Dr. Melissa Perry and the Search for Answers that Led Her to The Heartland Study

Eaters Deserve More Complete Information About Nutrition and Health Impacts on Food Labels
Multiple lines of evidence point to consumer food choices as major contributors to diet-related disease, and poor health and fitness. In a peer-reviewed journal article published today, authors Chuck Benbrook and Robin Mesnage cite studies indicating that “Some 90% of the estimated USD 4.3 trillion in annual health care costs in the US is triggered or made worse by poor food quality and diet-related disease.” Benbrook is the founder and former executive director of the Heartland Health Research Alliance (HHRA). The authors recommend novel metrics on both the nutrient density of food, and how to more accurately and usefully characterize the degree of food processing and its impacts on public health. The article is open access in the journal Foods and entitled “Enhanced Labeling to Promote Consumption of Nutrient Dense Foods and Healthier Diets.” The core nutrient density metric is a ratio: the percent of daily nutrient needs satisfied by a serving of food relative to the percent of a 2000 calorie daily diet taken up by the serving of food. This single metric is unmatched in comprehensively reflecting the nutritional quality of food. A graphic option to convey the metric on packaging is presented in Figure 3 in the new paper: A novel graphic is presented in Figure 5 to which integrates both the nutrient density and food processing metrics and graphics in a single graphic, shown below. The impacts of ultra-processed food (UPF) on public health outcomes is among the hottest topics in nutrition, medical, and public health journals, and media coverage on food quality and health outcomes. At the request of the journal, the authors developed a video abstract that explains the paper’s goals, methods, and key findings and recommendations. The authors conclude their paper with these observations: Transparent and accurate food product-specific ingredient and nutrient composition data should determine the content of nutrition health labeling. Efforts to soften the message should be resisted in light of the overwhelming need for new food labels that help bring about substantial improvements in food nutritional quality and dietary choices. Benbrook and Mesnage’s paper builds on public comments HHRA submitted in response to the US Food and Drug Administration (FDA) proposed rule in 2023 to update the definition of the term “healthy” on food labels. The proposed role would require foods labeled “healthy” to contain minimum amounts of foods recommended by USDA’s Dietary Guidelines, and to limit saturated fat, sodium, added sugar and other less healthy nutrients. Entitled “Food Labeling: Nutrient Content Claims; Definition of Term `Healthy’”, the comments recommended new nutrition/health messaging on the front of food packaging. Co-authors of comments included the chair of HHRA’s Policy Advisory committee Dr. Kathleen Merrigan, HHRA science advisors, and other experts working on how changes in farming systems and technology can increase the nutritional quality of food: Dr. Hannah Flower, Dr. Donald R. Davis, Dr. David Montgomery and Anne Biklé. In the comments, the authors introduced “NuCal” as a name for their new system. Resources HHRA February 2023 comments to the FDA. Benbrook and Mesnage (2024). Enhanced Labeling to Promote Consumption of Nutrient Dense Foods and Healthier Diets, Foods. https://doi.org/10.3390/foods13213377 Video Abstract: “Enhanced Labeling to Promote Consumption of Nutrient Dense Foods and Healthier Diets”
HHRA Weighs in on Key Pesticide Issues Under Review by the National Organic Standards Board
HHRA and ORG-Tracker, represented by Dr. Chuck Benbrook and Dr. Brian Baker, submitted comments to the Agricultural Marketing Service at the USDA in advance of the National Organic Standards Board (NOSB) meeting in Portland, Oregon, from October 22nd to 24th, 2024. Drs. Benbrook and Baker will both attend the conference and deliver public comments. ORG-Tracker is a project carried out by HHRA. It aggregates pesticide residue data from inspections of organic farms carried out by certifiers. The tables generated by ORG-Tracker utilize the results of certifier testing to compare residue frequency and risk levels to food produced on conventional farms. The team is working to more effectively highlight gaps and challenges faced by certification agencies to answer questions like What crops should we be testing, and where? Is a pesticide residue found in an organic sample likely caused by accident, pesticide drift, or an intentional and illegal application? How can we modify organic programs to better mitigate risk? The comments delivered to the USDA discuss risk-based certification, pesticide residue testing, and policies impacting the incorporation of so-called inert ingredients in the biopesticides approved for use on organic farms. They argue for a more rigorous, comprehensive, and health-focused approach to risk oversight. Regarding residue testing, they advocate for more expansive and effective data aggregation to inform consumers and the organics community. Finally, for inert ingredients, they recommend further review of current policy, including increased transparency of ingredients in pesticide products. Thank you to Drs. Benbrook and Baker for your advocacy and hard work! The three sets of comments are posted on HHRA’s website as part of our policy program: Comments to the NOSB on the Risk-Based Certification Discussion Document Under Consideration During the October 2024 Meeting in Portland, Oregon Written Comments on the NOSB Discussion Document “Residue Testing for the Global Supply Chain” Comments on the Inert Ingredients in Organic Pesticide Products Proposal dated August 13, 2024 Drs. Benbrook and Baker also submitted and presented comments at the Spring 2024 meeting of the NOSB, which are available on HHRA’s Policy and Regulatory Reform page.
Dr. Kimberly Yolton joins HHRA board
Dr. Yolton is a developmental psychologist and epidemiologist serving as Professor of Pediatrics at Cincinnati Children’s Hospital Medical Center. Her interests include exposures and experiences that may alter a child’s developmental trajectory from infancy through adolescence. She collaborates on research projects on typical child development as well as those focused on the impact of exposures to environmental toxicants, opiates and stress during early development.
Paul Hartnett, HHRA’s Executive Director
Paul Hartnett has served as HHRA’s CFO since our founding . With the departure of Russell King, Paul has now joined the board and Executive Director. We thank Russell for his service and wish him the best in his future endeavors.
Heartland Study Enrolls 1,000th Mother-Infant Pair
July 19, 2024 – In June of this year, the Heartland Study achieved a major milestone, enrolling its 1,000th mother-infant pair. Enrollment is now at 50% of goal. The objective of the Study is to help fill major gaps in our understanding of the impacts of herbicides on maternal and infant health. Currently in Phase 1, the Study is focused on evaluating associations between herbicide concentrations in body fluids and tissue samples from pregnant women and infants, and pregnancy/childbirth outcomes. Phase 2 is designed to evaluate potential associations between herbicide biomarkers and early childhood neurological development. Much appreciation for the mothers enrolled, and the entire Heartland Study Team including scientists, support staff and clinicians for this tremendous achievement, and for our funders to making this work possible. Read more about the study including peer-reviewed studies published in Chemosphere and Agrichemicals at our publications page. The investment required to conduct this study exceeds $1 million each year. You can support this important work by making a donation here.

“The Heartland Study team is all about relationships, the mutual respect we have for each other and how much we care about the families of the Heartland and their long-term health.”

–Dr. Melissa Perry, Co-Principal Investigator of The Heartland Study

Growing up in a rural Vermont community beset by hardship, Dr. Melissa Perry initially envisioned a career as a psychologist — someone who could help heal people emotionally scarred by poverty, substance abuse and other common struggles.

But Perry, who is one of two Co-Principal Investigators heading HHRA’s flagship project The Heartland Study, was ultimately guided by a wise professor to follow a path into public health instead. She worked her way to her current position as Chair of the Department of Environmental and Occupational Health at George Washington University (GWU), where she directs laboratory research exploring how chemicals in the environment affect human reproduction. She also teaches graduate students about the myriad ways that climate change is central to the future of public health.

Perry’s interest in chemical impacts on human health originated with her rural roots and the use of pesticides on the family farms that made up her childhood home town. Her focus on pesticides grew over time as Perry followed the publication of high-impact papers by teams affiliated with the National Cancer Institute (NCI). Today, she is one of the world’s leading experts on the impact of environmental chemicals like pesticides on sperm counts, an important factor in decreasing fertility rates.

The series of NCI papers in the 1990s and 2000s that inspired Perry reported research that benefited from novel methods of studying pesticide-cancer links among farmers and their families. For several pesticides, the papers showed that farmers who are more heavily exposed have higher rates of some rare cancers, compared to farmers rarely or only occasionally exposed to the same pesticides.

Perry was fascinated by the new tools the NCI was developing to track pesticide impacts on cancer in rural and farming communities, an interest that would shape her own scientific journey and career.

Her concern for the hazards of herbicide exposure mounted when Perry met Dr. Charles Benbrook at a Congressional staff briefing before the U.S. House of Representatives in Washington, D.C. in 2011. Benbrook, who now serves as HHRA’s Executive Director, was there to share information on the latest USDA data on herbicide use. His presentation focused on the rapidly rising use of several herbicides in the Midwest, driven by the spread of weeds newly resistant to glyphosate, the chemical in Roundup herbicides.

Perry was most concerned when she saw data pointing to likely, major increases in the use of 2,4-D and dicamba. Why? Because she had read papers published in the 1990s and 2000s reporting that these two old herbicides increase the risk of reproductive problems, birth defects, and some cancers. (Access papers on 2,4-D and dicamba in our bibliography.)

Benbrook’s presentation — and another by Dr. Dave Mortenson, a leading weed ecologist tracking the rapid spread of herbicide-resistant weeds — convinced Perry that herbicide-public health impacts needed more focused scrutiny. After a series of calls and emails with Benbrook and another colleague, Dr. Phil Landrigan, Perry agreed to serve as the Co-Principal Investigator of The Heartland Study, alongside Co-PI Dr. Paul Winchester, a neonatologist working in the NICU at Franciscan Health hospital in Indianapolis. Dr. Landrigan also joined The Heartland Study family as the chair of our Science Advisory Board.

Why Public Health Science is So Challenging

It is extremely challenging for scientists to prove definitively that one particular chemical can cause one particular health problem , or disease in one particular person. Scientists must determine if connections identified between chemical use and a birth defect, or a disease such as cancer is a correlation or a causation: Does a particular chemical actually cause a specific birth defect or cancer?

Two indisputable facts driven home by COVID add multiple dimensions of complexity to the basic question: Does chemical X cause health problem Y?

First, most diseases and reproductive problems are caused or made worse, at least in part, by other things impacting a person’s health. These “other things” that play a role in disease are often referred to as “comorbidities.” This term is one Americans have sadly heard many times as doctors explain why some people die from COVID and others hardly notice their infection.

Second, the ability of a person to fight off an infection, or quickly metabolize (break down) and excrete a pesticide they were exposed to, depends on the person’s age, health status, genetics, the air they breathe, the food they eat, and other chemicals or drugs they have recently been exposed to.

Dr. Perry understands that the challenge is not just to prevent disease among healthy adults. That in fact is the relatively easy part. Protecting pregnant women, infants and children, the elderly, the immunocompromised, people with chronic illness, and those with heightened susceptibilities to disease because of their genetics is the far more complex, yet crucial, challenge facing public health scientists.

As a Co-PI for The Heartland Study team, Perry is setting out to help answer some of those hard questions on behalf of the 100 million people living and working in the Heartland and the region’s farmers who need to keep weeds in check on their fields year in and year out.