Ask the Pharmacist: And you thought it was just Romaine

Suzy Cohen
Romaine lettuce has been linked to E. coli.

At this point, you should probably just throw out all your lettuce. It doesn’t matter if it came from Salinas, California because other states may be involved now. There have been over 100 reported cases across 23 states at the time of this writing. There is an official recall.

More:Ask the Pharmacist: Natural solutions for burning mouth syndrome

I’m not being an alarmist, Just the other day, we were told to trash those convenient bagged salad ‘kits’ because there are various types of lettuce in there, and some bags might have the contaminated E. coli leaves in it. The warning to consumers was about the brand called, Fresh Express Sunflower crisp chopped salad kits.

Just days after that urgent concern, the FDA has announced it is looking into several other E. coli outbreaks linked to lettuce grown from other states. There are multiple strains of pathogens and once infected, symptoms can show up between one day and a week later. 

One quick thing, if you are supported on warfarin or other anticoagulants, be aware that all salad greens are high in vitamin K (some more than others), so do not change your diet without your doctor’s approval and supervision. 

Here are some lettuce alternatives for those of you who wish to avoid Romaine and other lettuces. 

Rainbow or Swiss chard

These have broad green leaves attached to a bright crimson red stalk. The red in the leaves and stalk is due to the natural dye “betalain” which is used for liver health. If you’ve ever cooked chard, you know this shrinks to nothing. You can fill a giant 16 quart pot with these, and by the time you’ve steamed it over five minutes, you’ll end up with a spoonful.

I once bought six of these at once, and when I checked out at the supermarket, the cashier sarcastically asked me if I was going to eat all that myself. Without batting an eye, I quipped, “No I have a horse to feed!”


Like all leafy greens, spinach is high in fiber and promotes regularity. It contains oxalates, and it is very rich in potassium which regulates blood pressure.


Radicchio is a small, round reddish-purple sphere and pairs well with greens in a salad. It’s way tastier than red cabbage. Add radicchio to your salad because it is high in Vitamin C, Vitamin K and other micronutrients.

Mustard greens

Taste this green before chopping it into your salad, because most people must acquire the taste! I must be weird, I don’t mind eating it raw. If you lightly steam or blanche it, you will reduce the bitterness. This popular plant gives us mustard seeds, which can be turned into one of our favorite condiments.


Very versatile and contains over 50 vitamins and minerals.  Scientific data shows this can help prevent DNA cellular damage and, in that regard, perhaps slow the development of cancer. Sometimes people worry about the goitrogenic effect on iodine absorption, and subsequent production of thyroid hormone, but I think a little watercress is just fine. 

More:Ask the Pharmacist: Plants that are toxic to children and pets

Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Visit