases between 1998 and 2008 found that leafy vegetables — salads and the like — caused almost a quarter of all food poisonings. While the vast majority of the salad we eat is safe, leafy vegetables do cause more sickness than any other food product, including dairy and poultry.

Convenience salads are particularly risky. “Historically, the large E. coli outbreaks linked to leafy greens have all been [caused by] prewashed, chopped, bagged salads,” said Bill Marler, a prominent food safety attorney. “[These] mass-produced, washed, bagged, chopped leafy greens that get sent around the country have a lot more risk than people realize.”

It might be time to start rethinking whether packaged lettuces are really worth the risk.

Our salads today look very different from our grandparents’ salads

The salad we consume today looks pretty different from the salad our parents or grandparents ate. Instead of buying heads of lettuce that we wash and chop or rip up ourselves, over the past couple of decades, sales of precut and bagged greens have boomed.

These mixed greens wind up in our fridges or at restaurants already washed and ready to toss in a salad bowl. But during processing, bacteria living among the leafy greens has a moist environment in which to flourish.

“When you bag and chop [salad], bacteria just gets amplified — and when you ship it across the country, the bacteria has a chance to grow in the bag,” Marler explained.

That’s not the only reason salads are a major source of food poisoning. We eat them raw, which means there’s no cooking process to kill off pathogens. Contamination can also happen when lettuce is harvested, or from animals or water in the fields.

In this outbreak, a cluster of cases in Alaska were traced back to whole head lettuce, but the bulk of cases were caused by precut, packaged romaine. The packaging process also makes it more difficult to find the cause of contamination and prevent more people from getting sick. Different lettuces grown at different farms get mixed into bags that are distributed to supermarkets and restaurants all over the country, so food safety officials need to search for the common link among farms and suppliers.

That’s part of the reason the Food and Drug Administration announced last week that we may never know the precise cause of the romaine E. coli contamination. In an incredibly complicated diagram, it showed that a web of dozens of farms, processors, and distributors (all of which remain unnamed) were implicated in the current outbreak. Only the E. coli cases caused by whole head lettuce were traced back to a single farm.

Marler said this could signal that there’s an environmental problem in Yuma. Until the FDA figures out what the problem may be, it may be difficult to trust lettuce that’s grown there.

For now, at least one thing is clear: Greens from the Yuma growing region — the source of the outbreak — are not being sold or served any longer, since the growing season there is over. While that means it’s safe to eat romaine again, we may want to ask: In what form?

I asked Marler what lesson the public and health regulators could learn from these deaths, and he said that we need to understand that our love of convenience has also become a risk. When we eat salads that are prewashed and bagged, we increase our risk of food poisoning.

“Producers of romaine need to rethink the maybe the best way to do this is to send it as whole romaine and let restaurants wash it themselves,” Marler said. Salad eaters may also want to ask whether the convenience of packaged salad is worth the added risk.

Source: Vox

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Risotto with Shrimp and Asparagus

Ingredients

5 cups vegetable stock
12 oz fresh asparagus spears, cut into 2-inch lengths
2 tbsp olive oil
1 onion, finely chopped
1 garlic clove, finely chopped
generous 1-5/8 cups risotto rice
1 lb raw jumbo shrimp, shelled and deveined
2 tbsp olive paste or tapenade
2 tbsp chopped fresh basil
salt and pepper

Garnish

fresh Parmesan cheese
fresh basil sprigs

Method

  1. Bring the stock to a boil in a large pan. Add the asparagus and cook for 3 minutes until just tender. Strain, reserving the stock, and refresh the asparagus under cold running water. Drain and set aside.
  2. Return the stock to the pan and keep simmering gently over low heat while you are cooking the risotto.
  3. Heat the olive oil in a large, heavy-bottom pan. Add the onion and cook over medium heat, stirring occasionally, for 5 minutes until softened.
  4. Add the garlic and cook for an additional 30 seconds.
  5. Reduce the heat, add the rice, and mix to coat in oil. Cook, stirring constantly, for 2-3 minutes, or until the grains are translucent.
  6. Gradually add the hot stock, a ladleful at a time. Stir constantly and add more liquid as the rice absorbs each addition. Increase the heat to medium so that the liquid bubbles. Cook for-20 minutes, until all the liquid is absorbed and the rice is creamy.
  7. Add the shrimp and asparagus with the last ladleful of stock.
  8. Remove the pan from the heat, stir in the olive paste and basil, and season to taste with salt and pepper.
  9. Spoon the risotto onto warmed plates and serve at once, garnished with Parmesan cheese and basil sprigs.

Makes 4 servings.

Source: Risotto

Got Indigestion? A2 Milk Could Solve Your Problem

Michael Hill wrote . . . . . . . .

Milk got your stomach feeling sour?

Dairy companies looking for ways to appeal to people who avoid milk because of indigestion are promoting what they describe as a natural, easier-drinking alternative. It’s called A2 milk, which is produced by a subset of cows that produce milk lacking a protein that backers say is associated with milk’s dyspeptic tendencies.

That A2 claim has its skeptics, but the bet is that consumers will pay an extra dollar or more per half-gallon to drink milk that might not cause indigestion, gas and bloating.

“Our approach has been, ‘Listen, if you thought you had trouble with milk, try our A2 milk because you may be able to have it,’” said Dan Ripley, whose family farm in central New York has both ordinary cows and those producing what he sells as “Premium A2 Guernsey” milk.

The major A2 player in the United States, Australia-based a2 Milk Company, started selling its milk in California in 2015 and this year began making a big push into the Northeast. Its milk is now sold in major eastern chains such as ShopRite and Wegmans, and TV ads with the tagline “Love milk again” went up in recently New York City and elsewhere.

“The Northeast is really the big kahuna of the dairy industry in the U.S.,” said Blake Waltrip, the company’s U.S. CEO.

Dairy companies are pushing A2 milk, which is promoted as easier on the stomach. The claim has its skeptics, but the bet is that consumers will pay extra to drink milk that doesn’t cause gas and bloating. (June 1)

The company’s U.S. expansion complements its efforts to boost distribution in markets including Southeast Asia and the Middle East under a recent deal with the world’s biggest dairy exporter, New Zealand’s Fonterra.

Separately, Nestle SA, the world’s largest food company, began selling an A2 baby formula in China this year.

Most cows produce milk that contains both A1 and A2 proteins. Backers of this milk claim the A1 protein can cause bloating and other symptoms because of the way it breaks down when digested. Some cows naturally produce milk without the A1 protein, and farmers can breed those cows with an eye toward building a herd that produces milk that only contains the A2 protein.

This kind of milk still has lactose, but proponents say it could help people who mistakenly assume they’re lactose intolerant.

In Buffalo, New York, Public Espresso + Coffee co-owner James Rayburg said he has a history of milk issues but can pour A2 on cereal or add it to recipes without worries. His shop recently switched over to Ripley’s milk for all the drinks they serve.

“For me, I know if I’m feeling that much better about drinking that much milk, then our customers are feeling that way, too,” Rayburg said.

Not everyone is convinced.

The National Dairy Council, which represents U.S. dairy farmers, said the claim remains an unproven theory.

Bruce German, director of the Foods for Health Institute at the University of California, Davis, said existing studies have either methodological flaws or may have issues because they are funded by the industry.

“Unfortunately, all the studies are somewhat sort of flawed in various ways, and they seem to be spinning a rather attractive story around A2,” German said.

Ripley understands the skepticism and said he became convinced only after he discovered his own children could drink A2 without the digestion problems that afflicted them with regular milk.

Ripley Family Farm is essentially a competitor to Waltrip and the far larger a2 Milk Company, but both say the milk could be a boon to a U.S. dairy industry that has milk consumption dropping for decades and wholesale prices slumping amid a global oversupply.

While the vast majority of Ripley farm’s revenue comes from wholesaling traditional milk, selling Guernsey A2 milk and cheese is a way to make extra income.

Other farmers who sell to the a2Milk Company, like Hourigan’s Dairy Farm in central New York, get a premium for that milk from the company. While there are costs associated with segregating A2 milk and performing genetic tests to make cows produce the right type of milk, the extra money is appreciated.

“The milk market is kind of tough right now,” said Hourigan’s farm manager A.J. Wormouth, “and anything we can do to add value to your product definitely helps.”

Source: Associated Press

Opinion: Living Longer Not the Same as Living Healthy Longer

Blair Roblin wrote . . . . . . .

Of the terms used in the health-care lexicon, “compressed morbidity” is one of the more curious.

Though it sounds rather gruesome, it represents the optimal ending for beings of the mortal persuasion.

The term originated with Dr. James Fries, a professor at Stanford University School of Medicine. Compressing morbidity implies squeezing or compressing the length of time between the onset of chronic illness and death.

Let’s face the stark truth that nothing in life is more certain than our eventual death— taxes are a distant second, despite what Benjamin Franklin claimed.

Realistically, the best any of us can hope for is a long life with a relatively short period of morbidity at the end.

The glass-half-full corollary here is sometimes called “healthspan,” which is the healthy part of the lifespan. You can be excused for assuming that our healthspans have been increasing in lockstep with longer life expectancies in recent years.

Unfortunately, the evidence suggests we’ve been more successful at adding years of chronic illness to the end of life than adding years of health in themiddle.

Many jurisdictions track a healthspan statistic called “health-adjusted life expectancy” (HALE) which measures the average length of time people can expect to live in a healthy state, essentially without illnesses such as diabetes, heart disease and cancer. For Manitoba, Statistics Canada reports a HALE of 67 for males and 70 for females, more than 10 years short of life expectancy.

A quick history of life expectancy for homo sapiens is in order here. Long ago, humans often died rather early— and quickly — from childbirth (both mother and child), trauma caused by accidents or conflicts, infections, contagious diseases, bacteria, viruses and parasites.

As Thomas Hobbes might have put it, life tended to be “nasty, brutish and short.”

Early in the 20th century, worldwide advances occurred in public health, which included immunization, pasteurization and chlorination.

Big increases in life expectancy came simply from more people making it to middle age, never mind old age.

Today, the biggest threats to our health are chronic diseases, with onset typically occurring in adulthood.

These illnesses account for most deaths worldwide, but the incidence is even higher in developed countries such as Canada. Here, rates of chronic disease are now on the rise in the younger adult population as well, due to factors such as obesity.

So, is it feasible that we push out the onset of chronic illness?

The clear answer from the public health sector is that we can, with fitness, diet and lifestyle playing key roles. Most of us deal with these issues as daily challenges, though our success varies individually.

Amore complicated question is whether delaying chronic illness actually shortens it or just shifts it out in time. In other words, if we can forestall chronic illness until we are, say, 80, will we simply experience its full wrath later?

The implications here are profound, including for health economics. Fries and others have argued the lifespan has certain limits, as evidenced by mortality rates that naturally accelerate as we age. Therefore, if we can extend our healthspan, we will necessarily bump into these lifespan limits, thereby compressing the morbidity phase of chronic illness.

Here, my thoughts turn to Ed Whitlock, whom I regarded as a modern-day hero.

Ed was the Canadian who rewrote the record book in masters distance running, most famously running a sub-three-hour marathon when hewas 73 — and then again at 74. Sadly, Ed died last year at the age of 86.

While his lifespan was not exceptionally long, his healthspan was impressive.

In fact, he set another world record for his age group in the Scotiabank marathon just six months before his death.

We can’t live forever — and perhaps don’t want to — but health research tells us that postponing chronic illness can bring important advances in quality of life, even without extending total lifespan.

Health researchers may never win any awards for the terms they introduce — there’s probably no market for “compressed morbidity” T-shirts and collectibles — but the concept itself may lead us to health care’s pot of gold.

Source : Winnipeg Free Press Newspaper

Increased Physical Activity, Not Weight Loss, Enables Heart Patients to Live Longer

The finding was according to a new study conducted at the Norwegian University of Science and Technology (NTNU).

NTNU researchers have found that heart disease patients can gain weight without jeopardizing their health, but sitting in their recliner incurs significant health risks.

Weight loss seems to be associated with increased mortality for the participants in the study who were normal weight at baseline. The survey, which is an observational study based on data from HUNT (the Nord-Trøndelag Health Study), was recently published in the Journal of the American College of Cardiology (JACC).

Researcher Trine Moholdt in NTNU’s Department of Circulation and Medical Imaging collaborated on the study with cardiologist Carl J. Lavie at the John Ochsner Heart and Vascular Institute in New Orleans, and Javaid Nauman at NTNU.

They studied 3307 individuals (1038 women) with coronary heart disease from HUNT. Data from HUNT constitute Norway’s largest collection of health information about a population. A total of 120,000 people have consented to making their anonymized health information available for research, and nearly 80,000 individuals have released blood tests.

HUNT patients were examined in 1985, 1996 and 2007, and followed up to the end of 2014. The data from HUNT were compared with data from the Norwegian Cause of Death Registry.

During the 30-year period, 1493 of the participants died and 55 per cent of the deaths were due to cardiovascular disease.

“This study is important because we’ve been able to look at change over time, and not many studies have done that, so I am forever grateful to HUNT and the HUNT participants,” said Moholdt.

Exercise and live longer

The study revealed that people who are physically active live longer than those who are not. Sustained physical activity over time was associated with substantially lower mortality risk.

Participants in the study were divided into three categories: inactive; slightly physically active, but below recommended activity level; and physically active at or above recommended activity level.

The recommended activity level is at least 150 minutes per week of moderate physical activity or 60 minutes per week of vigorous physical activity.

A little is better than nothing

The risk of premature death was higher for the group of patients who were completely inactive than for either of the other groups. The prognosis for people who exercise a little bit, even if it is below the recommended level, is better than not exercising at all.

“Even being somewhat active is better than being inactive, but patients have to maintain the activity level. Physical activity is perishable – if you snooze you lose its benefits,” Moholdt says.

Exercise hard

HUNT participants were asked how hard the exercise activity was for them. Moholdt points out that this is a good way to determine the intensity of the exercise. A half-hour walk can be experienced very differently depending on how fit the person is.

The question then becomes how to translate these findings into practical guidelines.

“The clinical guidelines for heart disease patients currently include having normal weight and being physically active. I would put more emphasis on the exercise aspect. When it comes to physical activity, you have to do what gets you in better shape. That means training with high intensity. Do something that makes you breathe hard, so that it’s hard to talk, but not so hard that you can’t do it for four to five minutes,” says Moholdt. She adds that heart disease patients are often in poor shape, so it often doesn’t take much to get into high intensity mode.

When asked whether any of the study results were unexpected, Moholdt said that they weren’t surprising in terms of physical activity. “But the fact that gaining weight posed no increased risk when patients were already overweight, I think is a bit surprising,” she said.

Correlation between weight loss and increased mortality

The results indicate that weight gain does not seem to increase risk for already overweight patients, which would mean that it isn’t dangerous for a fat heart patient to gain a few pounds. What is dangerous is if the person does not engage in any form of exercise.

The findings in the study showed higher mortality among normal weight heart patients who lost weight. Moholdt points out that the survey is an observation study that does not look at underlying causes. It may be that patients who lost weight were sicker.

The obesity paradox

The development of cardiovascular disease has a causal relationship with obesity. Despite this strong correlation, the results from major meta-analyses indicate that people with cardiovascular disease who have a body mass index (BMI) above the normal weight range have better prognoses. This is often called the obesity paradox.

“What we’ve known for a while is that for heart patients it seems to be an advantage to be fat – the so-called obesity paradox. But although it seems like it pays to be overweight and that weight loss affects these patients adversely, all of these data are based on observation studies. To prove causality, randomized controlled trials are needed,” says Moholdt.

The relationship between BMI and life expectancy is complicated and depends on several factors. Erroneous sources are plentiful. Results from another analysis showed that normal weight, healthy non-smokers have the lowest risk of premature death.

Slimming down isn’t necessarily wrong

This study’s results do not mean that it is never a good idea for an overweight heart patient to slim down. Moholdt and her colleagues note in their JACC article that “in our view, desired or intentional weight reduction may be useful for overweight or obese individuals, although little data supports this view in studies of coronary heart disease patients.”

One hypothesis is that weight loss is associated with improved survival among overweight and obese coronary heart disease patients. This correlation was not evident in the study.

“It may be that weight is less important for heart patients, but we know that physical activity is very important,” Moholdt says.

Get rid of the bathroom scale

She believes that many people start exercising to lose weight, and then quit when they don’t get the desired results in the form of weight loss.

Moholdt encourages people to get rid of their bathroom scale. She says that numerous studies have shown that body composition changes through exercise and that muscles weigh more than fat.

“Exercise has a beneficial effect on all organs in the body – on the brain, heart, liver, vascular system and of course on our musculature,” she says.

Source: EurekAlert!


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