It's Passover, a time when Jews think more about their food than we usually do, which is a lot. I was raised in a kosher home where we had four sets of dishes, meat and milk each for chametz and Passover. Every year, cupboards were lined, closets were closed, and the house was prepared for Passover. My mother was not obsessive, even allowing my brother and I to eat Easter dinner once at the home of a close friend; I only partially expected lightning to strike when I ate something breaded.
The title of this entry is a pun, because quinoa is pronounced "Kin Wa". That's appropriate because in Hebrew the word for Passover is also a pun, meaning both "pass over" and "lamb", denoting the sign of the lamb on the doorposts of the Jews designating that the angel of death would pass over their homes on his way to foment the tenth and last plague on the Egyptians. There is a great debate about quinoa, a grain not known in Biblical places in Biblical times. Can we eat quinoa? A New York Times article on Sunday stated the state of the debate. Since I doubt anyone was in a position to take a four-day trek into the Bolivian wilderness to inspect quinoa processing operations in time for a holiday that began Monday night, the decision to eat quinoa or not must be left to the individual conscience. Assuming you know where you can get quinoa anyway.
Which brings up the larger point, as the New York Daily News asks, why do Seders, indeed Passover in general, put the "fun" in dysfunctional? Growing up, I remember Seders with my entire extended family at my great aunt's house, the only time during the year everyone would be together at once, but I also remember how little I understood of the davening in Ashkenazic Hebew at warp speed (the term hadn't been invented yet) and how so many of us little kids would end up being disciplined because we couldn't sit still through the hours of reading the entire Haggadah. The most wonderful Seder I remember was the first one, as an adult and a parent, where we had four children and eight adults (one child per family) and all the children made it through the entire service (much in English, much shortened), each one participating and no one leaving the table. At the end we all agreed to do it again together every year. Which we did until my own son, the eldest of the children, left for college, with additional children, another family, wandering members of extended families and the effects of one divorce bending but not breaking the group. The last time we were all together, the group strained the size of our dining room, but it was a happy strain.
One thing we did every year was read passages from 1001 Questions About Pesach, where we learned that a certain Ashkenazic rabbi believed that someone somewhere would soak fresh garlic in beer, so garlic was not permitted at Passover. And we would talk about these things, adults and children. We resolved the garlic thing against the rabbi's ruling, by the way.
My mother, like many others, has long sought to find ways to make cakes, breads and rolls in ways that meet the strict Passover requirements. Our family has rebelled against this idea. Many Orthodox families will stress over the preparations for the holiday for a month or more before. Our family has resolved this differently. Our view is that the Jews in Egypt got no notice of the Exodus, that was why they didn't have time to prepare. So we eat things that can be hastily prepared; our typical Passover meal is a fritata made with fresh vegetables.
Okay, so what's the "food liability law" angle to this? Well, there was one other key article this week, this from the Wall Street Journal, about the different degrees of preparation certain rabbis insist upon. There are different organizations with different certification standards, each with a different mark. And if you are not someone who accepts a particular mark, it is as though the food contained ham, cheese and, for Passover, French bread. If you invite a particularly observant Jew to your home, and assure him or her that all the food will be Kosher for Passover, do not be surprised if instead of a simple thank you, you are subjected to a cross-examination about every item.
Is there consensus? Yes, it is pretty clear that an unpeeled piece of fruit, which can be washed by the eater himself or herself, wll be acceptable. Better yet, an unpeeled banana, which need not be washed to be eaten.
Secretary of Agriculture Tom Vilsack issued a statement today emphasizing that U.S. pork products are safe and that there is no evidence that U.S. swine have been infected with the swine flu virus.
Calling trade restrictions on pork or pork products unnecessary, Vilsack said any such restrictions would be inconsistent with World Organization for Animal Health guidelines. “[I]t is not necessary to introduce specific measures for international trade in swine or their products, nor are consumers of pork products at risk of infection,” Vilsack said. The complete statement is available here.
A report in The New York Times notes that pork producers are questioning whether it is appropriate to call the virus “swine flu” given that there is no evidence of swine infection. The report states that officials in Thailand, one of the world’s largest meat exporters, have started calling the virus “Mexican flu.” An Israeli deputy health minister reportedly said Israel would follow suit to keep Jews from having to say the word “swine.”
The Centers for Disease Control has issued a study of the incidence of food-borne illness in ten states. The study, by the Foodborne Diseases Active Surveillance Network, known as "FoodNet", in general concludes that food-borne illness has not significantly either increased or decreased in the United States since 2004, after substantial gains in food safety from 1996 to 2004.
The Associated Press article on this, by Mike Stobbe, is entitled, "CDC: US food poisoning cases held steady in 2008." This is an appropriately neutral headline. What is interesting is how different media outlets have dealt with the story
Reuters, in an article by Julie Steenhuysen, uses the headline, "U.S. making little progress on food safety." She emphasizes in the lede the use in the study of the word "plateaued." Lyndsey Layton's Washington Post article is headed, "CDC Study Finds Some Food-Borne Illnesses Rising in U.S." The article's lede actually says that the rate has "remained stagnant", and nowhere in the article is any mention made of any specific diseases whose rates have risen (the article instead clumps together some where rates have either risen or remained constant, without distinguishing which are which). The UPI headline is "Little Progress in U.S. food safety", similar to the New York Times's "U.S. Food Safety No Longer Improving, Data Show".
On the rosier side, the Wall Street Journal's Jacob Goldstein blogged with the headline, "Reality Check on Foodborne Illness Rate." Goldstein takes the position that the lack of an increase given the wide publicity to certain outbreaks is an indication that things are doing well. It is not clear, however, whether Goldstein understood, as the Washington Post article reported,
The data did not include the ongoing national outbreak of salmonella illness linked to peanut products that began in late 2008 but peaked in the early months of 2009, with nearly 700 people sickened and nine killed.
So what does the report actually say?
Let's start with the report's own discussion of its own limitations. To start with the title of the report is "Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food --- 10 States, 2008." The word "Preliminary" is not featured in any of the above headlines. Many of the articles do point out that the report is based on data from ten states, covering about 45 million people. The report itself lists four important limitations to the validity of its data, none of which are discussed sufficiently in any of the media reports:
First, because FoodNet relies on laboratory diagnoses, changing laboratory practices might affect the reported incidence of some pathogens. For example, fewer laboratory-confirmed infections might be reported as a result of increased use of nonculture tests. Second, many foodborne illnesses (e.g., norovirus infection) are not reported to FoodNet because these pathogens are not identified routinely in clinical laboratories. Third, differences in health-care seeking behaviors between age groups might contribute to a much higher incidence of reported illness in certain age groups (e.g., young children and older persons) (10). Finally, although the FoodNet population is similar demographically to the U.S. population, the findings might not be generalizable.
That's a lot of noise. In particular, the fourth issue, whether it is appropriate to generalize from the data in these ten states to the rest of the country, is critical. FoodNet argues that its data are from states that, other than an underrepresentation of Hispanics, are not significantly different from U.S. census data for the entire country. This misses, however, what I think is the more critical question, which is whether the participation of these ten states in FoodNet indicates something different about the public health organizations of those states compared to the remaining states. It is possible that the other states are putting their funds into inspection and food safety education instead of statistics gathering, but it may be just as likely if not more that the states who participate are the ones whose public health organizations are the most modern and vigilant. What this might mean for trends is quite problematic. The ten states may have plateaued because they're doing all they can while there is progress elsewhere, or there may be worse conditions elsewhere that are not being reported.
The report covers ten enteric pathogens:
- Shiga toxin-producing Escherichia coli (STEC) O157
- STEC non-O157
The report indicated only one increase, that for salmonella, which it stated was "not significant." In addition, among salmonella serotypes, one (Saintpaul) increased significantly. We previously reported that saintpaul was the main pathogen found in bad tomatoes in 2008. Of the others, one increased some and one decreased some and the seven others didn't change.
What is significant is not so much that the reports of these diseases among the ten states are increasing or decreasing (they appear to be doing neither) but that we are nearly at 2010, when the national health goals contained in the federal government's "Healthy People 2010" program are supposed to be met. Salmonella incidence is supposed to be at 6.8 per 100,000 people by 2010 and it was at 16.2 in 2008, which is a long way away.
The other critical lesson from the report is that the apparent plateauing has occurred despite a number of important public health measures that have been taken in the period studied. These include the FSIS's salmonella initiative, the FDA's lettuce and spinach irradiation program, and the FDA's and Customs and Border Patrol's efforts relating to screening food imports.
I imagine that the FDA and the CDC and the various state public health agencies are feeling more than a little like Hans Brinker right now. However, I wonder if what is really going on, which the report doesn't talk about at all, is a combination of three things: (1) the low-hanging fruit has been taken care of to a great extent; (2) some of the measures the reports touts were not completely implemented due to funding and other constraints (the importation program would be where I would start in studying this); and (3) pathogens evolve.
Now let me let you in to what wasn't reported: the report doesn't look too different from last year's.
Here is the critical paragraph from this year's report:
Despite numerous activities aimed at preventing foodborne human infections, including the initiation of new control measures after the identification of new vehicles of transmission (e.g., peanut butter--containing products), progress toward the national health objectives has plateaued, suggesting that fundamental problems with bacterial and parasitic contamination are not being resolved. Although significant declines in the incidence of certain pathogens have occurred since establishment of FoodNet, these all occurred before 2004. Of the four pathogens with current Healthy People 2010 targets, Salmonella, with an incidence rate of 16.2 cases per 100,000 in 2008, is farthest from its target for 2010 (6.8). The lack of recent progress toward the national health objective targets and the occurrence of large multistate outbreaks point to gaps in the current food safety system and the need to continue to develop and evaluate food safety practices as food moves from the farm to the table.
Here is the corresponding paragraph from last year's report:
Although significant declines in the incidence of certain foodborne pathogens have occurred since 1996, these declines all occurred before 2004. Comparing 2007 with 2004-2006, the estimated incidence of infections caused by Campylobacter, Listeria, Salmonella, Shigella, STEC O157, Vibrio, and Yersinia did not decline significantly, and the incidence of Cryptosporidium infections increased. The incidence of Salmonella infections in 2007 (14.92 cases per 100,000) was the furthest from the national target for 2010 (6.80 cases), and only infections caused by Salmonella serotypes Typhimurium and Heidelberg declined significantly.
There's really not a lot of news here, and if there is any, it's that the closeness of 2010 is making those goals seem harder to achieve. When you actually look up the meaning of "plateau" in this context, Merriam-Webster's actually has two almost contradictory definitions. Definition 2(b) is "a relatively stable level, period or condition." Definition 3 is, "a level of attainment or achievement." Neither one has a negative connotation. In these times, even stability seems like a wonderful goal. Attainment or achievement sound wonderful.
The FDA and the California Department of Public Health announced on March 30 the recall of pistachios from Setton Farms, which have been linked to a discovery of salmonella originally identified by Kraft Foods in Back to Nature Trail Mix. The FDA has a list of recalled products, but that may grow.
Obviously, we have been through this drill before. It is interesting to note the reactions of different involved parties.
Kraft notes it as a "Consumer Alert" in the upper right hand corner of their home page. It's not particularly prominent, but it is visible.
Setton Farms, at least as of the time this post was entered, did not note the recall on its home page at all.
Given that information about a nationwide recall of their pistachio products is available on Fox Business, the New York Times, Huffington Post and pretty much any other news outlet, you would think that Setton Farms would have had someone update their website and put this in big red letters.
The New York Times has a piece on nutraceuticals that caught my eye as an example of the news media’s skepticism about fortified food. The article begins:
“O[ff] the coast of Peru swim billions of sardines and anchovies: oily, smelly little fish, rich in nutritious omega-3 fatty acids. Their spot on the food chain is low; many will be caught, ground up, and fed as fishmeal to bigger animals.
“But a few have a more exalted destiny: to be transported, purified and served at North American breakfast tables in the form of Tropicana Healthy Heart orange juice and Wonder Headstart bread. These new products promise to deliver the health benefits of fish oil without the smell and the taste — without, in fact, the fish.”
But the article’s author, Julia Moskin, without citation or attribution, poses these loaded questions: “Are we really that close to a world in which food functions as a nutrient delivery system, made possible by microencapsulation and fine-spray coating? And what would this mean for food and human nutrition?”
In the end, Ms. Moskin’s piece appears full of cynicism and doubt about the industry. She writes off nutraceuticals as a cheap marketing ploy:
“[W]ith recent rising costs in raw materials, flavorings and transport, many food companies are refocusing their research and development; instead of adding expensive ingredients like sun-dried tomatoes or honey-roasted almonds to existing products, the search is on for inexpensive ‘value-added’ products that customers will pay extra for.”
Ms. Moskin does quote claims made by the industry but notes that university scientists disagree with the claims—implying that these scientists must be right because they are not employed by industry.
To me, the article demonstrates the need for the industry to invest in more independent research and verification. As the nutraceuticals industry matures and grows, claims by industry will be met with growing suspicion and, inevitably, assertions of “consumer fraud.” Consumers may believe health claims by small health food companies that they “trust.” But once those same companies (and their industries) grower larger, people by their nature become more skeptical.