A recent report from several environmental consumer advocacy groups graded of 25 of the leading fast food restaurants on the use of antibiotics in the meat they use, and for anyone concerned with the use of antibiotics in the food supply the results are illuminating. The report yielded some surprising ratings for America’s most popular fast food restaurants, giving only two an A grade.

We often hear about the use of things like antibiotics, hormones, and other additives in our food, but not everyone knows exactly what effects they have on our health. Read on to learn more about what’s in your food and what’s being done to make sure everything we consume is healthy.

 Antibiotics

When most people think about antibiotics the first thing that comes to mind is the medicine you get for strep throat or ear infections, so how are antibiotics important in terms of what we eat? The answer lies at the beginning of the food production, when farmers raise livestock for food.

The purpose of antibiotics is to kill harmful bacteria, which is important for both humans and for animals in the food supply. The problem is that they do not necessarily kill all the bacteria. For example, they may kill 99 out of 100 bacteria cells. However, the one percent that survives is immune to the antibiotic and reproduces. Over time, the resistant bacteria can reproduce, making the antibiotic no longer effective, which mean that a stronger medicine is needed to kill the bacteria. Resistant bacteria may also be transmitted to humans during consumption, which can lead to significant health concerns. The growing population of resistant bacteria could pose a significant health risk as antibiotics become less and less effective.

Farmers treat their animals with antibiotics for several reasons, but most importantly they do it because they want to keep the animals healthy. The use of antibiotics has also led to larger and heavier animals, which also means more profit. The central issue with the use of antibiotics in livestock is the fact that they are used when they are not actually needed. While few argue that antibiotics should never be used on animals, the use of “sub-therapeutic” doses, which are given when an animal is not sick is what most people have a problem with. Over time, these doses lead to resistant bacteria, which may be transferred to humans when consuming meat.

FDA regulations instruct farmers to use antibiotics only when an animal is sick or if there is an unusually high risk of disease, but that is not always the case. According to the Friends of the Earth and National Resource Defense Council mentioned above, 70-80 percent of the antibiotics used in the United States are given to animals. The report found that 20 of the top 25 fast food chains received a failing grade for their antibiotics policies.

Hormones

Like antibiotics, hormones are used to make animals bigger and stronger. But the hormones contained in the meat that people eat is passed along to humans as well. The FDA approves and regulates all hormones that are used in food production. The amounts allowed in food are determined by the FDA through research and are supposed to be well below the levels that naturally occur in the human body, thereby preventing any negative effects.

When it comes to hormones, there are a lot of gray areas in terms of their health effects. The two largest concerns associated with their use are a possible increased risk of cancer and the early onset of puberty in children. Existing studies suggest that lifetime exposure to hormones like estrogen can be linked to greater risk of cancer, and hormones previously used in animals have actually been tied to cancer risk. Diethylstilbestrol (DES), was a used in the 1960s and was connected to heightened risk of certain forms of cancer, but DES use ended after this connection was discovered. The amount of estrogen present in food is significantly lower than levels that naturally occur in our bodies. Currently, there is not sufficient evidence to draw a clear connection between growth hormone use in animals and an increased risk of cancer. Hormones given to animals are essential for growth and development, and the FDA regulates them to ensure that their presence in our food remains at safe levels. According to the FDA:

People are not at risk from eating food from animals treated with these drugs because the amount of additional hormone following drug treatment is very small compared with the amount of natural hormones that are normally found in the meat of untreated animals and that are naturally produced in the human body.

One issue that has a stronger connection to the use of hormones in the food supply is the early onset of puberty in children. On average, children have been starting puberty earlier than in the past, which some scientists have linked at least in part to the presence of hormones in food. While food still has relatively low levels of these hormones, their mere presence can cause children to reach puberty earlier. Although studies have found a connection, the use of hormones, like most many food-related health issues, still requires further research to clarify the link.

Pesticides

While antibiotics and hormones are designed to fatten animals, pesticides serve a similar purpose for fruits and vegetables. Pesticides do not increase the size of fruits or vegetables, but they do help ensure their survival from threats such as insects or weeds. They also kill potentially harmful organisms such as mold or fungus which can grow on foods.

Due to the widespread use of such chemicals on most foods the EPA and similar organizations in other countries have set tolerances for the amount allowed in foods. These tolerances are set after conducting risk assessments, which look at the potential health risks of individual pesticides. Once the tolerance has been set, it is then enforced by the USDA and FDA, or a corresponding agency in another nation. Yet several questions remain about the use of pesticides as well as their effects on humans and the environment. Pesticides are not allowed to be used on foods until they have gone through an assessment and they are also occasionally re-evaluated to make sure the set tolerance is appropriate. Re-evaluating pesticides is the primary way to address issues with tolerances and new information about health effects.

Preservatives

Preservatives, like other food additives, are in foods to serve a purpose beyond increasing profits, but they also come with their own risks. Generally speaking, the purpose of preservatives are to make food last longer and prevent rotting.

While preservatives help keep things fresh, they may also harm the people who ingest them. A recent study by immunologists at Georgia State University found that pesticides can erode a protective lining in the colon, which can lead to inflammation and even change the nature of bacteria located there. This has been linked to higher rates of inflammatory bowel disease and obesity.

Preservatives are regulated by the FDA, which has the final say on which additives are approved for consumption. While the FDA regulates the use of preservatives, most additives are never actually tested by the FDA. This is because the FDA uses the GRAS labeling system for many things that are added to food. GRAS, an acronym for the term “Generally Recognized As Safe,” allows producers to add things to food according to established practices, but without requiring pre-approval from the FDA. While this system expedites the rate at which new products can go on the market, there have been several instances where the FDA approved the use of a certain additive, only to repeal it later when they proved to be carcinogenic. Examples of this include Cyclamate, Safrole, Saccharine, and most recently, trans fats.

The video below looks at a variety of food additives and their uses:

The Future of Food

Organic Food, Buying Local, and Farmer’s Markets

According to the United States Department of Agriculture (USDA), organic food is “produced without antibiotics, hormones, pesticides, irradiation or bioengineering.” By its very definition then, organic food has the potential to alleviate many of the alleged effects of added ingredients simply because it does not have them. What’s more, becoming certified organic by the USDA is a long, difficult, and expensive process. As a result, the validity of this label also comes with a certain amount of clout. In 2014, the combined sales of organic food in the United States was up 11.3 percent from the previous year to $39.1 billion, approximately five percent of the entire food market.

The rise in organic food sales can, at least in part, be associated with the rise in farmers’ markets. Between 2006 and 2014 the total number in America rose 180 percent to 8,268. Farmers are also turning to selling to local restaurants, distributors and even directly to local schools. Aside from offering food that does not contain any of the additives listed above, doing so has the added impact of reducing fuel costs and pollution.

The Food Industry

Another major change is on the part of the traditional food industry, from grocery stores to restaurants. With organic food emerging as a major trend, supermarkets have been quick to respond. Chains such as Whole Foods have been some of the most successful stores, as their businesses operate on the notion of selling these types of foods.

Fast food, on the other hand, is under a tremendous amount of pressure to use healthier food with fewer additives. The industry has taken some important steps, but based on evaluations like the report mentioned at the beginning of this piece, it has a long way to go. Even before the release of that report, efforts had been underway to rid menus of additives, GMOs, and the equally demonized high-fructose corn syrup. Industry leaders like Panera and Chipotle stopped using these ingredients in their food long before the issue came back up in the news.

Like the use of additives, organic foods also have their own costs and benefits. The first is price–organic food is notoriously more expensive than its non-organic counterparts, as are the prices in restaurants that serve them. Additionally, it is still unclear if they offer any more nutritional value than non-organic foods beyond the absence of additives, hormones, and pesticides. The following video details the pros and cons of organic food:

Conclusion

When people eat food that has antibiotics, hormones, or preservatives, these additives become part of the body and may have adverse effects on their health. We have recently taken important steps to understand what exactly goes into our food and how that affects our health, but there is still a lot that remains unknown. Buying organic food and trying to reduce the use of pesticides and certain additives is an important step to ensure that everything we consume is healthy. But taking these steps to monitor what we eat is only part of the equation; we also need more research to determine exactly how our bodies react to various things that are added to what we eat. While the FDA, USDA, and EPA regulate food production to ensure pesticides, additives, and hormones do not exceed safe levels, these regulations evolve with research. It is up to every individual to make their own informed choice based on their own means. When choosing food people should identify what goes into what they consume and how it is produced. As research progresses, recommendations and regulations can and will continue to change.

Resources

Primary

FDA: Steroid Hormone Implants Used for Growth in Food-Producing Animals

EPA: Pesticide Tolerances

Additional

Frontline: Is Your Meat Safe?

CNN: Report Examines Antibiotics in Meat on Fast Food Menus

Nature: Food Preservatives Linked to Obesity and Gut Disease

Organic Trade Association: U.S. Organic Industry Survey 2015

NPR: Are Farmers’ Market Sales Peaking? That Could be a Good Thing for Farmers

RxList: Antibiotic Resistance

Health: America’s Healthiest Grocery Stores

Entrepreneur: 7 Major Restaurants That are Getting Rid of Artificial Ingredients

National Institute of Health: NIH Human Microbiome Project Defines Normal Bacteria Make-up of the Human Body

Sustainable Tables: Additives

Organic Consumers Association: Beef, Hormones Linked to Premature Onset of Puberty & Breast Cancer

Michael Sliwinski

Michael Sliwinski (@MoneyMike4289) is a 2011 graduate of Ohio University in Athens with a Bachelor’s in History, as well as a 2014 graduate of the University of Georgia with a Master’s in International Policy. In his free time he enjoys writing, reading, and outdoor activites, particularly basketball. Contact Michael at staff@LawStreetMedia.com.

The post What’s in Your Food?: A Look at Regulating the Food Industry appeared first on Law Street.

Petri dishes do far more than indicate if you have strep throat. They were a key prop in the theater of antibiotic discovery. A mere glance in a petri dish ushered in the antibiotic revolution.

On a bright and sunny (just a guess) day in 1928, Alexander Fleming puzzled over what he saw in a petri dish of Staphylococcus bacteria. One small, moldy area of the dish had somehow dodged the enterprising colonization of the bacteria. Fleming speculated this was not a coincidence. He wondered if the mold, Penicillium Notatum, was somehow inhibiting bacterial growth. He experimented some more and eventually published his findings in the British Journal of Experimental Pathology. Fleming’s brick wall had been isolating the penicillin from the mold to use as a drug. Luckily his research eventually ended up in the hands of two scientists at Oxford who were ready to take up the challenge.

Penicillin — the first antibiotic — was used to treat a human patient in 1941. We’ve probably all taken them, but what are they really? Antibiotics are microorganisms (and now synthesized drugs) that attack the bacteria that cause infection in your body. Just as bacteria couldn’t grow on the moldy part of Fleming’s petri dish, bacteria cannot grow in a body on antibiotics.

World War II soldiers were among the first to benefit from penicillin before it was released to the general public in the late 1940s. Newspapers hailed it as a miracle drug.

The potential downside of this miracle drug had not evaded the experts, however. Alexander Fleming himself warned of microbes developing penicillin resistance in his acceptance speech for the Nobel Prize in Physiology or Medicine in 1945.

Miracles Happen

Antibiotics thwarted some of the leading causes of death in human existence. Childbirth, ear infections, and even simple skin scrapes were often deadly before these saviors entered the fray. Many children didn’t see their first birthdays, succumbing to infections we don’t think twice about today. Having surgery in the early 1900s? Just kiss your family goodbye before you go under the knife.

Antibiotics are microorganisms ideally adapted to kill other microorganisms while causing little or no harm to the host. The word “antibiotic” actually means “against life.”

Scientists design synthetic versions of these antibiotic microorganisms so we may have a profusion of drug options. About 150 million prescriptions are written for antibiotics every year.

And that’s a problem because…?

Antibiotics may be miraculous, but bacteria are not taking the challenge lying down. They’re fighting back by developing mechanisms to resist antibiotics. Don’t take it personally, it’s what any organism would do for the sake of survival. It turns out that bacteria are marvelous adaptors. Two million people in the United States suffer from antibiotic-resistant infections every year and many die as a consequence. Additionally, the CDC estimates a cool $20 billion in resulting economic burdens.

In short, our arsenal of antibiotics is losing efficacy. If this continues unchecked, we risk being thrust back into the dark ages of medicine when common ailments put many a healthy body six feet under. Antibiotic resistance is also detrimental to treatments for more serious illnesses. Therapies for cancer and organ transplants are often complicated with infection. Doctors rely heavily on antibiotics to keep their patients’ strained bodies free of infection. If antibiotics become ineffective, these life-saving treatments might be relegated to the past. It would mark one monumental step back in health care.

If you’re not scared yet…

Everyone loves a good villain to embody their fears. Emerging “superbugs” epitomize scary. When antibiotics were new, development was explosive. New drugs essentially kept microbes on their toes and resistance was less prolific. Invention of new drugs has now stagnated enough that bacterial evolution threatens to overtake our developmental countermeasures.

Welcome to the world of superbugs, aka resistant germs. These include nightmares like:

Carbapenem‐resistant Enterobacteri‐aceae (CRE): Literally nicknamed “nightmare bacteria.” It’s resistant to nearly all antibiotics and kills about half of the people infected by it.

Staphylococcus aureus (MRSA): MRSA usually manifests as a skin infection. Because of its resistant capabilities, it can wreak havoc by spreading through medical facilities.

These monsters aren’t made up, they’re frighteningly real and we may soon lose our ability to fight them.

Let’s Get “Sciencey”

Microbes are tricky little beasts. They will always evolve to develop resistance to what threatens them. The more bacteria are exposed to antibiotics (which we just learned is quite frequently), the more chances they have to develop resistance. When bacteria are exposed to antibiotics, susceptible strains die, leaving zero competition for the resistant ones so they are free to survive and flourish. Scientists call this selective pressure.

Resistant bacteria get that way by acquiring resistance genes through genetic mutation or getting the resistance from another bacterium. They can even get multiple resistant traits and end up developing resistance to multiple families of antibiotics.

Watch the video below for a perfect explanation of how this happens.

Why is this happening?

1. They’re over-prescribed: Antibiotics are some of the most commonly prescribed drugs used in medicine. For example, the first Ebola patient in the United States was sent home on antibiotics before doctors knew what he had. Antibiotics won’t do anything for Ebola or even the sinus infection they believed he had. Most sinus infections are viral so antibiotics don’t do anything — unless it was 1 out of the 100 cases where the sinus infection is caused by bacteria.
2. They’re mis-prescribed: Physicians often have to use incomplete or imperfect information. They prescribe antibiotics as a an all-purpose band-aid.
3. They’re used heavily: The chance of bacteria developing resistance increases with antibiotic use. Unfortunately, doctors must rely heavily on antibiotics to reduce risk of infection in critically ill patients. Furthermore, close proximity among sick patients in hospitals creates an ideal environment for resistant germs to spread.
4. They’re used in agriculture: Agriculture use accounts for half of the antibiotics produced in the United States. Scientists agree that adding antibiotics to feed is a key problem in developing antibiotic resistance. Agriculturally, antibiotics are used to promote animal growth and proactively prevent infections in addition to just treating sick animals.

Who is going to save us?

The CDC released a report on the threat of antibiotic resistance in 2013. It was the first exhaustive compilation of the health threats antibiotic resistance presents. If you’re not up to reading the whole 100 pages, here is a snapshot of the strategies they recommend to save us all from antibiotic resistance:

1. Prevent infections from happening in the first place: No infection, no antibiotics, and consequently less risk that resistance develops.

2. Track antibiotic resistance: Tracking will shed light on the specific mechanisms of resistance development. With this knowledge, intervention strategies will be more informed and more effective.

3. Change the way antibiotics are used: Antibiotics are generally overused. Up to 50 percent of antibiotic prescriptions are unnecessary. Physicians can take up the mantle of antibiotic stewardship by using antibiotics only when necessary.

4. Develop drugs and diagnostic tests: Bacteria develop antibiotic resistance as they evolve — it’s a natural process resulting from biological pressure. Introduction of new drugs will slow down this natural evolution. Diagnostic tests will allow us to understand and track the evolution in a more timely way.

Hey…did we budget for all of this?

Federal spending to combat antimicrobial* resistance has been limited. In 2014, the budget was $450 million. That figure sounds grand, but it amounts to just about $1.04 per American. On the other hand, antibiotic resistance costs the United States an estimated $55-70 billion each year.

A little bit lopsided, don’t you think?

*Antimicrobial resistance includes antibiotic resistance but also refers to resistance of other microbes like parasites and viruses. Antibiotic resistance refers specifically to bacteria that cause infection. Most strategies cover the more comprehensive antimicrobial resistance.

Making plans…

The Obama Administration announced a game plan in September for facing antimicrobial resistance. Here’s the to-do list:

• Leverage findings from the President’s Council of Advisors on Science and Technology (PCAST) report on combating antimicrobial resistance. The report suggests doubling the current federal investments from $450 million to $900 million a year. It also outlines recommendations for strong federal leadership, effective surveillance, research, clinical trials, increasing economic incentives for development, increasing stewardship for current antibiotic use, limiting agricultural use of antibiotics, and increasing international coordination.

• Implement the National Strategy for Combating Antibiotic Resistant Bacteria. The PCAST report was used to create a National Strategy for Combating Antibiotic Resistant Bacteria. The strategy focuses on five major goals:

Slow the development of resistant bacteria and prevent the spread of resistant infections; strengthen national one-health surveillance efforts to combat resistance; advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria; accelerate basic and applied research and development for new antibiotics, other therapeutics, and vaccines; and improve international collaboration and capacities for antibiotic resistance prevention, surveillance, control, and antibiotic research and development.

• Form a task force that combats antibiotic resistant bacteria. Established by Executive Order, the task force is responsible for implementing the National Strategy for Combating Antibiotic Resistant Bacteria. It is working on a detailed report of specific action plans due in February 2015.

• Finance diagnostic innovation. A $20 million prize, co-sponsored by the National Institutes of Health and the Biomedical Advanced Research and Development Authority, will be granted for a point-of-care diagnostic test that identifies antibacterial-resistant infections.

A little legal setback…

The July ruling in the NRDC v. US FDA case was marked as a major setback in the fight against antimicrobial resistance. The plaintiffs (including the Natural Resources Defense Council and Center for Science in the Public Interest) were dismayed that the court ruled against compelling the FDA to ban the use of antibiotics in healthy animals used for food.

The case overturned two other district court rulings that would have required the FDA to rescind approved use of antibiotics for purposes other than to treat sick animals. Companies could have gotten around the ruling if they proved the drug in question posed little risk for contributing to the development of antimicrobial resistance in humans.

Some other hangups

There are a few other pesky issues that might hinder some of the strategies for reducing antimicrobial resistance:

• Individual privacy could potentially get in the way of optimal surveillance of antibiotic resistance. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) guarantees privacy of health information that is individually identifiable. Patient preferences could determine what information can be used to track antimicrobial resistance.

• Companies lack incentives to create new antibiotics because the traditional sales volume and price linkage is missing. Because fighting antibiotic resistance forbids overusing one particular drug, companies would probably not get a good return on investment.

• Ponderous approval processes for new drugs might also hinder the speed of new antibiotic drug development. A balance will need to be struck in ensuring speed of innovation without compromising safety.
  

  ---

So the government has antimicrobial resistance under control?

It has a robust plan for taking action against antibiotic resistance, but being an informed patient never hurt anybody. The CDC recommends a few steps you can take, including abstaining from antibiotic use for viral infections, not saving leftover antibiotics, and not taking antibiotics prescribed for someone else.

The fight against antimicrobial resistance is really no fight at all, but a call for permanent change in our medical and agricultural systems. As long bacteria exist and want to survive, our desire to survive must be stronger.

Resources

Primary

CDC: Antibiotic Resistance Threats in the United States, 2013

President’s Council of Advisors on Science and Technology: Report to the President on Combating Antibiotic Resistance

Additional

Cochrane Summaries: Antibiotics for Acute Maxillary Sinusitis

Food Safety News: White House Calls for Action Plan to Address Antibiotic Resistance

The White House: New Executive Actions to Combat Antibiotic Resistance and Protect Public Health

CDC: Untreatable: Today’s Drug Resistant Health Threats

Explorable.com: History of Antibiotics

American Chemical Society: Discovery and Development of Penicillin

National Institute of Allergy and Infectious Diseases: Antimicrobial Drug Resistance

World Health Organzation: Antimicrobial Resistance

Huffington Post: Feds Failing to Act on Antibiotic Resistance Despite Grave Threat

Natural Resources Defense Council: Food, Farm Animals and Drugs

CDC: Legal Issues Associated with Antimicrobial Drug Resistance

CDC: White House Announces National Strategy for Combating Antibiotic Resistance

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Are We Doing Enough to Prevent Antibiotic Resistance? appeared first on Law Street.