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Pediatricians say farm use of antibiotics harms children (arstechnica.com)
98 points by shawndumas on Nov 17, 2015 | hide | past | favorite | 70 comments



80% of antibiotics are being given to livestock animals:

>The proportion of antibiotics sold in the United States each year that go to animals turns out to be not 70 percent, but rather 80 percent. Here’s CLF’s Ralph Loglisci, who got the confirmatory numbers from the FDA.

http://www.wired.com/2010/12/news-update-farm-animals-get-80...

And they also do it because it makes the animals gain weight:

>especially troubling is their use not to cure sick animals but to promote "feed efficiency," that is, to increase the animal's weight gain per unit of feed. These drugs are also regularly added to the feed and water of animals that are not sick in order to prevent diseases caused by overcrowded and unsanitary CAFO conditions. These nontherapeutic uses translate into relatively cheap meat prices at the grocery store.

http://www.ucsusa.org/food_and_agriculture/our-failing-food-...

I wish they'd save the antibiotics for humans so they'd be more effective. I also wonder if all the antibiotics are making humans gain weight.


If you click through to the report there are lots of numbers:

http://www.fda.gov/downloads/ForIndustry/UserFees/AnimalDrug...

Most of the antibiotics used for feed are ionophores and tetracyclines. Ionophones aren't used in humans but are only about 40% of the antibiotics used in feed. They are added to cattle feed because they cut down on illness caused by feeding grain (bloat is crazy, consider this a risky click: http://i.imgur.com/GfPvtBx.jpg ).

So most of the resistance concern would be with tetracyclines, where resistance is already a problem for many human infections.

The use of medically useful antibiotics as a feed additive should be stopped. I think it is harder to say that about ionophores.


What is going on in that picture?


Here's the article I got it from:

https://www.animalsciencepublications.org/publications/jas/p...

In the third picture, the rumen has become pressurized from bloat, a condition they get when something stops them from belching (often the wrong sort of microbial activity in their rumen).


Research animals have "ports" inserted so researchers can see various stages of digestion.

https://en.wikipedia.org/wiki/Cannulated_cow

This allows them to make sure things like "cow magnets" aren't going to be harmful


> I also wonder if all the antibiotics are making humans gain weight.

I'm wondering this too. Hopefully with the new research that's been happening with regards to gut flora we'll start to quantify how the amounts and type of bacteria affect digestive efficiency.


That's a pretty good bet. It works in cattle, and pigs (which are among the most closely related non-primates). And chickens. So maybe all vertebrates.

But I wonder whether there's more to it than "feed efficiency". Gut flora arguably changes nutrient mix before absorption. And some nutrients likely favor weight gain more than others. So perhaps one can recolonize with gut flora that favor overall health vs weight gain.


I'm surprised nobody mentioned this book:

"The Good Gut: Taking Control of Your Weight, Your Mood, and Your Long-term Health"

Justin and Erica Sonnenburg are Stanford researchers that address almost all of this directly in the book with research they've done. Microbiome in the gut are directly impacted by antibiotics and in sterile mice studies those fed the exact same diets gain more weight after antibiotic treatments than those that aren't. As the Ars article makes a point of this is critical in a child's gut, stating that even single rounds of antibiotics can have negative impacts to the childs microbiome for years (side effects being weight gain comparative to other children, etc).

Just started to read the book as I've been interested in probiotics and gut health for a few years now and there just isn't much data out there. The researchers wrote the book from a new parent perspective which is makes the book relatable to those who have.

Keep in mind this isn't a book focused on attacking antibiotics, but the study of the microbiome in general and so antibiotics come into the picture of the book early (not finished with the book yet). Very good book so far otherwise.


Cooking meat means our immune system has fewer bacteria to kill off once the meat has entered our bloodstream, thus it's less work for the same calories. Would antibiotics have a similar impact?

There was a recent study where one group of mice were fed raw meat, and another were fed cooked meat. The cooked meat group gained weight while the raw meat group lost weight.


Cooking meat has much more to do with breaking down some of the less digestible parts of the food.

For example, http://www.ncbi.nlm.nih.gov/pubmed/17827047 says "For meat, cooking compromises the structural integrity of the tissue by gelatinizing the collagen. Hence, cooked meat should take less effort to digest compared to raw meat. Likewise, less energy would be expended digesting ground meat compared to intact meat. We tested these hypotheses by assessing how the cooking and/or grinding of meat influences the energy expended on its digestion, absorption, and assimilation (i.e., specific dynamic action, SDA) using the Burmese python, Python molurus."

That abstract concludes "We found cooking to decrease SDA by 12.7%, grinding to decrease SDA by 12.4%, and the combination of the two (cooking and grinding) to have an additive effect, decreasing SDA by 23.4%. These results support the hypothesis that the consumption of cooked meat provides an energetic benefit over the consumption of raw meat."

For another example, see http://blogs.discovermagazine.com/crux/2011/12/08/why-calori... :

> Half the time the sweet potato or meat was presented raw, and half the time cooked; half the time it was also pounded and half the time unpounded. ... For both meat and sweet potato, Rachel found that when the food was cooked the mice gained more weight (or lost less weight) than when it was raw. Pounding had very little effect.

> We suspect that there are two major reasons for cooked beef providing more calories than raw beef. In cooked beef, the muscle proteins, like the sugars in cooked starch, have opened up and allowed digestive enzymes to attack their amino acid chains. Cooking also does this for collagen, a protein that makes meat difficult to chew because it forms the connective tissue wrapped around muscle fibers. However, we do not know the exact mechanisms.

Neither mention killing off bacteria, which makes sense as 1) meat doesn't enter the bloodstream but only its digestive products, and 2) stomach acids kill most of the bacteria.

That second paper is http://www.pnas.org/content/108/48/19199.abstract .

> The positive energetic effects of cooking were found to be superior to the effects of pounding in both meat and starch-rich tubers, a conclusion further supported by food preferences in fasted animals. Our results indicate significant contributions from cooking to both modern and ancestral human energy budgets. They also illuminate a weakness in current food labeling practices, which systematically overestimate the caloric potential of poorly processed foods.


Animal antibiotics are not the same as human antibiotics. LA-200, for instance, will kill a human but is quite effective in treating sick cattle.


LA-200 is just an oxytetracycline injection. Oxytetracycline is approved for use in humans.


I was thinking of Micotil, my mistake.


They touch on it in the article, but it is worth calling special attention to the use of antibiotics to add weight to the animals. It's not being used to treat disease, it's being used to "hack" the biology of the animal to increase yield.

Debate on the use of antibiotics for the agricultural industry seems to conflate this indiscriminate usage with targeted therapeutic use.


The other half of that sentence is important too:

> ... or prevent future illness

The future illness that they're often protecting the animal from is the natural result of feeding the animal an unnatural diet (corn, soy, etc...stuff that's cheaper than what the animal is historically fed). The illness that's being prevented isn't just possible, it's what would be expected without the antibiotic. Any controls on using antibiotics would need to include provisions for banning them in situations where the health of the animal was knowingly compromised. Otherwise, you create a loophole that allows the industry to make the animals sick and then use antibiotics to treat the sickness they caused.


Cattle is also fed with animal fat and flesh, not only corn. That's where the mad cow disease comes from. And the living conditions are also really bad. Chicken is stacked up high in boxes so small that they can't move, so it isn't a wonder that the aviary flu happened, given the high density of such operations. Industrial farms are basically subsidized with our health.

But back to your point, in nature being healthy is the norm, not the exception. Any operation where cattle is getting sick regularly should be shut down, sickness being the most valuable signal you can ask for.


High-density livestock management is a huge risk factor. Fomite alludes to this.


Do you have any evidence that the diets fed to farm animals increase the risk of illnesses?


Googling produces a ton of results, but here's one that looks pretty reputable (USDA, based off many other studies): http://www.sciencedaily.com/releases/2001/05/010511074623.ht...


The problem is there's also a third category: indiscriminate therapeutic use, or more accurately, indiscriminate prophylactic use. There's widespread use of antibiotics as a bandaid to keep the modern industrial farm from collapsing in a wave of bacterial epidemics brought on by the conditions of the farm itself.


It never ceases to amaze me how irrational most people are. On September 11, 2001 about 3000 people died in a very dramatic way, and the US launches the whole war on terrorism boondoggle, pretty much throws out the Constitution etc. But here 23000 people die every year, in a rather undramatic way, and not a whole lot is being done.


there are whole businesses based on human irrationality/outright stupidity (just few random examples - short term loans, gambling, smoking tobacco). We tend to think we are better than in reality, and tend to sidetrack evidence of contrary (maybe to be more happy with ourselves, who knows)


The increase of antibiotic resistance is a matter of legitimate public concern. But this article abuses the same "think of the children" meme that worldly people everywhere despise in politics and journalism of every sort.

Children are more susceptible to infection than healthy adults, but so are the elderly and people with compromised immune systems. We don't need to pull at the heartstrings to justify a conservative approach to the use of antibiotics.


I wish we didn't need to, but we've been talking about this issue for a decade or so already, and so far not much has been done. And as sad as it is, "think of the children" may be despised on HN, but it works perfectly well on GenPop.


Children are also going to live longer than the rest of us, and so will be getting old after most antibiotics become useless.


The same could be said about every problem facing the species.


Only ones with a presumed irreversible tipping point.


To be clear, the issue of antibiotic resistance is not such a problem. Generally, resistant bacteria are less fit than their nonresistant counterparts in the absence of the antibiotic, so we should expect that after a period of disuse antibiotics would once again become useful.


I doubt that people would stop using antibiotics. They'd use higher dosages, complex coctails, etc.


"Period of disuse" may mean hundreds of years when people die of simple cuts and there's no point of even having a hospital. Biology has a lot of intertia.


We may not need to wait nearly so long.

This is a quote from a book by Nick Lane that I think would be relevant here.

"studies show that bacteria can lose superfluous genes in a matter of hours or days. Such fast gene loss means that bacterial species tend to retain the smallest number of genes compatible with viability at any one moment."

The main reason he claims is that for bacteria, the speed of DNA replication is generally the limiting factor in speed of cell division and proliferation of said bacteria, so selection pressures lead to more favorable outcomes for the bacteria that maintain the smallest functional genome.

The book is Power, Sex, Suicide: Mitochondria and the Meaning of Life if you or anyone else is interested. Fascinating read I would recommend it.


Interesting, haven't heard of that observation or the book. Thanks!


Possibly, but you must bear in mind how rapidly bacteria reproduce and evolve. I'm not well enough informed to say exactly how long it would take, but I very much doubt it would be hundreds of years. (And people wouldn't necessarily die of simple cuts regardless -- we still have our immune systems and other means of sterilizing wounds.)


It's about a pediatrics article.


Yes, but this begs the question of why this particular article merits our attention. Biologists have been complaining for years, maybe decades, about the overuse of antibiotics. Any of thousands of publications on the subject could have been selected, yet this one carries with it an especially attention-grabbing headline. My objection is not with calling attention to the issue, only the way in which the writer went about it. Antibiotic resistance is a problem for the species as a whole, not just innocent children who need our protection.


I think you'll enjoy reading [0]. It's long, but very much worth the time. It tries to answer exactly the question you asked - why this particular article, instead of any of thousands of others that prove their points better and without controversy.

[0] - http://slatestarcodex.com/2014/12/17/the-toxoplasma-of-rage/


I did enjoy it. It was worthwhile, and not so long (for anyone else reading this).

I'm aware of the role of propaganda in society. Just yesterday I recommended to you and others Edward Bernays' Propaganda and a good post by Paul Graham on the same subject.

As I wrote then, I haven't formed a strong belief on Bernays' normative assertions on the value of propaganda to society. Either way, the fact that Bernays' wrote what he did is evidence that he didn't see anything wrong with pointing out propaganda when it is presented. My 'objection' would perhaps have been better characterized as identifying this article as a work intended to direct public opinion, rather than provide factual information.

Thanks for the read.


Don't mess with complex systems we don't understand. Whether it is GMOS, global climate or administering antibiotics to animals.

It should be incumbent upon those tinkering with complex systems to provide proof of non-harm. Right now, its the other way around, where those who are harmed have to provide proof of harm.


Please don't conflate issues with scientific backing (antibiotic abuse) with unscientific fearmongering (GMOs).

It drags the legitimate concerns down and makes them look like crackpot conspiracies.


There are reasons to be concerned with GMOs that are not at odds with science. Let me quote something from a comment from a few weeks ago:

---- begin quote ----

GMOs aren't inherently dangerous to human health or inherently environmentally destructive. But they do let producers do things faster and more extreme than they could do via conventional breeding techniques.

They've used those conventional techniques to reduce crop diversity, and select for things like uniform time to grow and uniform size/shape to make mechanical processing easy, over selecting for things like nutrition and flavor.

Is there any good reason to believe that the increased power GMO techniques give them won't be used to go even farther in those directions?

With great power comes great responsibility. I'm skeptical that the big food companies are responsible enough for GMO, and with government food regulation more determined by industry lobbying than by actual science I have little faith that the government will do anything to make sure GMO techniques are only used for good.

---- end quote ----


If we're going to regulate food production in ways that require producers to make commercial sacrifices to promote crop diversity, we should do that directly, rather than indirectly through regulations on GMOs. Because, obviously, producers have a variety of other ways besides GMOs to profit from reduced diversity.


Those, I agree, are legitimate concerns worth discussing. But 'bpodgursky is right that it's harder to discuss those when people are mostly vocal about some invented fear-inducing non-issues. This also holds for discussions about nuclear power.

About your concerns - it's worth noting that they're political/economical in nature and have nothing to do with genetic modifications itself. I agree with most of them, but personally believe that it's not enough to shut down the entire branch of science, as some of the opponents seem to want. But those issues definitely need to be addressed.


still waiting for that scientific backing, I don't see any outright proven threat. on the other hand, if this extra "power" allows us to create plants to feed hungry ie in Africa where usual crops wouldn't survive, that sounds like a real added value. or you want to explain a starving child that it should rather die because you don't like how the results are obtained?


>still waiting for that scientific backing, I don't see any outright proven threat.

We don't need scientific backing: it should be proven safe before using. Not proven a threat then removed from the market. Some of these things can be difficult to reverse.

The issue in Africa isn't a lack of food worldwide, it's distribution.


> Please don't conflate issues with scientific backing (antibiotic abuse) with unscientific fearmongering (GMOs).

GMOs are only unscientific fearmongering until some kind of a heretofore invisible link is found.

Now I'm not suggesting that one will be found, but to say that you know there isn't one is the height of arrogance. There are a great many things that science has known that have been later overturned.

For example, Semmelweis beat Pasteur to the punch by a solid 10 years but he died basically in disgrace because the medical community chose to ignore him.

https://en.wikipedia.org/wiki/Ignaz_Semmelweis

https://en.wikipedia.org/wiki/Louis_Pasteur

I'd love to provide another dozen examples but I don't have a handy list to show you. Rest assured that if science could be wrong at least once it's within the realm of possibility that it could be wrong again. There's definitely no law of the universe that prevents science from making a mistake or two along the way to knowledge.


By that logic you can assume anything is true. It is certainly _possible_ that GMOs are harmful, but without any evidence you have nothing to go on. I could use your exact same argument to argue against evolution or gravity.


You're trying to compare biology to biology and physics. Biology is messy and squishy and imprecise so you'll have an easier time there. Good luck on the physics front, though, because physics is so fundamental.

We have tremendous ability to make predictions in physics and then test those predictions roughly as many times as we care to. Biology is probably a few hundred years (or more!) from that.


If you want me to believe GMOs are harmful, you need a better argument than "biology is hard."

Sorry if that comes off as harsh. I'll admit that the misuse of genetic modification could have big consequences, but the regulation currently in place seems sufficient. If you have regulations you would like to add, I would love to hear them.


When you do physics you're basically trying to test one interaction and you might have a half-dozen other interactions that you have to contend with. And even then, it's really hard! NASA is continuing to investigate the EM drive on the tiny, tiny chance that it's real, but mostly to see what these folks got wrong.

In biology you don't have a half-dozen other interactions to contend with, you've got probably on the order of millions. How many organic molecules are there? Do you know? I sure don't and I spent a couple of years doing computational genomics. The best we could do is spend thousands of processor hours trying to understand how the genome affects things, much less the transcriptome or proteome. If you want to suggest that "oh, GMO is fine because biology isn't THAT HARD" then I would implore you to go revolutionize biology because everyone I talked to said it was very, very hard.

https://en.wikipedia.org/wiki/Genome

https://en.wikipedia.org/wiki/Transcriptome

https://en.wikipedia.org/wiki/Proteome


Alternatively, humans eat everything. From seeds to whales. Some things turn out to be bad for everyone, like hemlock. Some things are generally good, but very dangerous for a few, like peanuts.

As i see it, there are pretty much 2 cases for GMOs right now, and a third that worries me.

1, editing down a sequence to remove unwanted genes. Now, corn without gene X may be toxic. But, that seems unlikely. Billions of people have eaten corn one way or another, and there's bound to be a mutant corn without gene X that people have eaten, just due to random mutation. For this case, GMO's seem very safe.

2, combining genes from 2 things. Now, perhaps feature A weakens us in some way that feature B then exploits and becomes dangerous. Even then, as you say, our biology is fabulously complicated, and has worked solutions for a whole ton of problems. A potato with a cow gene doesn't see obviously more risky than eating potatoes and cows. For this case, GMOs seem a bit more risky, but not substantially more risky than the editing case.

3, Genes created from the imagination. Our biology, specifically digestive system, has had to deal with the prior cases as long as there have been things eating each other. Creating entirely new sequences that our biology has never seen, well, that's scary. we don't have 4 billion years of evolution to rely on.

So, to sum up, case 1 and 2 seem reasonably safe. At least the kind of thing we can try out, if there are bad effects, we can outlaw those specific bad sequences. case 3 is really scary, and those types of GMOs ought to go through something like clinical drug trials for widespread adoption.

edit

by safe, i mean safer than driving. likely far far safer than driving.

because biology is fabulously complicated, heuristics are the best we can do right now. The above, or more sophisticated variations seem reasonable. we don't know for sure, furthermore we can't know for sure. Perhaps a limited release/clinical trial style is better for case 2. But, there's a ton of those kinds of foods already, they've appeared safe so far. Today, that seems like a lot of effort for not much value.


Well,

1) "Ye cannae change the laws of physics". We're pretty sure that there isn't any molecule that you can flip around to have unicorns start popping out of thin air[0]. We have some bounds on the amount of damage one can do.

2) Yes, biology is messy and complicated. It's also extremely important that we master it. So there's little choice but to push forward.

[0] - well, unless it's a molecule your VCs know how to monetize.


> 1) "Ye cannae change the laws of physics". We're pretty sure that there isn't any molecule that you can flip around to have unicorns start popping out of thin air[0]. We have some bounds on the amount of damage one can do.

Sure, but every interaction is a hard fought lesson at the moment. If you naively chart it out we're going to be spending literally eons figuring this stuff out.

Now I realize that advances in a bunch of technologies means that we'll know way, way more than we do now in probably 20-30 years. Not just 50% more, not 500% more but probably a thousand times more.

But if there are a million molecules, there are on the order of n! permutations which give you a rough idea of the number of possible molecular interactions. Maybe instead of P(n,n) (which means that all molecules could react with all other molecules all at the same time for one reaction) you'd be talking about P(n,n-5) or so, but 10^6^5 is still 10^30 or a really, really big number. It'll overflow a 32 bit int, a 64 bit int and it uses up a substantial fraction of a 128 bit int.

People tend not to understand that biology isn't just a little squishy or weird, or "hard", the math makes the fact that we understand anything a tribute to human intelligence. It's not finding a needle in a haystack, it's finding a needle in a galaxy's worth of planets that are all covered in nothing but haystacks.


Sure it's hard to design GMOs, but testing their safety is much easier: feed the GMO to some lab rats and see what happens. Or am I missing something?


> If you want me to believe GMOs are harmful, you need a better argument than "biology is hard."

But the burden of proof that it's safe is on you. Not on those who prefer the conservative route.


But, suggesting all types of genetic modification are equivalent ("GMOs") is also unscientific fearmongering.


Well they're equivalent insofar as they used methods outside traditional breeding in order to achieve their goals; namely "artificial" sequence editing. Will all the modifications have the same potential for harm? It's an open question.

We do know that humans do pretty well on things that have been bred using ancient techniques. Might modern techniques do a better job? Absolutely yes. Might these modern techniques also introduce problems? You can't really rule it out.

I'm not suggesting that all GMO are evil and that they should be banned, destroyed, etc. But what I am suggesting is that when the rate of change we can achieve gets much, much faster than using traditional techniques it's entirely possible that we could do something bad that would take generations to shake out.

Presuming that we "know" something after a couple of years when it has to do with biology, especially when you're talking about humans, is pretty dicey.

Soylent seems to be OK for humans so far, but if all you eat/drink is soylent for a decade you might find out that it's got too much of something, or not enough of something else. It's entirely premature to proclaim soylent 100% safe, that'll take a couple of generations. I feel the same way about organisms that have had their breeding sped up significantly. Not definitely bad, but I'd prefer not to be the guinea pig myself.


Absence of evidence is not evidence of absence.

Allegations of harmful effects of smoking were also once crackpot ideas. So was lung cancer due to working in coal mines.

The point is that biological systems are complex. We don't understand them well. Its better to be safe than sorry.


We can't agree on what constitutes a good diet, or even basic things like how much red meat or sugar are unhealthy, or indeed if they are even unhealthy at all. And yet you believe that we fully understand the consequences of modifying plant DNA to add features like glyphosate resistance? The fact, is we don't understand the relationship between food, the human body, and good health.

I'm very afraid of our unscientific GMO processes.


> It should be incumbent upon those tinkering with complex systems to provide proof of non-harm.

It should be incumbent upon those demanding proof of a negative to explain how that might work in practice.


You're right, better dismantle the FDA post-haste since a solid half of what they do there is make sure that things don't harm people.


http://warisboring.com/articles/super-glue-built-planes-nuke...

Also, they delay life saving medicines for decades.


They try. But they're hugely understaffed. And they get conned a lot.


Unrelated to the issue of trying to prove a negative - can you demonstrate where the US Constitution allows the Federal Government to set up the FDA in the first place?

Some of what the FDA does is good and proper. But it's unconstitutional for the Federal Government to do it.


Downvotes don't count as demonstrating ;-P


It's no different than categorically stating that something is safe, simply because evidence of harm is yet to be found. See thalidomide, tobacco, DDT, and a host of others.

So, to the extent that both sides are being "unreasonable" in demanding proof, the difference is that we are moving forward with one side's thesis. In doing so, we are exposing people en masse to the risk of their being wrong.


Yes - both those positions are flawed. One leads to human progress, though, and the other to stagnation. I know which I'd choose.

It's also worth considering that people clamoring for "proof of safety" are usually the first to complain when you ask them for evidence to back up their pet projects (for example minimum wage laws). It's not even like they're being consistent about it.


>both those positions are flawed. One leads to human progress, though, and the other to stagnation

Of course the other side would say that this hoped for "human progress" can, and many times, has instead been human suffering.

But, it's a false choice you're offering which says that these two extremes are our only options. No one is arguing against "progress". The problem is our haste to declare something safe due to absence of proof, then subject people to it on a mass scale. We literally experiment on the general population.

And, how many times must we learn this lesson? The hubris on display here [1] reminds me of those who today trumpet the safety of, say, GMOs; dumping different pesticides on entire populations (still today), etc.

In hindsight, the scale of hubris on display in [1] is completely asinine. But, the "absence of proof" mindset that led to this folly is alive and well today.

[1] http://thesocietypages.org/socimages/2011/06/27/ddt-is-good-...


They say that GMOs are safe, not because of the test that they have done, but because of how long they have been feeding it to us. And they create new varieties constantly.


Homes prices had also always been trending up, until they didn't starting in 2008.


With antiobiotics so prevalent in livestock feed, why aren't they leading to the rise of a drug-resistant strain of something in livestock? Have they?




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