Dr. Regina Benjamin, Surgeon General Nominee, Receives Criticism For Her Weight

The Surgeon General is "the leading spokesperson on matters of public health in the federal government," and is responsible for "educating the American public about health issues and advocating healthy lifestyle choices."¹

I often wonder if, or how much, consumers of healthcare are critical of their healthcare providers. This gives me a clue.
________¹ Wikipedia: Surgeon General of the United States

Should Alternative Therapies Be Part Of Healthcare Coverage?

A growing number of Senators think they should:
Senators Seek Coverage For Alternative Therapies, Boston Globe, July 24

"[Senator Tom] Harkin, is the cosponsor of an amendment that says healthcare plans will not be allowed to “discriminate’’ against any healthcare provider who has a license issued by a state."

Some bloggers don't think they should:
Senator Tom Harkin Pulls A Fast One: Alternative Medical Practitioners Will Be Part Of The "Healthcare Workforce" Under Health Care Reform, Respectful Insolence at ScienceBlogs

"[Senator Tom Harkin] wants to legitimize quackery by including it in any federal plan under the guise of "preventative care." " ... Be afraid. Be very afraid."

There are some great therapies that fall under Alternative Medicine. I think there should be coverage to see a dietitian, especially if you have a metabolic disorder (e.g. diabetes), coverage for exercise classes and gym memberships, coverage for stress management classes.

There are a number of herbal remedies that rise to the level of effectiveness, for example, Saw palmetto for urination difficulties related to enlarged prostate, and St. John's Wort for mild-to-moderate depression. Both of these are science-backed and endorsed by the government's National Institutes of Health (given a Grade of A = "Strong scientific evidence for this use"). It would be advantageous, certainly financially, if provision of information about these and other science-backed therapies were covered.

On the other hand, I'm not fond of homeopathy or reiki.

What do you think? Would you like to see insurance (public or private) provide some coverage for alternative therapies?
________The photo demonstrates an alternative therapy for pregnancy discomfort: yoga. It has been shown to manage back discomfort, and improve circulation and posture.

Chronic Diseases On The Rise

Chronic diseases - diabetes, heart disease, intestinal diseases (e.g. celiac disease), skin diseases (e.g. eczema), arthritis, cancers. These are the primary causes of death and disability in the developed world. The CDC says they account for 70% of all deaths in the US. What has changed to make it so?

What someone eats is often implicated in the cause of these diseases. However, there's an area of research we should pay closer attention to - involving the immune system. Just because an illness manifests as some reaction to a particular food does not mean that food caused the illness. For example, diabetes manifests as elevated blood sugar, but it is not caused by eating sugar or starch. A common form of heart disease involves the accumulation of fat along arteries, but heart disease is not caused by eating fat. (However, once an individual has developed these conditions, what they eat can accelerate disease progression.)

Both diabetes and heart disease are diseases of inflammation. They, as do most chronic diseases, involve immune system cells and processes. It is the immune system which is primarily responsible for the characteristics of inflammation. So, you might say, it is the immune system which is responsible for diseases of inflammation.

The immune system's job is to protect the body from foreign substances, things like bacteria, viruses, and other proteins and molecules that could damage cells. It keeps track of what our normal cells and molecules look like, and when it can't recognize something as belonging to us, it initiates an attack. Example - Urushiol is an oil in poison ivy that elicits an immune response in humans, resulting in the classic signs of inflammation - redness, swelling, heat, pain, and loss of function. Urushiol does this by chemically changing the shape of proteins on skin cells it contacts. The immune system then fails to recognize these proteins as our own.¹

We already know that exposure to cigarette smoke and environmental pollutants such as pesticides increase - substantially - the incidence and severity of many chronic diseases, including diabetes, heart disease, and many cancers. We need to pay closer attention to the role of the immune system in the development of these diseases, especially given the rise in pollution that accompanies an increasingly urbanized world.

By the way, this is one reason I feel genetically engineered foods need more study, since they introduce foreign proteins to our bodies which have been shown to elicit an immune response.
________
I was looking for a photo to accompany this post and saw this. It is the Citarum River near Jakarta in Indonesia, "choked by the domestic waste of nine million people and thick with the cast-off from hundreds of factories."

The water is still used for drinking and to irrigate local crops.
________¹ Interestingly, the EPA says that urushiol "will become more potent with increased concentrations of carbon dioxide and climate change."

Money-Driven Medicine - The Documentary

While I'm on the topic of healthcare, Maggie Mahar's book, Money-Driven Medicine, was recently made into a documentary. It premiered in New York City last month.

Here's the website:
Money-Driven Medicine

Here are 4 excerpts from YouTube:
Part 1, 2:42 minutes
Part 2, 2:45 minutes
Part 3, 1:19 minutes
Part 4, 0:59 minutes

Here's Part 2. (This has the potential to make some people angry.)

________

Maggie Mahar Explains Why Healthcare Costs So Much

Maggie Mahar was on NPR's Fresh Air with Terry Gross yesterday. Here's her interview:
The Costs Of Health Care, Political And Financial

A few highlights:

Terry Gross (TG): One of your main concerns is that we need to eliminate unnecessary and ineffective treatments.

Maggie Mahar (MM): That's right. But then, that has to be done very carefully. I mean, this is not fat that's hanging out on the edges of the steak where you can see it. This is fat that's marbled through the meat.

MM: So we need to take a scalpel and very carefully excise that waste. And that's why we need a panel of physicians, health care experts, looking at the evidence. That's what President Obama has proposed: having an independent, bipartisan panel of doctors and other medical experts that is shielded from Congress and lobbyists to a large degree that is simply looking at the medical evidence and making decisions about which are the most effective treatments for patients who fit a particular medical profile, and then issuing guidelines -not rules, but guidelines - that will help doctors and steer them and patients toward the most effective treatments.

Here she discusses a single-payer system:

TG: If you had your way, what kind of system would you create? Would it be a single-payer system?

MM: If I were czarina, this is what I would do. I would create a hybrid system much like the system that the Obama administration is trying to create where you have both public sector insurance and the option of private sector insurance.

MM: Why don't I want a single-payer plan? First of all, it would be enormously difficult to persuade everyone in this country who has employer-based insurance to give it up and go into an unknown government plan.

MM: Secondly, and maybe even more importantly, a government plan, if that was all we had, depending on the politics of the government, could take away things that many of us feel are necessary to health care. It could become very stingy. It could decide only to cover certain people. It could decide to penalize people who were fat or who were - had other, you know, problems - mental-health problems, etcetera. And that's why I would always want escape hatch. I'd always want alternatives to the public sector plan and for Americans to be free to choose which plan they wanted.

Maggie Mahar authored Money-Driven Medicine: The Real Reason Health Care Costs So Much in 2006. From NPR:

"Money-Driven Medicine argues that, over the past century, the history of U.S. health care has been shaped by corporate interests' gradual encroachment on physician autonomy. According to Mahar, this has produced a system of costly and inefficient competition among providers, leaving Americans worse off than citizens of other industrialized nations."

________
Here's a video of Ms. Mahar discussing the same points as above. (The actual interview starts at 1:40. I'm not familiar with the venue or hosts.)



About medical tests, she said that while all tests provide risk, not all tests provide benefit. And sometimes tests harm, either through side effects of the test, or returning a false positive and requiring more risk-involving tests.

One test she said physicians could provide is listening and talking to a patient, but that doesn't generate income:

"It's not lucrative to talk to and listen to a patient. Doctors aren't paid to talk to a patient on the phone or to return an email. We pay primary care doctors, palliative care doctors who keep you out of pain when you're dying and offer you options, much less [than specialists]."

Also said: Medicare's administrative costs are 3% compared to industry's 25%. That's some discrepancy.

This woman knows her healthcare.
________

Prehistoric Grinding Stone

My previous post about the discovery of granaries which were thought to predate agriculture (domestication of plants) by about 1000 years, included a photo and illustration of one of the granaries.

This was interesting:

"The outer walls of the structure, which was constructed ~11,300 - 11,200 BP, are defined by a partially preserved mud wall. Inside the structure are used grinding stones in upright position that have been notched to hold wooden beams."

Used grinding stones? Wikipedia gives this photo of a Neolithic grinding stone, used "to grind up grains by swaying":


Click to enlarge.
That looks like barley to me, but I'm not sure, could be wheat. The seed also looks too large and starchy, too domesticated, to be a good representation of the wild grains found at the site.

It makes me wonder just how long ago humans were eating processed grains. By the looks of this, and from my reading, it was long before farming took off.
________

Prehistoric Granaries: Humans Have Been Eating Grain For A Long Time

What were humans eating before they domesticated grain? An exciting discovery in Jordan reveals that ... they were eating grain ... at least 1000 years before grain was domesticated. Specifically, wild oats and wild barley.

The finding was described in an article published in last month's Proceedings of the National Academy of Sciences:
Evidence For Food Storage And Predomestication Granaries 11,000 Years Ago In The Jordan Valley

What was found:
Very sophisticated, raised-floor food storage huts, or granaries. Here's an excavation of one of the granaries:


Click to enlarge.

"The outer walls of the structure, which was constructed ~11,300 - 11,200 BP¹, are defined by a partially preserved mud wall. Inside the structure are used grinding stones in upright position that have been notched to hold wooden beams."

Here's a reconstruction of the structure above:


Click to enlarge.
The cut out in the wall is for illustration purposes only. Entry was had by that little hole to the right. The picture shows:

"... upright stones supporting larger beams, with smaller wood and reeds above, and covered by a thick coating of mud. The suspended floor sloped at 7° and served to protect stored foods from high levels of moisture and rodents."

Sloping floors, air circulation, with "many granaries in use simultaneously" - and this was 1000 years before agriculture. Where did they get all this grain? From foraging, selective gathering, and rudimentary cultivation.

So, oats and barley (there is also mention of lentils) were not new food sources, even then.

Food As Commodity Fosters Social Inequality

There's another aspect to this story. Food storage, as evidenced by these granaries, contributed to a marked change in human way-of-life - a bump in the civilization curve. Successful storage of grain led to domestication of cereals and to farming, but also to:

• Sedentary lifestyles (and a "built landscape")
  
• Population growth
  
• New social organizations

The authors describe how food storage "represented a critical evolutionary shift in the relationship between people:"

"Food storage, population growth, sedentism, and social inequality are often interlinked. With greater sedentism, increased birth rates, and increased quality and quantity of domesticated foods we see the foundation for economic developments.

An excess or surplus, that is to say an amount or quantity beyond what is considered normal or sufficient, results in production beyond the immediate annual household needs. To be a true excess or surplus, it is necessary to produce enough yearly food resources to cover the subsistence needs of the group, to secure sufficient stored food to overcome any seasonal or yearly shortage, and still have remaining amounts that can be used for trade, exchange, or some form of social currency."

Indeed, the granaries above were communal structures, built separate from living quarters and accessible by many. Over the next 2000 years, by about 9500 BP, food storage was incorporated into houses, "reflecting evolving systems of ownership and property."

All that grain - I wonder what, if any, chronic diseases they suffered.

Related post: Prehistoric Grinding Stone
________BP = Before Present. It's a time scale that uses the year 1950 AD as its present origin.

Thoughts On Health Care

I've been following the healthcare debate. I'll say one thing, it's complicated. Everyone - drug and device makers, insurance companies, physicians, lawmakers, economists, consumers - has a stake. And those stakes don't easily align. It's messy. It reminds me of the 2003 Medicare Prescription Drug debacle that ended with the awful "donut hole," a gap in coverage placed strategically at a level that benefitted drug companies and providers at the expense of consumers. It gave the appearance of care and compromise. Morally and effectually awful.

The healthcare debate is central to almost every concern in the nation at the moment. It affects our economy, it addresses the ominous spending-down of entitlement programs, it affects GDP, the deficit, personal income, small and large business success (e.g. healthcare premium pay-outs), and of course public health. It has threads in food production, agriculture subsidies, and culture (perks for exercising, not smoking, and other preventative strategies). What doesn't this debate address? I can see why it's such a bear to tackle, why the House Bill is over 1000 pages, why the men and women we've elected to Congress, ordinary people with an extraordinary task, are missing deadlines.

Those of us with health insurance are right now paying upwards of $1000/year to cover those who receive care but don't pay for it. That number is unnecessarily inflated. Treating head lice and poison ivy in emergency rooms is a logistical and financial nightmare.

While I was glad for the reassurance the President gave last night:

"This debate is not a game for these Americans, and they cannot afford to wait for reform any longer. They are counting on us to get this done. They are looking to us for leadership. And we must not let them down. We will pass reform that lowers cost, promotes choice, and provides coverage that every American can count on. And we will do it this year."

I'm hoping that any legislation which gets passed doesn't look like the labyrinthine Medicare Act of 2003.

Here's the President's press conference from last night:


Here's the text of his remarks before he took questions:
Obama Makes Fresh Appeal on Health Care at Prime-time News Conference, PBS
________

The Minimalist: Salad Dressing

"Classic salad dressing has three components. It's got fat. It's got acid. And it's got some other flavor."
- Mark Bittman, NYTs Food Columnist

And his related article:
101 Simple Salads for the Season
________

"High Quality, Equitable Care For Every American, That Should Be Our Goal." -Maggie Mahar

This is a follow-up to my post Health Care: How Much Is Too Much To Save A Life? It does look like plans are being made for some rationing, among other things.

According to Health Beat's Maggie Mahar¹ in her article yesterday which dissected that $1.6 trillion price tag to reform healthcare over the next ten years...
Putting the Cost of the Democrats’ Plans for Reform in Context
... the spending cuts and projected savings in House and Senate plans aren't getting enough attention. They should, because they get to the root of the problem:

"Health-care inflation, driven in large part by over-use of advanced medical technologies, is the real threat to the economy. ... Tests and treatments that provide little or no benefit to the patient — while exposing him or her to needless risks — are making healthcare unaffordable."

From the article - a few spending cuts detailed in the 1018-page House bill (1018 pages - that's a lot of bill):

• It gives both Medicare and the public sector plan the power to reset reimbursements based on how much the treatment benefits the patient. ... Medicare could [lower] fees for those treatments that provide less benefit. ... patients could be required to pay for at least a portion of the additional costs of clinically less effective treatments.
  
  
• It encourages primary care — which is almost always less expensive than specialists’ care. ... It would raise Medicare payments to primary care physicians by at least 5 percent ... by 10 percent in areas where there is a serious shortage of primary care doctors.
  
  One reason that European medicine is more affordable than U.S. care is that patients receive far more primary care, and see many fewer specialists.
  
  In addition ... private insurers will no longer be allowed to charge co-pays for preventive care.
  
  
• It recommends that all manufacturers of drugs and devices be required to report their financial relationships with physicians, pharmacies, hospitals, and other organizations.

I like all of those: more money to primary care docs, no co-pays for preventative care, more visibility with drug companies, and more selective coverage for less effective treatments. This last one is a hot topic, but it needs to be debated. There are some tests and treatments that in my mind just aren't cost effective.

Here's Dr. Mahar talking (for less than a minute) about reforming Medicare, "so that Medicare is paying for effective care." (If you're too young for Medicare and thinking this doesn't apply to you, consider that Medicare will serve as the model for just about any proposed public program.)

________¹ Dr. Mahar is author of Money-Driven Medicine: The Real Reason Health Care Costs So Much, and Bull! A History of the Boom, 1982–1999. She has written for Institutional Investor, The New York Times, Barron's, and Bloomberg. She is a former Yale professor and current fellow at The Century Foundation.

The Animal Splay

When the temperatures climb, the animals splay.
They won't do this if someone is near, so the photos are blurry. I was tiptoeing close and zooming in:


He caught me!


It's difficult to see from this angle, but the squirrel's entire underbelly is smashed up against the wood, his limbs bent out to the side. From above he looks like a chicken butterflied for the grill.

Likewise, this blue jay's underbelly is smashed up against the mulch, wings splayed, beak open:


They hold these positions, keeping absolutely still, for several minutes, choosing only dry, unvegetated surfaces. I'll think I have a dead animal on my hands and as I creep close they suddenly take off!
________Photos: Bix

Health Care: How Much Is Too Much To Save A Life?

Here's a question...

"You have advanced kidney cancer. It will kill you, probably in the next year or two. A drug called Sutent slows the spread of the cancer and may give you an extra six months, but at a cost of $54,000. Is a few more months worth that much?

If you can afford it, you probably would pay that much, or more, to live longer, even if your quality of life wasn’t going to be good. But suppose it’s not you with the cancer but a stranger covered by your health-insurance fund. If the insurer provides this man — and everyone else like him — with Sutent, your premiums will increase. Do you still think the drug is a good value? Suppose the treatment cost a million dollars. Would it be worth it then? Ten million? Is there any limit to how much you would want your insurer to pay for a drug that adds six months to someone’s life?

If there is any point at which you say, “No, an extra six months isn’t worth that much,” then you think that health care should be rationed."

That's the beginning of an article by Peter Singer from the New York Times last week:
Why We Must Ration Health Care

How can you not come away from it thinking healthcare needs to be rationed? (Not hard to see it's already being rationed.)

The dilemma ... how much do you limit care? To whom? Should an 85-year-old receive the same benefits as a 14-year old?

What if the question wasn't saving a life but curing disability? What cost would we bear, if we had the technology, to return a quadriplegic to an active and independent life?

Certainly, something needs to change about how much we're spending:


Click to enlarge.
And how much it's projected we'll be spending:


Click to enlarge.
Related posts: "High Quality, Equitable Care For Every American, That Should Be Our Goal." -Maggie Mahar________Source for graphs: White House Council Of Economic Advisers, The Economic Case For Health Care Reform, Executive Summary, June 2009

Our Daily (Genetically Engineered) Bread

Monsanto is getting back into the Bread & Pasta business, a venture they left in 2004 because of opposition to genetically engineered (GE) wheat. We can't get these Non-GMO labels fast enough.

From the St. Louis Post-Dispatch, July 15:
After 5-Year Absence, Monsanto Is Back In Wheat

"Monsanto, the biggest seller of genetically modified seed, agreed [this week] to pay $45 million for WestBred LLC and could introduce new wheat varieties within a few years. WestBred specializes in wheat germplasm, the seed's genetic material.

Monsanto abandoned the wheat business after years of research and development ... citing a declining market for the variety it was developing. ... Critics contend the decision was less about economics than stiff opposition. The Canadian Wheat Board in March 2004 said the 10 largest customers for Canadian Western Red Spring wheat, including the U.K., Japan and Mexico, had rejected the possibility of genetically modified wheat."

They're not the only biotech company interested in wheat:

"Monsanto's return to wheat follows a similar move by Dow AgroSciences, which last month announced plans to develop genetically modified wheat in collaboration with World Wide Wheat LLC."

The wheat industry is ecstatic:

"The National Association of Wheat Growers hopes Monsanto's return to wheat means an infusion of research dollars into a business that remains mostly the domain of public land-grant universities. "We're excited to see Monsanto stepping up," said Joe Kejr, who chairs a joint biotech committee of the National Association of Wheat Growers and U.S. Wheat Associates, a group trying to develop export markets. "We have got to have that investment for the industry to be sustainable." "

________Photo is "Grace" by Eric Enstrom. From Wikipedia: "Eric Enstrom is famous for his 1918 photograph of Charles Wilden in Bovey, Minnesota. The photo is now known as Grace and depicts Wilden saying a prayer over a simple meal. In 2002, "Grace" was designated the state photograph of Minnesota."

100,000 Fit On A Pin Head; Only 10 Needed To Kill

E. coli O157:H7:

"Hundreds of thousands of the bug can fit on the head of a pin; as few as 10 can lodge in a salad and end in lifelong disability, including organ failure."
- Carolyn Lochhead, Crops, Ponds Destroyed In Quest For Food Safety, San Francisco Chronicle, July 13, 2009

10 bacteria. This is getting serious.

E. coli O157:H7 is more virulent than other strains of E. coli, and arguably more virulent than other pathogenic bacteria:

"What makes E. coli O157:H7 truly and decidedly dangerous is its very low infectious dose, and how relatively difficult it is to kill these bacteria. Unlike Salmonella, for example, which usually requires something approximating an "egregious food handling error, E. coli O157:H7 in ground beef that is only slightly undercooked can result in infection." "
- Bill Marler, The E. coli O157:H7 Bacteria and Hemolytic Uremic Syndrome (HUS), May 2009.

E. coli O157:H7:

• Multiplies at temperatures up to 44 degrees Fahrenheit
  
• Survives freezing and thawing
  
• Is heat resistant
  
• Grows at temperatures up to 111 degrees Fahrenheit
  
• Resists drying
  
• Can survive exposure to acidic environments
  
• Are easily transmitted by person-to-person contact.

E. coli O157:H7 is more widespread in our environment, and thus in our food, than it was 20 years ago (first recognized in 1982).¹ Most outbreaks have been traced to cattle - the bacteria live in their intestines. Vegetables and other food products become contaminated when the bacteria travel from cow excrement through water, or on insects, birds, and other animals, including humans. Milk becomes contaminated when it picks up the bacteria from udders.¹

E. coli O157:H7 has become the scourge of food suppliers and retailers, who risk losing millions if a consumer falls ill from contaminated food. It, along with other pathogens, is leading to questionable practices on farms in an attempt to limit its presence on vegetables.

E. coli 0157:H7 is a problem, a modern problem. We need modern solutions, something smarter and less destructive than the scorched earth practices described in Lochhead's article above. We need government, industry, and academia working together on this one.

President Obama's Food Safety Working Group (FSWG) would like your input:

"Have a suggestion for reforming food safety policy? Drop it in the FSWG email comment form, or let the Working Group know on twitter via their account FSWGListens or by using the hashtag #whsafefood in your tweets. You may also contribute via the White House Facebook page."

________¹ Wikipedia: Escherichia coli O157:H7.

Non-GMO Project Advertised In Times Square

The Non-GMO Project published this photograph of Times Square, New York City, today on their Facebook page. Their caption:

"This photo is from a webcam in Times Square last Tuesday afternoon. Whole Foods coordinated display of the Non-GMO Project seal there and in Las Vegas to help start building brand recognition for the Non-GMO Project. It's so exciting to finally have a positive way to engage people on the GMO issue!"

Love seeing the momentum building for this.
________

"Go, You Chicken Fat, Go!"

Shaun's comment on that map depicting the rise in obesity in the US had me recalling Greg Critser's 2003 book, Fat Land: How Americans Became the Fattest People in the World.

Critser said that in some places or subcultures, there was a tacit endorsement of being overweight. (In some places there was overt endorsement.) Chairs in restaurants got bigger, especially in fast food restaurants. Clothing sizes changed to accommodate a larger body for the same measurement. And a political correctness emerged (in the 1980s?) - where it was important not to shame people, especially children, for being overweight.

This last point might be illustrated by a theme song used by the President's Council on Physical Fitness, under JFK in the early 1960s. Its refrain was, "Go, You Chicken Fat, Go!" Also, according to Critser, in the 1970s the Council used an advertisement showing a giant marshmallow and declared, "Hey kid! If you see yourself in this picture, you need help!"

Here's the "Go You Chicken Fat Go!" song.¹ This is not satire. I remember having to do those President's Council push-ups in the hot sun in the parking lot next to my grade school.

"Give that chicken fat back to the chicken and don't be chicken again .... Noooo, don't be chicken again."

________¹ I cringed writing that song title.

Obesity, American, 1998-2008

________Source: Battle Of The Bulge, Economist, July 2009.

"For Many Giant Food Retailers, The Choice Between A Dead Pond And A Dead Child Is No Choice At All."

The title is a quote from an article that appeared in yesterday's San Francisco Chronicle - about practices being used on California farms in an attempt to reduce contamination from pathogens:

Crops, Ponds Destroyed In Quest For Food Safety

Says Bill Marler:

"It is a good opening discussion of the balance that we somehow have to forge between food safety, consumer convenience, industrialized agriculture and the environment."

Paul Roberts, in his book The End of Food, talks about how big food retailers, e.g. Wal-Mart, put pressure on suppliers (either growers directly, or manufacturers who in turn put pressure on growers) to provide a lot of product, at hard-to-meet times (out of season), for a cost that approaches a loss for the grower ... and now, to essentially sterilize their plots in the quest for safer food (and fewer lawsuits).

The grower is in a bind because they don't want to lose someone as big as Wal-Mart as a client. Even if they do, there's another big food retailer to take its place, with similar cost pressures.

So growers cut corners. They grow on every speck of land, too close to livestock farms, in densely seeded fields (requiring more chemicals). They turn over too much product, too fast, risking error and contamination.

Farmers markets are nice, but they're not where most people get their food. Money will have to come from somewhere, whether it be from consumers via the price they pay for food, the government via a shifting of subsidies and other incentives, or businesses via revenue restructuring.
________Photo from Paul Chinn via the SFGate article above. Caption: "Farmworkers harvest romaine lettuce to be shipped directly to market at Lakeside Organic Gardens Farm in Watsonville."

Whole Foods Joins Growing List Of Retailers With Non-GMO Labels

Good news! Many Whole Foods' private label brands (e.g. "365 Every Day Value") will bear a Non-GMO seal (shown to the left) this October, if everything goes as planned.¹ Whole Foods has partnered with the Non-GMO Project, a private, not-for-profit certifier of foods free from genetically engineered ingredients (mostly).

Some products from retailers shown to the right will also bear the seal. Visit NonGMOProject.org for a complete list of products and retailers that endorse the Non-GMO Project's certification.

Why choose Non-GMO?

The FDA does not require labels on foods that contain genetically engineered (GE) ingredients, claiming they are "substantially equivalent" to non-bioengineered foods. However, use of genetically engineered crops have profound environmental and human-health impacts, especially related to pesticide use. Also, although the FDA considers GE foods "no different" from their non-GE counterparts, there has not been adequate testing for their long-term health effects.

Chemicals used on GMO crops (genetically engineered to resist the chemicals, or to make their own pesticides) promote development of pests and other invasive insects and plants that are resistant to these chemicals, requiring their increased use.

These chemicals are a public health problem - on the farm, in the environment, on our plates:

"The human health impacts linked to pesticide exposure range from birth defects and childhood brain cancer in the very young, to Parkinson's’ Disease in the elderly. In between are a variety of other cancers, developmental and neurological disorders, reproductive and hormonal system disruptions, and more."
- What's On My Food?

It's encouraging to see US businesses jumping on the GMO-labeling wagon, a wagon most of the developed world has boarded (a wagon the US government has avoided):

"In 30 other countries around the world, including Australia, Japan and all of the nations in the European Union, there are significant restrictions or outright bans on the production of GMOs, due to environmental impact and concerns about GMO safety."
- Megan Thompson, executive director of the Non-GMO Project

________¹ Whole Foods Press Release, July 7:
Whole Foods Market® Partners with Non-GMO Project to Label Company’s Private Label Food Products Using New Third-Party Standard

Homeopathy

Don't watch this if you believe in homeopathy.

"I don't know, sometimes I think a trace solution of deadly nightshade or a statistically negligible quantity of arsenic just isn't enough."

________

Labeling of GE Foods Doesn't Look Promising

Obama made a campaign promise to make sure genetically engineered foods in this country are labeled.

With the appointment of Michael Taylor on Tuesday as senior advisor to FDA Commissioner Margaret Hamburg, I doubt this promise will be kept.

"Michael Taylor, a former Monsanto employee, [while working for the FDA, 1991-1994] was made responsible for developing FDA labeling policy for rBGH. With Taylor's help, the FDA declared that milk from cows treated with rBGH was just like regular milk."
- Martin Teitel in "Genetically Engineered Food: Changing the Nature of Nature"

The "just like regular milk" phrase above is an example of the FDA's "substantial equivalence" argument, an argument the FDA uses to defend their position of not requiring labels on GE foods, an argument that was developed during Michael Taylor's 91-94 stint at the FDA. It has been attributed, in part, to him.

The following is from the FDA's 1992 policy on GE foods (published while Michael Taylor served as FDA's Deputy Commissioner for Policy). It describes the "substantial equivalence" argument. The FDA continues to refer to it today.

Statement of Policy - Foods Derived from New Plant Varieties
FDA Federal Register
Volume 57 - 1992
Friday, May 29, 1992

"FDA has also been asked whether foods developed using techniques such as recombinant DNA techniques would be required to bear special labeling to reveal that fact to consumers. To date, FDA has not considered the methods used in the development of a new plant variety (such as hybridization, chemical or radiation-induced mutagenesis, protoplast fusion, embryo rescue, somaclonal variation, or any other method) to be material information within the meaning of section 201(n) of the act (21 U.S.C. 321(n)). As discussed above, FDA believes that the new techniques are extensions at the molecular level of traditional methods and will be used to achieve the same goals as pursued with traditional plant breeding. The agency is not aware of any information showing that foods derived by these new methods differ from other foods in any meaningful or uniform way, or that, as a class, foods developed by the new techniques present any different or greater safety concern than foods developed by traditional plant breeding. For this reason, the agency does not believe that the method of development of a new plant variety (including the use of new techniques including recombinant DNA techniques) is normally material information within the meaning of 21 U.S.C. 321(n) and would not usually be required to be disclosed in labeling for the food."

________

In Search Of The Mediterranean Diet

I'll be honest. I don't know what the "Mediterranean Diet" (MD) is. I know there's some olive oil in there, fresh fruit, wine (red?), vegetables, and a few bean dishes. But I couldn't come up with a weekly menu easily. What does it exclude? Do people who live in the Mediterranean region eat shredded wheat cereal? Soymilk? eggsbaconchipsandbeans? Blueberry muffins? Spaghetti and meatballs? Pumpkin pie? How much?

I imagine there's a lot of variability, with so many countries and cultures bordering the Mediterranean Sea, from Spain and Morocco, through France, Italy, Turkey, Israel, Egypt, and the rest of Northern Africa. Oh, and the Greek island Crete (I know Mediterranean Kiwi will say something if I don't). The benefits of the MD, if real (maybe it's the geographical location) probably depend on a combination of dietary factors, rather than any particular nutritional component.

This recent study in the British Medical Journal supports the existence of a dietary pattern, or at least it didn't refute it, "The results of our study do not refute the possibility of synergistic effects among foods and nutrients in the Mediterranean diet."

It investigated the relative importance of individual components of the MD:
Anatomy Of Health Effects Of Mediterranean Diet: Greek EPIC Prospective Cohort Study, BMJ, June 2009

Background:

• Participants were 23,349 men and women in the Greek segment of the 10-country-wide European Prospective Investigation into Cancer and nutrition (EPIC)
  
• Mean follow-up: 8.5 years
  
• Individuals were scored on "the nine widely accepted components of the Mediterranean diet:"
  • High intake of vegetables
    
  • High intake of fruits and nuts
    
  • High intake of legumes
    
  • High intake of fish and seafood
    
  • High intake of cereals
    
  • Low intake of meat and meat products
    
  • Low intake of dairy products
    
  • High ratio of monounsaturated to saturated lipids
    
  • Moderate intake of ethanol

(So, here is an outline of an MD - description and quantification was detailed in this and cited studies.)

Findings:

"Controlling for potential confounders, higher adherence to a Mediterranean diet was associated with a statistically significant reduction in total mortality."

The contributions of the individual components of the MD to this association (reduced mortality) were:

• 23.5% from moderate ethanol consumption
  
• 16.6% from a low consumption of meat and meat products
  
• 16.2% from a high vegetable consumption
  
• 11.2% from a high fruit and nut consumption
  
• 10.6% from a high monounsaturated to saturated fat ratio (indicates high olive oil consumption)
  
• 9.7% from a high legume consumption
  
  
• High cereal consumption had minimal beneficial effect. (6.1%)
  
• Low dairy consumption had minimal beneficial effect. (4.5%)
  
• High seafood consumption had a non-significant increase in mortality. (The authors state that their Greek population had too low a seafood intake for this finding to be meaningful, and that, although the positive association was unexpected, it was "probably owing to chance.")

________
In as much as foods consumed in Greece may reflect the Mediterranean diet, this investigation adds to accumulating evidence that a certain dietary pattern (i.e. high in fruits and vegetables while low in meat) rather than a certain dietary component, is responsible for longevity.

The study went further though by assigning relative importance to components of that successful dietary pattern - with the top three contributors being, in order of benefit:

1. Moderate alcohol intake
   
2. Low consumption of meat
   
3. High consumption of vegetables

How you would describe the Mediterranean Diet? What foods would you say it includes? Excludes?
________Photo of a traditional Greek salad I found on Havabite Eatery. Mediterranean Kiwi, can you vouch for its authenticity? (What are those shiny green roll-ups?)

How Often Do You Eat Organic Produce?

You buy/eat organic (as opposed to conventional or non-organic) fruits and vegetables :

1. Exclusively
2. Most of the time
3. If it looks good & the price is right
4. Once in a while
5. Never
6. Not sure/Don't pay attention

There's a poll for this question on the sidebar. I've added this post for a place to comment.


Poll Results

You buy/eat organic fruits and vegs:


________Photo of produce vendor at Pike Place Market, Seattle, WA, 1975, from Seattle Municipal Flickr stream.

Dairy Producer Underwrites Study: Finds Vegan Diets May Harm Bones

I'm not writing this as a defense of veganism as much as I am to point out what appears to be the undermining of research by business interests. (See my post, Corrupted Research.)

The following two studies were conducted by the same authors. They were published within 3 months of each other, but have different conclusions.

Veganism, Bone Mineral Density, And Body Composition: A Study In Buddhist Nuns, Osteoporosis International, April, 2009
Ho-Pham LT, Nguyen PL, Le TT, Doan TA, Tran NT, Le TA, Nguyen TV

Effect Of Vegetarian Diets On Bone Mineral Density: A Bayesian Meta-Analysis, American Journal of Clinical Nutrition, July, 2009
Lan T Ho-Pham, Nguyen D Nguyen and Tuan V Nguyen
________
The first study, published in April of this year, compared the bone mineral density (BMD) of:

• 105 monastery-dwelling Buddhist nuns, vegans for ~33 years
  
• 105 monastery-dwelling women, omnivores

Findings:

• There was no significant difference between vegans and omnivores in BMD
  
• There was no significant difference between vegans and omnivores in lean body mass or fat mass
  
• There was no significant difference between vegans and omnivores in prevalence of osteoporosis
  
• Intake of dietary calcium was lower in vegans compared to omnivores (330 mg/day vs. 682) however, there was no significant correlation between dietary calcium and BMD.

Conclusion:

"Although vegans have much lower intakes of dietary calcium and protein than omnivores, veganism does not have adverse effect on bone mineral density and does not alter body composition."

________
The second study, published in July of this year, was not an original investigation, but a meta-analysis (a review of previously-conducted studies). It included 9 observational studies that addressed the association between vegetarianism and BMD.

Findings:

• Vegetarians' bones were ~5% less dense than meat-eaters.
  
• Vegans' bones were ~6% less dense than meat-eaters.

Conclusion:

"The results suggest that vegetarian diets, particularly vegan diets, are associated with lower BMD, but the magnitude of the association is clinically insignificant. ... [Such that] the effect size is unlikely to result in a clinically important increase in fracture risk."

________
Why, after conducting and publishing a more in-depth study on veganism and bone density, including a literature review, and discovering that life-long vegans have bones essentially identical in density to meat-eaters, did these researchers hastily assemble and publish a review (a meta-analysis, a type of study prone to bias since you can cherry pick which studies to include and which statistics to run) that, lo-and-behold, found a slight decrease in BMD in vegetarians?

And why did this second study, with less clinically significant results, get more attention in the media?

I don't know. But the second study was funded by Amber Alliance of Malaysia, which owns F&B Nutrition Sdn Bhd, "a dairy products producer and wholesaler." (See Update below.)

Update, July 8: It has been brought to my attention (thank you, Mr. Nguyen) that the grant provided this study from "the AMBeR alliance" may refer to the Australian Medical Bioinformatics Resource. However, the Australian Medical Bioinformatics Resource does not on their website refer to themselves as the "AMBeR alliance."

The Australian Medical Bioinformatics Resource is affiliated with the Garvan Institute of Medical Research, which is funded by "CRC for Innovative Dairy Products."
________

"The Most Comprehensive, Authoritative Report On US Global Climate Change" - White House

The Administration's US Global Change Research Program issued the following report on June 16, 2009:

Global Climate Change Impacts in the United States

Describing it as...

"The most comprehensive, authoritative report on Global Climate Change Impacts in the US. ... Presents, in plain language, the science and impacts of climate change, now and in the future."

The report is gorgeous. And informative. Its key findings:

1. Global warming is unequivocal and primarily human-induced.
   
2. Climate changes are underway in the United States and are projected to grow.
   
3. Widespread climate-related impacts are occurring now and are expected to increase.
   
4. Climate change will stress water resources.
   
5. Crop and livestock production will be increasingly challenged.
   
6. Coastal areas are at increasing risk from sea-level rise and storm surge.
   
7. Threats to human health will increase.
   
8. Climate change will interact with many social and environmental stresses.
   
9. Thresholds will be crossed, leading to large changes in climate and ecosystems.
   
10. Future climate change and its impacts depend on choices made today.

A few more graphics I picked up from the report:



I live in the Northeast, near Philadelphia. I don't know if it's a result of global warming, but we've just experienced the wettest Spring/Summer I can remember. As to that herbicide effectiveness claim ... I read that pests and weeds develop resistance to insecticides and herbicides over time anyway, even without increases in CO₂. Does this mean we'll be using more of them in the future? (With their attendant endocrine disruptors?)________Thanks to Melinda and Sustainablog.