December 2010 Archive for On the Udder Hand

As this is the last week of the month, you can expect to see ubiquitous end-of-the-year roundups, highlighting the biggest stories of the past 12 months.  Ever the contrarian (hence the name of this blog!), I’ve decided instead to focus on arguably the biggest non-story of the past decade, certainly where food production meets public health:  the emergence – and rapid disappearance – of mad cow disease. 

It will be 10 years ago in March that Newsweek magazine ran this cover story about mad cow disease, which had broken out in the United Kingdom about five years prior.  Mad cow was a new and scary disorder caused by infected neurological tissues that were being spread through the meat supply.  It mimicked an existing brain disorder called Creutzfeld-Jakob Disease, which occurs spontaneously in one out of every one million people, usually in their senior years.  But this was not your father’s CJD; the new, variant CJD was aggressive, singling out young people, and just like in a bad zombie movie, it literally was eating through the brains of its victims, all of whom themselves seemed to have eaten infected meat products at some point in the 1990s. [And a technical footnote:  vCJD is the name of the disease once humans contract it; the Bossy-borne version is called bovine spongiform encephalopathy).

So Newsweek predicted it was just a matter of time that the same plague could descend upon the U.S.  Many other media outlets also began jumping on the bandwagon in early 2001, from 20/20, to 60 Minutes, all proclaiming that the “deadly spread” of mad cow, after it had ravaged merry old England, was about to follow the path of the Spice Girls and cross to our shores, exacting an even more lethal toll. 

Except, it didn’t.  It hasn’t.  And it won’t.  Here’s a quick quiz for you:  How many people across the world would you estimate to have died from mad cow disease in the past 15 years?:

A.         170

B.         1,700

C.         17,000

D.         170,000

Anytime there is a new and unknown disease threat, there is a natural human inclination to circle the wagons and fear the worst (do the words “swine flu” sound familiar?  How about “bird flu”?  What they have in common:  neither was worse than the same ol’ garden variety flu we’ve always had to deal with, despite dire initial predictions, including yet another Newsweek magazine cover story). 

Back in 2000, it didn’t help that the British government itself was already pushing the panic buttons.  Look at this statement from 10 years ago:  they were predicting that up to 250,000 British residents could die from mad cow, which is one in every 250 people there.  Extrapolate those numbers to the U.S., and the death toll forecast might have been 1 million.  That’s twice the number of Americans who have died of HIV/AIDs in the past 30 years.

And yet, and yet…the facts ultimately vanquish the scary things we see, or think we see, lurking in the shadows.  This chart from the U.K.’s repository for epidemiological data on all forms of CJD, lists the cumulative total of vCJD cases since the malady was first identified in the mid-1990s.  AND HERE IS THE ANSWER TO THE QUIZ:  A = 170. It includes “probable” cases of mad cow infection that weren’t, or haven’t, actually been confirmed by pathological tests.  So it’s an upward estimate.

That’s how many people have died from mad cow disease.  The mortality incidence peaked with the onslaught of news coverage in 2000, with 28 deaths.  But rather than escalating into the thousands, or even hundreds of thousands, the death rate rapidly dropped (and yes, everyone who gets infected dies).  This year, knock on wood, there will only be three deaths, same as last year, and following the general trend toward less than a handful of deaths annually.  All tragic for those families, to be certain, but also vanishingly rare, far rarer than other garden variety foodborne illnesses, or deaths cause by dog bites, or insect stings, or other freakish acts of nature.  Rare enough to still sometimes be news, unlike other causes of death.

This has been an all-England scrum: as far as we know, not a single American, that is, nobody who wasn’t a part- or full-time resident of the U.K. during the period that mad cow disease was spread in England in the 1990s, has succumbed.  Not one.  So much for that deadly spread in America.  This is due to preventions our government put in place back in the late 1990s, but it’s also due to the fact that livestock production practices, from the farm to the slaughterhouse, are different here than they were back in Britain.  And it appears likely that it’s also due to the fact that vCJD is not all that easy to contract.  Otherwise, the death toll in England would probably have been much higher than 170 cases out of about 62 million total residents.

So that’s my candidate for this year-end election:  one of the biggest non-events in medical history.  Except that mad cow disease, in England and America, was big, big news.  And created lots of concern.  And generated a significant amount of public policy efforts to go along with those headlines and eyewitness news coverage.  All to combat something that by any reasonable measure, has been an absolutely negligible health threat in every country other than Great Britain, where it’s now essentially extinct.  Have a great 2011!

President Obama signed the Child Nutrition Act earlier this week, the culmination of a year-long effort by a lot of people – including his wife – to improve the nation’s collective health and weight in general, and the quality of school kids’ lunches in particular.

The “Healthy, Hunger-Free Kids” bill authorizes an additional expenditure of six cents per typical school lunch, with the goal of making “better” foods more common in public schools.  It also places restrictions on when and where foods of dubious nutritional quality – for all intents and purposes, what we usually refer to as junk food – can be sold or offered in schools.

This is all well and good, as the nation fights a critical battle against obesity, which has gotten particularly scary in young people because it’s become so much more common.  And yet I have to wonder how much this top-down effort at regulating the types of foods served to kids will really help.

The reason I say this is that we still don’t really have a clear sense about whether the obesity crisis is due to what we’re eating, or what we’re not doing to work it off.  It’s a chicken and egg argument that has gone round and round, and the usual response is that, well, it’s both that we’re eating too much – especially too much of the wrong stuff – and we’re doing too little to exercise and get outside and burn off those calories.  But it seems like knowing a precise answer to this conundrum is the necessary first step in helping address it.  Otherwise, scarce public policy resources may be directed towards things that aren’t really all that valuable.

Clearly, soda consumption among young people has increased in the past generation.  It probably plays a part in adding to the total caloric load, particularly in our juvenile population.  But soda’s been around for a century.  And now there’s this new report from the Archives of Internal Medicine which shows that taxing sugar-sweetened sodas would only have a marginal impact on people’s weight – just one pound less. This report is a blow to the bandwagon notion that if we just restrict or tax the heck out of soda, we’ve vanquished the main villain in the fat fight. 

Then you have people who go after the effect that farm programs supposedly have on public health.  Back in the summer, there was this stunningly misinformed quote in a story the New York Times ran on this topic.  Barry Popkin, a professor at the University of North Carolina, said that:

“If we cut the subsidy on whole milk and made it cheaper only to drink low-fat milk,” he says, “people would switch to it and it would save a lot of calories.”

But there is no subsidy for different types of milks, either their production, or their consumption.   In most supermarkets, a gallon of whole milk typically costs the same, or in some cases, MORE than skim milk.  In fact, in the new school lunch bill basically says schools can only serve nonfat or low-fat milk.  And if you look at the longer term trends, whole milk consumption has plummeted, from 14 gallons per capita in 1985, to six last year, while low- and non-fat varieties have risen in popularity during the past 25 years, from 12 gallons then, to 15 gallons per person today.

That statement, by a nutrition expert no less, reminds me of what Mark Twain said more than 100 years ago:   "It ain't what you don't know that gets you into trouble.  It's what you know for sure that just ain't so."  How can we have clear understandings about the policy environment when assertions of fact just ain’t so?

NPR commentator John McWhorter also weighed in this week on the obesity topic, and makes an interesting point that access to healthy foods, even in the poorest parts of the inner city, are not necessarily the be-all and end-all of this process.  He states that a cultural shift in what foods we prefer is what it will take to change the overeating, underexercising vicious circle.  And that change will entail far more than more servings of carrots and less of Coke.

This obesity policy issue reminds me a great deal of the recent debate over the budget deficit, and how much of shrinking that fat monster is due to a need for more taxes, versus less spending:  it’s much less about the specific numbers involved, and much more about societal values and priorities.  And there are no clear answer in that, just firmly-held opinions that make finding clear answers all the more difficult.

The Wall Street Journal made notice earlier this week of a trend that’s part and parcel of the unmistakable locavore movement:  the appearance in the past decade of what are essentially farmstead dairy manufactures, farms that both milk the cows, and then make that milk into cheese, or yogurt, or similar products.  But the thing is, this dairy locavore movement is itself part of something larger.

The focus of the story was on the growth of these micro cheesemakers in New York state, but it’s also something that has happened in other parts of the country, making every manner of dairy product.

Such operations are certainly one way to avoid the proverbial “middleman,” and capture all the consumer retail dollars involve in such transactions.  This assumes, of course, that you have a ready market for those products.  New York, with its proximity to tens of millions of people, is well-situated in that regard.  Other less populace places, like, say, Nebraska, where there are more cows than people, pose a bigger challenge to creating a market suitable for sustaining this type of enterprise.

I was thinking about the growth of these grassroots dairy food makers while reading David Brooks’ book “Bobos in Paradise,” which is about a decade old itself (but I like to let certain books season a while before I read them).  Brooks, who also writes a column for the New York Times, hypothesizes that the growth of demand for things like farmstead, artisanal dairy products is a result of a certain demographic of people who have more disposable income, a counterculture outlook, and are willing to pay a significant premium for such non-mainstream consumer goods (good examples are microbrews, local wineries, or the stuff typically sold at farmers markets). 

Brooks’ book is a sociological profile of a type of people who tend to be trend leaders.  They display a more subtle form of conspicuous consumption, and you can see their imprint in all different kinds of marketing today (such folks have made Steve Jobs an even richer man).  Our media and politics have certainly fractured; so has the way consumer goods are produced and sold.

The challenge for farmers, of course, is that it’s hard to predict exactly what kind of market there is, long-term, for potentially fickle and picky customers.  Investing in a cheesemaking plant, and devoting considerable resources to marketing the resulting product, is a dicey deal even in the best of times – which these clearly are not.  Some succeed, while others don’t.  That’s the way it always is for small businesses.