[Read this blog post before you go see Food, Inc. – the movie]
The ongoing (recent) outbreak of Salmonella Saintpaul has drawn outcry from media, predictable knee-jerk proposals from lawmakers, and understandable fear and confusion among consumers. As with outbreaks in the past, the Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), and processing plants and farmers continue to take the blame for tainted food making us ill. But is our All-American sick gut deserving of some blame as well?
While our attention is focused on farm-to-table food safety and disease surveillance once we have gotten sick, the biological question of why we got sick is all but ignored.
Most experts working within what might be called the U.S. Food Safety System, that includes the efforts of some 15,000 people from 15 federal agencies, would readily acknowledge the complexity of detecting the admittedly small numbers of pathogenic bacteria and viruses in the 350 billion pounds of food in a farm-to-table chain that often spans multiple time zones and countries, as an insensitive prevention strategy at best.
Likewise, once an outbreak has been detected, sourcing the offending pathogen can prove difficult, as the recent Salmonella Saintpaul outbreak demonstrates even when a genetic match is made. While good farming practices, sampling and testing for detection, and the secondary prevention of tracking down the bad bug once an outbreak has been recognized are critical to a safe food supply, understanding why a person succumbs to what is often a very small number of initial organisms may be a relevant question and an additional strategy in reducing human suffering from foodborne pathogens.
By adding the biological question of why an individuals natural defenses failed to the intellectual concepts of testing, detection, and surveillance, we correctly insert personal responsibility into our national strategy and more importantly, draw attention to the much larger public health crisis, of which illness from foodborne pathogens is only a symptom of our sick, leaky guts.
The CDC warns “The elderly, infants, and those with impaired immune systems are more likely to have a severe illness” associated with tainted food (and water). By “impaired” the CDC is saying that within the complex network of specialized cells and organs that work together to defend against attacks from foreign invaders like Salmonella and E. Coli (toxin producing strains), something has gone wrong, increasing risk of getting sick – or worse.
A critical component to a properly functioning immune system is a healthy, and balanced population of bacteria. With names like bifidobacterium and lactobacillus, these and other natural inhabitants of the human gut make it their evolutionary job to fight invaders by competing for nutrients (which the invader needs to survive), compete for attachment sites on our intestinal walls (which the invader must do to cause harm), production of organic acids (that the invader does not like), and changing of pH of intestinal ecosystem (which the pathogen does not like either, but fast learning how to adapt). The things that are
This germ-on-germ warfare is literally fought daily in the American gut. When the good guys lose, we know this as diarrhea, fever, and abdominal cramps – or worse. We have all experienced or witnessed these lost battles at varying levels from being restricted to the house, visits to the emergency room, or in some extreme cases, the morgue. While this germ warfare has raged in the human gut as long as humans have been around, the rules of the battle are changing as humanity has started a large-scale experiment by shifting to a highly processed diet that has changed the nutrient supply that our friendly microbes evolved to depend upon.
The irony of the public running from vegetables and fruits that have been suspected in an outbreak, is that these foods contain essential nutrients (dietary fiber) that our gut bugs need to fight the good fight. Our change in diet, coupled with uncontrolled use of antibiotics, may be adversely altering our organic relationship with our most important weapon against foodborne pathogens.
The disruption and increased gut infections caused by pathogens is possibly having an irreversible impact on our entire gastrointestinal system. Like a siege of cannon fire on the walls of a fortress, the walls (barrier) begin to crumble (impaired) and become prone to invasion. Mounting evidence suggests acute and chronic infection by pathogens damage the delicate mucosal barrier that separates trillions of bacteria in our intestinal system from the sterile environment of our blood. As the steady flow of lost battles accumulate, the barrier and our immune system as whole become impaired, resulting in inflammation and movement of pathogens (and endotoxins) into our sterile blood. An impaired and leaky gut barrier plays an important role in a range of maladies such as irritable bowel disease, some cancers, sepsis, organ failure, heart disease and a cascade of other metabolic disorders.
By inserting personal responsibility and some basics of host-pathogen germ warfare into the multi stakeholder strategy for addressing foodborne threats, we may start to realize that we may not simply be experiencing a mathematical rise in foodborne illness as a result of sloppy farming and poor government oversight, but rather a tectonic-like shift in our nutritional landscape that has opened the pathogens door just enough for us to glimpse the future of human suffering. Just the thought makes my gut ache.
*A version of this blog post appeared as an op-ed in the San Francisco Chronicle, by NAKEDpizza co-founder.