Live from The Food Dialogues: Panel 2

My Generation

The second live blog, this time as Panel 2 commences discussing antibiotics and food.

Published on: November 15, 2012

We're back with Panel 2, again moderated by CNN's Ali Velshi, live from Times Center in midtown Manhattan. This topic: antibiotics and food. I expect this one to be more heated than the last.

Panelists include: Keith Ayoob, pediatric nutritionist, Albert Einstein School of Medicine; Barb Determan, Iowa pork producer; Jean Halloran, Consumers Union; Christine Hoang, veterinarian and assistant director of the Division of Scientific Activities of the American Veterinary Medical Association; Karen Jordan, North Caroline dairy farmer and veterinarian.

12:20 p.m. ET

Jean: "We have a crisis. 86% of antibiotics used in animals. Have campaign to get stores to carry only antibiotic free meat."

Ali: Any antibiotics use?

Jean: "Only for sick animals."

Ali: "Downside?"

Jean: "I don't think there would be. Only 15% are used on sick animals. We could have an 85% reduction. Would be significant reduction. Downside risk is that it helps to promote resistance. When you use these drugs, the bugs evolve. When exposed, only the ones that survive would."

Keith: "First, with my patients, we want to have safe food. I'm not a farmer. To that extent, I'll leave it to the farmers and veterinarians. But I want safe food. We have responsibility too. We have to handle food safely. When you look at last number of years, look at CDC, think antibiotics went in with good intentions. CDC says pathogens on raw meat have declined – 23% decline in food borne illnesses since 1996. I would imagine if we stopped all antibiotic use, that number would go up."

Ali: "Do we use prophylactically in humans?"

Keith: "Not usually. But we misuse more often than farmers. People stop using after 6 days, that's what gets antibiotic resistance going, far more than anything else.

If it makes for a more safe food supply and fewer pathogens, we need to have a very serious discussion before we change that dynamic."

12:24 p.m. ET

Ali: "What's your take on antibiotics and what would happen if stop using?"

Barb: "My responsibility is to supply safe wholesome food. Mother of three children and I want to provide safe wholesome food. We don't just use antibiotics, as you hear. You work with your veterinarian, part of pork Quality Assurance, a program that's been around for 20 years. Have herd health plan with our veterinarian and we follow that closely."

Ali: use in healthy animals?

Barb: "Sometimes, to prevent sick animals, but only carefully. No pressure to be antibiotic free – they want safe food and know that's part of it."

Christine: "Our association advocates for prevention uses. Important for safe food supply. It's hard to talk about it without be graphic about the animals moving to food supply. When you cut into animal and remove bowels, that's where you have the chance for contamination and e coli, etc. if you have an animal that's been sick in its life, have scars and adhesions and that can contaminate meat. We want animal healthy its whole life. Less chance of adhesions, scarring. Preventing disease is the idea. If animal is sick, have potential to use stronger antibiotic, keep disease from spreading throughout entire herd.

We've been reducing use for a long time. Early 1990s, have multiple committees implementing judicious use guidelines. Want to protect animal health and human health."

Keith: "I'm much more concerned about misuse of antibiotics by humans. I wish my patients would use the antibiotics they are prescribed as well as the farmers do."

12:30 p.m. ET

Jean: "We agree humans need to use antibiotics properly. Don't agree that antibiotics make food safer. 48 million food illnesses. These are major issues. Organic chicken raised without antibiotics – one category, no salmonella at all. Shows you can raise chickens without antibiotics and they're not overrun with disease causing bacteria."

Ali: Christine, why is that?

Christine: "There is a difference in organic and conventional production. Don't know why there's a difference between their testing and other testing. In national Microbial testing by USDA, see over 20 years a decline in salmonella resistance, over all the types."

Jean: "The database is very good. And I'll take her word that the levels have declined. But that doesn't mean you'll have worse results if you cut out antibiotic use altogether. We have systems that work without antibiotics and it doesn't result in less safe food. Argument to made as to whether the food is more expensive. Only slightly so, not wildly so."

Christine: "I don't think we're saying that not using antibiotics results in a less safe food supply. I'm saying that's one of the benefits of using antibiotics. Study shows it's safer with antibiotics."

Karen: "So if I wake up an CNN says there's no antibiotic use. We have to gear up prevention rate. Look for tools coming down that will be of help to us. My concern is what will the animal welfare be like until we get more tools? That's the sad thing. A cow with mastitis can be dead in 12 hours."

Ali: "If phasing out, is it conceivable to have antibiotic free meat?"

Karen: "We're not stupid in ag, we can see the trends. We want our antibiotics to be effective. It's our duty to keep looking at this – animal management, husbandry, nutrition."

Keith: "If we have this world where stores sell meat that's only been raised without antibiotics. If a sick animal gets an antibiotic, what do we do with that animal?"

Jean: "If we were so successful, would need to develop labels from herds where it shows animals came from farm that treated with antibiotics."

Keith: "So we have label that says 'not raised with antibiotics unless the animal got really sick'?"

12:40 p.m. ET

Jean: "We sent shoppers into supermarkets and asked to write down prices for no-antibiotics products. In general, under $10 a pound. A bit above the average price. In each market, there was a store that sold below average price."

Ali: What changes had to occur on the farm to make those standards happen?

Jean: "I'm not a farmer but I've read studies. In chicken, has to be much greater attention to cleanliness, more cleanouts of the facility. In chicken, the costs in the production systems are not that different."

Karen: "We're trying to do a better job every day. In that scenario, my costs go up dramatically. Costs me $7.20 to feed a cow a day. Takes 76 pounds of milk to pay her way. If she's milking 100 pounds a day and gets very sick and goes down to 30 pounds, that's a tremendous cost."

Ali: "So it may mean the consumer has to pay more money?"

Jean: "We have systems that favor sick animals. Dairy is different. What would happen in pork?"

Barb: "The cost that's included in those antibiotics is high. So we don't just throw them in there. We work with a veterinarian and work to make sure it's done right and in the least amount possible. That's the bottom line, and to give the consuming public a choice."

Christine: "It's not that it's not possible. It is. We get a good picture of what happens in other industries. In poultry, it's a very vertically integrated industry. If you have animals in antibiotic free production and it gets sick, you can simply move that animal into another line. And that may be why you're seeing costs very similar in chicken. But there is a cost. A cost to consumers and to the animal. If an animal gets sick,  you treat it and it goes into conventional system, or you cull it. As a veterinarian, you have to think about the choices: the animal, the food supply, the producer and their livelihood. It's a lot of decision making process when you think about whether to use the antibiotic."

12:50 p.m. ET

Question: are antibiotics given to healthy livestock?

Barb: "It depends on your farm. If your vet thinks that's necessary in careful amounts. It's not there constantly, it's used when your vet knows the history of your herd, your facility, and recommends that."

Question: antibiotics affecting our children and promoting early puberty?

Keith: "Um, no. that question cropped up last week, particularly with rBST in milk. That is a bovine hormone it will not work on people. It is absolutely no risk to children. When kids are overweight, they are much more likely to develop early. We need to leave milk alone.

Jean: "I don't disagree with that. Maybe on Barb's farm, they don't get that the majority of the time. But in the vast majority, they are getting antibiotics all the time, through feed and water."

1 p.m. ET

Christine: "I'm unsure how they know what drugs being used for – when we as vets don't know that?"

Jean: "I agree that the data is unclear. Numbers I'm using come from letters from industry assn. to congress. Assume they are giving their best estimate. But I don't have hard numbers."

Barb: "We have to keep track of what we're using. We have to participate in PQA. Assessments come in. As an industry, we have changed dramatically in that way. We know every drug that's been used on our way."

Jean: "But there's no requirement to send that to FDA."

Keith: "how much will use of treatment antibiotics go up if we stop preventative use?

Jean: Look at Denmark, where they transitioned after first couple years, and then got their practices much better. Some increase initially, but down overall."

Christine: "from our standpoint, prevention uses are important. Preventing disease before it occurs. Helps the animal because they're not needing treatment of higher drugs. There's animal welfare component, of a suffering animal by the time they're showing clinical symptoms. In Denmark, when they saw overall decrease, they had overall therapeutic use – exponential uses. They were using stronger drugs at higher uses. Whether that's good or bad, we can't say. There are parts of the data that are left out. They decreased microbial use by 40% - but from where? The mid1990s? Sure but at that point they had a high incidence of disease. There are a lot of confounding factors in data. It's really hard to draw conclusions based on trends."

1:10 p.m. ET

Keith: "What about economics? I work with a lot of low income families. Maybe 10% more doesn't affect some people. But I think it would for these families."

Jean: "Our members thought it was very interesting. There are people who see 10% as very significant. They're borderline anyway, in terms of food. Number one, Americans in general, consumer more meat and protein than they need to, and that other societies do. If we all reduced our meat consumption, would be better for us from a health perspective. If you're used to buying skinless, boneless chicken breast, could buy chicken legs at lower price point.

Keith: "I want you to come with me to give that talk. Changing people's eating habits is not easy to do. There has to be perceived value to taking antibiotics out, when the food supply is already safe."

Jean: "The benefit is to society at large of protecting antibiotics' benefit."

Ali: "You're right but I want to ask our farmers. Over the last several years, been an effort to communicate, even at restaurants, that better food might cost more. Does the consumer respond to, I'll pay a little bit more."

Karen: "Me personally? No, because I see our food supply is safe."

Barb: "We have data from USDA showing we consume less than 6 ounces a day, which is their recommended amount. In our industry, we are exporting a lot of our production to feed other folks in the world. That makes me very proud. And price point? That's huge for people. I come from a nice small town and we have good choices. I have a friend with four boys and she buys four gallons of milk a week. Those choices are so important to our fabric as a nation. If we want to buy organic milk or meat, it's there. But we're not pushing our philosophy on someone who's trying to feed a family of 6 every day."