*Dr. Greger's Newsletter--June-August 2005 issue*

[Guest guest]

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June - August 2005 issue of Dr. Michael Greger's quarterly newsletter

 

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CONTENTS (online at http://www.DrGreger.org/newsletters.html )

 

I. Latest Updates in Human Nutrition

A, Making the Healthiest Food on Earth Even Healthier

B. Treating Springtime Allergies with Spirulina?

C. Figs Fight Fatigue

D. Heart Attacks, Side-Effects, or a Healthy Diet

E. Plant-Based Diets Beneficial in Pregnancy

F. Soy and Cancer: A Meta-Analysis

G. Dairy Diet Myth

H. ATTACK OF THE SUPERBUGS

1. Chicken Out of Urinary Tract Infections

2. Campylobacter Joins the Resistance

3. The Hard-Boiled Truth: Salmonella and Eggs

4. Don't Wash Your Meat

5. Bacteria or Cancer

 

II. Bird Flu Update: Perfect Storm Gathering

 

III. Carbophobia Update: Atkins Is Toast

 

IV. Personal Update: New Job and New 501c3 Status

 

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I. LATEST UPDATES IN HUMAN NUTRITION

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A. Making the Healthiest Food on Earth Even Healthier

 

A quote from the May 2005 issue of the Center for Science in the

Public Interest's Nutrition Action Healthletter: " Get a bunch of

nutrition experts in a room and the conversation will inevitably turn

to dark leafy greens. " [1] How true that is. And two new studies just

discovered two ways to make your daily (at least!) green leafy salad

even healthier.

 

It's not enough to eat healthy food, we also have to absorb it. One

of the key components that makes dark green leafies so nutritious are

the carotenoid antioxidants, like alpha-carotene, beta-carotene, and

lutein. These compounds are lipophilic, though. " Lipo- " is from

lipos, the Greek word for fat (as in liposuction); " -philic " is from

the word philia, one of the four Greek words for love (as in... well

we won't get into that). So these carotenoid nutrients are fat-loving

molecules, and as such our body can use ingested fat to entice out

these nutrients trapped within our greens.

 

So researchers at Ohio State University paid about a dozen people to

eat salads (this is America, you've got to PAY people to eat salad)

with or without avocado, one of the healthiest sources of fat, and

then measured the amount of carotenoids that made it into everyone's

bloodstream. Those eating a salad including half an avocado absorbed

about 10 times more carotenoids than those eating the fat-free

salad![2]

 

Would the same hold true for the lycopene in salsa? Lycopene doubles

as an extremely powerful carotenoid antioxidant and the red pigment

that makes fruits and vegetables like watermelons and tomatoes red.

Adding avocado to salsa more than quadrupled the amount of lycopene

absorbed by test subjects.[3] (You wouldn't have to pay me to be in

that study--yum!)

 

The other salad enhancement study recently took place at the

Universitia di Urbino in Italy. With the understanding that it's the

antioxidants that give fruits and vegetables their anticancer,

antiviral, and anti-inflammation properties, scientists experimented

with adding different fresh herbs to salads and measuring their

resultant total antioxidant content. They found that adding just a

single sprig of fresh herbs (the weight of 3 paper clips worth of

thyme, sage or marjoram--a kissing cousin of oregano) literally

doubles the antioxidant power of a bowl of salad. It's almost like

eating two salads for the price of one! The researchers conclude: " We

stress the need to introduce aromatic herbs as a seasoning supplement

in the diet of every age group. " [5]

 

Right now at farmers' markets and plant nurseries across the country

are little pots of herbs desperate for a good home. Take them in,

nurture them, then rip off their limbs and eat them.

 

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B. Treating Springtime Allergies with Spirulina?

 

People have been harvesting pond scum for thousands of years. The

Aztecs, for example, were skimming it off lakes and into their diets

half a millennia ago. Were they onto something?

 

Spirulina is one of the most popular blue-green algae supplements on

the market. In addition to being one of the most concentrated known

source of nutrients (though how much of it can you really eat?),

there is building evidence of its anti-inflammatory properties. To

see if it might be of therapeutic value to seasonal allergy

sufferers, researchers at the University of California at Davis

School of Medicine enrolled 3 dozen sniffley sneezers into a

randomized, double-blind, placebo-controlled crossover study (one of

the most rigorous study designs to minimize various biases). Compared

to placebo, participants taking 2 grams of spirulina a day were able

to cut their production of inflammatory mediator Interleukin-4, a

chief conductor of allergic reactions within the body, by over 30%.[7]

 

So should those with runny noses run out and grab some? Two months

ago I would have said yes, but not now. I was actually in Hawai'i,

the spirulina export capital of the world, when the bombshell hit.

Published in the journal of the most prestigious scientific body in

the United States, the National Academy of Sciences, researchers came

to a disturbing revelation about the safety of blue-green algae in

general.

 

We've known for years that a few rare types of blue-green algae could

produce hepatotoxins (compounds toxic to the liver), but spirulina

was considered generally[8] free of any such toxins.[9] But in April

2005 a coordinated effort of researchers across the world found

evidence that almost all blue-green algae seem to be able to produce

a neurotoxin called BMAA (beta-N-methylamino-L-alanine). BMAA is bad

stuff. It's been implicated in a neurodegenerative disease as

horrible as its name sounds, amyotrophic lateral

sclerosis/parkinsonism-dementia complex. This disease attacked the

Chamorro people of Guam who were eating flying foxes, who in turn

were eating seeds of a cycad tree, whose watery roots concentrated

the toxin from a certain type of algae.

 

Now with this new study we know that the production of this

neurotoxin is not limited to some rare Guam algae, but may be

produced by almost all blue-green algae under the right conditions.

So it turns out the only two places you may be likely to find BMAA is

in the brains of Alzheimer's patients[10] and on the store shelves of

your local natural foods store in the form of blue-green algae.[11]

 

Until we know more, I strongly discourage people from eating

blue/green algae (including the spirulina that, until April, was what

made the popcorn I always smuggled into the movie theatre such a

brilliant green hue). Those interested in reducing inflammation will

have to choose other plant foods like--as one recent article

published in the Journal of Nutrition discovered--gazpacho, a

vegetable soup which " decreased biomarkers of inflammation in both

women and men. " [12]

 

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C. Figs Fight Fatigue

 

In search of some of the most nutrient-dense foods in existence,

chemists at the University of Scranton in Pennsylvania started

looking at dried fruit. Since 90% of a fruit's weight is water, they

figured that dried fruit might be ten times more nutritious by weight

than fresh. Well, it didn't quite work out that way. The drying

process destroyed about 80% of the chief antioxidant compounds, but,

given that the nutrition in dried fruit is ten times more

concentrated, dried fruits did still come out ahead, finishing out

with about 10% more antioxidant content than fresh (by weight). And

with all the fiber and minerals intact, dried fruit tested out to be

little nutrition powerhouses.

 

A new study out of Korea just found that the antioxidant boost

provided by fruit consumption only seems to last about 2 hours.[13]

So carrying around some trail mix is a convenient way to make sure

your body is constantly flooded with antioxidants throughout the day.

Which dried fruits are the best? Of the six fruits tested--apricots,

cranberries, dates, figs, raisins and plums--shooting to a surprise

finish at number one was... figs! (OK, OK, the study was paid for in

part by the California Fig Advisory Board, but still...).

 

Aren't dried fruits packed with concentrated sugars though? And isn't

sugar a pro-oxidant? Well, yes, but dried (and fresh) fruits are so

packed with antioxidants that not only do they successfully counter

the potential detriment of their own sugar, they are powerful enough

to take on a can of Coke, too. When you drink a dozen spoonfuls of

sugar in a soft drink (aka " liquid candy " ), the antioxidant capacity

of your blood drops dramatically as your body starts using up its

antioxidant stores to deal with the oxidant stress caused by all that

sugar. Well what if you doubled the amount of sugar you ingested by

drinking a cup of soda with a serving of dried figs on top? Even the

high fructose corn syrup in the soda is no match for the antioxidant

power of fruit. Despite the double sugar load, subjects washing down

their figs with soda still experienced an overall rise in antioxidant

levels in their bloodstream.[14] No, that doesn't mean you can eat or

drink all the candy you want as long as you pop a few raisins. Stick

with the fruit.

 

In addition to having the highest antioxidant content among the six

fruits tested, of the thousands of whole foods in the USDA nutrient

database, figs make the top ten for fiber content.

 

(For the curious, the top five are #1. Cloud ear mushrooms (the

number one fiber-containing whole food on the planet and I've never

even heard of it?), #2. Flax seeds (I've heard of those), #3. Sesame

seeds, #4. Dried unsweetened coconut, and #5. Air-popped popcorn).

 

And fiber consumption, according a new review, may help boost energy

levels.[15] Half the fiber we swallow is eaten by the good bacteria

in our colon. Our colonic comrades ferment the fiber we eat into

short-chain fatty acids, which our body then absorbs and sends

straight to our muscles to be used as a ready fuel source. Of course,

another byproduct of this fermentation product is gas, some of which

is absorbed by other bacteria to produce even more fuel for us, but

the rest of which is indeed excreted. Maybe a more appropriate title

would be Fight Fatigue with Fig Farts.

 

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D. Heart Attacks, Side-Effects, or a Healthy Diet

 

One of the laws of ecology is that you cannot do just one thing

(because everything is connected to everything else). Yet, when

physicians put people on statin drugs to cripple the enzyme that

produces cholesterol within your liver, they hope there won't be any

other effects. Unfortunately within the ecology of the body that too

often is not the case. About one in six people on these

cholesterol-lowering drugs experience other untoward effects,[16] and

there is growing concern about the very rare (but very serious)

life-threatening adverse reactions to this class of drugs. We've

known about the potential for rare cases of these drugs causing

muscle breakdown, but recently there's been increasing concern about

rare cases of these drugs causing nerve breakdown--a so-called

drug-induced polyneuropathy.[17] It seems that statins may also

co-cripple the synthesis of a key energy-producing enzyme in nerve

cells. Thankfully, one doesn't have to choose between the risk of

getting a heart attack and the risk of suffering side-effects from

life-long drug therapy. That's because David Jenkins has done it

again.

 

Currently one of the world's most respected nutrition researchers (it

was his team that invented the glycemic index), Dr. Jenkins has just

published yet another study proving that a completely plant-based

(vegan) diet alone can lower cholesterol levels as much as the

combination of a low-fat vegetarian diet AND a statin drug.[18]

Although, as drugs go, statins seem remarkably safe, users do risk

(albeit extremely rarely) being written up as case reports with

unpleasant names like " Toxic Epidermal Necrolysis from Atorvastatin. "

That one, published in the Journal of the AMA, described a horror

story of a woman whose skin erupted in blisters and then started

necrosing off. Patches of her skin started disintegrating and

sloughing off after only four days on the statin drug. After two

weeks on a morphine drip, thankfully, she pulled through.[19]

Contrast that with the side effects of a healthy plant-based diet.

What's the worse that can happen? Maybe less reading time on the

toilet because you're not constipated anymore?

 

As the revered Moses Maimonides wrote in the 12th century: " No

illness which can be treated by diet should be treated by any other

means. "

 

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E. Plant-Based Diets Beneficial in Pregnancy

 

Adequate magnesium status is critical for the health of both mother

and fetus during pregnancy. Magnesium deficiency during pregnancy is

associated with everything from bothersome calf muscle cramps to a

potentially life-threatening complication called eclampsia. So where

is magnesium found? Well, it forms the core of chlorophyll molecules,

so--you guessed it--dark green leafy vegetables, as well as beans,

seeds and whole grains. So researchers at the German Institute of

Human Nutrition reasoned that women who followed plant-based diets

would have a better magnesium status and fewer magnesium

deficiency-related complications than those following the Standard

American Diet (SAD). And, that's exactly what they found.

 

They followed over a hundred women through their pregnancies and not

only did those following a plant-based diet indeed have " markedly "

higher magnesium intakes, but they had significantly fewer leg cramps

during the second and third trimesters. The researchers conclude that

this is in line with the " substantial evidence from many studies that

plant-based or vegetarian diets can reduce the risk for many

nutrition-related diseases. " [20]

 

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F. Soy and Cancer: A Meta-Analysis

 

Some studies suggest that soy consumption prevents cancer, some

studies find no association and internet sites like Mercola.com

suggest that ingesting soy actually causes cancer. (Joseph Mercola,

who boasts the " #1 natural health website, " just received a warning

letter from the FDA ordering him to stop making illegal claims about

the products he sells. See

http://www.casewatch.org/fdawarning/prod/2005/mercola.shtml ). So

what does the balance of evidence show? That's where a meta-analysis

comes in.

 

Instead of picking and choosing studies to suit one's agenda,

meta-analyses look at essentially every study ever done on a topic

and kind of pool the data all together. A meta-analysis of the effect

of soy on cholesterol levels back in the '90s, for example, showed

that the evidence of a cardio-protective role of soy was so strong

that the FDA authorized a health claim on soy products that they may

reduce the risk of heart disease. Now finally, published in a recent

issue of the Journal of the American College of Nutrition, a

meta-analysis on the role of soy in cancer prevention.

 

Researchers looked at three types of cancer: breast cancer, prostate

cancer and gastrointestinal cancer (like colon cancer). Combining all

the best published studies, they found highly significant reductions

in cancer risk among consumers of soy products. Women of all ages who

eat soy enjoy 22% less breast cancer (36% less for postmenopausal

women!), male soy consumers are 34% less likely to get prostate

cancer, and both men and women who consume soy reduce their risk of

developing gastrointestinal cancer by 30%.[21]

 

The evidence is so strong that there is now another health claim

before the FDA--soon we may see labels saying that soy protects

against cancer as well.

 

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G. Dairy Diet Myth

 

" Drink Milk... Lose Weight " say the ads which ran in over 30

newspapers and magazines. October 2003, the dairy industry launched

an entire " Healthy Weight with Milk " campaign to boost sales.

Curiously, that also happened to be the same year a review of that

exact subject was published in the Journal of Nutrition. The review

found nine randomized controlled studies in the medical literature on

body weight and dairy. Seven of the nine studies found no significant

change in body weight compared to controls and the last two found

that those who increased their dairy consumption gained significantly

more weight than the nondairy control groups.[22] Subsequent and even

larger studies published in 2004[23] and 2005[24] showed the exact

same thing.

 

So, wait a second. How can the dairy industry's ads claim that " a

clinical study shows it helps you burn more fat and lose more weight

than just cutting calories alone? " Well, because there is actually

one tiny study, published by Michael Zemel of the University of

Tennessee, which did find that the 11 study participants instructed

to eat more dairy did seem to lose more weight. Yes, of course the

study was bought and paid for by the dairy industry, but it goes

further than that. This guy Zemel owns a patent on the claim that

dairy foods aid weight loss, which is licensed to dairy food

manufacturers. As the Center for Science in the Public Interest

noted, " In the world of patents and PR, a little science can go a

long way. " [25]

 

Similar maneuverings were involved in the increased dairy

recommendation in the new USDA Dietary Guidelines, even though a

recent World Health Organization review found no significant

relationship at all between low dairy consumption and osteoporotic

fracture risk.[26] Assigned to write the dairy guideline was Connie

Weaver, head of nutrition at Purdue University and a funding favorite

of the National Dairy Council. Walter Willet, head of nutrition at

Harvard, calls the guideline committee's report " egregious, " accusing

them of ignoring the evidence linking dairy to cancer. " There is no

nutritional requirement for dairy, " Dr. Willet told the Wall Street

Journal, " at all. " [27]

 

To hopefully clear up the dairy/weight question once and for all,

last week on June 6, 2005, Harvard researchers published what may be

considered the definitive study on the subject in the Archives of

Pediatrics and Adolescent Medicine. A study which followed the

milk-drinking habits of not 11 kids, or even 12 kids, but over 12,000

kids! After following these 9- though 14-year-olds for years, they

found that " children who reported higher total milk intake

experienced larger weight gains. " The more milk they drank, the

heavier they became. Boys who drank the " recommended " three servings

of milk a day were 35% more likely to become overweight and girls who

drank three servings were 36% more likely to become overweight over

time.[28]

 

" Given the high prevalence of lactose intolerance, the energy content

and saturated fat in milk, and evidence that dairy products may

promote both male (prostate) and female (ovarian) cancers, we should

not assume that high intakes [of dairy] are beneficial, " the

researchers told reporters. " Furthermore, these cancers may be linked

to consumption during adolescence. " [29]

 

What most surprised the researchers was that those who drank low-fat

milk (skim and 1%) gained the most weight of all! The weight gain

seemed tied more to the dairy protein intake than the dairy fat

intake (extra whey protein is often added to low-fat milk during

processing). Although there are at least four human studies that show

that the dairy protein whey itself may promote weight gain, the

researchers guessed that the blame lay in the growth hormones in

milk, like the sex steroid estrone found in whey. After all, milk is

designed by mother nature to start an 80-pound calf on her way to

1,400 pounds by her second birthday.

 

This new study has serious implications for our childhood obesity

epidemic, which not only has devastating health consequences but

social consequences as well. A study released the same week by

researchers at the Centers for Disease Control found that teens who

perceived themselves as overweight were more than twice as likely to

attempt suicide.[30]

 

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H1. SUPERBUGS: Chicken Out of Urinary Tract Infections

 

Urinary Tract Infections are the most common infectious disease in

women, affecting millions every year in the United States. And they

are getting harder and harder to treat as antibiotic resistance among

the chief pathogen, E. coli, becomes more and more common.

 

When people think of E. coli infection, they typically think of the

Jack-in-the-Box E. coli 0157:H7 infection, which starts as

hemorrhagic colitis (profuse bloody diarrhea) and can then progress

to kidney failure, seizures, coma and death. While E. coli 0157:H7

remains the leading cause of acute kidney failure of our children in

this country,[31] only about 50,000 people get infected every year

and only about 50 die. But literally millions of people get what's

called " extraintestinal " E. coli infections--urinary tract infections

(UTIs) which can invade the bloodstream and cause an estimated 36,000

deaths annually in the United States. That's over 500 times as many

deaths as E. coli 0157:H7. We know where E. coli 0157:H7 comes

from--fecal contamination from the meat, dairy and egg

industries[32]--but where do these other E. coli come from?

 

Medical researchers at the University of Minnesota published a clue

to the mystery this April in the Journal of Infectious Disease.

Taking over a thousand food samples from multiple retail markets,

they were not surprised to find evidence of fecal contamination in

69% of the pork and beef and 92% of the poultry samples as evidenced

by E. coli contamination. We know meat products are crawling with

intestinal bugs. In fact, animal manure has been found to be the

source of more than 100 pathogens, including bacteria, parasites and

viruses that could be transmitted from animals to humans.[33]

 

More surprising was that " >80% of their E. coli isolates from beef,

pork, and poultry exhibited resistance to >=1 antimicrobial agent,

and >50% of isolates from poultry were resistant to >5 drugs! " [34]

One rarely finds exclamation points in the medical literature.

 

But what was most surprising was that, for example, half of the

poultry samples were contaminated with the extraintestinal E. coli

bacteria. It seems that the UTI-type E. coli are food-borne pathogens

as well, " found in many retail foods, " the researchers write,

" particularly poultry but also beef or pork.... "

 

The researchers conclude: " The highest prevalences and densities of

resistant E. coli and ExPEC [Extraintestinal Pathogenic E. Coli] were

found in meat products. This is consistent with contamination of

animal carcasses with the host's fecal flora during slaughter and

processing and with use of antimicrobial agents in food-animal

production. " The researchers go so far as to say that the

extraintestinal pathogenic E. coli " may rival (or exceed) E. coli

O157:H7 as a foodborne pathogen. " [35] Science News comments on a 2005

California study which found the same thing:[36] " According to new

research, this wave of multidrug-resistant UTIs may have a surprising

source: eating meat. " [37]

 

The scientists suspect by eating chicken and other meat, women infect

their lower intestinal tract with these antibiotic-resistant bacteria

which can then creep up into their urethra. Commonsense hygeine

measures to prevent UTI's have always included wiping from front to

back after bowel movements and urinating after intercourse to flush

any infiltrators out. Now perhaps we can add a third measure:

avoiding meat.

 

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H2. SUPERBUGS: Campylobacter Joins the Resistance

 

Campylobacter is the most common bacterial cause of food poisoning in

the United States. One study found Campylobacter contaminating 98% of

retail chicken meat, the most common cause of Campylobacter

poisoning.[38] And the bacterium is growing dangerously resistant to

multiple classes of antibiotics. But we still have a few big-gun

antibiotics left to deal with resistant bugs. So, for the time being

(before the bacteria outsmart these new antibiotics as well), do we

have good evidence showing that partially resistant bugs like

Campylobacter currently pose a particular threat? We do now.

 

Typically, Campylobacter only causes a self-limited diarrheal illness

( " stomach flu " ) which doesn't require antibiotics. If the

gastroenteritis is particularly severe or if doctors suspect that the

bug may be working it's way from the gut into the bloodstream, the

initial drug of choice is typically a quinolone antibiotic like

Cipro. Quinolone antibiotics have been used in human medicine since

the 1980s, but widespread antibiotic-resistant Campylobacter didn't

arise until after quinolones were licensed for use in animal feed as

growth promoters in the early 1990s. In countries like Australia,

which reserved quinolones for human use only, resistant bacteria

simply do not exist.[88]

 

When the FDA announced they were intending to join other countries

and ban quinolone antibiotic use on U.S. poultry farms, the drug

manufacturer, Bayer, sued the FDA. Bayer lost the lawsuit last year,

but is currently appealing the decision. Meanwhile, poultry factories

continue to spike the chickens' water supply with these antibiotics

critical to human medicine. Evidence released in May 2005 found that

retail chicken samples from such factories are more than 450 time

more likely to carry antibiotic-resistant bugs. Even companies like

Tyson and Purdue which supposedly stopped using antibiotics years ago

are still churning out antibiotic-resistant bacteria-infected

chicken. Scientists think the bacteria that became resistant years

before are still hiding within the often dirt floors of the massive

broiler sheds or within the piping of the water supply. Another

possibility is that the carcasses of the chickens raised under

so-called " Antibiotic Free " conditions are contaminated with

resistant bacteria from slaughterhouse equipment which can process

over 200,000 birds in a single hour.[88]

 

In someone infected with Campylobacter, if the initial quinolone

antibiotic isn't effective, doctors switch to stronger antibiotics

reserved as a last resort. Does this delay lead to poorer patient

outcomes? Scientists recently studied thousands of patients with

Campylobacter infection to answer that question, and, indeed, the

delay in treatment caused by quinolone-resistant Campylobacter led to

up to ten times more complications--infections of the brain, the

heart, and the most frequent serious complication they noted,

death.[39]

 

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H3. SUPERBUGS: The Hard-Boiled Truth: Salmonella and Eggs

 

In June 2005, the Centers for Disease Control released data showing

resistant Salmonella led to serious complications as well.[40]

Foodborne Salmonella emerged in the Northeast in the late 1970s and

has now spread throughout North America. Salmonella hospitalizes

thousands of people every year and kills hundreds. And Salmonella

infection can be the gift that keeps on giving: Salmonella infections

can lead to chronic conditions such as arthritis, bone infections,

cardiac inflammation and neurological disorders.[41]

 

In the United States, more than one in five " broiler " chickens may be

Salmonella infected (at least in Russian roulette, there are six

chambers).[42] But it's even more of a problem with egg-laying hens.

Eggs are the primary vehicle for the spread of Salmonella bacteria to

humans, causing an estimated 80% of outbreaks. This year, the CDC

published the first estimate of how many Americans get Salmonella

from eggs every year. According to the best data we have, eating

Salmonella-infected eggs may cause 168,000 illnesses every year in

the United States alone.[43] A comic strip up in my office helps

explain the level of infection:

 

Father and daughter are in the grocery store. " That's a cow's

tongue?! " the girl exclaims, face contorted in disgust. " EEEEww...I

would never eat anything that was in a cow's mouth! "

 

" Me neither, " replies the father not looking up from his

shopping list. " Let's see... " he continues, " where are the eggs? "

 

Ruthie stops. " Wait a minute! " she exclaims, eyes wide in realization.

 

Can't you just wash off the eggs? Unfortunately, no. Many of the

tainted eggs are infected within the hens' ovaries even before the

shell forms, so you can't wash away the infection. And, as we'll see,

washing meat doesn't work either.

 

--------------

 

H4. SUPERBUGS: Don't Wash Your Meat

 

Can't you just wash off meat like one rinses off fruits and

vegetables? No. In fact, the new federal dietary guidelines

specifically recommend that " meat and poultry should not be washed or

rinsed. " The USDA explains: " Bacteria in raw meat and poultry juices

can be spread to other foods, utensils, and surfaces. " Juices?

Animals are not fruits. They don't have juice. In chickens, for

example, the " juice " is a fecal soup of bloody serum absorbed in the

scalding and cooling tanks in the slaughter house. Further, the

infection is actually inside these animals.

 

Millions of chickens are drowned alive in the scalding tanks (the

federal Humane Slaughter Act exempts all birds), which may introduce

the pathogens into their lungs. However new research from the USDA's

chief scientific research agency suggests that the primary source of

lung contamination with bacteria like Campylobacter is inhaled manure

during production (where up to tens of thousands of chickens are

overcrowded into broiler sheds) or during transport.[44]

 

The June 2005 issue of the Tufts University Health and Nutrition

Letter notes: " Your own hands, where they grasped the meat while

washing it, could become just as bacteria-laden as the surface of the

food....The best bet is to leave meat or poultry untouched until you

start cooking it " [45] (what are you supposed to do--levitate it into

the oven?) New research, though, suggests that even this precaution

may not be enough.

 

In March 2005, researchers published a study in which they swabbed

the external surface of prepackaged raw meat in the grocery stores

for fecal contamination. And did they ever find it. Even though most

of the packages looked clean on the outside, they found Salmonella,

Campylobacter and multidrug-resistant E. coli on the outer surface of

packages of meat. Just picking up a package of meat in the store

could put one at risk.

 

Poultry beat out the competition for the most contamination, followed

by lamb, pork and beef. One swab of a single Q-tip picked up over

10,000 live E. Coli bacteria. As few as 10 bacteria of the

hemorrhagic type (E. coli 0157:H7) can lead to a potentially fatal

infection.[46] The researchers conclude, " The external packaging of

raw meats is a vehicle for potential cross-contamination by

Campylobacter, Salmonella, and E. coli in retail premises and

consumers' homes. " [47]

 

OK, fine, but what if you handled the meat like they do in the

lab--first wiping the package off with rubbing alcohol using sterile

gloves, then cutting it open with a disposable blade before lifting a

piece out with sterile forceps into the oven--once it's cooked to the

proper temperature it's safe, right? Unfortunately, the internal

temperature required to cook the fecal contamination dead (160

degrees F) is the same temperature which produces carcinogenic

compounds called heterocyclic amines.

 

--------------

 

H5. SUPERBUGS: Bacteria or Cancer

 

In May 2005, a major review of these cooked-meat carcinogens was

published by researchers at the U.S. Department of Energy. When

skeletal muscles are heated beyond a certain temperature--be it moist

heat (boiling) or dry heat (broiling, frying, grilling)--the muscle

creatine combines with blood sugars and amino acids to create

heterocyclic amine carcinogens. Of all the meats tested, cooked

chicken breast formed the highest levels of these toxins.

 

Although there are cooking methods that result in lower carcinogen

concentrations (marinating followed by a microwaving pretreatment and

pouring off of the " juices, " followed by relatively low temperature

frying with frequent flipping), there does not seem to be a way to

cook meat to an internal temperature necessary to kill off bacteria

without producing at least some carcinogenic compounds. And even low

doses have been shown to cause human DNA mutations which could lead

to cancer.

 

Human studies suggest that eating well-done meat can raise the risk

of breast cancer, prostate cancer, and colon cancer by more than

400%. The researchers conclude, " There is a general consensus that

human exposure to potent genotoxic heterocyclic amine carcinogens

produced in meat during cooking is widespread. " [48] Meat consumers

are then faced with a dilemma, choosing between the risks of food

poisoning or cancer.

 

*******************************************************

 

II. BIRD FLU UPDATE: Prefect Storm Gathering

 

In my last update in March 2005 ( " Bird Flu Spreads its Wings "

http://www.drgreger.org/march2005.html ) we were left with a New

Scientist editorial entitled " Bird Flu Outbreak Could Kill 1.5

Billion People " and the head of the World Health Organization in Asia

saying " The world is now in the gravest possible danger of a

pandemic. " Well. according to the World Health Organization (WHO),

the situation is now even graver.

 

The WHO convened an emergency meeting last month, May 2005, to

discuss the latest findings. They issued a press release: " [The

findings] demonstrate that the viruses are continuing to evolve and

pose a continuing and potentially growing pandemic threat. "

 

There are three essential conditions necessary to produce the next

pandemic. First, a new virus arises from a nonhuman animal reservoir

(such that humans have no natural immunity to it). Second, the virus

evolves to be able to kill human beings efficiently. Third, the virus

must evolve to be able to spread between humans easily--via a sneeze

or handshake. So far, conditions one and two have been met in spades.

Three strikes and we're out.

 

At this time, nearly all of the human deaths have " involved people

who lived or worked with poultry, poultry meat or eggs in Southeast

Asia. " [49] USDA researchers tested thigh and breast meat in chickens

and effectively proved in a study published March 2005 that chicken

meat from infected birds can indeed be a source of infection.[50]

While UN officials have urged people to stop drinking duck's

blood[51] and eating " tiet canh " (congealed duck blood pudding) the

fear is that once bird flu has enough chances to mutate inside of

human hosts, it can then flood across the world human-to-human like

the bird flu epidemic did in 1918.

 

The global mortality from the 1918 pandemic has recently been revised

upwards to as many as 100 million people dead.[52] Experts fear this

new virus may turn out many times more deadly. " This is the worst flu

virus I have ever seen or worked with or read about, " one virology

chair who has been studying avian influenza strains for decades told

a reporter. " We have to prepare as if we're going to war and the

public needs to understand that clearly... if this does happen, and I

fully expect it will, there will be no place for any of us to hide.

Not in the United States or in Europe or in a bunker somewhere. The

virus is a very promiscuous and efficient killer. " [53] The top

Russian virologist offers a potential death count: " Up to one billion

people could die around the whole world in six months... We are half

a step away from a worldwide pandemic catastrophe. " [54]

 

Dr. Michael Osterholm, director of the U.S. Center for Infectious

Disease Research and Policy, is probably our nation's top expert. He

continues to make attempts to describe the ensuing unimaginable

horror. He suggests people consider the devastation of the recent

tsunamis in South Asia: " Duplicate it in every major urban centre and

rural community around the planet simultaneously, add in the

paralyzing fear and panic of contagion, and we begin to get some

sense of the potential of pandemic influenza.[55] An influenza

pandemic of even moderate impact will result in the biggest single

human disaster ever--far greater than AIDS, 9/11, all wars in the

20th century and the recent tsunami combined. It has the potential to

redirect world history as the Black Death redirected European history

in the 14th century. " [56]

 

" Nature " is considered by many to be the most prestigious scientific

journal in the world. They commissioned their senior reporter in

Paris to write a fictional yet realistic account of how the pandemic

could be expected to unfold. Writing as a blogger in December 2005,

it's fiction, but not fantasy. Read it in full at

http://www.nature.com/news/2005/050523/full/435400a .

 

According to the top experts in the world, these bird flu scenarios

are not just Chicken Little stories. " We're not crying wolf, " swears

Canada's top expert, head of the national microbiology lab. " There is

a wolf. We just don't know when it's coming. " [57] The head of the

CDC's International Emerging Infections Program in Thailand agrees:

" The world just has no idea what it's going to see if this thing

comes, " he said, but then stopped. " When, really. It's when. I don't

think we can afford the luxury of the word 'if' anymore. We are past

'if's. " [58]

 

So what can we do? Almost all of the antibiotics ever created only

work against bacteria. There are a few classes of drugs, including

drugs like amantidine, that work against certain viruses as well. But

the present bird flu virus has already evolved resistance to this

first generation of antivirals. How? " The Chinese have been

incorporating amantadine in their chicken feed, so we have lost that

as a treatment, " notes one U.S. flu expert.[59]

 

Scientists are pinning their hopes on oseltamavir (also known as

Tamiflu), the best prospect in the latest generation of antiflu

drugs. Unfortunately, there is not enough to go around. Made from

star anise, a plant in limited global supply, there is now a two-year

waiting list for new orders.[60] And the orders, of course, are

coming from dozens of rich Western countries who are attempting to

stockpile the drug,[61] not the poor countries like Vietnam where any

pandemic is likely to start.

 

" The only effective way to stop a global pandemic is to stop it in

Southeast Asia, " writes the editorial board of the journal of the

Canadian Medical Association. " Although likely to have only a limited

effect, stockpiles of oseltamavir need to be created throughout

Southeast Asia. " Scientists reason that if the human outbreak can be

caught early enough, maybe they could even stop it. Once the pandemic

hits, writes one leader in the field, " School closure, quarantine,

travel restrictions and so on are unlikely to be more effective than

a garden hose in a forest fire. " [62]

 

It's like a spark and a squirt gun, describes the director of the

U.S. National Vaccine Program. " If you aim properly you can get the

spark and be done with it. If you miss, though, the fire is going to

spread and there is nothing you can do to stop it. " [63] When a senior

public-health official was asked if he could imagine the developed

world sending its resources to combat the flu in Southeast Asia, the

reply was, " Who are you kidding? " [64]

 

The Western world is continuing in its " narcissistic planning, " [65]

ignoring pleas from the World Health Organization to pour resources

into Southeast Asia.[66] The U.K., for example, is spending $700

million to stockpile antiviral drugs. That's ten times the entire

health budget for Vietnam. In Cambodia, the total annual budget for a

campaign to encourage citizens to report suspected cases of bird flu

is about $3000.[67]

 

Once the outbreak spreads globally, though, stockpiles in rich

countries will provide no more than a pandemic " speed bump. " [68]

Canada, for example, has ordered 20 million doses although they

suspect they'd need more than 200 million.[69] Who's going to have

access to the limited supply? Priority for prophylactic treatment

goes first to " key decision makers. " [70] The current U.S. stockpile

would treat less than 2 percent of the population.[71] Some

scientists are advocating it just be sold over the counter and let

whomever can afford it have access.[72]

 

From the editorial board of one of the most prestigious medical

journals in the world, " If the greatest pandemic in history is indeed

on the horizon, that threat must be met by the most comprehensive

public-health plan ever devised. " [73] If one reads the

behind-the-scenes policy journals like Foreign Affairs, though,

senior officials admit that planning for what they call " the most

catastrophic outbreak in human history " is " abysmally

inadequate. " [74] Realizing that given the current political situation

the prospects for preventing the pandemic are practically

nonexistent, chief scientists like Osterholm are going to the

business community to at least work on providing an infrastructure

for survivors of what is being predicted in policy journals as the

" shutdown of the global economic system. " [75]

 

Speaking to a conference of agricultural bankers, Osterholm laid it

all out: " This is going to be the most catastrophic thing in my

lifetime. When this situation unfolds, we will shut down global

markets overnight. There will not be movement of goods; there will

not be movement of people. This will last for at least a year, maybe

two. " [76]

 

If we can't stop a human outbreak once it's started, can we stop a

human outbreak in the first place? The WHO advises that " [p]revention

of... avian influenza in humans is best achieved by controlling

infection in poultry. " [77] At this stage though, with over a hundred

million birds dead so far and confirmed spread into migratory wild

bird populations, this prospect seems similarly untenable. [78]

 

Asia provides a veritable genetic-reassortment laboratory for the

virus--the mix of an unprecedented number of people, pigs, and

poultry. " It is sobering to realize, " Osterholm writes, " that in

1968, when the most recent influenza pandemic occurred, the virus

emerged in a China that had a human population of 790 million, a pig

population of 5.2 million, and a poultry population of 12.3 million;

today, these populations number 1.3 billion, 508 million, and 13

billion, respectively. Similar changes have occurred in the human and

animal populations of other Asian countries, creating an incredible

mixing vessel for viruses. " [79] In that kind of environment, New

Yorker reporter Michael Specter wrote that " one sneeze from a pig

could be enough to start a pandemic. "

 

Large commercial poultry operations provide an ideal spawning ground

for new pandemic strains. Tens of thousands of broiler-type chickens

are crammed into large sheds. Because they live in their own manure,

the virus has an opportunity to be excreted in the feces and then

breathed in or swallowed by the thousands of other birds, allowing

the virus to rapidly and repeatedly circulate. With so many birds to

mutate within and pass back and forth, low virulence strains can

readily turn into deadly ones.[80]

 

Describing another deadly animal-to-human virus that arose in Asia,

this one in 1999, the Thai Minister of Public Health explains: " A

hundred years ago, the Nipah virus would have simply emerged and died

out; instead it was transmitted to pigs and amplified. With modern

agriculture, the pigs are transported long distances to slaughter.

And the virus goes with them. " And countries trying to protect their

poultry industries have covered up their outbreaks, making it that

much more difficult to stem the tide early.[81]

 

Charun Boonyarithikarn is another senior Thai public-health officer.

" Chickens used to live in our backyards, " he told a New Yorker

reporter. " They didn't travel much. Now, throughout the world, farms

have become factories. Millions of chickens are shipped huge

distances every day. We can't stop every chicken or duck or pig. And

they offer millions of opportunities for pathogens to find a niche. "

 

Dr Samuel Jutzi of the Food and Agriculture Organization told the

conference: " There is an increasing risk of avian influenza spread

that no poultry-keeping country can afford to ignore. " [82] Vietnam

has already banned duck and goose farming, but this may be a case of

too little too late.[83] Another pandemic may force humanity to

realize that it may have to give up the habit of raising birds

completely.

 

In response to the February 28, 2005 lead New Yorker story on the

threat of bird flu, staff writer Michael Specter was asked if, based

on his research, we would " have to rethink such things as large-scale

poultry farming? " He replied " Well, I can't imagine a better

prescription for killing large numbers of animals with a single

disease than packing tens of thousands of them into factory farms

where they are lucky if they have fifteen inches of personal space.

Still, the economic incentives toward factory production of food are

huge--we want cheap meat. So it's going to be very difficult to

change. " [89]

 

So what does the poultry industry think about the possibility of its

own industry leading to a worldwide epidemic that kills millions of

people? The Executive Editor of Poultry magazine wrote an editorial

on that very subject in its last issue: " The prospect of a virulent

flu to which we have absolutely no resistance is frightening.

However, to me, the threat is much greater to the poultry industry.

I'm not as worried about the U.S. human population dying from bird

flu as I am that there will be no chicken to eat. " [84]

 

*******************************************************

 

III. CARBOPHOBIA UPDATE: Atkins Is Toast

 

Although my latest book Carbophobia: The Scary Truth About America's

Low Carb Craze is selling well, I can hardly take credit for the

downfall of the Atkins Empire. Here's a sampling of recent newspaper

headlines: " Poor Sales Cripple Atkins Diet Firm, " [85] " Atkins Diet

Firm on Brink of Liquidation. " [86] And my personal favorite: " Good

Riddance to the Atkins Diet. " [87]

 

I will continue to do my part, though, in exposing the truth behind

these dangerous diets. I've got over a dozen live radio interviews

lined up this month--please see http://www.DrGreger.org/dates.html

for a schedule if you want to listen in. I'm excited to report that

my publisher, Lantern Books, has chosen Carbophobia for its quarterly

book club discussion. So if anyone's going to be near New York City

on June 27th, you should stop by. Details can be found on the Lantern

website http://www.LanternBooks.com . And of course, for the latest

updates, always keep it tuned to http://www.AtkinsExposed.org.

 

To commemorate the downfall of the high-fat fad in Britain, one

London paper asked some high-profile authors to write about their

experiences on the Atkins diet. One felt " as healthy and attractive

as a McDonald's cheeseburger. " Another had to " confess to feeling

like a constipated lump of lard. " A third wrote: " How do I feel now?

You know that expression 'You are what you eat'? Well, I feel like I

just ate a big bowl of stupid. And you wouldn't believe how fattening

that is. "

 

*******************************************************

 

 

IV. PERSONAL UPDATE

 

I am proud to announce that I have accepted a position with The

Humane Society of the United States (HSUS). I am now its Director of

Public Health and Animal Agriculture. After being on the road for a

bit too long, it was a welcome change to move to D.C. and stay in the

same time zone for more than a few days. So please note my new

mailing address (my latest contact information is always on my

website at http://www.DrGreger.org/bio.html).

 

With HSUS's bold new leadership and a stated mission to " create a

humane and sustainable world for all animals, including people,

through education, advocacy and the promotion of respect and

compassion, " I think I'm going to fit right in.

 

My first project is to help counter the Bush administration's

consideration of backpedaling on the downer cow ban (the

late-breaking news, of course, is that another U.S. downer may be

confirmed with mad cow disease this week--keep tuned to

http://www.organicconsumers.org/madcow ). For years the meat from

cows too sick or crippled to even walk was considered too risky to be

allowed in the federal School Lunch Program. So downer meat was

evidently not safe enough to feed to kids at school, but evidently

was safe enough to feed to kids once they got home from school (or

feed to adults for that matter).

 

Thankfully, after the discovery of the first confirmed case of mad

cow disease in the United States, the USDA finally banned the

inclusion of meat from downed cattle in the human food supply. Now,

with building pressure from some sectors of industry, the USDA seems

to be having second thoughts. For what we can all do to keep the

downer ban from going down, check out the April 21, 2005 issue of

HumaneLines, the Humane Society's free weekly electronic alert or,

even better, sign up at https://community.hsus.org/humane/join.tcl .

An alert should also be sent to HumaneLiines about how to support

Senate action to ban the use of quinolone antibiotic-treated chicken

in the National School Lunch Program.

 

I'm also proud to announce that after ponderous delays with the IRS,

the institute I set up to further my work is now an

officially-recognized 501c3 nonprofit organization. Any donations

sent to support my work are tax-deductible to the fullest extent of

the law. If anyone is so motivated they can click the donate button

at the bottom of my newsletter page at

http://drgreger.org/newsletters.html

 

*******************************************************

 

REFERENCES:

(Full text of specific articles available by emailing

article-request)

 

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[2] Unlu, NZ, et al. " Carotenoid Absorption from Salad and Salsa by

Humans Is Enhanced by the Addition of Avocado or Avocado Oil. "

Journal of Nutrition 135(2005):431-436.

[3] Ibid.

[4] Ibid.

[5] Ninfali P, et al. " Antioxidant Capacity of Vegetables, Spices and

Dressings Relevant to Nutrition. " British Journal of Nutrition

93(2005):257-266.

[6] Ninfali P, et al. " Antioxidant Capacity of Vegetables, Spices and

Dressings Relevant to Nutrition. " British Journal of Nutrition

93(2005):257-266.

[7] Mao TK, et al. " Effects of a Spirulina-Based Dietary Supplement

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[8] Iwasa M, et al. " Spirulina-associated hepatotoxicity. " American

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[9] " Health Canada Announces Results of Blue-Green Algal Products

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[10] Murch SJ, et al. Acta Neurologica Scandinavica. 110(2004)267-269.

[11] Cox PA. " Diverse Taxa of Cyanobacteria Produce

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[12] Sanchez-Moreno C, et al. " Consumption of High-Pressurized

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[22] Barr SI. " Increased Dairy Product or Calcium Intake: Is Body

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[26] Kanis JA, et al. " A Meta-Analysis of Milk Intake and Fracture

Risk: Low Utility For Case Finding. " Osteoporisis International 21

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[27] Zamiska N. " How Milk Got a Major Boost By Food Panel. " Wall

Street Journal 30 August 2004:B1.

[28] Berkey CS, et al. " Milk, Dairy Fat, Dietary Calcium, and Weight

Gain . " Archives of Pediatrics and Adolescent Medicine

1599(2005):543-50.

[29] Fox M. " Milk may make for heavier kids, study finds. " Reuters 6 June 2005.

[30] Eaton DK, et al. " Associations of Body Mass Index and Perceived

Weight With Suicide Ideation and Suicide Attempts Among US High

School Students. " Archives of Pediatrics and Adolescent Medicine

1599(2005):513-9.

[31] NIH National Institute of Allergy and Infectious Disease Fact

Sheet. " Foodborne Diseases. " February 2005.

[32] Schoenl JL and MP Doyle. " Variable colonization of chickens

perorally inoculated with Escherichia coli O157:H7 and subsequent

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[33] Commission of European Communities. Communicable Diseases

Resulting from Storage, Handling, Transport and Landspreading of

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[34] Jones TF and W Schaffner. " Perspectives on the Persistent

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[35] Johnson JR, et al. " Antimicrobial-Resistant and Extraintestinal

Pathogenic Escherichia coli in Retail Foods. " Journal of Infectious

Diseases 205(2005):1040-9.

[36] Ramchandani M, et al. " Possible Animal Origin of

Human-Associated, Multidrug-Resistant, Uropathogenic Escherichia

coli. " Clinical Infectious Diseases 40(2005):251-7.

[37] Brownlee C. " Beef About UTIs. " Science News 15 January 2005.

[38] Stern NJ, Line JE. " Comparison of three methods for recovery of

Campylobacter spp. from broiler carcasses. " Journal of Food

Protection 1992;55:663-6; Price LB, et al. " Fluoroquinolone-Resistant

Campylobacter Isolates from Conventional and Antibiotic-Free Chicken

Products. " Environmental Health Perspectives 113(2005):557-60.

[39] Hemls M, et al. " Adverse Health Events Associated with

Antimicrobial Drug Resistance in Campylobacter Species: A

Registry-Based Cohort Study. " Journal of Infectious Disease

191(2005):1051.

[40] Varma JK, et al. " Hospitalization and antimicrobial resistance

in Salmonella outbreaks, United States, 1984-2002. " Emerging

Infectious Disease. June 2005.

[41] International Journal of Food Microbiology 24(1994):11-31.

[42] Journal of Infectious Disease 183(2001):1295-9.

[43] Schroeder CM, et al. " Estimate of Illnesses from Salmonella

Enteritidis in Eggs, United States, 2000. " Emerging Infectious

Diseases 11(2005):113-5.

[44] " Finding the Source of Campylobacter. " USDA Agriculture Research

Service News 23 May 2005.

[45] " Why Not Wash Meat and Poultry Before Cooking? " Tufts University

Health and Nutrition Letter 23(2005):7.

[46] Foodborne Pathogens: Risks and Consequences, Report No. 122,

CAST- Council for Agricultural Science and Technology, September 1994.

[47] Burgess F, et al. " Prevalence of Campylobacter, Salmonella, and

Escherichia coli on the External Packaging of Raw Meat. " Journal of

Food Protection 68(2005):469-75.

[48] Knize MG and JS Felton. " Formation and Human Risk of

Carcinogenic Heterocyclic Amines Formed from Natural Precursors in

Meat. " Nutrition Reviews 63(2005):158-65.

[49] Editorial. " Avian influenzavirus: Are we prepared? " Canadian

Medical Association Journal 172(2005):965.

[50] Swayne DE and JR Beck. " Experimental study to determine if

low-pathogenicity and high-pathogenicity avian influenza viruses can

be present in chicken breast and thigh meat following intranasal

virus inoculation. " Avian Diseases 49(2005):81-5.

[51] Schuettler D. " Asia's Bird Flu Here to Stay, FAO Says. " Reuters

23 February 2005.

[52] Johnson NPAS and J Mueller. " Updating the Accounts: Global

Mortality of the 1918-1920 " Spanish " Influenza Pandemic. " Bulletin of

the History of Medicine 76(2002):105-115.

[53] Specter M. " Nature's Bioterrorist. " New Yorker 28 February 2005: 52-61.

[54] " Russian Expert Says Flu Epidemic May Kill Over One Billion This

Year. " Moscow News 28 October 2004.

[55] Kennedy M. " Parallels with the 1918 Spanish flu outbreak. "

National Post 9 March 2005.

[56] " Bird Flu Could Kill Millions " The Gazette (Montreal) 9 March 2005:1A.

[57] Kennedy M. " Parallels with the 1918 Spanish flu outbreak. "

National Post 9 March 2005.

[58] Specter M. " Nature's Bioterrorist. " New Yorker 28 February 2005: 52-61.

[59] " Can Tamiflu save us from bird flu? " New Scientist 2 June 2005.

[60] " Roche faces Tamiflu production bottleneck following WHO bird

flu warning. " Forbes 29 May 2005.

[61] " Can Tamiflu save us from bird flu? " New Scientist 2 June 2005.

[62] Editorial. " Avian influenzavirus: Are we prepared? " Canadian

Medical Association Journal 172(2005):965.

[63] Specter M. " Nature's Bioterrorist. " New Yorker 28 February 2005: 52-61.

[64] Specter M. " Nature's Bioterrorist. " New Yorker 28 February 2005: 52-61.

[65] Editorial. " Avian influenzavirus: Are we prepared? " Canadian

Medical Association Journal 172(2005):965.

[66] " WHO's call for international pandemic action unheeded. "

Canadian Medical Association Journal 172(2005):1429.

[67] Ibid.

[68] " Feds to stockpile antivirals as pandemic 'speed bump.' "

Canadian Medical Association Journal 172(2005):1428.

[69] Ibid.

[70] Ibid.

[71] Fox M. " U.S. still unprepared against new flu, experts say. " 26 May 2005.

[72] Laver G. " Influenza drug could abort a pandemic. " Nature 434(2005):821.

[73] Editorial. " Avian influenza: perfect storm now gathering? " The

Lancet 365(2005).

[74] " Q & A with Laurie Garrett. " Foreign Affairs July/August 2005.

[75] Osterholm MT. " Preparing for the Next Pandemic. " Foreign Affairs

July/August 2005.

[76] " Bird Flu Seen as the Next Pandemic. " Star Tribune (Minneapolis)

16 November 2004.

[77] Center for Infectious Disease Research and Policy. " WHO: flu

pandemic threat may be growing. " 18 May 2005.

[78] Schuettler D. " Asia's Bird Flu Here to Stay, FAO Says. " Reuters

23 February 2005.

[79] Osterholm MT. " Preparing for the Next Pandemic. " New England

Journal of Medicine 352(2005):1839-42.

[80] HorimotoT and Y Kawaoka. " Pandemic threat posed by influenza

viruses. " Clinical Microbilogy Reviews 14(2001):129-49.

[81] Specter M. " Nature's Bioterrorist. " New Yorker 28 February 2005: 52-61.

[82] " WHO warns of bird flu pandemic " BBC 23 February 2005.

[83] Piller C. " Vietnam officials ban duck, goose farming to staunch

bird flu. " Los Angeles Times 5 February 2005.

[84] Thaxton YV. " Are you Prepared for AI? " Poultry April/May 2005:5.

[85] The Independent 17 March 2005.

[86] Press Association 16 March 2005.

[87] Daily Mail (London) 16 March 2005.

[88] Price LB, et al. " Fluoroquinolone-Resistant Campylobacter

Isolates from Conventional and Antibiotic-Free Chicken Products. "

Environmental Health Perspectives 113(2005):557-60.

[89] Specter M and B Greenman. " Fighting the Flu. " New Yorker Online.

21 February 2005.

 

*******************************************************

 

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Until next time,

-Michael

 

--

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HEART FAILURE: Diary of a Third Year Medical Student

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My new book:

CARBOPHOBIA: The Scary Truth Behind America's Low Carb Craze

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