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To the Editor: In his Editorial about Shiga toxin-mediated hemolytic uremic syndrome, Dr Siegler¹ stated that "A multifaceted approach is required that includes novel ways of decreasing the EHEC (enterohemorrhagic Escherichia coli) carrier rate in livestock." I believe there are 2 additional measures that would decrease the carrier rate of EHEC as well as risk of other meat-borne diseases.

First, feeds based on grain alter the rumen flora in a way that encourages growth of enterotoxigenic E coli; feeding grass or hay for even a few days before slaughter has been found to greatly decrease the number of these organisms.^2-3 Second, consuming beef that was exclusively grass-fed has additional advantages in that it is lower in fat than grain-fed beef, has a lower proportion of saturated fat, contains substantial amounts of omega-3 and omega-6 fatty acids,⁴ and may even assist in lowering consumers' cholesterol levels.⁵

Mary Ellen Walker, MD, MPH
Vashon Island, Wash

1. Siegler RL. Postdiarrheal Shiga toxin-mediated hemolytic uremic syndrome. JAMA. 2003;290:1379-1381. FREE FULL TEXT 2. Diez-Gonzalez F, Callaway TR, Kizoulis MG, Russell JB. Grain feeding and the dissemination of acid-resistant Escherichia coli from cattle. Science. 1998;281:1666-1668. FREE FULL TEXT 3. Callaway TR, Anderson RC, Edrington TS, et al. Preslaughter intervention strategies to reduce food-borne pathogens in food animals. J Anim Sci. 2003;81(esupplement 2):E17-E23. 4. Fukomoto GK, Kim YS, Oduda D, Ako H. Chemical composition and shear force requirement of loin eye muscle of young, forage-fed steers.Madison, Wis: Research Extension Series. 1995;161:1-5. 5. Denke MA. Role of beef and beef tallow, an enriched source of stearic acid, in a cholesterol-lowering diet. Am J Clin Nutr. 1994;60(suppl 6):1044S-1049S. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290:3193-3194.

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