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OCA in Washington Post on Issue of rBGH

October 7, 2003
Elizabeth Chang, Washington Post Staff Writer

When Elaine Greene, an environmental consultant in Raleigh, N.C., noticed her daughter developing breasts at age 9, she was alarmed. Greene recalled hearing that the age of puberty was dropping among American girls -- a trend that worries some health experts. She also had read articles speculating that artificial growth hormones given to dairy cows to increase their milk production might be responsible.

For a woman who was already in the habit of purchasing organic meat and produce "to minimize any additional exposure to chemicals and hormones," the next step wasn't difficult. She resolved to buy only organic milk.

"It's an easy switch to make," she said.

Greene isn't alone. As organic food producers and advocacy groups have promoted theories linking milk from hormone-treated cows to early puberty -- as well as to increased antibiotic exposure and cancer risk -- sales of organic milk have soared, even though it costs up to twice as much as the conventional product. According to the international market research firm Datamonitor, U.S. sales of organic dairy products rose from $ 133 million in 1996 to $ 1.3 billion in 2001. That's $ 1.3 billion out of a $ 70 billion pie in combined conventional and organic dairy product sales, according to International Dairy Foods Association (IDFA).

"Growth in the dairy category, particularly organic milk, was largely driven by the continued use of hormones, such as rBGH [recombinant bovine growth hormone], and antibiotics in conventional dairy products," stated Datamonitor's report "U.S. Organics 2002."

"It's really just recently that people have started talking about [the health impact of rBGH]," says Jaeme Jaczkowski, a spokesperson for Horizon Organic, the nation's top producer of organic milk, located in Boulder, Colo. "I think people are really now starting to become concerned about their food safety."

Could hormones meant to make cows give more milk lead to early puberty, as some parents fear? On its face, it sounds plausible enough. But government and pediatric health experts say there are no scientific data to back up such an association. For one thing, they say, rBGH does not survive pasteurization. And even if it did, they add, it has absolutely no effect on human growth.

"Not only is there no evidence" that rBGH affects human growth, says Paul Kaplowitz, the new chief of endocrinology at Children's National Medical Center and a specialist in the issue of early puberty, "it's not even scientifically possible."

There is also no evidence that milk from hormone-treated cows contains harmful amounts of antibiotic residue or promotes cancer, say such experts as Stephen F. Sundlof, director of the Center for Veterinary Medicine at the Food and Drug Administration. The National Institutes of Health and a joint committee of the United Nations and the World Health Organization also have looked at the issue and concluded that rBGH is safe for humans.

"The thing has been studied up and down and sideways; there are no safety issues to consumers," said Susan Ruland, vice president for communications of the IDFA, which represents both conventional and organic milk producers. Many consumers, however, don't seem to be getting the message.

It may not be merely a matter of imagination that girls' bodies mature earlier today than they did a generation or so ago.

While the average age of onset of menstruation among U.S. girls has held steady at about age 12 for the past 50 years, the age at which girls start showing secondary sexual characteristics -- breasts and pubic hair -- seems to have changed. For years, pediatricians viewed age 11 as the mean age of breast development, on the basis of a classic study from the late 1960s. Even though the research was conducted in Britain and the study's participants were all white, American doctors largely took the findings to apply to girls in the United States.

But in 1997 a landmark analysis of 17,000 U.S. girls led by University of North Carolina professor Marcia Herman-Giddens showed that many American girls were beginning to show secondary sexual characteristics between ages 9 and 10. Half of African American girls and 15 percent of Caucasian girls in the study began development as early as age 8.

(Boys, too, may be maturing somewhat sooner, according to more recent research by Herman-Giddens, but that hasn't aroused as much concern.)

There are genuine reasons to worry if girls are entering puberty sooner. Not only can early breast development cause embarrassment for a girl whose body may be maturing faster than her emotions, there are possible health concerns as well. A study in the June 5 New England Journal of Medicine linked early breast development to breast cancer; a study in the June Journal of Pediatrics suggested a link between early breast development and adult obesity.

Why girls might be maturing earlier, no one knows for sure. Theories abound: Girls are better nourished. They have more body fat these days. They are exposed to more chemicals. But the changes documented in Herman-Giddens's study cannot be attributed, even in part, to artificial bovine growth hormone for one important reason: The data for her study were collected in 1992 and 1993, before rBGH was available for dairy herds in the United States.

Another problem with the rBGH and early puberty theory: Children today drink markedly less milk than they did a generation or two ago. According to the U.S. Department of Agriculture (USDA), milk consumption among girls ages 6 to 11 dropped by about one-third from the late 1970s to the late 1990s. Kaplowitz, who subscribes to the increased body fat theory, has little patience for those who blame hormone-treated cow's milk. "I'm really at a loss as to where this connection comes from," he says. "People are always eager to find environmental culprits for early puberty. It's a very emotional thing with a lot of people."

Herman-Giddens, however, takes a different view. Just because no good evidence exists that artificial growth hormones in milk harm human health, she says, doesn't mean the matter doesn't deserve further study.

"I don't take at face value what the government says about [rBGH], because I think they are very influenced by the dairy industry," she said. "I think there are a lot of questions about [rBGH]; I don't think there's been adequate research."

That same note of distrust is frequently sounded by groups that, in questioning the safety of conventional milk, pressing for more research or opposing the use of synthetic hormones altogether, are pitting their relatively puny resources against corporate and government might. These advocates include nonprofits such as the Center for Food Safety, the Environmental Research Foundation, the Organic Consumers Association and the Vermont Public Interest Research Group, along with businesses including Horizon Organic, Ben and Jerry's and Whole Foods.

"Tell the FDA to remove this potentially dangerous product from the market!" urges the Web site of the Center for Food Safety. But the FDA says some organic dairy producers go too far in promoting their alternative foods.

No matter what some product labels may say, there is no such thing as "hormone-free" milk. All milk has naturally occurring bovine growth hormone, which prompts a pregnant cow to produce milk for its calf. It's the synthetic version -- rBGH, also known as recombinant bovine somatotropin (rBST) -- that has drawn debate since the mid-1980s, when the FDA first started considering its use. The agency gave its approval in 1993.

The hormone, injected into cows every two weeks, can increase milk production up to 15 percent. About 22 percent of dairy cows in the United States receive rBGH, according to 2002 data from the USDA's National Animal Health Monitoring System.

Because the FDA has not found any human health problems involving rBGH, dairies whose milk is produced with rBGH needn't note on their labels that they use it. Sellers of organic products, however, must certify that they do not. And they must do so in a way that the FDA does not consider false or misleading. In a reinforcement of this point, the FDA issued warning letters to four organic milk producers last month, telling them to stop using the words "No Hormones" and "Hormone-Free" on their labels. The FDA recommends that labels instead identify organic milk as "from cows not treated with rBST" and include a disclaimer like this: "No significant difference has been shown between milk derived from rBST-treated and non-rBST-treated cows."

Some groups are backing off the claim of connections between milk and early puberty -- if a bit guardedly. "There's a sort of folk wisdom that hormones fed to animals are partly what's producing this," said Ronnie Cummins of the Organic Consumers Association, which has been in the forefront of efforts to set standards for organic foods and fight genetically engineered products. "There's no hard evidence to this effect," he said, "but it's certainly a concern."

Cummins gives less ground on other human health worries spurred by rBGH, however. "The primary concern with rBGH is two things," he said: "the increased antibiotic residues and the increased levels of a cancer tumor promoter called IGF-1."

The antibiotic residue argument goes this way: The more cows that get rBGH, the more milk produced and the greater the possibility that cows will develop udder infections, or mastitis. Farmers treat mastitis with antibiotics. The more antibiotics used, organic milk groups contend, the greater the likelihood some residue will turn up in milk.

That is a disturbing scenario, agrees the FDA's Sundlof, "but when you test it out, it doesn't exactly turn out to be true." Since the approval of rBGH, there has been no increase in the milk that has had to be discarded because of antibiotics, he said.

According to the FDA, the states and industry test all bulk milk tankers for antibiotics before processing; any milk that tests positive is thrown out. Inspectors test all tankers for beta-lactam antibiotics, which include the penicillin and cephalosporin classes of antibiotics; they also perform random tests for other antibiotics, such as tetracyclines. The FDA has set limits for each specific antibiotic (for example, 5 parts per billion for penicillin G, 300 for tetracycline) that determine when milk is to be discarded.

Less than one in every 1,000 bulk milk tankers is found to contain antibiotic residue in excess of those limits, the FDA says.

The Organic Consumers Association isn't satisfied that the antibiotic testing program is rigorous enough. For example, Cummins argues, the FDA doesn't test for off-label antibiotics. Sundlof asserts that the FDA also has field inspectors check dairy farm drug cabinets for unauthorized drugs.

Then there's the other concern that has captured the attention of organic and food safety advocates: insulin-like growth factor (IGF-1), a natural substance that is unaffected by pasteurization. Studies have linked higher levels of IGF-1 in the blood with a greater risk of breast cancer in premenopausal women and prostate cancer in men. Some studies' suggestion that milk from rBGH-treated cows has higher levels of IGF-1 than those found in milk from untreated cows has led some advocates for organic milk to posit a link between milk from rBGH-treated cows and breast and prostate cancer.

"You're increasing your risk of cancer by injecting the cows with rBGH," says Cummins.

Responds Arlan Rosenblum, a professor of pediatrics at the University of Florida, "There is a huge, huge fallacy in that reasoning." The problem, he said: IGF-1 "is a protein that will get broken down with the digestive enzymes."

Some groups contend there is a protein in milk that slows the breakdown of IGF-1, but again, government studies have found no cause for concern. According to a 1998 joint study by the U.N.'s Food and Agriculture Organization and the World Health Organization, even if the IGF-1 were absorbed, the amount absorbed would be less than the amount produced naturally in the human gastrointestinal tract.

The report concluded that there is no safety issue regarding IGF-1 in cows' milk. "The potential for IGF-1 to promote tumor growth will not increase when milk from rBST-treated cows is consumed, resulting in no appreciable risk for consumers," it said.

These studies have not satisfied some organic advocacy groups, which point out that the FDA is not conducting any long-term studies of rBGH. But that's not how the agency operates, said Sundlof. "We set a high standard up front," he said. The agency's pre-approval review of rBGH, he said, was "the biggest one ever," involving "half a million pages of data" studied for "well over 10 years."

Organic groups also argue that rBGH has not been approved for use in Canada or the European Union. Sundlof responds that Canada banned the use of rBGH/rBST because of concerns about increased mastitis in cattle, not because of any health effects on humans. And, he said, the EU has a blanket ban on artificial hormones in food production.

So what's a parent to do? Pediatricians say forgoing milk and milk products altogether is definitely not a good idea.

"Childhood and adolescence and their early twenties is when [children] accrue most of their bone mass," said Janet Silverstein, a Florida pediatrician who is chairwoman of the American Academy of Pediatrics section on endocrinology, and "and milk is a major source of calcium."

American children already are falling short. According to the USDA, nearly a third of children under age 5 don't receive adequate calcium.

By adolescence, the figure is stunning: 88 percent of girls ages 12 to 19 and 68 percent of boys the same age fail to get enough.

Whether parents choose to help supply their children with that calcium by serving organic or conventional dairy products doesn't matter.

"There's no difference in the milk," says the IDFA's Ruland.

Elaine Greene concluded that conventional milk had nothing to do with her daughter's development after finding out that the women on her husband's side of the family tend to mature early.

"In the case of my daughter, I think it's pretty clear [the cause of her early breast development] is genetics," she said.

Still, just to hedge her bets, Greene has continued buying organic milk.

"I'm basically looking at organic as an indicator of a higher quality of food," she said.

"I feel like it can't be a bad thing." *

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