The American Academy of Pediatrics (AAP) released a policy paper entitled “Organic Foods: Health and Environmental Advantages and Disadvantages” on October 22, 2012. It is slated for publication in an upcoming issue of the journal Pediatrics. This new review comes on the heels of a September, 2012 meta-analysis by a team of physicians at Stanford University, which stirred up substantial commentary, and badly needed discussion among scientists of appropriate methods to carry out such reviews (e.g., see my September 4 post, and letters to the editor of “The Annals of Internal Medicine,” especially the excellent letter from WSU colleague Dr. Preston Andrews).
The new AAP review focuses on the health benefits of organic food during a critical stage of life – infancy and childhood. It provides, for the most part, a solid overview of the major reasons why many parents choose to invest in organic food as a way to increase the odds of their child’s safe passage through their many stages of development, during which even a little bit of the wrong chemical, like an organophosphate insecticide, can do life-long damage.
Little is said in the AAP review about the prenatal impacts of pesticide exposure, although the review does cover published evidence pointing to a four to seven point loss of IQ in children born to mothers among those more heavily exposed prenatally to organophosphate insecticide residues in food.
The authors of the AAP piece cite published studies mostly done in Europe confirming higher, heart-healthy omega 3s and CLA in organic milk, but they do not mention, and likely were unaware of significant data from testing in the U.S. by dairy processors showing even larger differences. One reason may be that most conventional cows in Europe have access to pasture and their diets are not so heavily corn based, compared to conventionally managed cows in the U.S.
Cardiovascular benefits are optimized when a person’s daily diet provides a ratio of about 2.3 or less omega 6 for each unit of omega 3. This key omega 6:3 ratio typically varies in conventional milk from 6:1 to 8:1, largely because of the corn-heavy rations fed to most conventionally managed cows. Organic milk tends to fall in the 3:1 to 4:1 range, and Organic Valley research shows that the omega 6:3 ratio approaches 1:1 in milk from cows on a near-100% organic forage diet.
Like the Stanford study, the authors of the AAP piece do not see strong evidence of clinically significant responses among children following a switch to organic food.
What does a “clinically significant difference” mean to a physician? When a patient comes into the doctor’s office with X problem, the doctor carries out an exam and (usually) reaches a diagnosis as to both the problem and its cause. These insights are then followed by a recommended course of action that might include medication, a procedure, and/or some life style changes. The physician draws on evidence from highly refined, often long-term clinical trials that establish, for patients with this sort of problem, a reliable linkage between a defined treatment and a “clinically significant” improvement in the patient’s health status.
For there to be an expectation of a “clinically significant difference,” doctors treating a specific patient must believe that if the person does x, y, and z, as prescribed by the doctor, the person’s symptoms will subside and their health improve. If the person does not get better, the physician knows that he or she will likely be confronted by a sicker and disappointed (or angry) patient, and at worse, a letter from the patient’s lawyer.
In nearly all cases involving a person dealing with an acute or chronic illness, a person’s decision to buy organic food will not bring about, with a high level of reliability, a clinically significant improvement in health outcomes, especially not in the near-term and in the absence of other changes in dietary patterns. But does this mean there are no health benefits from consumption of organic food? No, it does not. Many factors can contribute to the etiology of disease. In fact, for a surprisingly large percentage of chronic health problems, physicians cannot answer a simple question often raised by patients – why did this happen to me?
For pregnant women and children, consumption of organic food tips the trajectory of population-wide health outcomes in a more health-promoting direction. By how much, no one knows. Long-term clinical trials involving consumption of organic food from at least six months before conception and on through the adolescence, will be necessary to begin sorting out what initially triggers or sets the stage for disease, and which factors then come into play in preventing or slowing the progression of disease. In the meantime, an ounce of prevention makes a lot of sense to many people, but for the most part remains an afterthought in clinical practice and biomedical research.