Unsolicited food additives. Spodlick DH, New England Journal of Medicine 1970 Dec 17;283(25):1412-3

Letter to the Editor, New England Journal of Medicine


To the Editor: R.C. Adams takes me to task (in the Correspondence in the November 5 issue) for my views on unsolicited food additives. My letter (in the September 3 issue) called for ". . . formal prospective investigations . . . at least in well fed levels of the American population" rather than restrospective surveys. This might determine if there is a pharmacologic (hence unwanted) effect of a chronic superabundance of particular additives. I also proposed that pending such studies, consumers should have the freedom to choose between plain and "fortified" foods.

The object of my complaint was that properly designed and controlled trials of the chronic effects of food additives in human beings had not been done. If certain vitamins and minerals (let alone BHA, BHT and so forth) have unwanted chronic pharmacologic effects at high levels of intake, those who are presumably not nutritionally deficient in one or more of these are being medicated without due therapeutic indications. Mr. Adams points out that a serving of liver may contain up to 75,000 U of vitamin A and asks, "Did nature make some grievous mistake in providing this richly nourishing food?" Nature provided livers to serve their owners' metabolism, not to become part of some other animal's metabolism.

Finally, I do not feel like being medicated on the basis of epidemiologic data - particularly if the adverse findings are drawn from population strata other than mine (Mr. Adams cites deficiencies in "4 per cent of children below the age of six" and so forth). It is true that we do mass immunizations in preventive programs based on epidemiologic data, but their aims and effects are fairly well understood and the doses are specific. It will not do to advocate mass administration of nutrients when the effects of completely uncontrolled dosage are not yet understood.

David H. Spodick, M.D.
Lemuel Shattuck Hospital
Boston, Mass.

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