UNIVERSITY OF CALIFORNIA
COOPERATIVE EXTENSION
NUTRITION PERSPECTIVES
Volume 25, No. 3
May/June 2000
TABLE OF CONTENTS
Dietary Guidelines 2000 for Americans Released
Uncle Sam Wants You – To Eat More Fruits and Vegetables
Q and A’s on Dietary Guidelines for Americans, 2000
How Can a Healthy Diet Be Achieved?
DRI’s for Dietary Antioxidants Released
UC Davis Health System: Current Research on Nutriceuticals
Tomatoes and Prostate Cancer
Treating Hypertension in the Patient with Type 2 Diabetes
Malnutrition among the World’s Children
Resources:
Website for Healthy Eating
New Agriculture and Natural Resources Catalog Is a Rich Resource for
Farmers, Gardeners, and Nutritionists
Information Centers Jumping-Off Point for Nutrition Resources
Subscription for NUTRITION PERSPECTIVES
Sheri Zidenberg-Cherr,
PhD, Editor
University of California
Department of Nutrition
One Shields Ave.
Davis, CA 95616
NUTRITION PERSPECTIVES is
prepared by Sheri Zidenberg-Cherr, PhD, Nutrition Specialist, Julie Schneider, and staff.
It is designed to provide research-based information on ongoing nutrition and food-related
programs. It is published bimonthly (six times annually) as a service of the University of
California Cooperative Extension and the United States Department of Agriculture.
Subscription to NUTRITION PERSPECTIVES is available from UC Cooperative Extension,
Department of Nutrition, University of California, Davis, California. Cost is ten dollars
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may be addressed to: NUTRITION PERSPECTIVES, University of California, Department of
Nutrition, One Shields Ave., Davis, CA 95616-5270. Phone (530) 752-3387; Fax (530)
752-8905.
DIETARY
GUIDELINES 2000 FOR AMERICANS RELEASED
The federal government released the fifth edition of “Dietary Guidelines for
Americans,” providing easily understood, science-based information on how Americans
can choose diets that promote good health.
The new guidelines, announced by President Clinton in his weekly radio address, have been
improved to be more consumer-friendly, to contain more specific scientific recommendations
and to address the need for safe food handling to prevent illness.
This edition of the Dietary Guidelines provides practical advice and useful information
for American families,” Health and Human Services (HHS) Secretary Donna E. Shalala
said. “They will help consumers apply the most current scientific knowledge to the
way they eat every day, both to promote health and to reduce their chances of developing
many chronic diseases.”
“The Dietary Guidelines are the gold standard when it comes to applying scientific
research to what people should be eating,” said Agriculture Secretary Dan Glickman.
The new guidelines continue to emphasize balance, moderation and variety in food choices,
with a special emphasis on grain products, vegetables and fruits. The guidelines include
specific examples of foods that deliver given nutrients, including choices for
vegetarians.
The new guidelines also emphasize physical activity as important for healthy living, more
than just for weight management. For example, physical activity can help build and
maintain healthy bones, muscles, and joints; build endurance and muscular strength; and
promote psychological well-being and self-esteem. Moderate physical activity for at least
30 minutes most days of the week is recommended for adults and 60 minutes for children.
For the first time, there is a guideline that focuses on keeping food safe to eat,
particularly the need to keep and prepare foods safely in the home. Recommendations
include keeping preparation areas and utensils clean; separating raw, cooked, and
ready-to-eat foods; cooking food to a safe temperature; and chilling perishable foods
promptly.
“We have long recognized the importance of a healthy diet,” said Secretary
Shalala. “The guidelines now highlight the integral relationships of physical
activity and safe food handling to healthful eating patterns.”
In his radio address, President Clinton also announced that the USDA will require
nutrition labeling for meat and poultry products, including all ground or chopped meat.
Under the rule to be proposed this summer, retailers would be required to provide
nutrition information through product labels or at the point of purchase by posting signs
or making information readily available in brochures or leaflets. The required information
would include fat, calories, and cholesterol content. Providing such information currently
is voluntary, but fewer than 60 percent of retailers did so last year.
The Dietary Guidelines are published every five years, and they provide the basis of the
“Food Guide Pyramid.” In addition to providing information to consumers,
the Dietary Guidelines form the basis for federal nutrition policy and programs.
The Dietary Guidelines for Americans were first published in 1980. The law requires that
they be updated every five years to incorporate advances in medical and scientific
research.
These updates are based on the recommendations of an 11-member Dietary Guidelines Advisory
Committee, a group of widely recognized nutrition and medical experts. The advisory
committee for this version was chaired by Dr. Cutberto Garza of Cornell University.
Source: USDA and HHS Press
Release, May 27, 2000
TO ORDER THE DIETARY GUIDELINES
The guidelines are also available from the Food and Consumer Service electronic bulletin board at FedWorld by calling (703) 321-3339 from your computer. The bulletin is available to the public. To order a single copy, send your name, address and 50 cents by check or money order to: Consumer Information Center, Department 378-C, Pueblo, CO 81009.
Amidst changes to address the prominent issue of overweight and obesity among Americans, one major change to the newly released 2000 US Dietary Guidelines for Americans puts the spotlight on encouraging the public to eat more of something for good health: a new guideline devoted solely to fruits and vegetables.
The new guideline states, “Eat a variety of fruits and vegetables daily.” Although fruits and vegetables were mentioned in the last revision of the Dietary Guidelines for Americans in 1995, fruits and vegetables are given greater prominence by being given their own guideline in this 2000 edition. The US Dietary Guidelines for Americans is the cornerstone of federal nutrition policy in the United States and establishes the science-based guidance on what Americans should eat to stay healthy.
Hundreds of scientific studies published since the Dietary Guidelines were last revised
indicate that high fruit and vegetable consumption helps prevent cancer, heart disease,
stroke, and plays a preventive role in birth defects, cataract formation, hypertension,
asthma, diverticulosis, obesity, and diabetes. A free copy of a report summarizing the
role of fruits and vegetables in preventing disease can be ordered by logging onto
www.5aday.com.
“Fruits and vegetables are the only exception to the state of over-consumption in the United States – in fact, Americans are actually suffering from a large deficit in this area,” said Elizabeth Pivonka, PhD, RD, president of the Produce for Better Health Foundation, which launched a national campaign* in February 1999 – at the onset of the Dietary Guidelines revision process – to advocate a greater prominence for fruits and vegetables in the federal guidelines. “This new, separate guideline is a critical step to jump start fruit and vegetable intake, which will improve the health status of all Americans.”
“We applaud the Departments of Agriculture and Health and Human Services for placing greater emphasis on plant-based foods in this edition of the Dietary Guidelines, especially fruits and vegetables,” said Dr. Margo Wootan, nutrition scientist at the Center for Science in the Public Interest. “The government needs to do more than just publish a pamphlet, cross its fingers, and hope that Americans eat better. The federal government needs to launch programs and implement policies that make the healthy choice the easy choice.”
To advocate for policies and programs that promote health eating and physical activity, the Produce for Better Health Foundation, the Center for Science in the Public Interest and several other consumer, health, and physical activity organizations have joined in a new National Alliance for Nutrition & Activity (NANA). NANA is working to create a healthier America through healthy eating and physical activity, including greater funding for the Centers for Disease Control and Prevention (CDC) and the 5 A Day Program – the largest federal nutrition education program targeted to the general public, which has a mere $1 million communications budget. CDC’s entire division of nutrition and physical activity has just $6.5 million dollars. In contrast, CDC has $100 million for anti-tobacco programs, though unhealthy eating and physical inactivity kill a similar number of people.
For information about the Dietary Guidelines for Americans, log on to www.usda.gov/cnpp .
The Produce for Better Health Foundation is a national, nonprofit educational foundation
working with the National Cancer Institute on the 5 A Day for Better Health Program. The 5
A Day Program is designed to increase consumption of fruits and vegetables to an average
of five or more servings a day to improve the health of Americans.
Q AND A’S ON DIETARY GUIDELINES FOR AMERICANS, 2000
What
are the Dietary Guidelines for Americans?
The Dietary Guidelines are 10 basic principles for healthy eating, grouped under an ABC scheme – Aim for fitness, Build a healthy base, and Choose sensibly ... for good health. The guidelines under each group are:
Aim
for fitness
Aim for a healthy weight
Be physically active each day
Build
a healthy base
Let the Pyramid guide your food choices
Choose a variety of grains daily, especially whole grains
Choose a variety of fruits and vegetables daily
Keep food safe to eat
Choose
sensibly
Choose a diet that is low in saturated fat and cholesterol and moderate in total fat
Choose beverages and foods to moderate your intake of sugars
Choose and prepare foods with less salt
If you drink alcoholic beverages, do so in moderation
Why
are the Dietary Guidelines important?
· They serve as the cornerstone of Federal nutrition policy.
· They provide sound advice to help people make food choices for a healthy, active life.
· They reflect a consensus of the most current science and medical knowledge available.
When
were the Guidelines first issued? How often are they revised?
· The Dietary Guidelines were first issued in 1980, and were revised in 1985, 1990, 1995, and again this year.
· The National Nutrition Monitoring and Related Research Act of 1990 requires the Secretaries of Agriculture and Health and Human Services to jointly publish a report entitled The Dietary Guidelines for Americans every 5 years.
Why
do the Guidelines change?
· The science base supporting the Dietary Guidelines is constantly changing. New scientific research, increased consensus among authorities on specific diet and health issues necessitated changes to the 1995 edition.
How
are revisions determined?
· Since 1985, every 5 years a Federal advisory committee composed of widely recognized experts in nutrition, medicine, and epidemiology has been invited to review the Guidelines and propose revisions. The current committee made recommendations for revision to the Departments of Agriculture (USDA) and Health and Human Services (HHS) after they examined the current scientific literature and heard comments from the public.
· The Departments of Agriculture and Health and Human Services independently and then jointly reviewed the committee recommendations, received and reviewed public comments, and considered research on consumer understanding of the Guidelines before finalizing the new edition of the Guidelines.
Who is the
audience for the Dietary Guidelines?
· The guidelines can be used by any groups that are interested in improving the health of Americans. Such groups might include Federal and local policymakers, physicians, health professionals and educators, food industry and trade associations, media, and consumer organizations. They can also be used by individuals interested in improving their own health or that of their family.
Do
the Dietary Guidelines make specific quantitative recommendations for nutrients and other
food components?
· Yes, in those cases where the scientific evidence is strong enough to support a quantitative recommendation. Since 1990, the Guidelines have recommended that no more than 30 percent of total calories come from fat, and that less than 10 percent of calories come from saturated fat.
· For sodium and cholesterol, the Guidelines do not make a specific quantitative recommendation but refer readers to the Daily Values used on Nutrition Facts labels as a guide to recommended intake levels.
· For nutrients and food components for which there is not enough scientific evidence to make a quantitative recommendation, the Guidelines provide directional guidance, e.g., “Choose a variety of grains daily, especially whole grains” and “Choose beverages and foods to moderate your intake of sugars.”
Do
the Dietary Guidelines apply to children?
· Yes, the Dietary Guidelines apply to healthy Americans two years of age and over.
· Where appropriate, the Dietary Guidelines give more specific advice for children and adolescents. For example, the Guidelines discuss ways to improve calcium and iron intakes in children and teenagers. Also, they include sections with specific advice related to children, including encouraging healthy weight and increasing physical activity in children, in order to focus attention on the growing problem of childhood obesity.
Will
following the Dietary Guidelines make me healthier?
· For most Americans, yes. Four of the leading causes of death in the United States are linked to diet, namely heart disease, stroke, cancer, and diabetes. Taken together, diet-related health conditions cost society about $250 billion annually in medical costs and lost productivity. Thirty to forty percent of deaths due to cancer can be prevented if people will choose a healthful diet and perform physical activity.
· A medical research study recently found that following a diet based on Dietary Guidelines principles was associated with decreased mortality in a group of adult women.
· It is important to recognize, however, that individuals vary in their responses to dietary change; thus, health improvements will be greater for some than others.
Are
Americans’ diets changing in the direction of the Dietary Guidelines’
recommendations?
· Yes and no. The percentage of calories from fat in the American diet has fallen from 37 to 33 percent of total calories from fat over the last decade. However, the actual intake of fat in grams has not decreased over this time span. Saturated fat intake has also decreased when expressed as a percentage of calories.
· Other aspects of the American diet still need improving. The increasing prevalence of obesity means that we are eating more calories and/or exercising less than we need to maintain healthy weight. Many people are also eating less than the recommended numbers of servings of fruits, vegetables, and whole grain products, and more sugars and salt than are needed for good health. For example, according to the Healthy Eating Index released by the USDA’s Center for Nutrition Policy and Promotion, only about 17 percent of people eat the recommended number of servings of fruit and only about 31 percent eat the recommended number of servings of vegetables.
What’s
new about the 2000 edition of the Dietary Guidelines?
· The emphasis on certain topics has changed to reflect emerging science and to be consistent with diet and health messages from other Federal agencies. For example,
· The fat guideline was reworded to place increased emphasis on the need to reduce the consumption of saturated fat because of its association with heart disease. The recommendation for limiting total fat was changed from “low in fat” to “moderate in total fat.” The upper limit on total fat intake remains at 30 percent, as in previous editions of the Guidelines. The role of trans fatty acids in raising blood cholesterol is also recognized.
· The weight guideline was reworded to “Aim for a healthy weight” because of the overwhelming scientific evidence about the health risks of overweight and obesity. This guideline is consistent with guidance about obesity from the National Institutes of Health, National Heart, Lung, and Blood Institute and the National Institute of Diabetes, Digestive, and Kidney Diseases.
· The order of the guidelines was changed to emphasize healthy weight and physical activity and a separate guideline on activity was included, “Be physically active each day.” The physical activity guideline is consistent with guidance in the Surgeon General’s Report on Physical Activity.
· In recognition of growing concerns about foodborne illness, a new guideline on consumer food safety was added, “Keep food safe to eat.” Keeping food safe is a critical element in ensuring that consumers know what and how to eat to stay healthy.
· Other changes in the Guidelines were made in an attempt to make the messages more practical and actionable. For example:
· The 1995 fruits, vegetables, and grains guideline was separated into two guidelines because of differences in the food groups, and the text was made more actionable: (e.g. “Eat a variety of grains daily, especially whole grains” and “Eat a variety of fruits and vegetables daily”). Expanded emphasis was placed on plant foods as an important foundation of healthful eating.
· The Guideline “Eat a variety of foods” was replaced with “Let the Pyramid guide your food choices.” [See below for the reason for this change.]
· The sodium guideline was reworded from “Choose a diet moderate in salt and sodium” to “Choose and prepare foods with less salt” to focus on actions consumers can take that will result in a diet moderate in sodium. The word “sodium” was removed from the title, and the difference between sodium and salt was clarified in the text.
· The sugar guideline was reworded from “Choose a diet moderate in sugars” to “Choose beverages and foods to moderate your intake of sugars” to focus on major sources of sugars in the American diet.
· A grouping scheme – “Aim for fitness, Build a healthy base, and Choose sensibly ... for good health” – was added to the Guidelines in an attempt to make them more memorable to consumers.
· The grouping theme organizes the guidelines into an easy-to-remember “ABC’s for good health” format.
· The grouping was included, in part, because the number of guidelines increased from seven to ten. The grouping also links guidelines with similar messages, so that they will be easy for consumers to remember.
Why
did the guidelines focus on three (ABCs) major messages: Aim for fitness; Build a healthy
base; Choose sensibly?
· Numerous studies indicate that consumers want messages that are simple, memorable, and meaningful. The ABCs for good health group the guidelines into 3 categories to help consumers remember them and follow their suggestions for changing dietary behavior.
Why
was the guideline to eat a variety of foods changed in the 2000 edition of the Dietary
Guidelines?
· There were three reasons for rewording the variety guideline to “let the Pyramid guide your food choices”:
(1) To better convey the purpose of the guideline as ensuring nutritional adequacy. Research shows that choosing foods from all the food groups improves nutritional adequacy
(2) To avoid possible misinterpretation of the variety message as encouraging over consumption of calories.
(3) To reference the Food Guide Pyramid, which serves as the core of many nutrition education activities and is widely recognized.
· The importance of “variety” is emphasized in the grain and fruit and vegetable guidelines. Choosing a variety of different foods from these groups is recommended for good health.
What
is the industry’s position on the Dietary Guidelines?
· The public, including industry was invited to offer the USDA and HHS oral comments on the Dietary Guidelines Advisory Committee report and proposed text for the Dietary Guidelines. Written comments were also accepted until March 15, 2000. The USDA and HHS received and reviewed more than 1,000 comments from the public and industry groups.
· In general, the food industry supports the Dietary Guidelines. The Dietary Guidelines Alliance was formed in 1995 as a partnership among food industry, government, and health organizations to help consumers implement the Guidelines. Alliance members seek to develop, through consumer research, effective messages about nutrition, taste, and physical activity that can be used in education, counseling, and communication initiatives.
· Certain industry groups have encouraged the USDA and HHS to take a stronger stand on issues ranging from vegetarian diets to supplement use. In the future, should the Dietary Guidelines Advisory Committee, charged with revising the guidelines, propose stronger language on the basis of the scientific evidence to the USDA and HHS, Department officials would consider such recommendations at that time.
Source: http://www.usda.gov/cnpp/pubs/DG2000/Qa5-2.pdf
HOW CAN A HEALTHY DIET BE ACHIEVED?
Along with regular exercise, being committed to keeping a healthy diet is one of the most important things you can do to contribute positively to your overall health. Reducing fat in your diet, for example, can lower your risk for certain cancers and certain heart diseases.
Here are some tips to follow for a healthy diet and lifestyle:
Eating with your health in mind:
The most important elements of healthful eating are:
· To eat
a daily diet that helps you either lose weight or keep your weight in the range that is
considered “healthy” or “ideal” for your height and sex
· To choose a diet that is low in
saturated fat and cholesterol, and moderate in total fat intake
· To eat foods high in fiber
· To reduce the number of calories in
your diet that come form processed sugars
· To choose and prepare foods with less
salt
· To drink the daily recommended amount
of water: 8 to 10 cups (64 to 80 ounces) of water a day
· If you drink alcoholic beverages,
drink them in moderation (no more than 1 drink per day for women and no more than 2 drinks
per day for men)
· Season vegetables and meats with herbs
and spices rather than using fatty sauces, butter, or margarine
· Choose low-fat or skim milk, rather
than whole milk
· Substitute plain low-fat yogurt or
low-fat cottage cheese whipped in a blender for sour cream or mayonnaise
· Substitute egg whites for whole eggs
when baking (substitute 2 eggs without yolks for every whole egg)
· Limit the number of egg yolks when
scrambling eggs
· Choose lean cuts of meat and trim off
any visible fat
· Remove the skin from poultry
Adding more
fiber to your diet:
· Eat
whole-grain cereals and breads
· Eat vegetables uncooked; if you cook
them, steam only until they are just tender
· Avoid peeling fruits and vegetables;
when appropriate leave the skins on, they are high in fiber
· Add beans to soups and salads
· Snack on fresh fruits and vegetables
or dried fruits (such as raisins or figs)
· Substitute water or unsweetened
beverages for sugared soft drinks
· Snack on fresh fruits and vegetables
or dried fruits rather than sugary snacks such as candies, cookies, cakes, and pies
For more information:
· Food and Drug Administration and Center for Food Safety and Applied Nutrition Food Information Hotline (888) INFO-FDA or www.fda.gov
· United States Department of Agriculture Center for Nutrition Policy and Promotion www.usda.gov/cnpp
· American Dietetic Association Consumer Nutrition Hot Line (800) 366-1655 or www.eatright.org
Inform
yourself:
www.jama-assn.org/consumer.htm
Adapted from: JAMA; Vol 283 No 16; April 26, 2000; p. 2198.
DRI’s for dietary antioxidants released
Insufficient evidence exists to support claims that taking megadoses of dietary antioxidants, such as selenium and vitamins C and E, or carotenoids, including beta-carotene, can prevent chronic diseases, says the latest report on Dietary Reference Intakes (DRIs) from the Institute of Medicine of the National Academies. In fact, extremely large doses may lead to health problems rather than confer benefits. But the report does call for increases in daily intakes of vitamins C and E to exploit their role in maintaining good health, and recommends an even larger amount of vitamin C for smokers. For the first time, the report also sets a ceiling on daily consumption of selenium and vitamins C and E to reduce the risk of adverse side effects from overuse.
Dietary antioxidants are nutrients that help protect cells from a normal – but damaging – physiological process known as “oxidative stress.” Such nutrients are a part of the natural makeup of many types of food, particularly fruits and vegetables. They also have been added to some foods and are available in the form of dietary supplements. For years, researchers have sought to understand the role of these antioxidants in reducing the risk of chronic diseases such as cancer, cardiovascular disease, eye diseases, and neurodegenerative diseases, which include Alzheimer’s and Parkinson’s. But many unanswered questions remain.
“A direct connection between the intake of antioxidants and the prevention of chronic disease has yet to be adequately established,” said Norman I. Krinsky, chair of the study’s Panel on Dietary Antioxidants and Related Compounds, and a professor of biochemistry, Tufts University School of Medicine, Boston. “We do know, however, that dietary antioxidants can in some cases prevent or counteract cell damage that stems from exposure to oxidants, which are agents that affect a cell’s molecular composition. But much more research is needed to determine whether dietary antioxidants can actually stave off chronic disease.”
The report – the third in a series on dietary recommendations for healthy Americans and Canadians – expands on the Recommended Dietary Allowances (RDAs) that the National Academy of Sciences has set periodically since 1941, and on Canada’s Recommended Nutrient Intakes. DRIs contain four categories of reference intakes – including RDAs, which are a set of values intended to help people maintain their health; and another set of values to help them avoid taking too much of a nutrient. Scientists from the United States and Canada collaborated on evaluation of the studies. Additional reports will be issued on DRIs for trace elements and other vitamins; electrolytes and water; protein, carbohydrates, fiber, and fats; and other food components.
Setting
New Dietary Recommendations
The report examines available scientific data on both beneficial and harmful health effects of four nutrients typically found in food: vitamins C and E; selenium; and carotenoids, some of which are sources of vitamin A for human beings. Whether carotenoids, including beta-carotene, function as antioxidants when consumed is still unknown. Although numerous epidemiological studies have suggested that foods rich in dietary antioxidants have a positive effect on chronic diseases, insufficient evidence exists to conclude that such nutrients, even in very high doses, will reduce the risk of diseases such as cancer; cardiovascular disease; cataracts; age-related macular degeneration, a common form of blindness in elderly people; diabetes mellitus; and neurodegenerative diseases.
In addition to setting daily intakes for vitamins C and E, and selenium, the report establishes “tolerable upper intake levels” for each of these three nutrients. The report underscores the finding that upper levels, or ceilings, should not be considered the recommended amount. Instead, they represent the maximum intake of a nutrient that is likely to pose no risk of adverse health effects in almost all individuals in the general population. Following are highlights of the report’s recommendations:
Vitamin C
Recommended intake levels of this nutrient were increased to achieve maximum saturation in the body. Women should consume 75 milligrams per day, and men should consume 90 milligrams daily. Because smokers are more likely to suffer from biological processes that damage cells and deplete vitamin C, they need an additional 35 milligrams per day. Vitamin C food sources include citrus fruit, potatoes, strawberries, broccoli, and leafy green vegetables.
The report sets the upper intake level for vitamin C, from both food and supplements, at 2,000 milligrams per day for adults. Intakes above this amount may cause diarrhea.
Vitamin E
Recommended daily intake levels also were increased for this nutrient; both women and men should consume 15 milligrams from food. This is equivalent to 22 International Units (IU) of natural-source vitamin E or 33 IUs of the synthetic form. Alpha-tocopherol is the only type of vitamin E that human blood can maintain and transfer to cells when needed. Food sources include vegetable oils, nuts, seeds, liver, and leafy green vegetables.
The upper level, based only on intake from vitamin supplements, is 1,000 milligrams of alpha-tocopherol per day for adults. This amount is equivalent to roughly 1,500 IU of “d-alpha-tocopherol,” sometimes labeled as “natural source” vitamin E, or 1,100 IU of “dl-alpha-tocopherol,” a synthetic version of vitamin E. People who consume more than this amount place themselves at greater risk of hemorrhagic damage because the nutrient can act as an anticoagulant.
Selenium
The recommended intake level for this nutrient was set at the amount associated with the highest activity of enzymes that guard against oxidants in the body. Women and men should take 55 micrograms per day, the report says. Food sources include seafood, liver, meat, and grains.
The report set the upper intake level for selenium at 400 micrograms per day. The level is based on nutrients from all sources. More than this amount could cause selenosis, a toxic reaction marked by hair loss and nail sloughing.
The report noted that most American and Canadian adults already get sufficient quantities of these three nutrients from their food.
Beta-carotene and Other Carotenoids
In laboratory tests, these nutrients have been shown to act as antioxidants, but the results have not been consistently duplicated in humans. In addition, data on the adverse effects of carotenoid over consumption are contradictory. For these reasons, the report does not recommend a daily intake level or an upper intake level for consumption of carotenoids. People should use caution before taking them in high doses; the report recommends beta-carotene supplementation only for the prevention and control of vitamin A deficiency.
More
Research Needed
As a general rule, healthy people should not routinely exceed upper intake levels, the report advises. How nutrient consumption above these levels may affect human health needs to be studied further in well-controlled clinical trials. Likewise, much more research is needed to investigate the role of dietary antioxidants and carotenoids in the prevention of chronic diseases; to explore the nutrient needs of specific groups of people, including children and the elderly; and to look into how selenium, vitamins C and E, and beta-carotene interact with each other and with other food components.
The study was funded in part by the US Department of Health and Human Services; Health Canada; the Institute of Medicine; the Dietary Reference Intakes Private Foundation Fund, including the Dannon Institute and the International Life Sciences Institute; and the Dietary Reference Intakes Corporate Donors’ Fund. Corporate fund contributors include Daiichi Fine Chemicals Inc., Kemin Foods Inc., M&M/Mars, Mead Johnson Nutrition Group, Nabisco Foods Group, Natural Source Vitamin E Association, Roche Vitamins Inc., US Borax, and Weider Nutrition Group.
The study was undertaken by a group of more than 40 scientists working under the auspices of the Institute of Medicine’s Food and Nutrition Board. The Institute is a private, nonprofit organization that provides health policy advice under a congressional charter granted to the National Academy of Sciences.
Pre-publication copies of Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids are available from the National Academy Press at the mailing address 2101 Constitution Avenue, NW, Washington, DC 20055; tel. (202) 334-3313 or (800) 624-6242; or http://books.nap.edu/catalog/9810.html. The cost of the report is $45.00 (prepaid) plus shipping charges of $4.50 for the first copy and $.95 for each additional copy.
Source:
http://www4.nationalacademies.org/news.nsf/isbn/0309069491?OpenDocument
UC DAVIS Health System: current research on NUTRICEUTICALS
The UC Davis Health System is at the forefront of research that is assessing foods, nutrients, herbs, and homeopathic remedies for their purported health benefits. And with the USDA’s Western Human Nutrition Research Center located on the Davis campus, the opportunities for nutrition research and collaborative efforts have never been greater.
Echinacea-spiked cranberry smoothies. Ginkgo breakfast cereals. Pre-packaged chicken and St John’s- Wort soups. At juice bars, health food stores, major supermarkets, drug stores, health clubs and over the Internet, Americans will spend an estimated $8 billion this year for pumped-up foods that promise better health. Herbal and homeopathic remedies will add millions more to the tab.
UC Davis is at the forefront of efforts to bring the most popular of these compounds under rigorous scientific scrutiny. The campus was among the first eight institutions in the country funded by the National Institutes of Health to study medicinal botanicals used in alternative medicine. UC Davis scientists have launched groundbreaking trials of ginseng, Ginkgo biloba, and shiitake mushroom extract. The investigations will provide consumers and their health-care providers with much-needed information about what’s effective and what’s not, and may well advance conventional medicine.
“Biology has provided us with millions of potential compounds in leaves and stems and branches. Our job is to use modern techniques of cell biology and molecular biology to find out what’s actually in those products, and then find out if they work, and if they do work, to make them even better,” says M. Eric Gershwin, chief of the Division of Rheumatology, Allergy, and Clinical Immunology.
Gershwin’s research team has developed cost-effective methods of rapidly screening botanical and glandular extracts using state-of-the-art, quantitative reverse transcription-polymerase chain reaction testing. Key human immune cells are cultured in a laboratory dish, mixed with various concentrations of an herb extract, and exposed to harmful radiation or toxins. Scientists then use the high-tech testing methods to assess mRNA and cytokine mRNA expression in the cells, a measurement of how vigorously the cells are fighting back.
A dozen folk remedies are now being screened using these techniques in laboratories at UC Davis. The list includes red-grape extract, reishi and maitake mushrooms, goldenseal, astragalus root, silymarin, bacopa, elderberries, shilagjit, moomiyo, bovine thymus, and bovine colostrum. Under a new agreement with a group of scientists in Shanghai, the list will soon expand to include promising compounds from the vast Chinese pharmacopoeia.
Ginseng
Used for millennia, especially in Asia, ginseng has become one of the top-selling herbal remedies in the United States, accounting for some $80 million in annual sales. Over the past decade, the root has moved from herbalists’ shops to major supermarket shelves, turning up in everything from salad dressings to super-charged fruit juices. Yet, until now, the root has virtually escaped scientific examination in the United States, having been studied almost exclusively in Asia.
Although Gershwin and his research team have shown that the root may possess medicinal properties, their work also suggests reason for caution. Ginseng’s biological effects varied tremendously, depending on species and brand, with one species being harmful at high doses.
The UC Davis scientists screened three species of ginseng. While American ginseng and Siberian ginseng both boosted the immune response of human cells in the laboratory tests, a third species, Korean ginseng, had no effect. Siberian ginseng, at the highest concentration tested, depressed rather than enhanced the cells’ immune responses.
Often drugs that are beneficial at one dose are toxic at higher doses, just one reason the UC Davis investigators believe popular folk medicines and herbal supplements should be scientifically evaluated, especially now that the compounds are being added to so many foods. The potential for drug interactions, both with other botanicals and with traditional pharmaceuticals, is another concern.
“Nutriceuticals should go through the same evidence-based testing as traditional medicines and dietary supplements,” Gershwin says. “And if a consumer buys a product, he or she ought to know what’s in there. There have been deaths from nutriceuticals. Hemlock, after all, is just a root.”
Human Testing
Katherine Gundling, an assistant professor of internal medicine, has launched the first randomized, placebo-controlled, double-blinded human study in the United States to assess whether panax ginseng can boost people’s immunity to influenza. In the study, 177 healthy adult volunteers received flu shots and then were divided into equal groups that either received ginseng or a placebo.
Investigators will measure levels of antibodies to influenza in the volunteers’ blood after the flu shots. The higher the antibody levels, the better the protection against the flu. At the end of the study, Gundling and her research team will determine whether the volunteers who took ginseng developed higher antibody levels, and came down with fewer or milder bouts of flu, compared to those who took the placebo.
If ginseng does help adults beat the flu, Gundling will test the traditional Chinese remedy next in people with asthma, chronic pulmonary disease, and other chronic lung diseases. A herb that could prevent upper respiratory tract infections, particularly in older adults, would be of profound public health importance. The flu and common cold often lead to life-threatening complications in the elderly and chronically ill, and occasionally prove deadly.
Ginkgo
Biloba
In another pioneering effort, Gundling and John Robbins, a professor of general medicine, are seeking 750 elderly Sacramento area volunteers for the first trial ever of Ginkgo biloba in the prevention of dementia. Researchers at The Johns Hopkins University School of Medicine, University of Pittsburgh, Bowman Gray School of Medicine at Wake Forest, and University of North Carolina are also recruiting large numbers of volunteers for the six-year study, funded by the NIH Office of Alternative Medicine.
In the multi-center study, volunteers, all healthy individuals 75 and older with no signs of dementia, will take either 240 milligrams of Ginkgo biloba or a placebo daily. Volunteers will undergo annual neurological exams and neuropsychological tests for evidence of cognitive decline.
“It is possible that ginkgo may slow the progression of cognitive changes over time among older individuals who are destined for age-related memory impairment and dementia,” Robbins says. “If ginkgo is found to be effective, it may give us a way to chip away at dementia, a disorder that today affects up to 20 percent of all people, if they live long enough.”
Mushrooms
and Broccoli
Ralph deVere White, director of the UC Davis Cancer Center, launched the first human trial outside Japan of an activated hexose-containing compound or 1,3-beta glucan, found in shiitake mushrooms. The mushroom compound has shown anti-cancer properties in some studies in Japan, and is used to treat cancer in more than 400 hospitals throughout Asia. In the United States, the compound is sold as a nutritional supplement.
The six-month study at UC Davis evaluated whether the extract could lower the level of prostate specific antigen (PSA) in 62 men with recurrent prostate cancer. None of the patients have reduced PSA levels, although the levels in four men had remained stable. While these results were not dramatic, cancer center researchers continue to look for novel and innovative trials of potential chemotherapy agents.
Other researchers at the College of Agricultural and Environmental Sciences are looking at altering genes in foods such as broccoli to magnify antioxidant and other anti-cancer properties. Their goal is to enhance health-promoting genes in plant foods that already have these genes or to transplant them in fruits and vegetables that are more amenable to the American palette.
Asthma
UC Davis in 1995 was awarded a $900,000 grant from the NIH Office of Alternative Medicine to study alternative approaches to asthma and allergies. With the grant, Gershwin and Judith Stern, a professor of nutrition and internal medicine, established the UC Davis Center for Complementary and Alternative Medicine Research in Asthma.
In the last five years, the UC Davis Center has awarded half a dozen research grants for studies of wheat-grass juice, vitamin C, acupressure, massage, and biofeedback in the management of asthma. Results of these investigations may help to expand the therapeutic options available to people with asthma, a disorder that affects some 15 million Americans.
Food
Allergies
If she could, plant biologist and physician Suzanne Teuber would eliminate food allergies from the planet. Since she can’t, the UC Davis food allergist is focusing her energies on the day when safe immunotherapies free thousands of Americans from the threat posed by their food allergies.
While allergies to milk, egg, wheat, and soy in infants are usually outgrown by age three, allergies to fish, crustaceans, peanuts, and tree nuts are usually permanent and life-threatening. It is estimated that at least 100 people die each year from food allergy in the United States and that the most frequent culprits are allergies to peanuts and tree nuts.
Teuber’s research focuses on identifying the specific genes and proteins contained in walnuts, peanuts, and other nuts that cause an allergic response and on developing immune system tolerance to the food allergen.
Source: Research at UC Davis Health System; April 2000, pp. 25-27.
Eating a lot of tomato-based food products may lower a man’s risk of contracting prostate cancer. Researchers from the University of Auckland in New Zealand studied 317 prostate cancer patients aged 40 to 80 and 480 cancer-free participants. They noted that men who consumed the highest amount of tomato-based food products had an 18 percent reduction in prostate cancer risk. The men reported eating cooked tomatoes, tomato soup or puree, tomato juice, ketchup, and pasta sauce. Lycopene, an antioxidant found in cooked tomato products, may have caused the lowered risk, researchers concluded. Vegetables rich in beta-carotene, such as carrots and broccoli, had no impact on risk reduction. Other studies, however, have found that beta-carotene could help reduce the risk.
Reference: Norrish AE, Jackson RT, Sharpe SJ, and Skeaff CM. Prostate cancer and dietary carotenoids. American Journal of Epidemiology; Vol. 151, January 15, 2000; pp. 119-127.
Source: Nutrition Week XXX(13), March 31, 2000; p. 7.
TREATING HYPERTENSION IN THE PATIENT WITH TYPE 2 DIABETES
A new clinical advisory issued by
the National High Blood Pressure Education Program (NHBPEP) recommends that physicians
pursue a more aggressive treatment approach to lower the blood pressure of patients who
have both hypertension and diabetes. The NHBPEP is coordinated by the National Heart,
Lung, and Blood Institute (NHLBI) of the National Institutes of Health.
Both diabetes and hypertension are independent risk factors for cardiovascular disease
(CVD). The advisory indicates that the coexistence of these conditions in a patient
imposes a need for a significantly lower goal blood pressure (135/80 mm Hg) than the goal
blood pressure recommended for a patient with hypertension who does not have diabetes
(140/90 mm Hg). Over 5 million Americans have type 2 diabetes and high-blood pressure.
Uncontrolled hypertension leads to stroke, heart failure, and kidney failure. It is clear
that the combination of these two CVD risk factors has important public health
implications.
This new report is part of a series of clinical advisories being issued by NHLBI to raise
health professional and consumer awareness of the health dangers posed by high blood
pressure. On May 4, 2000, NHLBI issued a clinical advisory to draw attention to the
problem of high systolic blood pressure. Systolic blood pressure measures the force
exerted by the blood as it flows through the arteries when the heart contracts. It is
expressed as the top number of the blood pressure reading and now is recognized to be the
most important indicator of heart disease risk in adults age 60 and older.
The authors of the new advisory note results from several studies showing that efforts to
lower high-blood pressure in patients with type 2 diabetes produce dramatic results. In
one study, near optimal control of hypertension (144/82 mm Hg) led to 44 percent fewer
diabetes-related strokes, 37 percent fewer cases of small blood vessel damage due to
diabetes (particularly diabetic retinopathy), and 32 percent fewer diabetes-related
deaths. Another study reported CVD deaths were reduced 76 percent in hypertensive patients
who had type 2 diabetes and 13 percent in patients who had hypertension but no diabetes.
The clinical advisory at is an update to the “Sixth Report of the Joint National
Committee on Prevention, Detection, and Treatment of High Blood Pressure” (JNC VI).
JNC VI was produced in 1997 by the NHBPEP, a federation of 45 professional, voluntary, and
official agencies.
To learn more about prevention and treatment of high blood pressure, visit NHLBI’s new, interactive high blood pressure Web site for consumers and health professionals at http://www.nhlbi.nih.gov/hbp.
Adapted from: NIH News Release, May 30, 2000. http://www.nhlbi.nih.gov/new/press/may30-00.htm
MALNUTRITION AMONG THE WORLD’S CHILDREN
While the number of stunted and underweight children in the developing world has fallen over the past 20 years, malnutrition could mentally impair more than one billion children by 2020 if more isn’t done, according to the Commission on Nutrition Challenges in the 21st[GNC1] century, which carried out a study for the United Nations. Currently, 30 million infants are born with low birth weights each year. Another 150 million preschool children are underweight and more than 200 million are stunted, the commission said. Severe vitamin A deficiency, which causes blindness, is on the decline in all regions but still affects up to 250 million preschool children in developing countries. More than 3.5 billion people in the developing world suffer from iron deficiency, which impairs the cognitive development of children. Maternal anemia, associated with very high rates of maternal death is “pandemic,” the commission said.
Adapted from: Nutrition Week XXX(13), March 31, 2000; p. 7.
RESOURCES:
A new website has been developed by the US Department of Agriculture to help people measure the quality of their diets. The Interactive Healthy Eating Index (IHEI) shows how people measure up to current dietary guidelines. It also analyzes dietary status and maintains a cumulative record so improvements in diets can be monitored. IHEI can be accessed at www.usda.gov/CNPP .
Source: Nutrition Week; Vol. XXX, No. 14; March 31, 2000; p. 7.
The Division of Agriculture and Natural Resources of the University of California has just published its 90-page 2000-2001 catalog, featuring extensive publications, posters, videos, and slide sets. The catalog covers a veritable “apples to zucchini” listing of crops and livestock with the latest information on environmentally sound pest control, irrigation management and scheduling, and other production information.
Some new farm and ranch titles include “IPM for Stone Fruits,” “IPM for Apples and Pears” (second edition), “Organic Apple Production Manual,” “Raisin Production Manual,” “The Safe and Effective Use of Pesticides” (second edition) and “Scheduling Irrigations: When and How Much.” But the catalog isn’t geared solely to production agriculture. Subject headings also include aquaculture, beekeeping, forest management, marine resources, pasture and range management, small farms, soils and water, and sustainable agriculture.
Backyard gardeners will find a wealth of information on pest control, tree hazards, vegetable gardening, and many related subjects. “Drip Irrigation in the Home Landscape” ought to be a popular seller. And home canners can choose among nearly two dozen leaflets on food preserving.
Nutritionists, educators, and human service agencies will be interested in “Don’t Give Kids a Tummyache,” “Food Guide Pyramid with a Mexican Flavor Lesson Plan” (in Spanish and English), “Children and Weight: What Health Professionals Can Do,” “Advances in Youth Development,” “Gateway to a Better Life: A Welfare to Work Curriculum.”
All Agriculture and Natural Resources (ANR) educational products have undergone rigorous technical review by University of California academic specialists.
The ANR 2000-2001 catalog and many publications are available at county offices of UC Cooperative Extension or online at http://anrcatalog.ucdavis.edu Or write to ANR Communication Services, University of California, 6701 San Pablo Ave., Oakland, CA 94608-1239; call toll-free (800) 994-8849 or email to drnrcs@ucdavis.edu .
Source:
ANR Reports; 13(9), March 8-April 12, 2000; p. 7.
INFORMATION CENTERS JUMPING-OFF POINT FOR NUTRITION RESOURCES
If you’re looking for resources on nutrition, the Food and Nutrition Information Center (FNIC) is a good place to start. The center’s Web site, for example, has numerous resources on nutrition and has links to other sources of information.
One feature available on the Web site is “Food and Nutrition Topics from A to Z.” More than 70 topics are listed, and many may be of interest to health professionals, such as adolescence; allergies and food sensitivities; breast-feeding; child nutrition and health; eating disorders; fitness and physical activity; herbal information; kids’ sites; school meals; and WIC. Under each heading are links to information from government agencies, medical associations, nonprofit groups, hospitals, and universities.
The FNIC is one of several information centers at the National Agricultural Library, which is part of the US Department of Agricultural Research Service. The National Agricultural Library has books, journals, and audiovisual materials on topics ranging from children’s literature to technical nutrition information. An on-line catalog of its collection, called the Integrated System for Information Services, is updated daily and contains bibliographic citations for books, reports, maps, journals/periodicals, audiovisuals, CD-ROM’s, software, and other materials added to the National Agricultural Library collections.
The FNIC also has resource lists and bibliographies on various nutrition topics. The resources contain reliable information and are available nationwide. Your local library or bookstore can help you locate many of the books, journals, and audiovisuals listed. Other items can be obtained directly from the source listed.
Some of the resource lists have been compiled especially for consumers, and may be appropriate for patients seeking more information on a particular topic. For example, the consumer Resource List on Food Allergies and Intolerances includes information on a 10-minute videocassette for children with food allergies; several cookbooks for allergy patients; a video on anaphylaxis, how to prevent reactions, and what to do if a reaction occurs; and the addresses and phone numbers of various allergy organizations.
To access the Food and Nutrition Information Center’s Web site, go to www.nal.usda.gov/fnic You also can phone: (301)
504-5719; fax: (301) 504-6409; email: fnic@nal.usda.gov
or write to Agricultural Research Service, USDA, National Agricultural Library,
Room 304, 10301 Baltimore Ave., Beltsville, MD 20705-2351.
Adapted from: AAP News; Vol. 16 No 5; May
2000, p. 15.
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