Clostridium difficile in the Food Supply

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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.

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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.

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Should Pregnant Women Drink Cow’s Milk?

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Foods of animal origin in general naturally contain hormones, but cow's milk may be of particular concern. The hormones naturally found even in organic cow's milk may have played a role in studies that found a relationship between dairy products and human illnesses, such as acne, certain cancers and male reproductive disorders. Milk consumption has also been associated with an increased risk of early puberty and endometrial cancer in postmenopausal women, but "hormonal levels in food could be particularly dangerous in the case of vulnerable populations, such as young children or pregnant women. To this critical population, even a small hormonal intake could lead to major changes in the metabolism."

If you check out my video Why Do Vegan Women Have 5x Fewer Twins, you can see that children are highly sensitive to sex steroids. Because their levels of sex steroids are very low, even a small variation would account for a major change in the total activity of the involved hormone. Because no lower threshold for estrogenic action has been established, caution should be taken to avoid unnecessary exposure of fetuses and children to exogenous sex steroids, even at very low levels.

In the AMA's Pediatrics Journal, the Chair of Boston Children's Hospital's Obesity Prevention Center along with the chair of Harvard's nutrition department questioned dairy industry recommendations that children should drink three glasses of milk a day. Dairy milk evolved to promote the growth of grazing animals at high risk for predation when small, so they needed to put on a few hundred pounds quickly in the first few months of life.

The consequences of lifetime human exposure to the growth factors in milk have not been well studied. "Milk consumption increases serum concentrations of insulin-like growth factor 1, which is linked to prostate and other cancers. In addition, modern industrial methods maintain dairy cows in active milk production throughout their pregnancies, resulting in a milk supply with high levels of reproductive hormones."

Pregnant cows excrete significantly higher levels of sex steroids into their milk than non-pregnant cows. The subsequent consumption of such dairy products from pregnancy results in additional consumer exposure. And it's not just dairy. Although dairy products are an important source of hormones, other products of animal origin must be considered as well. All edible tissues of animal origin contain estrogen. This may explain why, in a study of over a thousand women eating plant-based diets, vegan women have a twinning rate that is one fifth that of vegetarians and omnivores.

Twin pregnancies are risky pregnancies, with much higher complication rates. Many parents and physicians underestimate the negative consequences of multiple pregnancy, but "women with a multiple pregnancy face greater risks for themselves and their infants." Twin babies may be ten times more likely to die at birth. To avoid these complications, the research team writes, "women attempting conception should avoid milk and dairy products."

Minimizing dairy, our nation's #1 source of saturated fat may be a good idea for dads too: Dairy Estrogen and Male Fertility.

What about the endocrine-disrupting xenoestrogens--how do they compare with the natural hormones in our food supply? That was the topic of my video Estrogen in Meat, Dairy, and Eggs.

Then once they're born, best to stick to human milk:

Then as young children, dairy can sometimes cause another problem: Childhood Constipation and Cow's Milk

Here's a selection of other pregnancy-related videos:

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: LivingLandscapeArchitecture / Flickr

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Estrogen in Meat, Dairy, and Eggs

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Estrogen hormones can be thousands of times more estrogenic than typical endocrine-disrupting chemicals. Dietary exposure to natural sex steroids (in meat, dairy, and eggs) is "therefore highly relevant in the discussion of the impact of estrogens on human development and health." And chicken estrogen is identical to human estrogen--they're identical molecules. So it doesn't matter if it ends up in our drinking supply from women taking birth control pills excreting it in their urine, or cows excreting it into their milk. The source doesn't matter; the quantity does.

If you check out my video Estrogen in Meat, Dairy, and Eggs, you can see that a child's exposure to estrogens in drinking water is about 150 times lower than exposure from cow's milk, so our day-to-day estrogen exposure levels are more likely determined by whether or not we happen to eat dairy products that day.

Human urine is "often cited as the main source of natural and synthetic estrogens in the aquatic environment," but the level of estrogen even in the urine of heavy meat-eaters, who have significantly higher levels, pales in comparison to the estrogen excreted by the farm animals themselves. Pig, sheep, cattle, and chickens produce literally tons of estrogen every year.

Women may excrete 16 mg every day, but farm animals may release ten times more, or in the case of pregnant cows, thousands of times more. Animal waste may contribute an estimated 90% of total estrogens in the environment. Five gallons of runoff water contaminated with chicken manure may contain a birth control pill's worth of estrogen.

Estrogen levels in poultry litter are so high that when farmers feed chicken manure to their animals to save on feed costs, it may trigger premature development. Poultry manure has among the highest hormone content, quadruple the total estrogens, and nine times more 17-beta estradiol, the most potent estrogen and a "complete" carcinogen, as it exerts both tumor initiating and tumor promoting effects.

From a human health standpoint, do we really care about feminized fish, or the appearance of "intersex roaches"? The problem is that the hormones get into the food supply. Endogenous steroid hormones in food of animal origin are unavoidable as they occur naturally in these products. It's not a matter of injected hormones, which are banned in places like Europe in order to protect consumers' health. Sex steroid hormones are part of animal metabolism, and so all foodstuffs of animal origin contain these hormones, which have been connected with several human health problems. (See Why Do Vegan Women Have 5x Fewer Twins?)

What effects might these female hormones have on men? See Dairy Estrogen and Male Fertility.

The implications of this relatively new practice of milking cows even when they're pregnant is further explored in:

More on xenoestrogens 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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: BruceBlaus

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GMO Soy and Breast Cancer

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In response to concerns raised about the toxicity of Monsanto's roundup pesticide, which ends up in GMO foods (See Is Monsanto's Roundup Pesticide Glyphosate Safe?), Monsanto's scientists countered that these in vitro experiments used physiological irrelevant concentrations, meaning dripping roundup on cells in a petri dish at levels far above what would be realistically found in the human body.

Sure, it's probably not a good idea to mix up your alcohol with your roundup and chug the stuff, or try to commit suicide by drinking or injecting it. And there are rare cases of Parkinson's reported after getting directly sprayed with it, or working for years in a pesticide production plant, but that's not your typical consumer exposure.

As shown in my video GMO Soy and Breast Cancer, some of the researchers responded to the accusation claiming they used the kinds of concentrations that are used out in the fields. Therefore every little droplet we spray worldwide is above the threshold concentration they found to cause adverse effects. Monsanto's folks responded saying, "Yes, that's the concentration we spray, but that's not the concentration that human cells are bathing in. Once it gets into drinking water or food, it's highly diluted." And, they're quick to point out, if we look at people with the greatest exposure--pesticide workers--the vast majority of studies show no link between the use of Roundup and cancer or non-cancer diseases. There are a few suggestive findings suggesting a link with non-Hodgkin's lymphoma. One study of pesticide applicators suggested an association with multiple myeloma, and one study of the children of pesticide applicators found a tentative association with ADHD, but again these are folks experiencing a much greater exposure level than the general population that may just get a few parts per million in their food. But there had never been any studies done on the tiny levels found circulating in people's bodies, until now.

In a study out of Thailand, the maximum residue levels were set at parts per million (the concentrations found within human bodies is measured in parts per billion). The study found glyphosate can activate estrogen receptors at a few parts per trillion, increasing the growth of estrogen receptor positive human breast cancer cells in a petri dish. These results indicate "that truly relevant concentrations of the pesticide found on GMO soybeans possesses estrogenic activity."

But consumption of soy is associated with lower breast cancer risk (See BRCA Breast Cancer Genes and Soy), and improved breast cancer survival (See Breast Cancer Survival and Soy).

That may be because most GMO soy in the U.S. is fed to chickens, pigs, and cows as livestock feed, whereas most of the major soy food manufacturers use non-GMO soy. Or it could be because the benefits of eating any kind of soy may far outweigh the risks, but why accept any risk at all when we can choose organic soy products, which by law exclude GMOs.

The bottom-line is that there is no direct human data suggesting harm from eating GMOs, though in fairness such studies haven't been done, which is exactly the point that critics counter. This is why we need mandatory labeling on GMO products so that public health researchers can track whether GMOs are having any adverse effects.

It is important to put the GMO issue in perspective though. As I've shown (See Lifestyle Medicine: Treating the Causes of Disease), there are dietary and lifestyle changes we can make that could eliminate most heart disease, strokes, diabetes, and cancer. Millions of lives could be saved. A healthy enough diet can even reverse our number one killer, heart disease. So, I'm sympathetic to the biotech industry's exasperation about GMO concerns when we still have people dropping dead from everything else they're eating. As one review concluded "consumption of genetically modified food entails risk of undesirable effects... similar to the consumption of traditional food." In other words, buying the non-GMO Twinkie isn't doing our body much of a favor.

For more on the public health implications of genetically engineered crops in our food supply, check out the these videos:

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: Nesbitt_Photo / Flickr

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Is Insecticidal GMO Corn Safe?

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Recently the prominent science journal Nature editorialized that we are now swimming in information about genetically modified crops, but that much of the information is wrong--on both sides of the debate. "But a lot of this incorrect information is sophisticated, backed by legitimate-sounding research and written with certitude," adding that with GMOs, "a good gauge of a statement's fallacy is the conviction with which it is delivered."

To many in the scientific community, GMO concerns are dismissed as one big conspiracy theory. In fact, one item in a psychological test of belief in conspiracy theories asked people if they thought food companies would have the audacity to be dishonest about genetically modified food. The study concluded that many people were cynical and skeptical with regard to advertising tricks, as well as the tactics of organizations like banks and alcohol, drug, and tobacco companies. That doesn't sound like conspiracy theory to me; that sounds like business as usual.

We must remember there is a long legacy of scientific misconduct. Throw in a multi-billion dollar industry, and one can imagine how hard it is to get to the truth of the matter. There are social, environmental, economic, food security, and biodiversity arguments both pro and con about GMOs, but those are outside my area of expertise. I'm going to stick to food safety. And as a physician, I'm a very limited veterinarian--I only know one species (us!). So, I will skip the lab animal data and ask instead: What human data do we have about GMO safety?

One study "confirmed" that DNA from genetically modified crops can be transferred into humans who eat them, but that's not what the study found, just that plant DNA in general may be found in the human bloodstream, with no stipulations of harm (See Are GMOs Safe? The Case of Bt Corn).

Another study, however, did find a GMO crop protein in people. The "toxin" was detected in 93 percent of blood samples of pregnant women, 80 percent of umbilical cord blood samples, and 69 percent of samples from non-pregnant women. The toxin they're talking about is an insecticidal protein produced by Bt bacteria whose gene was inserted into the corn's DNA to create so-called Bt-corn, which has been incorporated into animal feed. If it's mainly in animal feed, how did it get into the bodies of women? They suggest it may be through exposure to contaminated meat.

Of course, why get GMO's second-hand when you can get them directly? The next great frontier is transgenic farm animals. A genetically modified salmon was first to vie for a spot at the dinner table. And then in 2010, transgenic cows, sheep, goats and pigs were created, genetically modified for increased muscle mass, based on the so-called mighty mouse model. Frankenfurters!

But back to children of the corn and their mothers. When they say it's a toxin, it's a toxin to corn worms, not necessarily to people. In fact I couldn't find any data linking BT toxin to human harm, which is a good thing since it's considered one of the few pesticides considered so non-toxic that it's sprayed on organic fruits and vegetables.

For more on on the public health implications of genetically modified crops, see:

I did a similar "controversial issue" video series on gluten. See:

For those interested in the genetic engineering of livestock, I published a few papers myself on the topic:

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: Jen Wilton / Flickr

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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

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Dioxins in U.S. Farm-Raised Catfish

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Dioxins are highly toxic pollutants that accumulate in tissue fat. Almost all dioxins found in people who don't work in toxic waste dumps or something similarly hazardous are believed to come from food, especially meat, milk, and fish, which account for about 95% of human exposure. We tend to only hear about it in the news, though, when there's some mass poisoning.

In 1957, for example, millions of chickens began dying, blamed on toxic components in certain feed fats. Factory farming was taking off, and the industry needed cheap feed to fatten up the birds. They ended up using a toxic fleshing grease from hide stripping operations in the leather industry that were using dioxin-containing preservatives. A subsequent outbreak in 1969 resulted from a pipe mix-up at a refinery that was producing both pesticides and animal feed.

In the 1990's, a supermarket survey found the highest concentrations of dioxins in farm-raised catfish. The source of dioxins was determined to be the feed, but that's surprising, since catfish aren't fed a lot of animal fat. Turns out it was dioxin-contaminated clay added to the feed as an anti-caking agent, which may have originally come from sewage sludge. The same contaminated feed was fed to chickens, so what may have started out in sewage sludge ended up on the plates of consumers in the form of farm-raised catfish and chicken.

How widespread of a problem did it become? This affected five percent of U.S. poultry production, that's people eating hundreds of millions of contaminated chickens. And if it's in the chickens, it's in the eggs. Elevated dioxin levels were found in chicken eggs too. When the source of the feed contamination was identified, the USDA estimated that less than 1% of animal feed was contaminated, but 1% of egg production means over a million eggs a day. But the catfish were the worst. More than a third of all U.S. farm-raised catfish were found contaminated with dioxins thanks to that ball clay. So the FDA requested that ball clay not be used in animal feeds. They even asked nicely, writing "Dear producer or user of clay products in animal feeds, continued exposure to elevated dioxin levels in animal feed increases the risk of adverse health effects in those consuming animal-derived food products... we are recommending that the use of ball clay in animal feeds be discontinued...We look forward to the industry's cooperation." (You can see the original letter in my video, Dioxins in U.S. Farm-Raised Catfish).

So how cooperative did the industry end up being? Half a billion pounds of catfish continued to be churned out of U.S. fish farms every year but only recently did the government go back and check. Published in 2013, samples of catfish were collected from all over the country. Dioxins were found in 96% of samples tested. Yeah, but just because catfish are bought in the U.S. doesn't mean they came from the U.S. And indeed some of the catfish were imported from China or Taiwan, but they were found to be ten times less contaminated. And indeed, when they checked the feed fed to U.S. catfish, more than half were contaminated, and so it seems likely that mined clay products are still being used in U.S. catfish feeds. Even "just small amounts of mineral clays added to fish feeds, together with the fact that catfish can be bottom-feeders may lead to higher than acceptable dioxin residues in the final catfish products."

The Institute of Medicine suggests strategies to reduce dioxin intake exposure, such as trimming the fat from meat, poultry, and fish, and avoiding the recycling of animal fat into gravy, but if almost all dioxin intake comes from animal fat, then eating a more plant-based diet could wipe out about 98% of exposure. Thus "a vegetarian diet or even just eating more plants might have previously unsuspected health advantages along with the more commonly recognized cardiovascular benefits and decreased cancer risk."

This is a good illustration of how we can't necessarily rely on regulators to protect our families' health. More on dietary dioxins and what we can do about it in Dioxins in the Food Supply and Counteracting the Effects of Dioxins Through Diet.

Even wild fish are exposed to industrial pollutants spewed into our waterways. See, for example:

Farmed fish is the worst, though: Farmed Fish vs. Wild-Caught.

Other pollutants in our food supply and how to avoid them:

Though the best way to detox is not to tox in the first place, our bodies can eventually get rid of much of the toxin load:

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: Brent Moore / Flickr

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Antibiotic-Resistant "Superbugs" in Meat

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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

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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

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