Organic versus conventional meat: is one better than the other?

Organic is no safer or better than conventional. This is the findings of a systematic review recently published by Stanford University looking at the topic of whether or not food raised organically is superior to food raised by conventional methods.(1) This publication is encouraging to see, as the authors examined hundreds of studies on the topic, not just on a few hand-picked studies. Meta analysis is a powerful objective method for analyzing a collection of conflicting evidence on a scientific topic.

Why is this organic question important? The organic market is seeing a massive increase in sales. According to the paper, the organic sales market went from $3.6 billion in 1997 to $26.7 billion in 2010.(2,3) The debate over organic food continues to heat up. The cost of organic food is usually 2 to three time more. But is it worth the extra cost?

The systematic review looked at two relevant points about how we might define “better”.

The first point is whether or not organic meat has less food-borne pathogens than conventionally raised meat. In analyzing the various studies, the authors did not find any significant difference in the amount of food-borne pathogens present. For example, in chicken 67% of organic samples were contaminated with Campylobacter versus 64% of conventional samples. Salmonella contamination was 35% for organic chicken versus 34% for conventional and E. coli contamination was 65% of organic samples versus 49% of conventional samples.(4)

The second point is whether or not there is antibiotic resistance bacteria present in organic meat, and if the amount of antibiotic resistant bacteria is lower in organic meat. All types of meat, including organic, have the potential to have antibiotic resistant bacteria.(5) While the review reported that conventionally raised chicken and pork are 33% more likely to have antibiotic resistance than organic meat, the findings weren’t statistically significant.1 This means that there is simply not enough data to prove the difference is more than chance. Also, just because meat has antibiotic resistant bacteria, does not mean that harm will necessarily result. A long chain of events must happen for human health harm to occur. First, the antibiotic resistant pathogens need to survive each processing step as well as cooking. Then the consumer needs to ingest the resistant bacteria, and have illness as a result that required antibiotic treatment. The harm would only result if all of these things happened and the bacteria did not respond to the antibiotic therapy.(6)

Bottom line, today’s modern farmer is not going to wipe out the human race. WHEW!


References
1Smith-Spangler, et al. 2012. Are Organic Food Safer or Healthier Than Conventional Alternatives?
Ann Intern Med 157:348-366.

2Dimitri, C. Oberholtzer L. 2009. Marketing U.S. Organic Foods: Recent Trends from Farms to Consumers. U.S. Department of Agriculture Economic Research Service, Economic Information Bulletin no. EIB-58.

3Organic Trade Association. 2010. U.S. Organic Industry values at nearly $29 billion in 2010.

4Miranda JM, et al. 2008. Antimicrobial resistance in Escherichia coli strains isolated from organic and conventional pork meat: a comparative survey. European Food Research and Technology. 226:371-5.

5Adams, J.U. 2012. Drug-Resistant Bugs found in Antibiotic-Free Meat. http://www.wired.com/wiredscience/2012/01/organic-meat-superbugs/

6Hurd, H.S. et al. 2004. Public Health Consequences of Macrolide Use in Food Animals: A Deterministic Risk Assessment. Journal of Food Protection. 67(5):980-992.

Wash your hands, there are resistomes in that dirt!

A remarkable paper by Forsberg et al. was just published in Science¹.  Using sophisticated “high-throughput” (fast and automatic) gene analysis techniques the authors demonstrated that soil contains antibiotic resistant bacteria and that resistance signals (messages, resistomes) are transmitted to other bacteria including types that make humans sick (pathogens). 

Now, I am not going to pretend to understand all the technical details of this elegant paper. However, I can understand that some may take this paper’s findings as “alarming”.  “The soil is awash with resistance, and it is due to antibiotic use in animals,” they may say.

However, as with all science, one paper’s findings must be compared and viewed in the greater body of knowledge.²  Also, when considering causation, timing is key. If we are creating this resistance pool, then there should be a time when little or no resistance existed. However, a few recent and also elegant papers show that antibiotics, as well as antibiotic resistance, have been around for a long, long time, way before people were using antibiotics, and maybe even before people walked the earth.  For example, Bhullar et al. found antibiotic multiple resistance in soil in a cave untouched for 4,000,000 years by mammalian life.³ Also, a study from D’Costa et al. found antibiotic resistance in 30,000 year old permafrost.⁴ Furthermore, another study states that a class of antibiotics called β-lactamases (which includes antibiotics such as penicillin), have been around for over 2 billion years, and even after decades of being used clinically, bacteria are still susceptible.⁵

I guess that is one more reason Mom made us wash our hands. However, it will be hard to explain to kids as they come screeching inside for dinner, “Wash your hands! That soil contains AB95 resistomes, DUDE!”

¹Forsberg, K.J. et al. 2012. The Shared Antibiotic Resistance of Soil Bacteria and Human Pathogens. Science 337:1107-1111

²Crombie, I.K, Davies, H.T. 2009. What is meta-analysis? Evidence-Based Medicine, 2^nd edition. pp. 1-8.
http://www.medicine.ox.ac.uk/bandolier/painres/download/whatis/meta-an.pdf

³Bhullar, K. et al. 2012. Antibiotic Resistance is Prevalent in an Isolated Cave Microbiome. PLoS One 7(4): 1-11.

⁴D’Costa, V. et al. 2011. Antibiotic Resistance is ancient. Nature 477:457-461http://www.nature.com/nature/journal/v477/n7365/full/nature10388.html

⁵Wright, G.D. 2007. The antibiotic resistome: the nexus of chemical and genetic diversity. Nature Reviews Microbiology 5:175-186. http://www.nature.com/nrmicro/journal/v5/n3/full/nrmicro1614.html

Antibiotics and Fat Babies

A recent report on NPR asks, "Could Antibiotics be a Factor in Childhood Obesity?" Another article on ABC News states, “Antibiotics too soon may set babies up for Obesity: Study.” 

I have to say these are about the funniest articles about antibiotics that I have seen in awhile. They are just laden with political implications! 

What is funny?

1.      Fortunately, the articles are clear that the evidence linking childhood obesity and antibiotic use is not strong.¹ NPR states, "Further studies are needed to confirm this trend." Of course, these articles refer to antibiotic treatment of the child, not animals. However, someone has already has made a connection to antibiotic use in food animals.^3,4

2.      For years some folks have been saying that antibiotic use in livestock does not really improve growth⁵ . However, these reports suggest even babies grow better with antibiotics⁶.  Additionally, the NPR article did cede that antibiotics in livestock may improve growth.

3.      Besides, what is wrong with a “fat” baby?  The article admits that the children showed no long term obesity problems, but that will likely be overlooked by the media.  Besides, what is what is wrong with a chubby bunny baby?  All of my children, except for one, looked like the old “Michelin Man”. Now they are perfect specimens of the human species (North European version).

4.      Sadly, like so many others, this article makes obesity someone else’s fault. It is the doctor who gave the antibiotics. Certainly, a baby cannot be expected to control its food consumption, but the parents can. Consumption is the key. It is not the food or antibiotics fault.

¹Barnett, S. 2012. Antibiotics too soon may set babies up for Obesity: Study. http://abcnews.go.com/Health/antibiotics-set-babies-obesity-study-suggests/story?id=17045227#.UDe3w6DNl7k

²Doucleff, M. 2012. Could Antibiotics Be a Factor in Childhood Obesity? http://www.npr.org/blogs/health/2012/08/22/159743999/could-antibiotics-be-a-factor-in-childhood-obesity

³The Huffington Post UK. 2012. Farmers may be causing Obesity Epidemic by Feeding Livestock Antibiotics. http://www.huffingtonpost.co.uk/2012/08/22/farmers-obesity-livestock-antibiotics-_n_1821941.html?utm_hp_ref=uk

⁴Collins, N. 2012.  Livestock Antibiotics ‘Could Have Contributed to Human Obesity.’ The Telegraph.
http://www.telegraph.co.uk/health/healthnews/9493178/Livestock-antibiotics-could-have-contributed-to-human-obesity.html

⁵Graham, JP et al. 2007. Growth Promoting Antibiotics in Food Animal Production: An Economic Analysis. Public Health Reports 122(1):79-87.

⁶Trasande, L et al. 2012. Infant Antibiotic Exposures and early life body mass. International
Journal of Obesity. http://www.nature.com/ijo/journal/vaop/ncurrent/full/ijo2012132a.html

           

 

New Campaign, “Meat without Drugs” could be inhumane!

As a public health veterinarian, I am concerned that a campaign such as “Meat without Drugs” could result in “Animals without Health”. A new report from Consumer Reports¹ provides some public opinion data that are not surprising. Given the constant drumbeat about the “overuse” of antibiotics in livestock production, consumers are frightened and convinced that there is a problem. One problem is that opinion polls and secret shopper surveys of labels are not scientific risk assessments. All peer-reviewed scientific risk assessments have demonstrated a negligible risk of human health harm due to livestock antibiotic use.^2,3,4

I think the bigger problem is that a campaign such as “Meat without Drugs” could mean that veterinarians have no way to treat sick animals or prevent epidemic diseases.  It is not possible to raise children without antibiotics. How do people expect us to raise these baby chicks, piglets and calves into wholesome meat, dairy and egg products without the assistance of modern medicine?  Actually, most of the antibiotics used on the farm are not the modern cutting edge products used by your local pediatrician.

Do the consumers and Consumer Reports know what happens to sick animals on organic farms, which produce animals without antibiotics? The veterinarian does not just give them some chamomile tea and send them to bed!  No, often they go untreated, hoping to get better. If that does not work then they may be treated (reluctantly) and then moved into a non-antibiotic-free group, maybe in the same barn. If they do shed some antibiotic resistant organisms, they are easily shared with their organic neighbors.  But the worst part is they may go UNTREATED. Once an ill animal is noted by the farmer, it has likely been sick for a while. There is little time left to treat before it dies. This waiting or denial of treatment is inhumane!

Data show that only about 13%⁵ of the total food-animal antibiotics used are for “growth promotion”. Very soon that amount will be zero, thanks to new guidance from the FDA⁶ . The remaining amounts are to prevent and treat painful deadly animal diseases. Does the consumer really want us to lose those tools that prevent animal suffering and improve food safety?

Some people say that raising animals in “crowded” conditions is the reason for needed antibiotic use. But pigs and kids can still get sick in any environment. Confinement housing is a means to provide protection from environmental extremes, predators, wildlife diseases, and stress; therefore reducing disease. Animal density is carefully monitored to provide optimal health.

Besides animal suffering, the impact of animal health on food safety and public health cannot be ignored. Healthy animals make safe food, and conversely  marginally healthy animals increase the risk of contamination from pathogens such as Campylobacter and Salmonella⁷ Additionally, a new report in Clinical Infectious Diseases showed an increased risk of Toxoplasmosis from organic livestock.⁸  Do you think Trader Joe’s or Whole Foods really want to sell more of these pathogens?

In summary, I think the choice of organically raised food products with clear labels is critical, and I am confident the USDA has and will continue to support accurate labeling. However, a problem in labeling should not put food safety, livestock health, and animal welfare at risk.

¹Consumer Reports. 2012. Meat on Drugs: The overuse of antibiotics in food animals and what supermarkets and consumers can do to stop it. Available online at: www.MeatWithoutDrugs.org
²Hurd, H.S. et al. 2004. Public Health Consequences of Marcolide Use in Food Animals: A Deterministic Risk Assessment. Journal of  Food Protection 67(5):980-992.
³Cox, L.A., Popken D.A. 2006. Quantifying potential human health impacts of animal antibiotic use: enrofloxacin and macrolides in chickens. Risk Analysis 26(1):135-146
⁴Anderson, S.A. et al. 2001. Assessment of the impact on human health of resistant Campylobacter jejuni from flouroquinolone use in beef cattle. Food Control 12(1):13-25.
⁵Animal Health Institute. 2012. Fact or Fiction: Common Antibiotic Myths. Available online at: http://www.ahi.org/issues-advocacy/animal-antibiotics/fact-or-fiction-common-antibiotic-myths/#2
⁶The Food and Drug Administration. 2012. Guidance for Industry #209: The Judicious Use of Medically Important Antimicrobial Drugs in Food Producing Animals. Available online at: http://www.fda.gov/downloads/AnimalVeterinary/GuidanceComplianceEnforcement/GuidanceforIndustry/UCM216936.pdf
⁷Coucil  for Agricultural Science and Technology. 2012. The Direct Relationship between Animal Health and Food Safety Outcomes. Available online at: http://www.cast-science.org/publications/?the_direct_relationship_between_animal_health_and_food_safety_outcomes&show=product&productID=155971
⁸Jones, J.L, Dubey, J.P. 2012. Foodborne Toxoplasmosis. Clinical Infectious Diseases. Epub ahead of print. 

Antibiotic use: Just how much is too much?

I recently read an article in Redbook¹ about the risk of antibiotic use in humans and animals; Not that I normally read Redbook. I never realized Redbook was such a political magazine. The article was aptly titled “Antibiotics are not candy.” It makes many good points about how human misuse may be contributing to the problem with antibiotic resistance in humans.  It also raises the valid concern about antibiotic usage in farm animals which may also be affecting antibiotic efficacy in humans. However, I need to point out a few potential untruths in the article.

1.  As terrible as Brody’s MRSA infection was, it was not from an animal type of MRSA. The type routinely cultured from pigs and poultry (ST398) rarely affects humans. The CDC has stated MRSA should not be considered as a foodborne illness.
2.  Other human disease examples noted in this article are not related to livestock, such as gonorrhea and carbapenem-resistant Enterobacteriaceae. (CRE). The association between chicken and urinary tract infections is scientifically very unproven.
3.  Another common resistant human infection, Vancomycin-resistant Enterococci (VRE), cannot not be blamed on vancomycin use in livestock.  Europe has the same rate of VRE as the US and we have never used, in animals, the vacomycin relative called avoparcin.
4.  The ideas shown in the compelling figure on page 151 have been evaluated in the multiple scientific peer reviewed papers and many confidential FDA required risk assessments. All that work has shown a negligible chance that the events would occur with frequency to harm the public health.

In regard to the article’s five (highly political) steps to fight super bugs, I would say:

1.  Use antibiotics correctly: Amen. The American Veterinary Medical Association and other practitioner groups have long promoted the prudent and judicious use of antibiotics.
2.  Buy meat labeled “raised without antibiotics” or “organic.”: If animals are raised without antibiotics, I wonder, “What happened to the ones got sick? Were they denied treatment so that farmer could get the premium price paid for antibiotic free?”
3.  Ask your favorite restaurants if they use meat raised without antibiotics: What does a veterinarian do for sick animals on a farm supplying Chipotle? Does this practice lead to animal welfare abuses?
4. Spread the message: Amen. We can all do better. I travel the world telling farmers and veterinarians to “put their antibiotic use house in order!”
5. Tell Congress to pass a law: NO.  As the article mentioned FDA has made a significant change in the way antibiotics will be used; spelling the end of growth promoting uses.  A law is too broad of a policy tool for this problem. It is like going after a mosquito with a bazooka.

I agree that resistant bacteria are an ongoing problem. But they have been for at least 4 million years.  Many types of resistant bugs were recently found in a cave in New Mexico, untouched by civilization.² (Also, resistant bacteria have been found in antibiotic-free meat, but that’s another topic for another blog.)³
 

¹Antibiotics are not candy. http://www.redbookmag.com/health-wellness/advice/how-antibiotics-cause-superbugs?click=main_sr

²Antibiotic Resistance Is Prevalent in an Isolated Cave Microbiome.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324550/pdf/pone.0034953.pdf

³ Drug Resistant Bugs found in Antibiotic-Free meat. http://www.wired.com/wiredscience/2012/01/organic-meat-superbugs/

Super Moms and Super Food

My hat goes off to the Pew organization for utilizing a special holiday, Mother’s Day, to push its unscientific agenda.¹  I must comment on super Moms as I am married to one!  My wife homeschools 8 children, runs two businesses, cares for 3 aged parents and puts up with me. Also, we raise two or three “natural” pigs a year.

What I can assure you is that Mom will use antibiotics when any of her babies need it!  People forget that farming is like running a maternity center and/or a nursery. Animals get sick just like kids. Therefore we need to be prudent in our antibiotic use. This is my message to veterinarians and mothers.

Preventive use of antibiotics can be prudent. After the second child in our house is diagnosed with “strep throat” the doctor will leave an open prescription for whoever in the house may need it, thus saving another doctor visit; reducing our health care costs.  The same is done on the farm. If the veterinarian can anticipate the disease outbreak, they may prescribe medicine for the entire group.  This prescription can reduce the total amount of product used on the farm and reduce the number of dead and suffering animals.

Of course, most Moms are also concerned about the safety of food for their “flock”.  I hope they understand that healthy animals are an important means to deliver safer meat.  In fact a report came out last week highlighting the inextricable link between animal health and meat safety.²

Some might argue if animals and my multiple kids, for that matter, were not raised in such high concentration, they would not need antibiotics. That is just not true.  I bet if you asked only Moms who had never used antibiotics to attend the “protest” it would have been a thin crowd.

¹http://www.saveantibiotics.org/moms/MothersDay.html
²Council of Agrictultural Science and Technology. 2012. The Direct Relationship between Animal Health and Food Safety Outcomes.
http://www.cast-science.org/download.cfm?PublicationID=155971&File=f0308f5988973b9a9f49461ae5d127335e74

Healthy Animals Make Confident Consumers

On May 7 I presented a commentary in Washington, D.C.  for the Council for Agricultural Science and Technology. The commentary, entitled "The Direct Relationship between Animal Health and Food Safety Outcomes," outlines how changes in production practices (for example, antimicrobial use) greatly impacts animal health, which in turn, has a significant impact on public health.


The paper is available for a free download at the link below.


http://www.cast-science.org/download.cfm?PublicationID=155971&File=f0308f5988973b9a9f49461ae5d127335e74