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Welcome to:FCSN 245-Basic Nutrition
Summer 2006
Virginia Bennett, PhD, RDDavid L. Gee, PhD
Course web page: www.cwu.edu/~bennettv
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Keys to SuccessFCSN 245 - Basic Nutrition
Organize into study groups– improves test scores– group extra credit points
Review copies of old exams on course web page– use as study guide before exam– read before lectures for important points
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Keys to SuccessFCSN 245 - Basic Nutrition
Use PowerPoint notes on course web page– print to reduce lecture note taking– These notes do not replace note taking or
attending classRead the assigned readings in the
textbook– clarification of lectures
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Keys to SuccessFCSN 245 - Basic Nutrition
Review/rewrite your notes ASAP!– Clarify note taking– Review for Clicker Points
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Keys to SuccessFCSN 245 - Basic Nutrition
Maximize your discussion group points– attend all discussion group session– do all assigned work
Attend lectures– Clicker points – lecture revisions– learning: listening + reading + doing
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Dietary Guidelines, Dietary Standards, & Nutrition
Education:
A Changing Science
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Causes of Death in the US1900
#1 Pneumonia and influenza (12%) #2 Tuberculosis (11%) #3 Diarrhea and enteritis (8%) #4 Heart disease (8%) #5 Stroke (6%) #6 Nephritis (5%) #7 Accidents (4%) #8 Cancer (4%)
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Causes of Morbidity and Mortality in the US
First half of the 20th CenturyInfectious DiseasesNutritional Deficiency DiseasesCurrent CausesChronic Non-infectious Diseases
– http://www.cdc.gov/nccdphp/factsheets/death_causes2000.htm
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Nutritional Concerns
First half of the 20th Century
–Adequacy Avoiding Deficiency
Current
–Imbalance Avoiding Excesses and Deficiency
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Nutrition Teaching Tools
First half of the 20th
Century – Four Food
GroupsCurrent
– Food Guide Pyramid
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1999 Food Supply Servings Compared w ith Food Guide Pyramid Serving Recommendations
0
2
4
6
8
10
12
Gr ains Vegetables Fr ui t Dair y Meat, etc(oz)
1999 Servings
PyramidRecommendations
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010
20304050
6070
Added fats (g) Added sugars(tsp)
1999 intake
PyramidRecommendations
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Government Nutritional Advice First half of the 20th Century
– Dietary Standards Emphasis on specific nutrients Recommended Dietary Allowances (RDA’s)
– Calories, protein, vitamins, minerals
Current
– Dietary Guidelines Emphasis on whole foods and macronutrients
– Dietary Reference Intakes (DRI’s) Updated version of the RDA’s
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Issued every 5 years– Jan 12, 2005
Issued by: – Dept of
Health and Human Services (DHHS)
– US Dept. of Agriculture (USDA)
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Dietary Guidelines for Americans – 2005
Feel better today. Stay healthy for tomorrow.– Make smart choices from every food
group– Find your balance between food and
physical activity– Get the most nutrition out of your
calories
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Dietary Guidelines for Americans - 2005
Nutrition: To know the facts…use the label
Play it safe with foodAbout alcohol, if you choose
to drink, do so in moderation.
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Government Nutritional Advice First half of the 20th Century
– Dietary Standards Emphasis on specific nutrients Recommended Dietary Allowances (RDA’s)
– Calories, protein, vitamins, minerals
Current
– Dietary Guidelines Emphasis on whole foods, macronutrients,
and balance
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Nutrition Food Labels
First half of the 20th century– Voluntary w/o nutritional claim– Old label format
Current– Mandatory– Nutrition Facts Label
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Nutrition Facts Label
1992 - NLEA – Nutrition Labeling Education Act
Mandatory on package of almost all foods– except fresh meats & produce
Focused on imbalances in US diet
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Nutrition Facts LabelServing SizeIngredient List
–Listed in descending amounts
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Labels: Daily ValueBased on dietary guidelines
(1990)How much of your allowance
of a particular nutrient one serving of that food provided
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Labels: Daily Value
Based on a 2000 Calorie Diet< 30% Calories from fat<10% Calories from saturated fat<300 mg cholesterol60% Calories from carbohydrate>12.5 g dietary fiber/1000 Calories
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Labels: % of what?% = parts per 100
– per 100 what?
% of Daily Value– per 100% of DV for that nutrient
% of Calories– per 100 calories
% by weight– per 100 grams
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Labels: % of what?
“Contains 7% Fat”
% Fat by weight = (8g Fat/112g total wt)x100– % Fat by weight = 7.1%
– Low Fat?
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Labels: % of what?% Calories from Fat
% Cal from Fat = (70 Fat Cal/160 Cal) x 100– % Cal from Fat = 44% – Low Fat?
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Labels: % of what?% Daily Value for Fat
% Daily Value = (8g fat/65g fat per day) x 100– % DV = 12.3%– Low Fat?
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Should Nutrition Facts Be Required on All Foods?
Fresh meats– servings per container
Fresh produce– cost of packaging
– consumer selection
Restaurants– no packaging
Fast Food Restaurants
– 50% of meals today are prepared by others
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Nutrient Claims&
Health Claims
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Nutrient Claims: Definition of Fat Terms
Fat Free: < 0.5 g/servingLow Fat: < 3 g/servingReduced Fat: 25% less
fat than regular
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Nutrient Claims - Definition of Saturated Fat Terms
Saturated Fat Free:– less than 0.5 g per serving
Low Saturated Fat:– less than 1 g per serving
Reduced or Less Saturated Fat:– 25% less than reference food
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Nutrient Claims - Definition of Terms
High – > 20% of Daily Value
Good– 10-19% of Daily Value
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Nutrition Facts Label: Allowable Health Claims
Food and Drug Administration (FDA)
Substantial evidence linking nutrient and disease prevention
Currently 14 approved health claims
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Nutrient Claims&
Health Claims
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Allowable Health Claims
Calcium and Osteoporosis–food “high” in calcium
Sodium and Hypertension–food “low” in sodium
Fat and Cancer–food “low” in fat
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Allowable Health ClaimsSaturated fat, cholesterol, and
Heart Disease– food “low” in saturated fat, cholesterol,
and total fat
Fiber and Cancer– food “good source” of fiber, low fat, not added
fiber
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Allowable Health Claims
Fruits, Vegetables, and Grains containing fiber, particularly soluble fiber and reduction in risk of heart disease.
Fruit & vegetables and Cancer– low fat, good fiber, carotenoids, & vitamin C
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Allowable Health ClaimsFolic Acid and Birth Defects
–“good” source of folic acid
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Allowable Health Claims
Soluble fiber such as oat fiber & psyllium seed husk and Heart Disease
Sugar alcohols & Dental Caries
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Allowable Health Claims
Soy protein and prevention of coronary heart disease– October 1999– “Diets low in saturated fat and cholesterol that
include 25 grams of soy protein a day may reduce the risk of heart disease. One serving of (name of food) provides >6.25 grams of soy protein.”
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Allowable Health Claims
Whole grains and reduced risk of heart disease and certain cancers– Whole grains must be more than 50% of food’s
ingredients
– Also low fat, etc…
Potassium and reduced risk of hypertension and stroke– Good source of potassium
– Low sodium, low fat, etc…
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Allowable Health ClaimsPlant sterols and stanols and
prevention of heart disease– Sept 2000
– Benecol & Take Control margarine spreads
– Functional Foods
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Functional Foods:a $10 Billion/yr market
Foods with added health promoting ingredients
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“FDA to Encourage Science-based Labeling and Competition for Healthier Dietary Choices”
July 10, 2003
New review process for qualified health claims on food labels.– New ranking system
A: unqualified claim B: good evidence, not entirely conclusive C: limited evidence, inconclusive D: little scientific evidence
New health claims to be investigated:– Benefits of
5-9 servings of fruits and vegetables Replacing solid fats with vegetable oils Several servings of fish per week Substituting nuts for proteins high in
saturated fats
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Qualified Health Claims
First FDA-approved qualified health claim (July 2003)– ‘Scientific evidence suggests but does not prove
that eating 1.5 ounces of most nuts, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease’
– March 2004 – FDA approves claim for walnuts– http://www.cfsan.fda.gov/~dms/qhc-sum.html
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Regulation of Dietary Supplements
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Dietary Supplement Health Education Act - 1994
Product derived from food (in pill, liquid, non-food form) designed to supplement diet
Cannot claim to diagnose, prevent, treat, or cure a specific disease other than those allowed by NLEA
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Dietary Supplement Health Education Act - 1994
Can make “Structure/function” claims The FDA does not review dietary
supplements for safety or effectiveness prior to marketing.
The FDA can prohibit sale of a dietary supplement if it “presents a significant or unreasonable risk”.
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How big is the dietary supplement industry?
Nutrition Business Journal 2003 Report– http://www.nutritionbusiness.com/
US market: $18.8 billion World market $150 billion
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Dietary Supplements Case Study:GHB
Gamma Hydroxy Butyrate– trace amounts of GHB found in beef
Claims: AnabolicStore.com (1/02)– “a powerful anabolic steroid used to build
muscle– “stimulate growth hormone release which aids
in fat reduction and muscle building”– “pleasant alcohol like, hangover free ‘high’
with potent pro-sexual effects”
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Dietary Supplements:GHB
Recent Headlines: Yahoo News (1/02)– “Risky sex, drugs: circuit party norm?”– “Date rape drug attacks on the rise”– “5 arrested in Western PA Club-drug ring”
Other names:– Liquid Ecstasy, Soap, Easy Lay, and Georgia Home Boy
GHB effects:– coma and seizures– w/ alcohol: nausea and breathing difficulties– withdrawal effects: insomnia, anxiety, tremors
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Dietary Supplements:GHB
GHB considered to be an illegal dietary supplement by the FDA– Prescription drug (schedule III) for treatment of cataplexy
(weakness, paralysis) in patients with narcolepsy Emergency Room cases
– 55 in 1994– 2973 in 1999– 4969 in 2000– 3340 in 2001
US Drug Enforcement Agency reports 72 deaths related to GHB use
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Dietary Supplements Case Study:
Ephedra“Botanical” (plant) productHerbs from the genus Ephedra (Ma
Huang)– Ephedra: collection of compounds from Ma Huang– Ephedrine: synthetic compound, active chemical of
ephedra, regulated as a drugClaims related to weight loss, increased
energy, body building
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Dietary Supplements:Ephedra
Chemically - ephedrine alkaloids are amphetamine-like compounds
Ephedrines are cardiovascular and nervous system stimulants
Since 1994, the FDA has received and investigated > 1000 reports of adverse effects
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Dietary Supplements:Ephedrine- A case study
High blood pressure, irregularities in heart rate, insomnia, nervousness, tremors and headaches, seizures, heart attacks, strokes and death
FDA proposes to limit amount and require warnings (6/97)
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Dietary Supplements:Ephedrine- A case study
Objections to proposed regulation– led by supplement industry
– evidence is not convincingFDA withdraws proposal (Apr 2000)Major study in NEJM 2000 reports
“convincing evidence linking ephedra and adverse effects”
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Dietary Supplements:Ephedrine- A case study
2002 Minnesota Viking lineman dies of heat stroke, used ephedra supplements. NFL bans ephedra use
2003 Baltimore Oriole pitcher dies of heat stroke, used ephedra supplements.
2003 Rand report for FDA– Modest benefit of ephedra/caffeine on short-term weight
loss– Very limited evidence on benefits to athletic performance– Very few clinical trials on safety: 2-3X risk for nausea,
vomiting, anxiety, palpitations– Case studies: 5 deaths, 5MI, 11 CVA, 3 seizures, etc.
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Dietary Supplements:Ephedrine- A case study
2003 FDA re-introduces proposed warning label:– Possible serious adverse effects: heart attack, seizures,
strokes, death
– Risk increases with dosage, exercise, caffeine
– Never to be used during pregnancy and lactation
Feb. 2004: FDA – sales of supplements containing ephedra and ephedrine alkaloids are prohibited
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Support of current Dietary Supplement Regulations
Freedom to use supplements Number of adverse effect cases small relative to use FDA approved foods with adverse effects
– NutraSweet– Olean
Testing for safety and effectiveness would greatly increase the cost of dietary supplements
Dietary supplements are derived from foods and should be regulated as foods
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Concerns on current dietary supplement regulations
DSHEA: Dietary supplements are ‘assumed’ to be safe and effective– No proof of safety– No proof of effectiveness– New drugs are assumed to be unsafe and
ineffective Drug companies must prove safety and
effectiveness of drugs.
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Concerns on current dietary supplement regulations
Dietary supplement industry is poorly regulated– Many studies showing supplements contain less
than or none of the active ingredient Ginseng - 60% failed test SAMe - 50% failed test glucosamine - 33% failed test
–Studies showing presence of illegal ingredients in dietary supplements
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Internet Marketing of Herbal Supplements
Morris & Avorn, JAMA 290:1505-1509 (2003)
Authors noted that 80% of US adults use internet to find health information
Analyzed 443 web sites– 8 common herbs (ginko, St. John’s Wort, etc)– 5 most popular search engines
81% of .com sites made health claims 55% claimed to treat, diagnose, or cure specific diseases 52% omitted standard federal disclaimer 32% of Kava retail sites did not mention FDA advisory
linking herb to liver toxicity
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USDA National Organic Standards
October 2002
What is “Organic”? Food grown and processed without:
– Conventional pesticides– Synthetic fertilizers or sewage sludge– Biotechnology – genetically modified
organisms (GMO)– irradiation
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Organic Label Guidelines
100% Organic– All product ingredients are organic
USDA Organic Seal can be displayed
“Organic”– >95% of products are organic
USDA Organic Seal can be displayed
“Made with Organic Ingredients”– >70% of ingredients are organic
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Organic Foods Are organic foods safer?
– Maybe… Credible evidence lacking USDA makes no claim of increase safety
Are organic foods pesticide free?– Depends….
Organic farmers can use ‘natural’ pesticides– Plant derived pesticides -Rotenone– Microbial pesticides - Bacillus thuringiensis– Synthetic pesticides - Insecticidal soaps, horticultural oils– Minerals - Sulfer, copper, copper-zinc
Very limited safety testing of ‘natural’ pesticides
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Organic Foods:Are organic foods pesticide free?
Pesticide residues in conventional, IPM-grown and organic foods: Insights from three U.S. data sets.– B.Baker, C.Benbrook, E. Groth, and K. Benbrook. Food Additives and
Contaminants, 19 (5): 427-446 (2002).
Using USDA data from 20 fruit and vegetable crops:– 73% of conventionally grown were positive of pesticide residues
23% of organically grown were positive
– 46% of conventionally grown were positive with multiple residues 7% of organically grown were positive with multiple residues
Questions:– Why do organically grown food have pesticide residues at all?– Are the levels of pesticides residues found unsafe?
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Organic Foods
Are organic foods more nutritious?– Very little credible evidence of this
Are organic foods more expensive?– Probably
Consumer Reports (Jan 1998) found organic produce to be on average 57% more expensive than non-organic
Are organic foods more friendly to the environment?– Probably
No pesticide runoff to pollute environment Use ‘sustainable’ agricultural techniques
– Reduced tilling, efficient use of water, etc…