Rat poop, bug bits, mice hair: How many ‘unavoidable defects’ are in peanut butter and other foods you eat? | CNN



CNN
 — 

Brace yourselves, America: Many of your favorite foods may contain bits and pieces of creatures that you probably didn’t know were there.

How about some mice dung in your coffee? Maggots in your pizza sauce? Bug fragments and rat hair in your peanut butter and jelly sandwich?

Oh, and so sorry, chocolate lovers. That dark, delicious bar you devoured might contain 30 or more insect parts and a sprinkling of rodent hair.

Called “food defects,” these dismembered creatures and their excrement are the unfortunate byproduct of growing and harvesting food.

“It is economically impractical to grow, harvest, or process raw products that are totally free of non-hazardous, naturally occurring, unavoidable defects,” the US Food and Drug Administration said.

So while there’s no way to get rid of all the creatures that might hitch a ride along the food processing chain, the FDA has established standards to keep food defects to a minimum.

Let’s go through a typical day of meals to see what else you’re not aware that you’re eating.

The coffee beans you grind for breakfast are allowed by the FDA to have an average of 10 milligrams or more animal poop per pound. As much as 4% to 6% of beans by count are also allowed to be insect-infested or moldy.

As you sprinkle black pepper on your morning eggs, try not to think about the fact you may be eating more than 40 insect fragments with every teaspoon, along with a smidgen of rodent hair.

Did you have fruit for breakfast? Common fruit flies can catch a ride anywhere from field to harvest to grocery store, getting trapped by processors or freezing in refrigerated delivery trucks and ending up in your home.

Let’s say you packed peanut butter and jelly sandwiches for everyone’s lunch. Good choice!

Peanut butter is one of the most controlled foods in the FDA list; an average of one or more rodent hairs and 30 (or so) insect fragments are allowed for every 100 grams, which is 3.5 ounces.

The typical serving size for peanut butter is 2 tablespoons (unless you slather). That means each 2 tablespoon-peanut butter sandwich would only have about eight insect fragments and a teensy bit of rodent filth. (“Filth” is what the FDA calls these insect and rodent food defects.)

Unfortunately, jelly and jam are not as controlled. Apple butter can contain an average of four or more rodent hairs for every 3.5 ounces (100 grams) and about five whole insects. Oh, and that isn’t counting the unknown numbers of teensy mites, aphids and thrips.

Apple butter can also contain up to 12% mold, which is better than cherry jam, which can be 30% moldy, or black currant jam, which can be 75% moldy.

Did you pack some of the kid-size boxes of raisins for your child’s midafternoon snack?

Golden raisins are allowed to contain 35 fruit fly eggs as well as 10 or more whole insects (or their equivalent heads and legs) for every 8 ounces. Kid-size containers of raisins are an ounce each. That’s more than four eggs and a whole insect in each box.

Any Bloody Mary fans? The tomato juice in that 14-ounce Bloody Mary could contain up to four maggots and 20 or more fruit fly eggs.

And if you’re having a fruity cocktail, just be aware that the canned citrus juices that many bars use can legally have five or more fruit fly eggs or other fly eggs per cup (a little less than 250 milliliters). Or that cup of juice could contain one or more maggots. Apricot, peach and pear nectars are allowed to contain up to 12% moldy fruit.

Oh, gosh, the possibilities are endless! Did you know there can be 450 insect parts and nine rodent hairs in every 16-ounce box of spaghetti?

Canned tomatoes, tomato paste and sauces such as pizza sauce are a bit less contaminated than the tomato juice in your cocktail. The FDA only allows about two maggots in a 16-ounce can.

Adding mushrooms to your spaghetti sauce or pizza? For every 4-ounce can of mushrooms there can be an average of 20 or more maggots of any size.

The canned sweet corn we love is allowed to have two or more larvae of the corn ear worm, along with larvae fragments and the skins the worms discard as they grow.

For every ¼ cup of cornmeal, the FDA allows an average of one or more whole insects, two or more rodent hairs and 50 or more insect fragments, or one or more fragments of rodent dung.

Asparagus can contain 40 or more scary-looking but teensy thrips for every ¼ pound. If those aren’t around, FDA inspectors look for beetle eggs, entire insects or heads and body parts.

Frozen or canned spinach is allowed to have an average of 50 aphids, thrips and mites. If those are missing, the FDA allows larvae of spinach worms or eight whole leaf miner bugs.

Dismembered insects can be found in many of our favorite spices as well. Crushed oregano, for example, can contain 300 or more insect bits and about two rodent hairs for every 10 grams. To put that in context, a family-size bottle of oregano is about 18 ounces or 510 grams.

Paprika can have up to 20% mold, about 75 insect parts and 11 rodent hairs for every 25 grams (just under an ounce). A typical spice jar holds about 2 to 3 ounces.

By now you must be asking: Just how do they count those tiny insect heads and pieces of rodent dung?

“Food manufacturers have quality assurance employees who are constantly taking samples of their packaged, finished product to be sure they’re not putting anything out that is against the rules,” said food safety specialist Ben Chapman, a professor in agricultural and human sciences at North Carolina State University.

Sometimes they do it by hand, Chapman said. “They take 10 bags out of a weeklong production and try to shake out what might be in here,” he said. “Do we have particularly high insect parts or was it a particularly buggy time of year when the food was harvested? And they make sure they are below those FDA thresholds.”

What happens if it was a buggy week and lots of insects decided to sacrifice themselves? Can they get all those eggs, legs and larvae out?

“They really can’t,” Chapman said. But they can take the food and send it to a process called “rework.”

“Say I’ve got a whole bunch of buggy fresh cranberries that I can’t put in a bag and sell,” Chapman said. “I might send those to a cranberry canning operation where they can boil them and then skim those insect parts off the top and put them into a can.”

That’s gross. Will I ever eat any of these foods again?

“Look, this is all a very, very, very low-risk situation,” Chapman said. “I look at it as a yuck factor versus a risk factor. Insect parts are gross, but they don’t lead to foodborne illnesses.”

Much more dangerous, Chapman points out, is the potential for stone, metal, plastic or glass parts to come along with harvested food as it enters the processing system. All foods are subjected to X-rays and metal detectors, Chapman said, because when those slip through, people can actually be hurt.

Also much more dangerous are foodborne illnesses such as salmonella, listeria and E. coli, which can severely sicken and even kill.

“Cross-contamination from raw food, undercooking food, hand-washing and spreading germs from raw food, those are the things that contribute to the more than 48 million cases of foodborne illness we have every year in the US,” Chapman said.

Well, put that way, I guess my disgust over that rodent poop in my coffee seems overblown.

Maybe.

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Worried about your drinking? Use Dry January to check it | CNN

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CNN
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There are lots of great reasons to decide to go “dry” in January and give up alcohol. Perhaps you imbibed a bit too much over the holidays or want to start a healthy routine and can’t afford the calories or the zap in energy and motivation that drinking can bring.

“Or it may be someone who truly is starting to wonder or question their relationship with alcohol, and this is an opportunity to really explore that,” said Dr. Sarah Wakeman, medical director of the Substance Use Disorders Initiative at Massachusetts General Hospital.

“For some people saying, ‘I’m not going to drink this entire month,’ might be really hard, so trying to do so may show you how easy or difficult it is for you,” said neuropsychologist Dr. Sanam Hafeez, who conducts classes at Columbia University’s Teachers College.

What is the advice from experts on how to have a successful “dry January”? Read on.

It helps to be clear about your goal to make it a habit, said Wakeman, an associate professor of medicine at Harvard Medical School.

“The research we have on goal setting says goals are more likely to be achieved if they’re really relevant to you as an individual and not abstract like ‘I should stop drinking because drinking is bad,’ ” she said.

Concrete goals such as embracing new sleep habits or an exercise routine will help make giving up drinking easier, she said.

“I really want to stop drinking because I know when I drink heavily I don’t get up the next morning and I don’t work out is a very specific goal,” Wakeman said.

Additional motivation can come from the health gains you can make from reducing or eliminating alcohol, experts say.

“Drinking less over time can have really measurable benefits in your health in terms of your blood pressure, your risk of cancer, your risk of liver disease and other conditions,” Wakeman said.

“Over the course of a month, you may notice some short-term benefits like better sleep, a better complexion due to improvements in your skin, feeling more clearheaded and having more energy,” she added.

READ MORE: Why my ‘Sober October’ lasted a year

Many of us may be familiar with SMART goals from work or school settings. They are used to help people set attainable goals. The acronym stands for:

  1. Specific: Set an achievable goal, such as cutting back on drinking three days a week. You can add days until you reach your final goal.
  2. Measurable: How many drinks will you cut — and what are the drink sizes? A beer is 12 ounces, a glass of wine is 5 ounces and a serving of spirits is 1.5 ounces.
  3. Achievable: Make sure there are not a bunch of social engagements where alcohol is likely to be served during your month of abstention.
  4. Relevant: How is not drinking going to help me with my life and health?
  5. Time based: Set a reasonable time frame to finish your efforts. If you like, you can set another goal later.

“If you set a bar too high, you may fail, so it’s better to set smaller goals to achieve it,” Hafeez said. “Nothing starts without an honest conversation with yourself.”

Informing a few friends or family members of your goal can help you reach it, experts say. For some people it may work to announce their plan on social media — and invite others to join in and report back on their progress.

“That’s where I think ‘dry January’ has kind of caught on,” Wakeman said. “If you publicly state you’re going to do something, you’re more likely to stick with it than if you keep it to yourself.”

READ MORE: How much you drink could have an influence on how your teen drinks

Drinking is often associated with social gatherings or fun times. That can train your brain to see alcohol as a positive. You can combat those urges by replacing your drink of choice with something equally festive or flavorful, experts say.

“For some people it can be just sparkling water, and for other people it’s actually having a mocktail or some sort of (nonalcoholic) drink that feels fun and celebratory,” Wakeman said.

“Substituting one behavior for another can work because you’re tricking your brain,” Hafeez said. “That can absolutely help you avoid temptation.”

An entire industry is devoted to making nonalcoholic drinks that taste (at least a bit) like the real thing. Some even claim to have added ingredients that are “calming” or “healthy.”

“I’m skeptical of anything that claims to relax you or have amazing health benefits that comes in a glass regardless of what it is,” Wakeman said. “But if it’s an alternative that allows you to feel like you’re not missing out on a social situation and helps you make the changes that you want to your alcohol consumption, I don’t think there’s any downside to that.”

READ MORE: How to stop using alcohol as a confidence crutch

5. Track your progress, goal and feelings

Even if you don’t end up cutting out all alcohol, tracking your emotions and urges to discover your triggers can be helpful, Wakeman said.

“Even just measuring your behavior, whether it’s alcohol or exercise or your diet, can be an intervention in and of itself,” she said.

“Even if someone’s not yet ready to make changes, just keeping a diary of when you’re drinking, what situations you’re drinking more and how you’re feeling at those times, can really help you identify sort of trigger situations where you may be more likely to drink,” Wakeman added.

There’s an additional piece that’s important in accomplishing a “dry January,” experts say. It’s important to notice if you — or a loved one — are showing any negative symptoms from cutting back or eliminating alcohol. It could be a sign that you need professional help to reach your goal.

“The first thing to be mindful of is whether or not you actually have an alcohol use disorder,” Wakeman said. “If someone’s been drinking very heavily ev

ery single day and is at risk for withdrawal symptoms, then it can actually be dangerous to stop abruptly.”

A person with an alcohol use disorder, who has gotten used to having a certain level of alcohol in their body every day, can go into withdrawal and experience severe physical symptoms such as shakiness, sweating, rapid heart rate and seizures.

“That would be a real indication that you need to talk to a medical professional about getting medical treatment for withdrawal and not stopping on your own,” Wakeman said.

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Don’t serve disordered eating to your teens this holiday season | CNN

Editor’s Note: Katie Hurley, author of “No More Mean Girls: The Secret to Raising Strong, Confident and Compassionate Girls,” is a child and adolescent psychotherapist in Los Angeles. She specializes in work with tweens, teens and young adults.



CNN
 — 

“I have a couple of spots for anyone who wants to lose 20 pounds by the holidays! No diets, exercise, or cravings!”

Ads for dieting and exercise programs like this started appearing in my social media feeds in early October 2022, often accompanied by photos of women pushing shopping carts full of Halloween candy intended to represent the weight they no longer carry with them.

Whether it’s intermittent fasting or “cheat” days, diet culture is spreading wildly, and spiking in particular among young women and girls, a population group who might be at particular risk of social pressures and misinformation.

The fact that diet culture all over social media targets grown women is bad enough, but such messaging also trickles down to tweens and teens. (And let’s be honest, a lot is aimed directly at young people too.) It couldn’t happen at a worse time: There’s been a noticeable spike in eating disorders, particularly among adolescent girls, since the beginning of the pandemic.

“My mom is obsessed with (seeing) her Facebook friends losing tons of weight without dieting. Is this even real?” The question came from a teen girl who later revealed she was considering hiring a health coach to help her eat ‘healthier’ after watching her mom overhaul her diet. Sadly, the coaching she was falling victim to is part of a multilevel marketing brand that promotes quick weight loss through caloric restriction and buying costly meal replacements.

Is it real? Yes. Is it healthy? Not likely, especially for a growing teen.

Later that week, a different teen client asked about a clean eating movement she follows on Pinterest. She had read that a strict clean vegan diet is better for both her and the environment, and assumed this was true because the pinned article took her to a health coaching blog. It seemed legitimate. But a deep dive into the blogger’s credentials, however, showed that the clean eating practices they shared were not actually developed by a nutritionist.

And another teen, fresh off a week of engaging in the “what I eat in a day” challenge — a video trend across TikTok, Instagram and other social media platforms where users document the food they consume in a particular timeframe — told me she decided to temporarily mute her social media accounts. Why? Because the time she’d spent limited her eating while pretending to feel full left her exhausted and unhappy. She had found the trend on TikTok and thought it might help her create healthier eating habits, but ended up becoming fixated on caloric intake instead. Still, she didn’t want her friends to see that the challenge actually made her feel terrible when she had spent a whole week promoting it.

During any given week, I field numerous questions from tweens and teens about the diet culture they encounter online, out in the world, and sometimes even in their own homes. But as we enter the winter holiday season, shame-based diet culture pressure, often wrapped up with toxic positivity to appear encouraging, increases.

“As we approach the holidays, diet culture is in the air as much as lights and music, and it’s certainly on social media,” said Dr. Hina Talib, an adolescent medicine specialist and associate professor of pediatrics at the Albert Einstein College of Medicine in The Bronx, New York. “It’s so pervasive that even if it’s not targeted (at) teens, they are absorbing it by scrolling through it or hearing parents talk about it.”

Social media isn’t the only place young people encounter harmful messaging about body image and weight loss. Teens are inundated with so-called ‘healthy eating’ content on TV and in popular culture, at school and while engaged in extracurricular or social activities, at home and in public spaces like malls or grocery stores — and even in restaurants.

Instead of learning how to eat to fuel their bodies and their brains, today’s teens are getting the message that “clean eating,” to give just one example of a potentially problematic dietary trend, results in a better body — and, by extension, increased happiness. Diets cutting out all carbohydrates, dairy products, gluten, and meat-based proteins are popular among teens. Yet this mindset can trigger food anxiety, obsessive checking of food labels and dangerous calorie restriction.

An obsessive focus on weight loss, toning muscles and improving overall looks actually runs contrary to what teens need to grow at a healthy pace.

“Teens and tweens are growing into their adult bodies, and that growth requires weight gain,” said Oona Hanson, a parent coach based in Los Angeles. “Weight gain is not only normal but essential for health during adolescence.”

The good news in all of this is that parents can take an active role in helping teens craft an emotionally healthier narrative around their eating habits. “Parents are often made to feel helpless in the face of TikTokers, peer pressure or wider diet culture, but it’s important to remember this: parents are influencers, too,” said Hanson. What we say and do matters to our teens.

Parents can take an active role in helping teens craft an emotionally healthier narrative around their eating habits.

Take a few moments to reflect on your own eating patterns. Teens tend to emulate what they see, even if they don’t talk about it.

Parents and caregivers can model a healthy relationship with food by enjoying a wide variety of foods and trying new recipes for family meals. During the holiday season, when many celebrations can involve gathering around the table, take the opportunity to model shared connections. “Holidays are a great time to remember that foods nourish us in ways that could never be captured on a nutrition label,” Hanson said.

Practice confronting unhealthy body talk

The holiday season is full of opportunities to gather with friends and loved ones to celebrate and make memories, but these moments can be anxiety-producing when nutrition shaming occurs.

When extended families gather for holiday celebrations, it’s common for people to comment on how others look or have changed since the last gathering. While this is usually done with good intentions, it can be awkward or upsetting to tweens and teens.

“For young people going through puberty or body changes, it’s normal to be self-conscious or self-critical. To have someone say, ‘you’ve developed’ isn’t a welcome part of conversations,” cautioned Talib.

Talib suggests practicing comebacks and topic changes ahead of time. Role play responses like, “We don’t talk about bodies,” or “We prefer to focus on all the things we’ve accomplished this year.” And be sure to check in and make space for your tween or teen to share and feelings of hurt and resentment over any such comments at an appropriate time.

Open and honest communication is always the gold standard in helping tweens and teens work through the messaging and behaviors they internalize. When families talk about what they see and hear online, on podcasts, on TV, and in print, they normalize the process of engaging in critical thinking — and it can be a really great shared connection between parents and teens.

“Teaching media literacy skills is a helpful way to frame the conversation,” says Talib. “Talk openly about it.”

She suggests asking the following questions when discussing people’s messaging around diet culture:

● Who are they?

● What do you think their angle is?

● What do you think their message is?

● Are they a medical professional or are they trying to sell you something?

● Are they promoting a fitness program or a supplement that they are marketing?

Talking to tweens and teens about this throughout the season — and at any time — brings a taboo topic to the forefront and makes it easier for your kids to share their inner thoughts with you.

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How to build a habit in 5 steps, according to science | CNN

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CNN
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Most of us assume those superachievers who are always able to squeeze in their workout, eat healthy foods, ace their exams and pick their kids up on time must have superhuman self-control. But science points to a different answer: What we mistake for willpower is often a hallmark of habit.

People with good habits rarely need to resist the temptation to laze on the couch, order greasy takeout, procrastinate on assignments or watch one more viral video before dashing out the door. That’s because autopilot takes over, eliminating temptation from the equation. Having established good habits, little to no willpower is required to choose wisely.

Sounds great, right? The only catch is that building good habits takes effort and insight. Thankfully, science offers both guidance on how to begin and strategies to lighten your lift. Here are a few research-backed steps sourced from my book, “How to Change,” that can set you on the path from where you are to where you want to be.

The way you define the goal you hope to turn into a habit does matter. Goals such as “meditate regularly” are too abstract, research has shown. You’ll benefit from being more specific about what exactly you aim to do and how often.

Don’t say “I’ll meditate regularly.” Say, “I’ll meditate for 15 minutes each day.”

Having a bite-size objective makes it less daunting to get started and easier to see your progress.

Now that you have established a specific goal, it’s time to think about what will cue you to follow through. Scientists have proven that you’ll make more progress toward your goal if you decide not just what you’ll do, but when you’ll be cued to do it, as well as where you’ll do it and how you’ll get there.

A plan like “I’ll study Spanish for 30 minutes, five days a week” is OK. But a detailed, cue-based plan like “Every workday after my last meeting, I’ll spend 30 minutes studying Spanish in my office” is much more likely to stick as a habit.

Making this kind of plan reduces the chances you’ll forget to follow through because the when and where in your plan will serve as cues to action that jog your memory. Even better: Put your plan on your calendar so you’ll get a digital reminder. An established, hyperspecific plan also forces you to anticipate and maneuver around obstacles and makes procrastination feel more sinful.

When we set out to build a new habit, most of us overestimate our willpower and set a course for the most efficient path to achieving our end goal. Say you hope to get fit by exercising regularly — you’ll likely look for a workout that can generate quick results such as grinding it out on a treadmill. But research has shown you’ll persist longer and ultimately achieve more if you instead focus on finding ways to make goal pursuit fun.

When it comes to exercise, this might mean going to Zumba classes with a friend or learning how to rock climb. If you’re trying to eat more fruits and vegetables, it might mean swapping doughnut breakfasts for tasty smoothies, which can combine multiple servings of fruits and veggies in one delicious drink. Because you are far more likely to stick with something you enjoy and repetition is key to habit formation, making the experience positive is critical, but it’s often overlooked.

One excellent way to make goal pursuit fun is to try what I call “temptation bundling.” Consider only letting yourself enjoy an indulgence you crave while working toward your goal. For example, only let yourself binge-watch your favorite show while at the gym or enjoy a beloved podcast while cooking healthy meals. My own research shows that temptation bundling improves follow-through; it transforms goal pursuit into a source of pleasure, not pain.

By the time we put a behavior on autopilot, a lot of us fall into fairly consistent routines, tending to exercise, study or take our medication at the same time of day and in the same place. But when you’re in the start-up phase of habit building, contrary to popular opinion, my research suggests it’s important to insert some variability deliberately into your routine.

You’ll still want to have a first best plan — maybe an 8 a.m. meditation session if you’re trying to kick-start a mindfulness habit. But you should also experiment with other ways of getting the job done. Try to mix in a noon session and maybe a 5 p.m. meditation, too.

Successful habit building relies on frequently repeating a behavior, and if your routine becomes too brittle, you’ll follow through less often. A flexible habit means you can still do what you need to even when a wrench is thrown in your first best plans — say, a traffic jam on the way to dropping the kids off at school that gets in the way of your morning meditation.

One way to be flexible that’s proven useful is by giving yourself “emergency reserves.” Emergency reserves are a limited number of get-out-of-jail-free cards for those days when you really can’t squeeze in your 10 minutes of meditation, regular jog or Spanish practice.

It’s more motivating to set a tough goal for yourself — meditating every day, for instance — than an easy one, according to research. But missing multiple subgoals along the way can be discouraging. A couple of emergency reserves each week give you the flexibility to miss a day when a real emergency arises without getting discouraged and abandoning your objective entirely.

This step is obvious but sometimes overlooked. Seek out social support. Social support isn’t just about having cheerleaders and people to hold you accountable — though both can add value, so I’d suggest telling your friends and family about your goals.

We’re strongly influenced by the behaviors of the people around us, evidence shows. Want to start running regularly? You’re probably better off joining an established running club than asking a few friends who aren’t yet in the habit of jogging to get in shape with you. People in the running club have already built the habits you want. You can learn from them about what works and gain friends who will make you feel like a slouch when you slack off.

Good habits are contagious, so try to catch some by hanging out with people who are a little ahead of you on the learning curve. It’s important not to get too crazy — if you try to train with marathoners when you’re just hoping to work up to a 5K, I’ve found it can be discouraging.

But in general, research by myself and others shows that finding people to socialize with and emulating those who have already accomplished what you want to accomplish can make a world of difference. As an added bonus, when you pursue your goals in tandem with people you like, that makes it more fun!

One last thing to keep in mind is that habits can take some time to form. They don’t click overnight. Despite claims that there’s a “magic number” of days it takes to form a habit, my collaborators and I have disproven this myth in our recent research. We all form habits at our own speed, but for simpler and frequently repeated behaviors such as hand sanitizing, we can expect speedier habit formation than for more complex behaviors such as hitting the gym, which, on average, can take months rather than weeks to put on autopilot.

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Blueberries have joined green beans in this year’s Dirty Dozen list | CNN

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CNN
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Blueberries, beloved by nutritionists for their anti-inflammatory properties, have joined fiber-rich green beans in this year’s Dirty Dozen of nonorganic produce with the most pesticides, according to the Environmental Working Group, a nonprofit environmental health organization.

In the 2023 Shopper’s Guide to Pesticides in Produce, researchers analyzed testing data on 46,569 samples of 46 fruits and vegetables conducted by the US Department of Agriculture. Each year, a rotating list of produce is tested by USDA staffers who wash, peel or scrub fruits and vegetables as consumers would before the food is examined for 251 different pesticides.

As in 2022, strawberries and spinach continued to hold the top two spots on the Dirty Dozen, followed by three greens — kale, collard and mustard. Listed next were peaches, pears, nectarines, apples, grapes, bell and hot peppers, and cherries. Blueberries and green beans were 11th and 12th on the list.

A total of 210 pesticides were found on the 12 foods, the report said. Kale, collard and mustard greens contained the largest number of different pesticides — 103 types — followed by hot and bell peppers at 101.

Dirty Dozen 2023

2023 Dirty Dozen (most to least contaminated)

  • Strawberries
  • Spinach
  • Kale, collard and mustard greens
  • Peaches
  • Pears
  • Nectarines
  • Apples
  • Grapes
  • Bell and hot peppers
  • Cherries
  • Blueberries
  • Green beans
  • “Some of the USDA’s tests show traces of pesticides long since banned by the Environmental Protection Agency. Much stricter federal regulation and oversight of these chemicals is needed,” the report said.

    “Pesticides are toxic by design,” said Jane Houlihan, former senior vice president of research for EWG. She was not involved in the report.

    “They are intended to harm living organisms, and this inherent toxicity has implications for children’s health, including potential risk for hormone dysfunction, cancer, and harm to the developing brain and nervous system,” said Houlihan, who is now research director for Healthy Babies, Bright Futures, an organization dedicated to reducing babies’ exposures to neurotoxic chemicals.

    There is good news, though. Concerned consumers can consider choosing conventionally grown vegetables and fruits from the EWG’s Clean 15, a list of crops that tested lowest in pesticides, the report said. Nearly 65% of the foods on the list had no detectable levels of pesticide.

    2023 Clean 15

    2023 Clean 15 (least to most contaminated)

  • Avocados
  • Sweet corn
  • Pineapple
  • Onions
  • Papaya
  • Frozen sweet peas
  • Asparagus
  • Honeydew melon
  • Kiwi
  • Cabbage
  • Mushrooms
  • Mangoes
  • Sweet potatoes
  • Watermelon
  • Carrots
  • Avocados topped 2023’s list of least contaminated produce again this year, followed by sweet corn in second place. Pineapple, onions and papaya, frozen sweet peas, asparagus, honeydew melon, kiwi, cabbage, mushrooms, mangoes, sweet potatoes, watermelon, and carrots made up the rest of the list.

    Being exposed to a variety of foods without pesticides is especially important during pregnancy and throughout childhood, experts say. Developing children need the combined nutrients but are also harder hit by contaminants such as pesticides.

    “Pesticide exposure during pregnancy may lead to an increased risk of birth defects, low birth weight, and fetal death,” the American Academy of Pediatrics noted. “Exposure in childhood has been linked to attention and learning problems, as well as cancer.”

    The AAP suggests parents and caregivers consult the shopper’s guide if they are concerned about their child’s exposure to pesticides.

    Houlihan, director of Healthy Babies, Bright Futures, agreed: “Every choice to reduce pesticides in the diet is a good choice for a child.”

    Nearly 90% of blueberry and green bean samples had concerning findings, the report said.

    In 2016, the last time green beans were inspected, samples contained 51 different pesticides, according to the report. The latest round of testing found 84 different pest killers, and 6% of samples tested positive for acephate, an insecticide banned from use in the vegetable in 2011 by the EPA.

    “One sample of non-organic green beans had acephate at a level 500 times greater than the limit set by the EPA,” said Alexis Temkin, a senior toxicologist at the EWG with expertise in toxic chemicals and pesticides.

    When last tested in 2014, blueberries contained over 50 different pesticides. Testing in 2020 and 2021 found 54 different pesticides — about the same amount. Two insecticides, phosmet and malathion, were found on nearly 10% of blueberry samples, though the levels decreased over the past decade.

    Acephate, phosmet and malathion are organophosphates, which interfere with the normal function of the nervous system, according to the US Centers for Disease Control and Prevention.

    A high dose of these chemicals can cause difficulty breathing, nausea, a lower heart rate, vomiting, weakness, paralysis and seizures, the CDC said. If exposed over an extended time to smaller amounts, people may “feel tired or weak, irritable, depressed, or forgetful.”

    Why would levels of some pesticides be higher today than in the past?

    “We do see drops in some pesticides since the early ’90s when the Food Quality Protection Act was put into place,” Temkin said. “But we’re also seeing increases of other pesticides that have been substituted in their place which may not be any safer. That’s why there’s a push towards overall reduction in pesticide use.”

    Chris Novak, president and CEO of CropLife America, an industry association, told CNN the report “willfully misrepresented” the USDA data.

    “Farmers use pesticides to control insects and fungal diseases that threaten the healthfulness and safety of fruits and vegetables,” Novak said via email. “Misinformation about pesticides and various growing methods breeds hesitancy and confusion, resulting in many consumers opting to skip fresh produce altogether.”

    The Institute of Food Technologists, an industry association, told CNN that emphasis should be placed on meeting the legal limits of pesticides established by significant scientific consensus.

    “We all agree that the best-case scenario of pesticide residues would be as close to zero as possible and there should be continued science-based efforts to further reduce residual pesticides,” said Bryan Hitchcock, IFT’s chief science and technology officer.

    Many fruits and veggies with higher levels of pesticides are critical to a balanced diet, so don’t give them up, experts say. Instead, avoid most pesticides by choosing to eat organic versions of the most contaminated crops. While organic foods are not more nutritious, the majority have little to no pesticide residue, Temkin said.

    “If a person switches to an organic diet, the levels of pesticides in their urine rapidly decrease,” Temkin told CNN. “We see it time and time again.”

    If organic isn’t available or too pricey, “I would definitely recommend peeling and washing thoroughly with water,” Temkin said. “Steer away from detergents or other advertised items. Rinsing with water will reduce pesticide levels.”

    Additional tips on washing produce, provided by the US Food and Drug Administration, include:

    • Handwashing with warm water and soap for 20 seconds before and after preparing fresh produce.
    • Rinsing produce before peeling, so dirt and bacteria aren’t transferred from the knife onto the fruit or vegetable.
    • Using a clean vegetable brush to scrub firm produce like apples and melons.
    • Drying the produce with a clean cloth or paper towel to further reduce bacteria that may be present.

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    We all need ‘Sushi Tuesdays’: Lessons in understanding and finding a way forward after suicide | CNN

    Editor’s Note: If you or someone you know is struggling with mental health, help is available. Dial or text 988 or visit 988lifeline.org for free and confidential support.



    CNN
     — 

    When Sam Maya, a beloved husband, father, friend, stockbroker and coach, died by suicide 16 years ago, he left a note. He apologized to his wife, Charlotte, for being a burden and telling her and their two sons, then 6 and 8, that he loved them.

    In her recent heartbreaking memoir, “Sushi Tuesdays: A Memoir of Love, Loss and Family Resilience,” Charlotte Maya bears witness to Sam’s life, death and the aftermath with a singular purpose: to humanize the face of suicide and help readers develop a fluency in discussing mental health.

    She spent nearly a decade writing “Sushi Tuesdays,” beginning with a blog by the same name, an homage to the weekly ritual she created after her husband’s death.

    Every Tuesday while her kids were at school, Maya set aside her overwhelming to-do list as a lawyer and widowed single parent. Tuesdays began with a yoga class, then therapy, followed by whatever she needed most: perhaps going back to bed, going on a hike or heading to a solo sushi lunch.

    I met Maya in a memoir workshop last year. I have a family history of mental illness and suicide, so I connected with her work and motivation for sharing her story.

    In 2021, suicide was the second leading cause of death for Americans ages 10 to 34, the fifth for ages 35 to 54, and the 11th leading cause of death nationwide, claiming the lives of more than 48,000 people, according to the US Centers for Disease Control and Prevention.

    The suicide rate among men in 2021 was nearly four times higher than the rate of women, according to the CDC. Research supports the assumption that men typically choose more effective and lethal means, such as firearms, to complete suicide, according to Dr. Ashwini Nadkarni, a psychiatrist and researcher at Brigham and Women’s Hospital in Boston.

    Additionally, men are less likely to seek treatment for depression due to gendered expectations that equate masculinity with emotional stoicism, Nadkarni said.

    Suicide is a national health crisis, Maya told me, but when we hear of such a loss, we often attribute each death to the unique problem the deceased faced, such as financial or legal troubles.

    These stressors don’t explain suicide, she said. “Lots of people lose money, and they don’t take their own lives. They figure things out.”

    When her husband died, Maya knew he had back pain and was stressed about work and money, but she didn’t think these things added up to being suicidal. In retrospect, she can now spot clues, such as his review of his will shortly before he died.

    “I wanted to turn back the clock after Sam died,” she said. “I felt so strongly that if I could get back to that morning, I could have changed everything. It’s hard to reckon with what cannot be undone, to face straight into what I did or didn’t do, where I failed, where Sam failed.”

    “Whenever I say that Sam made a mistake, the mistake I mean is that he didn’t ask for help,” Maya said. “It’s hard to say you’re suffering when you’re suffering, so let your loved ones know you are available to help.”

    Asking people directly about suicidal thoughts may reduce, rather than increase, suicidal ideation, according to a 2014 review of scholarly literature in the journal Psychological Medicine.

    That does require that people look for and notice signs that others may be struggling, such as changes in mood, behavior, appetite or sleep habits or that they are giving away cherished possessions.

    The writer has since remarried. The combined family includes Gregory Stratz (from left), Tim Stratz, Jason Maya, Parker (the dog), Charlotte Maya, Danny Maya and Daniel Stratz, here in 2011.

    Speaking directly about mental health became a trademark of Maya’s single parenting. She aimed for her boys “to live full and fruitful lives, not defined by their father’s suicide, not limited by their father’s suicide, but also not ignoring their father’s suicide.”

    Her sons grieved their dad in their own ways, including denial (one pretended his father was on an extended business trip) and rageful episodes that ended with destroyed Lego sets and tears. Maya mourned with them about the “daddy-shaped space in their hearts” but promised that someday they’d be able to say, “I survived my father’s suicide, and I can do anything.”

    “It can be awkward to say yes when people ask to help,” Maya said. “Because I was so shocked and overwhelmed, I just said yes. I recommend that course of action to people. Let people show up and help you.”

    The support from Maya’s village was so vast that she wrestled with which of her friends would be fully fledged characters in “Sushi Tuesdays” and which would have cameo appearances.

    She dealt with this challenge — and the confusion caused by many friends with names starting with the letter J — by cleverly referring to her friends, collectively, as “The Janes.” Given her background as a lawyer, she thought of them as Jane Doe No. 1, Jane Doe No. 2 and so on.

    In the book, readers meet District Attorney Jane who helped with the coroner’s office, Engineer Jane who gets the boys to school each day on time and Prayer Warrior Jane who prays for Maya while she’s “not exactly on speaking terms with God.”

    One friend, identified not as a “Jane” but as “Bess” in the narrative, is Katherine Tasheff, a college friend from Rice University. When Sam Maya died, Tasheff was a single mother living on a budget in Brooklyn and couldn’t travel to California to visit. So, she did what she could: She wrote her friend an email. And then another. And another. Morning and night for 365 days following Sam’s death.

    The emails were always heartfelt and genuine but often mixed with dark humor. In one, Tasheff wrote, “We did an informal poll on whose husband was most likely to take his own life, and I want you to know that Sam came in last place.”

    Almost immediately, Charlotte Maya replied, “Dead last?”

    This kind of banter fueled Maya, who told her therapist to “call 911” if she ever lost her sense of humor. Finding moments of levity, she said, helped her hold onto her humanity. “Humor doesn’t cancel out what is devastating,” Maya told me. “Just like gratitude cannot cancel out what is horrifying. What’s important is having the capacity to hold both of those things.”

    After her husband's death, Charlotte Maya says moments of levity helped her hold on to her humanity.

    Seven years after her husband died, in 2014, Maya felt ready to write about surviving his suicide. Tasheff acted with her signature hadn’t-been-asked swiftness, setting up a blog site for sushituesdays.com within an hour.

    By then, Maya had met and married the most eligible widower in her town, now nicknamed Mr. Page 179 because that’s where he shows up in the book. They each brought two sons to the marriage. (Coincidentally, each has a child named Daniel, so they now have two Daniels.)

    Maya continues to honor her Tuesdays with therapy and yoga, a hike with a friend, and sometimes a sushi lunch.

    She urges everyone — especially single parents and anyone managing anxiety or depression — to carve out a similar weekly ritual, even if it’s just an hour to “treat yourself with the same compassion as you treat your dearest friends.”

    The coping mechanisms that Maya relied on in her grief may further explain the gender disparity in suicide rates, according to psychologist Lauren Kerwin.

    Men may be less likely to have strong support networks or to engage with them when in stress or emotional pain and may be more likely to use maladaptive coping strategies, such as substance abuse or isolation, Kerwin said.

    Seeking social connection and professional help is critical to preventing suicide.

    “Now, more than ever, we have a better understanding of the neuroinflammatory basis for depression — the medical framework gives us a model in which to consider depression as a medical condition and one which can be treated,” said Nadkarni, the Boston psychiatrist.

    If you see warning signs or are worried about someone who may be struggling, the American Foundation for Suicide Prevention recommends you assume you are the only one who will reach out. Find a time to speak privately and listen. Let people know their life matters to you and ask directly if they are thinking about suicide. Then encourage them to use the national suicide hotline by calling or texting the 988 Suicide & Crisis Lifeline, contact their doctor or therapist or seek treatment.

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    Avian Flu Fast Facts | CNN



    CNN
     — 

    Here’s a look at avian flu.

    Avian influenza, also called avian flu or bird flu, is an illness that usually affects only birds.

    There are many different strains of avian flu: 16 H subtypes and 9 N subtypes. Only those labeled H5, H7 and H10 have caused deaths in humans.

    The most commonly seen and most deadly form of the virus is called “Influenza A (H5N1),” or the “H5N1 virus.”

    Most cases of human bird flu infections are due to contact with infected poultry or surfaces that are contaminated with infected bird excretions: saliva, nasal secretions or feces.

    Symptoms of avian flu include fever, cough, sore throat and sometimes severe respiratory diseases and pneumonia.

    The CDC recommends oral oseltamivir (brand name: Tamiflu), inhaled zanamivir (brand name: Relenza) and intravenous permavir (brand name: Rapivab) for the treatment of human illness associated with avian flu.

    The mortality rate is close to 60% for infected humans.

    Early 1900s –The avian flu is first identified in Italy.

    1961 – The H5N1 strain is isolated in birds in South Africa.

    December 1983 – Chickens in Pennsylvania and Virginia are exposed to the avian flu and more than five million birds are killed to stop the disease from spreading.

    1997 – Eighteen people are infected by the H5N1 strain in Hong Kong, six die. These are the first documented cases of human infection. Hong Kong destroys its entire poultry population, 1.5 million birds.

    1999 Two children in Hong Kong are infected by the H9N2 strain.

    February 2003 – Eighty-four people in the Netherlands are affected by the H7N7 strain of the virus, one dies.

    February 7, 2004 – Twelve thousand chickens are killed in Kent County, Delaware, after they are found to be infected with the H7 virus.

    October 7, 2005The avian flu reaches Europe. Romanian officials quarantine a village of about 30 people after three dead ducks there test positive for bird flu.

    November 12, 2005 – A one-year-old boy in Thailand tests positive for the H5N1 strain of avian influenza.

    November 16, 2005 – The World Health Organization confirms two human cases of bird flu in China, including a female poultry worker who died from the H5N1 strain.

    November 17, 2005 Two deaths are confirmed in Indonesia from the H5N1 strain of avian influenza.

    January 1, 2006 – A Turkish teenager dies of the H5N1 strain of avian influenza in Istanbul, and later that week, two of his sisters die.

    January 17, 2006 – A 15-year-old girl from northern Iraq dies after contracting bird flu.

    February 20, 2006Vietnam becomes the first country to successfully contain the disease. A country is considered disease-free when no new cases are reported in 21 days.

    March 12, 2006Officials in Cameroon confirm cases of the H5N1 strain. The avian flu has now reached four African countries.

    March 13, 2006 – The avian flu is confirmed by officials in Myanmar.

    May 11, 2006 Djibouti announces its first cases of H5N1 – several birds and one human.

    December 20, 2011 – The US Department of Health and Human Services releases a statement saying that the government is urging scientific journals to omit details from research they intend to publish on the transfer of H5N1 among mammals. There is concern that the information could be misused by terrorists.

    July 31, 2012Scientists announce that H3N8, a new strain of avian flu, caused the death of more than 160 baby seals in New England in 2011.

    March 31, 2013 – Chinese authorities report the first human cases of infection of avian flu H7N9 to the World Health Organization. H7N9 has not previously been detected in humans.

    December 6, 2013 – A 73-year-old woman infected with H10N8 dies in China, the first human fatality from this strain.

    January 8, 2014 – Canadian health officials confirm that a resident from Alberta has died from H5N1 avian flu, the first case of the virus in North America. It is also the first case of H5N1 infection ever imported by a traveler into a country where the virus is not present in poultry.

    April 20, 2015 – Officials say more than five million hens will be euthanized after bird flu was detected at a commercial laying facility in northwest Iowa. According to the US Department of Agriculture, close to eight million cases of bird flu have been detected in 13 states since December. Health officials say there is little to no risk for transmission to humans with respect to H5N2. No human infections with the virus have ever been detected.

    January 15, 2016 – The US Department of Agriculture confirms that a commercial turkey farm in Dubois County, Indiana, has tested positive for the H7N8 strain of avian influenza.

    January 24, 2017 – Britain’s Department for Environment, Food & Rural Affairs releases a statement confirming that a case of H5N8 avian flu has been detected in a flock of farmed breeding pheasants in Preston, UK. The flock is estimated to contain around 10,000 birds. The statement adds that a number of those birds have died, and the remaining live birds at the premises are being “humanely” killed because of the disease.

    February 12, 2017 – A number of provinces in China have shut down their live poultry markets to prevent the spread of avian flu after a surge in the number of infections from the H7N9 strain. At least six provinces have reported human cases of H7N9 influenza this year, according to Chinese state media, Xinhua.

    March 5-7, 2017 – The USDA confirms that a commercial chicken farm in Tennessee has tested positive for the H7N9 strain of avian flu, but says it is genetically different from the H7N9 lineage out of China. The 73,500-bird flock in Lincoln County will be euthanized, according to Tyson Foods.

    February 14, 2018 – Hong Kong’s Centre for Health Protection announces that a 68-year-old woman has been treated for the H7N4 strain. This is the first case of this strain in a human.

    June 5, 2019 – Since 2013 there have been 1,568 confirmed human cases and 616 deaths worldwide from the H7N9 strain of avian flu, according to the Food and Agriculture Organization of the United Nations.

    December 2019 – The United Kingdom Department for Environment, Food & Rural Affairs confirms that a case of H5N1 avian flu has been detected at a poultry farm in Suffolk. 27,000 birds are humanely killed because of the disease.

    April 9, 2020 – The USDA confirms that a commercial turkey flock in Chesterfield County, South Carolina has tested positive for the H7N3 strain of avian flu.

    January 2021 – India culls tens of thousands of poultry birds after avian influenza is detected in ducks, crows and wild geese in at least a dozen locations across the country.

    February 18, 2021 – Russian authorities notify WHO that they have detected H5N8 in humans. “If confirmed, this would be the first time H5N8 has infected people,” a WHO Europe spokesperson says in a statement.

    June 1, 2021 – China’s National Health Commission announces the first human case of H10N3.

    February 2022 – The USDA confirms that wild birds and domestic poultry in the United States have tested positive for the H5N1 strain of avian flu. By May 17, 2023, the CDC reports there are 47 states with poultry outbreaks.

    April 26, 2022 – China’s National Health Commission announces the first human case of H3N8.

    April 28, 2022 – The CDC announces a case of H5 bird flu has been confirmed in a man in Colorado.

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    Don’t use sugar substitutes for weight loss, World Health Organization advises | CNN



    CNN
     — 

    Don’t use sugar substitutes if you are trying to lose weight, according to new guidance from the World Health Organization.

    The global health body said a systematic review of the available evidence suggests the use of non-sugar sweeteners, or NSS, “does not confer any long-term benefit in reducing body fat in adults or children.”

    “Replacing free sugars with non-sugar sweeteners does not help people control their weight long-term,” said Francesco Branca, director of WHO’s department of nutrition and food safety. “We did see a mild reduction of body weight in the short term, but it’s not going to be sustained.”

    The guidance applies to all people except those with preexisting diabetes, Branca said. Why? Simply because none of the studies in the review included people with diabetes, and an assessment could not be made, he said.

    The review also indicated that there might be “potential undesirable effects” from the long-term use of sugar substitutes such as a mildly increased risk of type 2 diabetes and cardiovascular diseases.

    However, “this recommendation is not meant to comment on safety of consumption,” Branca said. “What this guideline says is that if we’re looking for reduction of obesity, weight control or risk of noncommunicable diseases, that is unfortunately something science been unable to demonstrate,” he said. “It’s not going to produce the positive health effects that some people might be looking for.”

    Non-sugar sweeteners are widely used as an ingredient in prepackaged foods and beverages and are also sometimes added to food and drinks directly by consumers. WHO issued guidelines on sugar intake in 2015, recommending that adults and children reduce their daily intake of free sugars to less than 10% of their total energy intake. Following that recommendation, interest in sugar alternatives intensified, the review said.

    “This new guideline is based on a thorough assessment of the latest scientific literature, and it emphasises that the use of artificial sweeteners is not a good strategy for achieving weight loss by reducing dietary energy intake,” said nutrition researcher Ian Johnson, emeritus fellow at Quadram Institute Bioscience, formerly the Institute of Food Research, in Norwich, United Kingdom.

    “However, this should not be interpreted as an indication that sugar intake has no relevance to weight-control,” Johnson said in a statement.

    Instead, one should cut back on using sugar-sweetened drinks, and try to use “raw or lightly processed fruit as a source of sweetness,” Johnson added.

    Dr. Keith Ayoob, scientific adviser for the Calorie Control Council, an international association representing the low-calorie food and beverage industry, told CNN via email the WHO’s “insistence on focusing only on prevention of unhealthy ‎weight gain and non-communicable diseases is at the very least, misguided.”

    Robert Rankin, president of the Calorie Control Council, said “low- and no-calorie sweeteners are a critical tool that can help consumers manage body weight and reduce the risk of non-communicable diseases.”

    The guidance is meant for government health organizations in countries who may wish to use the scientific analysis to implement policy changes for their citizens, Branca said.

    “That will likely depend on the way that which sweeteners are consumed in a specific country,” he said. “For example, in a country where consumption patterns are high, those countries might decide to take action in a way or another.”

    A total of 283 studies were included in the review. Both randomized controlled trials, considered the gold standard of research, and observational studies were included. Observational studies can only show an association, not direct cause and effect.

    Results from randomized trials found the use of non-sugar sweeteners had a “low” impact on reducing body weight and calorie intake when compared with sugar, and no change in Intermediate markers of diabetes such as glucose and insulin, according to the report.

    Observational studies also found a low impact on body weight and fat tissue, but no change in calorie intake. However, those studies found a low increase in risk for type 2 diabetes, high blood pressure, stroke, heart disease and death from heart disease, the report noted. A very low risk was also found for bladder cancer and an early death from any cause.

    WHO said that the recommendation was “conditional” because the identified link between sweeteners and disease outcomes might be confounded by complicated patterns of sweetener use and the characteristics of the study participants.

    In an emailed statement, the International Sweeteners Association, an industry assocation, said “it is a disservice to not recognise the public health benefits of low/no calorie sweeteners and is disappointed that the WHO’s conclusions are largely based on low certainty evidence from observational studies, which are at high risk of reverse causality.”

    However, observational studies that follow people over time are important, Branca said. “To show that overweight people can reduce their body weight requires a long-term study. And we’re not seeing that impact from the research we have.”

    The recommendation included low or no calorie synthetic sweeteners and natural extracts, which may or may not be chemically modified, such as acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and stevia derivatives and monkfruit, the report said.

    “Stevia and monkfruit are newer sweeteners so so there’s less published research in the scientific literature,” Branca said. “However they probably work in the body with a similar physiological mechanism as other sweeteners. We cannot say they are different from the others based on the data we have — they play the same role.”

    Many people consider stevia products to be more “natural,” since they are derived from the stevia plant. Some natural and artificial sweeteners add bulking sugars to their products to cut their sweetness and add bulk to the product for baking.

    A recent study by researchers at the US-based Cleveland Clinic found erythritol — used to add bulk or sweeten stevia, monkfruit and keto reduced-sugar products — was linked to blood clotting, stroke, heart attack and early death.

    People with existing risk factors for heart disease, such as diabetes, were twice as likely to experience a heart attack or stroke if they had the highest levels of erythritol in their blood, the study found.

    Just as many people have learned to eat and cook without salt, they can learn to reduce their dependence on free sugars and non-nutritive sweetners, Branca said.

    “We need to target children in early life,” he said. “For example, why do parents typically use sweeteners as a reward for children and after almost every meal? We need to recommend to parents to avoid building that sweetness Interest in young children — that’s a very important action to take.”

    Even if you are a true sugar “addict,” the good news is that you can tame your sweet tooth, registered dietitian Lisa Drayer said in an article for CNN. She provides the following steps:

    Train your taste buds. If you gradually cut back on sugar — including artificial sweeteners — and include more protein and fiber-rich foods in your diet, that can help you crave less sugar, Drayer said.

    “When we consume protein and fiber, it slows the rise in blood sugar if we consume it with a sugar-containing food. It can help satisfy us and help us reduce our sugar intake as well,” she said in a previous interview.

    Choose no-sugar-added foods and avoid all sugar-sweetened drinks. For example, choose whole-grain cereal or Greek yogurt with no sweeteners. The sugar-sweetened drinks to take off your grocery list should include sodas, energy drinks, sports drinks and fruit punch. Choose water instead.

    “If you like sweet carbonated beverages, add a splash of cranberry or orange juice to seltzer or try flavored seltzers. You can also flavor your own waters with fruit slices for natural sweetness or try herbal fruit teas,” Drayer said.

    Drink coffee and tea with no or fewer sugars. Be careful at coffee shops, Drayer suggested. All those lattes and flavored coffees can have as much sugar as a can of soda, or more.

    Enjoy fruit for dessert. Try cinnamon baked apples, berries or grilled peaches instead of cookies, cake, ice cream, pastries and other sweet treats, Drayer said.

    Watch for stealth sugars. Added sugars are often present in foods that you might not think of as “sweet,” like sauces, breads, condiments and salad dressings, Drayer said.

    “Pre-packaged sauces — like ketchup, BBQ sauce and tomato sauce — tend to be some of the biggest offenders of hidden added sugars in the diet,” Kristi King, senior pediatric dietitian at Texas Children’s Hospital and a national spokesperson for the Academy of Nutrition and Dietetics, told Drayer in a prior interview.

    Check nutrition facts labels. All foods and beverages must list the amount and kind of sugar on the label.

    Added sugars can go by other names such as “agave, brown sugar, corn sweetener, corn syrup, dextrose, evaporated cane juice, fructose, fruit juice concentrate, fruit nectar, glucose, high-fructose corn syrup, honey, invert sugar, lactose, malt syrup, maltose, molasses, maple syrups, raw sugar, sucrose, trehalose and turbinado sugar,” Drayer said.

    The higher up these added sugars are on the ingredients list, the greater the amount of added sugar in the product, she said.

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    ‘We never want to have this happen again,’ FDA official testifies about formula shortage | CNN



    CNN
     — 

    In a rare moment of bipartisan agreement, lawmakers were highly critical of the US Food and Drug Administration’s handling of the infant formula shortage Thursday.

    The hearing of the US House Oversight and Accountability Subcommittee on Health Care and Financial Services was one of several Congress has held to better understand what contributed to the recent formula shortage and to understand how to prevent more problems down the road.

    Rep. Lisa McClain, R-Michigan, said that the FDA has not been fully forthcoming with Congress and the public.

    “Why was the FDA unprepared for the crisis?” she asked in her opening statement.

    She said that the agency failed to prioritize food safety. “The FDA has not taken the action needed to prevent a similar crisis from happening again.”

    Rep. Katie Porter, D-California, said she agreed with McClain that another shortage could happen, “and that is a deadly serious problem.”

    “There is a lot of blame to go around,” Porter added. “It’s clear with today’s witness selection that Republicans want to blame the FDA, and I’ll level with you, I think some of that blame is well-placed. We’ve had two subsequent infant formula recalls in 2023 already, and we’re still seeing that the FDA can make further improvements on internal processes, intervene in issues sooner and follow through with more inspections to prevent further contamination.”

    Three major manufacturers in the US control over 90% of the formula market, and that consolidation is a “serious concern” that “contributed significantly to shortages,” according to Dr. Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition, who testified Thursday.

    A shortage that started in 2021 was exacerbated when the country’s largest infant formula maker, Abbott Nutrition, recalled multiple products in mid-February 2022 and had to pause production at its plant in Sturgis, Michigan, after FDA inspectors found potentially dangerous bacteria.

    The plant inspection was tied to an outbreak of Cronobacter sakazakii that had sickened at least four infants and killed two, although investigations did not find a genetic link between bacteria samples from the facility and bacteria found in the water and powder used to mix the formula that the infants had consumed.

    Mayne testified that it was difficult to trace the cases and determine how big of a concern the outbreak was. The bacteria is a common pathogen in the environment “but one about which we have limited information.”

    The FDA has urged the US Centers for Disease Control and Prevention to make Cronobacter infection a notifiable disease – meaning providers would be required to report cases to local or state public health officials – so public health experts would be able to more quickly determine the source of any contamination.

    In addition to the bacteria, an FDA inspection of the Sturgis plant found unsanitary conditions and several violations of food safety rules.

    A whistleblower had alerted the FDA to alleged safety lapses at the plant in February 2021, months before Abbott’s formula was recalled. The complaint suggested that the plant lacked proper cleaning practices and that workers falsified records and hid information from inspectors.

    Like other FDA leaders who have been called before Congress, Mayne testified that she was not made aware of the complaint right away. She called it “a failure of escalation.”

    “I do wish I had been made aware of this particular whistleblower complaint, but just to reiterate, the complaint was acted upon,” Mayne said. However, she noted, it was “less than ideal” how quickly there was an FDA inspection of the plant and how quickly the agency was able to act.

    When the whistleblower made the complaint, there was no process within the FDA to escalate it. The process has since changed so that if a complaint meets certain criteria involving vulnerable populations, hospitalizations or deaths, leadership would be immediately informed. If a consumer complaint involves an infant death or hospitalization, it also immediately gets escalated to leadership.

    To prevent future shortages, Mayne testified, it won’t just be the FDA that needs to change. The industry should do more to adopt enhanced food safety measures to “deliver the safest possible” infant formula, she said.

    The agency would also like better regulations. There have been been two infant formula recalls already in 2023, and in neither case was the manufacturer required to notify the FDA that it had found contamination before the formula left the plant.

    The FDA has asked formula makers to inform the agency about positive tests, but such reporting is only voluntary. If it were mandatory, the FDA could know about problems in real time and could take action.

    “Our food safety experts, our compliance experts can work with the manufacturers,” Mayne said. In such a collaboration, they could quickly identify what product to focus on to prevent a shortage.

    The FDA has taken recent steps to improve. In February, it announced that it is restructuring its food division to be more responsive and that it is creating an office of critical foods. The FDA is also hiring specialized infant formula inspection staff, Mayne said.

    The infant formula supply is generally in good shape, she said, but there are still some distribution issues.

    The in-stock rate is near 90%, even higher than pre-recall levels. But some rural areas are having a hard time getting all the formula they need.

    Formula manufacturers have been producing more than is being purchased week after week to build up supply, Mayne said. The Biden administration has also worked to bring in formula from manufacturers overseas.

    But another shortage is not out of the question, particularly if one of the country’s main manufacturers is taken offline for any significant amount of time.

    “We never want to have this happen again,” Mayne said.

    Lawmakers have proposed significant cuts, about 22%, to the FDA’s budget for 2023. Mayne said that consumers and the industry would be “adversely affected” if the cuts go through.

    “Broadly, across the FDA, I can say it would be devastating,” she said, resulting in a loss of 32% of domestic inspections and 22% of foreign inspections. The cuts would also disproportionately affect its food programs, which get much of their funding from the budget, unlike divisions involving drugs that get money from user fees.

    “We would be unable to do what I think American consumers expect us to do,” Mayne said.

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    Bacterial infection linked to recent baby formula shortage may join federal disease watchlist | CNN



    CNN
     — 

    US health officials may soon ask states to notify them of any cases of infants with serious infections caused by Cronobacter sakazakii, bacteria that can contaminate infant formula.

    Cronobacter infections typically strike infants who are less than 2 months old, and they can be fatal or permanently disabling.

    In an outbreak that the US Centers for Disease Control and Prevention investigated last year, four babies were sickened, including two who died. All the infants had been fed baby formula manufactured at the same factory in Sturgis, Michigan, triggering an extensive investigation by the US Food and Drug Administration and ultimately stopping production at the facility for months. The shutdown worsened ongoing supply chain issues and threw the country into a nationwide shortage.

    Ultimately, the FDA and the CDC could find no genetic links between Cronobacter samples from the facility and the bacteria found in the water and powder used to mix the formula that the infants had consumed.

    These infections are thought to be infrequent, but the true burden in the US is unknown because Cronobacter is not currently part of the National Notifiable Diseases Surveillance System, a list of about 120 illnesses given special priority by the CDC because they’ve been deemed to be important to public health.

    The Council of State and Territorial Epidemiologists, a nonprofit organization that advocates for effective disease surveillance, identified Cronobacter as a priority area for investigation this year.

    A work group was formed in the winter to assess conditions, risks and surveillance processes related to the bacterial infection, and it will present recommendations to advance Cronobacter surveillance in June.

    Adding Cronobacter infections to the national watchlist is among the strategies being considered.

    “When we look back at large-scale outbreaks over the course of the last year, many of those outbreaks were associated with diseases and conditions that were nationally notifiable, but not all of them,” said Janet Hamilton, executive director of the council – and Cronobacter was one of the exceptions.

    “So whenever we have something like that, that prompts the council to determine and assess whether we need to potentially be doing more.”

    Adding an illness to the national list can have a sizable impact. After E. coli O157 was added to the notifiable disease list in 1994 and most states required doctors to report cases by 2000, the number of reported outbreaks tripled.

    However, it would take quite some time for any changes to take effect.

    If the Council of State and Territorial Epidemiologists votes in favor of adding Cronobacter infections to the national list of notifiable diseases, the recommendation will go to the CDC for approval. If the CDC deems an illness to be notifiable, it’s up to state and local governments to adjust their reporting laws and develop processes for doctors to report cases to health departments, which then forward those reports to the CDC.

    The soonest that data collection could start is the beginning of 2024, and it would most likely be well into the year, depending on state legislative sessions.

    Currently, only two states, Minnesota and Michigan, require doctors to report Cronobacter cases, which may be diagnosed more generically as sepsis or meningitis, conditions that can result from an infection.

    “Unless detailed studies are done, the diagnosis as a Cronobacter illness may be missed,” FDA Commissioner Dr. Robert Califf wrote in a blog post last week. “The lack of mandatory reporting significantly hampers the ability to fully understand Cronobacter’s public health impact.”

    Dr. Peter Lurie, executive director of the Center for Science in the Public Interest, applauded the potential move.

    “I think it’s a necessary step. It is difficult to prevent diseases that you can’t count,” Lurie said.

    In addition, Lurie says, manufacturers should be required to notify the FDA when a batch of baby formula tests positive for Cronobacter before it leaves the plant. The FDA has asked manufacturers to tell it about positive tests, but such reporting is voluntary.

    Lurie says the FDA should also be doing more sampling and testing for Cronobacter in the environment to get a better understanding of where the bacteria can turn up.

    “I think we have a lot to learn there,” he said.

    Mitzi Baum, CEO of the group Stop Foodborne Illness, which has been advocating for the change, said she was grateful the Council of State and Territorial Epidemiologists was moving toward a vote on it.

    She said greater awareness of the infection was long overdue.

    “It’s always prefaced by ‘this is rare,’ but we don’t know how rare it is because it’s not reportable. And there needs to be a lot more education about this pathogen and a lot more research,” Baum said.

    Baum said her group is working with the council to create an education campaign to raise awareness of the infection among doctors. The next step, she says, is getting funding.

    The council’s Hamilton points out that “simply making something nationally notifiable doesn’t necessarily translate into awareness and recognition on the prevention side. If people don’t have the right set of information and education, by the time we’re doing public health surveillance for it, the disease or infection has already occurred.”

    According to the FDA, Cronobacter sakazakii is a common natural pathogen that can enter homes and other spaces on hands, shoes and other contaminated surfaces. It is “especially good at surviving in dry foods,” such as powdered baby formula.

    Infections are harmless for most people, but it can be life-threatening for infants, especially those who are born prematurely or with weakened immune systems. It’s particularly important to be sure that parents of high-risk infants know how to keep them safe, Hamilton said.

    “Providing good education around how to stop infections is really what leads to the level of change that we would love to see,” she said.

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