Healthy Livestock Agriculture - Healthy People:  Connecting Local Pasture-Raised Food and Consumers in Central North Carolina

Final Report for CS04-030

Project Type: Sustainable Community Innovation
Funds awarded in 2004: $10,000.00
Projected End Date: 12/31/2005
Region: Southern
State: North Carolina
Principal Investigator:
Sally Norton
Program on Integrative Medicine
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Project Information


“Healthy Livestock Agriculture & Healthy People” was inspired by the expressed interest in local sources of pasture-raised foods by holistic health providers who use dietary changes as part of therapy. The project was designed to facilitate access to healthy, grass-finished livestock products and to increase awareness among holistic and conventional health providers about the connections between agriculture and health. The project’s key accomplishment was publishing and disseminating the Consumer Guide to Locally Produced Livestock Products, Central North Carolina. The Consumer Guide provides new information about how to purchase meat, eggs, and dairy foods from local small-scale farmers, facilitating consumers’ search for health-supporting foods in Central North Carolina. Despite limited distribution, the Consumer Guide generated enthusiasm and excitement, which indicates a very real need for this information and suggests a strong potential for future growth in the demand for the products of grass-farmers. Very strong sales growth figures from participating farmers suggest that wider collection and distribution of this information on behalf of natural healing, public health, family farms, and economic diversity is warranted. Market research is also needed to inform effective strategies for outreach and education about grass-farming and direct-to-consumer sales of meats, eggs and dairy foods.

We are grateful for this rewarding opportunity.


Consumers and health professionals are increasingly motivated to change food-purchasing habits. One emerging trend involves concerns about the quality, safety, and nutritional value of meat, eggs, and dairy foods produced in large-scale confinement operations. Specific health and safety concerns of consumers and health professionals about meat and dairy foods produced in confinement operations include: reduced nutrient density (chemical fertilizers allow feeds to be grown on de-mineralized soils); altered fat profiles (due to use of grain-based feeds); possible contamination with herbicides or pesticides; exposure to hormone growth promotants; antibiotic exposure; possible chemical alterations resulting from stressful living and slaughter conditions for animals; exposure to chemical additives (including nitrates and other preservatives); and greater risk of allergy due to the introduction of genetically modified feeds. Environmental and ethical issues created by industrial food production systems and the deterioration of small farm profitability and sustainability trouble consumers as well. Due to these concerns, demand for locally produced livestock products from consumers and health professionals is growing. This trend clearly presents market opportunities for local farmers.

Small-scale North Carolina livestock producers face economic difficulties when participating in industrially integrated livestock production. Profit margins are shrinking and farming often provides only a meager, supplemental income. Some farmers have found that low-input production methods, coupled with direct-to-consumer sales, results in more stable prices than the commodity market and improves small farm profitability. Thus, more and more small-scale livestock producers are interested in increasing direct sales to improve the profitability of their operations.

While some resourceful consumers and farmers have connected via local farmers’ markets or other informal channels, health-concerned consumers are generally unable to access local producers’ grass-finished meats, eggs, and dairy products. In 2003, Triangle-area holistic health providers requested information about local sources of grass-finished meat from the UNC Program on Integrative Medicine. In response to this need, this project developed new alliances to collect and compile information about local sources of grass-finished livestock products to create a new resource to guide central North Carolina consumers to local farmers. The resulting Consumer Guide to Locally Produced Livestock Products, Central North Carolina includes detailed farm information and educational content to facilitate health care providers’ knowledge of and access to local, pasture-raised livestock products.

Project Objectives:

The objectives of this project were: 1) to collect producer information and publish findings in a local food guide for a five-county region in central NC; 2) to develop and disseminate educational materials about sustainability, nutrition, and food safety as it relates to the consumption of locally produced eggs, meat, and dairy products; and 3) to develop new partnerships to outline further projects and outreach opportunities.


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  • Tony Kleese
  • J. Michael Lanier


Materials and methods:

Development of survey instruments
Using input from agricultural experts and results from a pilot project conducted in fall 2004, we developed a three-part survey to collect information from local livestock producers to be included in the Consumer Guide to Locally Produced Livestock Products. Part one, the Livestock Production Methods questionnaire, included detailed questions about livestock feeding regimens, use of antibiotics and hormones, environmental impacts, animal welfare, and other practices. The Production Methods questionnaire included parallel versions for each of the following species of farm animal: beef cattle, dairy cattle, swine, sheep, goats, and poultry. Part two, the Direct Sales questionnaire, solicited information about how and where customers could purchase foods from the farmer. Finally, the Farm Impact questionnaire was designed to determine if publication and distribution of the Consumer Guide resulted in new consumers or increased sales for participating farmers.

Selection of producers for inclusion
Orange County and surrounding counties served as the focus of this project for a number of reasons, including proximity to grass-farmers and the holistic health care providers who had specifically requested information about pasture-raised meats. Other reasons included the development pressures on area farmland and the concentration of consumer and holistic health care providers in the Triangle region. In addition, the counties north, west, and east of Orange are designated by the NC GoldenLEAF Foundation as “economically distressed” and “historically tobacco dependant.” Orange County Cooperative Extension developed the initial list of small-scale livestock producers interested in increasing sales direct to consumers to be interviewed. Other referrals increased the size of the list and farmers from three additional counties in eastern North Carolina were included after recommendation by the Rural Advancement Foundation International-USA (RAFI) and the North Carolina Department of Agriculture (NCDA).

Producer/products data collection
A research assistant traveled to the farms of ten of the twenty-one participating producers to conduct an in-person interview that lasted about one hour. All other producers were interviewed on the phone or via U.S. Mail for convenience or other considerations. The Livestock Production Methods, Direct Sales, and Farm Impact questionnaires were all used during the interview. All initial interviews were completed by June 2005. Upon completion of data entry, all data from the Livestock Production Methods and Direct Sales questionnaires were mailed to participants for verification. Producers were asked to make corrections and fill in missing information if necessary and sign a declaration statement to confirm that all data was complete and accurate. Once the declaration form was received, information about the producer was included in the Consumer Guide. Near the end of the project, producers were contacted by phone and interviewed again using a modified Farm Impact questionnaire to document sales growth and solicit farmer feedback.

Consumer Guide development
Project collaborators created a tabular format to present detailed information about farms for consumer use. Participating producers reviewed drafts of the Consumer Guide to provide feedback on formatting. We also solicited feedback from consumer recipients to determine readability and usefulness of the Consumer Guide via a mail-in form included with each copy. This feedback was used in development of later editions of the Guide. Three editions of the Consumer Guide were produced: 1) Spring 2005 Edition (March 2005); 2) Summer Preview Edition (June 2005); and 3) Summer 2005 Edition (August 2005).

Consumer Guide distribution
As initially planned, we distributed the Consumer Guide to Locally Produced Livestock Products to participants at the March 2005 UNC-PIM Integrative Medicine professional conference, to staff at the Piedmont Health Services Center in Prospect Hill, and to complementary, alternative, and conventional medical providers practicing in the region who expressed an interest in this project. In addition, an electronic PDF file of the Consumer Guide was posted to the websites of the collaborating agencies. Participating producers were also listed in a special section of the 2005 Guide to Local and Organic Foods (published by the Carolina Farm Stewardship Association in March, 2005), which is widely distributed at public venues and events in North and South Carolina. The Consumer Guide was also distributed at several other educational events and presentations organized or attended by project collaborators.

Clinic intervention: Planning and implementation
The project team conducted two presentations for staff at the Piedmont Health Services Center at Prospect Hill. The Prospect Hill Clinic serves over 4700 users in the heart of our study region – at the intersection of Orange, Person, Caswell, and Alamance Counties. Clinic clientele suffer a high incidence of obesity, sedentary lifestyle, chronic disease, and uninsured status. Nearly half are seasonal migrant farm workers.

The first presentation introduced staff to the concepts of pasture-based livestock production (including nutrition, safety, and sustainability) and buying directly from local producers. The presentation included a PowerPoint with photos of local farms, farmers, and their livestock; farmers listed in the Consumer Guide as guest speakers (two local farmers attended); and samples of eggs, sausage, and cheese produced by local farmers. During the second presentation these concepts were reviewed and participants were served a catered lunch prepared with locally grown ingredients from farms listed in the Consumer Guide.

Participating staff completed knowledge tests prior to the first visit and after the second visit to determine whether the presentations had an impact on their awareness of nutrition, safety, and sustainability issues related to livestock production and their likelihood of purchasing meat, cheese, and dairy foods from local producers.

Research results and discussion:

Consumer Guide: Data
Of the twenty-five producers invited to participate, twenty-one accepted, three declined, and one farm, having discontinued livestock production, withdrew. The participants include start-up operations (sustainable production methods with direct sales business model), newly diversified operations (commodity with addition of grass-fed products with direct to consumer sales), and new conversions from commodity production to sustainable practices and direct sales. The number of counties represented by participating farms exceeded our initial goal of five counties, growing to ten counties. Together, these data are rich in detail and represent a baseline for future projects examining grass-farming in Central North Carolina.

The majority of producers indicated that they were comfortable with the survey process for collecting information about their methods and products and felt that the questions were clear and fair. All twenty-one farms returned their declaration statement confirming the accuracy of the data presented in the Guide, though awaiting these confirmations delayed printing of the final version.

Seven participating producers provided feedback on the formatting of the Consumer Guide prior to the publication of the initial edition in March. Most producers described information presented in the Guide as “easy to read,” “concise,” and “just right” and were satisfied with the way information about their operation was summarized for consumers. They agreed that the Guide would be a useful resource for consumers. The project’s advisory committee also reviewed the initial draft of the Guide in February 2005.

Consumer Guide: Printing and distribution
In March 2005, 241 copies of the Spring edition of the Consumer Guide (listing sixteen farms) were distributed to attendees at the UNC Integrative Medicine Conference “Improving Outcomes Through Integrative Practice.” In June, fifty copies of the Summer Preview edition were printed for the Prospect Hill Clinic staff presentations. In August, the completed Summer Edition was printed with twenty-one farms listed (all verifications received). Additional printings occurred in September and November due to demand and enthusiastic donations of paper from community members; a total of 441 copies of the Summer edition were printed. Overall, we printed 732 copies (total of all three versions) and 90% have been distributed to participating producers, the project advisory committee, alternative and conventional health providers, chefs and food purchasers for local groceries and restaurants, attendees at meetings related to alternative health care or sustainable farming, and the general public.

In March 2005, livestock producer data from sixteen farms was included in the Carolina Farm Stewardship Association’s 2005 Carolinas Guide to Local and Organic Food in a section called “A Special Look at Local Livestock Farms.”

An electronic PDF file of the Consumer Guide (Summer Edition) was posted to the websites of three collaborating agencies and received 102 unique hit counts on the Program on Integrative Medicine website over a four month period. The Spring Edition received thirty-nine unique hits. Hits for postings of the PDF on other websites are not known. The PDF file of the Consumer Guide was also emailed to at least forty alternative and conventional health providers in Central North Carolina. A few of these physicians and community members are reproducing and distributing paper copies of the Guide under their own initiative. Other individuals have shared the PDF electronic file with associates. One consumer asked for additional copies to distribute at his cancer-survivor support group.

Consumer Guide: Feedback from consumers
Eleven consumers returned the feedback form (provided with each copy of the Consumer Guide); other recipients responded via email or verbal comments to project collaborators. Although the response rate was low, respondents were uniformly positive. A majority of respondents described information presented in the Guide as “easy to read,” “concise,” and “just right.” Consumers also agreed that they knew more about local livestock producers, the kinds of products they sell, and how to purchase them after reading the Guide. A majority described the Guide as a useful consumer resource and said it increased the likelihood that they would purchase meat, eggs, and dairy foods from local producers. Several holistic health providers called the Guide “a good resource” for their patients. One consumer wrote “I absolutely love the Consumer Guide! I did not know that I had all these choices of farmers in my area.” Consumers also provided suggestions for information that could be added to future versions of the Guide. At presentations and meetings in which the Consumer Guide was distributed, many recipients expressed great enthusiasm about having a resource for local sources of “clean” and sustainably produced meats.

Several Guide recipients sent emails to express appreciation for the Consumer Guide. Here is one such message:

You are to be congratulated on the Consumer Guide to Locally Produced Livestock Products. As a physician and a cancer survivor, I found the Guide to be very helpful and extremely appropriate for restoring my personal health in the course of my battle with Non-Hodgkin’s lymphoma.

The Guide's discussion of the health benefits of grass-fed livestock food was compatible with my own research regarding the anticancer properties of such nutrients as CLA, for example. Finding local food sources rich in cancer fighters like CLA, and low in suspected carcinogens like hormones and pesticides has been a real challenge. The Guide is a huge help in getting this kind of information, so much so that I routinely share this Guide with other cancer survivors, including at the Cornucopia House Cancer Support Program in Chapel Hill, North Carolina.
I intend to share this excellent resource with others, including health care providers, and the Duke Comprehensive Cancer Center's Duke Cancer Patent Support Program and Cancer Patient Focus Group. Please let me know how I can obtain additional copies.

I have personally purchased meat and/or eggs from three farms listed in the Guide, and have used three of the farmers markets listed.

Thank you so much for creating this much needed guide. I believe there is a need for even more such information to be made widely available to the public. Please continue these efforts to connect consumers and health care professionals with local and sustainable livestock farmers.

Despite limited distribution, the Consumer Guide generated great enthusiasm and excitement indicating a very real need and interest – suggesting a strong potential for future growth in the demand for the products of grass farmers.

Consumer Guide: Impacts on participating producers
Using the Farm Impact questionnaire, we collected information about direct sales volume and customer base size from a subset of twelve farmers prior to publication of the Guide and again at the close of 2005 to detect growth of these operations and to determine if the Guide had a positive impact on either of these indicators for participants. We reached eleven producers for a follow-up interview. Seven of eleven participants reported increases in sales of meat, eggs, and dairy foods direct to consumers of more than 50% over 2004 sales. Five farmers reported that sales of at least one of their products had more than doubled since 2004. Two farms reported direct sales increases around one third over 2004 sales. Three farms reported direct sales growth of 5% or less over 2004. Sales of breeding stock to farmers are not included in this data. Most farmers expressed little confidence in their ability to accurately estimate the number of households in their customer base. However, almost all reported that the size of their customer base had increased in 2005. Rough estimates suggest that this sample of farms served an average of 200% more households in 2005 over 2004 in number of households served, with a range of 0-1000+%. No sales decreases were reported. These data, suggest strong growth of these operations and consumer interest in these products.

Increased direct sales for participating farmers cannot be attributed to the Consumer Guide or other project activities. These operations, whether a start-up pasture operation, a recent conversion from conventional methods, or a newly diversified operation, are all in early stages of growth. They are implementing their own sales and advertising programs and constantly seeking ways to find new customers. As they expand their production and/or proportion of direct sales, the volume of product available to sell increases. Also, local and national publicity on the topic of locally and sustainably produced foods has increased during the last year, unrelated to the publication of the Guide. In addition, the number of users who contact farmers they find in the Guide should continue to increase over the next year because the release of the Guide is recent and ongoing. However, seven of eleven farms indicated at least one new customer learned about their operation from the Consumer Guide. Most farmers felt very positive about the project and their participation and provided suggestions for improving and expanding the project. Some selected comments from participants are below:

I love the project. I think we need to look at our efforts and say…the increase is geometric. We’re where the organic produce people were five years ago.

We are very pleased this type of information is being compiled and made available to those who need and want it. Hopefully this will not only increase our visibility in the community as a business, but will let people know how they can buy the healthiest, locally produced foods to meet their dietary requirements and ethical preferences.

I am happy this is being done. [The project] is a great effort for championing the cause.

I am very pleased with the project.

It’s great – I hope you keep working at it. Awareness is a great thing. More education [is needed], many local people would buy grass-fed if they understood [the advantages].

[It is] very well designed and administered.

This project has been great. As crazy as my life has been, I have enjoyed being a part of it and think it will give me some publicity.

Farmers also had a variety of suggestions for future work: 1) wider distribution of the Consumer Guide (more grocers, more health practitioners); 2) improvements to the Guide (including strictly defined categories for producers based on practices and more detailed educational information about chemical residues in meat that is not raised on grass), 3) better connections with existing websites (e.g. NCDA “Goodness Grows” and “Gotta be NC” publicity programs, Eat Well online store); 4) connect participating farmers to agrotourism efforts; 5) more workshops/presentations to educate health practitioners and the general public; 6) creation of a logo (only participating farmers would be able to display it); and 7) creation of a North Carolina Grass-fed Farmers Council to increase publicity and impact on state agricultural policy.

Prospect Hill Clinic Intervention: Staff knowledge test results and other outcomes
Approximately thirty members of the Prospect Hill Clinic staff attended at least one of the two presentations. Attendees included physicians, nurses, aides and support staff. During the first visit, twenty-eight staff completed the pre-test; twelve staff completed the post-test after the second visit. Outcomes were evaluated by comparing the percentage of respondents who correctly answered similar questions from each test. Overall, staff showed increased knowledge of relevant topics on the post-test, including the percent of the food dollar spent on marketing (vs. paid to farmers), the link between routine use of antibiotics and resistant strains of bacteria, the influences of livestock diet on nutritional qualities of meat and eggs, the differences between yolks of factory farm eggs vs. free range eggs, examples of illnesses linked to confinement hog operations, and reasons for the use of arsenic in chicken and swine feed. Clinic staff also initiated an interesting discussion about North Carolina WIC and Food Stamp policies that discourage the purchase of local farm fresh foods.

Additional Outcomes
The new relationship with the Prospect Hill Clinic led to the successful application to Blue Cross Blue Shield of North Carolina to fund additional educational programming for patients and staff at the Prospect Hill Clinic. Intervention planning will focus on incorporating local farm fresh foods into preventative and therapeutic care for diabetes.

This project has increased the capacity of project staff to provide information to health providers and farmers, including the compilation of extensive resources about nutrition, safety, and sustainability issues related to pasture-based livestock production from academic literature, popular press, and the Internet. As a result, new information was included in the UNC Medical School curricula about conjugated linoleic acid (CLA) and cancer.

An additional effect of this project is increased communication between grass-farmers listed in the Guide.

Participation Summary

Educational & Outreach Activities

Participation Summary:

Education/outreach description:

Inclusion of our livestock producer data in the 2005 Carolina Guide to Local and Organic Food (published by the Carolina Farm Stewardship Association in March 2005). This five-page Livestock Section was called “A Special Look at Local Livestock Farms.”

Articles describing the Consumer Guide were published in several newsletters: Carolina Farm Stewardship Association newsletter, May 2005; Sierra Club NC newsletter, Summer 2005; and the Anthroposophical Society in North Carolina newsletter.

Application for funding from the GoldenLEAF Foundation in partnership with the UNC Keenan-Flagler Business School.

The Project Coordinator presented on the topic of nutritional advantages of grass-fed meats, dairy, and eggs at the annual Carolina Farm Stewardship Conference in Durham, NC, November 2005 and is scheduled to give two presentations at the Medicinal Foods Conference in Normal, Alabama, April 2006.

Other new connections were established with the Central NC Sustainability HUB group, a project of the Integral Institute (a new local non-governmental organization), and with NC consumers affiliated with the Weston A. Price Foundation and Slow Foods.

Project Outcomes

Project outcomes:

The key accomplishments for this project include: (1) the collection and compilation of data from twenty-one producers in ten NC counties; (2) the development of consumer-friendly introductory information about livestock agriculture and buying food from local farmers with some content on nutritional and sustainability advantages (print and PowerPoint); (3) the distribution of a local food guide, entitled Consumer Guide to Locally Produced Livestock Products, Central North Carolina; (4) the development of a PowerPoint presentation and consumer quiz about sustainability, nutrition, and food safety as it relates to the consumption of locally produced eggs, meat, and dairy products; (5) dissemination of the Consumer Guide (in print and via PDF electronic document) and our educational message to health professionals, consumers, and farmers via two regional conferences, four local educational seminars, several community newsletters, and several websites; (6) submission of a project proposal to the GoldenLEAF Foundation in partnership with the UNC Keenan-Flagler Business School; and (7) development of new affiliations that will benefit future projects.

A separate study was conducted by Ms. Munro-Leighton; results were summarized May 2005, in her unpublished master’s thesis, “A Political-Economy-of-Health Perspective on Pasture-Based Livestock Production in Central North Carolina.” This study reports central North Carolina small-scale livestock producers’ viewpoints regarding influences of historical, social, economic, and political factors on their farm operations and management practices.


Potential Contributions

This project resulted in three innovations that may be adapted for marketing, consumer education, and sustainable agriculture research or planning: 1) The Consumer Guide to Locally Produced Livestock Products, Central North Carolina uniquely provides consumers with detailed information about local producers, their products, and their production practices. 2) The Livestock Production Methods, Direct Sales, and Impact questionnaires developed to collect producer information are valuable for additional education and research. 3) Our outreach to health care professionals to raise awareness of the connections between agricultural practices (related to meat quality) and health offers a new model for increasing community support for local producers, especially in rural communities. In light of new research documenting the nutrient advantages of grass-fed livestock, we promote the Guide as “a new tool for healing.” Many of our holistic providers already practice nutritional medicine and require tools like the Guide to support lifestyle changes for clientele. Conventional health providers potentially benefit from reminders about concerns with dietary quality (for both patients and themselves) and the medical problems of antibiotic resistance. Our contact with staff at the Prospect Hill Clinic led to plans for an “integrative” diabetes education project that will include information on farm and garden fresh foods. We would like to find funding to help this community launch a farmers’ market site or Community Supported Agriculture- type subscriptions drop on the clinic grounds.

Future Recommendations

The Consumer Guide resulting from this project is an example of a tool for increasing direct sales to support small family farms participating in the emerging grass-finished livestock products industry. Versions of the Guide published for this project were targeted for use by health care providers and their clients. The Guide is also of use to a general audience. Limited distribution yielded a good response suggesting the need for wider outreach and distribution to this market. Funding is needed to expand distribution and outreach.

Other market segments (such as food gourmets, animal rights activists, religious groups, and environmentalists) may require specifically targeted information and marketing. Market research and development are needed to inform effective strategies for outreach and education of consumers and farmers about grass-farming and direct-to-consumer sales of meats, eggs and dairy foods. Outreach to extension personnel, researchers, health and environmental advocates should continue.

Given the potential importance to rural economies and the preservation of small-scale family farming, the enormous growth of direct sales from small, family grass-based farms deserves further study to elucidate factors impacting sales growth. Outreach to regional planners, decision-makers, lawmakers, funding agencies, and financial institutions is also needed.

Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture or SARE.