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

8. Overview Cloned Meats COOL Famine, Biofuels Conclusions re Role of Health Care Institutions

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

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

11. 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 UN FAO: “half the world’s food is wasted”

12. 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

13. 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

14. 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

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

16. 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 –Grass-fed cattle produce less methane, contain less saturated fat

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

18. 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

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

20. Agricultural Antibiotics and Food- Borne Human Infections CDC: “Antibiotic use in food animals is the dominant source of antibiotic resistance among food-borne pathogens.”

21. Agricultural Antibiotics and Food- Borne Human Infections: Examples Campylobacter fluoroquinolone resistance VREF (due to avoparcin use in chickens) MRSA in pork, chickens Gentamycin- and Cipro-resistant E. coli in chickens

22. 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

23. 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%

24. Agricultural Antibiotics and Food-Borne Human Infections US Preservation of Antibiotics for Medical Treatment Act – awaiting vote 2010: FDA to regulate agricultural antibiotics

25. Regulatory Failures Disease outbreaks in US Melamine milk contamination in China Inadequate funding of government agencies in US and abroad

26. 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 and MOU

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

28. 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

29. Biopharming GMOs designed to produce industrial chemicals and pharmaceuticals –Examples –Health and environmental risks Oregon Biopharm Bill and MOU ME enacts moratorium on outdoor planting of biopharmed crops (2009) Other bills

30. 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

31. 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

32. 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

33. 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

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

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

36. 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

37. Cloned Meats Approved by the FDA, 2008 No requirement for labeling Problems: –Very expensive, ?growth potential? –2007: 90% pre-natal failure rate –Surrogate suffering – spontaneous abortions, “large offspring syndrome” leading to early- term and stressful C-sections

38. Cloned Meats Problems –Post-natal health problems:enlarged tongues, heart/lung/liver/brain damage, kidney failure –High doses of hormones, antibiotics required (pre- and post-natally) NAS (2004): It is “impossible to draw conclusions about the safety of food from cloned animals”

39. COOL: Country of Origin Labeling Fish and seafood - 2005 Meats, poultry, fruits, and vegetables – 2008 Processed foods exempted

40. Famine and Biofuels Food prices rising worldwide –In part a consequence of rising oil prices (hydrocarbons necessary for transportation, fertilizing, and packaging) Corn, other food crops, being used for inefficient biofuels

41. 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

42. 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

43. Role of Health Care Institutions Buy certified coffee Create a value chain: string of companies or collaborating players working together to satisfy market demands for specific products and services

44. Role of Health Care Institutions HCWH, ANA, AMA President (’07- ’08) all oppose rBGH AMA supports sustainable food systems within health care institutions Role for everyone in food chain to contribute to sustainable foods

45. References, Further Information Campaign for Safe Food, Oregon Physicians for Social Responsibility: http://www.oregonpsr.org/programs/campa ignSafeFood.html http://www.oregonpsr.org/programs/campa ignSafeFood.html Food safety page of Public Health and Social Justice Website: http://phsj.org/?page_id=14 http://phsj.org/?page_id=14

46. 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

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