1. Issues in Sustainable, Healthy Agriculture Martin T Donohoe, MD, FACP Chief Science Advisor Campaign for Safe Food Oregon Physicians for Social Responsibility

2. Sustainable Foods A sustainable food system is one in which the environmental, social, and economic impacts of our decisions both sustain the needs of the current generation and allow for future generations to do the same

3. Sustainable Foods Produced, processed, stored and transported with minimal use of non- renewable energy sources Produced and handled in a way that supports strong regional economies Healthy as part of a balanced diet and do not contain harmful biological or chemical contaminants

4. Sustainable Foods Fairly or cooperatively traded between producers, processors, retailers, and consumers Non-exploiting of employees in the food sector in terms of rights, pay and work conditions Environmentally beneficial or benign in production and processing Accessible in terms of geographic access and affordability

5. Sustainable Foods High animal welfare standards in both production and transport Socially inclusive of all people in society Encourage knowledge and understanding of food and food culture

6. Overview Local, Sustainable Foods –Locally-grown food < 1% of $900 billion food industry in the US –Food typically travels 1500 miles from field to fork (25% increase over 1980) –16% of vegetables sold in US come from abroad; 44% of fruit –Air pollution, global warming Dietary Considerations/Components Pesticides –Worker health and safety Factory Farms/CAFOs/Agricultural Antibiotics

7. Overview GMOs Biopharming Food Irradiation rBGH Conclusions re Role of Health Care Institutions

8. Local Foods ↓ transportation costs –1/3 of agricultural energy costs go to processing, packaging, and transportation ↓ air pollution ↓ global warming

9. Local Foods Supports local economies –Financial –Local environments –Social cohesion Enhanced purchaser-supplier relationships

10. Wasted Food Household food waste adds up to $43 billion/yr in the U.S. An average American family of four tosses out $590/yr food Americans discarded 3 times as much food in 2005 as in 1985

11. Dietary Components/Considerations Health choices –Dietary information labels –Eliminate soda machines –Healthy snack machines –No bottled water –Animal/vegetable products ↓ fast foods ↓ trans fats ↓ obesity –Contributes to 300K deaths/yr in US –Major contributor to disease

12. Pesticides Air/water pollution ↓soil quality/fertility/diversity, inhibit nitrogen fixation, decrease crop yields 5.5 billion lbs/yr worldwide –1.2 billion lbs/yr in US Air pollution/global warming –1/3 of agricultural energy use goes to pesticide and fertilizer production

13. Pesticides and Human Health EPA: U.S. farm workers suffer up to 300,000 pesticide-related acute illnesses and injuries per year NAS: Pesticides in food could cause up to 1 million cancers in the current generation of Americans WHO: 1,000,000 people killed by pesticides over the last 6 years

14. Pesticides Farm worker health issues Floriculture, farm workers, and human rights –Hospital gift shops

15. Factory Farms/CAFOs Factory farms have replaced industrial factories as the # 1 polluters of American waterways Livestock responsible for more greenhouse gas emissions than the entire transportation sector –Methane, CO2, and NO

16. Factory Farms/CAFOs 1.4 billion tons animal waste generated/yr –130 x human waste Waste pollutes air, waterways –Fish kills –Human infections: Pfisteria

17. Factory Farms/CAFOs Farm subsidies favor factory farms –One week of developed world farm subsidies = annual cost of food aid to solve world hunger Decline of small, family farms and rural communities

18. Overuse of Agricultural Antibiotics Agriculture accounts for 70% of U.S. antibiotic use Use up 50% over the last 15 years

19. Agricultural Antibiotics and Food- Borne Human Infections CDC: “Antibiotic use in food animals is the dominant source of antibiotic resistance among food-borne pathogens.” –E.g., Campylobacter fluoroquinolone resistance, VREF (poss. due to avoparcin use in chickens)

20. Agricultural Antibiotics and Food- Borne Human Infections $4billion/yr to treat antibiotic-resistant infections in humans Alternatives –Vaccinate animals –Selective Dx/Rx –Control overcrowding and heat stress –Improve food handling and storage –Animal care/welfare –Worker welfare –Vegetarianism

21. Agricultural Antibiotics and Food- Borne Human Infections EU bans use of all antibiotic growth promoters effective 1/1/06 Three years after a Danish ban on routine use of antibiotics in chicken farming, the prevalence of antibiotic-resistant bacteria in chickens dropped from 82% to 12% US Preservation of Antibiotics for Medical Treatment Act, 2007 – awaiting vote

22. Genetically-Modified Organisms GMOs Definition Industrialization and corporatization of agriculture Inadequately regulated: USDA, EPA, FDA Famine and developing world markets Local bans/labeling laws –Oregon’s failed Measure 27 Biopharming –Oregon Biopharm Bill

23. Risks of GMOs Altered nutritional value of foodstuffs Allergies Gene transfer → superweeds ↑ pesticide/herbicide use

24. Risks of GMOs Ripple effects on other organisms Transfer of antibiotic resistance genes to livestock Interbreeding with wild relatives –Adverse effects on organic farmers, world markets

25. Biopharming GMOs designed to produce industrial chemicals and pharmaceuticals –Examples –Health and environmental risks Oregon Biopharm Bill –Other bills

26. Recombinant Bovine Growth Hormone (rBGH, Posilac©) Produced by Monsanto Adverse animal health effects Adverse human health effects –↑ IGF-1 → cancers –? ↑ risk of Variant Creutzfeld-Jacob Disease Successes of OR PSR’s CSF, HCWH

27. Food Irradiation Rationale Altered nutritional content of meat –Lipid peroxides, benzene → cancers –↓ antioxidant value –↑ trans fatty acids –↓ vitamin content Meat tastes worse May encourage sloppy handling – avoids roots of problem

28. Food Irradiation Animals fed irradiated foods show multiple adverse health effects Human health effects unknown Illegal in EU except for some herbs and spices Public/scientific opposition strong

29. Food Irradiation Labeling inadequate –Flower symbol, “electronically pasteurized,” no labeling Large school districts opposed to use in National School Lunch Program Costly –USDA estimates 13-20 cents extra / lb meat Does not destroy prions

30. Food Irradiation Irradiation facilities costly to build and maintain Worker safety issues ↑ transportation costs Homeland security

31. Food Irradiation Production of radioactive cobalt and cesium requires commercial reprocessing of high level nuclear waste (presently banned) Alternate, cheaper, and safer means of decreasing bacteria and food-borne infections exist

32. Alternatives to Food Irradiation Vaccinate animals, control overcrowding and heat stress, and improve food handling and storage Hire more government meat inspectors and use better equipment in our present, technically-sound but under-funded food inspection programs Fully cook meat, especially ground beef Improve sanitary conditions in cafeterias

33. Role of Health Care Institutions Practice nutritional ecology Support health of patients, staff, and local communities Set standards for other organizations –Example: Burger King in hospital cafeteria vs. GE/NY Presbyterian Hospital; Tobacco

34. Role of Health Care Institutions Hold farmers’ markets on hospital grounds Create hospital gardens to grow fresh produce, herbs, and flowers Compost, divert, and reduce food waste Buy certified coffee

35. Role of Health Care Institutions Create a value chain: string of companies or collaborating players working together to satisfy market demands for specific products and services Role for everyone in food chain to contribute to sustainable foods

36. Further Information Oregon Physicians for Social Responsibility’s Campaign for Safe Food –http://www.oregonpsr.org/programs/campaign SafeFood.htmlhttp://www.oregonpsr.org/programs/campaign SafeFood.html Thanks to Rick North, Neha Patel, and Karen Adams

37. Contact Information Public Health and Social Justice Website http://www.phsj.org martindonohoe@phsj.org