Dear Alice,

I would like to know if I should be concerned with the risk of contracting "bovine spongiform encephalopathy (BSE)" or its human variant, from the use of vitamins, supplements, over-the-counter medication, or pills prescribed by a doctor which contain gelatin?

I understand that one of the main components of gelatin comes from the bones and skin of cows and that it is often imported from other countries. I also understand that it is highly unlikely that the standard processes involved in producing gelatin would ever remove or disable the BSE contamination.

It is also very alarming that BSE has a long incubation period (years) whereby the infected person has no symptoms. However, when symptoms do occur, the person dies a horrible death, via a deformed and shrinking brain, usually soon thereafter.

Since gelatin is used in so many food products, is it realistic to try avoiding all gelatin?

What are the mathematical chances of contracting the disease from gelatin in a food product?

Is there fewer gelatins in a standard hard pill as opposed to a "soft gel" capsule?

I feel the FDA, U.S. Government, and more importantly, the food and supplement industries, should do more to insure that all food products and supplements used in America are free from contamination of this horrible disease in order to prevent any chance of an outbreak like the one seen in Europe a few years ago.

I would appreciate your thoughts on this subject.

Thank you,

Dear John,

Before getting to the specific matter at hand (the safety of gelatin and gelatin-containing products), let's review some basic information about Bovine Spongiform Encephalopathy (BSE) and the disease affecting humans that is thought to be related, a variant form of Creutzfeldt-Jacob Disease.

Bovine Spongiform Encephalopathy, also often called "mad cow disease," is a degenerative disease affecting the central nervous system (brain and spine) of cattle. Scientists have not yet determined the exact cause of the disease, which was first recognized in the United Kingdom in 1986. Current theory and research focus on prion proteins and their role in neurological disorders. While research on the actual cause continues, it has been recognized that BSE spreads among animal populations when livestock is fed meat and bone material from already infected animals. The BSE crises in the U.K. through the 1980s and 1990s were thought to have started when sheep infected with scrapie, a sheep disease recognized since the 18th century and is present in almost all countries with sheep populations, were fed to cattle. (Scrapie, similar to BSE, is not transmissible to humans.) The practice of feeding animal parts to other livestock is now completely banned in the European Union, including the U.K, and partially banned here in the United States and Canada.

There has been one case of BSE in the U.S., in a cow that was imported to the country from Canada. Canada has had three confirmed cases of BSE. The U.S. recently increased the number of cattle tested for BSE annually to half a million; thirty-six million cattle are slaughtered annually in the U.S..

Creutzfeldt-Jacob Disease (CJD) is a rare disorder that causes deterioration of mental function and movement in human beings. A variant form of CJD, abbreviated vCJD, first identified in 1996, is thought to be contracted through eating products from BSE-contaminated cattle, or more specifically, meat that came in contact with infected tissue (including the brain, spinal cord fluid, tonsils, or intestines) during slaughter. Because this is the most likely route of infection, governments have initiated prevention methods to detect and destroy BSE-carrying cattle, disallowing the use of live but non-ambulatory cattle ("downers") into the food supply, and preventing the organs from cattle of over 30 months of age from entering the food supply, since younger cattle are not known to exhibit symptoms of BSE.

It was realized soon after the discovery of vCJD that the disease could also be spread through blood during transfusions. As a result, blood banks have worked to minimize risk of transmission through this route. Though fatal, vCJD is rare: as of December 1, 2003, only 153 cases of vCJD had been reported worldwide. All cases of vCJD were in people who had lived at least for a time in a country where BSE also occurred among the cattle population.

You are correct in noting that the incubation period for vCJD seems to be rather long, estimated currently at 10 to 15 years. There are varying predictions of what this could mean for countries that have experienced BSE outbreaks or vCJD cases already. But studies are not yet reliable enough to give firm estimates of the impact that might be expected from known BSE outbreaks during the 1980s and 1990s.

Unfortunately, vCJD has no cure, and currently, no agreed-upon treatment. More research is needed not only to develop treatment options, but also to understand the disease itself.

Gelatin, derived from collagen, is a widely-used animal-derived product. In addition to being found in food products, gelatin is frequently used in the manufacture of pharmaceuticals. Gelatin is indeed made from skin and bones of cattle, as you mention in your question, but the primary raw material for modern gelatin production is actually pig skin. Pigs are not currently known to be affected by BSE or any similar disease. In addition to cow- and pig-based gelatin products, there are also fish-based and completely vegetarian versions of gelatin (to be discussed later in this answer).

In addition to the fact that most gelatin is not made from cows, there is no evidence that spongiform encephalopathy (leading to vCJD) is transmitted through gelatin. Still, measures are taken to prevent BSE-carrying cattle from entering the gelatin production process. It is also generally thought that the actual production of gelatin eliminates risk, though studies are still being carried out to determine whether the infectivity of any material that did make it through to production facilities would be completely eliminated. It's important to note, as well, that these tests are carried out with concentrations of BSE material thousands of times higher than those likely to be found, even were an infected cow to enter the production process for gelatin. It is, therefore, extremely unlikely that anyone would contract vCJD through gelatin.

Specifically, you asked about the gelatin content of soft-gel capsules versus that of "hard" pills. First, the gelatin content of soft-gel capsules differs from hard-gel capsules. According to gelatin manufacturers, the inactive ingredients of a hard capsule contain generally about 30 percent gelatin. The level of gelatin in a soft capsule is usually between 40 and 45 percent. Tablets (the "hard" pills) also contain gelatin as a binder and in the coating to make them less powdery. Levels vary, but are less than the amount used in gel caps. In medicine products, you will also find gelatin (in varying levels) in suppositories, dissolvable films, and emulsions (oils). Read ingredient information on the packaging for more specific information. If you feel strongly about avoiding gelatin, talk with your prescribing health care provider to determine whether liquids or effervescents without gelatin are available to substitute for tablets or capsules. Often, however, there are not.

After reading this information, you may no longer be interested in eliminating gelatin from your eating plan. Some people, however, do refrain from consuming gelatin for dietary or ethical reasons. Alternatives to pig- and cow-based gelatin do exist, such as kosher gelatin, which can be made from fish bones or seaweed. (Take note: some gelatin-containing products are marked kosher even though they are gelatin made from cows — you can check with the certifying organization for details.) Vegetarian gelatin alternatives include agar (or agar-agar), an algae, and carrageenan, a seaweed, which is now often used in commercial products as a thickening agent instead of gelatin. It is possible to avoid using regular gelatin if the individual wants to, but close attention would have to be paid to ingredients in the foods one buys. For example, gelatin is used as a stabilizer in various dairy products (including ice cream, cream cheese, sour cream, "Swiss style" yogurt), packaged gravies, sauces, lozenges, chewing gums, and marshmallows, and is sometimes used to clarify fruit juices, wine, and even beer (though little, if any, gelatin remains present in the final liquid product). Reading the packaging on food products should let you know whether the product contains gelatin or not.

As a side note for any Go Ask Alice! readers interested in avoiding gelatin for all purposes, not just internal consumption: gelatin is used in many cosmetic products, ointments, photographic film, and even in producing materials for paintball!


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