With boasts about foodstuffs’ health benefits, a grain of salt is needed, too

blueberries-300x225Foolishness about food and its health effects can run not only into the negative — the sky will fall if you even nibble on meat, butter, or eggs! — but also into extremes about its purported benefits. Which is why, as recent news reports indicate, skepticism and care need to be exercised about probiotics, so-called “super foods,” and, yes, once again, the supposed virtues of organic produce.

Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine who blogs on health research and policy at The Incidental Economist, tackled the myths that surround probiotics in a recent piece for the New York Times’, evidence-based “Upshot” column.

He reported that one fundamental problem in assessing the many benefits attributed to these food nostrums rests in their proliferation and confusion as to what exactly the are: Must probiotics be live cultures of organisms that are supposed to be safe and beneficial to normal activities that occur in the gut? Or can they be dietary supplements and non-living materials that can be delivered in powders and capsules? What exactly is in probiotics and how safe are they? That’s murky — and risky, he says, noting that these materials have caused illnesses and deaths.

And rigorous research hasn’t proved out their benefits, not only in illnesses and conditions that researchers might expect them to affect most — those affecting digestion or the intestinal tract — but also in a host of other maladies for which advocates say they improve gut health and the so-called teeming colonies of bacteria that constitute the human microbiome. As Carroll reported:

 [Medical studies] show that there is insufficient evidence to recommend [probiotics’] use to treat or prevent eczemapreterm laborgestational diabetesbacterial vaginosisallergic diseases or urinary tract infections. Reviews looking at the treatment or prevention of vulvovaginal candidiasis in womenpneumonia in patients hooked up to respirators, and colds in otherwise healthy people show some positive results. But the authors note that the studies are almost all of low quality, small, and often funded by companies with significant conflicts of interest. Individual studies are similarly disappointing for probiotics. One examining obesity found limited effects. Another showed they don’t prevent cavities in teeth. They don’t help prevent infant colic, either.

That hasn’t halted the hype for probiotics, of course, and the good doctor offers some common sense on them and the foods and goods supposedly rich in them: “People with no immune deficiencies should feel free to eat yogurt and sauerkraut, which can absolutely be part of a healthy diet. Eat them because they’re delicious, and most likely better for you than many other foods, not because of any health claim.”

Marketing hype for ‘super foods’

As for blueberries and macadamia nuts and some other foods surrounded by a fad frenzy, Marion Nestle, a molecular biology Ph.D., a UC Berkeley MPH, and the Paulette Goddard Professor, of Nutrition, Food Studies, and Public Health, Emerita, at New York University, has some key insights. She has written a new book, Unsavory Truth: How the Food Industry Skews the Science of What We Eat. In brief, in a piece for the Atlantic magazine, Nestle would like Americans to strip foods of imaginary red, yellow, and blue costumes in which they’re also emblazoned with a big “S.”

She dissects Big Food’s long, sustained campaigns to work with and around state and federal regulators so select items get surrounded with an aura that makes the public think they’re “super foods” — that they’re blessed with near-miraculous health benefits. They may be good for us, in reasonable and moderate quantities. On paper, they may have inherent attributes. Do these put them heads and shoulders above other edibles? As she reported:

 All these [“super”] foods are highly nutritious and well worth eating for their taste and texture—as well as for their health benefits. Is one fruit, vegetable, or nut better for you than another? The answer, as I keep saying, depends on everything else you eat or do. People who habitually eat largely plant-based diets are healthier. Variety in food intake and calorie balance are fundamental principles of healthful diets.

So, when moms, especially, marshal their constrained food dollars, they not only may not want to bust their budgets for “super foods,” they also may wish to be skeptical, too, spending big on pricey organics.

What does French study really show about organic foods and cancer?

They’d do so, despite a recently published study that got a lot of attention about findings from data on 70,000 or so French adults, mostly women in their 40s. This work suggested that  “those who primarily eat organic foods were more likely to ward off non-Hodgkin lymphoma and postmenopausal breast cancer compared to those who rarely or never ate organic foods.” Another news story on the study reported, “the most frequent consumers of organic food had 25 percent fewer cancers overall than those who never ate organic.”

But read closer and there’s lots to dig deeper into this much-publicized work. As F. Perry Wilson, a doctor with epidemiology expertise, observed, it’s key to start looking at this research with distance and care, though he reported: “Sometimes I know what the results of a study are going to be even before I finish reading the title …If the exposure of interest in a study is a luxury good, it will be associated with better health outcomes.”

As he, the New York Times, and other health experts who have posted on social media about this research have noted, it involves foods grown and produced in a different nation where standards and practices vary from those in America. The work is observational, meaning it is far from the most rigorous work. It does not control for important items like the subjects’ wealth (which may have been higher than average because they could afford organics) or other aspects of their health. It tells little or noting about a vast array of other cancer- or illness-causing influences that participants might have been exposed to, including pesticides and environmental toxins.

This study, combined with others, may help to reinforce the importance of a diet that’s more plant-based and includes well-grown produce.

Is that common sense? In my practice, I see the harms that patients suffer while seeking medical services, and their struggles to stay away from the risks of medical care by taking as many steps as they can to stay healthy.

Moderation matters in nutrition, study after study shows. There’s no hocus-pocus involved. We can stay healthier by eating less, and more plants, nuts, and fish. Research shows we should stay away from excess sugar, fat, and salt — which get laden into highly processed, fast foods and junk drinks like sodas and “energy” elixirs. If you’ve got the money, have made contacts — say, through one of the many area farmer markets — with a grower whose products you like and trust, go for organics. Quality food in moderation matters. Be careful you don’t scammed in groceries by produce purporting to be organic but that, presto, comes out in the back from the same boxes from the same farmers as “regular” fruits and veggies.

By the way, please don’t smoke (or vape), and do at least a little exercise.

All these measures can help Americans cut their problems with heart disease, cancer, and diabetes, without need for drastic measures or magical thinking. It’s food for thought.

Photo credit: Petar Milošević, ©Creative Commons
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