Clostridium difficile in the Food Supply

Clostridium difficile in the Food Supply.jpeg

Clostridium difficile is one of our most urgent bacterial threats, sickening a quarter million Americans every year, and killing thousands at the cost of a billion dollars a year. And it's on the rise.

As shown in C. difficile Superbugs in Meat, uncomplicated cases have been traditionally managed with powerful antibiotics, but recent reports suggest that hypervirulent strains are increasingly resistant to medical management. There's been a rise in the percentage of cases that end up under the knife, which could be a marker of the emergence of these hypervirulent strains. Surgeons may need to remove our colon entirely to save our lives, although the surgery is so risky that the operation alone may kill us half the time.

Historically, most cases appeared in hospitals, but a landmark study published in the New England Journal of Medicine found that only about a third of cases could be linked to contact with an infected patient.

Another potential source is our food supply.

In the US, the frequency of contamination of retail chicken with these superbugs has been documented to be up to one in six packages off of store shelves. Pig-derived C. diff, however, have garnered the greatest attention from public health personnel, because the same human strain that's increasingly emerging in the community outside of hospitals is the major strain among pigs.

Since the turn of the century, C. diff is increasingly being reported as a major cause of intestinal infections in piglets. C. diff is now one of the most common causes of intestinal infections in baby piglets in the US. Particular attention has been paid to pigs because of high rates of C. diff shedding into their waste, which can lead to the contamination of retail pork. The U.S. has the highest levels of C. diff meat contamination tested so far anywhere in the world.

Carcass contamination by gut contents at slaughter probably contributes most to the presence of C. diff in meat and meat products. But why is the situation so much worst in the US? Slaughter techniques differ from country-to-country, with those in the United States evidently being more of the "quick and dirty" variety.

Colonization or contamination of pigs by superbugs such as C. difficile and MRSA at the farm production level may be more important than at the slaughterhouse level, though. One of the reasons sows and their piglets may have such high rates of C. diff is because of cross-contamination of feces in the farrowing crate, which are narrow metal cages that mother pigs are kept in while their piglets are nursing.

Can't you just follow food safety guidelines and cook the meat through? Unfortunately, current food safety guidelines are ineffective against C. difficile. To date, most food safety guidelines recommend cooking to an internal temperature as low as 63o C-the official USDA recommendation for pork-but recent studies show that C. diff spores can survive extended heating at 71o. Therefore, the guidelines should be raised to take this potentially killer infection into account.

One of the problems is that sources of C. diff food contamination might include not only fecal contamination on the surface of the meat, but transfer of spores from the gut into the actual muscles of the animal, inside the meat. Clostridia bacteria like C. diff comprise one of the main groups of bacteria involved in natural carcass degradation, and so by colonizing muscle tissue before death, C. diff can not only transmit to new hosts that eat the muscles, like us, but give them a head start on carcass break-down.

Never heard of C. diff? That's the Toxic Megacolon Superbug I've talked about before.

Another foodborne illness tied to pork industry practices is yersiniosis. See Yersinia in Pork.

MRSA (Methicillin-resistant Staph aureus) is another so-called superbug in the meat supply:

More on the scourge of antibiotic resistance and what can be done about it:

How is it even legal to sell foods with such pathogens? See Salmonella in Chicken & Turkey: Deadly But Not Illegal and Chicken Salmonella Thanks to Meat Industry Lawsuit.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: USDA / Flickr. This image has been modified.

Original Link

Clostridium difficile in the Food Supply

Clostridium difficile in the Food Supply.jpeg

Clostridium difficile is one of our most urgent bacterial threats, sickening a quarter million Americans every year, and killing thousands at the cost of a billion dollars a year. And it's on the rise.

As shown in C. difficile Superbugs in Meat, uncomplicated cases have been traditionally managed with powerful antibiotics, but recent reports suggest that hypervirulent strains are increasingly resistant to medical management. There's been a rise in the percentage of cases that end up under the knife, which could be a marker of the emergence of these hypervirulent strains. Surgeons may need to remove our colon entirely to save our lives, although the surgery is so risky that the operation alone may kill us half the time.

Historically, most cases appeared in hospitals, but a landmark study published in the New England Journal of Medicine found that only about a third of cases could be linked to contact with an infected patient.

Another potential source is our food supply.

In the US, the frequency of contamination of retail chicken with these superbugs has been documented to be up to one in six packages off of store shelves. Pig-derived C. diff, however, have garnered the greatest attention from public health personnel, because the same human strain that's increasingly emerging in the community outside of hospitals is the major strain among pigs.

Since the turn of the century, C. diff is increasingly being reported as a major cause of intestinal infections in piglets. C. diff is now one of the most common causes of intestinal infections in baby piglets in the US. Particular attention has been paid to pigs because of high rates of C. diff shedding into their waste, which can lead to the contamination of retail pork. The U.S. has the highest levels of C. diff meat contamination tested so far anywhere in the world.

Carcass contamination by gut contents at slaughter probably contributes most to the presence of C. diff in meat and meat products. But why is the situation so much worst in the US? Slaughter techniques differ from country-to-country, with those in the United States evidently being more of the "quick and dirty" variety.

Colonization or contamination of pigs by superbugs such as C. difficile and MRSA at the farm production level may be more important than at the slaughterhouse level, though. One of the reasons sows and their piglets may have such high rates of C. diff is because of cross-contamination of feces in the farrowing crate, which are narrow metal cages that mother pigs are kept in while their piglets are nursing.

Can't you just follow food safety guidelines and cook the meat through? Unfortunately, current food safety guidelines are ineffective against C. difficile. To date, most food safety guidelines recommend cooking to an internal temperature as low as 63o C-the official USDA recommendation for pork-but recent studies show that C. diff spores can survive extended heating at 71o. Therefore, the guidelines should be raised to take this potentially killer infection into account.

One of the problems is that sources of C. diff food contamination might include not only fecal contamination on the surface of the meat, but transfer of spores from the gut into the actual muscles of the animal, inside the meat. Clostridia bacteria like C. diff comprise one of the main groups of bacteria involved in natural carcass degradation, and so by colonizing muscle tissue before death, C. diff can not only transmit to new hosts that eat the muscles, like us, but give them a head start on carcass break-down.

Never heard of C. diff? That's the Toxic Megacolon Superbug I've talked about before.

Another foodborne illness tied to pork industry practices is yersiniosis. See Yersinia in Pork.

MRSA (Methicillin-resistant Staph aureus) is another so-called superbug in the meat supply:

More on the scourge of antibiotic resistance and what can be done about it:

How is it even legal to sell foods with such pathogens? See Salmonella in Chicken & Turkey: Deadly But Not Illegal and Chicken Salmonella Thanks to Meat Industry Lawsuit.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: USDA / Flickr. This image has been modified.

Original Link

Benefits of Nutritional Yeast to Prevent the Common Cold

Benefits of Nutritional Yeast to Prevent the Common Cold.jpeg

Natural immunomodulators that can help regulate our immune system without side-effects have been sought for centuries, and all the while they've been sitting in the produce aisle. Plants produce thousand of active compounds, many of which modulate our immune system, but we can't forget the fungi (see Boosting Immunity While Reducing Inflammation).

Mushrooms have used for centuries as folk remedies, and for good reason. Some have been shown to boost immune function, so much so that a type of fiber found in shiitake mushrooms is approved for use as adjunct chemotherapy, injected intravenously to help treat a variety of cancers by rallying our immune defenses.

More than 6,000 papers have been published on these so-called beta glucans, but almost all of the data about preventing infections had come from petri dish or lab animal studies, until a few years ago when a series of experiments on athletes showed beneficial effects in marathon runners (see Preserving Immune Function in Athletes With Nutritional Yeast). What about the rest of us? We didn't know... until now.

As I explore in my video, Nutritional Yeast to Prevent the Common Cold, beta glucan fiber found in baker's, brewer's and nutritional yeast helps to maintain our body's defense against pathogens even in nonathletes, according to a double-blind, randomized, placebo-controlled trial. The recurrence of infections with the common cold was reduced by 25% in those that ate the equivalent of about a spoonful of nutritional yeast a day, and had fewer cold-related sleeping difficulties when they did get sick.

What about half a spoonful a day? Still worked! Subjects experienced a big drop in common cold incidence and a reduction in symptoms as well. Why is this? This study found that not only were upper respiratory infection symptoms diminished, but that mood states appeared to improve, for example a significant boost in feelings of "vigor." So the researchers suggest that maybe the yeast fiber is able to counteract the negative effects of stress on the immune system.

In terms of side-effects, two folks reported stomachaches, but they were both in the placebo group.

Unlike antibiotics and antivirals, which are designed to kill the pathogen directly, these yeast compounds instead appear to work by stimulating our immune defenses, and as such don't share the same antibiotic side effects. They stimulate our immune defenses presumably because our body recognizes them as foreign. But if it's treated like an invader, might it trigger an inflammatory response? Turns out these fiber compounds may actually have an anti-inflammatory effect, suggesting nutritional yeast may offer the best of both worlds, boosting the infection fighting side of the immune system while suppressing inflammatory components.

Yeast is high in purines, so those with gout, uric acid kidney stones, and new organ transplant recipients may want to keep their intake to less than a teaspoon a day. But is there any downside for everyone else? In California some packages of nutritional yeast are slapped with prop 65 warning stickers, suggesting there's something in it exceeding cancer or birth defect safety limits. I called around to the companies and it turns out the problem is lead. California state law says a product cannot contain more than half of a microgram of lead per daily serving, so I contacted the six brands I knew about and asked them how much lead was in their products.

KAL originally said "<5 ppm," but when we called back they said "<3 ppm." Even if it's 3, that translates into less than 45 micrograms per serving, nearly a 100 times more than the California limit. But perhaps that's better than Bob's Red Mill or Frontier Coop, who evidently don't test at all. But at least they got back to me. Redstar brand failed to respond to multiple attempts to contact them. Now Foods said they test for lead and claim that at least their recent batches meet the less than a half a microgram California standard. Unfortunately, despite repeated requests they would not provide me with documentation to substantiate their numbers. My favorite response was from Bragg's who sent me the analysis certificate from the lab showing less than 0.01 ppm, which means at most less than half the California standard, which I believe is the most stringent in the world. To put the numbers in context, in determining how much lead manufacturers can put into candy likely to be frequently consumed by small children, the Food and Drug Administration would allow about 2 micrograms a day in the form of lollipops, but as far as I'm concerned the less lead the better.

I was so frustrated by the lack of transparency I decided to test them for lead myself. NutritionFacts.org hired an independent lab to conduct our own tests for lead and shipped out 8 samples of nutritional yeast in their original package. The lab used standard practices for lead testing known as Official Methods of Analysis set by AOAC International. Lab technicians determined the lead values based on California Prop 65 standards. Here are the results from the brands we tested:

Bob's Red Mill - Test report shows no detectable lead (<0.01 ppm).

Bragg - Test report shows no detectable lead (< 0.01 ppm).

Dr. Fuhrman - Test report shows no detectable lead (< 0.01 ppm).

Frontier Coop - Test report shows lead levels at 0.021 ppm. It would take six tablespoons a day (based on the manufacture's listed density) to exceed the California Office of Environmental Health Hazard Assessment Maximum Allowable Dose Level (MADL) for chemicals causing reproductive toxicity.*

KAL - Test report shows lead levels at 0.011 ppm. It would take seven tablespoons a day to exceed the MADL.*

NOW Foods - Test report shows no detectable lead (< 0.01 ppm).

Red Star - Test report shows no detectable lead (< 0.01 ppm).

Whole Foods - Test report shows lead levels at 0.012 ppm. It would take six tablespoons a day to exceed the MADL.*

So what do all those numbers mean? None of the brands tested exceeded California prop 65 standards. No matter what brand, consuming a typical serving (2 tablespoons) per day is still well within safe limits.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

* The Maximum Allowable Dose Level for lead as a developmental toxin is 0.5 micrograms a day. How are MADL's calculated? Basically scientists figure out what the "no observable effect level" is, the level at which no birth defects or reproductive toxicity can be found, and then introduce a 1000-fold safety buffer. So for example, let's say there's some chemical that causes birth defects if expectant moms are exposed to two drops of the chemical a day, but there's no evidence that one drop a day is harmful. Do they set the Maximum Allowable Dose Level at one drop? No, they set it at 1/1000th of a drop to account for scientific uncertainty and to err on the side of caution. So by saying six tablespoons a day of nutritional yeast may exceed the MADL is in effect saying that the level of lead found in 6,000 tablespoons of nutritional yeast may cause birth defects. Like mercury, though, as far as I'm concerned the less lead exposure the better. I hope this will inspire companies to do further testing to see if the levels we found were just flukes.

Image Credit: Sally Plank / Flickr. This image has been modified.

Original Link

Benefits of Nutritional Yeast to Prevent the Common Cold

Benefits of Nutritional Yeast to Prevent the Common Cold.jpeg

Natural immunomodulators that can help regulate our immune system without side-effects have been sought for centuries, and all the while they've been sitting in the produce aisle. Plants produce thousand of active compounds, many of which modulate our immune system, but we can't forget the fungi (see Boosting Immunity While Reducing Inflammation).

Mushrooms have used for centuries as folk remedies, and for good reason. Some have been shown to boost immune function, so much so that a type of fiber found in shiitake mushrooms is approved for use as adjunct chemotherapy, injected intravenously to help treat a variety of cancers by rallying our immune defenses.

More than 6,000 papers have been published on these so-called beta glucans, but almost all of the data about preventing infections had come from petri dish or lab animal studies, until a few years ago when a series of experiments on athletes showed beneficial effects in marathon runners (see Preserving Immune Function in Athletes With Nutritional Yeast). What about the rest of us? We didn't know... until now.

As I explore in my video, Nutritional Yeast to Prevent the Common Cold, beta glucan fiber found in baker's, brewer's and nutritional yeast helps to maintain our body's defense against pathogens even in nonathletes, according to a double-blind, randomized, placebo-controlled trial. The recurrence of infections with the common cold was reduced by 25% in those that ate the equivalent of about a spoonful of nutritional yeast a day, and had fewer cold-related sleeping difficulties when they did get sick.

What about half a spoonful a day? Still worked! Subjects experienced a big drop in common cold incidence and a reduction in symptoms as well. Why is this? This study found that not only were upper respiratory infection symptoms diminished, but that mood states appeared to improve, for example a significant boost in feelings of "vigor." So the researchers suggest that maybe the yeast fiber is able to counteract the negative effects of stress on the immune system.

In terms of side-effects, two folks reported stomachaches, but they were both in the placebo group.

Unlike antibiotics and antivirals, which are designed to kill the pathogen directly, these yeast compounds instead appear to work by stimulating our immune defenses, and as such don't share the same antibiotic side effects. They stimulate our immune defenses presumably because our body recognizes them as foreign. But if it's treated like an invader, might it trigger an inflammatory response? Turns out these fiber compounds may actually have an anti-inflammatory effect, suggesting nutritional yeast may offer the best of both worlds, boosting the infection fighting side of the immune system while suppressing inflammatory components.

Yeast is high in purines, so those with gout, uric acid kidney stones, and new organ transplant recipients may want to keep their intake to less than a teaspoon a day. But is there any downside for everyone else? In California some packages of nutritional yeast are slapped with prop 65 warning stickers, suggesting there's something in it exceeding cancer or birth defect safety limits. I called around to the companies and it turns out the problem is lead. California state law says a product cannot contain more than half of a microgram of lead per daily serving, so I contacted the six brands I knew about and asked them how much lead was in their products.

KAL originally said "<5 ppm," but when we called back they said "<3 ppm." Even if it's 3, that translates into less than 45 micrograms per serving, nearly a 100 times more than the California limit. But perhaps that's better than Bob's Red Mill or Frontier Coop, who evidently don't test at all. But at least they got back to me. Redstar brand failed to respond to multiple attempts to contact them. Now Foods said they test for lead and claim that at least their recent batches meet the less than a half a microgram California standard. Unfortunately, despite repeated requests they would not provide me with documentation to substantiate their numbers. My favorite response was from Bragg's who sent me the analysis certificate from the lab showing less than 0.01 ppm, which means at most less than half the California standard, which I believe is the most stringent in the world. To put the numbers in context, in determining how much lead manufacturers can put into candy likely to be frequently consumed by small children, the Food and Drug Administration would allow about 2 micrograms a day in the form of lollipops, but as far as I'm concerned the less lead the better.

I was so frustrated by the lack of transparency I decided to test them for lead myself. NutritionFacts.org hired an independent lab to conduct our own tests for lead and shipped out 8 samples of nutritional yeast in their original package. The lab used standard practices for lead testing known as Official Methods of Analysis set by AOAC International. Lab technicians determined the lead values based on California Prop 65 standards. Here are the results from the brands we tested:

Bob's Red Mill - Test report shows no detectable lead (<0.01 ppm).

Bragg - Test report shows no detectable lead (< 0.01 ppm).

Dr. Fuhrman - Test report shows no detectable lead (< 0.01 ppm).

Frontier Coop - Test report shows lead levels at 0.021 ppm. It would take six tablespoons a day (based on the manufacture's listed density) to exceed the California Office of Environmental Health Hazard Assessment Maximum Allowable Dose Level (MADL) for chemicals causing reproductive toxicity.*

KAL - Test report shows lead levels at 0.011 ppm. It would take seven tablespoons a day to exceed the MADL.*

NOW Foods - Test report shows no detectable lead (< 0.01 ppm).

Red Star - Test report shows no detectable lead (< 0.01 ppm).

Whole Foods - Test report shows lead levels at 0.012 ppm. It would take six tablespoons a day to exceed the MADL.*

So what do all those numbers mean? None of the brands tested exceeded California prop 65 standards. No matter what brand, consuming a typical serving (2 tablespoons) per day is still well within safe limits.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

* The Maximum Allowable Dose Level for lead as a developmental toxin is 0.5 micrograms a day. How are MADL's calculated? Basically scientists figure out what the "no observable effect level" is, the level at which no birth defects or reproductive toxicity can be found, and then introduce a 1000-fold safety buffer. So for example, let's say there's some chemical that causes birth defects if expectant moms are exposed to two drops of the chemical a day, but there's no evidence that one drop a day is harmful. Do they set the Maximum Allowable Dose Level at one drop? No, they set it at 1/1000th of a drop to account for scientific uncertainty and to err on the side of caution. So by saying six tablespoons a day of nutritional yeast may exceed the MADL is in effect saying that the level of lead found in 6,000 tablespoons of nutritional yeast may cause birth defects. Like mercury, though, as far as I'm concerned the less lead exposure the better. I hope this will inspire companies to do further testing to see if the levels we found were just flukes.

Image Credit: Sally Plank / Flickr. This image has been modified.

Original Link

Why Does the Meat Industry Routinely Feed Animals Antibiotics?

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When farm animals are fed antibiotics, they can develop antibiotic-resistant bacteria in their guts. Manure contamination of meat can then transfer these gut bacteria to humans. These bacteria can even spread to vegetarians, since drug-resistant bacteria in the animal feces can also spread to people through crops or the environment. Exhaust fans can blow MRSA superbugs straight out into the surrounding area from pig or poultry operations. This may explain why human MRSA infections in Europe have been tied to just living in a region with industrial pig production, whether or not people have direct contact with livestock. These findings may not just be limited to Europe.

European factory farms pale in comparison to what we have here in the U.S. From an article published in the Journal of the American Medical Association's Internal Medicine: "proximity to swine manure application to crop fields and livestock operations was each associated with MRSA and skin and soft-tissue infections [in people in the U.S]. These findings contribute to the growing concern about the potential public health impacts of high-density livestock production."

An article published in Lancet Infectious Diseases explains that, "achievements in modern medicine, such as surgery, the treatment of preterm babies, and cancer chemotherapy, which we today take for granted, would not be possible without access to effective treatment for bacterial infections. Within just a few years, we might be faced with dire setbacks, medically, socially, and economically, unless real and unprecedented global coordinated actions are immediately taken" to protect these wonder drugs. Therefore, the use of antibiotics just to promote the growth of farm animals to slaughter weights should be banned worldwide. Europe stopped feeding pigs and chickens tetracycline and penicillin to promote growth about 40 years ago, something the U.S. meat industry continues to do to this day.

The Pew Commission recently published a five year update on their landmark blue ribbon commission report on current agricultural practices that found "the present system of producing food animals in the United States presents an unacceptable level of risk to public health." Their number one recommendation was to ban the non-therapeutic use of antibiotics, but agriculture lobbies are not going to give up the use of antibiotics without a fight (See Antibiotics: Agribusinesses' Pound of Flesh).

In December 2013, the FDA released "Guidance for Industry," their voluntary, non-binding recommendation for industry. They recommend antibiotics no longer be used to just fatten animals for slaughter, but emphasize that they are just that: toothless, non-legally enforceable suggestions. As mentioned in the Pew Commission report, "this voluntary approach has come under withering criticism from the public health and medical communities concerned about the increase in antibiotic-resistant bacterial pathogens."

The USDA is even considering going backwards, eliminating the requirement to even test for Staph aureus at all in the Federal School Lunch Program. They understand that "school-aged children are considered a 'sensitive population', hence, more stringent requirements, including sampling plans, may be considered to help assure safety and public confidence. However, the cost of such programs must be weighed against the cost of buying the food needed to support the program."

As one University of Iowa epidemiologist said, "although human health should take priority over farm animals, farmers will be reluctant to change until researchers can come up with safe and cost-effective practices to replace the use of antibiotics." How much are antibiotics really saving the industry? The net bottom-line benefit from the use of antibiotic feed additives may only be about $0.25 per animal, which means eliminating the risky practice of feeding antibiotics by the ton to farm animals would raise the price of meat less than a penny per pound.

For those not familiar with MRSA, please see my past videos on the topic:

For more on antibiotic use on the farm, see:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: AJC ajcann.wordpress.com / Flickr

Original Link

Antibiotic-Resistant "Superbugs" in Meat

NF-Mar10 MRSA Superbugs in Meat.jpeg

As a rule, "high-ranking public-health officials try to avoid apocalyptic descriptors. So it's worrying to hear those like the Director of the CDC warn of a coming health 'nightmare' and a 'catastrophic threat.'" A number of prominent publications recently warned of the threat of antibiotic resistance. The CDC estimates that at a minimum, more than two million people are sickened every year with antibiotic-resistant infections in the United States, with at least 23,000 dying as a result (See MRSA Superbugs in Meat).

We may be at the dawn of a post-antibiotic era. Achievements in modern medicine that we today take for granted, such as surgery and the treatment of preterm babies, would not be possible without access to effective treatment for bacterial infections. For example, without antibiotics, the rate of postoperative infection after a procedure like a hip replacement would be 40-50% and about one in three of those patients would die. So the so-called worst case scenarios where resistant infections could cost $50 billion a year might still be an underestimate. "From cradle to grave, antibiotics have become pivotal in safeguarding the overall health of human societies."

So the dire phrasing from head officials may be warranted. There are now infections like carbapenem-resistant enterobacter that are resistant to nearly all antibiotics, even to so-called drugs of last resort. Worryingly, some of these last resort drugs are being used extensively in animal agriculture.

According to the World Health Organization, more antibiotics are fed to farmed animals than are used to treat disease in human patients. Doctors overprescribe antibiotics, but huge amounts of antibiotics are used in fish farming and other intensive animal agriculture, up to four times the amount used in human medicine. Why? "Suboptimum growth to slaughter weight caused by unsanitary conditions can be compensated with the addition of antibiotics to feed." Instead of relieving any stressful overcrowded unhygienic conditions, it may be cheaper to just dose the animals with drugs.

In this way, factory farms are driving the growth of antibiotic-resistant organisms that cause human diseases. "This may help bolster the industry's bottom line, but in the process, bacteria are developing antimicrobial resistance, which affects human health."

In the United States, the FDA reports that 80% of antimicrobial drugs in the United States are used in food animals, mainly to promote growth in this kind of high-density production. This can select for antibiotic-resistant bacteria like methicillin-resistant Staph aureus, or MRSA, considered a serious threat in the United States.

These industrial pig operations may provide optimal conditions for the introduction and transmission of MRSA. U.S. pork producers are currently permitted to use 29 antibiotic drugs in feed--all without a prescription. Antiobitics are currently added to about 90% of pigs starter feeds.

When animals receive unnecessary antibiotics, bacteria can be come resistant to the drugs, then travel on meat to the store, and end up causing hard-to-treat illnesses in people.

MRSA present in retail raw meat may serve as a possible source of bacterial infections of food preparers in the food industry and the hands of consumers in the home. Once MRSA gets into our homes on meat, it can transfer to our cutting boards, knives, and onto our skin at a rate similar to the rate of transmission from touching an infected patient contaminated with MRSA. Washing of hands after touching raw pork is advised.

I know I've already covered this topic before, but it never fails to shock me that the meat industry can get away with something so forcefully and universally condemned by the public health community. What other industrial sector could get away with putting people at such risk? It speaks to the combined might of the livestock industry and the pharmaceutical industry in holding sway over our democratic process, no matter what the human health consequences.

If you've missed my other MRSA videos, check out:

And for more on this critical issue in general:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Jellaluna / Flickr

Original Link

Why are Chickens Fed Prozac?

NF-Jan28 Illegal Drugs in Chicken Feathers.jpeg

Between 1940 and 1971, the synthetic estrogen DES was prescribed to several million pregnant women with the promise that it would "help prevent miscarriages." Problems were first highlighted in 1953 when it became clear that DES was not only ineffective but potentially harmful. However, a powerful and emotive advertising campaign ensured that its use continued until 1971, when it was found to cause cancer of the vagina in the daughters of the mothers who took it. DES was also used to stunt the growth of girls who were predicted to grow "abnormally tall." As one pediatric textbook put it in 1968, "excessive tallness in girls can be a handicap ... it provides difficulty in the purchase of smart clothes; the victim is ineligible for certain sought-after professional positions such as air line hostess; and poses problems in selecting suitable dancing partners."

What most people don't know is that the greatest usage of DES was by the livestock industry, used to improve "feed conversion" in cattle and chickens. Within a year of approval, DES was fed to millions of farm animals. Although it was shown to be a human carcinogen in 1971, DES used in meat production was not completely banned until 1979. (Now, the meat industry just uses different synthetic estrogen implants.) Even decades after DES was banned, we're still seeing its effects--an elevation of birth defects even down to the third generation.

Arsenic is another human carcinogen that was fed to chickens. This time by the billions. The arsenic not only ends up in the meat (as I've talked about previously in Arsenic in Chicken and How Many Cancers Caused by Arsenic Laced Chicken?), but also in the feathers, which are fed back to the animals. Because a third of the bird is inedible, the industry takes billions of pounds of heads, bones, guts, and feathers and uses them as fertilizer and animal feed. This feather meal is fed back to chickens, pigs, cows, sheep, and fish. Straight feathers are not particularly nutritious; so guts, heads, and feet may be added for a little extra protein, and manure added for minerals. The problem is that feather meal used as animal feed could contribute to additional arsenic exposure in persons who consume meat. This gave researchers at John Hopkins University and Arizona State an idea. By testing feather meal, they might be able to find out what else chickens are fed. In their study, "Feather Meal: A Previously Unrecognized Route for Reentry into the Food Supply of Multiple Pharmaceuticals and Personal Care Products," (highlighted in my video, Illegal Drugs in Chicken Feathers) they found that all feather samples tested positive for antibiotic type drugs (between two and ten different kinds in each sample), including fluoroquinolones, which have been banned for years. Either the poultry industry is illegally still using the stuff, or it's being used in other animals fed to the chicken. Regardless, when feather meal is fed back to chickens, they are getting exposed to this drug that is against the law to feed to chickens, creating a cycle of re-exposure to banned drugs.

Then it just gets weirder. The feathers contained a half dozen other drugs: Prozac, an antihistamine, a fungicide, a sex hormone, and caffeine. Why doesn't the poultry industry just say no? Evidently, the antihistamines are to combat the respiratory problems from packing so many tens of thousands into the confinement sheds, and the caffeine helps keeps the chickens stay awake so they eat more and grow faster.

The drugs fed to chickens are one reason used to explain why poultry has been tied to increased cancer risk. See Chicken Dioxins, Viruses, or Antibiotics?.

The most concerning drugs currently in the U.S. poultry supply are the antibiotics, though. See, for example:

Ironically, not only may antibiotics in chicken contribute to antibiotic resistant infections, but to the infections in the first place. Check out my video Avoiding Chicken to Avoid Bladder Infections.

Then as if adding potentially harmful chemicals to the chickens themselves wasn't bad enough, more are added in the processing plant: Phosphate Additives in Chicken.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: U.S. Department of Agriculture / Flickr

Original Link

Making Your Own Mouthwash

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The effects of a vegetarian diet on systemic diseases like cancer, diabetes, and heart diseases have been studied and have revealed predominantly less systemic diseases in those eating plant-based diets. However, there have only been a few studies on oral health, which I covered in my videos Plant-Based Diets: Oral Health and Plant-Based Diets: Dental Health.

What's the latest? In a study of 100 vegetarians compared to a 100 non-vegetarians, the vegetarians had better periodontal conditions, showing less signs of inflammation like gum bleeding, less periodontal damage, and better dental home care, brushing and flossing 2.17 times a day compared to 2.02 times a day. The difference in home hygiene is not that large, though, so maybe it was something about their diet. However, vegetarians may have a healthier lifestyle overall beyond just avoiding meat. The researchers controlled for smoking, but other factors like obesity can adversely affect oral health, so there may be confounding factors. What we need is an interventional study, where researchers take people eating the standard Western diet, improve their diets, and see what happens. But no such study existed... until now.

With professional support of nutritionists, the participants of the study (highlighted in my video What's the Best Mouthwash?) with existing periodontal disease changed their dietary patterns to so-called "wholesome nutrition," a diet emphasizing veggies, fruits, whole grains, potatoes, beans, peas, lentils, and spices, with water as the preferred beverage. To make sure any changes they witnessed were due to the diet, researchers made subjects maintain their same oral hygiene before and after the dietary change. What did they find? They found that eating healthier appeared to lead to a significant reduction of probing pocket depth, gingival inflammation, and levels of inflammatory cytokines, which mediate the tissue destruction in periodontal disease. Therefore, the researchers conclude that wholesome nutrition may improve periodontal health.

Why might diet help? Plant-based diets have a number of nutritional benefits in terms of nutrient density, but it also may be about improving balance between free radicals and our antioxidant defense system. Traditionally, dietary advice for oral health was just about avoiding sugar, which feed the bad bacteria on our teeth. We now realize that some foods and beverages, like green tea, possess antimicrobial properties to combat the plaque producing bacteria directly.

If plaque is caused by bacteria, why not use antibiotics? Many such attempts have been made, however undesirable side-effects such as "antibiotic resistance, vomiting, diarrhea and teeth stains have precluded their use." In a petri dish, green tea phytonutrients effectively inhibit the growth of these bacteria, but what about in our mouths? Researchers found that rinsing with green tea strongly inhibited the growth of the plaque bacteria on our teeth within minutes. Seven minutes after swishing with green tea, the number of harmful bacteria in the plaque scraped from people's teeth was cut nearly in half.

If you swish sugar water in your mouth, within three minutes the pH on our teeth can drop into the cavity formation danger zone. But if 20 minutes before swishing with sugar water, you swished with some green tea, you wipe out so many plaque bacteria that the same sugar water hardly has any effect at all. The researchers conclude that using green tea as a mouthwash or adding it to toothpaste could be a cost effective cavity prevention measure, especially in developing countries.

In the "civilized world," we have antiseptic mouthwashes with fancy chemicals like chlorhexidine, considered the gold standard anti-plaque agent. If only it didn't cause genetic damage. DNA damage has been detected in individuals who rinsed their mouths with chlorhexidine-containing mouthwashes, and not just to cells in the mouth. 13 volunteers rinsed their mouths with the stuff for a few weeks, and there was an increase in DNA damage both in the cells lining their cheeks as well as in their peripheral blood cells, suggesting that chlorhexidine was absorbed into their bodies. It reduced plaque better than other antiseptic chemicals, but it's doubtful whether chlorhexidine can still be considered the golden standard considering how toxic it is to human cells.

Are we left with having to decide between effectiveness and safety? How about a head to head test between chlorhexidine and green tea? Researchers found that green tea worked better than chlorhexidine at reducing plaque. Using green tea as a mouthwash may be cheaper, safer, and better. If, as a bonus, you want to sprinkle some amla powder (dried Indian gooseberry powder) into it, you may make it an even better plaque buster. Amla evidently shows an outstanding cavity-stopping potential not by killing off the bacteria like green tea, but by actually suppressing the bacteria's plaque forming abilities.

I now keep a mason jar filled with cold-steeped green tea (Cold Steeping Green Tea) with a spoonful of amla in the fridge and swish and swallow a few times a day. For extra credit you can gargle a bit with it too (see my video Can Gargling Prevent the Common Cold?).

Green tea shouldn't be the primary beverage of children, though, as the natural fluoride content may cause cosmetic spots on the teeth. For more check out my video Childhood Tea Drinking May Increase Fluorosis Risk.

Another reason we may want to avoid antibacterial mouthwashes is that they can kill off the good bacteria on our tongue that are instrumental in enhancing athletic performance with nitrate-containing vegetables (See Don't Use Antiseptic Mouthwash). For more on this, check out my video from yesterday, Antibacterial Toothpaste: Harmful, Helpful, or Harmless?

Need a reminder what amla is? More on dried Indian gooseberry powder power in:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Norio Nakayama / Flickr

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How Fruits and Vegetables Can Prevent Asthma

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Asthma is the most common chronic disease in children and the prevalence is increasing around the world. Despite this, most research dollars are spent on adult chronic disease. "One might ask," a group of researchers posited "whether this is because our politicians and senior administrators feel themselves to be more likely to suffer from the latter, and thus ignore allergic diseases as they mostly impact children and young adults" - who don't vote.

An enormous study about asthma and allergies in childhood, highlighted in my video, Preventing Asthma with Fruits and Vegetables, was published that includes more than a million children in nearly a hundred countries, making it the most comprehensive survey of asthma and allergies ever undertaken. The researchers found striking worldwide variations in the prevalence and severity of asthma, allergies, and eczema--a 20 to 60-fold difference in prevalence of symptoms of asthma, allergic runny nose, and atopic eczema around the world. The large variability suggests a crucial role of local characteristics that are determining the differences in prevalence between one place and another.

What kind of environmental factors? Why does the prevalence of itchy eyes and runny noses range anywhere from 1% in India, for example, and up to 45% of kids elsewhere? There were some associations with regional air pollution and smoking rates, but the most significant associations were with diet. Adolescents showed a consistent pattern of decreases in symptoms of wheeze (current and severe), allergic rhinoconjunctivitis, and atopic eczema with increases in per capita consumption of plant foods. The more their calories and protein came from plant sources, the less allergies they tended to have.

In general, there seems to be an association between an increase in asthma prevalence and a decrease in consumption of fresh fruits, green vegetables, and other dietary sources of antioxidants, helping to explain why the prevalence of asthma and respiratory symptoms are lower in populations with high intake of foods of plant origin. High intakes of fat and sodium, and low intakes of fiber and carbohydrates, are linked with asthma, while traditional and vegetarian diets are associated with lower rates. For example, if we look closer within India, in a study of more than 100,000 people, "those who consumed meat (daily or occasionally) were more likely to report asthma than those who were strictly vegetarian." This also meant avoiding eggs.

Eggs have been associated (along with soft drink consumption) with increased risk of respiratory symptoms and asthma in schoolchildren. On the other hand, consumptions of soy foods and fruits were associated with reduced risk of respiratory symptoms. In fact, removing eggs and dairy from the diet may improve lung function in asthmatic children in as little as eight weeks. Therefore, it may be a combination of eating fewer animal foods and more plants.

High vegetable intake, for example, has been found protective in children, potentially cutting the odds of allergic asthma in half. And fruit has also shown a consistent protective association for current and severe wheeze and runny nose in adolescents, and for current and severe asthma, allergies, and eczema in children.

Why is this? I've talked about the endocrine-disrupting industrial pollutants (see Dietary Sources of Alkylphenol Endocrine Disruptors) building up in the meat supply that may increase the risk of allergic disease, but the increase in asthma may be a combination of both a more toxic environment and a more susceptible population. One review notes that, "The dietary changes which have occurred over recent years may have led to a reduction in these natural antioxidant defenses, resulting in a shift of the antioxidant status of the whole population and leading to increased susceptibility to oxidant attack and airway inflammation."

In adults, for example, the risk of airway hyper-reactivity may increase seven-fold among those with the lowest intake of vitamin C from plant foods, while those with the lowest intake of saturated fats may have a 10-fold protection, presumably because of saturated fat's role in triggering inflammation.

The protective effect of plant-based food may also be mediated through effects on intestinal microflora. It turns out that differences in the indigenous intestinal flora might affect the development and priming of the immune system in early childhood. Kids with allergies, for example, tend to be less likely to harbor lactobacilli, the good bacteria that's found in fermented foods, and naturally on many fruits and vegetables. Lactobacillus probiotics may actually help with childhood asthma, which may help explain why children raised on largely organic vegetarian diets may have a lower prevalence of allergic reactions. Infants raised this way tend to have more good lactobacilli in their guts compared to controls, though they were also more likely to have been born naturally, breastfed longer, and not been given antibiotics, so we can't really tell if it's the diet until we put it to the test (See Treating Asthma with Fruits and Vegetables).

More on preventing allergic diseases can be found in my videos Preventing Childhood Allergies and Preventing Allergies in Adulthood.

More on protecting lung function with fruits and vegetables can be found in Preventing COPD With Diet.

Surprised probiotics can affect immune function? Check out my video Preventing the Common Cold with Probiotics? And if you think that is wild, wait until you see Gut Feelings: Probiotics and Mental Health.

What might be in plants that's so beneficial? See Anti-inflammatory Antioxidants.

What might be in animal products that is harmful to lung function? There are endocrine-disrupting industrial pollutants that build up in the food chain that may be playing a role. See my video Alkylphenol Endocrine Disruptors and Allergies. Also there's an inflammatory omega-6 fatty acid found predominantly in chicken and eggs that may contribute to inflammation as well. See Inflammatory Remarks About Arachidonic Acid.

Choosing fragrance-free personal care products may also help reduce airway reactivity: Throw Household Products Off the Scent.

I compare the efficacy of plants to pills (Treating Asthma With Plants vs. Supplements?) and explore the role an entire diet filled with plants might play in Treating Asthma and Eczema With Plant-Based Diets.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: EdTech Stanford University School of Medicine / Flickr

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Chicken Salmonella Outbreaks Show Food Safety Systems Failure

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Salmonella causes more hospitalizations and more deaths than any other foodborne illness, and it's been on the rise. Salmonella causes a million cases of food poisoning every year in the U.S., and over the last decade or so the number of cases has increased by 44%, particularly among children and the elderly. And chicken is the number one cause of Salmonella poisoning.

Starting in Spring 2012, the Centers for Disease Control (CDC) documented more than 600 individuals infected across 29 states with a particularly virulent strain of Salmonella (one in three were hospitalized). Investigations pointed to Foster Farms--the sixth largest chicken producer in the US--as the most likely source of the outbreak. The CDC warned people, but nothing was done. Foster Farms apparently continued to pump out contaminated meat for 17 months.

Though there's only been a few hundred cases confirmed, for every confirmed case the CDC estimates 38 cases slip through the cracks. So Foster Farms chicken may have infected and sickened more than 15,000 people.

When USDA inspectors went to investigate, they found 25% of the chicken they sampled was contaminated with the outbreak strain of Salmonella, presumed to be because of all the fecal matter they found on the carcasses.

In their February 2014 issue, Consumer Reports published a study on the high cost of cheap chicken, finding 97% of retail chicken breast off store shelves was contaminated with bacteria that can make people sick. 38% of the salmonella they found was resistant to multiple antibiotics (considered a serious public health threat by the CDC). Consumer Reports suggested the cramped conditions on factory chicken farms may play a role, and indeed new research shows the stress of overcrowding can increase Salmonella invasion.

The Pew Commission released a special report on the Foster Farms outbreaks, concluding that the outbreaks bring into sharp focus the ineffectiveness of USDA's approach to minimizing Salmonella contamination in poultry products. The agency's response "was inadequate to protect public health," and to this day thousands of people are getting sick with this preventable foodborne illnesses. One of the Pew Commission's recommendations is to close facilities that are failing to produce safe food and keep them closed until their products stop sending people to the hospital.

What did Foster Farms have to say for itself? They said that their chicken was "safe to eat," that there's "no recall in effect," and that it is "Grade A wholesome." In the same breath, though, they say Salmonella on chicken happens all the time. Their chicken is "Grade A wholesome," but might kill us if we don't handle it right. (See Foster Farms Responds to Chicken Salmonella Outbreak).

As outspoken food safety advocate Bill Marler put it, the poultry industry's reaction to the presence of fecal contamination on chicken is that... sh*t happens.

Salmonella contamination is also a problem in the U.S. egg supply, sickening more than 100,000 people every year. See my video Total Recall.

Other pathogens in meat include Yersinia enterocolitica in pork (Yersinia in Pork), Staphylococcus (U.S. Meat Supply Flying at Half Staph), MRSA (MRSA in U.S. Retail Meat), Hepatitis E (Hepatitis E Virus in Pork), bladder-infecting E coli (Avoiding Chicken To Avoid Bladder Infections), Clostridium difficile (Toxic Megacolon Superbug), and Campylobacter, the most common bacterial chicken pathogen (Poultry and Paralysis).

Poultry appears to cause the most outbreaks, but is all chicken to blame equally? See my video Superbugs in Conventional vs. Organic Chicken.

How was it legal for Foster Farms to continue to ship our meat known to be contaminated with a dangerous pathogen? See my videos Why is selling Salmonella tainted chicken still legal? and Chicken Salmonella Thanks to Meat Industry Lawsuit.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day,and From Table to Able.

Image Credit: zoomar / Flickr

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