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Harvard Commentaries
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Reviewed by the Faculty of Harvard Medical School

Medical Myths Medical Myths

The Organic Advantage

August 30, 2012

By Robert H. Shmerling M.D.

Beth Israel Deaconess Medical Center

Imagine a new gasoline that claims to reduce future repair costs and lengthen the life of your car. Not only that, but this new gas will also improve mileage and reduce your car's exhaust pollutants.

If the gasoline cost an extra $2 to $3 dollars per gallon than your usual gasoline, would you buy it? Would you wonder if it's really as good as they say. Perhaps you'd ask to see the data that backs up the claims. What if you were told, "We know it's better because of the way we make the gas." What if a competitor markets a completely different "greener gas" but makes exactly the same claims about its advantages. Could you tell which one is best? Or, would you go back to your usual gas until you had more information? What if it were just 5 cents more per gallon? What if it were $5 more per gallon?

In my view, this scenario is similar to what consumers now face with organic foods. Although producers of organic foods are not allowed to claim health benefits, plenty of advocates endorse the idea that organic foods are healthier. And much of the appeal is intuitive: They have no synthetic fertilizers, growth stimulants, and so on.

So, are organic foods truly better? Are they worth the added cost? The answers may not be as clear as you think.

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A Complicated Issue

Don't get me wrong. I'm not saying organic foods are bad. In fact, they may be better for you and safer than conventional foods, and well worth their higher prices.

But, the issue is not straightforward. Before we all feel compelled to plunk down the extra cash required to purchase foods that carry the "organic" label, there are several reasons not to accept the "organic advantage" at face value. Any benefits they offer depend on:

  • How you define "organic"
  • How you define "better"
  • How much the potential (and unproven) benefits of organic foods is worth to you

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Defining "Organic"

Although the word "organic" has a number of meanings, when it comes to food, it refers to production using only feed and fertilizer that are free of antibiotics, growth hormones, pesticides, synthetic ingredients, bioengineering or radiation.

That may sound simple, but what about a fertilizer that is "chemically created" but is identical to fertilizer of animal origin? What about food that is mostly organic but has traces of food from a non-organic farm? How can the consumer know what the term "organic" means when they see it on a food label?

The U.S. government has taken some fairly recent actions to address these questions. Congress passed the Organic Foods Production Act in 1990. This led the United States Department of Agriculture (USDA) to create the National Organic Program that took effect in late 2002. This program created regulations for food producers who label their foods "organic," including the use of the "USDA Organic" seal. Anyone who violates the program's regulations can face a fine of up to $11,000.

According to the regulations:

  • Organic foods must not be produced using radiation, genetic engineering, petroleum-based or sewage sludge-based fertilizers, synthetic substances or "most conventional pesticides;" the list of allowed exceptions is remarkably long
  • Animals must not receive antibiotics or growth hormones. And, they must be allowed outdoors and fed only organic feed.
  • A food may be labeled as "100 percent organic" if all ingredients are organically produced.
  • A food may be labeled "organic" if at least 95% of the ingredients are organically produced. Only foods qualifying as "100% organic" or "organic" are allowed to use the USDA Organic seal.
  • "Made with organic ingredients" means that at least 70% of the ingredients are organically produced; these products cannot carry the USDA Organic seal.
  • If less than 70% of a product's ingredients are organically produced, the product itself cannot be called organic (and the seal can't be used), but individual ingredients that are organically produced may be described as such in the list of ingredients.

These labeling regulations are not about food safety or quality. They are about food production — the process of how the food is produced. Inspectors are supposed to certify food producers' methods to decide which label is most appropriate. They do not test the food for purity or any other measure of "organic-ness."

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Defining "Better"

When people talk about the "organic advantage," what do they mean? Here are three ways that organic foods might be better than "conventional" foods:

  • Health – A big part of the appeal of organic foods is the belief that they are good for human health. Advocates of organic foods often state that we can reduce cancer, heart disease, and other important health problems if only everyone limited their diets to organic foods. While they may be right, it's speculation at this point. A study published in the July 2009 American Journal of Clinical Nutrition reviewed 50,000 studies over 50 years and found no significant differences in the nutritional value of organic foods over conventionally produced foods.

    A more recent analysis of past research was published in the September 2012 Annals of Internal Medicine. It included 17 human studies and 223 studies of nutrients and contaminants in a variety of organic and conventional foods. These researchers also found no convincing evidence that organic foods were more nutritious.

    Perhaps information about health outcomes will come soon. For now, as I breeze through the produce section at my local grocer, I have some confidence that the organic apples are different from "conventional" apples. But I cannot be confident that they are worth the higher price because they provide significant health benefits.

    Another point to consider is that the added cost of organic foods could force people on tight budgets to choose less healthy food over fruits and vegetables.

  • Taste – I've heard it said that you can easily taste the difference between organic and non-organic foods, and that organic foods clearly taste better. But, a recent study at Kansas State University found that this wasn't true. A variety of otherwise identical vegetables (including lettuce, spinach, tomatoes, cucumbers and onions) were grown either organically or conventionally in carefully designed plots. Consumers were then asked to compare their taste in a blinded fashion. No major differences were reported for lettuce, spinach, tomatoes, cucumbers and onions. In fact, conventionally produced tomatoes were rated as having a stronger flavor. Perhaps the results would have been different for fruits, meats or other food items but, again, there is no compelling evidence that there is an "organic advantage" when it comes to taste.
  • Safety – It seems reasonable to assume that organic foods are safer than conventional foods. After all, pesticides, antibiotics and sewage sludge-based fertilizers can't be good for you, right? Fair enough. But to me, a key question is this: How unsafe are conventional foods? Do conventionally grown apples truly represent a health risk? And is the reduction of that risk worth the added price of organic foods? We have little or no data to answer these questions. And there are inexpensive ways to reduce pesticide exposure from conventional foods, such as washing, peeling, cooking or freezing them.

There may be other reasons people are willing to pay a premium for organic foods: Protecting the environment, humane treatment of animals, and even cultural or religious influences. But it seems to me that many people are paying more for organic foods based on assumptions and promises that are not backed up by real evidence.

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How Much Is the "Organic Advantage" Worth to You?

Putting aside concerns about how to define "organic-ness," and even if studies eventually prove that eating organic foods has significant health advantages, there's still the issue of price.

For example, if a single organic apple cost $8, would you buy it? What if the health advantage was small? Each person would still have to weigh the health advantage against the difference in price. Perhaps it would be an easy choice for some (especially the wealthy), a tougher one for others, much like the expensive car with the highest safety rating. Even for those who could afford it, some would choose to spend the money while others would not.

The organic food industry is a multibillion dollar enterprise. And it's growing. Sales of organic foods in the United States was about $3.6 billion in 1997. By 2010, annual sales of organic foods was more than $26 billion. It's remarkable how much we are willing to pay for these products despite the absence of a proven health advantage.

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A Myth in the Making or Ahead of the Curve?

Maybe the lack of scientific evidence is not a big deal to you. After all, we make plenty of decisions every day – health-related and otherwise — without scientific scrutiny to back them up.

My favorite example is the "parachute assumption." No one has performed a highly scientific study of whether using a parachute when jumping out of a plane is a good idea. We simply accept the idea at face value because the experience of skydivers using parachutes is compelling. (Of course, the occasional tragic parachute malfunction is also compelling.) We don't need to actually do the experiment comparing outcomes of 100 skydivers using parachutes with the experience of 100 skydivers not using parachutes. We can guess the results and have confidence that choosing to use a parachute is the right call.

In my view, the organic food advantage is not nearly so clear. Many years from now, we may have data that organic foods offer no measurable health or environmental benefits. At that point, many will have wasted considerable resources buying these foods based on the false expectation — a health myth — that the added cost was providing something positive.

Then again, if the data go the other way and it turns out that organic foods provide major health benefits, those who had chosen organic foods will be healthier and, perhaps, live longer than the "econonomizers" who were waiting for proof.

So, do we pay more now for possible benefit or wait for proof and save our hard-earned cash? I've made my decision. Regardless of what your decision is, know that neither of us can know at this time if we are right.

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Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.


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