I used the software Comprehensive Meta-Analysis to perform the Meta-Analysis. (See accompanying research paper in my LinkedIN profile for fuller discussion and visuals)
Some of you may see a dynamic ecosystem with jittery critters foraging for food, chipmunks nibbling on nuts and berries, deer gnawing on shrubbery. Below the eaves and across the meadow in the valley you may see insects eating insects, fish eating insects, maybe people eating insects - all as a sort of delicate, musical interplay where FOOD in the form of energy, nutrients, and molecules are exchange as life is created, sustained and passes.
'Delicate' was emphasized previously, because sometimes slight and imperceptible changes can offset the balance and flow of the ecosystem. An ecosystem that functions much like our bodies that are responsive to environmental hazard and most relevant to this discussion our own conscientious or unwitting consumption behaviors.
These behaviors manifest in illnesses such as diarrhea. Sometimes clinical recommendations are based on media hype rather than a true understanding of the evidence. Read on for an review and exploratory analysis of the title.
Diarrhea (in adults)
The major complications associated with diarrhea are:
1) fluid loss resulting in dehydration
2) electrolyte loss (Na, K, Mg, Cl, Zn)
3) Vascular collapse
Causes, sources and dietary factors of diarrhea
For short-term (acute: less than 14 days) diarrhea -
For long-term (chronic: more than 14 days) diarrhea -
For acute and chronic diarrhea, dietary factors related to the onset are but not limited to -
Hexitols, sorbitols, and mannitol
Spotlight: Most common diarrhea manifestations
(1) Bloody diarrhea AND (2) Watery diarrhea
Tips for Travelers
To prevent the onset traveler's diarrhea (aka ETEC or Montezuma disease) boil your water for at least 5 to 10 minutes if you must drink it in a cup;
Eat fruits and vegetables that you can peel (fruits and vegetables otherwise are the most commonly contaminated food for travelers); and,
Drink BOTTLED water contamination (STAY AWAY from the bottled fruit and soft drinks as these can sometimes cause diarrhea as we have learned).
Food politics: Food Contamination, Organic Food and Vegetarianism
Contamination in the U.S. food industry has the potential adulterate every stage of the delivery and production chain from the 'farm to the fork' (Paarlberg, p 186). Some examples of the cause of adulteration are (Paarlberg, p.187):
microbial contamination (at the farm)
inadequate sterilization, improper evisceration or ride removal (during production)
unsanitary conveyer belts (during delivery)
inadequate refrigeration (during storage and shelving)
cooks who do not wash their hands (at the fork)
FUN FACT: Regulatory funding for food safety has increased since 2001s attacks (especially with regard to import regulation for countries with lax safety standards) in the U.S. and has evolved to a prevention oriented system rather one that previously just traced contamination after it had occurred owing to the Food Safety Modernization Act (2010).
Despite concerted oversight, outbreaks though rare and highly localized are harder to contain in today's industrialized food economy. Robert Paarlberg contends (Food politics, p.191):
'Most fatalities from unsafe food still take place due to highly localized lapses, frequently inside private homes. Localized and traditional systems fail more often because they are less able to afford state-of-the-art technical options for food supply protection'
An effort that has been made to enhance food safety is called irradiation. The process involves exposing food briefly to X-rays, gamma rays, or electron beams. However, the process has experienced a little backlash in the U.S. because it sounds a lot like 'radiation' (which has a negative connotation), it makes food more costly, and might be a way for wealthy companies to hide the filthy conditions of their food processing plants
Organic Food: Safety and Nutrition
Purchasers of organic food are often motivated to pay more to gain some nutritional advantage and or avoid contamination.
There are many organic claimants out there that puff the advantages of going organic (Whole Foods, Fresh Foods, Organic Center). For example, the Organic Center published a review 'confirming' the nutritional superiority of plant-based organic foods, using misleading statistics to substantiate their claims.
Regarding contamination, the FDA found that 0.4 of domestic samples and 0.5 of imported samples had residues exceeding national and international tolerance levels for acceptable daily intake (ADIs). Carl K. Winter and Sarah F. Davis, food scientist at the University of California-Davis and the Institute of Food Technologies, found (Paarlberg, p.173):
'[T]he marginal benefits of reducing human exposure to pesticides in the diet through increased consumption or organic produce appear to be insignificant'
As a matter of fact, several outbreaks that have occurred in recent years revolved around the operations of organic certified or plants pending certification listed as follows:
(2006) California farm converting to organic certification was the source of an E.coli outbreak from 'bagged fresh spinach' killing 3 and injuring hundreds
(2009) 9 deaths from Salmonella contained in peanut butter products produced at Texas and Georgia organic certified plants
(2012) 53 deaths occurred from E.coli containing bean sprouts that were organically grown in Germany
There is no evidence to support the protective effects of organic eating versus conventional eating. What about vegetarianism?
Brief Words about Vegetarianism
Is vegetarianism healthier and or safer than meat-based diets? The Mayo Clinic, confirms that 'vegetarian diets can be safe and healthy' even for growing children and adolescents. Non-vegetarian diets often do not have adequate helpings of fruits and vegetables, too much red meat, too many processed meats, and too many overcooked meats that carry cancer risks. However, the German Center for Cancer Research found (Paarlberg, p. 141):
'...compared health conscious meat eaters vegetarians and found no difference in mortality rates'
The medical databases that I explored were PubMED, Medline, Cochran-Wiley, EMBASE, and Clinical Trials GOV. The statistical significance of each study compared to the other studies. I selected articles based on criteria outlined by the Jadad scale.
Meta-analysis and Results
From the studies available a forest plot was generated for comparison purposes and to generate a generalizable result.
The Netherland study contributed the most to the overall weight of the summary result that vegetarianism has a clinical benefit over meat eating. Alternatively, the Diet and risk of diverticular disease study contributed the least.
Though at first glance, it seemed like vegetarian versus meat-studies suggested a statistically significant OVERALL difference, this may be a little misleading. All of the studies showed marginal differences between these eating patterns. In other words there is not sufficient evidence to support clinical recommendations that say being a vegetarian can prevent you from having diarrhea.
Diarrheal illness (primarily water and bloody, acute and chronic varieties) are caused by dietary factors, the consumption of drugs, and issues related to contamination in food processing
There is a more illusory difference between organic foods and conventional foods with regard to generating hazards that threaten gastrointestinal health
Vegetarianism is believed to be safe and healthy, but an analysis of the cumulative results of current research regarding the clinical benefit of vegetarianism versus meat-eating suggests that more information is needed to make clinical recommendations about vegetarian interventions
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