The "Trouble with Antibiotics" in U.S. animal agriculture production

Frontline last night had an excellent report, the Trouble with Antibiotics, on the plausible link between dangerous antibiotic resistant diseases and the overuse of antibiotics in U.S. meat production.

Poultry and hog producers use large amounts of antibiotics even in healthy animals, as a growth promoter and to prevent disease. As bacteria evolve to become resistant to these antibiotics, we lose important tools for treating deadly diseases in humans, including Methicillin-resistant Staphylococcus aureus (MRSA).

For readers who want to inspect the scientific evidence for themselves, here are some links to research mentioned in the Frontline report.

Jessica Rinsky, Lance Price (interviewed in the report), and colleagues found livestock-associated MRSA in workers from industrial livestock operations but not workers from antibiotic-free livestock operations.

Andrew Waters, Lance Price, and colleagues found that MRSA bacteria reaches meat on supermarket shelves.

Joan Casey, Brian Schwartz, and colleagues found in the Journal of the American Medical Association (JAMA) that antibiotic-resistant bacteria cases in humans were geographically associated with the proximity of nearby meat producers in Pennsylvania. The Frontline interviewer did a great job questioning the scientists and explaining both the strengths and limits of this type of geographic association.

Concerned about the Frontline story, the federal government's National Pork Board has been scrambling to persuade people not to worry about this issue. Reuters reports today that the NPB is funding an online public information campaign to defend antibiotic use. The most damning part of the Reuters report alleges that the NPB is using search engine optimization (SEO) tools so that web users seeking information about antibiotics are directed to industry-friendly web sources.

Both Reuters and the Frontline report describe the pork board as an "industry" association, but the National Pork Board is a semi-public checkoff program. The U.S. Congress created this board, the Secretary of Agriculture appoints its members from a slate of candidates suggested by the industry, and the federal government uses its powers of taxation to collect the "mandatory assessment" -- a tax -- that funds this public information campaign. This is not a voluntary industry association. All pork board messages must be approved by the federal government as its own "government speech," so our government is complicit in this public information campaign to rebut the Frontline report.

The industry representatives interviewed in the Frontline report didn't really dispute any of the facts, but they engaged in a rhetorical game of shifting the burden of proof. They argued that no further regulation is needed, because there is not yet certain proof that some of the research associations represent true cause and effect. Since nothing is ever certain in this type of research, the industry representatives can feel safe that no level of evidence would ever clear their hurdle.

One of the best passages in the Frontline report was an interview with FDA Commissioner Margaret Hamburg. The interviewer asked why FDA does not collect information about the quantity of antibiotics administered by meat producers. Though Hamburg squirmed under the question, she essentially confirmed that FDA wanted this information but could not get it because of industry opposition. In other words, the industry representatives say no action should be taken until we have certain proof, while simultaneously hindering access to the data needed to investigate the question.

The industry is pursuing some voluntary steps to reduce antibiotic use for the purpose of "growth promotion," but it has defined this term narrowly so that most antibiotic use even in healthy animals will still continue.

The Frontline report is strongly recommended. Now is the time for stronger measures to restrain the overuse of antibiotics in U.S. meat production.

Frontline, October 14, 2014.

Web search interest in "food policy" and "agricultural economics"

Circa 2005, U.S. web search interest in the terms "food policy" and "agricultural economics" was about equal. Nowadays, web search interest in "food policy" is much higher. There may be lessons in this for U.S. agricultural and applied economists.

USDA's new Food Insecurity Nutrition Incentive (FINI) for affordable fruits and vegetables

Friedman School graduate student Cailin Kowalewski reports today in the student publication Sprout on USDA's new financial incentive program:

The USDA this week announced a new grant program that will help participants in the Supplemental Nutrition Assistance Program (SNAP) afford fruits and vegetables. The Food Insecurity Nutrition Incentive (FINI) program will offer $31.5 million in competitive grants to organizations from across the food system. These organizations will be able to use FINI funding to support projects that increase SNAP participant access to fruits and vegetables through incentive programs at the point of sale.

The Sprout article provides a history and overview of the new program, and it notes divergent views on implementation questions, such as whether the focus should be on farmers' markets or whether it should encompass larger-scale retail channels as well.

New composting rules in Massachusetts

Beginning next week, on October 1, about 1,700 Massachusetts businesses that produce substantial food waste must sort and divert that waste to composting or another destination other than landfill. The new program is one of the most ambitious in the country.

As the Boston Globe explains today:

As of Oct. 1, Massachusetts has banned any establishment that creates a ton or more of food waste per week from sending as much as a carrot peel to the state’s rapidly dwindling available landfills. Despite a recycling rate topping 40 percent, Massachusetts businesses and households still toss about 6.5 million tons of garbage every year — enough to fill up Fenway Park 74 times. Most of it is piled into a couple dozen landfills where it slowly decomposes, the organic stuff from kitchens and yards spewing the greenhouse gas methane into the atmosphere, or hauled to a handful of waste-to-energy incinerators where it is burned to create electricity.

So-called compostable organics make up more than 25 percent of the state’s commercial and household waste, and the goal of the new regulation is to divert much of that away from landfills. Where will it go? To composting facilities and energy plants that run on biogas (made primarily of methane) — places where it can actually be put to use.

Clare Leschin-Hoar covered the Massachusetts news for the Guardian this week. Elsewhere in the country, Seattle is pursuing a similar policy just this week -- but without limiting it just to large waste producers as the Massachusetts policy does. For further background, the Natural Resources Defense Council (NRDC) has a longer 2012 report with estimates on the scale of food waste going to landfills.

Most of these links were brought to my attention this week by Jennifer Otten, a faculty member in health services at the University of Washington. Professor Otten's food policy class uses my textbook, Food Policy in the United States: An Introduction. She reports that food waste issues make a great concrete local issue for use in food policy teaching: "Students get really into this topic, because it’s something they can do something about."

USDA's Healthy Incentives Pilot (HIP) finds significant positive impact on fruit and vegetable intake

USDA's Food and Nutrition Service yesterday released final results showing that the Healthy Incentives Pilot (HIP) had a significant positive impact on fruit and vegetable intake for low-income participants in the Supplemental Nutrition Assistance Program (SNAP).

In the pilot, which was conducted in Hampden County, Massachusetts, HIP participants received a 30% incentive added back to their benefit card when they purchased targeted fruits and vegetables in participating retailers. A randomly assigned control group received SNAP benefits as usual with no incentive.

On average HIP participant adults on SNAP consumed 0.23 cup-equivalents more in daily targeted fruits and vegetables -- a 25% increase -- compared to the non-HIP adults on SNAP.

HIP Participants Consumed 0.23 Cup-Equivalent 

More Fruits and Vegetables per Day

The HIP Evaluation Study was led by Abt Associates, Inc., with participation from Westat and the Friedman School of Nutrition Science and Policy at Tufts University. Susan Bartlett from Abt was the project director. On behalf of the Friedman School, I was director of design for the evaluation study and a co-author of the final report.

The pilot represents the most ambitious effort so far to deliver a healthy eating incentive to SNAP participants right through the SNAP card (as opposed to a separate coupon) and in a full range of participating retailers (as opposed to farmers' markets alone). The results complement new work being done by Wholesome Wave and others to explore the potential of financial incentives.

The primary results were based on two post-implementation rounds of surveys of SNAP participants. Preliminary results, based just on the first post-implementation survey round, were published recently in the American Journal of Agricultural Economics (may be gated). The new full report released today has more information about a wide variety of food spending, shopping behavior, and food intake outcomes, and it analyzes the likely cost of extending such a healthy incentives program nationwide.

Independent analysis of the Healthy Weight Commitment Foundation trillion calorie pledge

An independent evaluation reported today that the Healthy Weight Commitment Foundation succeeded in removing more than a trillion calories from the U.S. food supply, as originally pledged.

Through this pledge, leading food and beverage manufacturers had promised to reduce total food energy sold by 1 trillion calories, from a 2007 baseline through 2012.

Using Nielsen scanner data from supermarket electronic cash registers and from a random sample of consumer households, Shu Wen Ng, Meghan M. Slining, and Barry M. Popkin estimated calorie trends and reported the results today in the American Journal of Preventive Medicine.

To some extent, the accomplishment simply reflects downward trends in the packaged food and beverage sector, which is losing market share over time -- mostly to the restaurant industry but perhaps partly to healthier food options. In an accompanying editorial in the same journal, Dariush Mozaffarian asks whether the pledge is a "marketing ploy."

As a rule, nutritional targets -- and other quantitative information intended for general audiences -- should be stated in easily explained per-capita terms. Who knows what a trillion calories in aggregate even means?

It reminds me of silly infographics that take a common-sense concept and convert it to some obscure immense quantity. For example, in my in-box this month, I have an infographic from Guiding Stars, which aims to report the amount of running required to burn off the average American's sugar consumption. Sugar is estimated at 3 pounds per week (a sensible way of explaining the quantity), while the amount of running is stated as 2.7 times around the globe over a lifetime (an irrelevant quantity designed merely to appear large to easily-impressed readers).

Today's study by Ng, Slining, and Popkin nicely goes beyond its assessment of the original trillion calorie pledge and also reports the modest but non-negligible resulting calorie changes on a per-capita basis. To the extent that the results reflect improvements in particular categories, such as sugar sweetened beverages, the findings are still reasonably upbeat.

The Healthy Weight Commitment Foundation -- and the companies that made pledges -- will be delighted by today's coverage in major media outlets such as U.S. News and World Report, which states the good news broadly: "Obesity continues to plague the country, but it appears as though food companies are beginning to take strides in helping alleviate the problem."

Dariush Mozaffarian: to address chronic disease, we should focus on food patterns rather than nutrients

In my school's latest Wednesday seminar, the epidemiologist and cardiologist Dariush Mozaffarian methodically builds the scientific case for amending our traditional obsession with total fat (as a culprit in obesity) and saturated fat (as a culprit in heart disease).

Then, from about minute 47:30 to 50:30 in the video, he drops the hammer. Summarizing this large body of research, he argues that federal dietary guidance to address chronic disease should focus on food patterns rather than nutrients. In sharp criticism of the "Go, Slow, Whoa" guidance that still appears on the website of the National Heart, Lung, and Blood Institute, Mozaffarian concludes, "This is insane!."

The speech implies big changes afoot. And I don't just mean for federal dietary guidance. This summer, Mozaffarian took the helm as the fourth dean of my school, the Friedman School of Nutrition Science and Policy at Tufts University.

Dean Dariush Mozaffarian, MD DrPH-Global Dietary Priorities and Policies to Improve Cardiometabolic Health from Tufts Friedman School on Vimeo.