How You Can Help Fight Superbugs

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“As soon as antibiotics were discovered and developed for medical use, bacteria began the Darwinian ‘arms race’ that has been fought ever since.”  So wrote Steve Heilig in the most recent Journal of the San Francisco Medical Society, where he is a director. Due to overuse of antibiotics, “antimicrobial resistance has reached a crisis stage in human medicine.”  You are doubtless aware that doctors should not prescribe antibiotics for viral infections (colds and flu) unless there is good evidence of an additional bacterial infection.  You may not know that 70 to 80 percent of all antibiotics produced by U.S. companies are used in farm animals.  These animals are often penned in crowded, dirty conditions; they are fed low doses of antibiotics to prevent infections and promote growth.  Bacteria are killed by the low doses used, but some develop mutations that make them immune to the drugs.  These bacteria are passed on to the farmers, their contacts, and the consumer.  Thorough cooking can destroy them, but beware of cutting boards, knives, your hands, and ‘rare’ burgers. 

In a 1976 study, small amounts of tetracycline were given to a flock of chickens by a researcher.  He found that the chickens began to carry bacteria resistant to tetracycline and other antibiotics.  So did the farmers who tended them.  Based on this kind of evidence, in 1977 the FDA announced plans to ban the feeding of low doses of antibiotics to livestock.  However, there was strong backpressure from legislators and agribusiness, and the FDA failed to act on its own recommendation.  The American Academy of Pediatrics, the Centers for Disease Control, the National Academy of Sciences, and the World Health Organization had identified subtherapeutic use of antibiotics as a human health issue.  More than 30 years later, in 2011, the FDA reacted when sued by the Natural Resources Defense Council and other groups.  It revoked its 1977 recommendation (never implemented) and said a ‘voluntary effort’ would be more effective.  There is no evidence that this has worked.  Currently there are over 90,000 deaths per year due to antibiotic resistance.  The Centers for Disease Control are alarmed.  We all should be.

You may have heard of a dreaded bacterium called MRSA – methicillin resistant Staphylococcus aureus, which is found in the community as well as in hospitals.  MRSA related deaths in the U.S. have risen to over 19,000 per year. from antibiotic resistant bacteria.  In Iowa, large pig farms where 2000 pigs are confined shoulder to shoulder, nearly half of these animals carry MRSA according to a 2009 study.  Almost half the workers there carry MRSA as well.

Here’s news close to home – an Iowa pig farmer who used routine antibiotics joined Niman Ranch’s pork collective; he stopped confining his animals and using antibiotics. He found he had the same results as Danish farmers who banned subtherapeutic antibiotics in 2000.  Pork production rose, and the incidence of resistant bacteria fell dramatically in people and animals. 

What can we do to protect ourselves, our children and the public?  There is a microbiologist in Congress, Louise Slaughter, a Democrat from New York.  Every year she introduces a bill called The Preservation of Antibiotics for Medical Treatment Act. We should make sure our congressman, Jared Huffman, supports this bill.  We should refuse to buy or eat meat, poultry, eggs or fish treated with antibiotics.  If it is labeled organic, this is a given. Otherwise, ask the butcher behind the counter. Trader Joe’s shoppers answered a poll by Consumer Union; 69% wanted the store to stop selling meat raised on antibiotics.  The store has hedged on this; although they do sell some antibiotic-free meats, they “do not presume to make choices” for their customers. Bring up this issue when you shop there. Whole Foods does not sell antibiotic-raised meats.  While these personal choices can make the meat you buy more expensive, eating less of it, and using it as a condiment/flavoring for vegetables is a wise move.  When you eat out, ask about the source of the meat, be sure it is not too rare, or go vegetarian.  There is no conclusive proof as yet that taking a daily probiotic pill, or eating yogurt with live cultures is helpful, but some studies point in that direction.  I think it’s a good idea. 

Sadja Greenwood, MD   back issues at sadjascolumns.blogspot.com

Go to Health: Exercise 2013



New research on exercise is reported in the August issue of Scientific American. You probably know that the ‘runner’s high’ (also felt after vigorous dancing, biking, and many sports) is caused by the brain’s release of endorphins (opioid-like hormones that evoke pleasurable feeling). Recently, research has also shown that exercise increases our ability to concentrate, think and make decisions. Exercise increases the size of a part of the brain called the hippocampus. The specific part of the hippocampus affected by exercise is one that allows people to remember familiar surroundings. Animal studies have shown that exercise increases the level of chemicals responsible for triggering the growth of new neurons. A molecule known as brain-derived neurotrophic factor is responsible. Newborn neurons are thought to help with distinguishing between similar but different events and things. Think about this – go for a hike; create new brain cells!






New research on how exercise prevents heart disease goes beyond the lowering of blood pressure, lowering LDL cholesterol (the ‘bad’ kind) and raising HDL choesterol (the ‘good’ kind). The more important LDL related effect is that exercise increases the number of larger, safer, LDL particles and decreases the number of small, dangerous ones. A couch potato might have an identical cholesterol level as an active person, but be more at risk for heart attack because of the predominance of small LDL molecules.






Exercise is a key to keeping blood sugar normal. As you use your muscles, they need increasing amounts of glucose to fuel their efforts. The liver sends out more glucose and the pancreas releases insulin - to signal cells to draw glucose from the blood. As exercise becomes a daily habit, muscles grow more sensitive to the effects of insulin, so lower levels will accomplish the same result, and the pancreas does not have to work as hard to keep glucose levels normal. This is particularly helpful for people with type 2 diabetes, whose bodies have often become resistant to insulin. Recent studies show that combining aerobic exercise (like brisk walking) with resistance training (weights, leg presses, et al) is the best for keeping blood glucose normal.






We know that we should be exercising, but many Americans fail to achieve the recommended half an hour of moderate activity for five or more days a week. However, a recent analysis of six studies, totaling 655,000 adults tracked for about 10 years, found that people doing leisurely activities like washing the car or taking a stroll for 11 minutes a day had a 1.8-year longer life expectancy after age 40 than inactive people. Those who met the guidelines for moderate activity gained 3.4 years of life, and those who were active between 60 and 90 minutes a day had greater gains – 4.2 years. It seems that we evolved as creatures who moved – think about walking out of Africa to populate the rest of the world. If you find it hard to begin, get a dog. Then you’ll have to walk, and she’ll always love you.






Sadja Greenwood past issues at sadjascolumns.blogspot.com

Go To Health: Human Papilloma Virus and Its Consequences


Cervical cancer, detected by regular Pap smears before it becomes serious, is caused by a sexually transmitted virus. Nuns and lesbians don’t get cervical cancer if they never have intercourse with men. Condoms offer some protection. Were you ever told this when you (or your partner) went for a Pap test? These facts were ignored for years by the medical profession and popular culture – perhaps because of the discomfort people feel about discussing the nitty-gritty of sex, perhaps because of ignorance. The papilloma virus (HPV) that causes cervical cancer can also cause cancers of the vagina, vulva, penis, anus and throat. Cervical cancer is the most common of these problems, but the number of throat cancers from HPV are now on the rise. The actor Michael Douglas made headlines recently when he told a British newspaper that his throat cancer had come from performing oral sex.






Cancers of the base of the tongue, tonsils and walls of the pharynx are becoming more common. A decade ago, people with head and neck cancers were smokers or heavy drinkers. Now only 20% are smokers or drinkers, and the other 80% have cancers caused by an HPV infection. This year an estimated 14,000 people in the US will be diagnosed with head and neck cancers; most of them will be between 40 and 50 years old, and 3 out of 4 will be men, according to Dr. Robert Haddad of the Dana Farber Cancer Institute. Haddad talks about ‘an epidemic’ of HPV–related head and neck cancers. If oral sex is a factor, the predominance of men may be because vaginal fluid has more virus than the surface of the penis.






There are two vaccines available against HPV infection – Gardisil and Cervarix. These vaccines protect against many of the some 100 strains of HPV, including the high risk strains HPV-16 and 18 which are a known cause of cervical, throat, anal and vaginal cancers. A study supported by the National Cancer Institute has just been published which showed that sexually active young women in Costa Rica had 93% protection against infection with HPV types 16 and 18, after receiving immunization with Cervarix.. Although the study did not include men, it is believed that they would get the same protection with this vaccine.






The Gardisil vaccine was approved by the FDA and the CDC (Centers for Disease Control) for girls ages 9-26 in 2009, and for boys in 2011. Cervarix has also received FDA approval, and may be even more effective. The vaccine is given by 3 injections over 6-12 months. There has been controversy about these vaccines because of reports of serious reactions after injection, but careful studies by the CDC do not show that these reports are valid. Most side effects consist of pain, redness, and swelling at the injection site, and occasional fainting, fatigue, headache, muscle pain, gastrointestinal symptoms, and joint pain.






Women are advised to continue having Pap tests for cervical cancer even after vaccination, as the vaccines are not effective against all strains of HPV. Men and women should know they should not ignore difficulty swallowing or feeling/seeing a lump in the throat or on a tonsil. Seek medical attention promptly if this occurs. Sexually active people should also be aware of many other types of sexually transmitted disease, including HIV/AIDS, syphilis, gonorrhea (rapidly becoming drug resistant), Chlamydia, Herpes et al. Condoms are very helpful but not foolproof for prevention. The birth control pill and IUD are highly effective against pregnancy but do nothing to prevent STDs.. Have you ever wondered why sex scenes in movies and television never involve a discussion of these potential problems? Is it still that controversial? We have calorie counts on some menus, and dire (small print) warning on cigarettes. But nothing is said about sex. Young women in college are initiating hook-ups without emotional involvement so they won’t get derailed from their independent careers. The recent NYTimes article (7/12/13) about this did not mention STDs or birth control. Go figure.






Sadja Greenwood, MD, MPH -->

Just Label It

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Last November the California campaign to label genetically modified organisms (GMOs) was defeated by a 51 to 48 percent vote.  Many large companies and the Grocery Manufacturers Association put $46 million into fighting the proposition. $9.2 million was spent in support. Some people who buy brands like Cascadian Farm, Kashi, Horizon Organic, Muir Glen, and Odwalla were outraged last fall after learning the companies’ corporate owners helped fund the effort to defeat Prop 37. However, efforts to label GMOs in food are still underway.  Connecticut and Maine have passed labeling bills which will kick in when other states, including a neighboring state, pass similar laws.  Whole Foods markets will require GMO labeling on any product it stocks by 2018. The U.S. Department of Agriculture for the first time approved a non-GMO label claim for meat products, Chipotle began voluntarily labeling menu items containing GMO ingredients online, and the Senate Appropriations Committee voted last week to give the U.S. Food and Drug Administration funding to label genetically modified salmon if the agency approves the fish.

GMO cotton, soybeans, canola and corn are modified to make them resistant to the herbicide glyphosate –otherwise known as Roundup, so that weeds could be killed without harming the crop.  Most sugar beets are also genetically modified, although the final product is identical to the sugar from ordinary sugar beets.  Unless it is labeled organic, almost all cotton, canola, soy and corn grown in the US today is GMO.  The problem that has emerged is that weeds are becoming resistant to Roundup.  More must be used, along with other herbicides.   According to ScienceDaily, a website I respect, the annual increase in herbicides required to deal with tougher-to-control weeds on cropland planted to GE cultivars has grown from 1.5 million pounds in 1999 to about 90 million pounds in 2011.   Initially, Roundup was considered a safe herbicide with short duration of action.  However, a recent study from an Environmental Toxicology Program in Thailand, published in Food Chemistry Toxicology, indicates that Roundup may be an endocrine disruptor, inducing human breast cancer cells to grow by effecting estrogen receptors. 

Another problem with GMO crops is the effect on adjacent farmers and organic farms.  Pollen drift is a problem for farmers who plant non-GMO or organic crops.  Farmers using GMO seeds are required by Monsanto and other companies to buy fresh seed every year.  When GMO pollen blows into adjacent fields, and is harvested, the farmers can be sued for patent infringement.  In one high-profile case (Monsanto Canada Inc. v. Schmeiser) the Monsanto Company sued Percy Schmeiser for patent infringement after he replanted canola seed that he had harvested from his field, which he discovered was contaminated with Monsanto's patented glyphosate-tolerant canola. The Supreme Court of Canada ruled that Schmeiser was in violation of Monsanto's patent because he knowingly replanted the resistant seed that he had harvested, but he was not required to pay Monsanto damages since he did not benefit financially from its presence. In 2008, Schmeiser and Monsanto Canada came to an out-of-court settlement whereby Monsanto would pay for the clean-up costs of the contamination, which came to a total of $660. In May of this year, the US Supreme Court ruled unanimously that an Indiana farmer had violated Monsanto’s patent laws by saving Monsanto seed and replanting it.  He was fined $84,000. On the other hand, a few weeks ago a three-judge panel at the Court of Appeals for the Federal Circuit has ruled that a group of organic and otherwise non-GMO farmer and seed company plaintiffs are not entitled to bring a lawsuit to protect themselves from Monsanto’s transgenic seed patents “because Monsanto has made binding assurances that it will not ‘take legal action against growers whose crops might inadvertently contain traces of Monsanto biotech genes (because, for example, some transgenic seed or pollen blew onto the grower’s land).

Farmers have saved seeds since the beginning of agriculture, and have thus been able to select the best plants for changing conditions, such as drought, heat, cold, etc.  The conflict between traditional practices and patented GMO seed goes on in many parts of the world today – an unfinished story. More food will be needed to feed a world population growing upwards from 7 billion.  Are GMO crops necessary?     Stay tuned, and I will try to address this question.

Sadja Greenwood, MD    back issues on this blog

World Food - from Surplus to Scarcity

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In a recent column I explored the question of labeling genetically modified (GM) crops and discussed the problem of superweeds resistant to ‘Roundup’ and pollen drift from GM fields to adjacent non-GM fields.  I decided to devote this column to the question of whether GM crops are needed to feed a growing world population.  What I found is that while there is controversy about this issue, GM soybeans, corn, cotton and other crops are widely used throughout the world. 

GM cotton has been planted in India and China, with a gene for BT (Bacillus thuringiensis) inserted to serve as insecticide.  Initially successful, it has given rise to resistant pests that have also attacked other food crops.  Farmers also complain that GM seed is 3-8 times more expensive than ordinary seed.

 GM soybeans are widely planted in the US, Brazil, Argentina and China, and are mainly used as feed for cattle, swine and chickens. Without this crop, Europe would have to cut back on meat, dairy and egg production.   Soybean production in Brazil, used for  biodiesel and animal feed, is resulting cutting of the Amazon rainforest. 

Corn originated in Mexico, which is the home for hundreds of varieties.  Mexican framers fear that widespread planting of GM corn will lead to contamination of native varieties.   Mexico has legalized GM corn planting, but the issue is extremely controversial.  88% of U.S. corn is GM.

Golden rice, genetically modified to contain carotenes that will help with Vitamin A deficiency, has been planned for years and is now being tested in the Philippines, India and Taiwan.  Funding has come from the Bill and Melinda Gates Foundation to increase the bioavailability of  pro-vitamin A, vitamin E, iron and zinc in

golden rice, thereby preventing blindness and malnutrition in children in India, the Philippines and many African countries.  Companies that have developed golden rice have said that they will allow farmers to save and replant seed, and will not charge royalties until a farmer makes more than $10,000 year from golden rice.  Greenpeace and Dr. Vandana Shiva, the Indian anti-GMO activist, oppose the introduction of golden rice because of corporate control of agriculture, loss of biodiversity, and ignoring other important sources of carotenes such as green vegetables and fruits. 

On the one hand, GM crops for basic foods like corn, soy and canola are widely planted and used throughout the world. They have been successful in increasing supplies of animal feed and human food.  On the other hand, they have degraded the environment and resulted in resistant pests and weeds.  But these arguments pro and con are dwarfed by the larger reality of the world’s growing population and a transition from food surpluses to food and water scarcity in many parts of the world. There is serious aquifer depletion in China, India and the U.S., countries that produce half the world’s grain.  Food prices are rising and will continue to rise, according to Lester Brown of the Earth Policy Institute.  Brown’s latest book, Full Planet, Empty Plates, takes a serious look food & water scarcity and is a call to action. He calls for cutting carbon emissions by 80% by 2020, emphasizing wind and solar energy.  Brown is also strong on the need for worldwide family planning and the education of women.  The failure to take family planning seriously in most discussions of food and water scarcity, megacities and relentless population growth is troubling.  Wherever it has been introduced widely, on a voluntary basis, there has been a significant drop in birth rates.  South Korea and Taiwan have reduced their birth rates below replacement, and Thailand has also been successful with their program. Meeting women’s wishes for fewer children with modern contraceptives in South Asia and Africa could be tremendously helpful, but providing information and supplies, and overcoming cultural obstacles is a huge task.  An estimated 222 million women in developing countries do not want another pregnancy but lack access to contraception.  Many organizations are working on this, and deserve support. Obama is calling for increased funds for international family planning - $635.4 million.  In the Bill and Melinda Gates Foundation.  Melinda Gates is making family planning/contraception her priority for the next decade.  I should write another column on the many organizations that work on this issue.  If the environment is your issue, take a look at The Center for Biological Diversity, which links work to prevent extinction of wild animals and plants.  I appreciate the fact that they have an endangered species condom project, thereby linking human population growth with species extinction and climate change.  The Sierra Club has yet to take a strong stand on population growth nationally.  Stay tuned.

Eating on the Wild Side

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 Eating on the Wild Side

Jo Robinson, a health writer and food activist, has just published Eating on the Wild Side, a book that is loaded with new and interesting ideas.  I strongly suggest that you buy it!  Here are a few ideas from early chapters.  The fruits and vegetables we grow, buy and eat today have been made more palatable than their wild ancestors by centuries of plant breeding.  This does not mean genetic modification, but rather careful selection of varieties of each plant that are large, sweeter, less bitter and easier to chew and digest.  However, we have lost many of the important plant nutrients in this process. Industrial farming has taken the process further, and has resulted in loss of flavor.   Robinson suggests many ways to find, store and cook foods to optimize their taste and nutritional value.  

Here is what she says about lettuce.  The most intensely colored leaves have the most plant nutrients – so look for lettuce that is red, purple or reddish brown rather than all green.  The arrangement of leaves on the stem is also important – there are fewer plant nutrients in tightly packed leaves as in iceberg lettuce or even romaine than in looseleaf varieties.  Leaves need sunlight, but when they are more exposed to the sun, as in looseleaf lettuces, they must make more anti-oxidants to protect themselves against  UV light.  We absorb these compounds, which make up part of our own self-defense against disease.  Buy the freshest lettuces you can – packaged salad greens have been longer in transit than a heavy head of looseleaf lettuce with crisp leaves.  If you do buy packaged greens, look for ones that contain a mixture of dark greens that include some spicy ones, such as arugula, mustard greens or radicchio, and look for the most distant “use by” date.  When you get your salad greens home, Robinson suggests that you tear off the leaves, rinse them, and soak them for 10 minutes in very cold water. This will lower their temperature and slow the aging process. Dry them with a towel or salad spinner.  Then tear the leaves into smaller pieces – she says that this will double their antioxidant value.  The plant reacts as if it was being gnawed by a predator and produces a burst of nutrients to ward off the intruding insect.  You should eat the leaves within a day or two after tearing them.  If this seems like a lot of work, here is a final suggestion that sounds easy.  To store lettuce and other greens in the refrigerator, put them in a plastic bag, squeeze out the air and seal the bag; then use a needle or pin to prick the bag with 10-20 evenly spaced holes.  Put the bag in the crisper section of your fridge.  The tiny pinpricks will provide the most ideal level of humidity in the bag and enable the leaves to consume oxygen and give off carbon dioxide.  The leaves will stay alive, and fresher, for a longer time.  Mark these bags, so you can reuse them later.  Robinson likes to use this storage technique of microperforated bags for many fruits and vegetables.

Arugula, a member of the cabbage family, is exceptionally high in plant nutrients, and should be a regular ingredient in salads.  Look for younger plants with shorter leaves if you find it too peppery.  Use arugula as a spinach substitute in stirfry dishes.  Robinson warns that the healthful, anti-cancer properties of arugula can be lost into the water if the leaves are boiled.  In subsequent columns I will write about what Robinson says about artichokes, asparagus and tomatoes.  I’ll close by telling you that she recommends the smallest tomatoes you can find for both flavor and lycopene content.  Apparently there is a new tiny tomato called the currant tomato that is close to the earliest tomatoes found in the Andes, and a real winner. 

Sadja Greenwood, MD, MPH

Olive Oil and Your Brain, and a New View on Produce






Olive oil is known to have protective effects on bone, heart disease and breast cancer risk. Its use in the Mediterranean diet has been associated with a 30% lower risk of death from heart attacks and stroke in a recent Spanish study. Here’s more!






In 2009, Researchers at Columbia University in New York found that elderly people who were physically active and ate a Mediterranean diet, had a 32-40% lower incidence of Alzheimer’s disease (AD) compared with those who did not. The Mediterranean diet was defined as including a high consumption of vegetables, fruits, legumes, grains and fish, and a lower use of red meat. About 50 milliliters of olive oil (roughly 1/5th cup per day) is consumed.






Research into the lower amounts of dementia on this diet has found a compound in extra virgin olive oil called oleocanthal. Amal Kaddoumi and her colleagues at the University of Louisiana looked at whether oleocanthal helped to decrease the accumulation of beta-amyloid in the brain, as this substance is believed to be the culprit in AD. They applied different concentrations of oleocanthal to mouse brain cell cultures, and also gave oleocanthal to live mice. In both trials, levels of the two proteins that transport beta-amyloid out of the brain as well as enzymes that degrade beta-amyloid increased significantly. The researchers then introduced beta-amyloid into live mice brains. Compared with control groups, the mice given oleocanthal showed significantly enhanced clearance and degradation of the beta-amyloid peptides.






This study has exciting implications for the prevention of AD. While pharmacologists are figuring out how to make a medicine from oleocanthal, you can use extra-virgin olive oil as your main source of fat. Investigate how to make an oliveoil/herb spread for your bread. It is important to note that being physically active and eating a lot of fresh produce is also important to keep your brain healthy.






Breeding the Nutrition out of Food: Jo Robinson, an investigative reporter, has just published a book called Eating on the Wild Side. She notes that over the last 10,000 years since we stopped foraging for wild plants and instituted farming and gardening, we have selected the least bitter plants to grow in our gardens. While this has made some foods tastier, it has decreased their phytonutrients. Robinson is not talking about genetic engineering, but conventional selective plant breeding which has gone on for millennia but has recently accelerated. She notes that purple Peruvian potatoes have vastly more nutrients than the white potato, and blue corn is greatly superior to white corn, even though white corn is sweeter and more popular. I will write more about her findings when I get her book. In the meantime, she suggests arugula, which is very similar to its wild ancestor, and scallions, which resemble wild onions. She suggests using plentiful amounts of fresh herbs in cooking. Rebecca Katz, author of The Cancer Fighting Kitchen and The Longevity Kitchen, also promotes the use of herbs as ingredients in many dishes, including salads. Don’t overlook those amazing deep purple Japanese sweet potatoes if you can find them. Go for color, and spiciness; you will be on the right track.


Sadja Greenwood, MD, MPH -->

Umami – The Fifth Taste
















Why are Claire Heart’s soups at the Bolinas People’s Store so delicious? It’s partly the mystery of a great cook, but another reason is that she uses fresh organic ingredients, and makes sure that all the tastes on our taste buds are stimulated. (Maybe with the exclusion of bitter, although people who like coffee and beer, or flavor foods with citrus peel, are enjoying the mild taste of bitter.) We have taste buds on the tip of our tongues, where you can actually see them as tiny bumps; they are also located all over the tongue, the mouth and the throat. Each taste bud has receptor cells for sweetness, sourness, saltiness, bitterness and umami. Umami taste is described as savory and brothy. Except for the bitter taste, great cooks like Claire add just the right amount of each flavor. Coconut milk often adds to the mixture, giving a wonderful fragrance and the smooth mouth feel of fat. Flavors beyond the basic five are detected by our sense of smell.



















Umami is a transliteration of the Japanese word for a pleasant, savory taste. The receptors for umami are not the same as those for salt – umami receptors on the tongue respond to the amino acid L-glutamate. To get a first hand experience, chew a very ripe tomato (try a sun-dried one at this time of year), taste the flavor carefully, and feel the sensation in your mouth and cheeks. You’ll taste sweet and sour, and also umami.



















Here’s a bit of biochemistry: glutamate is the most abundant excitatory neurotransmitter in the human nervous system. It is involved with learning and memory. When sensitive people ingest too much glutamate, in the form of MSG (monosodium glutamate), they can develop headache, tightness in the face and jaw, heart irregularities, and even seizures. Most restaurants stopped using MSG in the 1990’s because of publicity about these problems, and customer complaints; they were adding it to food because it enhanced the taste so much.



















Umami found in natural foods will enhance taste but will not cause harm.







Most humans’ first taste of umami comes in mother’s milk; we learn to like it early! Foods high in the umami taste include kombu, nori, fish and shellfish, mushrooms, ripe tomatoes, green tea, soy beans, sweet potatoes, Chinese cabbage, carrots, and cheeses. Using these foods to enhance your home-made meals will bring you pleasure and good health. Eat cheese sparingly for flavor – it is high in saturated fat and salt.



















The FDA has stated that MSG is ‘Generally Recognized As Safe’, but requires that the words ‘monosodium glutamate ‘ be written on the label if it has been added to the food. However, there is a significant amount of controversy about other additives found in processed foods and fast food restaurants. These additives contain free glutamic acid but are not MSG; hydrolyzed vegetable protein, hydrolyzed soy protein, yeast extract and autolyzed yeast are examples. They impart an umami flavor to food. It is difficult to know if there is a valid concern about eating small amounts of these substances. However, the more we know about the way packaged and processed foods are designed to increase your wish to overeat them, the less desirable they seem. Too much fat, sugar, salt are causing health problems that are easily avoided by the thoughtful eater.



















Eden Foods: Here’s a sad and controversial new development. Eden







Foods is suing the Obama Administration over its mandate to cover birth control under the Affordable Care Act. Michael Potter, the company’s owner and CEO, claims that his religious beliefs are being violated by requiring him to pay for healthcare services, including contraception. You may know that Eden Foods is a pioneer in using cans that are free of Bisphenol A, and has many excellent organic products. The lawsuit has caused a good deal of controversy among groups supportive of reproductive rights. Some are choosing to boycott Eden products. Stay tuned.







Sadja Greenwood, MD, MPH

Go to Health: Protect Your GI Tract!






There has been a lot of ‘stomach flu’ in our community this year – actually it is not flu, and is not caused by the influenza virus, which affects the respiratory system. We can call it gastrointestinal disease (the GIs) indicating that it affects the stomach and intestines. The most common cause of the GIs is the norovirus – a group of viruses that cause inflammation of the stomach and large intestine, leading to nausea, vomiting, diarrhea, stomach cramps, low grade fever, headache, muscle aches and fatigue. There is no specific treatment for this disease, but it is vital not to become dehydrated; if you are affected, drink water, diluted fruit juice, and clear soup with some salt or miso. You should recover in 3-4 days, but some cases have lasted longer. Babies and young children can get dehydrated fast – so contact your doctor immediately if your child has serious vomiting and diarrhea. People who are frail or have weakened immune systems should also see their doctor promptly. Prevention of norovirus infection includes avoiding people with the GIs – this virus is highly contagious from handshakes, air droplets, surfaces and food. Wash raw fruits and vegetables carefully. Although the virus is not always destroyed by heat, you should still cook food carefully and completely, and definitely stay away from raw oysters and ceviche if you are determined to avoid getting sick.






Bacterial contamination of food is another serious source of GIs, with resistance to antibiotics a growing problem. Three quarters of antibiotics used in the U.S. are given to animals, not people. They are given to sick animals, and to prevent healthy animals from becoming sick. Antibiotics are also given routinely, to stimulate growth, since animals given low doses of antibiotics grow more quickly on the same amount of food. However, bacteria in the intestines of these animals become resistant to antibiotics, and are excreted in waste. Entering water and soil, they are found on fish, fruits and vegetables. They colonize the GI tracts and skin of farm workers and food processors. They are found in animal meat. They spread to the human population, who may develop antibiotic-resistant infections.






The FDA, the CDC (Centers for Disease Control), and state public-health labs monitor chicken, ground beef and turkey, and pork chops at retail stores nationwide. The percentage of chicken contaminated with salmonella rose to 12% in 2011. More than a quarter of infected samples were resistant to at least five samples of antibiotics.






Here is what you can do: have thoroughly cooked meat and fish when eating out. Forget about medium rare hamburgers unless you are certain the meat is organic. Wash raw vegetables carefully before eating, and know where they were grown, to avoid contamination from nearby factory farming of animals. Avoid fast food restaurants with the exception of Chipotle Mexican Grill, which says it never sells meat from animals treated with antibiotics. Whole Foods makes the same pledge. Niman Ranch, Marin Sun Farms, Applegate organics, Rocky and Rosie chicken and some other companies are also antibiotic free. Organic poultry and meat is less likely to harbor resistant bacteria as organic standards ban meat and fish given antibiotics.






Elderly people in nursing homes are especially vulnerable to illness from antibiotic resistant bacteria. They can benefit – and people of all ages can benefit – from a daily dose of probiotic bacteria. These are healthy bacteria that will colonize your intestines with good organisms which help to fight off the resistant bacteria. Unsweetened yogurt with live cultures can help, but even more beneficial bacteria are found in probiotic capsules, which should be kept refrigerated. We have 3 or more pounds of bacteria in our colons, helping us by digesting fiber and creating important vitamins such as vitamin K and B12. They thrive on the residues of vegetables and fruits, with lots of fiber. These bacteria, and those on our skin, mouth, nose and ears, are called the microbiome. Take care of your microbiome, people!


Sadja Greenwood, MD , MPH

Cold Chain Problem for Vaccines - Silk Worms can Help!

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The elimination of serious infectious diseases such as small pox and polio requires immense international collaborative effort. The World Health Organization, UNICEF, the Rotary Foundation, the Bill and Melinda Gates Foundation and many other groups are currently working on a number of infectious diseases, such as polio, tuberculosis, HIV/AIDS and diarrheal diseases.   Small pox was successfully eradicated in 1977, a momentous victory that required decades of work.   For polio and other serious infectious diseases, problems in poor countries include wars, lack of basic health infrastructure, lack of roads and electricity, ignorance and suspicion of the West, and anger stemming from the purported misuse of a Hepatitis B immunization program in Abbottabad to obtain DNA samples from suspected relatives of Osama bin Laden.  Workers bravely carrying out immunization campaigns in Pakistan, despite a fatwa from Islamist groups prohibiting vaccination, were killed in December 2012, and again January of 2013. Nine workers giving polio vaccine were killed in Nigeria in February, 2013.  Nigeria, Pakistan and Afghanistan are the only countries still reporting cases of polio. In resource-poor countries infectious diseases make up more than half of all deaths, and those who most need effective vaccines and antibiotics may not get them.  Measles is a leading killer of children worldwide, and can be prevented by vaccine, when and if it is available.

One of the problems with vaccination campaigns is the need to keep vaccines cold, when transporting them in hot areas which lack refrigeration and electricity. High temperatures are found to destroy almost half of the vaccines produced around the world.  Polio vaccine must be kept at 35 to 46 degrees F for vaccination to be successful.  Antibiotics and other medications also need to be protected from heat. According to the World Health Organization (WHO), as recently as 2008, almost half of all vaccines delivered to developing countries were ruined due to poor cold chain services. Further, cold chain “breaks” lead to ineffective vaccines being administered with a consequent loss of life and lack of vaccine compliance.

  Researchers at Tufts University have found that vaccines and other drugs can be stabilized in silk protein made from silkworm cocoons, enabling them to withstand temperatures as high as 140 degrees F for over 6 months.  They start with silkworm cocoons, boil them with sodium carbonate to separate a protein called fibroin, mix this with salt, then mix it with the substance to be preserved (the vaccine, or drug) and spread the result out as films, then freeze-dry it.  The films contain a fibroin matrix filled with tiny pockets that contain the medicine.  They are surprisingly stable for up to six months, regardless of temperature.  Silk protein is acceptable to the human body, used in wound closure, and may even have wound healing properties that are under investigation.  It can be taken orally without problems. Ultimately, substances made from silk may be used to replace a vein or a bone in the human body.  Tufts researchers note that silk protein can be used as packaging, for food and other products, thereby eliminating some of the problems of plastic use and disposal.

A team of four students from Harvard started a company, Vaxess Technologies, that is producing the new products, vaccines and medications, incorporated in silk fibroin.  In cooperation with the Tufts professors who developed the new silk technology, Vaxess hopes to have a product that will solve the cold-chain problem within a few years.  You can watch interesting videos on the new silk technologies presented by David Kaplan and Fiorenzo Omenetto (professors at Tufts) on TED or youtube.

Sadja Greenwood, MD, MPH   See other columns on this blog