Michael Blank: When did you start eating meat?

There is increasing evidence that eating meat has various negative outcomes. As well as red meat consumption being associated with colorectal cancer and overall increased mortality, consumption of all types of meat carries a risk of foodborne transmission of resistant bacteria.(1,2)

While farmers’ overuse of antibiotics in agriculture means that more antimicrobials are entering the environment, it is the survival of resistant organisms within the meat of these animals that is becoming more of a problem for humans.(3-5) And the more meat one eats, the greater the cumulative effect, especially when the meat is eaten in undercooked or raw forms.

“And when did you start smoking?” is a question every doctor and medical student knows how to ask. Might we also start risk assessing patients not responding to antibiotics with questions about meat consumption? If a blood culture comes back as resistant to most antibiotics, should we ask the patient, “When did you start eating meat, which type, and how often?” Of course, other risk factors would apply, such as exposure to prophylactic antibiotics, or immunosuppression. But with regards to meat, perhaps we could quantify it similarly to smoking but with Meat/Antibiotic Exposure Years (“MABEYs”.)

Would we ever reach a point in the future where CCGs start funding meat cessation clinics to reduce resistance transmission from animals?

And hypothetically, even further in the future, if we end up being left with an antibiotic of last resort–as we are constantly warned that we will be–would rationing antibiotics only for vegetarians be an option? Again, cigarette smoking might be a useful comparator. Today, when funding is scarce, an ITU bed might be fought over between a smoker and a non-smoker; would you give it to the non-smoker (all other factors being equal) as statistically he is more likely to survive?(6) In the future, would we apply a similar theory if we’re forced to choose whether a meat eater or non-meat eater gets that last-resort antibiotic? What would an ethics panel decide?

It is becoming harder to ignore the evidence surrounding the negative aspects of meat-eating. Should we start training the next generation of doctors to ask patients, “Have you thought about giving up meat?” Who knows, one day it could become a question that CCGs pay us to ask.

Michael Blank has recently completed FY2 and is now studying for a master’s in Tropical Medicine

Competing interests: I am a vegetarian, though increasingly aware that my dairy product consumption might exacerbate antibiotic usage for bovine mastitis (7)

  1. Zhao Z, Feng Q, Yin Z, Shuang J, Bai B, Yu P et al. Red and processed meat consumption and colorectal cancer risk: a systematic review and meta-analysis. Oncotarget. 2017;8(47).
  2. These include cancer, respiratory disease, heart disease, strokes, diabetes mellitus, infections, renal disease and liver disease. Etemadi A, Sinha R, Ward M, Graubard B, Inoue-Choi M, Dawsey S et al. Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study. BMJ. 2017;:j1957.
  3. Rushton, J., J. Pinto Ferreira and K. D. Stärk, Antimicrobial Resistance: The Use of Antimicrobials in the Livestock Sector. OECD Food, Agriculture and Fisheries Papers, 2014, No. 68, OECD Publishing. http://dx.doi.org/10.1787/5jxvl3dwk3f0-en.
  4. Acar J. Joint FAO/OIE/WHO Expert Workshop on non-human antimicrobial usage and antimicrobial resistance: scientific assessment. 2013. Available from: http://www.fao.org/3/a-bq500e.pdf
  5. Overview report on EU Member States’ 2013 residue monitoring plans as regards critically important antimicrobials. Luxembourg: Publications Office; 2015.
  6. Smoking and Mortality — Beyond Established Causes. New England Journal of Medicine. 2015;372(22):2168-2170.
  7. Burvenich C, Van Merris V, Mehrzad J, Diez-Fraile A, Duchateau L. Severity of E. coli mastitis is mainly determined by cow factors. Veterinary Research. 2003;34(5):521-564.