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Yesterday, the FDA proposed long-awaited action against use of antibiotics for non-therapeutic purposes in animal agriculture.

From the outside, this might look more like inaction.  The agency is asking drug companies to voluntarily cut back on producing antibiotics for non-therapeutic purposes and to require veterinary oversight of use of these drugs.

The announcement comes in the form of three documents in the Federal Register.

• Final Guidance for Industry: The Judicious Use of Medically Important Antimicrobial Drugs in Food-Producing Animals.
• Draft Guidance for Industry aimed at assisting drug companies in voluntarily removing from FDA-approved product labels uses of antibiotics for production rather than therapy, and voluntarily changing the marketing status to include veterinary oversight.  This is open for public comment.
• A draft of a proposed Veterinary Feed Directive regulation,  also open for public comment, outlining how veterinarians can authorize the use of antibiotics in animal feed.

In an FAQ on the announcement, the FDA answers some obvious questions:

4. What is “judicious use” and what are FDA’s recommendations?

“Judicious use” is using an antimicrobial drug appropriately and only when necessary;

Based on a thorough review of the available scientific information, FDA recommends that use of medically important antimicrobial drugs in food-producing animals be limited to situations where the use of these drugs is necessary for ensuring animal health, and their use includes veterinary oversight or consultation.

FDA believes that using medically important antimicrobial drugs to increase production in food-producing animals is not a judicious use (my emphasis).

5. Why did FDA decide to do this now?

FDA has worked with many stakeholder groups and the U.S. Department of Agriculture (USDA) to develop a strategy that will be successful in reducing antimicrobial resistance while minimizing adverse impacts on animal health and disruption to the animal agricultural industry.

In June 2010, FDA released a draft guidance document explaining its recommendations for change and in the interim period sought and received input from various stakeholders, including the animal pharmaceutical industry, animal feed industry, veterinary and animal producer communities, consumer advocacy groups and USDA.

Translation: this has been in the works for a long time and is the result of extensive discussions with the relevant industries.

As Food Safety News explains, the reaction of just about everyone to this announcement has been tepid.

• Food safety advocates object to voluntary, because it never works.
•  The meat industry insists that non-therapeutic antibiotics are essential for producing cheap meat under crowded conditions.

For example, the National Pork Producers make the usual industry arguments:

Harm to small farmers: The guidance could eliminate antibiotics uses that are extremely important to the health of animals…And the requirement for VFDs [veterinary oversight] could be problematic, particularly for smaller producers or producers in remote areas who may not have regular access to veterinary services.

Voluntary equals regulation: The guidance, which does not have the force of law but may be treated as such by FDA, is a move to address an increase in antibiotic-resistant illnesses in humans, which opponents of modern animal agriculture blame on the use of antibiotics in livestock and poultry production.

The science is “junk”: But numerous peer-reviewed risk assessments, including at least one by FDA, show a “negligible” risk to human health of antibiotics use in food-animal production.

My interpretation:

The FDA’s position on non-therapeutic use of antibiotics in animal agriculture is quite clear.  The agency recognizes that based on the science, the use of antibiotics as growth promoters in animals poses a serious risk to human health.

I’m guessing this is the best the FDA can do in an election year.

This move looks to me like a direct challenge to drug companies and meat producers to clean up their acts and take some responsibility for the effects of their misuse of animal antibiotics on public health.

It’s also a challenge to food safety advocates to make sure that the FDA monitors the effects of its voluntary guidance and, if the industries don’t cooperate, that the FDA gets busy on real regulations.

Addition: The account in today’s New York Times explains why the FDA is starting with voluntary efforts:

The reason for the reliance on voluntary efforts is that the F.D.A.’s process for revoking approved drug uses is lengthy and cumbersome, officials said. The last time the F.D.A. banned an agricultural use of a medically important antibiotic against the wishes of its maker, legal appeals took five years. In this case, hundreds of drugs are involved, each with myriad approved uses in various animals.

“You and I and our children would be long dead before F.D.A. could restrict all of these uses on its own,” Ms. Rogers [of the Pew Foundation]said.

The noise about lean finely textured beef (LFTB), commonly known as “pink slime,” is bringing attention to some of the more unsavory aspects of the U.S. political system—public relations spin, the revolving door, and other aspects of power politics.  Here are some recent examples:

According to the Sioux City Journal:

Gov. Terry Branstad on Monday called for a congressional investigation into the source of what he called a “smear campaign” meant to discredit the Lean, Finely Textured Beef made by a Siouxland company.

“Clearly, this is a safe product, it is a lean product, it helps reduce obesity, and there is a spurious attack being levied against it by some groups who are against it…And you can suspect who they might be — people who don’t like meat.”

Helena Bottemiller of Food Safety News reports that Branstad’s colleague, Steve King (Rep-Iowa) explains how the hearings will work:

Witnesses would be under oath and they’re of course obligated by law to tell the truth, those who have been the ones who have perpetrated this smear campaign against one of the stellar companies in the country…I think they’ll have an obligation then to explain themselves why they could not base their allegations on facts and what they’ve done to damage an industry.

Perhaps King will call on Representative Chellie Pingree (Dem-Maine) who has submitted a bill calling for labeling of LFTB. The the Sioux City Journa quotes Branstad’s comments about her:

Pingree is guilty of spreading “bogus misinformation” about lean, finely textured beef along with celebrity chefs and “media elites.”

Pingree should have no trouble explaining why she wrote the bill:

Consumers have made it pretty clear they don’t want this stuff in their food…If a product contains connective tissue and beef scraps and has been treated with ammonia, you ought to be able to know that when you pick it up in the grocery store.

Calling people up before congressional committees is harassment, given how rude congressional committee members typically are to witnesses.

On a lesser scale, Bettina Siegel, the school lunch advocate who initially wrote the USDA to stop using LFTB, has been so harassed by nasty comments on her blog that she has had to set up a filtering system (I’m considering doing the same).

The Concord Monitor reports that USDA undersecretary Joann Smith, the official who approved LFTB for use in school hamburger, was an appointee of President George H.W. Bush and formerly a beef industry advocate.

When Smith left government, she was appointed to the board of directors of Beef Products Inc., the maker of LFTB, which paid her $1.2 million over 17 years [actually, she was on the board of IBP, a supplier of BPI].

Republic Report says that Beef Products Inc. retains a team of lobbyists from the firm Olsson, Frank & Weeda. One lobbyist employed by the firm is Stephanie Herseth Sandlin, a former congresswoman from South Dakota and leader of the “Blue Dog Caucus” of pro-corporate Democrats.

It’s enough to make anyone start buying organics.

Addition, April 16: Food Safety News has published an excellent timeline on the history of the “pink slime” crisis.

Addition, May 10: Legal scholars weigh in on whether pink slime should be labeled.  No, they say, requiring labeling would violate the First Amendment.

On Tuesdays, I answer questions about nutrition in NYU’s student newspaper, the Washington Square News.   These appear intermittently on the newspaper’s website.  Today’s is about caffeine.

Question: What kind of effect does caffeine have on our metabolism and general health? What is an appropriate amount of caffeine to have? And are certain sources of caffeine better than others? 

Answer: Caffeine is a mild upper. It perks up your central nervous system and makes you feel more alert, energetic and cheery. Caffeine is common in plants, but coffee, chocolate and tea have the most. The amount of caffeine depends on the type, amount used and brewing time, from 30 milligrams for a small cup of weak tea to more than 300 milligrams for some of the larger and stronger Starbucks drinks. When caffeine appears on the labels, you know exactly how much you are getting.

Energy drinks made for adults, like Red Bull, contain about 80 milligrams in an eight-ounce can. Coca-Cola, Pepsi-Cola and other soft drinks marketed to children have much less — 30 to 40 milligrams in 12 ounces.

People react to caffeine in different ways and, by this stage in your life, you undoubtedly know how much of it you can handle and at what time of the day you can handle it. If you take in more than your personal limit, you may feel nervous, shaky and sleepless. The more caffeine you drink, the more you become accustomed to it and the harder it is to give up. Some researchers think that the mix of sugar with caffeine is what makes some people feel addicted to soft drinks.

Perhaps it’s the caffeine in coffee that makes researchers want to find something wrong with it. I have a thick file of papers claiming that coffee raises the risk for heartburn, cancer, heart disease, infertility, ulcers and many other health problems, but the observed effects are small, inconsistent and unconvincing. When given as a drug, caffeine stimulates urine production and suppresses appetite, but the amounts in all but the strongest coffees are too low to produce such effects. If you get shaky when you drink caffeinated beverages, it’s time to stop.

—A version of this article appeared in the Tuesday, April 10 print edition. Marion Nestle is a contributing columnist. Email her questions at dining@nyunews.com.

Additional note on the food politics of caffeine:  SenatorDick Durbin (Dem-IL) has just asked the FDA to enforce its own rules on drink labeling.  Some makers of high-caffeine “sports” drinks are marketing them as dietary supplements to avoid having to adhere to FDA rules on how much can go into soft drinks.

Karen Le Billon, French Kids Eat Everything: How our family moved to France, cured picky eating, banned snacking, and discovered 10 simple rules for raising happy, healthy eaters, HarperCollins, 2012.

I blurbed this one: It takes a brave couple to move two picky-eater kids to a small French town and convert them to foodie omnivores.  North Americans have much to learn from European food traditions, and the contrast between French and North American school lunches is a striking example.  A must-read for teachers as well as parents.

Jeannie Marshall, Outside the Box: Why Our Children Need Real Food, Not Food Products, Random House, 2012.

I blurbed this one too: Outside the box is about teaching kids how to appreciate real food but also about how globalization is changing the way the world eats.  In this beautifully writeen book about what needs to be done to preserve food culture in Italy and elsewhere, Marshall makes the political personal as she explains how she is teaching her son to enjoy the pleasures of eating food prepared, cooked, and lovingly shared by friends and family.

Bill and Claire Wurtzel, Funny Food: 365 Fun, Healthy, Silly, Creative Breakfasts, Welcome Books, 2012.

I wasn’t asked to blurb this one, but like it anyway:  Your kid doesn’t want to eat real food for breakfast?  No excuses.  This book illustrates 365 breakfasts made of eggs, toast, cereal, pancakes, fruit, cheese, yogurt, and other good things.  These are presented as faces, animals, and toys so easy to do that even a time-challenged parent can whip them up in a second.  I can’t imagine any kid resisting eating foods like these.    Silly, absolutely.  Worth it?  Give it a try.

Apparently as a result of a need to cut costs, the USDA is changing the way its inspectors oversee chicken processing.

As Dana Milbank of the Washington Post puts it, this is

a proposal to allow chicken slaughterhouses to inspect themselves — eliminating those pesky federal monitors who have the annoying habit of taking diseased birds out of the food supply.

Even if the Obama administration were inclined to bring down capitalism with an orgy of overregulation, there isn’t enough money in the budget to enforce the rules on the books.  That’s what the chicken fight is about: Spending cuts…are a form of de facto deregulation (my emphasis).

The New York Times account of this policy change notes that inspectors:

had observed numerous instances of poultry plant employees allowing birds contaminated with fecal matter or other substances to pass. And even when the employees try to remove diseased birds, they face reprimands….

The Agriculture Department proposal allows poultry plants to speed up their assembly lines to about 200 birds per minute from 140, hampering any effort to examine birds for defects.

But that’s not all.  The Center for Livable Future at Johns Hopkins  reports that meal made from chicken by-products (in this case, feathers) contains arsenic and antibiotics such as fluoroquinolones that have been banned by the FDA for use in poultry.

A study published in Environmental Science & Technology found fluoroquinolone antibiotics in 8 of 12 samples of feather meal collected from six states and China.

A second study found arsenic in every sample of feather meal tested.

These findings indicate that poultry producers are using these drugs, even though they are not allowed to.

The U.S. poultry industry raises about 9 billion chickens and 80 million turkeys for human consumption each year.  Meal made from their feathers is commonly added to feed for chickens, pigs, cattle, and fish.  This could be a reentry route into the human food supply for such drugs.

Nicholas Kristof explains in the New York Times that these studies also found feather meal to contain

an antihistamine that is the active ingredient of Benadryl…[and] acetaminophen, the active ingredient in Tylenol.  And feather-meal samples from China contained an antidepressant that is the active ingredient in Prozac.

Poultry-growing literature has recommended Benadryl to reduce anxiety among chickens, apparently because stressed chickens have tougher meat and grow more slowly. Tylenol and Prozac presumably serve the same purpose.

Such findings indicate some of the worst problems with industrial poultry production.  They result from pressures to produce chickens cheaply.  The faster chickens can be pushed to grow, the less feed they consume and the cheaper they are to raise.

I don’t know what the best system for inspection might be, but I’m quite sure that leaving food safety oversight to the discretion of the packers is not a good idea.  Neither is speeding up the line.  And neither is feeding chickens drugs that can affect human health.

Here is even more evidence for the need for an overhaul of our food safety system.

A single food safety system anyone?

USA Today’s Nanci Hellmich interviewed me and my co-author, Malden Nesheim, about Why Calories Count:

When it comes to calories, some people count them, others are confused by them and some just ignore them. Marion Nestle, a nutrition professor at New York University, and Malden Nesheim, professor emeritus of nutritional sciences at Cornell University, look at the topic in Why Calories Count: From Science to Politics. USA TODAY’s Nanci Hellmich talked to them about the new book.

Q: Why do women in general need fewer calories than men?

A: Women are smaller and generally have a higher body fat content than men. Fatty tissue needs less energy to maintain than does muscle mass. Pregnancy and breast-feeding increase women’s calorie needs.

Q: Why do some people have an easier time maintaining a healthy weight than others? How many calories are used by basal metabolism?

A: Genetics has plenty to do with body weight and some people seem to be able to eat vast amounts of food without gaining weight. About two-thirds the calories we need go for basal metabolism — the amount of energy needed to support basic body functions like breathing, blood circulation, kidney function, etc. The rest primarily supports physical activity. So if you want to lose weight, you have to eat less or move a lot more.

Q: Why does energy expenditure decline as much as 20% by age 50 and 30% by age 71 and older?

A: This, in our opinion, is one of life’s great tragedies. Basal metabolism drops with age and so does muscle mass. Lots of people are less physically active when they get older. Staying active does lots of good things for health and one of them is compensating for the decline in calorie needs.

Q: Are all calories created equal when it comes to weight loss?

A: If you lock people in a metabolic ward and feed them the same number of calories in reduced-calorie diets that vary in fat and carbohydrates (all measured), you can show that they lose weight at the same rate regardless of diet composition. The number of calories determines how fast they lose, nothing else.

In the real world, some people lose weight faster on low-carbohydrate, high-fat diets, such as the Atkins diet, especially at the beginning when they excrete so much water. Some people find that low-carbohydrate diets make it easier to reduce calories and stay satiated. And it’s always a good idea to cut back on desserts and sodas.

Q: Do excess calories make some people gain weight faster than others?

A: Here’s where genetics comes in. In controlled studies of overfeeding, everyone gains weight when they eat more calories than they expend, but at different rates. Some people can overeat and gain only a little weight — growing teenage boys are a good example. They may spontaneously increase their physical activity to burn off excess calories. Other people easily store more of the extra calories as fat.

Q: What is your best advice to people who want to lose weight?

A. Our mantra is: Get organized; eat less; eat better; move more; get political. By get political, we mean work to change the food environment to one that makes it easier to eat healthfully: Support labeling laws and nutrition education; stop advertising to children; support agricultural policies that encourage consumption of fruits and vegetables, local food systems, and environments that encourage physical activity.

Q: What do calories have to do with politics?

A: How much food people eat — and whether they are malnourished or overweight — is affected by income, education, and, therefore, the political system. Many companies and vested-interest groups have a stake in how calories are marketed, perceived, labeled, and promoted, not least because eating less is bad for business.

Efforts to do something about obesity in adults and children focus on eating less or on eating better, meaning more fruits, vegetables, and grains but consuming less of sodas, fast food, snacks, and other highly profitable items.

Such matters as soda taxes, listing calories on food labels or menu boards, or campaigns to promote smaller portions are all political responses to concerns about calorie consumption. For years, consumer groups have pushed for calorie and nutrition labeling on alcoholic beverages, but the Treasury Department (not the FDA) regulates such things and responds to the wishes of the industry.

Dr. Michael Osterholm, the director of the University of Minnesota’s Center for Infectious Disease Research and Policy, and a well known advocate for safe food, has asked for a correction to my post of several days ago.

He thinks the post can be interpreted as suggesting that he has financial ties to Beef Products, Inc (BPI), the maker of the ingredient.

In reading over the post, I can see how that interpretation is possible.  That was certainly not my intention.

Dr. Osterholm tells me that neither he nor his University of Minnesota Center have financial, consultative, or political ties to BPI or to Cargill (which also makes the ingredient).

His concerns about the issue have to do with facts about food safety and with correcting misinformation.

I did not mean to suggest otherwise, have personally apologized to him, and have edited the post accordingly.

Today’s New York Times has a long investigative piece on White House interference with FDA decision-making.

The FDA is supposed to make regulatory decisions on the basis of science. When President Obama came into office, he pledged to make decisions based on science and facts rather than ideology:

The truth is that promoting science isn’t just about providing resources—it’s about protecting free and open inquiry…It’s about ensuring that facts and evidence are never twisted or obscured by politics or ideology. It’s about listening to what our scientists have to say, even when it’s inconvenient—especially when it’s inconvenient.

The Times article documents instances in which the administration failed to keep that pledge.  Most of the instances concerned FDA-regulated drugs and devices, but one involves calorie labeling on restaurant menus.

Recall that when President Obama signed the health care reform act in 2010, he signed menu labeling into law.  This required chain restaurants and vending machines to post calorie labels.

The F.D.A.’s first draft of the guidelines — approved by the Department of Health and Human Services and the White House — included rules for movie theaters, lunch wagons, trains and airlines.

But when the FDA released its proposed regulations a year ago, these venues were exempted.

As I said at the time, “Uh oh. Food is sold everywhere these days as anyone who has been to a drug store lately can attest.”

According to the Times’ account, a White House health adviser insisted on these exemptions out of fear that Fox News might view labels on movie popcorn

as an especially silly example of the government intrusions that conservatives often mocked as the nanny state… This was the era of Glenn Beck, and the White House was terrified that Beck would get up and say this is all part of the nanny state.

That’s bad enough but I noticed other key omissions in the FDA’s proposed rules.  For one thing, they allow impossibly large ranges such as the 200-to-800 calories that Chipotle posts, for example.

For another, they say nothing about alcoholic beverages.  As I explain in Why Calories Count, alcohol calories count and alcohol is almost as calorie as fat (7 per gram).  The FDA is ducking this ostensibly because it does not have jurisdiction over alcohol (the Treasury Department does).

The FDA needs to take a good hard look at these issues.

It has not yet propose final rules.  Maybe the Times’ article will give the FDA some breathing room and allow it to do the right thing this time.

And the FDA needs to get the rules out fast.  If the Supreme Court strikes down health care reform, will that mean the end of menu labeling as well?