Archive 2007 2008 2009 2010

Q: My farmers’ market sells locally made raw-milk cheeses. Are they safe?

A: Food poisoning from raw-milk cheeses is reported almost every year. It is clear that pregnant women, young children, and those in frail health should not eat most raw-milk cheeses. According to the FDA, pregnant women should particularly avoid Mexican-style soft cheeses (queso fresco or queso blanco) made from raw milk, which have caused several outbreaks of food poisoning. Listeria, a pathogen sometimes found in raw milk and its products, can damage the fetus permanently, besides sickening the woman. However, the danger of raw-milk cheese for healthy adults is a subject of debate.

We strongly advise you not to drink raw milk, which makes up a tiny percentage of milk sales but accounts for more than twice as many disease outbreaks as pasteurized milk. Turning raw milk into cheese does not necessarily kill the pathogens.

Parmesan and Roquefort are aged cheeses made from raw milk, and the FDA regards raw-milk cheese as safe if aged for at least 60 days. Dry crumbly cheeses are generally thought to be safer than soft creamy ones. There is little scientific evidence behind this, but food poisoning outbreaks from these two very popular cheeses have never been reported.

Artisanal raw-milk cheese (made in small quantities by traditional methods) is a thriving business in the U.S., with its own lobbying groups. They say raw milk yields more complex and earthy flavors. They point out that while pasteurization does make milk safer, it does not kill all pathogens, and that careful handling is actually the key to safety. Cheeses from pasteurized milk, they point out, can get contaminated along the way. Groups such as Oldways and Slow Foods also support the safety of raw-milk cheese, as does some university research.

Raw-milk cheeses can be sold legally in many states (and now in Quebec), but not in others. Nevertheless, raw-milk soft cheeses—aged or not, legal or not, local or imported—can be found in most well-stocked specialty cheese stores, usually clearly labeled as such.

Q: Do PMS pills such as Pamprin work?

A: They may help some women, but it’s hard to predict, since premenstrual syndrome (PMS) symptoms are so varied. For most women premenstrual symptoms (bloating, headaches, breast soreness, irritability, and fatigue) are minor and vanish in a few days. But for others the problems may last for as long as two weeks.

Over-the-counter PMS tablets typically contain a pain reliever (such as acetaminophen, as in Tylenol) to combat headaches and the pain of cramping; a diuretic (such as pamabron or ammonium chloride) supposedly to relieve bloating; and an antihistamine (such as pyrilamine maleate) supposedly to reduce irritability.

If your main symptoms are headaches and cramping, a simple pain reliever would be a cheaper option, since the PMS pills cost about $5 for just 20 pills, enough for only a few days. Other pain relievers, notably ibuprofen (such as Advil), may actually be more effective against cramping than the acetaminophen found in most PMS pills. If you suffer from serious physical symptoms, talk to your doctor. The mild diuretics in these pills are unlikely to have much of an effect. As for irritability and other emotional symptoms, don’t expect an antihistamine to help much, except to make you a little sleepy.

Q: How often do I need full-mouth X-rays from my dentist? I want to minimize my exposure to X-rays.

A: Every five years or so, but it depends on your oral health and history, your age, and whether you have symptoms or signs of dental problems. You will also need less extensive "bitewing" X-rays every 12 to 24 months. If your oral health is good, bitewings every 24 months or so will be enough. But if you have many fillings, crowns, and bridges, you’ll need more frequent bitewings.

There are three types of dental X-rays. Bitewing X-rays are used primarily for the molars; they show the exposed teeth and only part of the roots. Periapical X-rays show the whole tooth, from crown to root tip, and some of the bone surrounding the roots. "Full-mouth" X-rays include these two kinds. In addition, panoramic X-rays, which provide a wide view of the upper and lower jaw, are used if you have jaw problems, cysts, or impacted teeth, or if you’re going to have a tooth extraction.

The radiation exposure from today’s dental X-rays is very small, but there’s no point in getting X-rays you don’t need. In addition, you should wear a lead apron during the procedure. Pregnant women should postpone X-rays, if possible.

Q: Is it okay to use hot tap water for cooking and drinking? It saves time.

A: No, unless you’re certain your plumbing does not contain lead, according to the EPA. Hot water is far more likely to leach lead from the pipes. Lead solder in plumbing pipes was banned in the U.S. in 1986, but older plumbing may still contain lead-soldered joints. Brass plumbing parts may also contain lead. The longer water stands in the pipe, the more lead is likely to dissolve.

It’s important not to use hot tap water to mix baby food or formula. Lead is especially dangerous for fetuses, infants, and children. Let the cold water run for a minute to flush out standing water if the faucet hasn’t been run for a while. If you need warm or hot water, the microwave is a quick solution.

UC Berkeley Wellness Letter, August 2009