Chapter 33
   BREAD- ONE OF THE FOODS
THAT CAUSES
ATHEROSCLEROSIS

  • BREAD CONSUMPTION IS ASSOCIATED WITH INCREASED INCIDENCE OF ATHEROSCLEROSIS
  • MOST BREADS ARE YEAST-FERMENTED PRODUCTS
  • BREAD CAN BE FUNGAL/MYCOTOXIN CONTAMINATED
  • BREAD CAUSES ATHEROSCLEROSIS
THE REPORTED CLINICAL FACTS

Bread, Cookies, Biscuits, Cakes Cause Coronary Heart Disease And Myocardial Infarction

Willett et al (1993) reported the results of a study of the dietary data from 85,095 participants in the Nurses' Health Study.

During 8 years of followup, there were 431 cases of new coronary heart disease (nonfatal myocardial infarction or death from coronary heart disease.

Cookies, biscuits, cake, and white bread were each significantly associated with higher risks of Coronary heart disease.

Reduction in Dietary Sugar Intake Associated
With Increased Longevity Following Myocardial Infarction

West and Evans (1986) analysed lifestyle changes in long term survivors of acute myocardial infarction. They used a retrospective questionnaire and interviewed 10 year survivors of uncomplicated myocardial infarction examined smoking, diet, exercise, weight, medication, and treatment since discharge from hospital in 19734 and made comparisons with controls from normal populations.

Long term survivors of myocardial infarction were found to have made a number of changes in their eating habits including consuming much less sugar, cake, and biscuits.
 
Whole Wheat Bread Protects Against Myocardial Infarction/
 White Bread Increases Incidence Of Myocardial Infarction

Fraser et al (1992) reported the results of a prospective cohort investigation of 31,208 nonHispanic white California SeventhDay Adventists.

Using dietary information obtained at baseline which was related to risk of definite fatal coronary heart disease or definite nonfatal myocardial infarction, it was found that persons who usually consumed whole wheat bread experienced lower rates of definite nonfatal myocardial infarction and definite fatal coronary heart disease when compared with those who usually ate white bread.

 CLINICAL PERSPECTIVE

The recent Harvard study of the dietary habits of 90.000 cookies and bread (Lancet 1993). The bread is of course a American nurses followed for 5 years revealed increased atherosclerosis occurred in those nurses who were heavy consumers of two items characteristic of the Western diet, Baker's yeast fermentation product and many cookies have yeast added either for raising the dough or flavor or both. The sugar and fruit (fructose) in cookies are well known to elevate human blood cholesterol levels and to contribute to obesity problems, a well known risk factor for atherosclerosis.

The grains used in cookies and bread not unusually contain toxicogenic fungi and mycotoxins and the moisture content of these finished food products tend to promote further growth of these fungi (stored bread and cookies get moldy).

 
THE REPORTED ANIMAL STUDIES

Baker's Yeast Found to be Atherogenic In Rats

Zhikhar et al (1990) investigated the metabolic efficiency of baker's yeast fed to rats. Atherosclerotic-type morphologic changes were observed in the aorta and did not depend on the amount of the yeasts fed to the animals. In addition, the kidneys became infiltrated with lipids and cholesterol.

Dietary Yeast Induces Hypercholesterolemia and Atherosclerotic Lesions In Rabbits

Voskresenskii and Bobyrev (1981) induced experimental atheroarteriosclerosis in rabbits by keeping the animals on a diet which included dried yeast.

The authors found that there was moderate hypercholesterolemia associated with the development of destructive changes and calcinosis in the arteries, in addition to lipidosis and fibrosis.

It was concluded that the nature of the induced atherosclerotic lesions were quite similar to those found in humans.
 

THE CORRELATIVE FUNGAL / MYCOTOXIN FACTS

Baker's Yeast Inhibits Liver Detoxicating Function

Double stranded RNAs are present in Baker's yeast, S. cerevisiae. When Masycheva et al (1988) administered these yeast-derived RNAs to mice, they observed that they had an inhibitory effect on the liver detoxicating function.

This ability of Baker's yeast to decrease the efficiency of the liver to detoxify toxins points to an enhancing effect of Saccharomyces on the toxicity of mycotoxins in general, a situation which hardly can be considered desirable in the dietary intake.

THE CORRELATIVE FUNGAL / MYCOTOXIN FACTS

Fungal Contamination Of Bread
Described Over 100 Years Ago
 
Smith (1885) and Welte (1895) described the occurrence of various kinds of fungi which grew on Graubrot as well as other major kinds of breads which can be colonized spontaneously with Aspergillus nidulans, Asp. glaucus, Penicillium glaucum, Rhizopus nigricans ( Mucor stolonifer).

Fungal Contamination Of
Bread Described In 1919

Herter and Fornet (1919) conducted an assessment of various baked goods with respect to their fungal content. The following fungi (listed in order of frequency) were isolated: Aspergillus glaucus, Rhizopus nigricans, Penicillium crustaceum, Oospora variablis, Penicillium olivaeum, Aspergillus fumigatus, Aspergillus niger, Aspergillus flavus, Aspergillus nidulans, Aspergillus candidus.

Patulin Contamination
Of Bread (2 Studies)

1. Reiss (1973b) determined that a species of the widely occurring Penicillium expansum could produce patulin toxin on a variety of breads such as graham, wheat germ, and linseed bread.

2. Tyllinen et al. (1977) isolated considerable amounts of patulin toxin in moldy bread varieties in Finland. Rye varieties contained higher amounts than did wheat ones.

Ochratoxin Contamination Of Bread

Rehm and Schmidt (1970) found that a species of Aspergillus ochraceus produced ochratoxin on wheat and rye breads.  

Reiss (1978b) determined that this same fungal species produced ochratoxin in cake at optimal levels of moisture. Below a certain point of moisture content, however, the fungus was no longer able to grow.
 

Penicillic Acid Contamination Of Bread

Tyllinen et al. (1977) isolated penicillic acid from spontaneously molded white bread in Finland.
 

Ochratoxin Contamination Of
Bread And Cereals In Yugoslavia

Pavlovic et al. (1979), investigating the problem of ochratoxin as a cause of Balkan nephropathy, conducted a survey of 768 samples of cereals and bread which were locally produced in an area of Yugoslavia where Balkan nephropathy is prevalent. They found that ochratoxin was constantly present in parts of foodstuffs. The mean frequency of ochratoxin contamination of cereals in the study period was 8.7 percent, but a pronounced annual variation was encountered, with frequencies of contamination up to 43 percent. This significant amount of ochratoxin contamination is undoubtedly a major contributor to the high incidence of the epidemic nephropathy of this region, since it is a known kidney toxin.

Ochratoxin Contamination Of Bread And Flour In England

Osborne (1980) reported the finding of ochratoxin in moldy bread and flour consumed in England.

Ochratoxin Causes Breast Tumors In Mice

In female mice, fibroadenomas in the mammary gland were found in over half of the animals which were dosed with ochratoxin (Boorman [1988]).

 

CLINICAL PERSPECTIVE

Solid loaves of bread bear little resemblance to the powdery flour used to make them. This may explain why so few studies have been conducted relative to the potential for fungi/mycotoxin contamination of bread. Extensive evidence, however, shows variable and widespread presence of fungi and mycotoxins in all grains.

Initially, fungal growth is not visible which means that the consumer remains unaware of this food hazard until the molds finally become visible. Only then is the bread discarded without the consumer realizing that the bread being fed to the family—including infants being weaned off of breast milk—was invisibly moldy prior to discarding.

Unfortunately, bread is one of the first foods given to children.

Toxicity Of Spontaneously Molded
Bread Taken Off The Bakery Shelf

In the early 1970's, reports appeared which dealt with the discovery that bread taken off of the bakery shelf had a potential for harboring toxic fungi and mycotoxins. Tyllinen et al. (1977) reported on the degree of toxicity of moldy bread. The researchers found molds of Penicillium, Aspergillus and Paecilomyces in spontaneously moldy Finnish bread.

A check for mycotoxins revealed patulin in varying concentrations in the majority of the samples analyzed. Penicillic acid was found in 20% of the samples. It was also determined that higher amounts of the toxins were found in dark bread than in white bread.

Fungi/Mycotoxins Found In Moldy
Bread And Other Moldy Supermarket Foods

Davis et al. (1975) tested forty-five fungi which had been isolated from moldy supermarket foods for toxicity to brine shrimp. Twenty-two of these isolates were subsequently tested for toxicity to chicken embryos.

Among the highly toxigenic fungi were Cladosporium sphaerospermum, from a bakery product, and Aspergillus niger and Penicillium corylophilum, from bread. Approximately one-third of the fungal cultures were moderately to highly toxic to brine shrimp and chicken embryos.

 CLINICAL PERSPECTIVE

The problem of molds and their toxins in food purchased from grocery stores is quite real as has been documented throughout the FUNGALBIONICÓ Book Series. The medical profession ignores the problem, trusting the food scientists to shoulder the responsibility of keeping the public informed.

However, the amount of interest in what is on the grocery shelf is quite minimal judging from the lack of studies reporting the fungal contamination in foods at the point of purchase.

Aflatoxin In Corn Not
Destroyed By Baking

Stoloff and Trucksess (1981) studied the effect of boiling, frying, and baking on the stability of aflatoxins in naturally contaminated corn grits or cornmeal. Corn grits naturally contaminated with aflatoxins were used to make boiled grits. Portions of the boiled grits were then used for making pan-fried grits. Cornmeal naturally contaminated with aflatoxins was also used to make corn muffins.

From aflatoxin analyses of the products before and after preparation of the table-ready products it was determined that 72% of the aflatoxin found in the original grits could be recovered after the grits were boiled. The recovery of aflatoxin after the grits were fried was 66% or 47%, depending on whether 3 cups of water or 4 cups of water per cup of grits, respectively, were used for preparing the boiled grits before frying. Similarly, it was determined that 87% of the aflatoxin found in the original cornmeal could be recovered from baked muffins.

Deoxynivalenol In Wheat Flour 
Not Destroyed By Baking

Scott et al. (1984) processed two hard red spring wheats
(1 and 2) which had been naturally contaminated with deoxynivalenol (DON) using commercially common cleaning, tempering and scouring processes. These were then milled further, again using standard milling procedures. The purpose was to assess human intake of deoxynivalenol (DON, vomitoxin) from wheat sources in light of differing effects of food processing on DON retention.

The resulting flours were baked into bread and, in some cases, cookies and doughnuts. No appreciable losses of DON occurred during the cleaning, milling or baking processes. Some fractionation took place during milling. Up to two-fold increases in DON concentrations were observed in shorts and feed flour fractions. Lesser increases were found in the bran from wheat 2 (none for bran from wheat 1) and there was some correlation of ash concentration with DON levels in the flour streams from pilot milling of the two wheats.

Aflatoxin-Producing Aspergillus Grows
Well In German Breads And Cakes

Reiss (1981) investigated the growth of the aflatoxigenic molds Aspergillus flavus and Aspergillus parasiticus on various types of bread and found that the highest yields (4 micrograms/kg) of the toxin were found on whole wheat bread. The toxin levels decreased with increasing time of growth; which was probably due to a further metabolism of aflatoxin.

These fungi also grew better and produced more toxin on cake which was moist than on cake with lower water content.

Ochratoxin Found In Human Blood
Traced To Bread Consumption In Poland

Golinski et al. (1991) measured cereal samples, human blood and pig blood over an extended period of time for the presence of ochratoxin.

Of 1,353 cereal samples, 11.7% contained ochratoxin. Of 1,372 samples of feed, 1.5% contained ochratoxin; of 368 bread samples, 17.2%; of 215 flour samples, 22.3%; of 894 pig serum samples, 37.4%; and of 1,065 human serum samples, 7.2%.

Seasonal variations in the natural occurrence of ochratoxin were observed, with an increased percentage of positive samples in the spring. As a result of these variations in the measured blood levels of ochratoxin it is concluded that seasonal variations in moisture and overall weather are significant factors which can contribute to increases or decreases in the amount of mycotoxins in stored grains.

Consumed grains which were stored over the winter in damp conditions will typically result in higher blood levels of ochratoxin.

Aflatoxin Found In Human Blood/Urine
Traced To Cornbread Consumption In Poland

Nelson et al. (1980) determined aflatoxin levels in the serum and urine of 17 patients with Reye's syndrome and in control subjects. 23% of all persons studied had levels of aflatoxin which were indicative of recent exposure.

Aflatoxin levels were associated with ingestion of cornmeal and cornbread. The researchers concluded that this prevalence of aflatoxin may be of public health importance.

Bread Made With Mold-Damaged Wheat
Caused An Epidemic Of Gastroenteritis In India

Bhat et al. (1989) reported on a gastrointestinal epidemic among a considerable segment of the population of Kashmir Valley, India.

Epidemiological investigations and laboratory-based studies indicated that the outbreak was associated with the consumption of bread made from mold-damaged wheat.

Evidence of mold damage of wheat consisted of the presence of molds (such as Fusarium sp., Aspergillus sp.), and varying quantities of trichothecene mycotoxins (such as deoxynivalenol, nivalenol, acetyldeoxynivalenol, T-2 Toxin) in samples tested. The symptoms were reproduced in dogs fed extracts of contaminated samples.

It was concluded that, since trichothecene mycotoxins, especially deoxynivalenol trichothecene, cause symptoms in man, there is increased need for a reappraisal of their safety limits in food.

Aflatoxin-Contaminated Bread Kills Dogs

Ketterer et al. (1975) reported on the death of a group of dogs fed aflatoxin-contaminated (from moldy bread) food. The autopsy of one dog revealed a jaundiced carcass, a firm bile-stained liver and hemorrhage into the gastrointestinal tract, as well as microscopically-confirmed liver damage.

Aspergillus flavus was isolated from the moldy bread and also from a sample of vomitus. Aflatoxin was also detected in the moldy bread and extremely high levels of aflatoxin were present in the vomitus. Moldy Bun Caused Severe

Muscle Tremors In A Dog

Hocking et al. (1988) investigated a 1-year-old Siberian Husky dog with severe muscle tremors after the ingestion of a moldy hamburger bun.

Penicillium crustosum and the tremorgenic mycotoxin penitrem A were isolated from the remaining portion of the hamburger bun. When grown in pure culture, the Penicillium crustosum produced large amounts of penitrem A, along with other penitrem compounds.

 

Food Poisoning Caused By Aspergillus
flavatoxin Contamination Of Bread

Tabibi and Salehian (1974) reported on an outbreak of food poisoning caused by bread which had become molded by Aspergillus flavatoxin in the winter of 1967 in Teheran, Iran.
 

CLINICAL PERSPECTIVE

Food poisoning episodes caused by various microbial contaminations is a commonly encountered clinical problem, particularly amongst travelers. The routine medical tests for investigating patients presenting with gastroenteritis do not include a search for fungi or mycotoxins.

There is a clear need for health providers to stop ignoring the existence of fungi as a cause of many so-called non-specific illness in patients.

Patients with AIDS, for example, frequently present with non-specific complaints which turn out to have a fungal etiology. It is only because the patient has AIDS that fungal cultures are ordered!
 

Antifungal Additives Prevent
Mycotoxin Formation In Bread

In 1976, Reiss found that it was possible to partially prevent the formation of mycotoxins in whole wheat bread by adding the antifungal agents citric acid and lactic acid. See also Groll and Luck (1970).
 

Different Bread Packaging Produces
Variable Protection Against Fungal/Mycotoxins

Reiss (1975) reported on the influence of different packing foils on the growth of Aspergillus flavus and the formation of aflatoxins from various kinds of sliced bread.

Old fashioned unwrapped loaves of bread sitting quietly on the bakery shelf or in someone's kitchen may not be as healthy as they appear to be.

CLINICAL PERSPECTIVE

It is quite clear that yeast-fermented bread and its potential fungal/mycotoxin contamination constitute a major cause of atherosclerosis. Conversely, Asiatic and Mediterranean women, who are not heavy bread eaters, have considerably less atherosclerosis.

Convincing women of the fact that fermented bread causes atherosclerosis will be as difficult a task as convincing women not to smoke tobacco in order to prevent lung cancer and other tobacco-caused malignancies.
 
 

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