E. Coli Bacteria:
E. Coli is back in the news and once again causing hysteria beyond its actual threat. Yes, this latest outbreak has sickened three thousand people in 12 countries since it first appeared on May 1st and killed, at last count, 31 people, all but one in Germany so far. But to put that in perspective: about 16 times that many people have died in German traffic accidents during the same time period, and yet you're not getting daily body counts in the news for those deaths. I'm not saying that 31 deaths don't matter. Of course they do! I'm just saying that we need to keep things in perspective and then examine the situation rationally.
So let's take a look at E. Coli, what it is, what it does, and why this new strain is particularly alarming. At the same time, we'll also explore some of the more alarmist statements now populating the blogosphere, and finish by offering some recommendations.
E.Coliis the abbreviation for Escherichia Coli, a bacterium commonly found in the lower intestines of warm-blooded animals -- humans included. In a newborn infant, E. Coli actually represents one of the most abundant bacteria in their intestinal tracts. (They pick it up during childbirth, when they pass through the birth canal, or by coming into contact with the bacteria in the hospital or at home.) As probiotics (beneficial bacteria such as acidophilus) become established in the intestinal tract, primarily through breastfeeding, that percentage drops dramatically. In a typical adult on a Western diet, E. Coli comprise approximately 0.1% of the total bacteria count within that adult's intestines. On a high meat diet, however, that number can climb many multitudes higher. At normal levels, the E. Coli typically found in the colon is not only harmless, but may actually be beneficial in that it produces vitamin K2 and B-complex vitamins for its host and helps prevent the establishment of pathogenic bacteria within the intestine. At higher levels, those benefits are offset by E. Coli's displacement of other more beneficial bacteria such as Lactobacillus bifidus. In general, most strains of E. Coli are harmless, but others can cause illness ranging from diarrhea to pneumonia. E. Coli infections from dangerous strains can be mild to life-threatening.
It should be noted that E. Coli bacteria are not always confined to the colon, and can, for example, migrate into the urinary tract, where they can lead to urinary tract infections. They also have the ability to survive for periods of time outside the body, which means they can easily be passed along in contaminated food supplies or on surfaces that we come in contact with every day. Essentially, E.Coliare everywhere -- in our food supplies, on computer keyboards, pocketbooks, money, shopping cart handles, and of course, our hands. In fact, anytime that we eat something, drink something, or touch something that has been associated with animals, including pets, or people who have not recently washed their hands, we are subject to contamination.
In addition, the genetics of E. Coli, as with all bacteria, are easily altered, which is both good and bad. On the positive side, E. Coli have been deliberately altered to produce beneficial products such as vitamin B12. Most B12 found in vitamin supplements is now grown in giant vats of genetically modified E. Coli cultures. E. Coli has also been modified to produce human growth hormone, human tissue plasminogen activator, and human insulin. On the negative side, E. Coli, as can most bacteria, swap DNA with other bacteria to mutate itself and acquire resistance to different antibiotics. (We'll talk more about this in a bit.)
As we just discussed, E. Coli is easily passed from person to person, particularly if people don't wash their hands after going to the restroom -- even if all they're doing is "number one." The problem is that if they touch any surface in the restroom with their hands, they are likely to pick up E. Coli left there by a previous visitor. Restaurants are a particular concern, as are day care centers, nursing homes, and hospitals. The bottom line is that E. Coli is very contagious -- particularly the harmful strains.
- Meat, but especially any kind of ground meat (beef, lamb, or turkey) -- notably any pink or undercooked parts.
- Contaminated Water.
- Dairy, even pasteurized. Yes, I know government "health experts" say this is only a problem with raw milk products. Not even close. Yes, pasteurization kills all E. Coli, but contamination from post-pasteurization piping and equipment surfaces in contact with finished milk products is a problem.1 Interestingly, because "raw" dairy farmers know they can't rely on pasteurization to eliminate any contamination, they tend to be fanatical about keeping their cows and dairy raising environments clean so that no E. Coli get into the milk in the first place, in addition to keeping all surfaces in their dairy operation clean so nothing is contaminated after the fact. On the other hand, many commercial dairies function as though pasteurization gives them a free pass and so tend to be much more lax in their cleanliness protocols, not only in cow cleanliness and their milking operations -- contamination as the milk exits a dirty cow teat is a real problem -- but also in their packaging operations. In fact, upwards of 10% of commercial dairy transported in bulk containers is contaminated by E. Coli 0157:H7. Keeping cows clean is obviously not a major priority for these dairies.2 They count on pasteurization to eliminate any bacteria after the fact, so why spend "unnecessary" money up front?
- Vegetables, grown close to the ground (think spinach, lettuce, carrots, etc.) -- either contaminated by toxic fertilizer or by water that has come in contact with animal waste.
- Sprouts, can be a problem too since bacteria can stick tightly to the surface of seeds and can then lay dormant for months. Once water is added to make them grow, the number of bacteria carried within the seeds can reproduce up to 100,000 times. It appears this was at least the initial driving cause in the German outbreak.
- Produce, handled by contaminated hands after harvesting. This is a special problem in grocery stores as customers who may have E. Coli on their hands (after changing a diaper, for example) grab, paw, squeeze, and thump fruits and vegetables -- and then place that food back in the bins -- thus spreading contamination to the entire bin…in addition to passing that contamination along to the next customer who picks up the produce. (This is something German health officials might want to look at as an additional problem in the current outbreak -- as different people handled the contaminated sprouts and then touched other produce.)
As we discussed, E. Coli strains typically found in the colon are either harmless, or even beneficial, at normal levels. But there are some strains that are highly toxic to the human body and cause sickness, and, in the vulnerable, even death. Of these, the most notable (at least until the outbreak in Germany), has been 0157:H7, one of the enterohemorrhagic strains of E. Coli. Enterohemorrhagic simply means it causes intestinal bleeding. Until the recent outbreak in Germany, 0157 was the strain you heard about in almost all cases of E. Coli poisoning. So where did 0157 come from?
It turns out animals aren't the only life forms subject to viral infection. Bacteria too can be infected by viruses, which can then insert their DNA into the bacteria, and that's what happened with 0157. At some point in the past, at least one E. Coli cell was infected by a virus that was able to insert its own DNA into the bacterium's chromosome. Then, when the bacterium divided, it replicated this "new" chromosome in the daughter cell. Then again, and again, and again until this new strain of E. Coli was firmly established. So what did this new little piece of DNA in the chromosome do?
As it turns out, this new piece of DNA contains instructions for the production of a special protein called Shiga-like toxin (SLT). SLT causes severe damage to the cells that line the intestinal wall and can lead to diarrhea, dehydration, and even hemorrhaging. It is particularly lethal to children and the elderly who can't tolerate too much blood and fluid loss.
But 0157 is yesterday's news. In the current European outbreak, we're talking about a new strain never before seen, E. Coli 0104:H4.
Much has been made in some blogs of the fact that the strain of E. Coli involved in the German outbreak (0104) is extremely rare. While E. Coli 0104:H4 has been seen in humans before, it has never previously been responsible for a widespread outbreak. That said, it is both similar to and different from 0157. It is similar in the sense that like 0157, 0104 is Shiga toxin producing and thus causes intestinal bleeding, along with other symptoms similar to infection with 0157. The specific symptoms vary from person to person but often include severe stomach cramps, low fever, diarrhea (often bloody), and vomiting. Most people recover within five to seven days. Unfortunately with 0104, the symptoms tend to be stronger, with a higher percentage of cases leading to hemolytic-uremic syndrome, or HUS. Specifically, HUS leads to the destruction of red blood cells and severe kidney problems, sometimes leading to kidney failure and death. HUS, if it occurs, usually arises about a week after diarrhea starts. 0104 is also different in that previous E. Coli outbreaks have mainly hit children and the elderly, but the European outbreak is disproportionately affecting adults, especially women, although that could simply be because women eat more salads than men in Germany. And it is different in the sense that it is noticeably more resistant to antibiotics than 0157. In fact, it seems to be resistant to 14 different antibiotics, whereas 0157 is normally resistant to only one.
As a side note, antibiotic resistance is irrelevant when it comes to treatment since even if antibiotics worked perfectly against this strain, doctors would never prescribe them because, in destroying the microbes, the drug would hasten the release of the Shiga toxin as the bacterial cells burst -- sort of a Catch 22 -- thereby increasing the chances of life-threatening complications. Better, when possible, to maintain hydration and let your body's immune system kill the infection, thus releasing the toxins more slowly.
There is some talk on the blogosphere that 0104 had to be bio-engineered in a government lab and released either deliberately or by accident. The argument is that the sudden appearance of a strain of E. Coli that is resistant to 14 different antibiotics cannot possibly happen naturally. It can only happen as the result of engineered, sustained, and repeated exposure of E. Coli to all these antibiotics in a laboratory.
As it turns out, that's not true. Nature is highly capable of producing such a strain. Since bacteria cells are everywhere, it is possible for them to acquire genetic information from other sources such as viruses, plasmids (self replicating bits of DNA), or just naked pieces of DNA floating about. In fact, it is not uncommon for bacteria to continually mutate and evolve, continually swapping genes with each other. And frighteningly, this often happens between entirely different species of bacteria. In effect, not only are bacteria programmed to "evolve" defenses against antibiotics (thus the danger in over-prescribing antibiotics), but once they produce such a defense, they are also programmed to rapidly share that defense with other species of bacteria -- thus rapidly spreading that resistance from strain to strain and species to species. Or to put it another way, 0104 didn't necessarily have to be exposed to all the different antibiotics it is now resistant to. It could have picked that resistance up by being exposed to resistant staph or enterococcus bacteria. To me, if you actually think about what that means, it's a whole lot more frightening than imagining scientists in a lab trying to concoct mutant bacteria. Why? Because it's actually happening now; because resistance can be swapped across species in a matter of months; and because it can go worldwide in a matter of days! That's terrifying.
Fortunately, the current outbreak does not represent a worldwide pandemic. It's already starting to wind down -- with its spread slowing. The incubation period for strains such as 0104 is about three to eight days, and most people recover within 10 days. In the end, the outbreak is likely to just fade away as the source of contamination, bean sprouts, appears to be transitory. And any contaminated food is likely to have either been consumed or unsold and tossed out within one to two weeks of first appearing in the market.
In the meantime, it certainly has had consequences far beyond the actual threat. Hundreds of millions of dollars/euros have already been lost in false accusations as the farming industry of entire countries (read Spain) have been falsely accused of being the source, resulting in bans on all agricultural exports from that country. Expect lawsuits and demands for compensation.
That said, this E. Coli outbreak now ranks as the third-largest in recent world history, and the deadliest.
It's also probably worth mentioning that this is not the only E. Coli outbreak happening right now. East Tennessee hospitals have reported at least eight cases of E. Coli infection (most likely the old 0157 standard strain) with a 2-year-old girl in southwest Virginia having died from the same infection.3
As usual, they are recommending that you wash your food thoroughly, practice proper techniques when cooking, especially when using cutting boards, and cook your meats until all pink is gone. All good advice, but it may not keep you as safe as you are led to believe. First, if the contamination came from the water used in irrigating lettuce or spinach crops for example, the E. Coli would actually be "inside" the produce, and not just on its surface. Thus, no amount of washing will get rid of it. Also, food and eating are not the only sources of contamination. Some of the people infected in the Tennessee outbreak I just mentioned were infected while swimming in untreated water. And whatever you do, don't shake hands with anyone, or carry a purse, or use a computer keyboard -- all likely sources of contamination.
Whenever there's an E. Coli outbreak, you can count on a number of "concerned" health authorities, not to mention grocers and food processors, using the opportunity to tout the virtues of food irradiation. According to an AP story currently appearing on various news sites, "Zapping salad fixings with just a bit of radiation can kill dangerous E. Coli and other bacteria -- and food safety experts say Europe's massive outbreak shows wary consumers should give the long-approved step a chance."4 And then there's the story in the Canadian Press that reads, "The Canadian government should reopen the discussion about irradiating food in light of the world's deadliest E. Coli outbreak that has claimed 24 lives in Europe, a consumer group said Tuesday."5 You've got to admire such support for irradiation, especially when the source of the contamination is unknown.
But irradiation is not a panacea. First of all, it doesn't protect against any post irradiation contamination. (Think of that customer with the unwashed hands who was just squeezing the tomatoes ahead of you.) But more importantly, the safety of irradiated food is highly questionable. And no, I'm not talking about radioactivity. Irradiated food is not radioactive -- an absurd claim that "authorities" derisively love to put in the mouths of the health conscious. As quoted in the Canadian Press article cited above:
" Irradiation still has that connotation of Cold War," said University of Guelph food microbiologist Dr. Keith Warriner. Especially after Japan, obviously with the reactor that gives you negative things. The worry is in certain consumers' minds there is a risk there."
Tim Sly of Ryerson University's School of Occupational and Public Health agrees there's a fear factor at play but said it's not based on science. "The whole sense that you may glow in the dark of course is completely rubbish," said Sly.
And they're right! The concern that you will glow in the dark is total nonsense, but it's also totally disingenuous. Here's the problem with irradiation.
When food is irradiated (using electrons, gamma rays, or x-rays), most of the radiation passes through the food without being absorbed. The small amount that is absorbed destroys any insects or bacteria on grains, produce, or spices, extends shelf life, and prevents fruits and vegetables from ripening too fast. Thus, food irradiation is now being used to replace chemical fumigants, sprout inhibitors, and post harvest fungicides. Higher doses can kill Salmonella and other harmful bacteria that can contaminate meats and poultry and cause food borne diseases.
Again, the energy used in food irradiation does not cause food to become radioactive. True enough, but it does break chemical bonds in the food. In fact, the singular purpose of irradiation is to break chemical bonds in the living cells of insects, bacteria, molds, etc. for the specific purpose of killing them. The problem is that this process, if it is strong enough to destroy those pests, also fundamentally changes chemical bonds in the cells of the food itself and does indeed produce radiotoxins and aflatoxins -- no matter the dosage or the source.
Again, they have nothing to do with radioactivity. The word radiotoxins was first coined by Russian researchers experimenting with food irradiation to describe the molecules created in the food exposed to irradiation. Since that word was considered frightening to American consumers, the FDA came up with a couple of "softer" terms. They now call the known molecules, such as formaldehyde and benzene (both carcinogens), that are created by irradiation "known radiolytic products."
As for those chemical molecules created by irradiation that have never before been seen on the planet, the FDA came up with the equally delightful "unique radiolytic products."
In addition to destroying all bacteria and parasites and producing radiolytic byproducts, irradiation has the added "benefit" of destroying nutrients -- as much as 70 percent of vitamins A, B1, and B2 in irradiated milk and about 30 percent of the vitamin C. Irradiation also has the ability to accelerate the growth of aspergillus mold, which produces the most potent natural carcinogens known to man, called aflatoxins. But for many of you, this must all seem so theoretical. If irradiation is truly dangerous, wouldn't there have to be hard evidence available somewhere that proves it? And there is:
- In the FDA's final report approving food irradiation, they stated that when up to 35 percent of the laboratory animal's diet was irradiated, feeding studies had to be terminated because of "premature mortality or morbidity."6
- At the University of Illinois, the Department of Medicine fed irradiated food to mice and 17 percent of the animals had to be killed or died, due to respiratory problems so severe they couldn't even move around their cages.7
- Researchers at the Medical College of Virginia fed rats with irradiated beef. All the male rats died of hemorrhagic syndrome within thirty-four days.8
In approving food irradiation, the FDA started with 441 studies, including the three I just mentioned. They accepted 226 for further review, but then narrowed their criteria and selected only sixty-nine for in-depth review. Of these, the FDA itself reported that thirty-two showed adverse effects and thirty-seven studies showed safety problems. Then, without explanation, they eliminated all but five studies (including every negative study) and said they would base their decision on those five studies alone. Maybe it's just me, but this kind of "science-based" assessment doesn't really give me a warm, comfy feeling when it comes to irradiated foods.
Foods already approved for irradiation in the U.S. include fruits, vegetables, wheat, flour, herbs, spices, nuts, seeds, peas, pork, chicken, and beef -- and most of it is unlabeled. The FDA requires a label stating that a food has been irradiated only if it was irradiated as a "whole food" and then sold unchanged. But if you process it in any way, if you add any other ingredients to it, it no longer requires a label stating that it, or any of its ingredients, was irradiated. To put it simply, an irradiated orange would require a label, but irradiated orange juice would not.
The simplest way to avoid irradiated food is to buy organic. By law, at least so far, organic food cannot be irradiated. But keep in mind that the definition of organic food is constantly under assault and has been stretched in ways beyond imagining.
Any death is tragic and seemingly unnecessary deaths even more so. But that said, it's important not to overreact. As long as we eat "living" foods, there is some risk of food poisoning. Even irradiating food does not eliminate all risk. As we've already discussed, it doesn't eliminate the risk of post-irradiation contamination. And based on our experience with dairy pasteurization, it seems to encourage sloppy behavior on the production end, since the assumption is that any bacteria will be "cleaned up" later. If you don't think that eating "live" foods matters, then that's a different story. Nevertheless, you should probably keep in mind that if you irradiate sprouting seeds to kill bacteria, you have a different problem; irradiated seeds can't sprout. They're effectively dead. More immediately, though, the economic impact of this recent outbreak has been huge. Over the last week, misguided authorities have warned consumers to avoid eating cucumbers, tomatoes, and lettuce, in addition to sprouts. As a result, the German Association for Fruit and Vegetable producers said Wednesday that its members were losing the equivalent of $7 million a day because of the crisis. And Spanish farmers have lost upwards of 600 million Euros.
No wonder producers and grocers are so keen on irradiation. It's not about health; it's about money. It should be noted, though, that in Europe (unlike in the U.S.), food irradiation is not widely used -- although it is being written into the Codex guidelines, which will ultimately govern Europe. And outbreaks such as the current one in Germany will likely be used to buttress the arguments of its supporters such as the British Medical Association. Truly, it will be interesting to watch over the next few months to see how much of an attempt is made to manipulate the current outbreak to sway public opinion in favor of irradiation.
So, what's the solution? Some governments seem to prefer the "nuke the food" option. Regulations increasingly are allowing for irradiation of what ends up on the shelves. And if you fear dying from food-borne illness above all else, then by all means opt for the nuked meats, pasteurized milk, and irradiated vegetables. There's even a minute chance it will allow you to postpone your death...at least until the radiotoxins and aflatoxins kick in. If that option doesn't appeal to you, try buying organic produce from local purveyors that you know, and wash it thoroughly. In addition, keep your immune system functioning at maximum and some pathogen destroyers in the medicine chest.
Scientists have known for years that it is possible to improve the functioning of the immune system. Here in the United States, the approach has been to use expensive, proprietary drugs. Current favorites include concentrated cytokines such as Interleukin and Interferon. The rest of the world, on the other hand, has adopted a more natural approach by seeking to use natural substances to:
- Stimulate and strengthen your immune system
- Fight infection
- Strengthen tissue against assault by invading microorganisms
- Stimulate macrophage capability
- Increase T-Cell production and protect T-helper cells
- Complement the action of Interferon and Interleukin 1
- Assist the Cell Mediated Immune Response
Surprisingly, not only are the natural immune boosters far safer than the drug approach (having far fewer side effects); they are also far more powerful than their pharmaceutical counterparts.
Let's take a look at some of the more powerful immune boosters available to us. First, we'll look at the herbal boosters, then a couple of other options that are available.
- Echinacea contains echinacoside (a natural antibiotic, comparable to penicillin in effect) that can kill a broad range of viruses, bacteria, fungi, and protozoa, which makes it invaluable in wound healing and in the treatment of infectious diseases. Research has also reported echinacea's efficacy in treating colds, flu, bronchitis, tuberculosis, infections, etc.
- Pau d'arco nourishes the body's defense system and helps protect against pathogenic organisms. It has been used for centuries to improve immune function, detoxify, and reduce pain throughout the body. Research has shown that it contains a natural antibacterial agent, has a healing effect on the entire body, cleanses the blood, and kills viruses.
- Suma can help combat fatigue (including treatment of chronic fatigue and low-energy conditions), prevent colds and flus, speed healing, regulate blood sugar, and stimulate the sex drive.
- Astragalus root is an immunostimulant used in the treatment of chronic viral infections, hepatitis, edema, common cold, and flu. In vitro, Astragalus increases the interferon response to viral infection and works synergistically with administered interferon. And astragalus increases phagocytic activity and antibody levels and improves the functioning of natural killer cells.
- Medicinal Mushrooms: Many of the compounds found in Reishi, Maitake, and Cordyceps mushrooms are classified as Host Defense Potentiators (HDP). It is believed that combinations of these compounds target and strengthen the human immune system as well as aid in neuron transmission, metabolism, hormonal balance and the transport of nutrients and oxygen. Through a host-mediated (T-cell) immune mechanism, they help the body regulate the development of lymphoid stem cells and other important defense responses.
- Beta 1-2/1-6 Glucan, a natural complex carbohydrate found primarily in the cell walls of yeast, works by "activating" macrophage cells.
- Aloe Vera: The polysaccharide component of aloe vera, acemannan, possesses significant immune enhancing and antiviral activity. Products with high levels of acemannan activity have been proven to increase lymphocyte response to alloantigen by enhancing the monocyte release of interleukin-I. In addition, acemannan has been shown to increase macrophage levels and have a positive effect on CD-4, CD-8, T-4, and T-8 levels.
- Alkylglycerols are naturally manufactured in the body and are found in mother's milk, the liver, the spleen, and bone marrow. They play a major role in the production and stimulation of white blood cells. They also help to normalize bone marrow function. The immune supportive effect of AKG's helps our bodies protect against bacterial, fungal, and viral infections. The most potent source of AKG's in the world is shark liver oil.
- Lactoferrin is one of the cytokines produced in the human body. It can significantly boost the immune system and/or help the body recover from any existing infection.
- Bovine colostrum: The immune factors in colostrum have been shown to help the body resist pathogens such as viruses, bacteria, yeast and fungus. In addition, colostrum contains a number of antibodies to specific pathogens including E. Coli, salmonella, rotavirus, candida, streptococcus, staphylococcus, H pylori, and cryptosporidia. Also, medical research has shown that proline-rich-polypeptide, a component of colostrum, works as an immunomodulator, boosting a low immune system and balancing out an overactive immune system.
- Glutathione: In addition to being a powerful antioxidant, glutathione works to support the active functioning of the immune system and is a key component of all lymphocytes.
- Mangosteen contains a unique group of antioxidants called xanthones. Xanthones, particularly beta and gamma mangostin, are naturally antibiotic, antiviral, and anti-inflammatory, and are some of the most powerful antioxidants found in nature (over 14 times the Oxygen Radical Absorbance Capacity of red raspberries). In addition, recent studies have confirmed that gamma Mangostin is a potent COX inhibitor, an important factor in reducing inflammation, pain and fever.
Macrophage attacking E. Coli
Pathogen destroyers represent an alternative, complementary route to optimizing your immune system. They don't build immune function as the immune boosters do. Instead, they "free up" immune function by directly destroying pathogens in the body that would otherwise "occupy the attention" of your immune system.
However, when it comes to Shiga toxin producing E. Coli strains, you need to exercise caution. You can use antipathogens if you catch the infection early, but once an infection is full bore, you don't want to use them for the same reason you don't want to use antibiotics -- they kill the E. Coli bacteria too quickly, thus releasing the Shiga toxin too quickly into the bloodstream. Your immune system works more slowly and in some cases can carry the E.Coli cells out of the body before they release their Shiga toxin.
- Olive Leaf Extract has a long history of being used against illnesses in which microorganisms play a major role. In more recent years, a drug company discovered that in vitro (test tube) testing, an extract from olive leaf (calcium elenolate) was effective in eliminating a very broad range of organisms, including bacteria, viruses, parasites, and yeast/mold/fungus.
- Oil Of Wild Mountain Oregano is antiviral, antibacterial, anti fungal, and anti parasitic. The key components, the isomeric phenols, in dilutions as low as 1 to 50,000, destroy a wide range of pathogens, including: Candida albicans, Aspergillus mold, Staphylococcus, Campylobacter, Klebsiella, E. Coli, Giardia, Pseudomonas, and Proteus. Another phenol constituent, thymol, actually helps boosts the immune system.
- Garlic is one of the best infection fighters available for both bacterial and viral infections. One of its many ingredients, allicin, breaks down into more than 100 biologically active sulfur-containing compounds that do not appear to create resistant bacteria strains. In addition, fresh garlic extract has been shown to be deadly to many viruses. As a side note, while allicin may still serve as a general marker of garlic's potency, research increasingly points to S-allylcysteine and other compounds as the most therapeutically active ingredients in garlic. And garlic has one significant advantage over most other antibiotics, natural or pharmaceutical -- it is kinder to the beneficial bacteria living in your intestinal tract.
Just remember that while it's disturbing to consider that 5,000 people annually die from food poisoning (in the U.S.), 560,000 die from cancer. While it's true that you can't absolutely avoid risk, you can choose which risk you prefer to take.