By this time everybody knows—or ought to—that the non-therapeutic use of antibiotics in farm animals is a threat to human health. 

Using antibiotics to promote animal growth or reduce feed requirements is a bad idea.  Widespread use of these drugs induces microbial resistance, making the antibiotics ineffective against human disease.

So you would think that public health agencies would be falling all over themselves trying to reduce antibiotic use in farm animals.  No such luck.  Proposals to restrict use of antibiotics for therapeutic purposes runs up against the interests of meat and poultry industries. 

The best the FDA can do falls far short of what is needed.  Witness its pussy footing on cephalosporin drugs.

On January 4, the FDA proposed a final rule on use of cephalosporin drugs in animal agriculture.

The rule bans some “extralabel” (i.e., unapproved) uses of cephalosporin antimicrobial drugs in some food animals—cattle, swine, chickens, and turkeys. 

As the FDA’s press release explains, it is banning use of cephalosporins:

• At unapproved dose levels, frequencies, durations, or routes of administration
• In forms that are not approved for use in cattle, swine, chickens, and turkeys because they are intended for humans or companion animals
• For disease prevention

These are all good things but should do much more. 

Cephalosporins are used in humans to treat pneumonia, skin and soft tissue infections, pelvic inflammatory disease, diabetic foot infections, and urinary tract infections.

If bacteria are resistant to cephalosporins, doctors have fewer options for treatment and these are less effective or more harmful.

 What is troubling is that the FDA proposed a more restrictive ban in 2008 but reversed the decision under pressure from industry veterinarians.

As Food Safety News reports, the new order, which is scheduled to go into effect in April, follows a couple of previous notices published last year. 

In November, the FDA turned down consumer petitions calling for a ban on the non-therapeutic use of a broader range of antibiotics in farm animals. 

In December, the FDA admitted that it had given up a plan first announced in 1977 to withdraw approval for penicillin and tetracyclines in animal feed.

Apparently, the FDA has decided to try to get drug companies and the meat and poultry industries to reduce the use of antibiotics voluntarily.

Good luck with that. 

Philip Brasher writes in the Des Moines Register that the new restrictions will hit hardest on the chicken industry, which uses the drugs for disease prevention. 

He says the FDA’s 2008  proposal would have blocked hog producers from treating illnesses that aren’t listed on the label.   He quotes the chief veterinarian for the National Pork Producers Council:

We are pleased that FDA balanced the need to protect animal health with their concerns about resistance.

This is not about animal health.  Nobody is trying to stop the use of antibiotics to treat animal disease.  At issue is their use as growth promoters or feed savers.

Congresswoman Louise Slaughter (Dem-NY) understandably views the FDA’s action as “tepid.”  She has introduced the  Preservation of Antibiotics for Medical Treatment Act to deal with the problem of non-therapeutic antibiotic use.  Of the FDA’s proposal, she said:

This is a modest first step by the FDA…but we’re really just looking at the tip of the iceberg. We don’t have time for the FDA to ploddingly take half-measures. We are staring at a massive public health threat in the rise of antibiotic-resistant superbugs. We need to start acting with the swiftness and decisiveness this problem deserves.

We do indeed.  Her bill deserves much support.   Public health should not be left up to the meat, poultry, and drug industries to decide.

Addition, January 12: I missed the New York Times editorial on this issue:

It’s time for the F.D.A. to consider the public’s health as carefully as it considers the interests of intensive agriculture and pharmaceutical companies.

The amazing New York City Health Department, almost unique in its interest in public health and willingness to do what it can to improve the health of New Yorkers, adds another campaign to its collection of hard hitters.  This one is on the need to reduce portion sizes.

The subway campaign posters in Spanish and English.  Here’s an example in Spanish.

I especially like this campaign because much of the work on increasing portion sizes in the food supply was launched by my former doctoral student, now Dr. Lisa Young.  See:

• Young LR, Nestle M, The contribution of expanding portion sizes to the US obesity epidemic. American Journal of Public Health, 2002. 92(2): p. 246-9.
• Young LR, Nestle M, Expanding portion sizes in the US marketplace: implications for nutrition counseling. Journal of the American Dietetic Association, 2003. 103(2): p. 231-4.

Larger portions do three things:

• They have more calories, obviously.
• They induce people to eat more calories
• They induce people to underestimate the number of calories they are eating

All of these induce people to eat more than they need or should.

The expansion of portion sizes alone is sufficient to explain rising rates of obesity.

The Health Department’s campaign makes sense.  Let’s hope it helps.

Update, January 10: The American Beverage Association doesn’t like the ads much, according to Crain’s:

Portion control is indeed an important piece of the solution to obesity,” said said Stefan Friedman, New York spokesman for the American Beverage Association, in a statement. “But instead of utilizing scare tactics, the beverage industry is offering real solutions like smaller portioned containers and calorie labels that show the number of calories in the full container, right up front, to help people chose products and sizes that are right for them and their families.

And if you think the New York City ads are tough and hard-hitting, try these “Strong4Life ads from the state of Georgia.  Shocking people out of complacency?  Or just shocking?

Update, January 25: The New York Times reports that the shocking photograph of an overweight man with a leg amputation was “photoshopped” from a stock photo.

This is unfortunate, as it opens the Health Department up to unnecessary criticism:

The American Beverage Association, which opposes the city’s efforts against sodas and fast food, called the advertisement overwrought. “This is another example of the ‘What can we get away with?’ approach that shapes these taxpayer-funded ad campaigns,” Chris Gindlesperger, the association’s director of communications, said in a statement.

While everyone is arguing about the effect of high and low protein diets on weight gain, US News has come out with another one of its rankings, this time on diets.

The committee of experts advising US News ranked diets basically on the basis of ease of use, taste, flexibility, and effectiveness. They advised against diets that are too restrictive, require or eliminate certain foods, or are otherwise difficult to follow.

They ranked Weight Watchers #1 as the best weight-loss diet:

Dieters can eat whatever they want as long as they don’t exceed their allotted daily points. No foods are forbidden, occasional treats are encouraged, and the plan emphasizes all-you-can-eat fresh fruits and veggies. Experts liked the optional weekly meetings, since support is crucial to compliance. They also applauded Weight Watchers for being realistic, flexible, and filling. It scored more than a full star above the average in this category and was crowned the easiest diet to follow.

Weight-loss diets must do two things: restrict calories, and provide balanced nutrient intake.  As we explain in Why Calories Count: From Science to Politics (publication date April 1), this boils down to “eat less” and “eat better.”

Diets have to allow you to eat foods you love (in moderation, of course).

Food is a great source of pleasure and many of us live to eat.  Not being able to eat the way we used to is one of the great tragedies of getting older.  Alas!

To the extent that any diet plan helps you eat less, eat better, and enjoy what you are eating, it ought to work.

I was intrigued by the new study from the Pennington Research Center concluding that weight gain depends on calories, not how much protein you eat.

The idea that the protein, fat, or carbohydrate content of your diet matters more to weight than how many calories you eat persists despite much evidence to the contrary.

This study did something impressive.  It measured what people ate, how much they ate, and how much energy they expended under tightly controlled conditions.

This is unusual.  Most studies of weight gain and loss depend on participants’ self reports.

Measuring is much more accurate, as I discuss in my forthcoming book with Malden Nesheim, Why Calories Count: From Science to Politics (out April 1).  If you want calorie balance studies to be accurate, you have to measure and control what goes in and out.  The Pennington is one of the few laboratories in the country that can do this.

Pennington researchers got 25 brave people to agree to be imprisoned in a metabolic ward for the 12 weeks of the study.  The volunteers had to eat nearly 1,000 extra calories a day over and above what they needed to maintain weight.  Their diets contained either 5%, 15%, or 25% of calories from protein.

All of the volunteers gained weight (no surprise), although the low-protein group gained the least.  Most of the weight ended up as body fat.  The medium- and high-protein groups also gained muscle mass.  The low-protein group lost muscle mass.

All of the differences in weight gain among individuals could be accounted for by energy expenditure, either as activity or heat (protein causes higher heat losses).

The Wall Street Journal (January 4) did a terrific summary of the results:

This tells you that low-protein diets cause losses in muscle mass (not a good idea), and that there isn’t much difference between diets containing 15% protein (the usual percentage) and higher levels.

The study also suggests that higher protein diets won’t help you lose weight—unless they also help you cut calories.  That calories matter most in weight gain and loss is consistent with other studies based on measurements, not estimations.

Of course the quality of the diet also matters: it’s easier to cut calories if you are eating plenty of vegetables, fruits, whole grains and a varied diet based largely on relatively unprocessed foods—and it’s harder to gain weight on such diets.

Reading the New York Times dining section this morning kicked up my annoyance at use of the term “protein” to refer to meat.  A story about what to do with holiday leftovers says “…repurposing top-quality proteins into dinner is easier than it seems.”

Another on Simon Doonan’s new book, Gay Men Don’t Get Fat, quotes him as pointing out that “straight food…tends to be leaden, full of protein, thick with fat.” Now you know.

But protein is a nutrient.  Foods are sources of nutrients.

Nutritionists like me consider protein a “macronutrient,” meaning that foods contain many grams of protein and also that protein is a source of calories (4 per gram as opposed to 9 for fat and 4 or so for carbohydrate).

Diets contain about 15% of calories from protein on average, an amount much greater than most people need—about twice the minimum required for maintenance and growth.

“Protein” is most definitely not a synonym for meat or even tofu (see table).  I’ve listed the plant sources of protein in Italics.

FOOD SOURCES OF PROTEIN IN U.S. DIETS

Source: J Am Diet Assoc. 2010 February ; 110(2): 291–295.

Grains, vegetables, and fruits are not the biggest sources, but they are important contributors.  Vegans, who consume no animal products at all, do not lack for protein.

And while proteins from meat resemble our own proteins more than do proteins from vegetables, their constituent amino acids are the same in all foods.  Varying food intake and eating enough food takes care of amino acid balance.

Hence, my peevishness at the use of “Protein” as a separate category in USDA’s MyPlate (see previous post).

Grains and dairy, each with its own sector, are important sources of protein in American diets.

Why protein?  USDA used to call the group “meat” even though it contained beans, poultry, and fish.  The meat industry ought to be happy about “protein.”  Meat producers have spent years trying to convince Americans to equate meat with protein.

A plea: let’s keep terms clear and talk about nutrients when we mean nutrients and foods when we mean foods.  Protein is not food.

NOTE: More about protein tomorrow when I discuss the new JAMA study on whether high-protein diets help you lose weight (spoiler alert: they don’t).

Sales of organic foods continue to increase at a faster pace than sales of conventional foods.  This alone makes people suspicious of the organic enterprise.

Another reason is confusion about what organic production methods are, exactly.  If you are part of the food movement, you probably want your foods to be organic, local, seasonal, and sustainable.  You might also want them produced by farm workers who have decent wages and living conditions.

Unfortunately, these things do not necessarily go together.

• Organic means crops grown without artificial pesticides, fertilizers, GMOs, irradiation, or sewage sludge, and animals raised without hormones or antibiotics.  Certified Organic methods follow specific rules established by USDA.
• Local means foods grown or raised within a given radius that can range from a few to hundreds of miles (you have to ask).
• Seasonal refers to food plants eaten when they are ripe (and not preserved or transported from where they were grown).
• Sustainable means—at least by some definitions—that the nutrients removed from the soil by growing plants are replenished without artificial inputs.

That these are different is illustrated by a recent article in the New York Times about industrial organic production in Mexico.  The story makes it clear that organics do not have to be local, seasonal, sustainable, or produced by well paid workers.

While the original organic ideal was to eat only local, seasonal produce, shoppers who buy their organics at supermarkets, from Whole Foods to Walmart, expect to find tomatoes in December and are very sensitive to price. Both factors stoke the demand for imports.

Few areas in the United States can farm organic produce in the winter without resorting to energy-guzzling hothouses. In addition, American labor costs are high. Day laborers who come to pick tomatoes in this part of Baja make about $10 a day, nearly twice the local minimum wage. Tomato pickers in Florida may earn $80 a day in high season.

The cost issues are critical.  Dairy farms in general, and organic dairy farms in particular, are entirely dependent on the cost of feed for their animals, and the cost of organic feed has become almost prohibitively expensive.  This has caused organic dairy producers to cut back on production or go out of business.  As another New York Times article explains,

The main reason for the shortage is that the cost of organic grain and hay to feed cows has gone up sharply while the price that farmers receive for their milk has not.

While the shortage may be frustrating for consumers, it reveals a bitter truth for organic dairy farmers, who say they simply need to be paid more for their milk.

Why is the price of feed rising?  Simple answer: because 40% of feed corn grown in the United States is being used to produce biofuels.

Why do farmers grow corn for biofuels?  Because the government gives them tax credits and other subsidies to do so.

But in a small step in the right direction, the ethanol tax credit program was allowed to expire last week,”ending an era in which the federal government provided more than $20 billion in subsidies for use of the product.”

One person quoted in the article connected the dots:

Production of ethanol, with its use of pesticides and fertilizer and heavy industrial machinery, causes soil erosion and air and water pollution. And it means that less land is available for growing food, so food prices go up.

Organics do not exist in isolation.  Their production is connected to every other aspect of the food system.

Wouldn’t it be nice to have a food system that promoted organic, local, seasonal, sustainable agriculture and paid farm workers a living wage?

Wouldn’t it be nice if the 2012 Farm Bill supported that kind of a food system if not instead of than at least along side of the one we have now?

I will be watching to see what Congress does with the Farm Bill.  Stay tuned.

My monthly Food Matters (first Sunday) column in the San Francisco Chronicle takes out a crystal ball…

Q: What’s on the food politics agenda for 2012? Can we expect anything good to happen?

A: By “good,” I assume you mean actions that make our food system safer and healthier for consumers, farmers, farm workers and the planet.

Ordinarily, I am optimistic about such things. This year? Not so much. The crystal ball is cloudy, but seems to suggest:

Political leaders will avoid or postpone taking action on food issues that threaten corporate interests. Sometimes Congress acts in favor of public health, but 2012 is an election year. Expect calls for corporate freedom to take precedence over those for responsible regulations. Maybe next year.

Something will happen on the farm bill, but what? Last fall’s secret draft bill included at least some support for producing and marketing fruits and vegetables, and only minimal cuts to SNAP (food stamps). Once that process failed, Congress must now adopt that draft, start over from scratch or postpone the whole mess until after the election.

SNAP participation will increase, but so will pressure to cut benefits. With the economy depressed, wages low and unemployment high, demands on SNAP keep rising. In 2011, SNAP benefits cost $72 billion, by far the largest farm bill expenditure and a tempting target for budget cutters. While some advocates will be struggling to keep the program’s benefits intact, others will try to transform SNAP so it promotes purchases of more healthful foods. Both groups should expect strong opposition.

Childhood obesity will be the flash point for fights about limits on food marketing. The Lancet recently summarized the state of the science on successful obesity interventions: taxes on unhealthy foods and beverages, restrictions on marketing such items, traffic-light front-of-package food labels, and programs to discourage consumption of sugar-sweetened drinks and television viewing. Expect the food industry to continue to get Congress to block such measures, as it did with U.S. Department of Agriculture school nutrition standards (hence: pizza counts as a vegetable).

The Federal Trade Commission will postpone release of nutrition standards for marketing to children. Although Congress asked for such standards in the first place – and the standards are entirely voluntary – it just inserted a section in the appropriations bill requiring a cost-benefit analysis before the FTC can release them. Why does the food industry care about voluntary restrictions? Because they might work (see previous prediction).

The Food and Drug Administration will delay issuing front-of-package labeling guidelines as long as it can. The FDA asked the Institute of Medicine for advice about such labels. The institute recommended labels listing only calories, saturated and trans fat, sodium and sugars – all nutrients to avoid. Although the institute did not mention traffic-light labels, it did recommend check marks or stars, which come close. The food industry much prefers its own method, Facts Up Front, which emphasizes “good-for-you” nutrients. It is already using this system. Will the FDA try to turn the institute recommendations into regulations? Maybe later.

The FDA will (still) be playing catch-up on food safety. The FDA got through the 2011 appropriations process with an increase of about $50 million for its inspection needs. This is better than nothing but nowhere near what it needs to carry out its food safety mandates. The FDA currently inspects less than 2 percent of imported food shipments and 5 percent of domestic production facilities. The overwhelming nature of the task requires FDA to set priorities. Small producers think these priorities are misplaced. Is the FDA going after them because they are easier targets than industrial producers whose products have been responsible for some of the more deadly outbreaks? Time will tell.

On the bright side, the food movement will gather even more momentum. While the food industry digs in to fight public health regulations, the food movement will continue to attract support from those willing to promote a healthier and more sustainable food system. Watch for more young people going into farming (see Chronicle staff writer Amanda Gold’s Dec. 25 article) and more farmers’ markets, farm-to-school programs, school meal initiatives, and grassroots community efforts to implement food programs and legislate local reforms. There is plenty of hope for the future in local efforts to improve school meals, reduce childhood obesity, and make healthier food more available and affordable for all.

And on a personal note: In April, University of California Press will publish my co-authored book, “Why Calories Count: From Science to Politics.” I’m hoping it will inspire more thinking and action on how we can change our food system to one that is better for people and the planet.

Happy new year!

In preparation for the holiday season, Secretary of Health and Human Services Kathleen Sebelius and Agriculture Secretary Thomas Vilsack held a press conference  to promote the departments’ efforts on food safety.

They announced release of the administration’s progress report from its Food Safety Working Group.

They also highlighted additional places to get government information about food safety at home:

• Food Safety Blog
• FoodSafety.gov 
• Tips on Holiday Food Safety

I didn’t pay much attention to these announcements until I read the slightly snarky account in Food Chemical News (December 22). 

The Obama administration patted itself on the back today with a new report that both lists the accomplishments over the past three years of its Food Safety Working Group (FSWG) and identifies the group’s top priorities for the coming year.

Released just minutes before a short media call that served as more of a pep rally, The Federal Food Safety Working Group Progress Report, a 31-page document, summarizes for stakeholders a host of activities that have taken place at government agencies over the past three years related to detecting foodborne pathogens, enhancing surveillance, responding to food safety problems, improving food safety at the retail level and educating consumers.

The list of the administration’s food safety accomplishments is long and detailed, and many are impressive.

But what the report does not say is telling.  Neither the USDA nor FDA have the resources or power to require the industries they supposedly regulate to produce safe food.

As Mark Bittman explains in his Opinionator column in the New York Times, politics defeats even the most rational and thoroughly science-based safety measures, leaving the FDA unable to do much more than politely request “voluntary guidance” of industry.

Bittman focuses on the political barriers to doing what the FDA has been asking for since 1977:  a ban on the use of antibiotics for non-therapeutic purposes, in this case to make food animals grow faster.   The result: “Bacteria 1, FDA 0.”

Here’s the nut: The F.D.A. has no money to spare, but the corporations that control the food industry have all they need, along with the political power it buys.

That’s why we can say this without equivocation: public health, the quality of our food, and animal welfare  are all sacrificed to the profits that can be made by raising animals in factories….Animals move from farm to refrigerator case in record time; banning prophylactic drugs would slow this process down, and with it the meat industry’s rate of profit.

Lawmakers beholden to corporate money are not about to let that happen, at least not without a fight.

For more than 20 years, the Government Accountability Office has called for creation of a single food safety agency that unites the safety oversight functions of the FDA and USDA and has the authority to require food to be produced safely.

In this Congress?  Hopeless.

But Congress can be changed—and that’s a worthy thought for the new year.