Imported candy at top of contaminated food list in California

Following a state law mandating testing, the California Department of Public Health (CDPH) issued more alerts for lead in candy than for the other top three sources of food-borne contamination combined, according to the first analysis of outcomes of the 2006 law by researchers at UC San Francisco and CDPH.

For many years, the state health department’s Food and Drug Branch has routinely prepared and disseminated health alerts to regional and county public health programs, practicing community clinicians, and the general public warning of potentially toxic food exposures. However, until the 2006 law mandated a surveillance program, the CDPH did not test widely for lead in candy. The new study shows that in the six years before the law went into effect, from 2001 to 2006, only 22 percent of the alerts about food contamination involved lead in candy. Once the program was implemented, however, 42 percent of the food contamination alerts issued by state health officials were for lead in candy, nearly all of it imported, which was more than the total for SalmonellaE. coli, and botulism, according to an analysis of alerts issued between 2001 and 2014. The study was published Oct. 26, 2017, in Environmental Health Perspectives.

Lead is a toxic heavy metal that can cause developmental delays, neurological damage, hearing loss, and other serious health problems in young children and adults. The study found that active community monitoring can identify lead in food products such as candy so they can be recalled before too many people have eaten them. Without such testing, health investigators must wait until after children have been poisoned to look for the sources, which is especially difficult when the source is as perishable as candy. “With this policy change identifying lead sources is more upstream and community-based,” said Margaret Handley, Ph.D., MPH, a professor of Epidemiology and Biostatistics at UCSF and the first author of the study. “By testing candy and issuing alerts when foods are found to be contaminated, we can identify and remove sources of lead before children become poisoned.”Image result for Imported candy at top of contaminated food list in California

As many as 10,000 California children under the age of six are poisoned by lead each year, and 1,000 of them are exposed to very high levels of the toxic metal. Most efforts to reduce exposure focus on the lead found in gasoline and industrially contaminated soil, as well as lead-based paint, which children take in when they eat paint chips or breathe in dust. However, after several high-profile poisoning cases, the California legislature passed a law requiring the state health department’s Food and Drug Branch to increase surveillance of lead in candy and to issue health alerts when levels are high. Over the 14-year study period, state public health officials issued 164 health alerts for food contamination. Of these, 60 were lead-related, and 55 of those were from imported food, mostly candy from Mexico (34 percent), China (24 percent) and India (20 percent). Two alerts were issued for imported foods that were not candy: One for a toasted grasshopper snack called chapuline, the other for spices.

To get an in-depth look at how well the testing program was working, the study analyzed data for the years 2011-2012 and found that state officials had tested 1,346 candies. Of these, 65 different products were found to contain lead, and 40 of those exceeded the federal limits for children (.10 parts per million). These candies came from a more diverse set of countries compared to the overall 2001 to 2014 samples; just over a third (35 percent) came from India. The others came from Taiwan (12 percent), China (11 percent), Mexico (9 percent), Pakistan (6 percent), Hong Kong (4 percent), the United Kingdom (3 percent), and one sample each from Germany, Indonesia, Thailand, Turkey, and Spain.

Since the candy testing program is not comprehensive, the researchers said the actual number of contaminated candies and other foods on the market could be even higher. “As more lead sources are identified we must develop prevention approaches for all of them, and not just replace one prevention approach with another,” Handley said. “If there is anything we have learned from the lead poisoning disaster in Flint, Michigan, it is not to oversimplify or cut corners when it comes to identifying and removing sources of lead poisoning.”

Adapted from: University of California – San Francisco. “Imported candy at top of contaminated food list in California: More health alerts issued for lead in candy than for Salmonella, E. coli or Botulism.” ScienceDaily. ScienceDaily, 26 October 2017. <www.sciencedaily.com/releases/2017/10/171026085753.htm>

Nutritional Nugget

Prepare for the after-school rush! Prep small containers of fruits and veggies the night before so kids can help themselves when they get home.

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Arita: A type of Japanese porcelain characterized by asymmetric decoration

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~Pema ChÖdrÖn

 

Individualized IBS diets reduce symptoms better than placebo

Individualized elimination diets guided by leukocyte activation tests reduced symptoms of irritable bowel syndrome (IBS) better than a sham diet in a randomized controlled trial.

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Researchers concluded that this dietary strategy may enable patients with IBS to alleviate their symptoms with fewer food restrictions than those required by the low FODMAP diet, which could improve long-term adherence. “We didn’t expect results like this,” Ather Ali, ND, MPH, MHS, assistant professor of pediatrics and of medicine at Yale School of Medicine, said in a press release. “The people who consumed the diet consistent with the test did significantly better than people on the sham diet.” In a parallel-group, double-blind trial, Ali and colleagues analyzed blood samples from 58 adults with IBS (mostly white women) using a leukocyte activation test to measure immune response to individual foods. Then they randomly assigned participants to adhere to a diet restricting meals consistent with the test results, or to a sham diet restricting foods inconsistent with the test results, for 4 weeks.

An average of 13 foods was eliminated among all participants out of a possible 200 that were tested, the most common of which included strawberries and cinnamon (low FODMAP foods) followed by almonds, apples, onions and pears (high FODMAP foods). Additionally, overall diet adherence rates were statistically comparable, and patients reported no adverse effects related to the intervention. Patients on the individualized diet showed significantly more significant increases in IBS Global Improvement Scale (GIS) scores compared with those on the sham diet, which served as the primary endpoint. At 4 weeks, the mean difference in scores between groups was 0.86 (95% CI, 0.05-1.67), and at 8 weeks it was 1.22 (95% CI, 0.22-2.22).

Both groups showed significant improvements in IBS Symptom Severity Scale scores, but those on the individualized diet showed significantly higher reductions relative to the sham diet. At 4 weeks, the mean difference in score change from baseline between groups was –61.78 (95% CI, –4.43 to –119.14), and at 8 weeks it was –66.42 (95% CI, –5.75 to –127.09). Both groups experienced statistically comparable changes in mean IBS Adequate Relief and quality of life scores. Further analysis of plasma samples from strong responders showed that reduced levels of a single protein (neutrophil elastase) were associated with reduced symptoms.

The investigators concluded that this study provides novel data supporting the strategy of using leukocyte activation testing to develop individualized diets for IBS. “If these intriguing results can be replicated in larger and more diverse samples they can provide insight into another way to treat a condition that can often be very frustrating,” Ali said in the press release. “It can be debilitating, and patients are often looking for dietary approaches to it.” – by Adam Leitenberger

Adapted fromAli AWeiss TRMcKee D, et al. Efficacy of individualized diets in patients with irritable bowel syndrome: a randomized controlled trial. 

Daily Nutrition Nugget

Eating healthy on a budget can seem difficult…But it can be done! Many fruits, vegetables, and legumes (beans and peas) cost less than $1 per serving.

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