UNIVERSITY OF CALIFORNIA
COOPERATIVE EXTENSION
NUTRITION PERSPECTIVES
Volume 27, No. 3
May/June 2002
TABLE OF CONTENTS
PAGE
The Department of Health and Human Services Announces Plans
to Study Ephedra
NHLBI Study Shows Weight Concerns Increase Girls' Risk of Becoming
Smokers
National Women's Health and Fitness Day
School Breakfast Participation Rises, Lunch Falls In February
Health Care Providers Need Training In Warfarin-Vitamin K
Interactions
St. John’s Wort, Placebo, and Antidepressant Trials
Diabetes Prevention: New Nutrition Recommendations Provide
Support for the Importance of Lifestyle Change
Thirty-One Ways to Save Money and Eat Healthier
What Makes Tomatoes and Broccoli Cancer-Protective?
TV In Bedroom Linked to Childhood Obesity
Eat Your Procyanidins, Compounds In Fruits and Vegetables
Resources:
How Much Are You Eating? Brochure Released by USDA
Websites:
The Center for Weight and Health Website
Aim for a Healthy Weight Web Page
Book Reviews:
Handbook of Vitamins
Updated Nutrition Text Now Available
Natural Compounds In Cancer therapy, Promising Nontoxic Anti-Tumor
Agents from Plants & Other Natural Sources
Subscription for NUTRITION PERSPECTIVES
Sheri Zidenberg-Cherr,
PhD, Editor
Department of Nutrition
University of California
Davis, CA 95616
NUTRITION PERSPECTIVES is
prepared by: Sheri Zidenberg-Cherr, PhD, Nutrition Specialist, Cristy Hathaway,
Nutrition Assistant, 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
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THE DEPARTMENT OF HEALTH AND HUMAN SERVICES ANNOUNCES
PLANS TO STUDY EPHEDRA
The Department of Heath and Human Services Secretary Tommy G. Thompson recently
announced new efforts to expand scientific research on the safety of ephedrine
alkaloids and to aggressively pursue the illegal marketing of non-herbal synthetic
ephedrine alkaloid products.
"It is crucial that we have a full understanding of these dietary supplements," Secretary Thompson said. "By increasing our breadth of knowledge about these supplements, we can give consumers the information they need to make informed decisions about these products."
HHS recently funded the RAND Corporation to conduct a comprehensive review of the existing science on ephedrine alkaloids, particularly those in dietary supplements. The review is projected to be finished by early fall and, once complete, will clarify the existing state of the science on ephedrine alkaloids. The National Institutes of Health (NIH) will use this information to guide an expanded research effort to better understand the safety of ephedrine alkaloids.
Herbal ephedrine alkaloids, which are commonly referred to as ephedra, are marketed in the United States as weight loss, energy and sports supplements. Ephedrine alkaloids are active chemicals found naturally in a number of plants, including the Ephedra species, but can also be produced synthetically (i.e. non-herbal).
Adverse event reports regarding the use of dietary supplements containing ephedrine alkaloids have been received by the Food and Drug Administration (FDA) and have raised questions regarding the safety of these products. However, the FDA has advised that adverse event reports alone regarding dietary supplements containing ephedrine alkaloids do not provide a scientific basis for assessing the safety of these products and that there is need for further scientific research.
The FDA has begun a major effort to strengthen its adverse event monitoring system by incorporating existing reporting systems into a new, unified reporting system to track and analyze adverse event reports. The new system will improve the FDA's ability to conduct market surveillance and better monitor the safety of all dietary supplements, including ephedrine alkaloids. Secretary Thompson encouraged industry to work with the FDA in this endeavor and to develop labeling that best protects consumer health. "I urge manufacturers to include FDA's 1-800-MEDWATCH telephone number on their product labels. Consumers can use the Medwatch number to report adverse events," he said.
Secretary Thompson also announced today new efforts to aggressively pursue the illegal marketing of non-herbal synthetic ephedrine alkaloid products. As part of these efforts, the FDA recently sent six warning letters to firms unlawfully selling non-herbal ephedrine-containing products over the Internet. Six letters went to manufacturers of products that contain the drug ephedrine or norephedrine hydrochloride (a synthetic, non-herbal, version of the herbal ingredient ephedra) labeled as dietary supplements for use in weight loss, suppression of appetite, enhanced libido, and the like. These products violate the law because they are not legal dietary supplements and are illegal drugs. Also, the FDA warned another company for illegally promoting its ephedrine product as an alternative to street drugs. "This action is yet another example of HHS' strong commitment to protecting the public from the dangers of unlawfully marketed drug products," said Secretary Thompson.
In October 2001, at the FDA's request, US Marshals seized $2.8 million worth of a non-herbal synthetic ephedrine product marketed as a dietary supplement. The manufacturer in April 2002 signed an agreement prohibiting it from manufacturing and distributing such products. The firm also agreed to destroy the seized products at its’ own expense.
These warning letters notify the firms that they must inform the FDA within 15 days of their plans to correct the violations or else face further enforcement actions by the FDA. Enforcement options include seizure of the illegal product and injunction from manufacturing and distributing the product, as well as prosecution of the companies and individuals.
"These products are not for everyone," said Dr. Lester M. Crawford, Deputy Commissioner of the FDA. "Consumers should read the labels carefully to ensure their proper use." Consistent with industry standards and warnings that already appear on many products, consumers under the age of 18 or pregnant or nursing women should not use these products. As the warnings further state, adult consumers should consult a health care provider prior to using such products if they have current or previous history of high blood pressure, heart or thyroid disease, a seizure disorder, depression, diabetes, difficulty urinating, prostate enlargement, glaucoma, or are using any prescription drug.
Consumers should consult with a physician prior to using dietary supplements containing ephedrine alkaloids if they are using a monoamine oxidase (MAO) inhibitor (MAO inhibitors are drugs used in the treatment of selected atypical depressions) or any allergy, asthma, or cold medications containing ephedrine, pseudoephedrine or phenylpropanolamine. Consumers should discontinue use if any of the following symptoms are experienced: rapid or irregular heartbeat, chest pain, severe headache, shortness of breath, dizziness, loss of consciousness, sleeplessness, or nausea.
Source: HHS Press Release; June 14, 2002.
NHLBI STUDY SHOWS WEIGHT CONCERNS INCREASE GIRLS' RISK OF BECOMING SMOKERS
Concern about weight and the drive to be thin increase the risk a girl will become a daily smoker by the time she's 18 or 19 years old, according to a new study sponsored by the National Heart, Lung, and Blood Institute (NHLBI). Weight concerns increased the risk for both black and white girls.
The study found that other factors early in life also increased the risk of later smoking, including stress, a parent with high school or less education, being from a one-parent household, drinking alcohol, poor academic performance, and poor conduct. Each factor affected the risk to differing degrees in black and white girls.
The study, which appears in the June issue of "Preventive Medicine", was based on data from the NHLBI-sponsored Growth and Health Study (NGHS). Lead investigator Dr. Carolyn Voorhees of The Johns Hopkins University Medical School and an NHLBI Research Fellow at the time of the study, led the analysis with collab-orators at the University of California at Berkeley, CA, Children's Hospital Medical Center in Cincinnati, OH, Westat, Inc, in Rockville, MD, and the Maryland Medical Research Institute in Baltimore, MD.
"Getting youths not to start smoking has been very hard," said NHLBI Director Dr. Claude Lenfant. "Many environmental, social, and psychological factors are involved in determining which youths are at most risk. By helping to identify key factors involved in girls' decisions to smoke, the study may lead to the development of more effective smoking prevention programs." "Many of the factors identified in this study as increasing girls' risk of becoming smokers were not even on our radar screens 10 years ago," said Voorhees, "and the drive for thinness among black girls has not been previously reported."
National surveys show that teenage smoking, especially among whites, is on the rise, with the biggest increase being among high school seniors. More than 3,000 young persons start smoking each day, according to Federal estimates. Current predictions are that, in the United States, more than 5 million of today's young smokers will go on to die of a tobacco-related illness.
NGHS involved 2,379 black and white girls at three locations, Richmond, CA, Cincinnati, OH, and metropolitan Washington, DC. The girls were followed for 9 years and were ages 9 and 10 at the start of the study.
Researchers looked at five categories of smoking. The categories were based on the number of days a girl had smoked over 30 days: No smoking, experimental (5 or fewer days), occasional (6-19 days), regular (20-29 days), and daily (30 days).
Researchers also assessed the girls' blood lipids, blood pressure, food intake, and physical activity. Additionally, girls underwent in-depth interviews on various subject areas. Most assessments were repeated annually. Information on parental and guardian education and other topics also was gathered.
In this study, researchers compared the effects of risk factors for becoming a daily smoker in black and white girls, as well as examining the impact of each risk factor independently for each group.
Among the study’s other key findings were:
· White girls were more likely than black girls to become daily smokers, while black girls were more likely than white girls to become experimental or occasional smokers.
· For black girls, weight concerns and a drive for thinness at ages 11-12 were the most important factors leading to daily smoking at ages 18-19.
· For white girls, in addition to weight concerns at ages 11-12, poor conduct and stress at those ages and having a one-parent household were the most important factors leading to daily smoking at ages 18-19.
"The findings show that we need to offer young teenage girls healthy ways of controlling their weight and dealing with stress," said Dr. Eva Obarzanek, NGHS project officer at NHLBI. "But we also must provide smoking prevention and cessation programs through schools, community, and other outlets."
NHLBI press releases, fact sheets, and other materials are available online at: www.nhlbi.nih.gov.
Source: NIH Press Release; Monday, June 3, 2002.
NATIONAL WOMEN'S HEALTH AND FITNESS DAY
What is National Women's Health & Fitness Day?
Women's Health & Fitness Day is a new annual health promotion event for women of all ages, set to debut on Wednesday, September 25, 2002. In future years, this event will always be held on the last Wednesday in September. It is believed to be the first national event of its kind, with participation by local organizations throughout the US that will focus attention on the importance of regular physical activity and health awareness for women. The event is similar in concept to its "sister" event, National Senior Health & Fitness Day, the nation's largest older adult health promotion program held every May. Women's Health & Fitness Day will also be part of a new National Women's Health & Fitness Week, to be held annually the last week in September.
On Wednesday, September 25, 2002, hundreds of local organizations throughout the country will host women's health and fitness events at hospitals, health clubs, park and recreation districts, local health and service organizations, schools, retirement communities, houses of worship, senior centers, and other community locations. An estimated 20,000 to 30,000 women are expected to participate in these local activities as part of the first year's event.
What Will Women Do at These Local Events?
Local health and fitness activities will vary widely based on the organizations hosting the events and the interests of local women in these communities. Activities will be noncompetitive and may include walking events, exercise demonstrations, health screenings and health information workshops.
How Can Local Organizations Participate in National Women's Health & Fitness Day?
All local groups interested in hosting a Women's Health & Fitness Day event must register to be an official host site and legally use the event name and logo. The event registration fee is $29.95 plus shipping, and includes the official Women's Health & Fitness Day Program Manual, an easy to use resource guide that has everything a local organization needs to plan a successful Women's Health & Fitness Day event.
The registration fee also includes an official 2002 Women's Day T-shirt, event banner and sample incentive items. There will also be a special toll-free number for local organizations to call for free consulting help with event planning. The 2002 Women's Health & Fitness Day registration form will be available in late Spring 2002.
Why Have a National Women's Health & Fitness Day?
The goal of this new event is to encourage women to take control of their health: to learn the facts they need to make smart health choices, and to make time for regular physical activity. It is also believed to be the first national event of its kind that is celebrated locally on the same day throughout the country.
Because of its grassroots nature, the event provides an excellent opportunity for local organizations to showcase the health-related programs and services they offer to women in their communities.
Who Organizes This New Event?
National Women's Health & Fitness Day is a public/private good health partnership organized by the Health Information Resource Center (HIRC), a national clearinghouse for consumer health information professionals. The HIRC's "sister" organization, the Mature Market Resource Center, is the official organizer of National Senior Health & Fitness Day, the nation's largest older adult health promotion event, which is always held the last Wednesday in May.
The HIRC staff will coordinate all Women's Health & Fitness Day host site registrations along with the sales and distribution of event incentive items and samples/information from our national and state/local event sponsors.
Other HIRC programs include Family Health & Fitness Day USA; the nine year old National Health Information Awards http://www.healthawards.com; the World Wide Web Health Awards http://www.healthawards.com; and the healthprograms.com http://www.healthprograms.com Web site.
If My Organization Decides to Participate in Women's Health & Fitness Day, Must I Have the Event on Wednesday, September 25?
Since much of the national and local media coverage will focus on Women's Health & Fitness Day events on Wednesday, September 25, 2002, it is preferred, but not required, that you hold your event that day. Because Women's Health & Fitness Day is also part of the new National Women's Health & Fitness Week, you have the option of holding your Women's Day event during the last week in September 2002. (Please note that none of the Women's Health & Fitness official incentive items, T-shirts, banners, bags, posters, etc., will have the Wednesday, September 25 date printed on them.)
2002 Women's Health & Fitness Day Theme Contest
As part of the first year's activities, The HIRC will sponsor a theme contest among women 18 years and older to select a slogan for the fall's event. The HIRC is looking for a short theme or message emphasizing the importance of physical activity and health awareness for women. The winner will receive a cash prize and see her theme featured on selected 2002 Women's Health & Fitness Day event incentive items.
Entries must be postmarked by Friday, May 31, 2002, and should be sent to: 2002 Theme Contest, Women's Health & Fitness Day, P.O. Box 883, Libertyville, IL 60048. Please include your name, address and daytime phone number. You may enter as often as you wish. Send post cards or letters, or enter by fax: 847-816-8662, or e-mail: info@fitnessday.com.
Questions About National Women's Health & Fitness Day?
Please contact Carrie Farella, program coordinator, National Women's Health & Fitness Day, 1-800-828-8225, weekdays 8-6 Central time. (After hours, please use the voice mail.) E-mail: cfarella@fitnessday.com.
Source: [Online source]: http://www.fitnessday.com/.
SCHOOL BREAKFAST PARTICIPATION RISES, LUNCH FALLS IN FEBRUARY
Participation in the National
School Breakfast Program rose from 7.84 million in January 2002 to 7.97 million
in February 2002, according to preliminary data from the USDA’s Food and
Nutrition Service (FNS). The number of school-children eating school breakfasts
this past February was a 3.4 percent increase from February 2001 when 7.7 million
participated in the program.
More than 137 million school breakfasts were served in February 2002, 74 percent
free and 8.7 percent at reduced price.
Participation in the National School Lunch Program fell from 27.92 million in
January 2002 to 27.78 million in February 2002, according to FNS. Compared to
February 2001, when 27.6 million children ate school lunch, participation in
the program rose slightly (0.7 percent) in February 2002.
Schools served more than 469 million lunches in February 2002, 47.6 percent free and 9.5 percent at reduced price.
Source: Nutrition Week; XXXII(11) June 10, 2002; p. 8.
HEALTH CARE PROVIDERS NEED TRAINING IN WARFARIN-VITAMIN K INTERACTIONS
Health care professionals
can benefit from more training about interactions between drugs and nutrients,
particularly the interactions between the anticoagulant warfarin and foods rich
in vitamin K, to counsel patients appropriately and ensure the best outcomes.
That is the finding of researchers who surveyed 160 randomly selected clinicians,
including physicians, pharmacists, dietitians, and nurses practicing anticoagulant
therapy at 10 Massachusetts hospitals (1). The clinicians completed a 30-question,
98-item survey of their knowledge in interactions between warfarin and drugs
and warfarin and foods.
The pharmacists and dietitians scored well in their own areas of expertise, warfarin-drug and warfarin-food interactions, respectively, but they did not perform as well as in other areas. Physicians scored similarly to pharmacists in general drug-nutrient interactions, but they scored lower in other areas. Nurses tended to score the lowest among the health care professionals studied.
Out of a possible score if 100, the mean overall scores were: 72.5 for pharmacists, 62.5 for physicians, 56.9 for dietitians, and 50.2 for nurses. Pharmacists scored significantly higher, 75.9 on the drug interaction section, whereas dietitians scored higher, 73.0 on food interactions. Using sample menus, more than 87 percent of the clinicians were able to identify common foods that contain a high level of vitamin K, such as broccoli and spinach; less than 25 percent, however, could identify other vitamin K-rich foods, such as pea soup, coleslaw, and dill pickles.
Couris and colleagues suggest that health care providers who either prescribe warfarin or monitor patients taking the anticoagulant should advise their patients on interactions between the drug and vitamin K and also on the vitamin K content of foods (1). The researchers point to earlier research showing that family practice residents were able to identify just 61 percent of 14 common drug-nutrient interactions (2). Although 94 percent of those residents knew vitamin K could reduce the effectiveness of warfarin therapy, just 43 percent knew broccoli contained high levels of vitamin K.
“Inadequate knowledge of drug-nutrient interactions may lead to inappropriate patient counseling and result in adverse medical consequences. Deficiencies in knowledge of warfarin-vitamin K interactions may result in insufficient anticoagulation or hemorrhagic complications,” Couris and colleagues write. For example, vitamin K can interfere with anticoagulation therapy, with increased vitamin K intake precipitating abnormal clotting or resistance to warfarin.
References:
1.
Couris RR, Tataronis GR, Booth SL, Dallal GE, Blumberg JB, Dwyer JT. Development
of a self-assessment instrument to determine daily intake and variability of
dietary vitamin K. J Am Coll Nutr, 2000; 19:439.
2. Lasswell AB, DeForge BR, Sobal J, Muncie HL Jr, Michocki R. Family medicine
residents' knowledge and attitudes about drug-nutrient interactions. J Am Coll
Nutr, 1995; 14:137.
Source: Nutrition & the MD; 28(3); March 2002; p. 8.
ST. JOHN’S WORT, PLACEBO, AND ANTIDEPRESSANT TRIALS
Results of studies of the effectiveness of St. John’s wort (Hypericum perforatum) for the treatment of major depression and depressive symptoms have been inconsistent. In a recent randomized trial, the Hypericum Depression Trial Study Group used a placebo control and sertraline as an active comparator to evaluate the efficacy of St. John’s wort in adult outpatients with moderately severe major depression. After 8 weeks of treatment, change from baseline in the Hamilton Depression (HAM-D) scale and rates of full response were not significantly different from placebo in either the St. John’s wort or sertraline group. Walsh and colleagues reviewed placebo-controlled trials of medications for major depressive disorder published between 1981 and 2000 and observed that the response to placebo was variable, but often substantial, and was significantly correlated with the year of publication, increasing in recent years. In an editorial, Kupfer and Frank described the current debate about the use of placebo controls in randomized clinical trials and discuss their contention that placebo-controlled trials of antidepressant therapy will be necessary for the foreseeable future.
References:
1.
Walsh BT, Seidman SN, Sysko R, Gould M. Placebo response in studies of major
depression; variable, substantial, and growing. JAMA; April 10, 2002; pp. 1840-1847.
2. Kupfer DJ, Frank E. Placebo in clinical trials for depression: complexity
and necessity. JAMA; 287(14); April 10, 2002; pp. 1853-4.
Resource:
1.
Hypericum Depression Trial Study Group. Effects of Hypericum perforatum (St.
John’s Wort) in major depressive disorders. JAMA; 287(14); April 10, 2002;
pp. 1807-1814.
Source: JAMA; 287(14); April 10, 2002; p. 1763.
DIABETES PREVENTION: NEW NUTRITION RECOMMENDATIONS PROVIDE SUPPORT FOR THE INPORTANCE OF LIFESTYLE CHANGE
In January, the American Diabetes Association released new nutritional guidelines for the treatment and prevention of diabetes. The guidelines were published in the January 2002 issue of Diabetes Care, a journal of clinical research (1).
Although many of the guidelines reflect information contained in previous position statements and technical reviews, there are some significant changes in the recommendations, including the following:
· The nutrition principles and recommendations are classified into four categories according to their levels of supporting evidence: those for which there is strong supporting evidence, some supporting evidence, or limited supporting evidence, and those that are based on expert consensus.
· For the first time, the 2002 recommendations address how lifestyle approaches (weight management and physical activity) may prevent or delay the onset of diabetes.
The Role of Medical Nutrition Therapy in Diabetes
A position statement outlining the recommendations strongly supports the role of medical nutrition therapy (MNT) in the management of diabetes. MNT encompasses not only the clinical principles of treatment but also takes into account an individual’s circumstances, cultural and ethnic preferences, and ability to realistically maintain lifestyle changes.
Two recent studies demonstrated the critical importance of glycemic control in preventing microvascular complications associated with diabetes. Both the Diabetes control and Complications Trial and the United Kingdom Prospective Diabetes study relied on MNT to achieve treatment goals.
The technical review paper outlining the 2002 recommendations stresses that registered dietitians trained in diabetes management are the health professionals most qualified to provide MNT for people with diabetes. This review quotes multiple studies that have shown that MNT provided by registered dietitians is an effective way to reduce hemoglobin A1c levels and to improve dyslipidemia.
Nutrition Principles and Recommendations for People with Diabetes
In all, the guidelines provide 51 nutrition recommendations divided into 15 categories. A majority of the recommendations are for people with either type 1 or type 2 diabetes and deal with nutrient components of the diet such as carbohydrates, protein, fat, energy balance (including physical activity), micronutrients, and alcohol. Three of the recommendation categories address special populations: children and adolescents, women who are pregnant or lactating, and older adults. Other categories address clinical conditions such as acute complications, hypertension, dyslipidemia, nephropathy, and catabolic illness. The final category of recommendations addresses the prevention of diabetes.
Each recommendation has been assigned a grade (A, B, C, or E) according to the weight of the scientific evidence that supports it. An “A” rating means that there is supportive evidence from multiple, well-conducted studies; “B” is an intermediate rating signifying that there is some supporting evidence; “C” means that there is limited supporting evidence; “E” means that the recommendation is based on expert consensus.
A majority of the 2002 recommendations have received A, B, or E ratings, and only a few that have C ratings are included. For example, under recommendations about carbohydrate, an A rating was assigned to the recommendation that “foods containing carbohydrates from whole grain, fruits, vegetables, and low-fat milk are important components and should be included in a healthy diet,” because many well-controlled studies have shown this to be true. An E rating was given to the recommendation that “sucrose and sucrose-containing foods should be eaten in the context of a healthy diet,” because this is based on expert consensus. Other examples of the recommendations are included in the table below.
For a complete listing of all the recommendations, please visit www.diabetes.org or call 1-800-342-2383 and request a copy of the guidelines.
Examples of the American Diabetes Association’s 2002 Nutrition Recommendations for the Treatment and Prevention of Diabetes and Related Complications
Nutrition Recommendations Grading
Carbohydrates
· Foods containing carbohydrates from whole grains, fruits, vegetables, and low-fat milk are important components and should be included in a healthful diet. A
· With regard to the glycemic effects of carbohydrates, the total amount of carbohydrate in meals or snacks is more important than the source or type. A
· Nonnutritive sweeteners are safe when consumed within the Adequate Daily Intake levels established by the FDA. A
· Although the use of low-glycemic index foods may reduce postprandial hyperglycemia, there is not sufficient evidence of long-term benefit to recommend use of low-glycemic index diets as a primary strategy in food/meal planning. B
· Sucrose and sucrose-containing foods should be eaten in the context of a healthful diet. E
Fat
· In all, <10 percent of energy intake should be derived from saturated fats. Some individuals (i.e., those with LDL [low-density lipoprotein] cholesterol levels ³100 mg/dL) may benefit from lowering saturated fat intake to <7 percent of energy intake. A
· Reduced-fat diets, when maintained long-term contribute to modest loss of weight and improvement in dyslipidemia. B
Energy Balance and Obesity
· Structured programs that emphasize lifestyle changes including education, reduced-fat (<30 percent of daily energy) and energy intake, regular physical activity, and regular participant contact, can produce long-term weight loss on the order of 5 to 7 percent of starting weight. A
· Standard weight-reduction diets, when used alone, are unlikely to produce long-term weight loss. Structured, intensive lifestyle programs are necessary. A
Prevention of Diabetes
· Structured programs that emphasize lifestyle changes including education, reduced fat and energy intake, regular physical activity, and regular participant contact can produce long-term weight loss of 5 to 7 percent of starting weight and reduce the risk for developing diabetes. A
· All individuals, especially family members of individuals with type 2 diabetes, should be encouraged to engage in regular physical activity to decrease risk of developing type 2 diabetes. B
References:
1. Marion J. Franz JP, Bantle CA, et al. Evidence-based nutrition principles
and recommendations for the treatment and prevention of diabetes and related
complications. Diabetes Care; January 2002; pp. 202-212.
Source: Food Insight; January/February 2002; pp. 5 & 8.
THIRTY-ONE WAYS TO SAVE MONEY AND EAT HEALTHIER
Everyone wants to save
money and keep grocery costs low. Try these money-saving strategies to increase
savings and improve your health.
1. In-season produce is often less expensive: asparagus in spring, zucchini
in summer, pears in fall and leafy greens in winter.
2. Investigate the farmers markets in your area. Local produce hasn’t
traveled long distances, so it is often in better condition and lower-priced.
3. Where available, picking your own berries and other produce provides a good
workout.
4. Growing your own herbs, vegetables and fruit in a yard, patio or sunny windowsill
is inexpensive and rewarding.
5. Buy only as much fresh produce as you will use within 3 or 4 days. After
that, the nutritional value decreases. Throwing away food is expensive; use
overripe fruit like bananas and peaches in baking.
6. Choose canned or frozen fruits and vegetables when fresh is expensive or
unavailable, but remember to avoid added sugar and salt. Always read food labels.
7. To prevent impulse shopping, always shop for groceries with a list.
8. Shop on a full stomach to prevent unplanned purchases or selecting convenience
foods low in nutrition.
9. Use coupons only for products you were planning to buy anyway. Try to combine
sale items with coupons for extra savings.
10. Try store-brand products; you may not find much difference between theses
and more expensive brand names.
11. Where bulk foods are available, choose to scoop your own grains, beans,
cereals, nuts, etc. You’ll save money by buying only what you need.
12. Buy juices as frozen concentrate instead of ready-use bottles or cartons.
The nutritional content is the same. Choose only 100 percent fruit juices.
13. Buy plain brown rice or other whole grains and add your own herbs and spices,
instead of prepackaged blends.
14. Purchase plain, nonfat yogurt and add your own chopped apples, dash of cinnamon
and drop of vanilla. You’ll get less sugar for less money.
15. Instead of a gallon of ice cream, buy popsicles or ice cream sandwiches
(or try soy versions). Although individually wrapped packaged options cost more
per unit, they will help you control portion sizes and, in turn, save money.
16. Decide which convenience foods you really need. Would you rather slice mushrooms
or tear your own lettuce leaves than buy prepackaged options? Or is the reduced
preparation time well worth a few extra dollars?
17. Consider joining a food co-op or membership store.
18. Make your own sandwiches so you can control the amount of mayonnaise and
heap on more veggies. Make sure to choose a fiber-rich, whole-grain bread.
19. Keep a bottle of water with you all day long instead of buying sodas. Water
has no calories, caffeine or sugar.
20. Bring your lunch to work instead of buying it. Stir-fry or veggie pasta
leftovers can be quickly microwaved. Bonus: Since you won’t sit in a restaurant
or wait in a cashier’s line, you’ll have time for a midday walk.
21. Rather than going to the vending machine, bring snacks from home: fresh
fruit salad, raisins or other dried fruits, unsalted nuts, raw veggies, baked
tortilla chips, flavored rice cakes or crunchy whole-grain cereal.
22. Instead of buying deli turkey by the pound, purchase a whole turkey breast,
roast it in the oven, slice into individual portions and freeze in zip-top bags
until needed. These are perfect for quick sandwiches or salad toppings.
23. When you purchase meat, divide it into 3-ounce servings (the size of a deck
of cards) and place in freezer-safe bags or containers. This will help control
portion sizes and encourage you to use less meat in casseroles, stir-fries and
pasta sauces.
24. Always keep a few cans of beans on hand to us as a meat substitute in various
dishes.
25. Cutting down on meat leaves more money to buy a variety of veggies, even
out of season. Eating a variety of foods will make smaller portions of meat
less noticeable.
26. When you’re too tired or busy to cook a full meal, don’t fall
into the expensive trap of going out to eat. Instead, make a veggie-filled sandwich
or have soup and whole grain crackers.
27. Always freeze leftovers (rather than refrigerate them) unless you will definitely
use them the next day.
28. Try making your own salad dressing with olive oil, flavored vinegar and
your favorite seasoning.
29. Since baked goods freeze well, make muffins and quick breads in large quantities.
Include whole grains, shredded vegetables and fresh or dried fruits.
30. Create your own trail mix with unsalted nuts, whole-grain cereal, pretzels
and chopped dried fruits in place of the store-bought kind, which often contain
excess salts, sugar and saturated fat.
31. Remember that eating healthfully now will save money on health costs in
the future. Fill your plate with two-thirds (or more) vegetables, fruits, whole
grains and beans and one-third (or less) animal foods.
Source: American Institute for Cancer Research Newsletter; Spring 2002; Issue 75; pp.1-3.
WHAT MAKES TOMATOES AND BROCCOLI CANCER-PROTECTIVE?
Some previous studies have shown that eating tomatoes and broccoli lowers the risk of developing prostate cancer. New American Institute for Cancer Research (AICR) research is investigating exactly which components in these foods may provide protection.
Epidemiological studies
have found that intake of tomatoes and tomato products is linked with reduced
prostate cancer risk. Some recent evidence also suggests that broccoli consumption
may be another potent weapon in the fight against prostate cancer.
Although more studies are needed to confirm these findings, even the possibility
of a diet-prostate cancer link holds great interest for researchers. Prostate
cancer incidence has risen steeply in the last decade; it is now the second-leading
cause of cancer deaths among American men. Consequently, scientists have been
diligently studying the compounds within these vegetables that could protect
against cancer.
Looking closely at Lycopene and Sulforaphane
Many scientists speculate that a phytochemical called lycopene is the protective substance in tomatoes. Lycopene is a carotenoid, a large group of phytochemicals that also includes beta-carotene. Lycopene is what gives tomatoes their red color, and it isn’t found in many other fruits and vegetables.
John Erdman, PhD, of the Division of Nutrition Sciences at the University of Illinois at Urbana-Champaign and a recent AICR grantee, is cautious about attributing the protective effect to one substance too soon. “We don’t know exactly which components in tomatoes may lower the risk of prostate cancer. Lycopene could have a large or small effect,” he says.
Besides the fact that more phytochemicals are still being discovered, it may be that the cumulative effect of several substances together proves to be more effective than any one substance alone. “We don’t believe in a magic bullet. The synergy among the different components within a whole food may be quite important,” he notes. The same might be true for sulfarophane, the phytochemical found in broccoli, which scientists believe reduces cancer risk as well.
Whole Foods vs. Individual Substances
In case lesser-known phytochemicals turn out to be the effective ones, Dr. Erdman and his colleague Elizabeth Jeffery, PhD, a nutritional toxicologist and an expert on broccoli, are studying both whole vegetables. In their new study, the scientists are investigating what happens when rats with prostate cancer are fed freeze-dried powders made from tomatoes, broccoli or both. They speculate that this diet will slow tumor growth.
In separate trials, they will observe the effects of two different types of freeze-dried powders: one set made from the whole tomato or broccoli and one made from the phytochemical (lycopene or sulfarophane, respectively). They then hope to determine which type of powder is more effective in delaying tumor growth.
Three Mechanisms Will be Tested
For this project, the rats will be implanted with a slow-growing cancer tumor that closely corresponds to human prostate cancer, which takes decades to develop. Dr. Erdman predicts that the broccoli and tomato powders, or a combination of both, will inhibit tumor growth via one of several possible mechanisms: by reducing the effect of male sex hormones that may increase the risk of prostate cancer; by increasing the rats’ antioxidant levels; or by increasing the amount of enzymes that boost the function of antioxidants.
The findings of Dr. Erdman and Dr. Jeffery may someday lead to large-scale observational human studies, but for now they offer another reason to add extra servings of broccoli and tomatoes to soups, salads, pastas, stir-fries and other dishes.
Adapted from: American Institute for Cancer Research Newsletter; Spring 2002; Issue 75; p. 8.
TV IN BEDROOM LINKED TO CHILDHOOD OBESITY
Preschool children who have a television set in their bedrooms are about 30 percent more likely to be overweight (greater than the 85th percentile for body mass index) than those without one, found a study in the June 2002 issue of the Pediatrics journal (1). The study of more than 2,700 children one to five years old in the WIC program found that 40 percent had a television set in their bedroom and watched 4.8 hours more television per week than children without TVs. More than 25 percent of one-year-old children watched more than two hours of television a day. For each additional hour of television watched, the children had a 6 percent greater risk of being overweight. Go to www.pediatrics.org, to read the study’s abstract.
Reference:
1. Dennison BA, Erb TA, and Jenkins PL. Television Viewing and Television in
Bedroom Associated With Overweight Risk Among Low-Income Preschool Children.
Pediatrics; June 2002; 109: 1028-1035.
Source: Nutrition Week; XXXII(11) June 10, 2002; p. 6.
EAT YOUR PROCYANIDINS, COMPOUNDS IN FRUITS AND VEGETABLES
Alyson Mitchell, an assistant professor of pharmacology and toxicology in the food science and technology department at UC Davis, is studying how fruits and vegetables affect the body’s ability to neutralize carcinogens that we eat, drink, breathe or are otherwise exposed to, and how they may prevent cancer.
Everyone knows a diet high in fruits and veggies is good for your health, not just for fighting cancer but for heart disease and diabetes as well. Cancers of the lung, pancreas, colon and prostate are particularly influenced by diet. Scientists believe that a diet high in plant foods may reduce the risk of these malignancies by as much as 50 percent. But how much, why and how it all works is a complicated subject filled with uncertainties and conflicting hypotheses.
In general, plant foods are thought to play two powerful roles as anti-carcinogens. First, they help neutralize free radicals. To generate energy, millions of chemical reactions within the body must take place. During these reactions, some of the electrons get moved into strange, unstable configurations. These unpaired electrons are called free radicals. Free radicals are a byproduct of metabolism and have the ability to oxidize neighboring cells and create abnormal changes by attaching to genetic material (DNA).
Oxidation is akin to the process that causes metal to rust. “Oxidation can lead to the formation of reactive species that prompt carcinogens. And it makes us all age, darn it,” said Mitchell. “These kinds of reactive compounds can cause cancer though their interactions with DNA and important cellular macromolecules.”
Phytochemicals in fruit and vegetables attach to free radicals, taking away the ability of these unstable molecules to affect surrounding cells. Secondly, they induce enzymes in the body that that repair damages cells and make toxins water-soluble so that they can be excreted in urine. Fruits and vegetables are loaded with compounds that do both, compounds like flavonoids. Flavonoids serve many roles in plants. Some, like the bitter tannins found in tea and wine, repel insects. Others put the colorful hue in fresh produce. “Eat your colors, that’s pretty good advice for a healthy diet,” said Mitchell.
Mitchell is interested in procyanidins, a flavonoid found in all kinds of common foods: grapes, barley, green tea, peaches, apples, red wine, berries, even cocoa. Procyanidins make your body produce enzymes called glutathione S-transferases (GST’s). GST’s are part of a family of protective molecules known as phase 2 enzymes. These little worker cells mop up free radicals and otherwise do all the heavy lifting of detoxifying molecules before they can cause DNA damage. “Glutathione S-transferases are ubiquitous, your body makes them in virtually every cell,” said Mitchell. “But more is definitely better. They are the most important defense system we have to protecting against chemical carcinogens. And they can’t be replicated in pills.”
With a grant from the American Cancer Society, Mitchell is studying whether mice fed a diet high in purified procyanidins experience a greater induction of glutathione S-transferases than mice fed a standard diet. Then, she’ll use state-of-the-art liquid chromatography and mass spectrometry to measure the expression of glutathione S-transferases isoenzymes in the cells. She’ll also look at the ability of procyanidins to protect against laboratory-induced free radicals. Mitchell will use this information to identify the mechanisms by which procyanidins protect against cancer. ”We’re looking not just at molecules in a jar, but which foods have high levels of procyanidins, so that we can make useful distinctions,” she said.
Her project is one of many at UC Davis seeking to identify how constituents of the diet may prevent cancer. Key players include scientists from Lawrence Livermore National Laboratory, the United States Food and Drug Administration’s Western Human Nutrition Research Center, the UC Davis Departments of Nutrition, Agriculture, Epidemiology and Preventative Medicine, Mitchell’s home department of Food Science and Technology, and individual investigators scattered throughout the division of the Biological Sciences. Their efforts and more are part of the UC Davis Cancer Center program in cancer control. After all her work is done, Mitchell expects no greater revelation than the advice given by dietitians (and mothers) everywhere: Eat your fruits and veggies. “People are very confused about the whole antioxidant story. A lot of misinformation has gotten out. Every week, it’s something new. As a result people aren’t listening,” said Mitchell. “Antioxidants are very important. But you don’t need to buy them in pills. There are simple dietary changes you can make to ensure you get an ample supply.”
As you might guess, Mitchell is not a fan of antioxidant supplements. Flavonoids, she points out, work in combination with one another, which is why food is a better way to go.
Besides, she added, “when we extract compounds from foods, we’re extracting chemicals about which we know very little. There are more than 1,600 flavonoids in food, yet we don’t know the pharmacology or toxicology of more than a handful of them.” In Mitchell’s view; better to get those compounds in food. After all, it’s worked better that way for centuries
Adapted from: Synthesis; Spring 2002; 5(1); pp.16-18.
RESOURCES:
HOW
MUCH ARE YOU EATING? BROCHURE RELEASED BY USDA
The first in a series of consumer brochures based on the dietary Guidelines
for Americans, 2000, "How much are you eating?" has just been released.
This brochure provides insight for consumers on sensible eating and reasonable
portion sizes. These publications may be viewed and downloaded from the website:
www.cnpp.usda.gov. To order copies of this brochure,
or copies of the Dietary Guidelines for Americans bulletin or 5-panel consumer
brochure, see the ordering information on the website.
Source: [Online source]: www.cnpp.usda.gov.
WEBSITES:
THE CENTER FOR WEIGHT AND HEALTH WEBSITE
The Center for Weight and
Health website facilitates interactions among researchers, policy makers and
community based providers from various disciplines and institutions who are
concerned about weight, health and food security, and promoted collaboration
on projects between professionals and members of diverse communities. To visit
the Center for Weight and Health website, go to: http://www.CNR.Berkeley.EDU/cwh/.
Adapted from: [Online source]: http://www.CNR.Berkeley.EDU/cwh/.
AIM FOR A HEALTHY WEIGHT WEB PAGE
This web page, http://hin.nhlbi.nih.gov/joinhin/news/nutrition.htm, provides information for patients and public as well as health practitioners and professionals. The patient pages take individuals through determining their weight status, then moves them step-by-step through choosing lifestyle changes to effectively lose weight. The pages include:
· BMI Calculator
· Obesity-Associated Disease Risk Chart
· Interactive Menu Planner
· Shopping List and Ideas
· Guide to Physical Activity
· Menus and Recipes
The professional pages
include the full text of The Clinical Guidelines Evidence Report, The Executive
Summary of the Guidelines, and the Practical Guide. Other useful tools to assist
practitioners who evaluate and treat obese and overweight patients include:
Electronic Textbook
This interactive guide is based on various sections of The Evidence Report and
provides the information in an easy to access Web format. It includes an interactive
menu planner and BMI calculator.
Palm OS Tools
A succinct and practical point-of-care reference for download and use on Palm
OS devices. The BMI Calculator and highlights of the guidelines are packaged
for use in the clinical setting.
Slide Show
Appropriate for both professionals and the public, The Evidence Report is formatted
as a Power PointÔ presentation. Includes 150 slides and accompanying notes
consisting of six sections:
· Clinical Guidelines
Core Set
· Evidence-Based Methodology
· Background Data
· Practical Tips
· Special Considerations
· Future Research
Source: Aim for a Healthy Weight; March 2002; 28(3); p.8.
BOOK REVIEWS:
Handbook of Vitamins is a comprehensive, clinically focused text that reflects the marked growth in our knowledge of vitamins over the past 10 years. The presentation of the material and the inclusion of exciting advances in vitamin-related research make this an excellent resource for clinicians, dietitians, and advanced students in the nutritional sciences. Chapters are organized into discussions of vitamin history, chemistry, analytic procedures, biological assays, metabolism, biochemical functions, nutritional requirements, food sources, deficiency and toxicity symptoms, and factors influencing vitamin status. Discussions include new insights into vitamin functions (with a focus on their role as catalysts, cellular regulators, and co-substrates), recent pharmacologic uses of vitamins, and the role of vitamin-like accessory factors in health and disease. In addition, 3 new chapters have been added to the text: “Bioorganic Mechanisms Important to Coenzyme Function,” “Ascorbic Acid Regulation of Extra-cellular Matrix Expression,” and “Nutrients and Oxidation: Actions, Transport, and Metabolism of Dietary Antioxidants.” The editors are to be commended for integrating the contributions of many learned scientists into and excellent nutritional reference.
HANDBOOK OF VITAMINS, 3rd edition, edited by Robert B Rucker, John W Suttie, Donald B McCormick, and Lawrence J Machlin, 2001. Marcel Dekker Inc., New York
Source: Beshgetoor D. Am J Clin Nutr; 75(5); May 2002; p. 955.
UPDATED NUTRITION TEXT NOW AVAILABLE
The 2001 edition of the
International Life Sciences Institute’s Present Knowledge in Nutrition,
the mega-paperback classic that provides an overview of current knowledge in
nutritional requirements in health and disease, has recently been published.
The new edition, edited by Dr. Barbara A. Bowman of the CDC and Dr. Robert M.
Russell of the Jean Mayer USDA Human Nutrition Research Center at Tufts University,
is more than 100 pages longer than its predecessor and has been reorganized
in logical sections. New chapters include “Nutrition Monitoring in the
US,” “Functional Foods,” and “The Human Genome and Nutrition.”
In the vitamin K chapter of the new text, the basic metabolism of the vitamin
is reviewed similarly to the c hapter in the previous edition, but with less
emphasis on biochemistry and more emphasis on function, especially related to
vitamin K function in bone metabolism. The requirement section has been updated
to reflect the recent National Academy of Science Dietary Reference Intakes.
More than one -third of the references cited have been published since the previous
edition. The text is easy to read and should remain very useful for nutrition
students and clinicians and for researchers looking for the basics.
Source: Merritt RJ. Nutrition & the MD; March 2002; 28(3); p.8.
NATURAL
COMPOUNDS IN CANCER THERAPY, PROMISING NONTOXIC ANTI-TUMOR
AGENTS FROM PLANTS & OTHER NATURAL SOURCES
An increasing number of cancer patients are interested in adding natural remedies to their treatment but are faced with an overwhelming amount of information regarding possible choices. This book is intended for patients, physicians, and researchers and has three purposes: 1) to summarize the existing research, 2) to present a hypothesis as to how natural compounds may be integrated into cancer treatment, and 3) to indicate possible future research direction.
The book’s 23 chapters are organized into three major sections that discuss the cellular events in cancer development and progression, the concomitant events at the level of the whole organism, and individual compounds that have shown some promise in the treatment of cancer. The first two sections provide a concise and well-referenced summary of the events leading to cancer development and progression. In each subsection, examples are presented of how these events can be influences by one or more specific natural compounds. The result is a well-constructed argument for integrating such compounds into a mechanism-based approach to cancer treatment. The text also supports the argument that combinations of substances, each acting on 1 or 2 different events in turn, origenesis or carcinogenesis, are likely to give the best results. Another reason Boik gives for the need to combine natural compounds is that the plasma concentrations achieved after their consumption are often many-fold lower than the concentrations found to be effective in vitro.
One of the underlying assumptions throughout the book is that there will be “synergism” (rather inaccurately used to describe mostly additive effects) not only among natural compounds but also between them and chemotherapeutic agents. A few examples are cited to illustrate that additive or synergistic effects can, indeed, occur. Unfortunately, the potential for serious adverse effects resulting from interactions of natural compounds with each other and with pharmaceuticals are not taken into account. Yet, such interactions are currently the focus of intense research.
In the third section of the book, Boik discusses 38 individual compounds. The term natural compound, never actually defined in the book, includes a few plant extracts, but mostly a variety of isolated substances, such as flavonoids, terpenes, polysaccharides, vitamins, lipids, enzymes, and hormones. It is not entirely clear what the criteria for choosing the particular compounds were because the level of evidence ranges from 1 or 2 in vitro studies for some substances to ³12 animal studies along with some data from human trials for others.
Readers should be aware that the information presented is incomplete and lacks detail. For example, Boik does not discuss that some of the compounds (e.g., quercetin) not only inhibit some tumors but enhance others in certain animal models. It is also not mentioned that some substances (e.g., certain mushroom polysaccharides) must be given intravenously and are ineffective when taken orally. Although the book contains some valuable information and interesting hypotheses, I am concerned that it represents an oversimplified outlook on natural compounds in cancer treatment and urge great caution in interpreting and using the information presented.
John Boik. Natural compounds in cancer therapy – promising nontoxic anti-tumor agents from plants & other natural sources. 2001. Oregon Medical Press, LLC, Princeton, MN.
Source: Borchers AT. Am J Clin Nutr; 75(5); May 2002; p. 955.
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