Reality Health

By Dr. Sara Levine

Dear Dr. Levine,

I have always encouraged my family to eat a lot of fruits and vegetables.  Everyone knows that they are an important part of a healthy diet.  Recently, I am having misgivings about eating so much fresh produce.  Last year spinach caused one type of deadly food poisoning.  Now tomatoes are making people sick.  Is there any safe and healthy food anymore? Will washing fruits and vegetables in a special way help at all?

Please do not lose faith.  Fruits and vegetables are still critical for good nutritional health.  You are correct, though, in pointing out that there could be some significant improvements in the safety of our food supply. Here in the United States we have one of the safest food supplies in the world, yet every year the CDC estimates 5000 people die from food-borne illness.   In 2006, spinach contaminated with Ecoli 0157 caused 199 illnesses and 3 deaths. 

Since April of this year, there have been 707 reported cases of salmonella with at least 71 hospitalizations related to consumption of tomatoes contaminated with salmonella Saintpaul.  While these numbers sound extremely large, it is important to put them into perspective. 

Although eating fruits and vegetables does require vigilance against food-borne illnesses, their myriad health benefits cannot be ignored. The risk of harm from eating fruits and vegetables is far outweighed by their benefits.  The Foodborne Diseases Active Surveillance Network estimated an incidence of bacterial and parasitic foodborne illness in 2007 of only 4 cases per 10, 000 people.  In contrast, an estimated 80 million Americans suffer from one or more types of heart disease. 600,000 people died in 2004 from coronary heart disease or stroke. 

In fact, if all major forms of cardiovascular disease were eliminated, it would add almost 7 years to our life expectancy.  This does not begin to include the millions affected by diabetes mellitus, cancer, and an entire spectrum of illness caused or exacerbated by obesity and/or an unhealthy dietary intake. Eating less fruits and vegetables and more processed foods would only serve to increase the number of individuals who suffer from diabetes, heart disease, and cancer.  This is clearly not a realistic solution.

Living a healthy lifestyle, including a diet high in fruits and vegetables, as well as regular exercise, is always a smart health decision.   However, the lack of adequate funding for food safety inspections in our country has forced us to become more critical of our food’s origin.  The FDA is underfunded, and food inspections have decreased by 81% since 1970.  The amount of food imported to the United States has increased, yet the FDA only inspects 1%.  This makes buying from local farmers and producers of vegetables and fruit a much more attractive solution.  It is easier to research the health and food safety practices of a local supplier than trying to trace the trail of food that has changed hands many times and originated internationally. 

Important to note is that a major source of bacterial contamination of food is through egss, meat, chicken, and other raw or undercooked animal products.  Fruits and vegetable are not the sole source of such illness.  Recent vegetable related outbreaks have made major press and are not to be minimized, but the basic concern is for improving the scrutiny of our entire food supply. 

Yes, sometimes it seems that there is no safe or healthy food anymore. Clearly, we cannot simply stop eating.  This means that we must strive to make the best choices from the food available to us.   By becoming aware of the origin of our food and decreasing the amount of processed foods we eat, we increase our control over the quality of what we eat. 

We must educate ourselves about kitchen and food preparation safety techniques.  Simple examples include cooking food containing animal products adequately and keeping foods requiring refrigeration at appropriate temperatures.  Washing our produce in running tap water, preparing them in an area isolated from contact with animal products, and removing outermost layers of lettuce and other leafy vegetables are a few other helpful pointers. 

Although special vegetable and fruit cleansers may do a good job of cleaning the exterior of the produce, the inside of the fruit or vegetable might be contaminated.  Unfortunately, this means that washing alone will not prevent all illness.  Make sure not to leave cut fruit and vegetable at room temperature for hours as this too can increase bacterial contamination.  Last, but not least, remember to wash your hands before any food preparation or contact.

Sincerely,

Sara Levine, M.D., F.A.A.P.

Dr. Sara Levine is board certified by both the American Board of Internal Medicine and the American Board of Pediatrics and has been practicing medicine for more than nine years.  She graduated summa cum laude from Case Western Reserve University and was elected to Phi Beta Kappa.  She received her M.D. from Case Western Reserve University School of Medicine. She has completed Advanced Clinical Education in Child and Adolescent Obesity from the University of California, San Francisco.   Dr. Levine is in private practice in Boca Raton.