Fast food restaurants step up in the war against superbugs

Why fast food is an important ally in the fight against superbugs

Today marks the third annual publication of the Chain Reaction report, a scorecard of the 25 largest fast food and fast casual restaurants’ use of meat and poultry raised without antibiotics.

The results are encouraging: “In a few short years, our scorecard and associated public calls to action have inspired many restaurant companies to step up to the plate,” says Lena Brook, food policy advocate at the Natural Resources Defense Council, which is part of a six member consumer interest coalition putting together these reports. “In 2015, just five companies received passing grades. This year, that number is up to 14.”

It is the first time that more than half of the companies surveyed were taking steps toward an antibiotics-free meat and poultry supply, being much more proactive on the issue than the country’s largest grocery stores.

This is good news, since the use of antibiotics in agriculture is a massive human health issue. “The threat to public health from the overuse of antibiotics in food animals is real and growing,” says Dr. Lance Price, founding director of the Antibiotic Resistance Action Center at George Washington University, who was not involved with the study. “About 70 percent of the antibiotics sold in the United States are used in meat and poultry production. Most of these are used on healthy animals to promote growth, or prevent disease in crowded or unsanitary living conditions.”

This kind of usage has been shown to breed antibiotic-resistant bacteria. For example, the report cites several instances of E. coli with resistance to colistin, a last-resort antibiotic used in human medicine, moving from pigs to people. At least 23,000 Americans die every year from drug-resistant bacteria, estimates the Centers for Disease Control and Prevention, and that number continues to rise due chiefly to the overuse of antibiotics.

WATCH: Miles explores the rise of antibiotic-resistant bacteria for the PBS NewsHour.

Bacteria can become resistant to antibiotics via different mechanisms, all of which have to do with the bacteria being exposed to a nonlethal amount of antibiotics and “learning” how to combat it in the process. You may have heard that not finishing your course of antibiotics leaves bacteria that are now desensitized to the drug. While this is true in some cases, the main driver of antibiotic resistance is overuse of antibiotics, not underuse.

It doesn’t matter if the antibiotics are being used for treatment, prevention, or growth promotion: the effect of breeding antibiotic resistance is the same. And nowhere is the chronic, low-level overuse of antibiotics more pervasive than in the agricultural industry. If we don’t figure out how to limit this overuse, the modern miracle that is effective antibiotic treatment is at risk of disappearing.

“To put it plainly, if we don’t rein in antibiotic resistance, half a century of medical progress could be reversed,” says Brook.

Changing the policies of the largest restaurant chains could have a large beneficial effect.

“The nation’s fast food restaurant chains are in a unique position to address the antibiotic resistance crisis,” reads the Chain Reaction report. “Fast food chains are huge buyers of meat and poultry. A quarter of all chicken produced in the United States is sold through fast food restaurants, according to the National Chicken Council, and McDonald’s has been cited in the media as the largest buyer of beef in the United States. Fast food restaurants can demand that their suppliers reduce or eliminate antibiotic use in the production of the meat and poultry they purchase.”

“Americans eat a lot of fast food and most fast food restaurants serve a lot of meat,” agrees Price. “Consumers are making demands on these restaurants and they are starting to respond. This is so important right now because we are not expecting much movement to improve antibiotic use in food animal production through federal policies anytime soon.

Chain Reaction III: Winners and Losers

To assess the industry’s practices, Brook and her colleagues sent surveys to 25 of the largest restaurant chains in the nation and followed up with some independent research of their own. The three main things they were looking for was that antibiotics-free policies were being implemented, that they had timebound goals, and that they were being assessed by a certified third party. These considerations were compiled to give each company a grade: A for a completely antibiotics-free supply line, all the way down to F for no policy in place or for declining to participate.

As in past years, Chipotle and Panera Bread have come out on top, the only two restaurants to receive an A rating, with antibiotic-free policies for their chicken, pork, and beef.

“We’re proud to have led the way on antibiotic reduction for more than a decade, starting with introducing chicken raised without antibiotics in 2004, and we’re thrilled to be recognized with an A grade for the third consecutive year,” said Sara Burnett, Director of Wellness and Food Policy at Panera Bread. “Today at Panera, 100% of poultry, bacon, breakfast sausage, and ham served on sandwiches and salads is raised without antibiotics.”

Scorecard of antibiotics-free meat and poultry usage by the 25 largest fast food chains in U.S.

KFC gets the most-improved award, jumping from an F last year to a B- this year by committing to transition its entire product line to use chicken raised without medically-important antibiotics by the end of 2018.

Applebee’s, Domino’s, Olive Garden, Chili’s, Buffalo Wild Wings, Little Caesars, Arby’s, IHOP, and Cracker Barrel all did not respond to the survey, part of the 11 of the top 25 fast food restaurants that received an F grade for having limited or no policies on the matter whatsoever.

Domino’s, which chose not to participate and received an F grade for it, still maintains they are purchasing at least some chicken, beef, and pork products that have had minimal antibiotic treatment. “The ‘grade’ is not something that troubles us,” writes Tim McIntyre, Domino’s Executive Vice President of Communication, Investor Relations & Legislative Affairs. “We choose to rely on science, the USDA, and American farmers to determine how best to raise and treat their animals, and the ones doing the grading don’t like our answers.”

Cracker Barrel, another non-participant that received an F, still maintained that it strived to provide the best quality food for its customers. “We use only beef, pork, and poultry raised without human-grade, medically important antibiotics,” said Janella Escobar, Director of Corporate Communications.

Sonic did return a survey, but it was deemed too vague and didn’t respond to all the criteria requested by the authors of the report, so they were given an F as well. “Effective January 2017, poultry suppliers should only administer antimicrobial drugs to animals for the prevention, control and treatment of disease,” says Kristin Davis, Director of Communications.

The other F-grade companies did not respond to requests for comment.

Chicken producers flock to the forefront

Notably, several of those companies that received an F rating (Olive Garden, Dairy Queen, Arby’s, and Chili’s) have ties to Sanderson Farms, the third largest chicken producer in the country, which proudly advertises its use of antibiotics. Sanderson Farms says that using antibiotics is good, since it keeps their chickens healthy and isn’t present in the final product as per federal regulations, but that is a misdirection from the issue of breeding antibiotic resistant superbugs on the farm.

Sanderson Farms usage of antibiotics is totally legal, even considering the new January 2017 regulation from the FDA that was referred to by the Domino’s, Cracker Barrel, and Sonic representatives. This regulation asks for producers to phase out the use of medically-important antibiotics for anything except disease treatment and prevention.

This sounds good, but the large loophole is that antibiotics can still be given to animals at low, constant doses ostensibly to prevent infection when, in fact, it’s to promote growth in the animals. “Allowing prevention use permits antibiotic use to continue unabated in many cases,” note the Chain Report authors.

Yet, market forces seem to be moving the industry above and beyond those fairly lax federal regulations on antibiotics use in agriculture. Sanderson Farms is an exception now, however, not the rule.

“Today consumers increasingly want to know where the meat is from, how it was raised, what it was fed — and whether or not it was given antibiotics,” the report notes. For example, “a 2016 Mintel Study found that three in five consumers (59 percent) want to know the origin of beef in burgers, including 68 percent of millennials.”

Pressure on the companies is coming from investors as well. Having investors join the growing voices calling for antibiotics-free meat and poultry no doubt helped sway KFC’s parent company, Yum! Brands, to announce in April that it would stop using chickens that were treated with medically-important antibiotics by the end of 2018.

There has been much progress on the chicken front, while beef and pork producers in general are lagging behind. “Chicken has been the easiest nut to crack, so to speak, because the birds have much shorter life spans compared to pigs and cows,” says Brook. “In addition, the chicken industry is the most vertically integrated—that is, supply chains are owned by the same company that sells the product—of any in U.S. meat production. Vertical integration makes it easier for companies to implement changes in production practices throughout their supply chain.”

WATCH: Miles reports on the use of antibiotics in the pork industry for the PBS NewsHour.

“The average chicken in the US lives just 42 days and in one place (they are delivered to a barn at day one and don’t leave again until taken to slaughter),” explains Price. “For pigs, it would require that we give the animals more space and better hygiene. That’s what they did in Denmark and the Netherlands. Don’t get me wrong: we can get over these hurdles, but we have to work together to do it and we need to act urgently.”

The best of the best have taken their business elsewhere. Chipotle, for example, has had to go to the U.K. and Canada to get much of its antibiotic-free pork. It is only recently that the pork and beef industries in the U.S. have started to feel the pressure.

“Companies like Cargill, Tyson, and Smithfield announced new initiatives in the past year to reduce antibiotics use in some of their beef and pork, so some momentum is building,” says Brook, “but we need much more comprehensive change in both industries.”

Substitute worries

The reduction in the demand for meat and poultry raised with antibiotics could bring other issues.

“As restaurant chains make progress on curbing the routine use of antibiotics, there is significant concern that producers may increase use of other growth-promoting agents, such as metal compounds, hormones, and beta agonists,” note the Chain Report III authors.

Metals, such as zinc and copper, are given to pigs and poultry because they also have antimicrobial effects. If producers shift from antibiotics to metals-based growth-promotion, the same issues of antibiotic resistance will persist.

Hormones are already widely used on the farm and are given to “90 percent of cattle on feedlots,” yet few studies have been conducted to see how trace hormone residue affects the endocrine system in humans who consume that meat.

Beta-agonists, such as ractopamine, can stay on meat through the production line and “cause elevated heart rates and heart-pounding sensations in humans”.

At the moment, these are lesser worries than the overuse of antibiotics on the farm. But fast food restaurants and consumers should keep these issues in mind as the industry keeps trending toward alternatives.

Onwards to an antibiotics-free fast food experience

The progress made by the largest fast food chains over even the past two years has been heartening. However, every side of the equation needs to do their part to enact meaningful and lasting change. Chain Reaction III has recommendations for all parties involved.

Producers should commit to phasing out non-therapeutic use of antibiotics for their animals entirely, beyond what the government requires, and restaurant chains should commit to buying more than antibiotics-free chicken.

WATCH: PBS NewsHour economics correspondent Paul Solman explores how market forces are, for some, driving the shift away from antibiotics.

Consumers should both pressure their favorite restaurants to buy meat and poultry that was raised without the use of antibiotics–and investors should take note of these emerging market trends.

And, of course, all of this would be accelerated if the federal and state governments adopted more stringent rules on this issue, following the lead of California and Maryland.

“The tremendous change we’ve seen in the chicken industry in a few short years leaves me hopeful that we can accelerate similar transitions away from routine antibiotics use across the pork and beef industries,” says Brook. “When big buyers like McDonald’s, Subway, and KFC step up, it sends a clear message to producers that the demand for responsibly produced meat and poultry is there, and that the changes producers make can be quite meaningful to human health.”

“We are at a point when we could be facing a future without antibiotics. We must rein in all unnecessary uses in human medicine and animal agriculture,” Price agrees. “It is good to see the market responding to consumer demand, but we need to move beyond just chicken. I have to be hopeful.”

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