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*Dr. Greger's Newsletter--June-August 2005 issue*

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  • Michael Greger, M.D.
    ************************************** June - August 2005 issue of Dr. Michael Greger s quarterly newsletter
    Message 1 of 1 , Jun 15, 2005

      June - August 2005 issue of Dr. Michael Greger's quarterly newsletter


      CONTENTS (online at http://www.DrGreger.org/newsletters.html )

      I. Latest Updates in Human Nutrition
      A, Making the Healthiest Food on Earth Even Healthier
      B. Treating Springtime Allergies with Spirulina?
      C. Figs Fight Fatigue
      D. Heart Attacks, Side-Effects, or a Healthy Diet
      E. Plant-Based Diets Beneficial in Pregnancy
      F. Soy and Cancer: A Meta-Analysis
      G. Dairy Diet Myth
      1. Chicken Out of Urinary Tract Infections
      2. Campylobacter Joins the Resistance
      3. The Hard-Boiled Truth: Salmonella and Eggs
      4. Don't Wash Your Meat
      5. Bacteria or Cancer

      II. Bird Flu Update: Perfect Storm Gathering

      III. Carbophobia Update: Atkins Is Toast

      IV. Personal Update: New Job and New 501c3 Status



      A. Making the Healthiest Food on Earth Even Healthier

      A quote from the May 2005 issue of the Center for Science in the
      Public Interest's Nutrition Action Healthletter: "Get a bunch of
      nutrition experts in a room and the conversation will inevitably turn
      to dark leafy greens."[1] How true that is. And two new studies just
      discovered two ways to make your daily (at least!) green leafy salad
      even healthier.

      It's not enough to eat healthy food, we also have to absorb it. One
      of the key components that makes dark green leafies so nutritious are
      the carotenoid antioxidants, like alpha-carotene, beta-carotene, and
      lutein. These compounds are lipophilic, though. "Lipo-" is from
      lipos, the Greek word for fat (as in liposuction); "-philic" is from
      the word philia, one of the four Greek words for love (as in... well
      we won't get into that). So these carotenoid nutrients are fat-loving
      molecules, and as such our body can use ingested fat to entice out
      these nutrients trapped within our greens.

      So researchers at Ohio State University paid about a dozen people to
      eat salads (this is America, you've got to PAY people to eat salad)
      with or without avocado, one of the healthiest sources of fat, and
      then measured the amount of carotenoids that made it into everyone's
      bloodstream. Those eating a salad including half an avocado absorbed
      about 10 times more carotenoids than those eating the fat-free

      Would the same hold true for the lycopene in salsa? Lycopene doubles
      as an extremely powerful carotenoid antioxidant and the red pigment
      that makes fruits and vegetables like watermelons and tomatoes red.
      Adding avocado to salsa more than quadrupled the amount of lycopene
      absorbed by test subjects.[3] (You wouldn't have to pay me to be in
      that study--yum!)

      The other salad enhancement study recently took place at the
      Universitia di Urbino in Italy. With the understanding that it's the
      antioxidants that give fruits and vegetables their anticancer,
      antiviral, and anti-inflammation properties, scientists experimented
      with adding different fresh herbs to salads and measuring their
      resultant total antioxidant content. They found that adding just a
      single sprig of fresh herbs (the weight of 3 paper clips worth of
      thyme, sage or marjoram--a kissing cousin of oregano) literally
      doubles the antioxidant power of a bowl of salad. It's almost like
      eating two salads for the price of one! The researchers conclude: "We
      stress the need to introduce aromatic herbs as a seasoning supplement
      in the diet of every age group."[5]

      Right now at farmers' markets and plant nurseries across the country
      are little pots of herbs desperate for a good home. Take them in,
      nurture them, then rip off their limbs and eat them.


      B. Treating Springtime Allergies with Spirulina?

      People have been harvesting pond scum for thousands of years. The
      Aztecs, for example, were skimming it off lakes and into their diets
      half a millennia ago. Were they onto something?

      Spirulina is one of the most popular blue-green algae supplements on
      the market. In addition to being one of the most concentrated known
      source of nutrients (though how much of it can you really eat?),
      there is building evidence of its anti-inflammatory properties. To
      see if it might be of therapeutic value to seasonal allergy
      sufferers, researchers at the University of California at Davis
      School of Medicine enrolled 3 dozen sniffley sneezers into a
      randomized, double-blind, placebo-controlled crossover study (one of
      the most rigorous study designs to minimize various biases). Compared
      to placebo, participants taking 2 grams of spirulina a day were able
      to cut their production of inflammatory mediator Interleukin-4, a
      chief conductor of allergic reactions within the body, by over 30%.[7]

      So should those with runny noses run out and grab some? Two months
      ago I would have said yes, but not now. I was actually in Hawai'i,
      the spirulina export capital of the world, when the bombshell hit.
      Published in the journal of the most prestigious scientific body in
      the United States, the National Academy of Sciences, researchers came
      to a disturbing revelation about the safety of blue-green algae in

      We've known for years that a few rare types of blue-green algae could
      produce hepatotoxins (compounds toxic to the liver), but spirulina
      was considered generally[8] free of any such toxins.[9] But in April
      2005 a coordinated effort of researchers across the world found
      evidence that almost all blue-green algae seem to be able to produce
      a neurotoxin called BMAA (beta-N-methylamino-L-alanine). BMAA is bad
      stuff. It's been implicated in a neurodegenerative disease as
      horrible as its name sounds, amyotrophic lateral
      sclerosis/parkinsonism-dementia complex. This disease attacked the
      Chamorro people of Guam who were eating flying foxes, who in turn
      were eating seeds of a cycad tree, whose watery roots concentrated
      the toxin from a certain type of algae.

      Now with this new study we know that the production of this
      neurotoxin is not limited to some rare Guam algae, but may be
      produced by almost all blue-green algae under the right conditions.
      So it turns out the only two places you may be likely to find BMAA is
      in the brains of Alzheimer's patients[10] and on the store shelves of
      your local natural foods store in the form of blue-green algae.[11]

      Until we know more, I strongly discourage people from eating
      blue/green algae (including the spirulina that, until April, was what
      made the popcorn I always smuggled into the movie theatre such a
      brilliant green hue). Those interested in reducing inflammation will
      have to choose other plant foods like--as one recent article
      published in the Journal of Nutrition discovered--gazpacho, a
      vegetable soup which "decreased biomarkers of inflammation in both
      women and men."[12]


      C. Figs Fight Fatigue

      In search of some of the most nutrient-dense foods in existence,
      chemists at the University of Scranton in Pennsylvania started
      looking at dried fruit. Since 90% of a fruit's weight is water, they
      figured that dried fruit might be ten times more nutritious by weight
      than fresh. Well, it didn't quite work out that way. The drying
      process destroyed about 80% of the chief antioxidant compounds, but,
      given that the nutrition in dried fruit is ten times more
      concentrated, dried fruits did still come out ahead, finishing out
      with about 10% more antioxidant content than fresh (by weight). And
      with all the fiber and minerals intact, dried fruit tested out to be
      little nutrition powerhouses.

      A new study out of Korea just found that the antioxidant boost
      provided by fruit consumption only seems to last about 2 hours.[13]
      So carrying around some trail mix is a convenient way to make sure
      your body is constantly flooded with antioxidants throughout the day.
      Which dried fruits are the best? Of the six fruits tested--apricots,
      cranberries, dates, figs, raisins and plums--shooting to a surprise
      finish at number one was... figs! (OK, OK, the study was paid for in
      part by the California Fig Advisory Board, but still...).

      Aren't dried fruits packed with concentrated sugars though? And isn't
      sugar a pro-oxidant? Well, yes, but dried (and fresh) fruits are so
      packed with antioxidants that not only do they successfully counter
      the potential detriment of their own sugar, they are powerful enough
      to take on a can of Coke, too. When you drink a dozen spoonfuls of
      sugar in a soft drink (aka "liquid candy"), the antioxidant capacity
      of your blood drops dramatically as your body starts using up its
      antioxidant stores to deal with the oxidant stress caused by all that
      sugar. Well what if you doubled the amount of sugar you ingested by
      drinking a cup of soda with a serving of dried figs on top? Even the
      high fructose corn syrup in the soda is no match for the antioxidant
      power of fruit. Despite the double sugar load, subjects washing down
      their figs with soda still experienced an overall rise in antioxidant
      levels in their bloodstream.[14] No, that doesn't mean you can eat or
      drink all the candy you want as long as you pop a few raisins. Stick
      with the fruit.

      In addition to having the highest antioxidant content among the six
      fruits tested, of the thousands of whole foods in the USDA nutrient
      database, figs make the top ten for fiber content.

      (For the curious, the top five are #1. Cloud ear mushrooms (the
      number one fiber-containing whole food on the planet and I've never
      even heard of it?), #2. Flax seeds (I've heard of those), #3. Sesame
      seeds, #4. Dried unsweetened coconut, and #5. Air-popped popcorn).

      And fiber consumption, according a new review, may help boost energy
      levels.[15] Half the fiber we swallow is eaten by the good bacteria
      in our colon. Our colonic comrades ferment the fiber we eat into
      short-chain fatty acids, which our body then absorbs and sends
      straight to our muscles to be used as a ready fuel source. Of course,
      another byproduct of this fermentation product is gas, some of which
      is absorbed by other bacteria to produce even more fuel for us, but
      the rest of which is indeed excreted. Maybe a more appropriate title
      would be Fight Fatigue with Fig Farts.


      D. Heart Attacks, Side-Effects, or a Healthy Diet

      One of the laws of ecology is that you cannot do just one thing
      (because everything is connected to everything else). Yet, when
      physicians put people on statin drugs to cripple the enzyme that
      produces cholesterol within your liver, they hope there won't be any
      other effects. Unfortunately within the ecology of the body that too
      often is not the case. About one in six people on these
      cholesterol-lowering drugs experience other untoward effects,[16] and
      there is growing concern about the very rare (but very serious)
      life-threatening adverse reactions to this class of drugs. We've
      known about the potential for rare cases of these drugs causing
      muscle breakdown, but recently there's been increasing concern about
      rare cases of these drugs causing nerve breakdown--a so-called
      drug-induced polyneuropathy.[17] It seems that statins may also
      co-cripple the synthesis of a key energy-producing enzyme in nerve
      cells. Thankfully, one doesn't have to choose between the risk of
      getting a heart attack and the risk of suffering side-effects from
      life-long drug therapy. That's because David Jenkins has done it

      Currently one of the world's most respected nutrition researchers (it
      was his team that invented the glycemic index), Dr. Jenkins has just
      published yet another study proving that a completely plant-based
      (vegan) diet alone can lower cholesterol levels as much as the
      combination of a low-fat vegetarian diet AND a statin drug.[18]
      Although, as drugs go, statins seem remarkably safe, users do risk
      (albeit extremely rarely) being written up as case reports with
      unpleasant names like "Toxic Epidermal Necrolysis from Atorvastatin."
      That one, published in the Journal of the AMA, described a horror
      story of a woman whose skin erupted in blisters and then started
      necrosing off. Patches of her skin started disintegrating and
      sloughing off after only four days on the statin drug. After two
      weeks on a morphine drip, thankfully, she pulled through.[19]
      Contrast that with the side effects of a healthy plant-based diet.
      What's the worse that can happen? Maybe less reading time on the
      toilet because you're not constipated anymore?

      As the revered Moses Maimonides wrote in the 12th century: "No
      illness which can be treated by diet should be treated by any other


      E. Plant-Based Diets Beneficial in Pregnancy

      Adequate magnesium status is critical for the health of both mother
      and fetus during pregnancy. Magnesium deficiency during pregnancy is
      associated with everything from bothersome calf muscle cramps to a
      potentially life-threatening complication called eclampsia. So where
      is magnesium found? Well, it forms the core of chlorophyll molecules,
      so--you guessed it--dark green leafy vegetables, as well as beans,
      seeds and whole grains. So researchers at the German Institute of
      Human Nutrition reasoned that women who followed plant-based diets
      would have a better magnesium status and fewer magnesium
      deficiency-related complications than those following the Standard
      American Diet (SAD). And, that's exactly what they found.

      They followed over a hundred women through their pregnancies and not
      only did those following a plant-based diet indeed have "markedly"
      higher magnesium intakes, but they had significantly fewer leg cramps
      during the second and third trimesters. The researchers conclude that
      this is in line with the "substantial evidence from many studies that
      plant-based or vegetarian diets can reduce the risk for many
      nutrition-related diseases."[20]


      F. Soy and Cancer: A Meta-Analysis

      Some studies suggest that soy consumption prevents cancer, some
      studies find no association and internet sites like Mercola.com
      suggest that ingesting soy actually causes cancer. (Joseph Mercola,
      who boasts the "#1 natural health website," just received a warning
      letter from the FDA ordering him to stop making illegal claims about
      the products he sells. See
      http://www.casewatch.org/fdawarning/prod/2005/mercola.shtml ). So
      what does the balance of evidence show? That's where a meta-analysis
      comes in.

      Instead of picking and choosing studies to suit one's agenda,
      meta-analyses look at essentially every study ever done on a topic
      and kind of pool the data all together. A meta-analysis of the effect
      of soy on cholesterol levels back in the '90s, for example, showed
      that the evidence of a cardio-protective role of soy was so strong
      that the FDA authorized a health claim on soy products that they may
      reduce the risk of heart disease. Now finally, published in a recent
      issue of the Journal of the American College of Nutrition, a
      meta-analysis on the role of soy in cancer prevention.

      Researchers looked at three types of cancer: breast cancer, prostate
      cancer and gastrointestinal cancer (like colon cancer). Combining all
      the best published studies, they found highly significant reductions
      in cancer risk among consumers of soy products. Women of all ages who
      eat soy enjoy 22% less breast cancer (36% less for postmenopausal
      women!), male soy consumers are 34% less likely to get prostate
      cancer, and both men and women who consume soy reduce their risk of
      developing gastrointestinal cancer by 30%.[21]

      The evidence is so strong that there is now another health claim
      before the FDA--soon we may see labels saying that soy protects
      against cancer as well.


      G. Dairy Diet Myth

      "Drink Milk... Lose Weight" say the ads which ran in over 30
      newspapers and magazines. October 2003, the dairy industry launched
      an entire "Healthy Weight with Milk" campaign to boost sales.
      Curiously, that also happened to be the same year a review of that
      exact subject was published in the Journal of Nutrition. The review
      found nine randomized controlled studies in the medical literature on
      body weight and dairy. Seven of the nine studies found no significant
      change in body weight compared to controls and the last two found
      that those who increased their dairy consumption gained significantly
      more weight than the nondairy control groups.[22] Subsequent and even
      larger studies published in 2004[23] and 2005[24] showed the exact
      same thing.

      So, wait a second. How can the dairy industry's ads claim that "a
      clinical study shows it helps you burn more fat and lose more weight
      than just cutting calories alone?" Well, because there is actually
      one tiny study, published by Michael Zemel of the University of
      Tennessee, which did find that the 11 study participants instructed
      to eat more dairy did seem to lose more weight. Yes, of course the
      study was bought and paid for by the dairy industry, but it goes
      further than that. This guy Zemel owns a patent on the claim that
      dairy foods aid weight loss, which is licensed to dairy food
      manufacturers. As the Center for Science in the Public Interest
      noted, "In the world of patents and PR, a little science can go a
      long way."[25]

      Similar maneuverings were involved in the increased dairy
      recommendation in the new USDA Dietary Guidelines, even though a
      recent World Health Organization review found no significant
      relationship at all between low dairy consumption and osteoporotic
      fracture risk.[26] Assigned to write the dairy guideline was Connie
      Weaver, head of nutrition at Purdue University and a funding favorite
      of the National Dairy Council. Walter Willet, head of nutrition at
      Harvard, calls the guideline committee's report "egregious," accusing
      them of ignoring the evidence linking dairy to cancer. "There is no
      nutritional requirement for dairy," Dr. Willet told the Wall Street
      Journal, "at all."[27]

      To hopefully clear up the dairy/weight question once and for all,
      last week on June 6, 2005, Harvard researchers published what may be
      considered the definitive study on the subject in the Archives of
      Pediatrics and Adolescent Medicine. A study which followed the
      milk-drinking habits of not 11 kids, or even 12 kids, but over 12,000
      kids! After following these 9- though 14-year-olds for years, they
      found that "children who reported higher total milk intake
      experienced larger weight gains." The more milk they drank, the
      heavier they became. Boys who drank the "recommended" three servings
      of milk a day were 35% more likely to become overweight and girls who
      drank three servings were 36% more likely to become overweight over

      "Given the high prevalence of lactose intolerance, the energy content
      and saturated fat in milk, and evidence that dairy products may
      promote both male (prostate) and female (ovarian) cancers, we should
      not assume that high intakes [of dairy] are beneficial," the
      researchers told reporters. "Furthermore, these cancers may be linked
      to consumption during adolescence."[29]

      What most surprised the researchers was that those who drank low-fat
      milk (skim and 1%) gained the most weight of all! The weight gain
      seemed tied more to the dairy protein intake than the dairy fat
      intake (extra whey protein is often added to low-fat milk during
      processing). Although there are at least four human studies that show
      that the dairy protein whey itself may promote weight gain, the
      researchers guessed that the blame lay in the growth hormones in
      milk, like the sex steroid estrone found in whey. After all, milk is
      designed by mother nature to start an 80-pound calf on her way to
      1,400 pounds by her second birthday.

      This new study has serious implications for our childhood obesity
      epidemic, which not only has devastating health consequences but
      social consequences as well. A study released the same week by
      researchers at the Centers for Disease Control found that teens who
      perceived themselves as overweight were more than twice as likely to
      attempt suicide.[30]


      H1. SUPERBUGS: Chicken Out of Urinary Tract Infections

      Urinary Tract Infections are the most common infectious disease in
      women, affecting millions every year in the United States. And they
      are getting harder and harder to treat as antibiotic resistance among
      the chief pathogen, E. coli, becomes more and more common.

      When people think of E. coli infection, they typically think of the
      Jack-in-the-Box E. coli 0157:H7 infection, which starts as
      hemorrhagic colitis (profuse bloody diarrhea) and can then progress
      to kidney failure, seizures, coma and death. While E. coli 0157:H7
      remains the leading cause of acute kidney failure of our children in
      this country,[31] only about 50,000 people get infected every year
      and only about 50 die. But literally millions of people get what's
      called "extraintestinal" E. coli infections--urinary tract infections
      (UTIs) which can invade the bloodstream and cause an estimated 36,000
      deaths annually in the United States. That's over 500 times as many
      deaths as E. coli 0157:H7. We know where E. coli 0157:H7 comes
      from--fecal contamination from the meat, dairy and egg
      industries[32]--but where do these other E. coli come from?

      Medical researchers at the University of Minnesota published a clue
      to the mystery this April in the Journal of Infectious Disease.
      Taking over a thousand food samples from multiple retail markets,
      they were not surprised to find evidence of fecal contamination in
      69% of the pork and beef and 92% of the poultry samples as evidenced
      by E. coli contamination. We know meat products are crawling with
      intestinal bugs. In fact, animal manure has been found to be the
      source of more than 100 pathogens, including bacteria, parasites and
      viruses that could be transmitted from animals to humans.[33]

      More surprising was that ">80% of their E. coli isolates from beef,
      pork, and poultry exhibited resistance to >=1 antimicrobial agent,
      and >50% of isolates from poultry were resistant to >5 drugs!"[34]
      One rarely finds exclamation points in the medical literature.

      But what was most surprising was that, for example, half of the
      poultry samples were contaminated with the extraintestinal E. coli
      bacteria. It seems that the UTI-type E. coli are food-borne pathogens
      as well, "found in many retail foods," the researchers write,
      "particularly poultry but also beef or pork...."

      The researchers conclude: "The highest prevalences and densities of
      resistant E. coli and ExPEC [Extraintestinal Pathogenic E. Coli] were
      found in meat products. This is consistent with contamination of
      animal carcasses with the host's fecal flora during slaughter and
      processing and with use of antimicrobial agents in food-animal
      production." The researchers go so far as to say that the
      extraintestinal pathogenic E. coli "may rival (or exceed) E. coli
      O157:H7 as a foodborne pathogen."[35] Science News comments on a 2005
      California study which found the same thing:[36] "According to new
      research, this wave of multidrug-resistant UTIs may have a surprising
      source: eating meat."[37]

      The scientists suspect by eating chicken and other meat, women infect
      their lower intestinal tract with these antibiotic-resistant bacteria
      which can then creep up into their urethra. Commonsense hygeine
      measures to prevent UTI's have always included wiping from front to
      back after bowel movements and urinating after intercourse to flush
      any infiltrators out. Now perhaps we can add a third measure:
      avoiding meat.


      H2. SUPERBUGS: Campylobacter Joins the Resistance

      Campylobacter is the most common bacterial cause of food poisoning in
      the United States. One study found Campylobacter contaminating 98% of
      retail chicken meat, the most common cause of Campylobacter
      poisoning.[38] And the bacterium is growing dangerously resistant to
      multiple classes of antibiotics. But we still have a few big-gun
      antibiotics left to deal with resistant bugs. So, for the time being
      (before the bacteria outsmart these new antibiotics as well), do we
      have good evidence showing that partially resistant bugs like
      Campylobacter currently pose a particular threat? We do now.

      Typically, Campylobacter only causes a self-limited diarrheal illness
      ("stomach flu") which doesn't require antibiotics. If the
      gastroenteritis is particularly severe or if doctors suspect that the
      bug may be working it's way from the gut into the bloodstream, the
      initial drug of choice is typically a quinolone antibiotic like
      Cipro. Quinolone antibiotics have been used in human medicine since
      the 1980s, but widespread antibiotic-resistant Campylobacter didn't
      arise until after quinolones were licensed for use in animal feed as
      growth promoters in the early 1990s. In countries like Australia,
      which reserved quinolones for human use only, resistant bacteria
      simply do not exist.[88]

      When the FDA announced they were intending to join other countries
      and ban quinolone antibiotic use on U.S. poultry farms, the drug
      manufacturer, Bayer, sued the FDA. Bayer lost the lawsuit last year,
      but is currently appealing the decision. Meanwhile, poultry factories
      continue to spike the chickens' water supply with these antibiotics
      critical to human medicine. Evidence released in May 2005 found that
      retail chicken samples from such factories are more than 450 time
      more likely to carry antibiotic-resistant bugs. Even companies like
      Tyson and Purdue which supposedly stopped using antibiotics years ago
      are still churning out antibiotic-resistant bacteria-infected
      chicken. Scientists think the bacteria that became resistant years
      before are still hiding within the often dirt floors of the massive
      broiler sheds or within the piping of the water supply. Another
      possibility is that the carcasses of the chickens raised under
      so-called "Antibiotic Free" conditions are contaminated with
      resistant bacteria from slaughterhouse equipment which can process
      over 200,000 birds in a single hour.[88]

      In someone infected with Campylobacter, if the initial quinolone
      antibiotic isn't effective, doctors switch to stronger antibiotics
      reserved as a last resort. Does this delay lead to poorer patient
      outcomes? Scientists recently studied thousands of patients with
      Campylobacter infection to answer that question, and, indeed, the
      delay in treatment caused by quinolone-resistant Campylobacter led to
      up to ten times more complications--infections of the brain, the
      heart, and the most frequent serious complication they noted,


      H3. SUPERBUGS: The Hard-Boiled Truth: Salmonella and Eggs

      In June 2005, the Centers for Disease Control released data showing
      resistant Salmonella led to serious complications as well.[40]
      Foodborne Salmonella emerged in the Northeast in the late 1970s and
      has now spread throughout North America. Salmonella hospitalizes
      thousands of people every year and kills hundreds. And Salmonella
      infection can be the gift that keeps on giving: Salmonella infections
      can lead to chronic conditions such as arthritis, bone infections,
      cardiac inflammation and neurological disorders.[41]

      In the United States, more than one in five "broiler" chickens may be
      Salmonella infected (at least in Russian roulette, there are six
      chambers).[42] But it's even more of a problem with egg-laying hens.
      Eggs are the primary vehicle for the spread of Salmonella bacteria to
      humans, causing an estimated 80% of outbreaks. This year, the CDC
      published the first estimate of how many Americans get Salmonella
      from eggs every year. According to the best data we have, eating
      Salmonella-infected eggs may cause 168,000 illnesses every year in
      the United States alone.[43] A comic strip up in my office helps
      explain the level of infection:

      Father and daughter are in the grocery store. "That's a cow's
      tongue?!" the girl exclaims, face contorted in disgust. "EEEEww...I
      would never eat anything that was in a cow's mouth!"

      "Me neither," replies the father not looking up from his
      shopping list. "Let's see..." he continues, "where are the eggs?"

      Ruthie stops. "Wait a minute!" she exclaims, eyes wide in realization.

      Can't you just wash off the eggs? Unfortunately, no. Many of the
      tainted eggs are infected within the hens' ovaries even before the
      shell forms, so you can't wash away the infection. And, as we'll see,
      washing meat doesn't work either.


      H4. SUPERBUGS: Don't Wash Your Meat

      Can't you just wash off meat like one rinses off fruits and
      vegetables? No. In fact, the new federal dietary guidelines
      specifically recommend that "meat and poultry should not be washed or
      rinsed." The USDA explains: "Bacteria in raw meat and poultry juices
      can be spread to other foods, utensils, and surfaces." Juices?
      Animals are not fruits. They don't have juice. In chickens, for
      example, the "juice" is a fecal soup of bloody serum absorbed in the
      scalding and cooling tanks in the slaughter house. Further, the
      infection is actually inside these animals.

      Millions of chickens are drowned alive in the scalding tanks (the
      federal Humane Slaughter Act exempts all birds), which may introduce
      the pathogens into their lungs. However new research from the USDA's
      chief scientific research agency suggests that the primary source of
      lung contamination with bacteria like Campylobacter is inhaled manure
      during production (where up to tens of thousands of chickens are
      overcrowded into broiler sheds) or during transport.[44]

      The June 2005 issue of the Tufts University Health and Nutrition
      Letter notes: "Your own hands, where they grasped the meat while
      washing it, could become just as bacteria-laden as the surface of the
      food....The best bet is to leave meat or poultry untouched until you
      start cooking it"[45] (what are you supposed to do--levitate it into
      the oven?) New research, though, suggests that even this precaution
      may not be enough.

      In March 2005, researchers published a study in which they swabbed
      the external surface of prepackaged raw meat in the grocery stores
      for fecal contamination. And did they ever find it. Even though most
      of the packages looked clean on the outside, they found Salmonella,
      Campylobacter and multidrug-resistant E. coli on the outer surface of
      packages of meat. Just picking up a package of meat in the store
      could put one at risk.

      Poultry beat out the competition for the most contamination, followed
      by lamb, pork and beef. One swab of a single Q-tip picked up over
      10,000 live E. Coli bacteria. As few as 10 bacteria of the
      hemorrhagic type (E. coli 0157:H7) can lead to a potentially fatal
      infection.[46] The researchers conclude, "The external packaging of
      raw meats is a vehicle for potential cross-contamination by
      Campylobacter, Salmonella, and E. coli in retail premises and
      consumers' homes."[47]

      OK, fine, but what if you handled the meat like they do in the
      lab--first wiping the package off with rubbing alcohol using sterile
      gloves, then cutting it open with a disposable blade before lifting a
      piece out with sterile forceps into the oven--once it's cooked to the
      proper temperature it's safe, right? Unfortunately, the internal
      temperature required to cook the fecal contamination dead (160
      degrees F) is the same temperature which produces carcinogenic
      compounds called heterocyclic amines.


      H5. SUPERBUGS: Bacteria or Cancer

      In May 2005, a major review of these cooked-meat carcinogens was
      published by researchers at the U.S. Department of Energy. When
      skeletal muscles are heated beyond a certain temperature--be it moist
      heat (boiling) or dry heat (broiling, frying, grilling)--the muscle
      creatine combines with blood sugars and amino acids to create
      heterocyclic amine carcinogens. Of all the meats tested, cooked
      chicken breast formed the highest levels of these toxins.

      Although there are cooking methods that result in lower carcinogen
      concentrations (marinating followed by a microwaving pretreatment and
      pouring off of the "juices," followed by relatively low temperature
      frying with frequent flipping), there does not seem to be a way to
      cook meat to an internal temperature necessary to kill off bacteria
      without producing at least some carcinogenic compounds. And even low
      doses have been shown to cause human DNA mutations which could lead
      to cancer.

      Human studies suggest that eating well-done meat can raise the risk
      of breast cancer, prostate cancer, and colon cancer by more than
      400%. The researchers conclude, "There is a general consensus that
      human exposure to potent genotoxic heterocyclic amine carcinogens
      produced in meat during cooking is widespread."[48] Meat consumers
      are then faced with a dilemma, choosing between the risks of food
      poisoning or cancer.


      II. BIRD FLU UPDATE: Prefect Storm Gathering

      In my last update in March 2005 ("Bird Flu Spreads its Wings"
      http://www.drgreger.org/march2005.html ) we were left with a New
      Scientist editorial entitled "Bird Flu Outbreak Could Kill 1.5
      Billion People" and the head of the World Health Organization in Asia
      saying "The world is now in the gravest possible danger of a
      pandemic." Well. according to the World Health Organization (WHO),
      the situation is now even graver.

      The WHO convened an emergency meeting last month, May 2005, to
      discuss the latest findings. They issued a press release: "[The
      findings] demonstrate that the viruses are continuing to evolve and
      pose a continuing and potentially growing pandemic threat."

      There are three essential conditions necessary to produce the next
      pandemic. First, a new virus arises from a nonhuman animal reservoir
      (such that humans have no natural immunity to it). Second, the virus
      evolves to be able to kill human beings efficiently. Third, the virus
      must evolve to be able to spread between humans easily--via a sneeze
      or handshake. So far, conditions one and two have been met in spades.
      Three strikes and we're out.

      At this time, nearly all of the human deaths have "involved people
      who lived or worked with poultry, poultry meat or eggs in Southeast
      Asia."[49] USDA researchers tested thigh and breast meat in chickens
      and effectively proved in a study published March 2005 that chicken
      meat from infected birds can indeed be a source of infection.[50]
      While UN officials have urged people to stop drinking duck's
      blood[51] and eating "tiet canh" (congealed duck blood pudding) the
      fear is that once bird flu has enough chances to mutate inside of
      human hosts, it can then flood across the world human-to-human like
      the bird flu epidemic did in 1918.

      The global mortality from the 1918 pandemic has recently been revised
      upwards to as many as 100 million people dead.[52] Experts fear this
      new virus may turn out many times more deadly. "This is the worst flu
      virus I have ever seen or worked with or read about," one virology
      chair who has been studying avian influenza strains for decades told
      a reporter. "We have to prepare as if we're going to war and the
      public needs to understand that clearly... if this does happen, and I
      fully expect it will, there will be no place for any of us to hide.
      Not in the United States or in Europe or in a bunker somewhere. The
      virus is a very promiscuous and efficient killer."[53] The top
      Russian virologist offers a potential death count: "Up to one billion
      people could die around the whole world in six months... We are half
      a step away from a worldwide pandemic catastrophe."[54]

      Dr. Michael Osterholm, director of the U.S. Center for Infectious
      Disease Research and Policy, is probably our nation's top expert. He
      continues to make attempts to describe the ensuing unimaginable
      horror. He suggests people consider the devastation of the recent
      tsunamis in South Asia: "Duplicate it in every major urban centre and
      rural community around the planet simultaneously, add in the
      paralyzing fear and panic of contagion, and we begin to get some
      sense of the potential of pandemic influenza.[55] An influenza
      pandemic of even moderate impact will result in the biggest single
      human disaster ever--far greater than AIDS, 9/11, all wars in the
      20th century and the recent tsunami combined. It has the potential to
      redirect world history as the Black Death redirected European history
      in the 14th century."[56]

      "Nature" is considered by many to be the most prestigious scientific
      journal in the world. They commissioned their senior reporter in
      Paris to write a fictional yet realistic account of how the pandemic
      could be expected to unfold. Writing as a blogger in December 2005,
      it's fiction, but not fantasy. Read it in full at
      http://www.nature.com/news/2005/050523/full/435400a .

      According to the top experts in the world, these bird flu scenarios
      are not just Chicken Little stories. "We're not crying wolf," swears
      Canada's top expert, head of the national microbiology lab. "There is
      a wolf. We just don't know when it's coming."[57] The head of the
      CDC's International Emerging Infections Program in Thailand agrees:
      "The world just has no idea what it's going to see if this thing
      comes," he said, but then stopped. "When, really. It's when. I don't
      think we can afford the luxury of the word 'if' anymore. We are past

      So what can we do? Almost all of the antibiotics ever created only
      work against bacteria. There are a few classes of drugs, including
      drugs like amantidine, that work against certain viruses as well. But
      the present bird flu virus has already evolved resistance to this
      first generation of antivirals. How? "The Chinese have been
      incorporating amantadine in their chicken feed, so we have lost that
      as a treatment," notes one U.S. flu expert.[59]

      Scientists are pinning their hopes on oseltamavir (also known as
      Tamiflu), the best prospect in the latest generation of antiflu
      drugs. Unfortunately, there is not enough to go around. Made from
      star anise, a plant in limited global supply, there is now a two-year
      waiting list for new orders.[60] And the orders, of course, are
      coming from dozens of rich Western countries who are attempting to
      stockpile the drug,[61] not the poor countries like Vietnam where any
      pandemic is likely to start.

      "The only effective way to stop a global pandemic is to stop it in
      Southeast Asia," writes the editorial board of the journal of the
      Canadian Medical Association. "Although likely to have only a limited
      effect, stockpiles of oseltamavir need to be created throughout
      Southeast Asia." Scientists reason that if the human outbreak can be
      caught early enough, maybe they could even stop it. Once the pandemic
      hits, writes one leader in the field, "School closure, quarantine,
      travel restrictions and so on are unlikely to be more effective than
      a garden hose in a forest fire."[62]

      It's like a spark and a squirt gun, describes the director of the
      U.S. National Vaccine Program. "If you aim properly you can get the
      spark and be done with it. If you miss, though, the fire is going to
      spread and there is nothing you can do to stop it."[63] When a senior
      public-health official was asked if he could imagine the developed
      world sending its resources to combat the flu in Southeast Asia, the
      reply was, "Who are you kidding?"[64]

      The Western world is continuing in its "narcissistic planning,"[65]
      ignoring pleas from the World Health Organization to pour resources
      into Southeast Asia.[66] The U.K., for example, is spending $700
      million to stockpile antiviral drugs. That's ten times the entire
      health budget for Vietnam. In Cambodia, the total annual budget for a
      campaign to encourage citizens to report suspected cases of bird flu
      is about $3000.[67]

      Once the outbreak spreads globally, though, stockpiles in rich
      countries will provide no more than a pandemic "speed bump."[68]
      Canada, for example, has ordered 20 million doses although they
      suspect they'd need more than 200 million.[69] Who's going to have
      access to the limited supply? Priority for prophylactic treatment
      goes first to "key decision makers."[70] The current U.S. stockpile
      would treat less than 2 percent of the population.[71] Some
      scientists are advocating it just be sold over the counter and let
      whomever can afford it have access.[72]

      From the editorial board of one of the most prestigious medical
      journals in the world, "If the greatest pandemic in history is indeed
      on the horizon, that threat must be met by the most comprehensive
      public-health plan ever devised."[73] If one reads the
      behind-the-scenes policy journals like Foreign Affairs, though,
      senior officials admit that planning for what they call "the most
      catastrophic outbreak in human history" is "abysmally
      inadequate."[74] Realizing that given the current political situation
      the prospects for preventing the pandemic are practically
      nonexistent, chief scientists like Osterholm are going to the
      business community to at least work on providing an infrastructure
      for survivors of what is being predicted in policy journals as the
      "shutdown of the global economic system."[75]

      Speaking to a conference of agricultural bankers, Osterholm laid it
      all out: "This is going to be the most catastrophic thing in my
      lifetime. When this situation unfolds, we will shut down global
      markets overnight. There will not be movement of goods; there will
      not be movement of people. This will last for at least a year, maybe

      If we can't stop a human outbreak once it's started, can we stop a
      human outbreak in the first place? The WHO advises that "[p]revention
      of... avian influenza in humans is best achieved by controlling
      infection in poultry." [77] At this stage though, with over a hundred
      million birds dead so far and confirmed spread into migratory wild
      bird populations, this prospect seems similarly untenable. [78]

      Asia provides a veritable genetic-reassortment laboratory for the
      virus--the mix of an unprecedented number of people, pigs, and
      poultry. "It is sobering to realize," Osterholm writes, "that in
      1968, when the most recent influenza pandemic occurred, the virus
      emerged in a China that had a human population of 790 million, a pig
      population of 5.2 million, and a poultry population of 12.3 million;
      today, these populations number 1.3 billion, 508 million, and 13
      billion, respectively. Similar changes have occurred in the human and
      animal populations of other Asian countries, creating an incredible
      mixing vessel for viruses."[79] In that kind of environment, New
      Yorker reporter Michael Specter wrote that "one sneeze from a pig
      could be enough to start a pandemic."

      Large commercial poultry operations provide an ideal spawning ground
      for new pandemic strains. Tens of thousands of broiler-type chickens
      are crammed into large sheds. Because they live in their own manure,
      the virus has an opportunity to be excreted in the feces and then
      breathed in or swallowed by the thousands of other birds, allowing
      the virus to rapidly and repeatedly circulate. With so many birds to
      mutate within and pass back and forth, low virulence strains can
      readily turn into deadly ones.[80]

      Describing another deadly animal-to-human virus that arose in Asia,
      this one in 1999, the Thai Minister of Public Health explains: "A
      hundred years ago, the Nipah virus would have simply emerged and died
      out; instead it was transmitted to pigs and amplified. With modern
      agriculture, the pigs are transported long distances to slaughter.
      And the virus goes with them." And countries trying to protect their
      poultry industries have covered up their outbreaks, making it that
      much more difficult to stem the tide early.[81]

      Charun Boonyarithikarn is another senior Thai public-health officer.
      "Chickens used to live in our backyards," he told a New Yorker
      reporter. "They didn't travel much. Now, throughout the world, farms
      have become factories. Millions of chickens are shipped huge
      distances every day. We can't stop every chicken or duck or pig. And
      they offer millions of opportunities for pathogens to find a niche."

      Dr Samuel Jutzi of the Food and Agriculture Organization told the
      conference: "There is an increasing risk of avian influenza spread
      that no poultry-keeping country can afford to ignore."[82] Vietnam
      has already banned duck and goose farming, but this may be a case of
      too little too late.[83] Another pandemic may force humanity to
      realize that it may have to give up the habit of raising birds

      In response to the February 28, 2005 lead New Yorker story on the
      threat of bird flu, staff writer Michael Specter was asked if, based
      on his research, we would "have to rethink such things as large-scale
      poultry farming?" He replied "Well, I can't imagine a better
      prescription for killing large numbers of animals with a single
      disease than packing tens of thousands of them into factory farms
      where they are lucky if they have fifteen inches of personal space.
      Still, the economic incentives toward factory production of food are
      huge--we want cheap meat. So it's going to be very difficult to

      So what does the poultry industry think about the possibility of its
      own industry leading to a worldwide epidemic that kills millions of
      people? The Executive Editor of Poultry magazine wrote an editorial
      on that very subject in its last issue: "The prospect of a virulent
      flu to which we have absolutely no resistance is frightening.
      However, to me, the threat is much greater to the poultry industry.
      I'm not as worried about the U.S. human population dying from bird
      flu as I am that there will be no chicken to eat."[84]


      III. CARBOPHOBIA UPDATE: Atkins Is Toast

      Although my latest book Carbophobia: The Scary Truth About America's
      Low Carb Craze is selling well, I can hardly take credit for the
      downfall of the Atkins Empire. Here's a sampling of recent newspaper
      headlines: "Poor Sales Cripple Atkins Diet Firm,"[85] "Atkins Diet
      Firm on Brink of Liquidation."[86] And my personal favorite: "Good
      Riddance to the Atkins Diet."[87]

      I will continue to do my part, though, in exposing the truth behind
      these dangerous diets. I've got over a dozen live radio interviews
      lined up this month--please see http://www.DrGreger.org/dates.html
      for a schedule if you want to listen in. I'm excited to report that
      my publisher, Lantern Books, has chosen Carbophobia for its quarterly
      book club discussion. So if anyone's going to be near New York City
      on June 27th, you should stop by. Details can be found on the Lantern
      website http://www.LanternBooks.com . And of course, for the latest
      updates, always keep it tuned to http://www.AtkinsExposed.org

      To commemorate the downfall of the high-fat fad in Britain, one
      London paper asked some high-profile authors to write about their
      experiences on the Atkins diet. One felt "as healthy and attractive
      as a McDonald's cheeseburger." Another had to "confess to feeling
      like a constipated lump of lard." A third wrote: "How do I feel now?
      You know that expression 'You are what you eat'? Well, I feel like I
      just ate a big bowl of stupid. And you wouldn't believe how fattening
      that is."



      I am proud to announce that I have accepted a position with The
      Humane Society of the United States (HSUS). I am now its Director of
      Public Health and Animal Agriculture. After being on the road for a
      bit too long, it was a welcome change to move to D.C. and stay in the
      same time zone for more than a few days. So please note my new
      mailing address (my latest contact information is always on my
      website at http://www.DrGreger.org/bio.html).

      With HSUS's bold new leadership and a stated mission to "create a
      humane and sustainable world for all animals, including people,
      through education, advocacy and the promotion of respect and
      compassion," I think I'm going to fit right in.

      My first project is to help counter the Bush administration's
      consideration of backpedaling on the downer cow ban (the
      late-breaking news, of course, is that another U.S. downer may be
      confirmed with mad cow disease this week--keep tuned to
      http://www.organicconsumers.org/madcow ). For years the meat from
      cows too sick or crippled to even walk was considered too risky to be
      allowed in the federal School Lunch Program. So downer meat was
      evidently not safe enough to feed to kids at school, but evidently
      was safe enough to feed to kids once they got home from school (or
      feed to adults for that matter).

      Thankfully, after the discovery of the first confirmed case of mad
      cow disease in the United States, the USDA finally banned the
      inclusion of meat from downed cattle in the human food supply. Now,
      with building pressure from some sectors of industry, the USDA seems
      to be having second thoughts. For what we can all do to keep the
      downer ban from going down, check out the April 21, 2005 issue of
      HumaneLines, the Humane Society's free weekly electronic alert or,
      even better, sign up at https://community.hsus.org/humane/join.tcl .
      An alert should also be sent to HumaneLiines about how to support
      Senate action to ban the use of quinolone antibiotic-treated chicken
      in the National School Lunch Program.

      I'm also proud to announce that after ponderous delays with the IRS,
      the institute I set up to further my work is now an
      officially-recognized 501c3 nonprofit organization. Any donations
      sent to support my work are tax-deductible to the fullest extent of
      the law. If anyone is so motivated they can click the donate button
      at the bottom of my newsletter page at


      (Full text of specific articles available by emailing

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      [77] Center for Infectious Disease Research and Policy. "WHO: flu
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      [82] "WHO warns of bird flu pandemic" BBC 23 February 2005.
      [83] Piller C. "Vietnam officials ban duck, goose farming to staunch
      bird flu." Los Angeles Times 5 February 2005.
      [84] Thaxton YV. "Are you Prepared for AI?" Poultry April/May 2005:5.
      [85] The Independent 17 March 2005.
      [86] Press Association 16 March 2005.
      [87] Daily Mail (London) 16 March 2005.
      [88] Price LB, et al. "Fluoroquinolone-Resistant Campylobacter
      Isolates from Conventional and Antibiotic-Free Chicken Products."
      Environmental Health Perspectives 113(2005):557-60.
      [89] Specter M and B Greenman. "Fighting the Flu." New Yorker Online.
      21 February 2005.


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      HEART FAILURE: Diary of a Third Year Medical Student
      (full text now available free): http://www.upalumni.org/medschool

      My new book:
      CARBOPHOBIA: The Scary Truth Behind America's Low Carb Craze

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