PrintFavism?
So I bought fava beans for the first time ever, almost 2 lbs. And I was innocuously looking on epicurious to find a recipe, even though I thought I knew what I'd do with them (braise with some radishes). Found a little footnote at the very end of a recipe:
"Be aware that fava beans can cause a potentially fatal food intolerance in some people of Mediterranean, African, and Pacific Rim descent."
Anyone heard of this? A quick google shows that it is, indeed, true.
I've never eaten favas and am part Spanish. My husband is southern French w/ some Spanish , don't think he's ever eaten favas.
I guess I'll throw them out, which sucks (I hate, hate, hate throwing out food), but am I totally overreacting? I never heard of this before, and certainly never saw any mention in any of my cookbooks, but there it is.
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18 Comments:
This seems really strange to me; aren't fava beans from the Mediterranean?
Nicholas H at 9:26PM on 04/16/08
That's exactly what I thought, Nicholas H, but everything I found mentioned that Mediterranean people have the highest rate of this condition. Weird.
renzata at 10:15PM on 04/16/08
There are some wacky interactions and reactions...Remember Phen/Fen? It primarily attacked women of Mediterranean descent with some kind of heart malfunction.
Before you throw them out, did it mention that the effect was cumulative? This would mean that over time a buildup of whatever harmful chemical is what would cause the problem. Maybe a one-time ingestion is not potentially dangerous?
chiff0nade at 10:18PM on 04/16/08
No, it didn't say cumulative, and it said that sensitivity varies. For some folks, even a sniff of the pollen can be enough.
But what I start to wonder is whether it's the kind of disorder that would be screened in blood donations. I have given blood.
Here's a link, for anyone who's curious:
http://www.g6pd.org/favism/english/index.mv?pgid=intro
renzata at 10:37PM on 04/16/08
No, it isn't screened for in blood donations. It's quite uncommon. I'd be more concerned if I or my SO had a personal or famiy history of allergies before this.
lemons at 11:25PM on 04/16/08
My admittedly very brief/precursory look-up and review, suggests that if they were a threat to you or your husband you'd probably have discovered it long ago...
Have you ever eaten lima beans? If you had one of the variants of the condition, you'd likely have reacted to those.
There are a whole slew of other potential triggers, including aspirin. Doesn't seem like you'd have gotten this far along in life with the condition without already knowing you were vulnerable.
LoCo at 12:12AM on 04/17/08
Eat the favas, you only live once, living in fear of something doesn't help. Just imagine the sense of accomplishment you will have if you and your husband eat two pounds of Favas and don't keel over and die. The worst thing that will probably happen is that you have gas and wind up farting on each other.
nelson5757 at 10:01AM on 04/17/08
Sorry nelson, but if he's at high risk, I don't think I'm going to gamble on this one. We'll eat unpasteurized cheeses and raw/rare meats and fish, blood and guts and all the rest, but this seems to be a genuine potential threat:
"This enzyme, glucose-6-phosphate dehydrogenase (G-6-PD), is essential for assuring a normal life span for red blood cells, and for oxidizing processes. This enzyme deficiency may provoke the sudden destruction of red blood cells and lead to hemolytic anemia with jaundice following the intake of fava beans, certain legumes and various drugs."
I understand now that women won't be at risk, as they can only be carriers of the gene. So at worst, I'll eat them myself. But until I get confirmation that he's eaten them before from his mom (he's not sure), I'll remain conservative.
If I appear overly concerned, it may also have to do with the fact that we are among the unfortunately uninsured.
renzata at 11:28AM on 04/17/08
Frankly, whether you're insured or not, it just doesn't seem to be worth it. There is another thing - I may not hesitate for a second and eat something that may be "risky" myself, but I certainly wouldn't feed it to anybody if I knew it may cause as "little" as gas and cramps, let alone anything more serious. Why would you? We live only once, that's true, but I fail to see how it means that we should eat something that may make us gravely ill or, at best, uncomfortable? Plus, in this particular case, the consequences seem severe enough, and seriously - fava beans? It's not like it's the kind of food that you have to eat at least once in your life.
brooke29 at 12:19PM on 04/17/08
I'm with you, brooke29, although gas and other common mild gastrointestinal fusses are kind of inevitable from many delicious foods (veg, beans, etc) so I don't necessarily stop at that point (depends on who's eating).
But I definitely agree that eating $3 worth of fava beans is not worth the risk of destroying all your red blood cells. It's not a matter of discomfort, apparently, bu a matter of hospitalization.
renzata at 12:41PM on 04/17/08
Forgot to add:
what's really surprising me in all of this is how unlikely it was for me to even learn of it. None of my cookbooks mentioned it, including the big veggie guide by well-known cookbook writer/food authority. It just happened to be tacked onto the end of a recipe on epicurious, just a little footnote. Which made me wonder whether this is really unknown, or whether I was just especially ignorant/oblivious to it, particularly given that favas seem to be a bit trendy these days.
renzata at 12:44PM on 04/17/08
Renzata,
It is a C-O-N spiracy by the fava bean growers of America to keep this information out of the public eye. Renzata, I am portuguese which I think makes me swarthy enough to be a Meditterean, all of the males in my family have eaten Fava beans for years without repercussions (other than the gas).
nelson5757 at 1:17PM on 04/17/08
That's pretty terrifying, actually, but my whole family is Sicilian and has eaten fava beans for as long as I can remember with no repercussions. Still, it's good to know.
embolini9 at 4:11PM on 04/17/08
This topic really piqued my interest. I've done a lot more reading on it, and I must say that I really think you are significantly overstating the risk. It appears the condition is most frequently caught in childhood. The likelihood of your husband having a severe enough form of this condition to cause a reaction, and never having been exposed to any of the usual triggers would seem to be pretty remote. Other than fava beans, the most commonly encountered triggers are:
- other broad beans, such as lima beans (widely eaten in the US)
- sulfa drugs (widely prescribed anitibiotics)
- quinine (found in tonic water)
- aspirin and other NSAIDs
Certainly he must have consumed at least one of these substances at some time in his life? At the very least, ordinary aspirin? If he has experienced no problems, he is very unlikely to be at risk. Furthermore, the symptoms are rarely severe, and always subside as soon as exposure to trigger ends, except in people who have the severe form of the deficiency (if he had this form, he'd be chronically ill), or other complicating health conditions (e.g., infection, diabetes, etc.).
Finally, in the US, the condition is seen most frequently in male African-Americans, and occurs in only 10%-14% of that population.
He can get a blood test for about $50, but that's only going to tell him if he's deficient. About 1/2 of all people with the condition will experience no symptoms whatsoever.
I'm no doctor or geneticist, but if it were my son or husband, I wouldn't be overly concerned. Obviously, you and he should do what you think is best. Personally, I'd fix the beans, have him try a small portion. If he likes them, and has no reaction, all is well. In the highly unlikely event of a reaction, it is doubtful it would be severe, and will normally subside in about a week or less. The NIH says the episodes are usually brief and that spontaneous recovery is the usual outcome.
Check out this Information Bulletin put out by the US military. They test soldiers because of the danger associated with anti-malarials (quinine-derived). Not the only report I read, but helpful and probably reliable.
LoCo at 5:34PM on 04/17/08
LoCo,
Thanks for the info and the reassurance. I looked at the page you linked, and again at the page I saw (linked above) and am not sure about a couple of things:
- Where are you getting the relation with lima beans? I haven't seen this connection mentioned anywhere, and fava beans are old world and limas new, so I didn't assume that they'd be closely related.
- I didn't see aspirin on the "avoid" list at the site I visited, but I notice it's on the link you provided; not sure what to make of it. I didn't see other NSAIDs mentioned, but maybe the link is one I should already know of, not sure.
I don't know his full medical history, what sort of antibiotics he's encountered. I know that I showed him the fava bean, in and out of the pod, and asked if he recognized them and had ever eaten them. He said he recognized them but didn't think he'd eaten them (although apparently they put a dried feve in king's cake?). He's not American, so I can't use those demographics. He doesn't drink tonic, either, and like me, might have taken aspirin once or twice in his life.
Basically, I understand now that the likelihood of him having the deficiency is slim, albeit higher than most of the world population, and if I overstated the risk, it's because I am only starting to understand it, and was extremely surprised to learn that there even was a risk. And I also understand that many people with deficiency may experience mild reactions, and certainly they all don't keel over and die.
But for now I think that I will just eat them, or cook them and freeze them for later. My paranoid tendencies wonder if, maybe, he never ate favas before because his mom knew not to feed them to him. I have no idea. But it's not worth the worry and fuss for, literally, a hill of beans.
renzata at 9:24PM on 04/17/08
I'd say, throw them out. It's not a vital part of anyone's diet. I know the curiosity must be killing you, but, as you said, it's not worth it.
As you said, if it were just diarrhea or something minor, meh, throw caution to the wind. The effects are pretty serious in the off-chance that his tolerance to this has been compromised or close to it.
I used to drink like a fish in high school and stopped when I was 16, over 20 years ago. A year ago, I drank 2 very small sips of white wine at a family party. A few minutes later, I had to sit down. I had a hard time breathing, felt really hot, and could feel my heart racing. It passed after 10 minutes or so, but wow that was really uncomfortable and had family members worried. I had nothing to eat or drink for a couple hours before drinking this to make me question any association with other food/drink.
Tolerance can change over time.
Cassaendra at 8:13AM on 04/18/08
@renzata... first, let me say that when I used the word "overstating" it was not intended to be critical (I think it came across that way). I was only trying to reassure you of the probable minuscule risk, based on my reading. Although I'm not a clinician, I do have a lengthy background analyzing research literature and medical charts. Nevertheless, this is definitely just my own take on the material I came across, and is not intended as medical advice in any way.
That said, I saw lima beans mentioned in more than one source, but did not make a note of which ones. I agree that it does not necessarily make sense that they'd be a trigger as they are a different genus. On the other hand, the trigger element relates to certain compounds that require the G6PD enzyme for processing, so this may not be relevant. Also, several sources mention soy as a trigger (yet another genus). I have not found an authoritative source for the lima bean or soy references.
I found it very interesting that, side from jaundice in babies and known familial history, the most common way the condition is discovered is an episode triggered by illness or infection, most typically a bout of flu. That's why it's usually diagnosed long before adulthood. (Also, routine screening of newborns is apparently standard in countries where the condition affects at least 3-5% of males).
NSAIDs are mentioned the NIH and other sources. However, aspirin is the one that comes up consistently across virtually all sources.
@Cass, although I agree that tolerance can vary over time with things like allergies, this particular condition is a recessive genetic disorder -- a person either has a symptomatic variant or doesn't.
LoCo at 1:11PM on 04/18/08
LoCo I wasn't offended by any means, and I appreciate that you've taken some fair amount of time to do research, obviously much more than I did.
This leaves me wondering, still, why this is the first I've heard of it. That is, it seems to be a fairly serious risk for some people, but I've never seen any word of it until now. But if, like you say, people find out from a young age, I suppose it's like nut allergies, and you know if you need to know.
Thanks for the help.
renzata at 1:34PM on 04/18/08