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.

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

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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Virus in Chicken Could Be Linked to Obesity

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Recently, there has been research examining the connection between poultry consumption and weight gain. One study out of the Netherlands examining about 4,000 people, correlated chicken consumption with weight gain. Another study followed 89,000 people in four other countries and found that animal protein intake was associated with long-term weight gain, and poultry was the worst, with 40 percent more weight gain than red meat or processed meat.

What makes poultry so bad? Yes, chickens are fatty these days because of the way we've genetically manipulated them--up to ten times more fat and calories than they used to have--but one bizarre theory postulated that it might be due to an obesity-causing chicken virus. In one study, one in five obese humans tested positive to the chicken virus SMAM-1, with those exposed to the chicken virus averaging 33 pounds heavier than those testing negative.

SMAM-1 was the first chicken virus to be associated with human obesity, but not the last. The original obesity-causing chicken virus SMAM-1 was able to effectively transmit obesity from one chicken to another when caged together, similar to a human adenovirus Ad-36, a human obesity-associated virus first associated with obesity in chickens and mice. Ad-36 spreads quickly from one chicken to another via nasal, oral or fecal excretion and contamination, causing obesity in each chicken. This of course raises serious concerns about Ad-36-induced adiposity in humans.

The easiest way to test this hypothesis is to experimentally infect humans with the virus. However, ethical reasons preclude experimental infection of humans, and so the evidence will have to remain indirect. In the absence of direct experimental data, we must rely on population studies, similar to how researchers nailed smoking and lung cancer. About 15 percent of Americans are already infected with Ad-36, so we can follow them and see what happens. That's exactly what a research team out of Taiwan did (highlighted in my video Infectobesity: Adenovirus 36 and Childhood Obesity). They followed 1,400 Hispanic men and women for a decade and found that not only were those exposed to the virus fatter than those who were not, but also over the ten years, those with a history of infection had a greater percentage of body fat over time.

Most studies done to date on adults have found a connection between exposure to Ad-36 and obesity, and all studies done so far on childhood obesity show an increase in prevalence of infection in obese children compared to non-obese children. We're now up to more than a thousand children studied with similar findings. Obese children who tested positive for the virus weighed 35 pounds more than children who tested negative.

The virus appears to both increase the number of fat cells by mobilizing precursor stem cells and increase the accumulation of fat within the cells. If we take liposuction samples of fat from people, the fat cell precursors turn into fat cells at about five times the rate in people who came to the liposuction clinic already infected. Fat taken from non-infected people that was then exposed to the virus start sucking up fat at a faster rate, potentially inducing obesity without increasing food intake.

Just as Ad-36 can be transmitted horizontally from one infected chicken to another in the same cage, subsequently causing obesity in each chicken, this same virus is also easily transmitted among humans, raising the question as to whether at least some cases of childhood obesity can be considered an infectious disease. Researchers publishing in the International Journal of Pediatric Obesity speculate that this animal adenovirus may have mutated to become a human adenovirus capable of infecting humans and causing obesity.

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: Glasseyes view / Flickr

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What is ‘Meat Glue’?

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The so-called "meat glue enzyme" transglutaminase is used by the meat industry to add value to meat by gluing together smaller scraps into a larger chunk. And it's not just used to make fake steak--the American Meat Institute estimates that it's used in about "eight million pounds of meat every year in the United States." Transglutaminase can be used to cross-link pieces of any type of meat, fish, or meat product, and hence can be used to produce large chunks of virtually intact looking meat or fish out of small meat or fish cuttings. When researchers actually tested for transglutaminase in 20 samples of meat from the supermarket, they found meat glue in only two of the samples--in a sample of salmon and a sample of turkey (See Is Meat Glue Safe?)

Where does meat glue come from? For decades, the sole commercial source of transglutaminase was from the livers of guinea pigs. Now it can be sourced much cheaper. However, the future of meat glue remains uncertain because of "communication difficulties."

One of the reasons the industry uses meat glue enzymes is because, "restructured meat can be made from underutilized portions of the carcasses." For example, you can get away with adding up to 5% tendons to beef, and some people can't tell the difference.

This has raised food safety concerns. There is a "risk that otherwise discarded leftovers of questionable microbial quality could find their way into the reconstituted meat."

One can actually take a microscope and see introduced E. coli O157:H7 along the glue lines where meat pieces were enzymatically attached, which shows that the restructuring process can translocate fecal matter surface contamination into the interior of the meat.

Furthermore, people who have problems with gluten may develop problems when ingesting meat treated with the meat glue enzyme, since it functions as an auto-antigen capable of inducing an autoimmune reaction. (Many gluten reactions may not actually be to gluten, though. See my video Is Gluten Sensitivity Real? and most need not worry about gluten sensitivity. See my video Is Gluten Bad For You?).

Some meat additives, however, may actually improve food safety. See Meat Additives to Diminish Toxicity, Viral Meat Spray and Maggot Meat Spray.

More on E. coli O157:H7 in my video, Meat May Exceed Daily Allowance of Irony. For those interested in the politics of this "Jack-in-the-Box" strain, see my blogs E. coli O145 Ban Opposed by Meat Industry and Supreme Court case: meat industry sues to keep downed animals in food supply. From a population perspective, the E. coli in chicken is more of a concern. See my video Avoiding Chicken To Avoid Bladder Infections.

-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: Wheeler Cowperthwaite / Flickr

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Meat Industry Wins Right to Sell Tainted Meat

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In my last post, I talked about a particularly virulent strand of Salmonella traced to Foster Farms. But while even Mexico banned the importation of Foster Farms' chicken on public health grounds, it was still sold in the United States. Why wasn't there a recall? How could Foster Farms continue to legally sell chicken contaminated with this virulent strain of Salmonella? It all goes back to Supreme Beef v. USDA, a court case in which the meat industry sued the USDA after they had the audacity to try to shut down a slaughter plant that was repeatedly found violating Salmonella standards. The meat industry won. The Federal Appeals Court ruled that it wasn't illegal to sell contaminated meat; what was illegal was the USDA trying to protect the public by shutting down the plant. Because normal cooking practices destroy Salmonella, the presence of Salmonella in meat does not render the meat "injurious to health." Salmonella-infected meat is thus legal to sell to the consumer.

We can get infected no matter how well the meat is cooked though. According to researchers, even though consumers "may eliminate Salmonella on ready-to-cook chicken by proper cooking, they could still be exposed to and acquire a Salmonella infection from cross-contamination of other foods with Salmonella from raw chicken during meal preparation." If we measure the transfer rate from naturally contaminated poultry legs purchased in supermarkets to cutting boards in the kitchen, overall, 80% of the leg skins in contact with the cutting board for ten minutes transferred Campylobacter (another dangerous bacteria found in chicken feces) infection to the cutting board. And then if we put cooked chicken back on that same cutting board, there's about a 30% chance it too will become contaminated.

Even though people know that washing hands can decrease the risk of food poisoning, only about 2/3 say they actually do it. Even though most people know about cross contamination, 1/3 don't even say they wash their cutting boards. Though awareness appears to be growing, even when people wash the cutting boards with hot soapy water we can still find Salmonella and Campylobacter (see Avoiding Chicken to Avoid Bladder Infections). The reason most people have more bacteria from feces in their kitchen than their bathroom is because people rinse their chickens in the sink, not the toilet .

Foster Farms swore they'd try to reduce the number of chickens they were producing with this virulent strain of Salmonella from 1 in 4 to just 1 in 20. Why not a zero tolerance policy in countries such as Sweden? Because then, as the head of food safety for Costco noted, "you wouldn't have a poultry industry."

Other countries have been able to raise chickens without Salmonella. One industry-funded scientist complained that if the entire onus to produce safe products is placed on industry, "it then gives the consumer no personal responsibility to handle their product correctly." That's like a car company saying we can't make safe cars because then no one will wear a seat belt.

I've touched on this topic before in my videos Salmonella in Chicken and Turkey Deadly but Not Illegal, Zero Tolerance to Acceptable Risk, and Unsafe at Any Feed.

More on the issue of cross-contamination in:

Note when it comes to egg-borne infection the issue is not just cross-contamination, given Salmonella can survive the most common egg cooking methods. Check out my video Total Recall.

Though some meat additives may make meat safer (Viral Meat Spray and Maggot Meat Spray), others may increase the food safety risk. See my video Phosphate Additives in Chicken.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videoshere 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: Danny Huizinga / 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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Viral Food Poisoning from Pesticides?

NF-Mar3 Did Pesticides Cause Your Food Poisoning?.jpg

Although the most serious causes of food poisoning like Salmonella come largely from animal products (for example, most foodborne-related deaths have been attributed to poultry), millions of Americans are sickened by produce every year, thanks to noroviruses. Noroviruses can spread person-to-person via the fecal-oral route or by the ingestion of aerosolized vomit, which together may explain most norovirus food outbreaks. But a substantial proportion remained unexplained. How else can fecal viruses get on our fruits and veggies?

The pesticide industry may be spraying them on (See Norovirus Food Poisoning from Pesticides).

The water that's used to spray pesticides on crops may be dredged up from ponds contaminated with fecal pathogens. When you hear of people getting infected with a stomach bug like E. coli from something like spinach, it's important to realize that the pathogen didn't originate from the spinach. Intestinal bugs come from intestines. Greens don't have guts; plants don't poop.

"The application of pesticides may therefore not only be a chemical hazard, but also a microbiological hazard for public health." What is the industry's solution? To add more chemicals! "The inclusion of antiviral substances in reconstituted pesticides," researchers assert, "may be appropriate to reduce the virological health risk posed by the application of pesticides." Or we could just choose organic.

Likewise the Salmonella in alfalfa sprout seeds (See Don't Eat Raw Alfalfa Sprouts) likely came from manure run-off or contaminated irrigation water. But this pesticide angle adds a whole new route for fecal pathogens to pollute produce. Broccoli Sprouts are safer, and organic sprouts may therefore be safer still (See Broccoli Sprouts).

Organic foods may also be healthier (see Cancer Fighting Berries) and don't carry the potential chemical hazards associated with pesticides. See my videos:

-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: jetsandzeppelins / Flickr

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Superbugs on Retail Chicken

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One of the most concerning developments in medicine is the emergence of bacterial super-resistance--resistance not just to one class of drugs, like penicillin, but to multiple classes of drugs (so-called multi-drug resistance). In the 2013 Retail Meat Report, the FDA found that more than a quarter of the Salmonella contaminating retail chicken breast were resistant to not one but five or more different classes of antibiotic treatment drugs.

Throughout history there has been a continual battle between humans and pathogens. For the last half century, this battle has taken the form of bugs versus drugs. When we developed penicillin, the U.S. Surgeon General declared, "The war against infectious diseases has been won." However, the euphoria over the potential conquest of infectious diseases was short lived.

In response to our offensive, bacteria developed an enzyme that ate penicillin for breakfast. In fact, bacteria can excrete such large quantities of the enzyme that they can destroy the drug before it even comes into contact. So we developed a drug that blocks the penicillin-eating enzyme. That's why you may see two drug names on an antibiotic like Augmentin--one is the actual antibiotic (amoxicillin), and the other is a drug that blocks the enzyme the bacteria tries to use to block the antibiotic (clavulanate). But the bacteria outsmarted us again by developing a blocker blocking blocker--and so it goes back and forth. However hard we try and however clever we are, there is no question that organisms that have "been around for three billion years, and have adapted to survive under the most extreme conditions, will always overcome whatever we decide to throw at them."

So we went from first generation antibiotics, to second generation antibiotics, to third generation antibiotics. We now have bacteria that have evolved the capacity to survive our big-gun third generation cephalosporins like ceftriaxone, which is what we rely on to treat life-threatening Salmonella infections in children.

Where are these super-duper-superbugs found? According to one study profiled in my video, Superbugs in Conventional vs. Organic Chicken, "almost 90% were isolated from chicken carcasses or retail chicken meat."

But what if we only ate antibiotic-free organic chicken? In the first such study ever published, researchers compared multidrug-resistant bacteria in organic and conventional retail chicken meat. All of the conventional chicken samples were contaminated; however, the majority (84%) of organic chicken meat samples was also contaminated. So 100% versus 84%. Organic is definitely better, but odds are we could still be buying something that could make our family sick.

Where do these antibiotic resistant bacteria come from if organic producers are not using antibiotics? A possible explanation is that day-old chicks come from the hatcheries already infected with these bacteria before they arrive at the farms. Or, they could become contaminated after they leave the farm in the slaughter plant. Organic chickens and conventionally raised chickens are typically all slaughtered at the same plants, so there may be cross-contamination between carcasses. Finally, factory farms are dumping antibiotics and antibiotic-resistant bacteria-laden chicken manure out into the environment. Researchers can pick up antibiotic-resistant genes right out of the soil around factory farms. So even meat raised without antibiotics may be contaminated with multi-drug resistant bacteria.

In a cover story in which Consumer Reports urged retailers to stop selling meat produced with antibiotics, the researchers noted some store employee confusion: "An assistant store manager at one grocery store, when asked by a shopper for meats raised without antibiotics, responded, 'Wait, you mean like veggie burgers?'" On second thought maybe the employees weren't so confused after all.

I addressed this issue previously in video such as:

Isn't it illegal to sell meat contaminated with dangerous bacteria? Unfortunately no. See why in my video Salmonella in Chicken & Turkey: Deadly But Not Illegal. Reminds me of the case I wrote about in Supreme Court case: meat industry sues to keep downed animals in food supply.

-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: Chilanga Cement / Flickr

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What is Actually in Chicken Nuggets?

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In a scathing expose of the USDA's new meat inspection program, the Washington Post quoted a representative from the meat inspectors union, who said:

"pig processing lines may be moving too quickly to catch tainted meat... Tremendous amounts of fecal matter remain on the carcasses. Not small bits, but chunks."

What about the other white meat?

In the video, Autopsy of Chicken Nuggets, you can see an infographic the Physician's Committee for Responsible Medicine created to highlight what they consider to be the five worst contaminants in chicken products. In their investigation of retail chicken products in ten U.S. cities, they found fecal contamination in about half the chicken they bought at the store. But with all the focus on what's in chicken products, we may have lost sight on what may be missing--such as actual chicken.

Researchers from the University of Mississippi Medical Center and the Baptist Medical Center recently published an "autopsy" of chicken nuggets in the American Journal of Medicine. The purpose was to determine the contents of chicken nuggets from two national food chains. Because chicken nuggets are popular among children, the researchers thought that parents should know more about what they may be feeding to their kids.

The nugget from the first restaurant was composed of approximately 50% skeletal muscle, with the remainder composed primarily of fat, blood vessels and nerves, and generous quantities of skin or gut lining and associated supportive tissue. The nugget from the second restaurant was composed of approximately 40% skeletal muscle with lots of other tissues, including bone.

"I was floored," said the lead investigator. "I had read what other reports have said is in them and I didn't believe it. I was astonished actually seeing it under the microscope." I profile some of those other pathology reports in my videos What's in a Burger? and What Is Really in Hot Dogs?

The researchers concluded that since actual chicken meat was not the predominant component of either nugget, the term "chicken" nugget was really a misnomer.

If we're going to eat something chicken-ish that isn't chicken meat, why not truly boneless chicken: Chicken vs. Veggie Chicken.

More on fecal contamination of chicken in Fecal Bacteria Survey, of fish in Fecal Contamination of Sushi, and of pork in Yersinia in Pork. How can that be legal? See Salmonella in Chicken & Turkey: Deadly But Not Illegal.

More on the preservatives in chicken in Phosphate Additives in Meat Purge and Cola and antibiotic contamination in Drug Residues in Meat.

Estrogenic Cooked Meat Carcinogens also build up in poultry in particular, something the Physicians Committee also tested for previously: Fast Food Tested for Carcinogens.

-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: Jacob Enos / Flickr

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