Does eating organic food reduce cancer risk?

Not so much, according to this paper published a few days ago in the British Journal of Cancer. Here is what the authors did:

We examined the hypothesis that eating organic food may reduce the risk of soft tissue sarcoma, breast cancer, non-Hodgkin lymphoma and other common cancers in a large prospective study of 623 080 middle-aged UK women. Women reported their consumption of organic food and were followed for cancer incidence over the next 9.3 years.

Here is what they found:

At baseline, 30%, 63% and 7% of women reported never, sometimes, or usually/always eating organic food, respectively. Consumption of organic food was not associated with a reduction in the incidence of all cancer (n=53 769 cases in total) (RR for usually/always vs never=1.03, 95% confidence interval (CI): 0.99–1.07), soft tissue sarcoma (RR=1.37, 95% CI: 0.82–2.27), or breast cancer (RR=1.09, 95% CI: 1.02–1.15), but was associated for non-Hodgkin lymphoma (RR=0.79, 95% CI: 0.65–0.96).

Conclusions: In this large prospective study there was little or no decrease in the incidence of cancer associated with consumption of organic food, except possibly for non-Hodgkin lymphoma.

These findings mesh well with other research I've pointed to in the past noting that food pesticide are a relatively small risk in the grand scheme of things. If the results had been the other way around (that eating organic food reduced cancer risk), I would have pointed out that this is an observational study and that it is really hard to identify causation. For example, maybe people who eat organic engage in all kinds of other healthy activities that reduce cancer risks. Organic consumption is likely correlated with income (given the higher price of organic), and higher income folks are likely to be able to better protect against all kinds of illnesses than poorer folks. That's what I would have said had this study shown a correlation between organic consumption and reduced cancer risk.

Thus, it is only fair play to apply the same thinking to this study which generates a result consistent with arguments I've made in the past. The article finds little to no correlation among people who choose to eat organic and cancer risk. But, maybe people at greater risk for cancer in the first place choose to eat more organics, hoping it will reduce the odds? Maybe people who can't afford to eat organic self-protect in other ways, such as more exercise or eating more fruits and veggies? I don't personally find such explanations for the null result very plausible, but these are the sorts of things one must worry about in observational studies.

To really provide a definitive answer to this question, one needs to do a randomized controlled trial. Or, at a minimum, apply some of the more advanced identification methods and sensitivity analyses that are today being used in the best economics papers (eg, regression discontinuity designs, propensity score matching, model specification comparison, etc). In many ways, it seems to me that much of what I read in epidemiology and nutrition reminds me of the state of the econometrics literature in economics 20 years ago.

Natural and Organic Craziness: It's not just food

My wife likes to buy cosmetics products from a company called Paula's Choice.  One of the things she likes about the company is that it reports on the scientific testing it does on its own products and that of its competitors. 

In any event, my wife alerted me to an interview with the company's owner, Paula Begoun, which I found fascinating.  It seems the cosmetics world is grappling with many of the same issues as the food world.

Paula was interviewed on radio by another cosmetic's industry insider: Karen Yong.  Here are some excerpts from the transcript when the discussion turned to "natural" and "organic" cosmetic products:

Paula Begoun:. . . On the other side of the coin one of the things many cosmetic companies have to deal with is the fear mongering around the evilness of cosmetic ingredients which I've written about extensively and I know you have opinions on.

How are the cosmetics companies, the Lauders, the Shiseidos dealing with this fear mongering that the organic natural cosmetic world is putting out there.

Karen Young:It's frightening and it's probably the biggest thing that I'm confronted with right now. I'll try to narrow it down a little bit because as you know it's a huge category.

Paula Begoun:Wait, you're not frightened about the ingredients, you're frightened by the influence…

Karen Young:The press.

and

And the other piece of that as you alluded to is the whole natural organic green-washing thing, which is so confusing that even those of us who are supposed to understand what's going on here, it's really, really difficult.

Paula Begoun:I'm often shocked by the women really do believe – I get asked it all the time. “Should I be scared of what I'm using. Is it killing me? And I'm using this natural product.” And I know what those products contain. That's what we do for a living here at Paula's Choice is we review everybody else's products and look at what the formulas are and what they contain and what they can and can't do for skin.

00:20:36And lots of natural ingredients that show up in natural products are bad for skin. And I'm looking at this woman telling me I'm so scared other products are killing me and I'm going, yeah, I know, but you're breaking out, your skin is red. I know what you're using isn't protecting you from aging, or sun damage, and on and on. And they're frightened of everybody else's ingredients except the company that is dong the fear mongering.

00:21:00Of course, they never tell you what problem ingredients their products contain, but, yeah, it's an insane – so, how are the Lauders and the Shiseidos, I mean, Lauder is not going to give up. They're not going to go all natural. They know that all natural isn't going to fly for skin. And lord knows an elegant product without silicone is almost impossible. And there's nothing wrong with those ingredients. What are they doing about this aside from I know that the industry went away from parabens.

and

Paula Begoun:Actually, you know, it's interesting, because one of the things that happens when you start making “all natural products” is you increase the need for higher levels of preservatives.

Karen Young:Preservatives!

Paula Begoun:And there aren't any so-called natural, although even the natural preservatives when you have to increase it that much, then you're getting irritation. Preservatives kill things. That's what they do.

Karen Young:Absolutely.

00:24:37You're getting irritation and possibly you're making it more difficult to stabilize the formula.

Paula Begoun:You know, we're just reviewing a product line that, you know, we haven't run into this in a long time. A lot of the natural product lines, while the formulas may have issues in terms of irritating ingredients and jar packaging and fragrance, and I'm going to ask you about jar packaging in just a second, but one of the things that we haven't run into in a very long time is a company claiming that it's all natural but it actually isn't, it actually uses synthetic ingredients.

00:25:15This is one of the first times in a while I would say in the past, I don't know, three, four years that we actually ran into a company that is lying through their teeth. Their products are about as natural as polyester. Do you see that – do you run into that in your research?

Karen Young:Yes.

Paula Begoun:Yeah, you see that, too.

Karen Young:Because as you know there is no definition for natural. It's completely arbitrary. You can use the word anyway you like. And consumers, as you mentioned earlier, consumers are incredibly confused about what does natural mean and what does organic mean. I mean, that theoretically is defined by the FDA and consumers really don't understand that either.

Natural Parody

A colleague sent me a link to the following video.  I found it funny, if not misinformed at times.  The irony, of course, is that many people also believe things about organic food that also aren't true.  The organic labels causes people to ascribe all kinds of mystical properties to a food.  It is also worth pointing out that, at least for meat, "natural" can't be slapped on anything - it has to be "minimally processed", among other things, according to the USDA.  In any event - it's good for a few laughs

The new gentleman farmer

That's the the title of a story in the winter issue of WSJ.Money magazine.

The piece documents the rise of the gentlemen and gentlewomen farmers: folks who made millions elsewhere and who are now trying their hand at agriculture - primarily organic agriculture.  

Here are some of the folks jumping in:

It's late afternoon on a Friday, but Lerner, the 58-year-old tech pioneer who co-founded Cisco Systems, is still working, driving her Range Rover around the pastures and barns that make up her 800-acre Ayrshire Farm in Upperville, Va 

. . .

The nation is in the middle of an organic-food boom, and in case you haven't noticed, a surprising number of boldface names are becoming part of it. That includes Oprah Winfrey, who is growing kale, carrots and more than 60 other varieties of vegetables, fruits and herbs on her organic farm on the Hawaiian island of Maui, as well as comedian Roseanne Barr, who is growing macadamia nuts and produce on her organic farm on Hawaii's Big Island. Fashion-world honchos George Malkemus and Anthony Yurgaitis—president and vice president, respectively, of designer shoe brand Manolo Blahnik—have a dairy farm in Litchfield, Conn., where the 325 cows are pasture-fed (at least when the weather allows; otherwise, they are given a special diet of high-quality hay and a premium feed)

Are they making any money?  

It appears not.  Indeed much of their fortunes are being lost (or rather perhaps we should say they are spending their fortunes on a consumption good or experience).

But by Lerner's own admission, she has yet to turn a profit on her $7 million-a-year business, which includes two additional farms in the area, bringing her total acreage to 1,200. And at times, it seems she is consciously running it as a nonprofit entity, especially given the considerable time and energy she devotes to research on organic farming practices.

It seems she is having to make some big changes:

she has taken a series of steps to save money, including farming out some of her operations and making adjustments in her meat-packaging operations. Her biggest step of all, though, is deciding to sell a good chunk of the farm. Indeed, some 600 of Ayrshire's 800 acres are now on the market, replete with the mansion she's restored. The asking price: $30 million. To many, this might be seen as an acknowledgement that Lerner has ultimately failed in her mission. She prefers to view it as the next step in the evolution of her business. 

More generally:

But the good intentions of these type-A types notwithstanding, the economics of organic farming are a potential blow to their fairly large egos. These are individuals with scores of successes in life, but experts say that despite the price premiums that come with organic labeling or other likeminded practices, the math doesn't always work out. It is just too expensive to do. For that matter, almost all farming, organic or conventional, is a financial boondoggle when it's outside the realm of factory farming. The median projected income of the American farm in 2013? It's actually a loss of roughly $2,300, according to the U.S. Department of Agriculture. Is it any wonder that—the organic boom notwithstanding—the number of farms in the U.S. has been on a dramatic decline, from a high of nearly 7 million in the 1930s to 2.2 million today?

Although I have been critical of many of the claims of organic agriculture, one shouldn't be too quick to conclude that all organic farming is unprofitable.  Indeed, many conventional producers have switched some of their operation to organic because they expect higher profits (i.e., they expect the higher price premiums for organic to compensate for lower yields and higher input costs).  But, the ones making money at it typically aren't "gentlemen farmers" or mom-and-pop set-ups.  

In terms of profitability, it may matter less whether one is an organic or non-organic farmer as compared to whether the producer uses efficient practices and technologies.  For example, here is a study about dairies by some of my former colleagues at Purdue University published in the American Journal of Agricultural Economics.  They show that the technology used by organic farms is less efficient than that used by non-organic (organic is about 13% less productive).  However, there are differences in efficiency across farms, both organic and non-organic.  As they say:

To our knowledge, our research is the first to show that economies of scale also exist in organic dairy production.

In other words, size matters - even if you're organic. Larger dairy farms are going to have lower costs. That's true for non-organic and it is true for organic.  Also:

We find that compared to the Upper Midwest, the technology used by farms in the Southeast is more productive. Farms with cows of higher weight also produce more milk. . . .In terms of management practices we find that farms that tend to rent more of their land for either crop production or pasture are less productive. Intuitively, a renter does not have the same incentive as a land owner to invest in the productivity of the land. Farms that raise more of their own feed seem to be less productive. . . .

If gentlemen farmers want to make more money, they may have to stop being so gentlemanly and get down to business.

Does Big Farming Mean Bad Farming?

That was the subtitle of an interesting article in the Washington Post.   While I do not agree with all the premises of the article, it does a good job debunking the notion that small size is the same as sustainable. 

Size, as they say, isn’t everything. As shorthand, the big-equals-bad equation is convenient. But it obscures an inconvenient truth: Plenty of small farmers do not embrace sustainable practices — the Amish farmers I know, for example, love their pesticides — and some big farmers are creative, responsible stewards of the land. “Tony’s is a fantastic operation,” says Helene Murray, executive director of the Minnesota Institute for Sustainable Agriculture. “And he just happens to grow a lot of corn and soybeans.”

and  

Thompson’s farm is not organic as he once dreamed it would be. Indeed, after studying the scientific literature, he finds himself mostly comfortable using genetically modified seeds. The rewards inherent in herbicide-tolerant soybeans outweigh the risks, he says. While he does have some concerns about GM corn, he says, “the prevailing technology is a good path, maybe the best available at the moment. This will change. We will learn.”

Still, Thompson has many tools to improve his farm’s environmental sustainability.

In my experience, Thompson is not all that unusual as a farmer - most are continuously trying to find ways to make food more abundant while making sure they leave healthy vibrant farmland for their kids.