Welcome to our leadership blog series! This month, Michelle Naman -the Chapter President of Bastyr University, Washington– discusses the risk factors associated with pesticides and environmental toxins in our food, what we can do to protect ourselves, and how to approach patients with this information.
Pesticides and Environmental Toxins in Our Food
We are all familiar with the abundant use of pesticides in both organic and conventional produce, and that these pesticides can be found in agricultural and urban land, rivers, aquifers, and wells. Many of us are familiar with some of the reported and researched effects of these pesticides, even if the USDA and EPA are unwilling to confirm causation or severity. Multiple studies show pesticides contributing to infertility (1), increasing the risk of autoimmune conditions and causing long-term neurologic, developmental and reproductive disorders (2). As the data around pesticide harm continues to evolve and grow, an overwhelming amount of studies show there is harm in being exposed to and consuming small amounts of pesticides over the long-term. As future naturopathic doctors, we are the experts in natural health. We must be aware of how to ameliorate the effects of these chemicals while we work to prevent and reverse the progression of disease related to toxic exposures.
In good conscience, how do we recommend that our patients eat more fruits and vegetables and drink more water knowing we may be contributing to their toxic burden? Consider how often a higher consumption of fiber-containing fruits and vegetables is part of the naturopathic treatment plan from both practitioners and student clinicians. Is there any informed consent or education about the presence of pesticides if this patient does not suffer from chemical sensitivities? This should remain a standard topic of discussion with more specific recommendations as our knowledge of chronic pesticide exposure effects increases.
In helping patients make more informed decisions about this topic, we need to be well versed in exposure differences across organic and conventional produce. Again and again, studies show that organic produce has fewer pesticides than conventional produce with the average number of different pesticides being 0.8 and 3.2, respectively (3,4). Those eating conventional produce over time will be exposed to a much higher amount of pesticides than organic produce eaters, a concern which has been expressed by toxicologists for many years (5). Even organic foods are exposed to synthetic pesticides, despite the laws governing the “organic” label. This is in large part due to cross-contamination by wind and groundwater (6). Twenty-five synthetic pesticides are currently approved for organic use (2). This not-so-small number, along with overall exposure amounts, should be taken into consideration when helping patients make the decision on whether or not to buy organic. The Environmental Working Group (EWG) simplifies which produce items are more necessary to buy organic and which are less necessary, depending on the number and kinds of pesticides used. Below is their wonderfully simple infographic for patients that can be downloaded for free from the EWG’s website as a pocket guide to pesticide-free produce (7).
Taking into consideration the cost of organic produce compared to conventional, it’s imperative that I touch on ways patients with limited resources can gain access to organic produce. In Washington state (any many others), farmers markets accept SNAP (Supplemental Nutrition Assistance Program) and some even match the amount spent on fresh produce. A $2:$5 match, for example, means for every $5 spent, the market gives the shopper an additional $2 to be spent on produce (8). SNAP can also be used to buy seeds and edible plants, enabling patients to control and monitor the environment of their plants, eliminating the need for pesticide use. The USDA estimated that for every $1 spent on seeds, $25 worth of produce can be grown (9).
While taking the time to reflect and write on this, I have become more aware of the consequences that can come with sharing the above information with patients. Yet another decision to make: has the patient expressed a concern about pesticides in their food? Do they have a chemical sensitivity that might ease if they eliminate as many pesticides from their foods as possible? These are questions that quickly have us reaching for something like the “Dirty Dozen and Clean Fifteen”. But how and when do we communicate concerns to an adult patient with multiple sclerosis, hepatic or renal disease, autoimmune conditions, cancer? How much information is available to us concerning pregnant or nursing mothers? Would children be more susceptible to the effects of pesticides during their development? These are tough questions that are not yet fully answerable through the literature, in spite of what we can assume from basic physiology and toxicology.
However, here are some recommendations that can be used as general tools for patient education and empowerment on this topic. One review found that washing and soaking produce lead to only a small reduction of pesticide residue, however peeling, soaking in chemical baths and blanching reduces pesticides much more effectively (10) Oregon State University along with the EPA suggests washing all produce, whether or not you plan on eating the skin, rinsing produce as opposed to dunking, and scrubbing firm produce with a brush (11). Another study analyzed the most effective way to remove pesticides from strawberries, finding that ultrasonic cleaning and boiling decreased the residues for all or most of the compounds tested for, and washing with ozonated water to be the third most effective method, followed by washing with tap water (12).
When dealing with more complex cases that may contain a toxicity piece, it is always important to make ourselves aware of sources of obvious environmental exposures to which our patients may be exposed. A small number of exposures daily over the course of many years can easily contribute to pathology in susceptible populations. Let’s not forget the most relevant principles of naturopathic medicine to this topic- tolle causam, preventare and docere!
Author: Michelle Naman
CHAPTER PRESIDENT, BASTYR UNIVERSITY KENMORE
Michelle is a third-year student at Bastyr University. She grew up in a coastal town in New Jersey and obtained her bachelor’s degree from Clemson University in Genetics with a minor in Spanish. There she was also a member of the service sorority Gamma Sigma Sigma. Since 2012, she has tutored high school and college students in biology, chemistry, genetics, and English. Previous to starting at Bastyr, she was a Project Assistant at The Children’s Hospital of Los Angeles. She served as the NMSA Social chair for the 2017-2018 school year and is excited to continue her journey with NMSA as president. In her free time, she enjoys yoga, weightlifting, hiking, cooking and extensive traveling.
- Schrag, S., & Dixon, R. (1985). Occupational Exposures Associated with Male Reproductive Dysfunction. Annual Review of Pharmacology and Toxicology,25(1), 567-592. doi:10.1146/annurev.pharmtox.25.1.567
- Demory-Luce, D., & Motil, K. (n.d.). UpToDate. Retrieved October 15, 2018, from https://www.uptodate.com/contents/organic-foods-and-children.
- PDP Database Search. (n.d.). Retrieved October 15, 2018, from https://apps.ams.usda.gov/PDP
- Haspel, T. (2018, May 21). The truth about organic produce and pesticides. Retrieved from https://www.washingtonpost.com/lifestyle/food/the-truth-about-organic-produce-and-pesticides/2018/05/18/8294296e-5940-11e8-858f-12becb4d6067_story.html?noredirect=on&utm_term=.9b6ef3c3bbf5
- Cedergreen, N. (2014). Quantifying Synergy: A Systematic Review of Mixture Toxicity Studies within Environmental Toxicology. PLoS ONE,9(5). doi:10.1371/journal.pone.0096580
- Fuhrer, G., Gilliom, R., Hamilton, P., Morace, J., Nowell, L., Rinella, J., Wentz, D. (1999). The Quality of Our Nation’s Waters- Nutrients and Pesticides. Retrieved from https://pubs.usgs.gov/circ/circ1225/html/occurrence.html
- Get Your Copy: EWG’s Shopper’s Guide to Pesticides in Produce™. (n.d.). Retrieved from https://secure.ewg.org/p/salsa/web/common/public/signup?signup_page_KEY=6030&track=FoodNews_HPCard&_ga=2.191297769.271279138.1541097031-820492555.1540688106
- EBT Matching Programs. (n.d.). Retrieved from http://wafarmersmarkets.org/ebt-match/
- Salzman, N. (2011, July 06). Using SNAP Benefits to Grow Your Own Food. Retrieved from https://www.usda.gov/media/blog/2011/07/06/using-snap-benefits-grow-your-own-food
- Chung, S. W. (2018). How effective are common household preparations on removing pesticide residues from fruit and vegetables? A review. Journal of the Science of Food and Agriculture. doi:10.1002/jsfa.8821
- How can I wash pesticides from fruit and veggies? (n.d.). Retrieved from http://npic.orst.edu/faq/fruitwash.html
- Lozowicka, B., Jankowska, M., Hrynko, I., & Kaczynski, P. (2015). Removal of 16 pesticide residues from strawberries by washing with tap and ozone water, ultrasonic cleaning and boiling. Environmental Monitoring and Assessment,188(1). doi:10.1007/s10661-015-4850-6