The berries you topped on your yogurt at breakfast and the salad you nibbled at lunch may not be as healthy as you thought. According to a new report released by the Center for Science in the Public Interest (CSPI), lettuce, tomatoes, sprouts and berries – produce we associate with good health – are among the top 10 riskiest foods regulated by the Food and Drug Administration (FDA).
Using data from the Centers for Disease Control (CDC) and other sources, CSPI estimates that just ten foods under FDA regulation, accounted for over 40 percent of all foodborne illnesses since 1990.
This is disturbing news given that the report does not cover the meat industry (beef, pork, poultry), long criticized in books like Fast Food Nation and movies like Food Inc. The FDA is responsible for regulating produce, seafood, shell eggs and dairy products along with packaged foods like cookie dough and peanut butter – nearly 80 percent of the food supply.
Over 1,500 outbreaks were linked to the top ten foods, with almost 50,000 illnesses reported ranging from stomach cramps and diarrhea to long-term health problems and even death. Given that many cases are not reported, these numbers represent a sliver of total foodborne related cases. In 1999, the CDC estimated that for every case of salmonellosis, another 38 go unreported.
The top 10 riskiest foods include 1) leafy greens 2) eggs 3) tuna 4) oysters 5) potatoes 6) cheese 7) ice cream 8) tomatoes 9) sprouts and 10) berries. Salmonella was linked to a third of the outbreaks. The pathogens E. Coli, Campylobacter, Scombrotoxin, Norovirus and Vibrio were also linked with outbreaks in these foods.
Leafy Greens – 363 outbreaks involving 13,568 cases represented almost 30 percent of all reported illnesses. A deadly strain of E. coli was responsible for problems with spinach in 2006 and accounts for 10 percent of all leafy green outbreaks. Norovirus is linked to almost two-thirds of cases and Salmonella for 10 percent. Inadequate hand washing and cross-contamination of cutting boards contributes to the problem. Initial contamination can occur on farmland through contact with manure, contaminated water, etc.
Shell Eggs – 352 outbreaks involving 11,163 cases, with the vast majority associated with Salmonella. Contamination can occur when animal waste is not cleaned properly from the shell. Half of the cases occurred in restaurants and are associated with uncooked or runny eggs.
Tuna – 268 outbreaks or 2,300 cases. The most common cause of illness was caused by scombrotoxin which can not be destroyed by cooking or freezing. Two-thirds of outbreaks occurred in restaurants.
Oysters – 132 outbreaks involving 3,409 cases. Oysters can be contaminated with the Norovirus prior to harvesting. Not surprisingly, the majority of cases occur in restaurants.
Potatoes – 108 outbreaks involving 3,659 cases. Most outbreaks involve Salmonella and are typically related when multiple ingredients are used as in potato salad. Cross contamination of raw and cooked ingredients contributes to the problem.
Cheese – 83 outbreaks involving 2,761 cases. Most cases are associated with Salmonella. Pasteurization reduces the chance of contamination during processing and production.
Ice cream – 74 outbreaks involving 2,594 cases. Majority of cases occurred in homes which likely relates to undercooked eggs in homemade ice cream.
Tomatoes – 31 outbreaks involving 3,292 cases. Most cases associated with Salmonella which can infect the plant and fruit while it is growing. Almost three-quarters of cases associated with restaurants.
Sprouts – 31 outbreaks involving 2,022 cases. Salmonella and E. coli account for the majority of cases. Contamination occurs when seedlings are germinated in warm humid conditions that are ideal for bacterial growth.
Berries – 25 outbreaks involving 3,397 cases. Strawberries, raspberries, blackberries and other berry products. Most of illnesses caused by Cyclospora which leads to diarrhea, dehydration and stomach cramps.
That health promoting foods like fruits and vegetables are included in the top ten list is ironic. But, a globalized food system and large-scale production and processing makes this issue more likely.
“Outbreaks give the best evidence of where and when the food safety system is failing to protect the public,” said Sarah Klein, lead author of the report. “It is clearly time for FDA’s reliance on industry self-regulation to come to an end. The absence of safety plans or frequent inspections unfortunately means that some of our favorite and most healthful foods also top the list of the most risky.”
To address the problem of food safety, the House passed the Food Safety Enhancement Act in July 2009. If passed in the senate, the FDA Food Safety Modernization Act would ensure that food processors design and implement food safety plans and provide specific safety standards for food growers. It would require FDA to visit high-risk plants every 12 months or less and other facilities every 3-4 years.
The Bottom Line
While we can’t control how foods are grown and produced, we can control how we process foods in our home.
- Proper handling starts with washing hands thoroughly with soap and water.
- Thoroughly wash all fruits and vegetables.
- To avoid cross contamination, separate cutting boards, plates and knives for produce and meats. When finished, thoroughly wash with hot soapy water.
- Salmonella bacteria is killed when food is thoroughly cooked. Cooked food especially poultry that stands at room temperature for an extended period of time is at risk.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.