CHICAGO — The evening's menu featured grass-fed, antibiotic-free beef over pasta, fresh seasonal vegetables and fresh organic peaches — items right at home in the city's finest restaurants.
But instead, the dishes were prepared for visitors, staff and bed-bound patients at Swedish Covenant Hospital.
The Chicago-area hospital is one of 300 across the nation that have pledged to improve the quality and sustainability of the food they serve, not just for the health of their patients but, they say, the health of the environment and the U.S. population.
For many of these institutions, the initiative includes buying antibiotic-free meats. Administrators say they hope increased demand for those products will reduce the use of antibiotics to treat cattle and other animals, which scientists believe helps pathogens become more resistant to drugs. The Centers for Disease Control and Prevention estimate that antibiotic-resistant infections kill 60,000 Americans a year.
Although the U.S. doesn't keep national records on antibiotic use in animals, the Pew Charitable Trusts estimate that up to 70 percent of all antibiotics used in the U.S. are administered to healthy animals to speed growth and compensate for crowded living conditions. Some of these drugs, such as penicillin and tetracycline, are also used to treat sick people.
Last week, as a congressional panel debated the nontherapeutic use of antibiotics in agriculture, Rep. Jan Schakowsky, D-Ill., presented a petition organized by the nonprofit coalition Health Care Without Harm and signed by more than 1,000 health care professionals supporting the Preservation of Antibiotics for Medical Treatment Act. Introduced by Rep. Louise Slaughter, D-N.Y., it would phase out the nontherapeutic use in animals of seven types of medically important antibiotics.
Last month the Food and Drug Administration also released draft guidelines for the "judicious use" of antibiotics for growth promotion in animals. The CDC and the U.S. Department of Agriculture support the FDA's guidance, which states that "using medically important antimicrobial drugs for production or growth enhancing purposes ... in food-producing animals is not in the interest of protecting and promoting the public health."
Meat producers respond that there is not enough evidence to definitively link human antibacterial-resistant infection to animal use.
"The CDC, FDA and USDA all say that they believe there is a link, but we don't know," said Dave Warner, spokesman for the National Pork Producers Council. "They believe it, so they are going to ban these products because of a belief and not a scientific fact?"
Hospital administrators who have signed on to buy antibiotic-free meat say they hope to use their purchasing power to discourage the use of antibiotics in agriculture. According to the Association for Healthcare Foodservice, the institutions spend about $9.6 billion on food and drink a year.
An early adopter of healthier hospital menus, Swedish Covenant's director of nutrition, Maria Simmons, started serving grass-fed antibiotic and hormone-free Tallgrass beef nearly five years ago. While the hospital's purchases of other sustainable foods have fluctuated with budgets and availability, this item has been a constant.
Simmons said the hospital uses the beef in one menu item a day served to patients and in the cafeteria, including "meat sauces, Salisbury steaks, meatloaf, beef stew and in our Korean seaweed soup."
Diane Imrie, director of nutrition services at Fletcher Allen Health Care in Vermont, also started serving antibiotic-free beef at the hospital in recent years as part of her plan to switch to local, seasonal, sustainable food.
"When we started a sustainability council at the hospital a few years ago, antibiotic reduction was one of the first things on my list," she said. "I think it has the most impact on farming, the environment and public health."
Imrie estimated that her food costs rose about $67,000 last year when she switched to antibiotic-free chicken from conventional. "But that's also about the same cost as treating a single MRSA infection," she said, referring to drug-resistant staphylococcus bacteria.
Like Simmons, Imrie said she has found inventive ways to offset the cost of the antibiotic-free meats, such as choosing ground beef and stewing cuts instead of more expensive options. Simmons said the beef she buys ranges from 50 cents to $1 more a pound.
Simmons also said she is able to negotiate with vendors because the hospital buys food in large amounts. "Once they realize the volume and the fact that you will keep buying this, they work with you," she said.
Carolyn Lammersfeld, national director of nutrition at Cancer Treatment Centers of America, oversees a menu full of organic, antibiotic-free chicken, beef and dairy at the organization's facilities across the country.
Using the ingredients is primarily a response to patient demand, Lammersfeld said, but the centers are also "watching the controversy over the nontherapeutic use of antibiotics and their potential to cause resistant strains of bacteria."
The issue is of particular concern for cancer patients, who have compromised immune systems, she noted. "Many also might already being taking antibiotics, so they don't want additional ones in food if they can avoid it," Lammersfeld said.
Simmons said she buys the Tallgrass beef "not only because is it antibiotic and hormone-free but it's higher in omega-3 fatty acids, conjugated linoleic acids and lower in saturated fats."
But she is also aware of the effects that creating a demand for the meat may have on animal raising practices.
"The push was for healthier food all around and the fact that it was antibiotic and hormone-free and could support the new legislation on antibiotic resistance just worked well together," Simmons said. "It's a natural progression."
FROM ANIMALS TO HUMANS
Answers to some common questions on antibiotic resistance and agriculture from the Centers for Disease Prevention and Control:
Q. Why are bacteria becoming resistant to antibiotics?
A. Antibiotics kill or inhibit the growth of susceptible bacteria. Sometimes one of the bacteria survives because it has the ability to neutralize or evade the effect of the antibiotic; that one bacteria can then multiply and replace all the bacteria that were killed off. Exposure to antibiotics therefore provides selective pressure, which makes the surviving bacteria more likely to be resistant.
Q. How does antibiotic use in animals differ from use in humans?
A. In humans, antibiotics are usually used to treat sick individuals. Sick animals are sometimes treated individually, but often whole flocks or herds of animals are treated at once, including animals that are not ill. In humans, antibiotics are not given to promote growth, yet this is a major reason for using antibiotics in animals.
Q. Which antibiotics used in food-producing animals are related to antibiotics used in humans?
A. The majority of antibiotics used in food animals belong to classes of antibiotics which are also used to treat human illness; these include tetracyclines, sulfonamides, penicillins, macrolides, fluoroquinolones, cephalosporins, aminoglycosides, chloramphenicols, and streptogramins. Bacteria resistant to antibiotics used in animals will also be resistant to similar antibiotics used in humans. When an ill person is treated with an antibiotic to which the bacteria is resistant, the antibiotic will not help and may even make the illness worse.
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