romaine lettuce recalls

What’s Going On with Romaine Lettuce?

Nutrition, Preventative Health

Just in time for your holiday meals, one popular salad staple has landed—again—on the recall list. Our concierge family practice doctors in Jupiter are as curious as you are about the seemingly endless recalls of romaine lettuce, so we wanted to look into why this keeps happening:

 

We wondered: Is there something about romaine lettuce, in particular, that attracts the E. coli bacterium? As it turns out, there seem to be two factors implicated in the repeated outbreaks: the locations where it’s grown and the shape of its growth.

Unfortunately, despite the concerted efforts of federal, state, and local scientists, no one seems to have a definitive answer as to why this otherwise healthy and tasty vegetable has been causing so many problems recently. But researchers are getting closer.

 

Most recent outbreak

Symptoms of E. coli bacterial infection include stomach pain or non-bloody diarrhea that worsens over several days. It can take up to 10 days to begin feeling symptoms after consuming affected food, which is why outbreaks are so difficult to track down.

The infection is normally self-limiting, meaning the body fights it off with no complications other than feeling fairly miserable for a few days. But it can also lead to more severe complications, especially for infants and children under five, older adults, and those with compromised immune systems.

In the most recent outbreak last month, 67 incidents of food poisoning linked to romaine lettuce were reported across 19 states. On November 26th, the Centers for Disease Control and Prevention (CDC) warned consumers not to eat any romaine lettuce grown in the Salinas area. This includes any type of romaine lettuce, as well as pre-cut or premixed or packaged salads, spring mixes, and Caesar salad, or any sandwiches or wraps that might contain romaine lettuce.

Whether the label says “grown in Salinas” or doesn’t specify its origin, the CDC recommends discarding it. Romaine lettuce that has been grown in a greenhouse or hydroponically appears to be safe.

 

Possible causes

Nearly all romaine lettuce grown in the U.S. originates from two main areas: the Salinas Valley in California and the Imperial and Coachella valleys in Southern California and around Yuma, Arizona.

The affected lettuce has been found to be contaminated with a strain of E. coli known as O157:H7, which produces a type of toxin that can lead to severe gastrointestinal illness, as well as kidney failure, and possible death.

This particular strain is common in animals, including goats, deer, feral pigs, and especially cattle. Last year’s outbreak was attributed to contamination of surface water possibly used to irrigate and harvest the crop (with high-pressure water knives, which are used to cut the vegetables, as opposed by slicing them from the roots by hand).

Perhaps not surprisingly, many of the outbreaks have occurred within weeks of the time when nearby farming operations fertilize their fields. And the spring 2018 outbreak was tentatively linked to a nearby cattle factory farm, although no conclusive cause was proved. It would certainly make sense, however, if such a concentrated source of bovine fecal matter was so close, that the contamination could have migrated from that source.

The other problem with romaine lettuce is that it’s normally not cooked. Because of the large-scale way we produce our food, much of it is contaminated with such bacteria as E. coli and salmonella, which proper cooking methods destroy. But because romaine’s crinkled leaves grow in an elongated rosette shape, it’s difficult if not impossible to wash it sufficiently to remove all of the surface contamination.

 

What should you do?

The U.S. Food and Drug Administration (FDA) provides the following advice to minimize the chances of contamination.

Always practice safe food handling and preparation measures. Wash hands, utensils, and surfaces with hot, soapy water before and after handling food.

For refrigerators and other food preparation surfaces and food cutting utensils that may have come in contact with contaminated foods, it is very important to thoroughly clean these areas and items.

Consumers should follow these simple steps:

  • Wash the inside walls and shelves of the refrigerator, cutting boards, and countertops; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel.
  • Wash hands with warm water and soap for at least 20 seconds before and after handling food.
  • Wipe up spills in the refrigerator immediately and clean the refrigerator regularly.
  • Always wash hands with hot, soapy water following the cleaning and sanitization process.

If you think you have become ill from eating contaminated foods, be sure to talk to us. While food poisoning may result in nothing more than a few days of misery, it can also be dangerous. We can advise you on the best ways to recover.

Celery Juice: Refreshing Tonic Or Miracle Medicine?

Healthy Living, Nutrition

Our concierge family practice doctors at MD 2.0 in Jupiter have been receiving questions lately from some of our patients regarding the latest fad in “miracle cures,” celery juice. Touted on the Internet, in women’s magazines, and in a recent book as the answer to everything from diabetes to heart disease to heartburn, the benefits attributed to daily consumption of celery juice seem too good to be true.

So we thought we’d take a look at some of the claims for the efficacy of celery juice and see whether there’s any science behind it.

 

The claims

Celery juice, the so-called “miracle elixir,” is said to contain “previously unknown sodium cluster salts that actually neutralize pathogens secretly causing hundreds of symptoms and conditions.” The juice is also said to reduce inflammation throughout the body, which is known to trigger numerous health issues.

As a result, proponents claim, a daily glass of celery juice can lower blood pressure, reduce LDL (known as the “bad” cholesterol), ease arthritis, asthma, joint pain, and a host of other chronic illnesses, as well as promoting rapid and effortless weight loss and even curing some cancers.

 

The reality

Celery is a healthy vegetable, containing such vitamins and minerals as vitamins C and K, folate, calcium, potassium, and magnesium. And, like other vegetables, it is high in antioxidant polyphenols, known to reduce inflammation, boost the immune system, and neutralize free radicals which are responsible for cellular damage. But what about the “miracle elixir” claims?

First of all, nutritionists say there is no such thing as “sodium cluster salts.” Celery does, however, contain salt, and juicing the vegetable concentrates the amount of salt you get. The recommended intake of celery juice is 16 ounces in the morning, 30 minutes before breakfast. One bunch of celery, the amount needed to make 16 ounces of celery juice, contains approximately 800 mg. of sodium, The Washington Post reported recently.

“That’s more than you’ll get in two orders of french fries,” Charleston, S.C.-based registered dietitian Debbie Petitpain told The Post. Petitpain is a spokeswoman for the Academy of Nutrition and Dietetics.

Second, while inflammation can be a trigger for many serious and even deadly illnesses (see our recent blog, “Inflammation: The Silent Killer”) there’s no evidence that celery juice can reduce inflammation any better than numerous other fruits and vegetables, including beets, cabbage, parsley, or lettuce.

Finally, juicing any fruit or vegetable extracts some of the healthy fiber they contain. Fiber is not only filling, it helps maintain regularity, prevents the development of diverticulitis and hemorrhoids, and lowers cholesterol and blood glucose levels.

 

The conclusion

“There is no one ‘superfood’ that can meet all of our daily requirements,” Petitpain told The Post. “And in fact, research continually shows that the best nutrition comes from consuming a variety of food groups and various foods within each group.”

The popular book on celery juice also recommends, in addition to the morning drink, a diet high in fruits and vegetables, free of dairy, sugar, and processed foods. This alone would lead steady weight loss and better health overall, even without the juice.

There is no question that celery is high in many nutrients and antioxidants that can help alleviate many diseases. Unless you’re allergic to celery, as some people are, there’s no reason not to try it if you’re not on a low-salt diet.

But we believe that the most sensible eating plan is one that includes a wide range of fresh fruits, vegetables, low-fat meats and seafood, whole grains, legumes, and nuts. If you’d like more information on this or any related topic, be sure to contact us.

primary care jupiter fl

The Danger In Ultra-Processed Foods

Health Basics, Nutrition, Preventative Health

Sausages. Mayonnaise. Pizza. Potato chips. Bacon. Even whiskey, gin, and rum. All these foods and many more share two common traits: All were “processed” into their familiar form by humans, and all have been implicated in an increased risk for early death.

Our concierge primary doctors in Jupiter want to make you aware of the latest studies on the dangers of consuming these foods as the primary part of your diet.

The difference in these studies is that they don’t just address so-called “junk” foods like cookies and fast foods, but many of the items that all of us have in our kitchens and rely on as staples of our diet.

 

The studies

Published last month in the journal BMJ, one study followed more than 100,000 adults in France for five years. They found that those who ate the most processed foods were 23 percent more likely to experience a heart condition or stroke than those who consumed the lowest amounts.

The second study, also published in BMJ, tracked 20,000 Spanish adults over 20 years. Those who ate the most processed foods were 62 percent more likely to die during the study period than those who ate the lowest.

“High consumption” was defined as four or more servings of ultra-processed foods daily, with health risks rising 18 percent for each additional daily serving.

While researchers cautioned that correlation doesn’t prove causation, both studies controlled for such other possible risk factors as lifestyle, demographics, physical activity, weight, and overall health in drawing their conclusions. They also noted that their findings correspond to other earlier studies showing an association between highly processed foods and higher risks of obesity, high blood pressure, high cholesterol, and some cancers.

 

The cause

Researchers classified foods into roughly three categories:

  • “unprocessed or minimally processed” foods included fruits, vegetables, milk, eggs, legumes, meats, poultry, fish and seafood, yogurt, white rice and pasta, and natural juices;
  • “processed” foods included cheeses, breads, beer, wine, ham, and bacon;
  • “ultra-processed” foods included potato chips, pizza, cookies, chorizo, sausages, mayonnaise, chocolates and candies, artificially sweetened beverages, and whisky, gin, and rum.

 

They also created a separate category called “processed ingredients,” which included salt, sugar, honey, olive oil, butter, and lard.

The problem seems to stem from the processing, which changes foods from their natural state into something that will last longer on our shelves. These tend to be high in poor-quality fats, additional sugar, salt, and preservative chemicals, and low in vitamins and fiber. The common factor can be summed up in the phrase “convenience foods”; that is, foods that are quick and easy to prepare at home.

Dr. Andrew Freeman, a cardiologist who was not involved in the study, told CBS News, “I like to say: The longer the shelf life, the shorter your life.” Freeman directs cardiovascular prevention and wellness at National Jewish Health in Denver.

 

The solution

The takeaway in both these studies, as well as preceding ones is, the closer to a food’s natural state that you can eat, the better the effect on your overall health.

Freeman told CBS News that the most heart-healthy diet is one rich in whole foods, particularly plant-based foods like fruits and vegetables, legumes, whole grains, and nuts. He added that, for affordability and convenience, fresh-frozen vegetables were perfectly acceptable.

Simply switching from sodas to water is another good choice, as well as substituting fresh fruit for sweets. Options for quick snack foods include such treats as homemade sweet potato chips, and oven-“fried” vegetables like cauliflower and broccoli, as well as celery and carrot sticks cut up and stored in water.

If you have any questions about a healthy eating plan, please let us know. We can help you substitute a healthy diet for foods likely to negatively impact your health.

unhealthy food

Our Diets Are Killing Us

Concierge Medicine, Nutrition, Preventative Health

Question: What causes more deaths worldwide than smoking?

Answer: Food. And it’s not tainted food; it’s the unhealthy food we put on our plates every day.

Our concierge primary care doctors in Jupiter have told you many times about the importance of a healthy diet. Now a new study published this month in the journal Lancet warns that as a species, we don’t eat properly, and we’re paying for it.

“In many countries, poor diet now causes more deaths than tobacco smoking and high blood pressure,” Ashkan Afshin, lead study author, told CNN.

Afshin is an assistant professor at the Institute for Health Metrics Sciences at the University of Washington.

And it’s not just the bad things we eat—salt, red meat, sugar—that are contributing to premature deaths around the world; it’s the good things we don’t get enough of: fruits, vegetables, nuts and seeds, and so forth.

“Poor dietary habits . . . overall cause more deaths than any other risk factors globally,” Afshin told CBS News.

Dietary risk factors

The study took place over 27 years in 195 countries. Israel had the lowest number of diet-related deaths, followed by France, Spain, Japan, and the principality of Andorra. Uzbekistan had the highest, with the U.S. ranking 43rd out of 195.

The study results attributed one in five deaths (about 11 million people) annually around the world to the following dietary risk factors:

  • high sodium
  • low whole grains
  • low fruit
  • low nuts and seeds
  • low vegetables
  • low fiber
  • high trans fats
  • high sweetened beverages
  • low legumes
  • high red meat
  • high processed meat
  • low calcium
  • low milk
  • low omega-3s
  • low polyunsaturated fatty acids

Note: Omega-3 fatty acids are found in seafood. Polyunsaturated fatty acids are found in some nuts and seeds, salmon, and vegetable oils.

Healthy beats unhealthy

In their analysis of the 15 dietary factors, researchers found that the lack of healthy foods was worse than consumption of unhealthy foods. In other words, not eating fruits, vegetables and so forth was responsible for more deaths than eating red meat, processed foods, and the like.

As a result, Afshin recommended that policy makers should not just focus on what not to eat, but what to replace those foods with. The study estimated that three million deaths globally could be attributed to high sodium intake, but another three million were caused by lack of whole grains, with two million more caused by inadequate fruit intake.

They estimated that cardiovascular disease (CVD) was the leading cause of diet-related deaths around the world, followed by various cancers and diabetes, all of which were attributed to diet. Of course, other factors—including physical inactivity, environmental, economic, and social factors—contribute as well, according to Bruce Lee, associate professor of international health at Johns Hopkins Bloomberg School of Public Health.

“Diet can contribute to noncommunicable disease (NCDs) via increased body weight and obesity, elevated blood pressure, hyperlipidemia or high levels of fat in the blood, and conditions that lead to high blood sugar levels,” he told The Washington Post. Lee, who is also executive director of the Global Obesity Prevention Center, added that another problem is that “unhealthy foods such as those that are highly processed with artificial ingredients are often cheaper to make, store, ship, and prepare. Therefore, such foods have replaced more natural and healthy foods in foods systems around the world.”

Another factor is the profit motive.

“Refining grains is highly profitable,” Corinna Hawkes, director of the Centre for Food Policy at the University of London, told CNN. “Take corn, for example. You can refine it into different ingredients: animal feed, refined flours, and high-fructose corn syrup, to name three. So manufacturers are generating multiple value streams from this refining process.”

What you can do

As much as possible, try to adhere to a Mediterranean-style diet: abundant amounts of nuts, seeds, fresh fruits and vegetables, use of olive oil in cooking, moderate portions of fish and poultry, and little red meat.

Also beware of marketing claims that a product is “whole grain,” because often a whole grain has been stripped of one or more of its components: the bran, the germ, or the endosperm. Look for the stamp provided by the Whole Grains Council that certifies a product actually contains all three of these components.

And as always, check with us for any questions or concerns you may have about the food your family eats.

The Downside of Diet Soda

Nutrition, Preventative Health

Our concierge family practice doctors in Jupiter, applaud any effort by our patients to avoid, or at least reduce, their dietary intake of sugar whenever possible. But one of the solutions many people turn to instead may not be an improvement. Diet soda and other drinks replace sugar with the artificial sweetener aspartame, which seems to be implicated in several health issues associated with diet soda consumption as noted in several recent studies.

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new-years resolutions doctors

Easy New Year’s Resolutions for Your Health

Concierge Medicine, Health Basics, Healthy Living, Holiday Safety, Lifestyle, Nutrition

As humans, we look to a new year for a fresh start, especially regarding our health. Toward that end, we make resolutions, which we have every intention of keeping but which are often forgotten by February.

Our concierge doctors in Jupiter, Florida at MD2.0, would like to offer you some ideas on small ways to improve your overall health that we hope you’ll find easier to stick with.

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why am i bloated

What You Need To Know About Bloating

Healthy Living, Nutrition, Preventative Health

It’s one of the most common complaints your concierge doctors at MD 2.0 in Jupiter, Florida, hear from our patients: “Doctor, I’m so bloated.” 

But what does that really mean? Sometimes people use the term to describe gassiness or constipation, thinking “bloated” sounds more polite. But it can be confusing because, in addition to those two causes, there are many other reasons why a person can be experiencing a feeling of fullness or pressure in the abdomen.

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