Healthy nutrition: say no to GMO's

Image: www.foodfightthedoc.com

Are you ready for a food fight?! Sorry to disappoint if scenes from Animal House are running through your mind, because it's not that kind of fight to which I'm referring. The GMO conflict is waging on and at the risk of sounding overly dramatic, the very essence of our food and our health is at stake. One ongoing battle front for concerned American consumers is the call for GM food labeling. Unlike most other industrialized countries, the US doesn't label GM foods (1).

Just what is a GMO? -
I've posted about GM foods in the past, but in case you missed those posts (found here and here), I'll just briefly explain that GMO or GM are acronyms for Genetically Modified Organism. You may also see GE used, and this stands for Genetically Engineered. GM foods are the result of  taking specific selected gene(s) from one kind of organism and placing them into a related or unrelated organism (2). According to the World Health Organization (WHO), GMO's contain genetic material that "has been altered in a way that does not occur naturally" (2). In other words, not "present in, or produced by nature" (8).

"It's not nice to fool mother nature" -
What's wrong with the good, old, conventional, natural methods of breeding our crops? Well, it's seems they're just too time consuming and not very accurate. Never mind that this is how nature works. Biotechnology now allows scientists to modify plants in a lab in order to enhance certain desirable traits for crops such as drought tolerance and pest and disease resistance. For example, scientists can take a gene from a bacterium that is resistant to an herbicide like Roundup and insert it into a soybean plant cell to create a Roundup resistant soybean (1). This is viewed as a major benefit to farming because now farmers are able to plant these Roundup resistant GM seeds, known as "Roundup ready" seeds, and then use Roundup to kill the weeds without harming the crops. Are you sensing a theme here? The company that patented the Roundup ready seeds also patented the Roundup.

Well, I'm sure it will come as no surprise to you to learn that there's more to the story, but that's for another post. For now, it might be helpful to know how The World Health Organization answers the question of why foods are being genetically modified. After all, they are looking out for the world's health.  Here's what they have to say: 

"GM foods are developed – and marketed – because there is some perceived advantage either to the producer or consumer of these foods. This is meant to translate into a product with a lower price, greater benefit (in terms of durability or nutritional value) or both." [emphasis added]

Hmmm... Let's briefly examine two of the reasons stated in the WHO statement for why GM foods are developed and marketed:

1. product with a lower price
2. product with a greater benefit (durability or nutritional value or both)

Is less expensive food of greater benefit nutritionally? -
A product with a lower price that has a greater benefit than a product with a higher price would be outstanding. I love a bargain, but I'm no economist. However, it's probably safe to say most of us would agree that getting something valuable for a lesser cost seems like a good thing. So, in an effort to make food cheaper and more abundant, cost effective and time efficient farming practices have evolved over the decades. GM crops are one result. Some advantages of GM foods are pest and disease resistance, herbicide as well as cold, heat and drought tolerance, and even greater nutritional benefit (3).  On the other hand, as a very wise biology professor once said, "for every yin, there's a yang", or put another way, for every benefit, there's a consequence.  


Admittedly, the modernization and industrialization of farming practices have brought prices down significantly on some foods. But ultimately at what cost? Consider that the top GM crops are corn and soy which go into many processed foods (9). In fact, "thousands of products on supermarket shelves are made with ingredients from genetically modified crops" (9).  For example, high fructose corn syrup or soy protein is used frequently in the manufacture of prepackaged convenience foods. Yes, the benefits of these foods are that they're cheap and convenient, but there are consequences as well.

A 2006 report from the USDA Economic Research Service revealed some interesting statistical trends on the percent of income American's spent on food over the last 70 years. In 1930, Americans spent 24.2% of their income on food, compared with 9.5% in 2004 (4). Slate has broken it down further by food eaten at home and compared the percentages by country 

Image from: Slate.com

(shown in the bar graph at right). The point being, Americans are paying a lower price for their food than at any other time in history and are also spending less than most countries. If, as WHO states, GMO's are being developed and marketed as products with a nutritional benefit, is the benefit being reflected in the public health? Are Americans healthier?


The fact is obesity rates in America are at the highest rates ever recorded and the diseases that correspond with being overweight/obese are increasing dramatically (5). You can check out the Center for Disease Control and Prevention's (CDC) interesting animated map here, that shows by state how obesity rates have increased since 1985. The map illustrates that during the past 20 years, "there has been a dramatic increase in obesity in the United States and rates remain high. In 2010, no state had a prevalence of obesity less than 20%. Thirty-six states had a prevalence of 25% or more and 12 of these states had a prevalence of 30% or more" (5).


Is the American penchant for inexpensive, fast, processed and prepackaged, GM foods coming with the unexpected cost of diminishing health and rising health care costs? According to the US Surgeon General, "Obesity is the fastest growing cause of disease and death in America" (6). "One out of every eight deaths in America is caused by an illness directly related to overweight and obesity" and this statement was made back in 2003 (6). Sadly, things haven't improved since then. Does the cheaper cost of GM foods balance out the health care costs of poor nutrition? According to the National Institutes on Health, "on average, people who are considered obese pay 42% more in health care costs than normal-weight individuals" (7). Is there really a lower price/increased nutritional benefit to GM foods?


GM food labeling-
Considering the above information, the critical factor in maximizing our potential for good health is good nutrition. This is only possible by having access to healthy foods and having the ability to make informed decisions about what foods we choose to eat. The fact that GM foods are not labeled in the US makes this impossible. Bearing in mind a 2008 survey, found here, which showed 87% of Americans polled felt labeling of GM food was necessary, it would seem that the US government would enact a GMO labeling policy.  This has been proposed, but unfortunately still not enacted and surely standing to benefit most from GM foods will continue to insist the labeling of GM foods is unnecessary. Considering the mounting research that shows evidence of harm from GMO's (10), it seems prudent to let our government officials know that we feel the labeling of our foods is highly important.

The following statement sums up succinctly the importance of making healthy food choices:

"Every day, several times a day, you make food choices that influence your body's health for better or worse.  Each day's choices are repeated over years and decades, the rewards or consequences become major. That being the case, paying close attention to good eating now can bring you health benefits later"  (5).

Tips to Avoid GMO's:
So, until GM food labeling becomes a reality, and this is a big question mark right now, you will have to do a little due diligence to avoid GMO's. You can limit your consumption of GMO's by making careful food choices. Here are a few suggestions for ways to avoid GM foods:

1. Steer clear of the top 4 at risk ingredients found in prepackaged, processed convenience foods - corn, soy, cottonseed and canola.
2. Try to buy organic foods when possible. 
3. Try to buy only grass fed meat or wild caught fish.  Feed fed cattle and farm raised fish are likely to be fed GM food.
4. Watch out for GM sugar beet sugar which is on the market now.

For more suggestions visit the True Food Shopper's Guide, which includes specific name brand non GMO foods to buy or GM foods to avoid. They even have an app available for your smart phone.  Lastly, please consider signing the petition found at the Institute for Responsible Technology. We need to let President Obama know that Americans want meaningful GM food labeling now, because the stance the US government seems to be taking to human consumption of GMO's is that they are innocent until proven guilty.  This principle may work for the justice system, but seems reckless when applied to our food supply, especially considering how absolutely crucial food is to our health and very survival.
 
Sources
(1) Wikipedia, Genetically modified organisms, Retrieved from http://en.wikipedia.org/wiki/Genetically_modified_organism August 2011

(2) World Health Organization, Food Safety retrieved from http://www.who.int/foodsafety/publications/biotech/20questions/en/ August 2011
(3) Whitman, D. B., Genetically Modified Foods: Harmful or Helpful? April 2000, Retrieved from http://www.csa.com/discoveryguides/gmfood/overview.php August 2011
(4) US Department of Agriculture Economic Research Service Retrieved from http://www.ilfb2.org/fff06/51.pdf August 2011
(5) Centers for Disease Control and Prevention (CDC), Retrieved from http://www.cdc.gov/obesity/data/animated_map_slides/map26.jpg August 2011
(6) US Surgeon General Statement
(7) US Department of Health & Human Services National Institutes of Health, WIN, Retrieved from http://www.win.niddk.nih.gov/statistics/index.htm#overweight August 2011
(8) Free Dictionary, natural, Retrieved from www.thefreedictionary.com/natural, August 2011
(9) True Food Now, Retrieved from  http://truefoodnow.org/shoppers-guide/ on August 2011
(10) Responsible Technology, The Campaign for healthier eating in America, Retrieved from http://www.responsibletechnology.org/docs/140.pdf August 2011

DCIS Diagnosis? At least get a second opinion.

Image via Wikipedia

When it comes to your health, YOU are your own best advocate. I recently found this out the hard way. In January of this year I went in for a routine mammogram that turned out to be anything but routine.  My doctor did a biopsy and sent it off to a pathologist. His diagnosis: ductal carcinoma in situ or DCIS.

What is DCIS? It's a type of early stage breast cancer located in the milk duct(s). In situ, I learned, is Latin for "in place". In the world of cancer this is a good thing because it means that the cancer cells are contained within the breast's milk duct, and haven't broken out and infiltrated to other areas. The Wikipedia image above illustrates the type, placement and progression of cells from normal to invasive breast cancer.

DCIS has become one of the most commonly diagnosed breast cancers.  It is also sometimes referred to as Stage Zero. To add to the confusion, some doctors don't consider DCIS cancer at all. Yet, the treatments for DCIS are typically the same as those for early stage invasive cancers. Most doctors I spoke with used the terminology ductal carcinoma in situ. Whatever it's called, when you hear you have cancer it rocks your world.

After my doctor called to report the pathology diagnosis of DCIS, I started thinking about how my life had been completely altered by one individual's assessment of my biopsy. It occurred to me that everything hinged on that pathology report. After the initial shock wore off, I found myself in a state of denial. However, in my case denial turned out to be a good thing because it motivated me to get a second opinion.

I'm fortunate to live near a university hospital and several large medical centers with expert physicians. Still, I decided to seek a second opinion from a pathologist outside of  my area. I learned that it's not uncommon for local patholgoists to support each others diagnoses.  As a result, it's important to get a second opinion from a pathologist who is at least associated with a different hospital. I chose the expertise of  Dr. Michael Lagios, an independent pathologist located in California who is experienced in the pathology of  DCIS. His diagnosis differed from that of the first pathologist. Now, I felt I needed a third opinion to break the stalemate so to speak.

My third opinion came from a group of doctors affiliated with a local hospital, but not from the same hospital as the first pathology report. They all agreed that mine was a tricky case, but that's where their agreement ended. They were split in their diagnoses.  My case was then presented to a tumor conference.  Ask your  doctor if they attend these sessions which are usually held monthly. At the very least, it is important that they are discussing your case with other experts. The consensus of the tumor conference was that they leaned more toward the second pathologist's opinion.

Needless to say, trying to get a diagnosis was a very frustrating, time consuming and emotional journey, but for me it was absolutely necessary! I realized that sometimes doctors really don't have all the answers. I was fortunate. My radiology oncologist, Dr. Mark A. Engleman, didn't scorn or dismiss me. He didn't diminish my need for a third opinion.  He supported me and encouraged me to be my own health advocate. He recognized the importance of getting the most precise diagnosis possible BEFORE he started radiation treatment. Not all doctors feel comfortable when put in this position. I can't say enough about his care and professionalism.

I'm still not sure I feel I've received an absolutely definitive diagnosis. One thing I do know for certain. When it comes to DCIS pathology there is sometimes a gray area. It isn't always a clear cut, black or white situation. Unfortunately in my case the uncertain diagnosis has made decision making about treatments more challenging. The up side is because I sought these additional expert opinions I feel I can make a more informed evaluation and decision regarding treatments. This approach worked for me. Having said that, I'm still working toward feeling okay with the uncertainty surrounding my diagnosis and the treatment decisions I made.

The Dallas Morning News ran a New York Times article this week that hit a nerve for me. Stephanie Saul's  article discusses the difficulties of diagnosing DCIS and she shares one woman's compelling journey from misdiagnosis to treatment in the video below. Sadly, the woman in the article lost a quarter of her breast and later learned she didn't have cancer. Perhaps if she had sought a second opinion, she might have been spared that trauma and loss. If I can share one thing I've learned from my experience it's this - when it comes to DCIS, or really any diagnosis, it's important to be your own health advocate and consider a second opinion.

 




Sources
http://www.wisegeek.com/what-is-a-pathologist.htm
http://www.wikipedia.com
 http://www.dcis.info/second-opinion.html

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Slash, Burn and Poison: Is this the only way?

After the shock, denial and numbness a woman often feels after receiving a diagnosis of breast cancer, comes the time to discuss treatment. To my surprise and dismay, I learned that the current treatment options for breast cancer are basically one-size-fits-all. Regardless of tumor size, grade or stage there are basically three ways to treat breast cancer. Dr. Susan Love calls these traditional treatments; slash, burn and poison. In other words surgery, radiation and chemotherapy.


Now, please don't get me wrong. It's wonderful that there are treatments! It's also a blessing that medicine has evolved beyond radical mastectomy, which was the primary treatment for breast cancer at one time. This procedure resulted in removal of the entire breast, pectoral muscles, fat and all lymph nodes under the arm. Now that's radical! Thankfully, researchers decided to test another treatment. Some extremely brave women participated in clinical trials that led to breast conserving surgery (lumpectomy), along with radiation becoming a viable breast cancer treatment.

Not too many years ago breast cancer wasn't openly discussed.  There were no pink ribbon campaigns and not much breast cancer awareness. Now, money for research is being generated that's resulting in ongoing breast cancer studies.  This has lead to new knowledge and a greater understanding of breast cancer. Yet, with all this progress the reality is that regardless of the stage, grade or size of an individual's breast cancer, for the most part treatment still centers around surgery, radiation and chemotherapy.

Why hasn't treatment of breast cancer evolved as quickly as one would hope based on the amount of research and resources? Well, one reason might be a result of the way doctors have traditionally approached cancer.  The conventional thinking is that cancer needs to be wiped out as completely as possible from the body. This is often accomplished at the expense of healthy cells.  Even though the understanding of cancer is evolving, many doctors still adhere to the kill the cancer at all costs mindset. Some health experts blame our litigious society. This creates a fear of malpractice lawsuits and drives doctors to treat cancer as aggressively as possible.

Perhaps another cause of the lack of change to breast cancer treatment stems from our health care system itself, which tends to reward more treatment, rather than health outcomes (Kaiser). At the risk of sounding paranoid, one more motive might be a result of corporate greed. The fact is companies spend billions of dollars in research, development, testing and acquiring of government approval for their treatments. According to Breast Cancer Action, this results in corporations influencing the way breast cancer is treated. This can happen in one of two ways. The company that made the treatment can provide biased information about their product directly to doctors, or the company can give money to influential organizations in an effort to financially persuade "the type of information the organization provides to people."   

One thing is evident. The research and treatment of cancer is itself becoming a big industry. With this thought in mind, there is a growing need for accountability and transparency with regard to how the health care industry, medical community and government agencies approach cancer policy and treatment. To begin with patients should have access to unbiased information in order to make informed treatment decisions. Regardless of the reason for the slow evolution of the treatment of breast cancer one fact still remains. There are many kinds of breast cancer and it should no longer be treated with a one-size-fits-all attitude, nor should the only options be the slash, burn and poison approach. What do you think? Is this really the only way?

Sources
http://www.cancer.gov/bcrisktool/
http://www.cedars-sinai.edu/Patients/Programs-and-Services/Breast-Center/Treatment-and-Procedure-Innovations/Surgical-Options.aspx
http://www.webmd.com/breast-cancer/breast-cancer-brca-gene-test
http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358
http://bcaction.org/index.php?page=cancer-policy-perspective