What does antibiotic resistance have to do with your food choices?
By Dr. Laura Freeman, Medical Director Plant Based Health Online (IG: @drlaurafreeman and her website: www.pbho.co.uk)
Antibiotics are a crucial component of modern medicine. We have made huge strides in preventing and treating infections since penicillin was first discovered almost 90 years ago.
But now we are facing significant problems with antibiotic resistance. Bacteria are changing in ways whereby they are no longer susceptible to antibiotics. This means that many of the antibiotics we currently rely on could rendered ineffective and infections could spread more easily.
This problem with antibiotic resistance is not a hypothetical one. We are already seeing that some cases of TB and gonorrhoea for example are not responding to last resort antibiotics. We know that currently around 700, 000 people lose their lives each year due to antimicrobial resistance. It has been well documented that if we don’t make changes to current practices, this figure would increase to 10 million a year by 2050 - surpassing all annual cancer deaths. This also holds financial implications with a cumulative cost of 11 trillion dollars and the world bank estimates this would force 28 million people into extreme poverty.
Another problem is that no new classes of antibiotics have been developed since the 1980’s. And although there’s many challenges in the development of new drugs, one concern is that pharmaceutical companies don’t want to spend millions of dollars on developing novel medications that then need to be used sparingly.
This is a global problem and so, in any discussion around antibiotic resistance we need to tackle change collectively. It is true that the low and middle income countries will suffer more severely, but nobody should feel immune - many people will suffer in developed countries too - with longer, more severe infections and an increase in the number of deaths because of infections we no longer have effective treatments for.
In fact by 2030, our use of antibiotics is projected to increased by more than 30%. This number could increase up to 200% if we don’t make any changes to current practices.
Although resistance has occurred naturally in the environment for millennia, it is our misuse and overuse of antibiotics that drive the problems we are facing now. Human antibiotic use is largely responsible but less widely known, is the problem of widespread use of antibiotics in animal agriculture. Whilst there is some variance from country to country it is thought that between 40-70% of all antibiotics sold globally are used for animals, not humans.
Our increasing demand for meat directly translates to an increase in antibiotics used in animals. Antibiotics are given to animals to treat infections but they are also given prophylactically - to prevent infection. In some countries antibiotics are still given as growth promoters in order to achieve a reduced time to slaughter. This directly impacts human health and human antibiotic resistance both through direct contact with animals - for farmers and vets for example, but also for the wider population who are preparing and consuming animal products.
With an increased use of antibiotics in animals, we will also see antibiotic resistance in animals themselves. Indeed, the UK government 20 year antibiotics vision report stated ‘untreatable infections in animals threatens sustainable food production in growing populations’. However, we already know that our current food system is unsustainable. Whilst reducing antibiotic use in animal agriculture is key, reducing our demand for meat and shifting towards a whole food plant based diet has to be part of the solution.
References
1. United Kingdom Department of Health (2019) The UK’a 20 year vision for antimicrobial resistance. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/773065/uk-20-year-vision-for-antimicrobial-resistance.pdf
2. United Kingdom Department of Health (2019) Tackling antimicrobial resistance 2019-2024. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/784894/UK_AMR_5_year_national_action_plan.pdf
3. Landers TF, Cohen B, Wittum TE, Larson EL. A review of antibiotic use in food animals: perspective, policy, and potential. Public Health Rep. 2012;127(1):4-22. doi:10.1177/003335491212700103
4. Marshall BM, Levy SB. Food Animals and Antimicrobials: Impact on Human Health. American Society for Microbiology. doi: 10.1128/CMR.00002-11