I’m writing from my almost native state of Florida to wish everyone a Happy New Year!

It’s kind of a peculiar tradition, isn’t it? Every January 1 wishing people- many of whom you haven’t spoken with in months or perhaps only communicate with once a year – that they are happy, or at least begin their year happy. I suppose it’s a projection of oneself to be happy.  It’s also part of basic human nature that goes back to the beginning of civilization, recognizing the beginning and closing of a natural cycle.

I read that the first known New Year revelers were the Babylonians, who more than 4,000 years ago chose the spring equinox (mid-March) to ring in the New Year.  The Egyptians preferred celebrating at the start of fall (September 21) and the Greeks preferred the winter solstice (December 21). According to Britannica.com the Roman’s started celebrating the New Year on Jan. 1 in 153 BC. For European Christians that date moved around from March 25 and December 25 for hundreds of years until the Roman Catholic Church made January 1 the official New Year’s Day in the Gregorian calendar in 1582. European countries slowly adopted January 1 as the day to celebrate the New Year over the next few centuries. England didn’t make it official until 1752 and Russia waited until 1918. The Jewish New Year is still celebrated on Rosh Hashanah, which is determined through the lunar calendar and falls between September and October every year. Chinese New Year celebrations last for a month, which start in late January or early February. I can go on with all the different celebrations, but the point is, globally, we all recognize that the Earth has revolved around the sun one more time and we’ve all gotten a year older.

As the Earth starts its newest solar orbit, I suppose now is as good a time as any to reflect on the past year and look forward to the New Year. For many of my colleagues entwined in the so-called “Good Food Movement,” 2012 saw modest improvements in the food system and some significant setbacks.  In 2012, the Organic Trade Association reported that the US organic food market outpaced conventional food sales growth and the organic food industry created more than half a million jobs. We saw a steady increase in farmers markets across the country. Many are now accepting SNAP (food stamps) and other federal nutrition benefits, such as WIC.  Sadly, on the political front, we’ve seemed to hit a roadblock with a stalled Farm Bill and the defeat of California’s Proposition 37, which would have required all genetically modified food sold in stores carry a label.

Instead of focusing on the specific challenges we have ahead of us, I wanted to remind all of my friends that like every “movement for change,” it takes perseverance, patience, and time to make any significant headway. As for those who think we’re all a bunch of ivory tower elitist tilting against windmills, we would all do well to remember the words of Mark Twain who said, “A man with a new idea is a crank — until the idea succeeds.”

Which reminds me of a Mahatma Gandhi quote, which Dr. Robert Lawrence, Director, Johns Hopkins Center for a Livable Future, often repeated to the staff while I was there. “First they ignore you, then they laugh at you, then they fight you, then you win.” It’s a great quote, and when Dr. Lawrence said it, I always found it inspiring. However, like so many things, the quote may not be as accurate as we all thought. While searching for the exact wording of the quote, I came to find out that there is a dispute over whether Gandhi actually said this. The cool thing is (this might be of great interest for Dr. Lawrence who has lived in Baltimore for decades) a close variation of the quote was made in Baltimore during a 1914 US trade union address by Nicholas Klein.  “And, my friends, in this story you have a history of this entire movement. First they ignore you. Then they ridicule you. And then they attack you and want to burn you. And then they build monuments to you. And that, is what is going to happen to the Amalgamated Clothing Workers of America.”

I’m not sure that by quoting Mark Twain, Mahatma Gandhi and an early 20^th Century union leader actually helps ward off any elitists barbs, but I do believe now is a good time to take a close look at the people who are working for change in the food system. I haven’t been privy to any national surveys, but my unscientific polling shows that the “movement” continues to lack significant diversity.  I believe we lack diversity, not only among many cultural groups, but also among the people who make up the so-called Middle America. This means we need to be willing to talk and work with people who don’t agree with us. We need to help everyone understand that the way large industrial-style farms are producing the so-called cheap food that they’re eating now is decimating the environment – polluting our water, our air and destroying our disappearing and what used to be plentiful rich soil.  We need to explain that responsibly grown whole foods are not just healthier for us to eat, but over the long term they will help protect public health and the environment for generations to come.

The editors of Scientific American recently encouraged U.S. hog farmers to “follow Denmark and stop giving farm animals low-dose antibiotics.” Sixteen years ago, in order to reduce the threat of increased development of antibiotic resistant bacteria in their food system and the environment, Denmark phased in an antibiotic growth promotant ban in food animal production. Guess what? According to Denmark’s Ministry of Food, Agriculture and Fisheries the ban is working and the industry has continued to thrive. The government agency found that Danish livestock and poultry farmers used 37% less antibiotics in 2009 than in 1994, leading to overall reductions of antimicrobial resistance countrywide.

Courtesy: Ministry of Food, Agriculture and Fisheries, Danish Veterinary and Food Administration, July, 2010

Except for a few early hiccups regarding the methods used in weaning piglets, production levels of livestock and poultry have either stayed the same or increased. So how did Danish producers make this transition, and why isn’t the U.S. jumping to follow suit? Like many things in industrial agriculture, the answer is not clear.

If any country knows how to intensively produce food animals, particularly pigs, it is Denmark. In 2008, farmers produced about 27 million hogs. In fact, the Scandinavian country claims to be the world’s largest exporter of pork. Thus Scientific American editors argue that the Danish pork production system should serve as a suitable model to compare to ours. U.S. agriculture economists from Iowa State University agree. In a 2003 report, Drs. Helen Jensen and Dermot Hayes stated that Denmark’s pork industry is “…at least as sophisticated as that of the United States… and is therefore a suitable market for evaluating a ban on antibiotic growth promotants (AGPs).”

Based on Denmark’s experience, concerns that an AGP ban in the U.S. would cripple the industry appear to be overblown. A study published last year in the American Journal of Veterinary Medicine by Danish researchers suggested that Denmark’s AGP ban in food animals reduced overall antibiotic use and did not significantly impact production. In fact, recent numbers from Denmark show production levels of hogs increased by roughly 50% between 1992 and 2008.

So what additional changes did Danish hog producers make in their methods of production to ensure that the AGP ban did not negatively affect their bottom line to a significant degree? Robert Martin, Senior Officer of the Pew Environment Group and former Executive Director of the Pew Commission on Industrial Farm Animal Production, visited several Danish hog farms in 2009 to see first hand what producers were doing to compensate for not being able to use antibiotics as growth promoters. Martin listed some of what he describes as the most important changes:

• Switching to lower density models of housing pigs
• The use of open pen & deep bedding systems
• Cleaning barns more frequently and systematically
• Improved ventilation systems
• Improved quality of feed
• Extending weaning period for piglets

Martin explains that many of these changes were phased in as farmers adopted a set of new best practices. Martin says immediately following the ban, Danish producers did see an increase in mortality of young pigs. “But instead of reverting to using antibiotics as a crutch,” Martin continued, “they initiated changes in their system.” For example, Martin learned that many producers extended the piglet weaning times by about 10 days, allowing maternal antibodies in milk to provide increased immunity. Martin also pointed out that reducing the crowded conditions and switching to a dry, deep bedding system, “allowed them to manage waste more effectively.” He said the changes are also “more humane for the pigs.” Moreover, Martin says, “They also paid more attention to feed mixtures instead of relying on antibiotics for weight gain.”

Dr. Jensen and Hayes’s report, published in the Iowa Ag Review, determined a ban similar to Denmark’s could cost the U.S. industry more than $700 million dollars over 10 years and increase the price of pork by about 2 percent at the grocery store. Hayes noted, in recent email exchanges with the Center for a Livable Future, that in the long run a ban would not keep producers from making money. He also wrote, “hog farmers would reduce production until prices recovered, so there is no profit impact.” When it comes to the study’s findings Hayes believes the economics are secondary:

“The key take away for me from our studies was that the ban at the finishing stage worked as planned and reduced antibiotic use by a lot. However, when they extended the ban to the weaning state they ended up using more antibiotics and these were stronger human-use antibiotics. So a ban at the weaning stage did not work in terms of its original intent.”

It is worth noting that recent Denmark data shows weaner mortality is significantly lower since the ISU study was published in 2003. Despite that fact, Hayes is correct. The therapeutic use of antibiotics has increased since the ban was instituted. According to the latest Danish Integrated Antimicrobial Resistance Monitoring and Research Program (DANMAP) report, therapeutic antibiotic use rose by almost 13% from 2008 to 2009. DANMAP also found the occurrence of resistance in Danish pork increased during that time period, “and is not significantly lower than in imported pork.” However, resistance to the antibiotic ciprofloxacin, an important antibiotic in human medicine, was very low in E. coli from Danish pork in contrast to imported pork. It is important to point out that therapeutic use poses much less antibiotic resistance risk than low-dose application. Don’t forget, Denmark’s overall antibiotic use in all food animal production remains nearly 40% lower then when the ban was first initiated.

If the AGP ban is, at the very least, reducing overall antibiotic use and Danish pork production levels are increasing why wouldn’t U.S. producers follow suit? The National Pork Producers Council (NPPC) lobbyists publicly maintain they still don’t believe antibiotic use in food animals poses a risk to human health. In a presentation prepared for the World Pork Expo 2010, Chelsea Redalen, the NPPC’s Director of Government Relations, maintained that there is “little to no evidence that restricting or eliminating the use of antimicrobials in food-producing animals would improve human health or reduce the risk of antimicrobial resistance to humans.”

Statements like these, repeatedly made by hog industry representatives, leave many public health experts exasperated. Numerous peer reviewed research studies including in the U.S. and the Netherlands clearly demonstrate the transmission of antibiotic resistant bacteria from food animals to people. Studies out of the Netherlands published in the Journal of Emerging Infectious Diseases and the Annals of Clinical Microbiology and Antimicrobials, demonstrate that MRSA (Methicillin-resistant Staphylococcus aureus) was transmitted from pigs to a farmer, and between pig farmers and their family.

Despite industry claims, U.S. government health officials have concluded there are direct links between antibiotic use in food animal production and the risk of antibiotic resistant infections in people. Responding to a letter from Drs. Robert Lawrence and Keeve Nachman of the Johns Hopkins Center for a Livable Future (CLF), the director of the U.S. Centers for Disease Control and Prevention, Dr. Thomas Frieden, confirmed that the CDC, “feels there is strong scientific evidence of a link between antibiotic use in food animals and antibiotic resistance in humans.”

CLF helped bring to light recently released FDA data showing that 80% of the antibiotics produced for human and animal use in the U.S. are sold for use in food animals. Even if significant portions of those antibiotics are used to treat disease, Dr. David Love, CLF scientist, says he finds that statistic, “astounding.” Love believes, “if producers are reliant on the use of antibiotics to produce animals in a highly concentrated way, it means that the design of these farms makes them breeding grounds for diseases.” “Even more troubling to me,” Love says, “is the unwise use of antibiotics for growth promotion in animal production, which compromises antibiotics, a precious resource used to protect the public’s health.”

Currently there is proposed federal legislation that would greatly limit antibiotic use in U.S. food animal production. Congresswoman Louise Slaughter (D-NY) recently reintroduced the Preservation of Antibiotics for Medical Treatment Act, better known as PAMTA. The bill would ban the routine use of antibiotics “deemed” critical in human medicine to promote growth in healthy animals.

So, should the U.S. follow Denmark’s lead and stop all food animal producers from dishing out low dose-antibiotics? Public health experts say it appears that those with a higher priority on limiting health risks are at loggerheads with those unwilling to change or corporations more concerned about the risks of increased costs. One thing is clear – most large pork producers do not plan on instituting a ban voluntarily.

Story was first published in Grist Magazine.

Antibiotics, one of the world’s greatest medical discoveries, are slowly losing their effectiveness in fighting bacterial infections and the massive use of the drugs in food animals may be the biggest culprit. The growing threat of antibiotic resistance is largely due to the misuse and overuse of antibiotics in both people and animals, which leads to an increase in “super-bacteria”. However, people use a much smaller portion of antibiotics sold in this country compared to the amount set aside for food animals. In fact, according to new data just released by the Food and Drug Administration (FDA), of the antibiotics sold in 2009 for both people and food animals almost 80% were reserved for livestock and poultry. A huge portion of those antibiotics were never intended to fight bacterial infections, rather producers most likely administered them in continuous low-dosages through feed or water to increase the speed at which their animals grew. And that has many public health experts and scientists troubled.

For years scientists concerned about the threat of antibiotic resistant bacteria in food animal production have been trying to figure out just how much antibiotics producers are using each year. The best they could do was come up with rough estimates. That is because the data was never publicly available, until now.

In accordance with a 2008 amendment to the Animal Drug User Fee Act, for the first time the FDA released last week an annual amount of antimicrobial drugs sold and distributed for use in food animals. The grand total for 2009 is 13.1 million kilograms or 28.8 million pounds. I found the stories covering this revelation interesting, but they did not convey the whole picture. It is important to understand how this amount compares to the total available for people. So, I decided to find out for myself and contacted the FDA for an estimate of the volume of antibiotics sold for human use in 2009. This is what a spokesperson told me:

“Our Office of Surveillance and Epidemiology just finished an analysis based on IMS Health data. Sales data in kilograms sold for selected antibacterial drugs were obtained as a surrogate of human antibacterial drug use in the U.S. market. Approximately 3.3 million kilograms of antibacterial drugs were sold in year 2009. OSE states that all data in this analysis have been cleared for public use by IMS Health, IMS National Sales Perspectives™.”

3.3 million kilograms is a little over 7 million pounds. As far as I can determine, this is the first time the FDA has made data on estimates of human usage public. Below is a breakdown of the FDA numbers prepared by my colleague, Dr. David Love, also from the Johns Hopkins Center for a Livable Future, which compares the estimated amounts of human usage with food animal usage.

Take a look at the data for tetracycline. More than 10 million pounds of the antibiotic were sold for the use in food animals. That’s more than all of the antibiotics combined set aside for humans in 2009. Many studies suggest the high use of tetracycline in food animals, particularly in pigs, has lead to the increased rates of bacterial resistance to the antibiotic, such as Methicillin-resistant Staphylococcus aureus or MRSA.

Despite this new information, the hog industry denies the suggestion that it is overusing antibiotics. In response to the FDA’s report, the National Pork Producers Council also pointed out to Food Safety News’ Helena Bottemiller that, “ionophores … are not used in human medicine, they don’t have anything to do with the effectiveness of antibiotics in people.” That statement is inaccurate. All uses of antibiotics have the potential to decrease the effectiveness of antibiotics in people. Ionophores are no exception. While several industry funded studies determined that ionophore use in animals is “not likely” to transfer resistance from animals to people, researchers couldn’t come to a definitive conclusion because ionophores can lead to bacterial resistance to the antibiotic bacitracin, which is commonly used to treat skin and eye infections.

Every time an antibiotic is used there is a risk of adding to the growing pool of antibiotic resistance. LivableFutureBlog readers might recall an October blog post in which Dr. Ellen Silbergeld, professor of environmental health sciences at the Johns Hopkins Bloomberg School of Public Health, warned that, “Bacteria respond to chemical structures, not brand names, and resistance to one member of a pharmaceutical class results in cross resistance to all other members of the same class.” Silbergeld says when bacteria develop resistance to one member of that class of antibiotics it can be resistant to all.

So, what is the government doing to ensure we don’t squander the effectiveness of antibiotics for human use on the production of food animals? Since President Barack Obama took office, the FDA says it has taken several steps. Dr. Joshua Sharfstein, Principal Deputy Commissioner of the FDA, took a stand last year by stating that the Administration, “supports ending the use of antibiotics for growth and feed efficiency” in food animals. However, instead of requiring industry take action, the FDA released a draft-guidance last June that essentially asks industry to voluntarily end the use of antibiotics as growth promoters in food animals and include veterinary oversight or consultation on all antibiotic use.

Lawmakers such as Congresswoman Louise Slaughter and Senator Barbara Boxer have been introducing versions of the Preservation of Antibiotics for Medical Treatment Act (PAMTA) for more than a decade that would mandate antibiotic use changes in food animals. Earlier this year it looked like the bill had a good chance of passing, but the bill failed to make it to the floor of the House or Senate. While not perfect, PAMTA would ban the use of medically important antibiotics as growth promoters. Passage of PAMTA would be an important step in saving the potency of antibiotics for human use. However, the current version of the bill could be stronger if it followed more closely the recommendations from the Pew Commission on Industrial Farm Animal Production final report, which calls for a ban on the non-therapeutic use of all antibiotics, not just those considered medically important, in food animals.

Now that we officially know that food animals use an overwhelming majority of our antibiotics, I hope it is more clear to everyone that legislation limiting the overuse and misuse of antibiotics in livestock and poultry must be passed. The next battle, which industry has already begun, is defining what non-therapeutic use will constitute. Producers are already claiming that the use of antibiotics for growth promotion has decreased, maintaining current low-dose usage is aimed at disease prevention. Regardless, all low-dose usage of antibiotics can lead to a significant increase in antibiotic resistance. As Dr. Alexander Fleming, the discoverer of penicillin warned, “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.”

I had to share a news release that the Franciscan Center of Baltimore sent out today regarding its launch of a Healthy Monday campaign.

For Immediate Release:

September 27, 2010

Public Health Campaign & Celebrity Chef Help Franciscan Center Serve Dignity With Its Meals

The Franciscan Center of Baltimore, in partnership with The Johns Hopkins Center for a Livable Future (CLF), kicked off its own Healthy Monday campaign today to promote healthy food choices among its clients. The goal: to ensure that everyone, regardless of their socio-economic status, has access to safe, nutritious and delicious meals. With the help of celebrity chef Kim O’Donnel and CLF’s two outreach projects, Baltimore Food and Faith and the Johns Hopkins Healthy Monday Project, the Franciscan Center wants to show that providing a large variety of high quality foods for Baltimore’s hungry not only promotes dignity among its clients, but may also improve their health.

The Franciscan Center has a long legacy of feeding the poor and homeless in Baltimore. The Center serves as many as 500 meals a day. So far it has served 78 thousand meals this year alone. In an effort to promote personal dignity through healthy and sustainable living, the Franciscan Center has partnered with various local farmers, businesses, groups and organizations like CLF, the Abell Foundation, Campus Kitchens, First Fruit Farms and Wegmans Supermarket to bring healthy, organic produce and vegetables to Baltimore’s most needy in an attempt to increase the personal health of an at risk population.

According to Baltimore’s Food Policy Task Force Final Report, “Many Baltimore City residents are affected by health problems associated with a poor diet.” The Task Force also found that one in every three adults in Baltimore is obese and two out of three is considered overweight. Ed McNally, Franciscan Center Executive Director, believes that, “if we can increase the nutrition content in the food served to the City’s poorest and most disadvantaged citizens — many with or at risk for contracting disease — then we will positively impact public health.

Saint Francis of Assisi said, “It is not fitting, when one is in God’s service, to have a gloomy face or a chilling look.” McNally added today that the Franciscan Center believes, “that you can’t serve an unhealthy meal with a smile. It is the next step; there is nothing more dignified than a nutritious meal.” Rev. Dred Scott, Pastor of St. Matthew United Methodist Church in Turner Station agrees. “At St. Matthew we are always looking at quality of life issues,” says Rev. Scott. He believes that, “if you are what you eat, then eating healthy and having access to healthy, nutritional food is a must. Our community garden has provided fresh produce to a substantial number of people in the community over the past several years at no cost.” Rev. Scott and McNally are both members of CLF’s Baltimore Food and Faith advisory board.

O’Donnel, a trained chef and author of the newly released “Meat Lover’s Meatless Cookbook,” took time off from her book tour to share recipes and some cooking tips with the Franciscan Center’s two full-time cooks today. O’Donnel says, “I was proud to take part in today’s event. Food is such an integral part of everyone’s life. Helping to promote the idea that everyone deserves access to healthy delicious food is very important to me.”

“Launching Healthy Monday has been a challenge,” says Kim Greggory, Franciscan Center cook. “But by bringing in experts, like Chef O’Donnel, to teach us how to prepare healthier balanced lunches, I’ve been able to not only better prepare fresh vegetables, but I take that knowledge home and feed my own family better,” added Greggory.

O’Donnel has long supported Healthy Monday and Meatless Monday through her columns at the Washington Post and several popular blogs. Healthy Monday is a public health initiative whose goal is to prevent chronic diseases by offering people weekly prompts to start and sustain healthy behaviors, such as making healthy food choices. The Johns Hopkins Center for a Livable Future, based at the Johns Hopkins Bloomberg School of Public Health, serves as technical and scientific advisor for Healthy Monday and its sister campaign Meatless Monday. McNally says Meatless Monday is just the first of many Healthy Monday programs the Franciscan Center plans to promote throughout the year.

Additional information can be found on the following web pages:

The Franciscan Center: http://www.franciscancenterbaltimore.org/
Johns Hopkins Center for a Livable Future: http://www.jhsph.edu/clf
Healthy Monday: http://www.healthymonday.org/
Kim O’Donnel: http://www.kimodonnel.com/

Monday, September 27, 2010

Leadership at the U.S. Food and Drug Administration (FDA) made it abundantly clear last week that the low-dose usage of antibiotics in food animals, simply to promote growth or improve feed efficiency, needlessly contributes to the emergence of antibiotic resistant bacteria and poses a serious threat to public health. Despite the fact that the FDA is taking a hard-line stance on the issue, I find it frustrating to see that the agency appears to be hamstrung from taking the necessary steps to mandate industry end the risky practice. Even more exasperating, is that it appears that the FDA may actually relax a current directive that already regulates antibiotic use. However, unlike many critics I don’t believe that this is an example of the Obama administration buckling under industry pressure. Rather, I view it as a loud and stern call for Congress to take action. Producers concerned more about profit than protecting public health are not going to cut their dependence on non-therapeutic antibiotic use in food animals unless lawmakers pass strict legislation.

On June 28, the FDA fired a serious warning shot across the bow of industrial food animal producers stating in a new draft guidance that it expects industry to change its antibiotic use practices. The draft guidance asks for two simple things: stop using “medically important” antibiotics as growth promoters, limiting use to only treating sick animals; and ensure that producers do not administer these drugs without veterinary supervision. Unfortunately, the FDA says guidance documents, “do not establish legally enforceable responsibilities.” Why didn’t leadership go a step further and issue a proposed rule? I’ll address the possible answer in a moment. But what has me scratching my head are discussions about potentially changing a current medicated animal feed rule that’s already on the books.

The FDA recently sent out a notice warning that it might modify its veterinary feed directive (VFD), citing informal complaints that the rule is “overly burdensome.” The VFD was issued 10 years ago in response to the passage of the Animal Drug Availability Act of 1996, which required the FDA to regulate the approval and marketing of new animal drugs and medicated feeds. Any medicated feed that falls under the VFD category can only be used under the supervision of a veterinarian. According to the American Veterinary Medical Association’s website “the purpose of the added professional control is to reduce the rate of development of [antimicrobial] resistance and thereby prolong the period of effectiveness of the medication.” It is important to note that the VFD only applies to new drugs and that feeds containing approved antibiotics before 2000 can and are sold over-the-counter without a prescription or supervision of a veterinarian.

So, if the FDA Principal Deputy Commissioner Joshua Sharfstein went out on a limb to call the overuse of antibiotics in food animals, “an urgent public health issue,” why would the FDA consider changing a 10-year-old rule that could relax regulation of antibiotic use even further? That’s exactly what the American Academy of Pediatrics, The Pew Charitable Trusts, Union of Concerned Scientists, Institute for Agriculture and Trade, Food and Animal Concerns Trust and Humane Society of the United States want to know. Back in May the organizations sent a list of specific questions to FDA Commissioner Margaret Hamburg regarding the Advance Notice of Proposed Rulemaking (ANPR):

· From whom did the [overly burdensome] comments come – the industrial farming industry, veterinarians, or other stakeholders?

· The FDA suggests that the ANPR is being undertaken to help “improve the program’s efficiency.” Since the primary requirement of the program is that veterinarians provide oversight on the use of certain drugs, does improved program efficiency simply mean less meaningful oversight from licensed veterinarians?

· How is the ANPR consistent with Deputy Commissioner Joshua Sharfstein’s July 13, 2009, testimony that, “protecting public health requires the judicious use in animal agriculture of those antimicrobials of importance in human medicine…FDA also believes that use of medications for prevention and control should be under the supervision of a veterinarian?” (emphasis added)

Late last month the FDA decided to extend the comment period on the ANPR for an additional 60 days, after receiving complaints that the original 90-day comment period was not enough time to develop “meaningful or thoughtful response.” That means the public now has until August 27 to speak up. If you’re interested in writing a response you may first want to read a new study published in PLoS One which links antibiotic use on veal calf farms in the Netherlands to a new strain of methicillin-resistant Staphylococcus aureus – ST398 (a.k.a. Staph superbug.) The authors say this is the first study that shows “direct association between animal and human carriage of ST398,” and that this latest revelation warrants the prudent use of antibiotics on the farm.

While I don’t want to see the VFD weakened in any way, I am more concerned about the medicated feeds that are not covered under the directive. Which is pretty much everything except the two drugs that have been placed under the VFD category. The Union of Concerned Scientists (UCS) estimated in 2001 that as much as 70 percent of all the antibiotics sold in the U.S. were used to promote growth in food animals. And yes, there are plenty of cases of irresponsible antibiotic use going on in people, but it doesn’t compare to the amount in animals. The UCS claims “nearly 13 million pounds [of antibiotics] per year – are used in animal agriculture for these non-therapeutic purposes. This amount is estimated to be more than four times the amount of drugs used to treat human illness.”

Of course industry disputes this claim. The Animal Health Institute – an organization that lobbies for pharmaceutical companies such as Bayer, Pfizer and Novartis – told the New York Times that it estimated only “13 percent of agricultural antibiotics were used to promote growth.” As Times reporter Gardiner Harris keenly pointed out, if the FDA, “some day bans growth promotion as a use, there is a chance producers would simply relabel such uses as preventative.”

While serving as the communications director for the Pew Commission on Industrial Farm Animal Production my colleagues and I met with AHI staff in 2006 to discuss antibiotic use in food animals. They were trying to “redefine” therapeutic and non-therapeutic uses of antibiotics even back then. They presented us with similar statistics. It wasn’t until we started discussing the use of antibiotics to prevent production diseases, such as liver abscesses in feedlot cattle (ruminants, designed to eat forage such as grass or hay, that are finished on grain can develop several metabolic and infectious diseases), that we began to realize they were lumping the use of antibiotics to make up for poor living conditions and animal husbandry in the same therapeutic category. There are some hard-liners who would argue medicating animals to prevent “production diseases” should not fall under the “therapeutic” category as well. Keep in mind, regardless of the definition, these low-dose treatments can still lead to the emergence of antibiotic resistant bacteria. And FYI, studies reveal cattle switched from grain-based diets to hay were less likely to shed the deadly antibiotic resistant bacteria E. coli O157:H7.

So, why hasn’t the FDA called for an outright ban? Industry has thwarted the agency’s attempts to end the non-therapeutic use of antibiotics for more than three decades. If history were any indicator, a call for a new ban would most likely end with the same fate. I am certain that if FDA leadership decided to release a draft directive last week, rather than a draft guidance, industry would already be preparing to take the FDA to court. At best, a court action could tie up any rule for years; at worst, it could set back future regulations by another decade or more. That’s why public health will remain at risk until Congress takes action and passes legislation designed to end the practice once and for all.

While it is not perfect, there is proposed legislation on the table right now entitled the Preservation of Antibiotics for Medical Treatment Act (PAMTA). Congresswoman Louise Slaughter introduced the latest version of PAMTA last March. The bill calls for:

· Phase out the non-therapeutic use in livestock of medically important antibiotics;

· Require this same tough standard of new applications for approval of animal antibiotics;

· Does not restrict use of antibiotics to treat sick animals or to treat pets and other animals not used for food.

More than 300 organizations including the Center for a Livable Future, American Public Health Association, American Medical Association, and National Association of County and City Health Officials support the passage of the PAMTA.

The American Veterinary Medical Association (AVMA) is vehemently opposed to PAMTA. Dr. Michael Blackwell, public health veterinarian and vice chair of the Pew Commission on Industrial Farm Animal Production, says that to his knowledge, “the AVMA remains the only major medical or public health organization not recommending changes in agriculture practices to help ensure sustainability where the use of antimicrobials is concerned.”
Dr. Raymond Tarpley, AVMA member and retired Texas A&M professor, recently submitted a post for the Livable Future Blog imploring the AVMA to change its stance on antimicrobial use in food animals. The AVMA and industrial food animal producers claim that the benefits of low-dose antibiotic use to efficient production and food safety outweigh the risk of developing more antibiotic resistance. Dr. Tarpley says that view, however, is only valid in the context of the current unhealthy industrial animal production environment:

… where disease risks can be heightened and growth rate performance reduced by stressors such as poor ventilation and hygiene, inadequate temperature regulation and animal crowding interfering with natural behaviors. Elevated risks have led to a dependence on low-dose antimicrobials to compensate for these suboptimal husbandry practices made worse by large numbers of animals producing large quantities of untreated wastes that often trigger respiratory distress in a microbially rich environment.

When it comes to the FDA’s draft guidance on antibiotic use in food animals, the fact that FDA leadership is willing to take a hard-line stance on such a politically charged issue is commendable. I understand the argument that change takes time and that the agency must be methodical in its approach, especially when the powerful food animal and pharmaceutical industries will do everything they can to thwart it. However, timing is everything. If the FDA believes it cannot take a stronger stance now, then Congress must move on PAMTA. As Congress faces another potential shift in control, if PAMTA fails passage this year, I fear it could be another decade before we see an end to the irresponsible use of antibiotics in animal agriculture, and by then it might be too little too late.
Wednesday, July 7, 2010

The list of Meatless Monday supporters continues to grow across the globe, and surprisingly to some, many of the latest enthusiasts make their living either cooking meat, such as chef Mario Batali or producing it, like rancher Nicolette Hahn Niman. What makes Meatless Monday so successful is its simple and inclusive message which promotes moderation with the goal of improving public health and the health of the planet.

Nicolette and her husband Bill run the BN Ranch in Northern California near the seaside raising heritage turkeys and beef cattle on pasture. Bill knows a thing or two about ranching. He founded the famous Niman Ranch Inc. known for its sustainable and humanely raised meats. Nicolette is a Renaissance woman of sorts—new mom, writer, environmental lawyer, and interestingly, a vegetarian.

I recently was able to catch Nicolette for a few minutes by phone to ask her why she and Bill support Meatless Monday. She made it clear that she didn’t have much time; she was in the midst of a writing project, running the ranch (Bill was traveling) and taking care of her 14-month-old son who I could hear in the background chatting and occasionally clinking the keys of their piano. Knowing that time was short; I got straight to the point:

RL: A lot of people mistakenly believe that the Meatless Monday campaign is promoting the demise of all meat production, while it has always maintained that its message is simply one of moderation and inclusion of omnivores and vegetarians alike. As a rancher yourself, what would you say to any farmer who is threatened by the MM campaign?

NHN: Bill and I are very supportive of the Meatless Monday campaign and here’s why: We think that to really improve the way food is being produced and the way people are eating in this country people should eat less meat but eat better meat. All food from animals—meat, dairy, fish, eggs—should be treated as something special. Anyone who is raising food animals in the traditional healthy way, without relying on industrial methods, drugs and chemicals, is someone who will benefit from people embracing that approach. We think the Meatless Monday campaign is part of a shift in attitudes about meat, towards something that is precious not something that is consumed without thought or in enormous quantities.

RL: You just wrote an interesting piece in the Atlantic entitled “Can Meat Eaters Also Be Environmentalists?” Well, can they?

NHN: Yes, definitely. The idea that it is a contradiction to be a meat eater and an environmentalist is just a misunderstanding of the most ecologically sound food production systems, which, in my view, definitely involve animals. There has been a lot of media attention to the idea that meat [production] is environmentally damaging. That’s because of bad practices that are rampant and widespread, such as total confinement systems with liquefied manure, use of hormones, feeding of antibiotics. The evidence is now irrefutable that these practices endanger the environment and public health. I’ve spent most of the last 10 years highlighting those problems to the public. But that is totally different than saying that raising farm animals is inherently environmentally damaging, which just isn’t true. I’ve been doing a lot of research into the role that animals play in rebuilding soils, and how grazing pastures are far better than any other agricultural land use in terms of erosion and in carbon sequestration. One thing I’ve become convinced of is that the best farming mimics nature, and natural ecosystems are all built on the relationships of sunshine, water, plants, and animals. So, I would say that actually the most environmentally sound diet includes some meat, dairy, and eggs.

RL: Is it important to point out that the majority of the meat products people eat in America are produced on industrial farms? Would you agree with that?

NHN: Much of the meat—most, actually—that is being produced and consumed in the United States today is being produced in environmentally damaging ways. I do not endorse any of those systems. In fact, I explicitly and strongly oppose them. That’s totally different than the fundamental question of whether or not meat is environmentally damaging per se and people are confusing those issues all over the place.

RL: Back in November you posted a must-read eater’s guide on how to avoid industrially produced foods in the Huffington Post. Could you give us a few quick pointers or the most important things you would tell people?

NHN: Yes. It was a long article, and hard to summarize in just a few words. But I’d say the most important thing is to try to just get closer to the source of your food, try to learn how and where your food was produced. The easiest ways to do that are to try to buy directly from farmers through farmers’ markets, community supported agriculture programs [CSAs], farm stands, and any place where you can get food directly from a farmer. Even in those places, I still encourage people to talk with the farmer about how the food is being produced, not to assume that it’s being raised in the way that you want it to be. Recently I’ve been saying, “I try to get all my food from a place I’d enjoy visiting.” That kind of sums up my approach. I also think that growing some of your own food is a great way to get out of the industrial system. So, people can have a vegetable garden, even if they just have a terrace or a fire escape where they can have a flowerpot with some tomatoes and some herbs. You know, just starting to do a little bit. And if you have a yard why not have a garden, maybe have a flock of egg-laying hens? I think it makes a big difference to just start taking baby-steps away from the industrial food system. Anything to get involved with how your food is produced. Eating is something that most of us tend to do without much thought. The more you start paying attention to it you realize it’s something worth investing time in. Building delicious, healthy meals ends up being something that is incredibly rewarding and not a chore.

RL: What is your advice to people who would rather not eat industrially produced foods but are limited either by higher costs or easy access?

NHN: Well, that is challenging because the whole industrial model has been successful at creating food that is cheap in terms of its cost at the grocery checkout. But our food is also cheap in the other sense of the word, in that it’s lacking in quality; these days it’s less nutritious, less safe, and less healthful than ever before. Generally one does pay more for food that is raised on traditional and/or organic farms. Here again, raising some of your own food to the extent possible is one way to eat good food affordably. Also, doing more of your own cooking and baking as opposed to buying prepared foods helps make good food affordable, because whole ingredients tend to be cheaper than prepared foods. And then some tricks for [saving money on] vegetables and fruits especially [includes] eating things when they are in season. In the season of abundance the cost tends to go down. You especially notice that when you are buying directly from farmers, because in the season of plenty they usually have more than they can handle and the prices are lower. When you are talking about things like meat, learning how to use some of the less popular cuts, cuts that are no less flavorful or nutritious, is a great way to save some money. My husband, Bill, who really knows meat, always talks about that. He says that some of the tastiest and most nutritious cuts of meat are some of the most underappreciated. They are often a lot cheaper.

RL: You’ve gained quite of bit of praise for your book, “Righteous Porkchop, Finding A Life And Good Food Beyond Factory Farms.” Michael Pollan is quoted as saying your book is, “A searing, and utterly convincing, indictment of modern meat production. But the book brims with hope, too, and charts a practical (and even beautiful) path out of the jungle.” You couldn’t have paid for a better endorsement. Instead of focusing on the indictment part, could you tell me more about the hope that he mentioned?

NHN: Yes, I like focusing on the hope, too. A lot of my book is about farmers that are doing things the right way from the standpoint of the environment, animal welfare, and human health. I firmly believe that it’s a myth that this country cannot feed itself with traditional, non-industrialized farming. A lot of my book is dedicated to disproving that myth and proving that traditional, sustainable farms are economically viable. And I just tell the stories and describe what a lot of those farmers are doing, as well as presenting the economic data to show that it’s an economically viable system. But I think it is really important to keep in mind that our country is heavily subsidizing with public dollars the current form of industrial agriculture. If we really want a sustainable healthful food system we need to take the dollars that we are putting into agriculture and shift it towards good methods. I support the use of public funds for agriculture, but I don’t understand why we’re not putting it towards a food system that is environmentally benign and producing healthy food.

Tuesday, June 8, 2010

Knowing that the obesity epidemic in the United States has some scientists predicting that for the first time in history American children will live shorter lives than their parents, my wish for the next decade is to see First Lady Michelle Obama, President Barack Obama and his administration succeed in their mission to ensure that every American child has access to healthy and affordable food. A recent gathering of Obama Administration officials invited to discuss their efforts to improve America’s food system left me hopeful that my wish will come true.

Last month in D.C. Kathleen Merrigan, Deputy Secretary of Agriculture, Dora Hughes, Counselor to the Secretary of Health, and Sam Kass, White House assistant chef and Food Initiative Coordinator for the First Lady each shared their goals for the next year during an event for the W.K. Kellogg Foundation’s Food and Community Program. Surprisingly it wasn’t their words that left me so inspired; rather it was the words of 10-year-old David Martinez-Ruiz. Kass shared with the audience a letter that the D.C. elementary school student had presented to the First Lady following his class visit to the White House Garden.

One of the things that I want to say about being at the White House was how gentle the feeling was. It felt surprisingly natural to be there. We planted on a warm day. The sun was out and there was a little breeze. The grass was beautiful and green. The people made us feel good. I liked the way the staff person who helped me was very gentle with the worms we found. I think about the garden as being gentle: gentle with nature, gentle to your body, and gentle with each other.

There was not a dry eye in the house after Kass finished reading that letter. David’s sentiments regarding the White House Garden were shared by many of his Bancroft Elementary School classmates. Kass says it is experiences with kids like David that continue to spur the First Lady to champion new and creative ways to help children regain a healthy connection to food and physical activity. By doing so, Mrs. Obama hopes she can help her husband’s administration lead the way in the fight to end the childhood obesity epidemic in America.

The obesity rate in the U.S. has doubled since 1980. According to Secretary of Health Kathleen Sebelious, “over two thirds of American adults — and almost one out of every five American children — are obese or overweight.” Shockingly the CDC found that the number of adolescents who are overweight has actually tripled in the last 30 years. Being overweight increases a child’s risk of developing a laundry list of preventable diseases including: heart disease, asthma, and type 2 diabetes. In fact, one in three kids born in 2000 are at risk of developing diabetes in their lifetime — for children of color that rate is even greater.

So what’s going on? Why are our children so heavy? Ostensibly, the answer seems to be simple — kids are consuming too many calories and not moving enough. However, obesity experts Drs. David Kessler and Kelly Brownell argue that the root cause is much more complicated. Both point to underlying forces that have powerful influence over what our kids are eating and craving — namely the abundance of easily accessible and inexpensive processed foods.

Dr. Kessler, a pediatrician, former FDA Commissioner and author of, “The End of Overeating,” claims that the way food companies process, package and market foods plays a key role in the obesity epidemic. Many of these processed foods contain significantly higher levels of fat, sugar and salt, and when consumed it is believed that they trigger primal cravings to eat more. Dr. Kessler calls it, “conditioned hypereating.” Dr. Kessler says research has found in both animals and humans that, “eating foods high in sugar, fat and salt makes us eat more foods high in sugar, fat and salt.”

Processed foods have become ubiquitous in the American diet and make their way into almost every meal. Dr. Brownell director of the Rudd Center for Food Policy and Obesity at Yale University, argues that these “nutrient-poor, calorie-dense foods cost less and are more accessible than more healthful choices.” Nothing exemplifies this more than the number of low-cost high-volume fast-food restaurants located on the Main Streets of every town in America. Dr. Brownell also warns that marketing practices targeted at kids and adults alike encourage overconsumption of calories. There are plenty of other theories as to why processed foods lead to overeating. For instance, some claim synthetically produced sugars like high fructose corn syrup fail to trigger satiation hormones that tell your brain to stop eating.

Mrs. Obama admits that she didn’t pay too much attention to how food can affect her health until she became a mother. While speaking to David’s class during a White House Garden harvest party she shared what she learned about the benefits of eating healthier foods:

… with the help of our kids’ doctor, I became much more aware of the need for my kids to eat healthy… I’ve learned that if it’s fresh and grown locally, it’s probably going to taste better… And that’s how I’ve been able to get my children to try different things, and in particular fruits and vegetables. By making this small change in our family’s diet and adding more fresh produce for my family, Barack, the girls, me, we all started to notice over a very short period of time that we felt much better and we had more energy.

Now with the help of several Administration agencies including the U.S. Departments of Agriculture, Education and Health the First Lady is leading an initiative to tackle America’s childhood obesity epidemic by making sure kids are eating healthier and moving more. Dr. Hughes, who is a physician board-certified in internal medicine and earned a Master of Public Health degree at Harvard, said she believes the collaborative efforts to fight childhood obesity will be a hallmark of the Obama Administration.

Ironically, as the waistlines of America’s children continue to expand, statistics show that food-insecure households have reached record numbers. The latest 2008 U.S. food insecurity survey found that 49 million people had difficulty meeting basic food needs. President Obama, who has pledged to end child hunger by 2015, said he was particularly troubled to learn, “that there were more than 500,000 families in which a child experienced hunger multiple times over the course of the year.” Kass claims that too often health and nutrition issues are considered to be unrelated to hunger issues. He argues that, “if we assure that all children have equal access to healthy and affordable foods, we will make great strides in tackling both issues.”

Since government numbers indicate that 60 percent of the nation’s public school students receive the majority of their nutrients at school, a keystone to Mrs. Obama’s healthy kids initiative is efforts to encourage improvements to the National School Lunch Program. Agriculture Secretary Tom Vilsack says that providing school children with fruits, vegetables and more nutritious food is a priority for the USDA. There are a few encouraging examples of school districts across the country that are making remarkable strides in school lunch reform without significant government assistance. From Baltimore, Maryland to Berkley, California school districts have adopted progressive programs to teach kids where their food comes from and to encourage them to eat healthy foods. Most recently Washington, D.C. Council members introduced a bill that would require public schools to establish a farm-to-school program and to “create a monetary incentive to serve foods that are locally-grown, locally-processed, and minimally-processed from growers engaged in sustainable practices.”

Helping to improve every American’s relationship with food will not be easy. A fact that Dr. Merrigan, who is leading the, Know Your Farmer, Know Your Food Initiative, understands all too well. The initiative’s goal is to build strong local and regional food systems, which includes creating opportunities for farmers to supply local schools with their harvests. Merrigan admitted that moving the initiative forward in a huge government bureaucracy “is really difficult” and confusing to navigate. She says equally difficult is determining how to establish priorities and deciding what to do first.

If Dr. Merrigan were to ask me for my advice, I would suggest a good place to start is opening a dialogue with America’s parents — the people who purchase and monitor the food kids eat every day. Each parent who walks into a supermarket has the right and should expect better access to healthy and affordable whole foods for their kids. Michael Pollan, journalist and author of “Omnivore’s Dilemma” and most recently “Food Rules” would argue that most of the foods we buy in the grocery store today are not food at all, but rather “edible food substances” designed by food scientists to mimic “real foods.” One of my favorite food rules that Pollan offers in his new book is, “Don’t eat anything your great-grandmother wouldn’t recognize as food.” As savvy American consumers, parents should be able to buy foods that they know are healthy for their children. Price conscious parents on a limited budget shouldn’t be forced to buy foods that are more likely to make their children sick simply because a healthier alternative costs more. Likewise, parents looking for convenient prepackaged or easy to prepare meals, which their kids often find more palatable, shouldn’t have to compromise their child’s health just because a healthier alternative is not available or too expensive.

Parents must also demand more of the schools that provide lunches for their children. Very few schools across the U.S. prepare their students’ meals with fresh ingredients anymore. Instead, they depend on prepackaged meals made up of those tasty but much less healthy processed foods that are chock-full of sugar, fat and salt like chicken nuggets or pizza. And now we’re learning that many of those processed foods may pose greater food safety issues. It was shameful to read in the USA Today that most fast-food chains impose more stringent food safety standards for their processed beef, “than those set by the Agricultural Marketing Service for beef supplied to the National School Lunch Program.”

Perhaps the biggest challenge of increasing demand for healthy foods is ensuring that every American child prefers to eat them and find them just as or even more satisfying than the processed foods that they eat. Sam Kass — speaking with his chef’s hat on — offers his own food rule on that topic. While creating satisfying and tasty meals is important, Kass says, “anybody who cooks for somebody else has the responsibility to safeguard the health and well-being of the people that they are feeding.” I would take it a step further and assert that any company that prepares, serves or advertises food for children is ethically bound to ensure that it is just as healthy as it is palatable. It is also incumbent upon the government to assure that food companies do the right thing for children’s health and make it easier for them to do so.

I believe that if America’s food supply shifts from one that is primarily made of processed foods engineered to encourage overeating to one composed of more balanced healthy and whole foods along with a change in the American appetite that enjoys smaller portions and finds whole foods just as satisfying and tasty, we will then begin to see an end to the childhood obesity epidemic and the chronic diseases associated with it. Dr. Kessler says, “Our greatest gift to future generations of young people would be to find a way to prevent the cue-urge-reward habit cycle from ever taking hold.”

It’s a tall order, but young people like David Martinez-Ruiz continue to give me hope. If his simple experiences with the White House Garden helped him recognize the “gentle” effects of freshly grown foods on his body and on the environment then it is possible to encourage every American child to better appreciate and demand healthy foods.

So what can we do to maintain a healthy weight until then? It’s not easy, but one way is to focus on changing our eating behaviors. Next Monday I’ll take a look at encouraging research out of Dr. Brownell’s Rudd Center for Food Policy and Obesity that found calorie labels at restaurants, “result in the consumption of significantly fewer calories.” And I’ll introduce you to a new Healthy Monday awareness campaign entitled Monday 2000, designed to remind people that the average person should keep their daily caloric intake to about 2,000 calories a day.

Tuesday, January 12, 2010

It is disappointing to see members of the media spread misinformation due to their own ignorance, gullibility, or, worse, disinterest in digging for the truth — especially when it has to do with the health of children. Case in point, a reporter from a South Dakota talk radio show apparently believes that Baltimore City Public Schools’ Meatless Monday meals are lacking in protein. Last Friday, Tom Riter asked U.S. Agriculture Secretary Tom Vilsack a rather leading question (notice how many times he said “bother”) during a USDA news conference to preview the Obama administration’s priorities for the Child Nutrition Act Reauthorization:

Mr. Secretary, I was wondering if it bothered you… that… you were talking about the importance of the nutrition for the school children… and I was wondering if it bothered you that school districts like Baltimore, Maryland institute Meatless Mondays… not letting the children have protein in the diet by doing that. Does that bother you?

Seriously? He thinks Baltimore City Schools are denying kids their recommended daily allowance of protein? I hate to break it to you Mr. Riter, but meat isn’t the only food that contains protein. The United States is among the very few wealthy nations in the world where people derive the majority of their dietary protein from animal sources. The global average is 30% of dietary protein from animal sources, including dairy and eggs, and 70% from grains, vegetables, and fruit.

If Mr. Riter had bothered to contact the Baltimore City Schools he would have found that each meat-free meal contains more than the amount of protein required by the USDA. My guess is that Mr. Riter jumped to his mistaken conclusion after reading misleading quotes from a meat lobby organization, or he really needs to brush up on his basic biochemistry.

Not being a biochemist myself, I wanted to confirm with an expert that eating a meat-free diet one day a week in no way denies a child of a well-balanced nutritious meal. So I emailed Dr. Marion Nestle, a nationally renowned food expert and professor of nutrition, food studies and public health at New York University. Dr. Nestle responded:

 Consider it confirmed.

But what about the claims that we need to eat animal proteins because they contain certain “necessary” amino acids that vegetable proteins don’t? Professor Nestle replied:

Prepare for a biochemistry lecture: all proteins are made of the same amino acids. ALL. No exceptions. The difference between animal and vegetable proteins is in the content of certain amino acids. If vegetable proteins are mixed, the differences get made up. Even if they are not mixed, all you have to do to get the right amount of the low amino acids is to eat more of that food. There is no ‘need’ for animal proteins at all.

However, Dr. Nestle did say:

Meat makes a huge difference in the diets of deprived kids in developing countries not only because of its protein, but also because its nutrients are sometimes more absorbable than those from vegetables. For American kids, who eat plenty of calories, it’s far less important.

By the way, if Mr. Riter had actually tried to find out what the kids were being served, he would have found animal proteins are still on the menu. Below is a sample of the meals Baltimore kids are eating on Mondays. You might notice that the meals contain dairy products.

Meatless Monday Menu 1

Veggie Lasagna or Grilled Cheese w/ Tomato

Mixed Vegetables, Steamed Broccoli, Pineapple Tidbits & Fresh Fruit

1%, Chocolate, Straw- berry, Non-fat milk

Meatless Monday Menu 2 

Pasta Primavera with mozzarella sticks or Grilled Cheese w/ Tomato

Romaine Salad, Garlic Bread, Steamed Broccoli & Fresh Fruit

1%, Chocolate, Straw- berry, Non-fat milk

Meatless Monday Menu 3

Veggie Quesadilla on a Whole Wheat Tortilla or Grilled Cheese w/ Tomato

Black beans and rice, Refried beans, Corn, & Fresh Fruit

1%, Chocolate, Straw- berry, Non-fat milk

Regarding Mr. Riter’s leading question, Secretary Vilsack didn’t bite. Instead he made it clear that all of our schools are feeding students foods that are packed with too much saturated fats and salt:

It’s fairly clear from the [recently released] Institute of Medicine study and other additional studies that we’ve got far too much sodium, far too much saturated fat in the diets of children, and far too many discretionary calories. The result is that youngsters are not getting the nutrition they need and we need to do a better job.

I’d be remiss if I didn’t point out that Feedstuffs, a popular agribusiness newspaper, recently took the time to get most of the story straight regarding the Meatless Monday program at Baltimore City Public Schools. Here’s an excerpt for an article published today:

Interestingly… Anthony Geraci, director of food and nutrition services for BCPS, doesn’t see Meatless Monday as having anything to do with denying kids meat. In his opinion, Meatless Monday is simply a marketing ploy he has adopted to expose kids to more plant-based proteins.

Feedstuffs’ Trent Loos, a rancher and radio show host, traveled to Baltimore and posted a video of his interview with Geraci. Geraci is a very persuasive person. He obviously won Loos over with his ambitious plan to change the way Baltimore students think about food.

ABC World News with Charles Gibson aired acomprehensive piece last week on Baltimore City Schools school lunch revolution as well. You might recognize the reporter, Dr. Richard Besser, former acting director of the Centers for Disease Control and Prevention.

Like Tony Geraci often says, we can’t lose sight of the fact that the campaign to improve the foods served in public schools isn’t about politics or corporate profits, it’s about the health and well-being of children.

Sometimes change happens in the most unexpected places. When I learned that Baltimore City Public Schools was on a mission to change the way its more than 80,000 students thought about food, I have to admit, I was surprised. The cash strapped school system has long faced difficult challenges and the last place I expected to see noticeable reform was with its food services department. To top that off, you could have bowled me over, when I heard that the City Schools’ new chef/dietitian, Mellissa Mahoney, convinced her boss, Tony Geraci, to let her develop her own Meatless Mondaylunch menus. To be honest, I doubt that Mahoney needed to do a lot of convincing. When it comes to dreaming up innovative and cost effective ways to feed kids healthy, tasty, whole foods, Geraci isn’t shy about pushing the envelope. It’s Geraci’s bold and sometimes brash entrepreneur spirit that has captured the attention of food policy experts across the country, including the White House.

Last week Geraci, hired a little over a year ago to reform Baltimore City Public Schools’ food services program, wasinvited to testify before a congressional sub-committee that is looking for innovative practices to improve child nutrition. Geraci touted what the Baltimore school system has already achieved:

We now provide fresh fruit with every lunch we serve. All over Baltimore, students are learning what an actual, locally grown peach tastes like instead of some synthesized peach flavoring. And as of this school year all of the peaches, lettuce, tomatoes, cucumbers—all of our fruits and vegetables—come from Maryland farms.

While many credit Geraci’s tenacious leadership abilities for what has been accomplished in Baltimore, Geraci will be the first to tell you that much of the groundwork was laid by a strong group of volunteers and innovative community organizers dedicated to changing the way people and children think about food in the Baltimore region. In 2006, a study by the Baltimore Efficiency and Economy Foundation highlighted reasons why school lunch reform in City Schools was sorely needed, and even listed Geraci as a potential consultant. Geraci says, however, that if it were not for a small group of students, whom he calls school lunch revolutionists, he would not be in Baltimore today. One of those young revolutionists, Alice Sheehan, was invited to share her story at the same congressional hearing with Geraci. Sheehan is currently an 8th grader in the Baltimore City Public Schools system, and she wasn’t shy about telling members of the House Committee on Education and Labor what spurred her and her fellow school lunch revolutionists to stand up and demand that school leaders “get rid of the overcooked, tasteless and just plain disgusting food.” She went on:

[more than 3 years ago] Our story started with the endless grumbling about lunches at school. Tired of the complaints and ready for action, our student council and others together took samples of our prepackaged lunch down to the Baltimore City School Board to demonstrate what it would be like to eat this every day. If that is what they feed us, we said, they should have to eat it too. The Board turned up its nose: no thanks! But the deed was done: we had started acting and not just complaining.

With the help of their Social Studies teacher, Peter French, Sheehan and a handful of her fellow classmates, who were studying the U.S. Constitution at the time, came up with a Cafeteria Bill of Rights.

The Cafeteria Bill of Rights include:

o The right to nutritious and delicious food for breakfast and lunch

o The right to fresh fruit and fresh vegetables each day

o The right to choose-more than one main selection each day

o The right to give feedback and have input on the quality and selections made and have our input be given serious consideration

Following an impressive grassroots campaign and a Baltimore Sun article critical of the food quality and taste disparities between City Schools and nearby better funded schools, the young school lunch reformers scheduled a meeting to talk with the newly hired Baltimore City Public Schools CEO Dr. Andrés Alonso. Sheehan described the meeting:

And we gave him our Cafeteria Bill of Rights, and told him of our expectations for a better and healthier school lunch system. He was sympathetic with our cause, and admitted how much he disliked the pre-packaged food at his own cafeteria. He said he would do something about it. And he did. The NEW director of food and nutrition, Mr. Geraci, has been working hard to improve our lunches ever since.

Last month White House Assistant Chef and Food Initiative Coordinator Sam Kass along with officials from the U.S. Departments of Education and Agriculture met up with Geraci, an accomplished chef himself, at the City Schools’ new Great Kids Farm. The 33-acre organic teaching farm – complete with a variety of vegetables and fruits, not to mention goats, chickens and bees – is Geraci’s pride and joy. Geraci says the farm serves as a powerful tool to teach children about food by reconnecting them to how it’s grown and raised and teaching them that food doesn’t come from the grocery store. He proudly told his guests that the farm is virtually self-sufficient thanks to: the hard work of its farm manager, Greg Strella, dozens of volunteers, donations from non-profits, revenue from its community supported agriculture shares and sales to local restaurants.

It may take longer than he hopes, but Geraci is trying to wean the school system from the pre-packaged meals that many of the schools serve and replace them before the end of this school year with cooked meals prepared right on school property. For the majority of the system’s schools, which no longer have kitchens, Geraci is already working on plans to convert an old warehouse into a central kitchen, from which fresh cooked meals can quickly be delivered. Currently the school system is serving kids regional fruits, veggies and dairy after brokering deals with local suppliers and acquiring a fleet of refrigerated trucks and milk coolers.

Mathew Yale, Deputy Chief of Staff for the Secretary of Education, told Geraci he’s most interested in learning about how the school system made so many changes without a significant increase in federal or state funding. Geraci says it takes a lot of hard work, ingenuity, and luck. Much of the equipment he’s received came through grants or donations. The trucks and milk coolers were a $1.3 million gift from the Mid-Atlantic Dairy Association. But Geraci says if the feds gave the school system more freedom to spend federal dollars to purchase produce, his office would be able to buy a great deal more local fruits and veggies. His favorite example of typical waste inherent in the system is comparing the cost of locally grown apples to apples trucked from states as far away as Washington, almost 3,000 miles from Baltimore. A case of Maryland apples costs the Baltimore City Public Schools about $6, while a case of government-approved apples costs them about $56. Geraci says, “it’s outrageous! Why would we spend almost ten times as much money for food that we can grow in our own backyard?” He says, “it not only saves the City Schools money, it puts cash back into the local economy.”

Incorporating Meatless Monday into this year’s lunch menu plans, Geraci says, was another innovative cost cutting measure. The move not only saves the district money but it serves as an educational tool as well. Meatless Monday gives the school system an opportunity to expose students to different cultures, Geraci says, through various meat-free recipes and meals from around the world. U.S. meat industry lobbyists quickly grumbled about Baltimore’s lack of meat options on Mondays, inferring that the meals may lack proper nutrition and claiming menu decisions should be left to the experts not administrators. If the lobbyists had bothered to talk to the person who came up with the idea, Mellissa Mahoney, they would have learned that she is a dietitian and that she ensured each meal surpassed all USDA required nutrition standards. Jokingly, Geraci testified in front of House Education and Labor committee members that he had “an unholy love of pork,” but he insisted that, “[Meatless Monday] is not about denying people meat. This is about beginning a conversation about alternatives… beginning a conversation about change.”

1. Guarantee funding for competitive, one-time grants that will help schools develop their own farm to cafeteria projects—menus, procurement, and educational and promotional materials that get local produce into schools.

2. Increase the reimbursement rate for all child nutrition programs in line with actual costs.

3. Apply the same high nutritional standards to all foods and beverages sold within schools, even those not covered by the United States Department of Agriculture’s school meals program.

4. Encourage purchasing of local fruits and vegetables through the Fresh Fruit and Vegetable Program.

5. Incorporate language changes in existing Child Nutrition Reauthorization feeding programs to promote increased local food purchasing.

6. Provide mandatory and consistent funding for the Team Nutrition Network to enable a consistent and coordinated nutrition education approach

The American Veterinary Medical Association’s recent “response” to the Pew Commission on Industrial Farm Animal Production’s final report on the state of industrial animal agriculture is disconcerting. It appears that leadership of the veterinary professional organization is attempting to misuse science to obfuscate and delay critically needed changes in the food animal production system rather than tackling very real public health and environmental threats head on.

For years a groundswell had been building from a widespread group of experts and advocates in the areas of public health, environment, social justice, and animal welfare sounding the alarms about the serious problems industrial food animal production poses. But until the Pew Commission on Industrial Farm Animal Production (PCIFAP) decided to take on the politically controversial issue, there had never been a comprehensive examination of industry’s practices by such a respected and diverse panel of experts. Following a grueling 2½ -year discovery process, and despite several overt attempts by industry to discredit it, the Commission concluded that the scientific evidence was too strong and the public health risk too great to ignore and offered a series of consensus recommendations on how to repair our unsafe food animal production system.

The tone and timing of the AVMA’s 38-page response to the PCIFAP final report, 15 months after it was released, is quite telling. The document’s executive summary starts out by suggesting that the PCIFAP’s technical reports (published separately) were “biased,” and that, “the Pew report contains significant flaws and major deviations from both science and reality.” Another telling facet is that the “response” contains very little scientific citation to backup its rebuttal. It’s not a coincidence that this response coincides with the recent revelation that the Obama Administration supports the idea of banning the use of key antibiotics as growth promoters in food animals, which happens to be one of the PCIFAP’s key recommendations. Not to mention, this year’s version of the Preservation of Antibiotics for Medical Treatment Act (PAMTA) appears to have a much better chance of passing than in any prior year.

The AVMA depends heavily on its relationships with the animal agriculture, pharmaceutical and other industries. The AVMA’s attack on the PCIFAP final report smacks of being more like an industry-choreographed campaign to defeat PAMTA than a conscientious review of a hugely important document.

Two prominent veterinarians trained in public health are dismayed over the AVMA’s PCIFAP final report response. One of those veterinarians is the PCIFAP’s vice chairman, Dr. Michael Blackwell. As the former dean of University of Tennessee’s College of Veterinary Medicine, a retired assistant U.S. surgeon general, and a former chief of staff of at the Office of the U.S. Surgeon General, Dr. Blackwell’s expertise in both veterinary medicine and public health is undeniable. Dr.Blackwell says he’s, “shocked over the fact that the AVMA did not try to learn the truth about the Commission’s work, even from one of its own members,” and “instead chose to write a response from the perspective of the industry.”

Dr. Christine Hoang, assistant director for the AVMA’s scientific activities, confirmed that the writing group, selected by AVMA leadership, never reached out to Dr. Blackwell or even attempted to poll other members of the PCIFAP to clear up any questions they may have had with the final report recommendations. Dr. Blackwell pressed the AVMA to allow him to discuss the Commission and its report. However, he says the writing group only allowed him 20 minutes via phone to speak to six committees. Dr. Blackwell concluded that the AVMA was not interested in what he had to say. When asked why the AVMA writing group did not reach out to PCIFAP members, the AVMA’s CEO, Dr. Ron DeHaven, said that the writers felt discussions would not be productive, because they had reviewed the same data and came up with different conclusions. Dr. DeHaven added that a few of the AVMA writing group members, who had been contacted by the PCIFAP during its discovery process, felt that the PCIFAP final recommendations did not reflect information that they had provided the PCIFAP commissioners and believed that further discussion with PCIFAP members was not warranted.

In a letter to his Texas congressional representatives, another AVMA member, Dr. Raymond Tarpley, shared his disappointment with the organization’s stance on PAMTA:

I am dismayed that my professional organization (the AVMA of which I am a member) has chosen to pursue a reckless policy that favors the misuse of critical antibiotic compounds for reasons other than medical necessity. Microbial resistance to loose and repeated antibiotic exposure for non-therapeutic reasons has been proven, and while the AVMA has apparently buckled to pressures from industrial animal agriculture, it is without doubt an unwise investment in the health of our animals and human population to continue to use these valuable compounds to promote industry profits at the expense of societal risk

In a letter to the White House earlier this month, Big Food representatives tried to defend the use of antibiotics in food animals as growth promoters, using similar arguments that the AVMA laid out in its PCIFAP final report response. Industry continues to point to European data, collected by countries that banned the use of antibiotics for growth promotion in food animals several years ago, to bolster its claim that a ban in the U.S. would backfire and increase the number of sick animals. In its PCIFAP final report response, the AVMA claimed animal deaths and disease in Denmark rose following its ban, “requiring more therapeutic antibiotic use to treat the resultant diseases.

Dr. Tarpley dismisses the AVMA’s interpretation of the Danish data:

Contrary to statements by the AVMA, the ban on antibiotics in Denmark has been shown to have positive benefits for human and animal welfare, while not harming the industry. Their interpretation of the Danish data reflects the bias of the AVMA in the spin of data favorable to industry.

Setting the Record Straight

It’s not just Dr. Tarpley who dismisses the AVMA’s findings on antibiotic bans. Last month, two Danish researchers from the National Food Institute at the Technical University of Denmark, Drs. Frank Møller Aarestrup and Henrik Wegener, submitted written testimony for a U.S. House Committees Rules hearing on PAMTA to, “set the record straight.”

As you may be aware, representatives of organizations funded by U.S. agri-business have criticized and mis-represented the facts on the Danish ban of antibiotics since its inception.

They explained that over the long-term, the ban on antibiotics for growth promotion in Danish pigs not only reduced antibiotic use by more than 50 percent but overall pork production has increased by 43 percent.

Despite its recognition that veterinarians should increase their coordination among physicians and public health professionals, the AVMA’s stance on public health prevention appears to be out of sync with the rest of the world. In video and audio recordings posted on the AVMA’s website, Dr. DeHaven kept using the the term “theoretical risk.”

…the Pew Commission recommends the elimination of the use of certain antibiotics in animals based on a purely theoretical risk to human health.

Recent statements from Dr. Frederick Angulo, a veterinarian himself and the Center for Disease Control and Prevention’s Deputy Chief of the Enteric Diseases Epidemiology Branch, appear to contradict Dr. DeHaven’s claim.

There is scientific consensus that antibiotic use in food animals contributes to resistance in humans. And there’s increasing evidence that such resistance results in adverse human health consequences at the population level.

There is overwhelming evidence documented not only in the PCIFAP’s technical report, Industrial Farm Animal Production, Antimicrobial Resistance and Human Health, which was conducted by experts at the Johns Hopkins Bloomberg School of Public Health, but in other peer-reviewed research conducted all over the world, that proves the use of antibiotics in food animals contributes to the growing pool of antibiotic resistance in nature. It is undeniable that low-dose use of antibiotics, (i.e., using it as a growth promoter in animals) leads to the selection of bacteria with resistance to many of the antibiotics doctors depend on to treat people for serious infections.

Dr. Blackwell didn’t hold back his disappointment in a letter that he recently sent to Dr. DeHaven regarding the AVMA’s refusal to recognize that animal agriculture is a major contributor to antibiotic resistance.

To my knowledge, the AVMA remains the only major medical or public health organization not recommending changes in agriculture practices to help ensure sustainability where the use of antimicrobials is concerned. As a public health veterinarian I find this disconcerting and embarrassing.

Public Health vs. Cost Effectiveness

So why is the AVMA clinging to this term “theoretical risk?” Here lies one of public health’s biggest conundrums. The goal of public health professionals is to take all reasonable efforts to protect people from preventable diseases. Often times reasonable can be defined as cost effective. The big question, especially now as the health care reform debate rages on across the country, is whether preventative health care measures are cost effective? If you’re only focusing on quarterly returns and immediately measurable public health benefits, the answer most likely is no. This is especially true in the eyes of Big Ag, because it’s going to cost money upfront to retrofit all of those industrial farms that are dependent on antibiotics to make up for the unhealthy conditions in which the animals we eat are produced. Not to mention, you can’t measure in a short period time how much money was saved due to public health disease prevention measures.

How do you measure the cost savings or return on investment in cases where an antibiotics ban prevented people from getting sick and going to the doctor or the hospital? We know a great deal about the costs of drug resistant infections in the United States in terms of health care costs, increased morbidity, and increased risk of death. Over longer periods of time we can measure whether doctor visits or reported illnesses are decreasing among certain populations or regions touched by industrial animal agriculture. Dr. Ellen Silbergeld, a nationally renowned expert in antimicrobial resistance and its relations to agriculture, and the lead author of the PCIFAP’s antimicrobial resistance technical report, says there is no question that removing antibiotics and other antimicrobials from animal feed will save money through reduced human medical costs. Dr. Silbergeld says based on multinational studies (ex. Austrian study) in Europe following the ban on antimicrobials in animal feeds, “there is clear evidence that this ban was associated with reduced prevalence of drug resistant pathogens in people in hospitals in the E.U.”

It doesn’t surprise me that researchers in Denmark found that Danish farmers initially saw increases in animal disease when the antibiotic ban went into effect. However, after farmers improved ventilation systems and gave the animals more space, within a relatively short period of time they found production actually increased while at the same time they greatly reduced the need for antibiotics.

When it comes to cost savings, particularly when you’re looking at environmental health cost savings, the PCIFAP argues that you have to take into account the externalized costs of industrial animal production. Right now Big Ag is very happy to let the public pick up the tab. Those externalized costs, among a host of other things, include increased environmental health risks from the introduction of antibiotic resistant bacteria like MRSA or novel viruses like the current H1N1 swine flu, particulate matter known to exacerbate asthma, the emissions of countless toxic gasses from enclosed barns and environmental pollution from excess nutrients (animal feces & urine) contributing to the dead zones in the Gulf of Mexico and choking the Chesapeake Bay. Don’t forget about the contamination concerns of nitrates and other pollutants in well water from all that liquid animal waste sprayed onto or pumped into the ground that is not agronomically absorbed.

The PCIFAP’s technical report entitled An Economic Analysis of the Social Costs of the Industrialized Production of Pork in the United States can be applicable in almost any public health prevention cost analysis. This particular analysis determined that when you consider several “external” costs of industrial hog production and subsidies, using the alternative and more sustainable hoop barn system costs about 25 percent less than the use of conventional concentrated animal feeding operations (CAFOs). (Ironically, without including externalities, CAFOs only have a 26-cents per hundredweight advantage over hoop barns.) Using the same equation that researchers devised for the PCIFAP economics report and inputting the externalized costs, we could get a glimpse at the potential cost effectiveness of an antibiotics ban for growth promotion in industrial food animal production in the U.S. The tough part is agreeing on what those externalized costs are and whether they can be attributed to animal agriculture — hence the reason for all of this industry obfuscation and attempts to misuse science to muddy the issues. The longer Big Ag can hold off on paying for upgrades and changes to the system the longer it can continue to make money at the public’s expense.

It’s interesting to note that Dr. DeHaven himself played a role in the PCIFAP’s early discovery process. During a 2006 meeting in Washington, DC Dr. DeHaven took part in a discussion panel consisting of several members of the USDA invited to discuss their role in regulating animal agriculture. At the time, Dr. DeHaven was the head of the USDA’s Animal and Plant Health Inspections Service.

I sincerely hope that the 78,000 veterinarians, whom AVMA leadership say they represent, view the AVMA’s response to the PCIFAP final report with the same scrutiny as Drs. Blackwell and Tarpley. It’s a black eye on an incredibly important profession filled with some of the most brilliant people I know.

(Note: I served as the Communications Director for the Pew Commission on Industrial Farm Animal Production)