New York: With the recent recalls of millions of gallons of ice cream as well as several tons

of hummus, pine nuts, frozen vegetables and various meat products, you might think the US
food supply is an unholy mess. Its not. Its arguably the safest in the world.
Yet despite continually improving processing methods and quality controls, the number of
cases of food-borne illness has remained stubbornly high since the 1990s, with the
incidence of people getting sick from some pathogens increasing. Some experts wonder if
weve reached a point of diminishing returns in food safety whether our food could
perhaps be too clean.
Industrial food sanitation practices along with home cooks antibacterial veggie washes,
chlorine bleach kitchen cleaners and sterilisation cycle dishwashers kill off so-called good
bacteria naturally found in foods that bolster our health. Moreover, eliminating bad or
pathogenic bacteria means we may not be exposed to the small doses that could inoculate
us against intestinal crises.
No one is saying you need to eat a peck of dirt before you die to be healthy, said Jeffrey T.
Lejeune, a professor and head of the food animal research program at Ohio State University
in Wooster, Ohio. But there is a line somewhere when it comes to cleanliness. We just dont
know where it is.
The theory that there might be such a thing as too clean food stems from the hygiene
hypothesis, which has been gaining traction over the past decade. It holds that our modern
germaphobic ways may be making us sick by harming our microbiome, which comprises all
the microscopic beasties bacteria, viruses, fungi, mites, etc that live in and on our
bodies.
Research so far has focused primarily on the detrimental effects of caesarean births and not
breast-feeding, which may inhibit the formation of a robust microbiome, and the use of
antibacterial soaps and antibiotics, which diminish the microbiome once it is established.
A result is an immune system that essentially gets bored, spoiling for a fight and apt to react
to harmless substances and even attack the bodys own tissues. This could explain the
increasing incidence of allergies and autoimmune disorders such as asthma, rheumatoid
arthritis and inflammatory bowel syndrome.
There is also the suggestion that a diminished microbiome disrupts hormones that regulate
hunger, which can cause obesity and metabolic disorders.
When it comes to food-borne illness, the idea is that fewer good bacteria in your gut means
there is less competition to prevent colonisation of the bad microbes, leading to more
frequent and severe bouts of illness.

Moreover, your underutilised immune system may lose its ability to discriminate between
friend and foe, so it may marshal its defences inappropriately (e.g., against gluten and
lactose) or not at all.
All of this is hard to prove. While there has been some research to support the effectiveness
of consuming harmless bacteria, known as probiotics, in reducing the likelihood of
gastrointestinal infection, there are ethical issues involved in dosing humans with known
dangerous pathogens like salmonella and listeria.
But animal experiments have lent some credence to the theory. Researchers at Texas Tech
University in Lubbock have found that guinea pigs fed less virulent strains of listeria are less
likely to get sick or die when later fed a more pathogenic strain. And anyone who has visited
a country with less than rigorous sanitation knows the locals dont get sick from foods that
can cause tourists days of toilet-bound torment.
We have these tantalising bits of evidence that to my mind provide pretty good support for
the hygiene hypothesis, in terms of food-borne illness, said Guy Loneragan, an
epidemiologist and professor of food safety and public health at Texas Tech.
This is not to say wed be better off if chicken producers eased up on the salmonella
inspections, we ate recalled ice cream sandwiches and we didnt rinse our produce. But it
raises questions about whether it might be advisable to eradicate microbes more selectively.
It is worth noting that serious food-borne diseases the ones that make it into the news,
like listeria, salmonella, E. coli, cryptosporidium and campylobacter are mainly diseases
of immuno-compromised populations. And thats getting to be a significant number of people,
thanks to our ageing population.
Its a cruel reality that anyone 55 and older is potentially immuno-compromised, said Haley
Oliver, assistant professor of food science at Purdue University in West Lafayette, Indiana.
Also included are young children, pregnant women, the estimated 1.2 million people with
HIV, cancer patients, organ recipients and anyone who has been prescribed a lot of
antibiotics.
The three people who died after eating listeria-laced Blue Bell ice cream, prompting a recall
of the companys product last month, ate it while inpatients at a hospital in Wichita, Kansas.
Local health officials said listeriosis may have contributed to but did not cause these
peoples deaths. Seven more people were sickened nationwide.
That leaves millions who, experts said, ate the remaining five years worth of ice cream
included in the recall and probably didnt have so much as a stomach cramp. Research
shows listeria is commonly found in dirt and in households, particularly in rural communities,
and those who come in contact with it often remain asymptomatic.

When disease happens you have to have a perfect storm of enough of the pathogen
present in the food, the person ate enough of that food and that person was immunocompromised, Oliver said. But because of the hygiene hypothesis we may be becoming a
more naive or vulnerable population.

Shes not so worried for herself since she travels widely on USAID missions to places with
abundant food-borne pathogens like India and Afghanistan. She and other food science
experts interviewed said they ate potentially disease-carrying foods like sushi, medium-rare
steaks and items that they dropped briefly on the floor (invoking the five-second rule).
Its a personal trade-off, said Martin Wiedmann, professor of food safety at Cornell
University. If its something I really like, I might be willing to take more risk, which in his
case is eating raw oysters, albeit from very cold waters.
But risk is difficult to gauge because of factors like age, illness, popping too many antibiotics,
psychological stress or possibly too clean a diet.
On the upside, efforts like the Human Microbiome Project and Earth Microbiome Project are
using advanced methods to identify all the microbes living on and within us, as well as in the
soil and also in foods, to see how all those invisible organisms interact to promote or inhibit
disease.
Its exciting because methodological approaches to getting this data are almost outpacing
our ability to analyse it, said Lejeune at Ohio State. Were going to have these humongous
data sets that were going to have to sift through and figure out what it all means.
New York Times News Service