There's a joke I like to tell, that the difference in places I lived before in Indiana, is that seeing a goat or a chicken used to be a field trip and now it's my commute. Once you get over that, though, one of the perks of living closer to farmland, sometimes even just across the street, is that you have access to amazingly fresh food.

Two summers ago, we participated in a farm share, where each week we would get a box of organically-raised produce. It's not an understatement to say that this completely redefined the eating habits of my family. We went from a meat-heavy diet to a much more vegetable-oriented one. My wife became much more concerned with how our food was raised and processed, and before long she was near-obsessed with whether our food was organic.

Should she be?

That's the topic of this week's Healthcare Triage.

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Organic food is grown without synthetic pesticides, fertilizers, antibiotics, or hormones. Today it accounts for more than 31 billion dollars in sales a year in the United States. More than four percent of all food sold is organic, and whole industries and companies have grown up around its production and marketing.

Many people have are organic food fans because they think it's healthier than non-organic food. Some think it's more nutritious. Others think that it's safer, as pesticides or other chemicals used in conventional farming are dangerous. They're willing to pay more for organic food. Look, I'm almost hesitant to get into this, because this always, and I mean ALWAYS, results in a flood of hate mail. But here on Healthcare Triage, we rely on research, and research says there's no difference.

The best and most recent study was published in September of 2012 in the Annals of Internal Medicine. It was a systematic review that collected and analyzed all the studied published in the medical literature published between 1996 and 2009 that compared organic to conventionally-grown food. As you can imagine, there were a lot of studies done over that time. Let's go over them in detail.

There were 223 studies that compared organic and conventionally grown food for nutrient content and contaminants. 153 looked at fruits, vegetables, and grains, and 71 looked at meats, poultry, and eggs. Seventy percent were from Europe, and twenty-one percent were from the US or Canada.

There were no significant differences in the vitamin content of organic and conventional plant or animal products. With that many studies, of course, you can cherry pick one or two that might make a food type look better, but overall? No difference.

They conducted further studies that looked at eleven other nutrients including ascorbic acid, potassium, calcium, phosphorus, magnesium, iron, protein, fiber, quercetin, kaempferol, flavonols, and phenols. They found statistically significant differences in only two.

One was phosphorous, and was due to one really outlying study, and when they got rid of that study, the significant differences went away. The other was phenols, and was mostly due to two studies that did not report sample size, which is really odd.

Some studies reported that organic milk had more omega 3 fatty acids, but they were pretty much all looking at raw milk, which almost none of us drink. Besides, why are you drinking milk anyway? Is it because the milk industrial complex told you to? You obviously haven't read any of my rants on that, have you?

Stan, write it down. We're doing that in a future episode.

Anyway, back to the researchers. They looked at pesticide levels in the two types of food, too. Organic food did have a significantly lower chance of being free of any pesticides at all, which isn't surprising given that they use no pesticides and conventionally raised food does, but when they looked at the studies examining whether the level surpassed maximum allowed safety limits, it turned out that differences were no longer significant.

Bacterial contamination with e. coli was found in seven percent of organic food and six percent of conventionally raised food. No significant difference. And when they looked at all the food types, and all the bacteria you can likely imagine, they found no significant differences. There were also no significant differences in contamination with fungal toxins or heavy metals.

But, look, what we really care about is what happens to actual humans who eat this stuff. Are they healthier? The analysis included seventeen studies examining over 13,800 participants. Two of them looked at pregnant women and children, to see if the type of food they ate changed whether they developed asthma, eczema, wheezing, or other symptoms or markers of atopic disease. It didn't.

Eleven more looked at adults who weren't pregnant, and most examined biomarker levels and serum, urine, breast milk, and semen among those who ate organic or conventionally grown food. Overall? Wait for it-! No significant differences.

Only one study looked at clinical outcomes, though. It found that eating organic meat in the winter actually increased the risk of illness due to campylobacter infection.

This enormous body of research shows that there just doesn't seem to be any real health benefits or protections from eating organic food. I know lots of you are going to refuse to believe that, but that's what the evidence says.

But don't take my word for it, listen to a real expert: Norman Borlaug, for those of you who aren't West Wing fans, and, really, what's wrong with you if you're not? He won the Nobel Peace Prize in 1970. Why? Because he arguably saved more lives than any other person in human history for developing disease-resistant, high-yielding plant varieties that saved, like, a billion people from starvation. Towards the end of his career, he argued that there's just no way to feed the world's population without chemical fertilizers and technological advancements. With no proven benefit from organic methods, we're only hurting ourselves and the chance for others to eat cheaply and easily by advocating for them. He called organic food, and I quote, "Ridiculous."

Please note that I'm not making any arguments here about differences in organic and conventional farming with respect to how they effect the environment, how they treat workers, and how they treat animals. There may be differences there and if you want to make those arguments, fine. But when you talk about nutrition and safety, that's where you're on shaky ground.

My eating habits changed when we had the farm share because I was eating a wider variety of healthy foods and they tasted good. That's not because of how they were fertilized as much as it was that they were fresh and non-industrial. Once you've tasted a homegrown tomato, the ones you buy in the store are intolerable. They're grown to stay fresh longer and be pretty much indestructible. Tomatoes you grow for yourself are grown to taste awesome even if they're ugly. And better tasting food is more likely to be eaten. That's an argument for organic food that makes sense, but we need to be honest about what it costs.

It's much more expensive than conventionally grown food, and many people can't afford it. Additionally, as Norman Borlaug said, it's unlikely we could feed everyone using only organic techniques, certainly not without a whole lot more people being forced back into the agricultural sector.

And we should not be making any type of fruit or vegetable the enemy, please. Talking anyone who's willing to eat healthy food out of doing so isn't helping the collective waistline, people! I'm for anything that helps us get people worldwide to eat more healthy food and less crappy food. I'm not sure that organic food is the most cost-effective way to do so, but one thing I do know is that it's often being sold as more nutritious and less likely to harm you than conventionally raised food. That's counterproductive, and it's just not true.