Food & Nutrition

  1. ADA Statement
    Consumers can safely enjoy a range of nutritive and nonnutritive sweeteners when consumed in a diet that is guided by current federal nutrition recommendations, such as the Dietary Guidelines for Americans and the Dietary References Intakes, as well as individual health goals
  2. Nutritive
    • Calories
    • Sugar
  3. Non-Nutritive
    • No calories
    • Truvia
  4. Added Sugars
    Eaten separately or used in processed or prepared foods
  5. Caloric Sweeteners
    Consumed directly and as food ingredients
  6. Sugars
    All monosaccharides and disaccharides
  7. Monosaccharides
    Glucose and fructose
  8. Disaccharides
    Sucrose
  9. Sugar
    Indicates “sucrose” in ingredients
  10. Non-Nutritive Sweeteners
    • Very similar to monosaccharides
    • Harder to digest- good because no calories, bad because it could create intestinal problems
    • Saccaharin
    • Asparame
    • Acesulfame K
    • Sucralose
    • Neotame
    • Stevia
    • Sweetness synergy
    • -Blending improve overall sweet taste profile
  11. Macronutrient substitutes
    –Sugar substitutes
    –Sugar replacers
    –Alternative sweeteners
    Other names for Non-Nutritive Sweeteners
  12. 4 kcal/g
    Energy from "Sugars"
  13. 2 kcal/g
    Not fully absorbed from the gut
    Energy from Sugar Alcohols/Polyols
  14. 0 kcal/g
    Energy from Non-Nutritive Sweeteners
  15. Food and Drug Administration (FDA) US
    Scientific Committee of Food (SCF) Europe
    Joint Expert Committee of Food Additives (JECFA) United Nations
    World Health Organization (WHO)
    Generally recognized as safe (GRAS)
    Who regulates sweeteners?
  16. Monosaccharide Polyols
    • Sorbitol
    • Mannitol
    • Xylitol
    • Erythritol
    • D-Tagatose
  17. Sorbitol
    • 2.6 kcal/g
    • GRAS- Label must warn about a laxative effect
    • 50%-70% as sweet as sucrose; some individuals experience a laxative effect from a load of > 50 g
  18. Mannitol
    • 1.6 kcal/g
    • Approved food additive; the label must warn about a laxative effect
    • 50%-70% as sweet as sucrose; some individuals experience a laxative effect from a load of > 50 g
  19. Xylitol
    • 2.4 kcal/g
    • Approved food additive for use in foods for special dietary uses
    • As sweet as sucrose; new forms have better free flowing abilities
  20. Erythritol
    • 0.2 kcal/g
    • Independent GRAS determinations; no questions from FDA
    • EDI mean: 1 g/p/d; 90th percentile: 4 g/p/d
    • 60%-80% as sweet as sucrose; also acts as a flavor enhancer, formulation aid, humectant, stabilizer and thickener, sequestrant, and texturizer
  21. D-Tagatose
    • 1.5 kcal/g
    • Independent GRAS determinations; no questions from FDA
    • EDI mean: 7.5 g/p/d; 90th percentile: 15 g/p/d ADI 15 grams/60 kg adult/d
    • 75%-92% as sweet as sucrose; sweetness synergizer; functions also as a texturizer, stabilizer, humectant, and formulation aid
  22. Disaccharide Polyols
    • Isomalt
    • Lactitol
    • Maltitol
    • Trehalose
  23. Isomalt
    • 2 kcal/g
    • GRAS affirmation petition filed
    • 45%-65% as sweet as sucrose; used as a bulking agent
  24. Lactitol
    • 2 kcal/g
    • GRAS affirmation petition filed
    • 30%-40% as sweet as sucrose; used as a bulking agent
  25. Maltitol
    • 2.1 kcal/g
    • GRAS affirmation petition filed
    • 90% as sweet as sucrose; used as a bulking agent
  26. Trehalose
    • 4 kcal/g
    • Independent GRAS determinations; no questions from FDA
    • EDI mean: 34 g/p/d; 90th percentile: 68 g/p/d
    • 45% as sweet as sucrose; functions also as a texturizer, stabilizer, and humectant
  27. Polysaccharide Polyol
    HSH
  28. HSH
    • 3 kcal/g
    • GRAS affirmation petition filed
    • Hydrogenated starch hydrolysates; maltitol syrup
    • 25%-50% as sweet as sucrose (depending on the monosaccharide composition)
  29. How is it made?
    Properties in food and beverage systems?
    How much will be consumed and will certain groups be particularly susceptible to it?
    Is it safe and does it cause adverse effects to individuals or offspring (e.g., cancer?)
    Questions from FDA about artificial/non-nutritive sweeteners
  30. Testing of Sugars
    • Establish safety limits
    • Acceptable Daily Intake (ADIs)
    • 100 times less than no observed effect level “NOEL” from animal studies
    • Human intake usually much less than ADI
  31. Nutritive Sweeteners
    • Inborn desire for sweet taste
    • Easily digestible by most (Lactose intolerance)
    • Rare genetic abnormalities of carbohydrate mechanism
    • -Galactosemia, inherited fructose intolerance
    • No distinction between added and natural sugars to the body
  32. Sucrose
    • Sugar canes
    • Beets
    • Disaccharide of glucose + fructose
  33. Fructose
    • Mainly from fruit
    • Corn
    • Added to food and beverages as “high fructose corn syrup”
    • Replaced sucrose because of sweetening power, lower cost, and enhances flavor, color, and product stability
    • Synergizes sweetness potential of sucrose and some nonnutritive sweeteners
    • Syrup easier to handle than a solid
  34. Dietary Fructose Intake
    • Young men and women in age groups 15–18 y and 19–22 y had highest mean
    • Women had lower intakes than men
    • Found in a lot of fast foods and vending machines
    • Total sweetener availability increased by 2.2 g/d (1.0%) while HFCS increased by 4.0 g/d (6.0%)
  35. 10% Total come from fructose
    20% of Carbohydrate come from fructose
    -Sucrose, lactose, glucose, maltose, starch
    Percentage of energy that comes from our diet from fructose
  36. High Fructose Corn Syrup
    • Glucose + fructose (about 40% to 60% fructose)
    • Corn --> glucose syrup --> HFCS
  37. The fructose:glucose ratio in US food is mainly unchanged since we started using it in the 1960s
    -Unclear how or why HFCS would affect satiety or absorption
    “Based on the currently available evidence, the expert panel concluded that HFCS does not appear to contribute to overweight and obesity any differently than do other energy sources"
    Replacing sucrose
    High Fructose Corn Syrup Controveries
  38. Underestimated- more by women, kids, obese
    Food intake that is self reported is...
  39. Overestimated
    Food availability from economic estimates is...
  40. FDA regulated
    Labeling of Nutritive Sweeteners
  41. Sugar-Free
    Less than 0.5 g sugar= 2 calories
  42. Reduced or Less Sugar
    Reduced by 25%
  43. No Sugar Added
    No sugars added during processing
  44. Nutritive Sweeteners and Polyols
    • Can be labeled as sugar-free because they replace sugar sweeteners
    • Contain less energy than sugars
    • Potential health benefits
    • -Reduced glycemic response
    • -Decreased caries risk
    • -Prebiotic effects (help healthy bacteria in gut)
  45. Prebiotics of Nutritive Sweeteners
    • Short-chain carbohydrates
    • Resistant to human digestive enzymes
    • Reach cecum and affect colonic bacteria
    • Researchers: “consumed” by colonic microflora and might promote colon health and control disease conditions
  46. Sensory qualities
    –-Clean sweet taste, no bitterness, odorless
    Safety
    Compatibility with other food ingredients
    Stability in different food environments
    Non-Nutritive Sweeteners are Evaluated for
  47. Acesulfame K
    • 5,6-dimethyl-1,2,3-oxathiazine-4(3H)-one-2,2 dioxide
    • 200 times sweeter than sucrose
    • 95% excreted unchanged in urine
    • Does not change intake of potassium
    • OK for high cooking/baking temps
    • Approved as a general-purpose sweetener
  48. Evaluation of Acesulfame K
    • Evaluated by JECFA in 1983 for safety
    • Approved in 1988 by the FDA
    • 1996 FDA approved as general purpose sweetener
    • ADI of up to 15 mg/kg bw/day
    • EDI is estimated at 20% of ADI
  49. Aspartame
    • Dipeptide + methanol
    • 160-220x’s sweeter than sucrose
    • Decomposes with excess heat; loses sweetening power
    • SCF and other agencies find: NOT a carcinogen and not associated with neurobehavioral disorders
    • Intestinal esterases hydrolyze aspartame to aspartic acid, methanol, and phenylalanine
    • 4 kcal/g, but so intensely sweet, the calorically insignificant amount needed
  50. Aspartame in the Body
    • –One serving milk has 6 times more phenylalanine and 13 times more aspartic acid
    • –Tomato juice has 6 times more methanol than an equal volume beverage sweetened 100% with aspartame
  51. Facts about Aspartame
    • ADI 40 mg/kg by/day
    • Intake about 6% of ADI
    • One packet of table top sweetener contains 35 to 40 mg of aspartame
    • 12 ounce soda has 225 mg (=100 mg phenylalanine)
    • 8 ounces yogurt up to 32 mg
  52. Neotame
    • 7,000-13,000 times sweeter than sucrose
    • Very low absorption from intestine
    • July 5, 2002 approved as a general purpose sweetener by the FDA
    • FDA ADI 18 mg/day
    • EDI .04 mg/kg bw/day
    • JECFA ADI 2 mg/kg bw/day
  53. Stevia
    • FDA GRAS approval as general purpose sweetener in December 2008
    • Stevia rebaudiana, South America
    • -Rebaudioside A is a component of the plant that provides sweetness
    • 250 to 300 times sweeter than sucrose
    • Steviol not absorbed by body
    • JECFA ADI 0-4 mg/kg bw/day
    • Marketed as Truvia and PureVia
  54. Saccharin
    • 200-700 times sweeter than sugar
    • Provides no energy
    • Largest volume, lowest cost high-intensity sweetener used in world
    • 2001 US Federal legislation
    • Declared no longer needs cancer warning
    • 1977 congress tried to ban because of concern about cancer in rats
    • ADI 5 mg/kg bw/day
    • Not to exceed 12 mg/fluid ounce in beverages and 30 mg per serving in processed goods
  55. Sucralose
    • 600 times sweeter than sucrose
    • Provides essentially no energy
    • Poorly absorbed
    • Heat stable
    • Contains 3 Chlorines which make it different
    • 1998 approved as a tabletop sweetener
    • -Desserts, confections, nonalcoholic beverages
    • 1999 approved by FDA as general purpose sweetener
    • ADI- 5 mg/kg bw/day
  56. Alitame
    Cyclamates
    Neohesperidine
    Thaumatin
    Non-Nutritive Sweeteners not Approved Yet
  57. Nutritive Sweeteners and Pregnancy
    • Acceptable
    • Ones with calories
  58. Non-Nutritive Sweeteners and Pregnancy
    Based on well-designed and approved clinical investigations
  59. Saccharin and Pregnancy
    • Can cross the placenta and remain in fetal tissue
    • Slow clearance
    • Can avoid by careful label reading
  60. Non-Nutritive Sweeteners and Pregnancy
    • No change observed
    • Fertility
    • Size
    • Body weight
    • Growth
    • Mortality
  61. Sweeteners and Obesity
    • High intakes of sweetened foods and beverages
    • Possible association with increasing amount or overweight and obesity
    • Surprisingly little evidence supports a strong direct link of added sugars with obesity (when controlling for the increase in energy)
  62. Fructose and Obesity
    • May blunt circulating insulin and leptin levels
    • Less feeling of satiety
    • May result in increased energy intake
  63. Obesity and Beverages
    • "Liquids" with sucrose and fructose may promote weight gain because less satiating than solid foods
    • Remember that HFCS is about 40%to 60% fructose, so effects may be similar to sucrose (50% each of fructose and glucose)
  64. Obesity and Non-Nutritive Sweeteners
    • Originally developed for people with diabetes
    • Long term maintenance of body weight
    • Rodent studies aren't always the same in humans
  65. In animals, they usually don't promote weight gain (but sugars do because of calories!)
    Do nonnutritive sweeteners maintain a highly sweet food environment and promote obesity?
  66. Diabetes
    • Sugars don't appear to cause it
    • Must control their TOTAL carbohydrate (not just their intake of "sugar")
    • Nonnutritive polyols have lower glycemic response; safe for those with diabetes
    • Nonnutritive do not affect glycemic response, so OK to incorporate in the diet
  67. Behavior and Non-Nutritive Sweeteners
    • FDA mandates that behavioral tests be done for food additives, such as nonnutritive sweeteners
    • No behavioral effects seen with ADI levels of intake
  68. Aspartame and Behavior
    • Headaches
    • Seizure
    • Hyperactivity
    • Brain tumors
  69. Nitrates (NO3-)
    • Naturally occurring in fruits, vegetables, cereals
    • Nitrogen (N) source for plants
    • Rarely used as a food additive in US
  70. Nitrites (NO2-)
    • Food additive approved for meat, poultry, fish
    • Formed in body
    • Key role in nitric oxide (NO) production
  71. N-Nitroso compounds
    Nitrosamines, Nitrosamides
  72. Arginine
    An amino acid produced by oxidation
  73. Vasodilator
    Cellular messenger
    Protect organs from ischemic damage
    Chronic expression associated with inflammatory conditions, tissue damage, DNA damage, carcinomas
    Importance of Nitric Oxide
  74. Food Safety and Inspection Service (FSIS) U.S.
    Department of Agriculture (USDA)
    Food & Drug Administration (FDA)
    Who regulates food additives in meat, eggs, and poultry?
  75. Sodium Nitrite
    Potassium Nitrite
    Examples of Food Additives Exempted from Food Regualtions
  76. Sodium Nitrite
    • Used alone or in conjunction with sodium nitrate as a color fixative in cured meat and poultry products (bologna, hot dogs, bacon)
    • Helps prevent growth of Clostridium botulinum, which can cause botulism in humans
  77. Food Additives
    • (ADI): 4.2 mg/kg bw/day
    • -Must be 100 times less than no observed effect level “NOEL” from animal studies
    • Human intake usually much less than ADI
  78. Nitrates: Potassium Nitrate and Sodium Nitrate
    • Cured meat products other than bacon
    • Subject to prior sanctions issued by USDA for use as sources of nitrite, with or without sodium or potassium nitrite, in the production of cured red meat products and cured poultry products
    • Rarely used in food processing
  79. Nitrites: Potassium Nitrite and Sodium Nitrite
    • Cured meat and poultry products
    • Subject to prior sanctions issued by USDA for use as color fixatives and preservative agents, with or without sodium or potassium nitrate, in the curing of red meat and poultry products
  80. Baby, junior, or toddler food
    Nitrates/Nitrites are NEVER allowed in...
  81. Nitrite as a Food Additive
    • Decreases growth of Clostridium botulinum
    • -Bacteria produces a lethal toxin, which can lead to respiratory failure
    • Flavor, texture, pink color of cured meats
    • Bacon, fermented sausage, hot dogs, bologna, salami, corned beef, ham, other smoked or cured meat, fish, and poultry
  82. Fruit
    Vegetables
    Food additives
    H2O contamination
    Nitroglycerin
    L-arginine-NO synthase pathway
    Sources of Nitrates
  83. Food additives
    Nitroglycerin
    Amyl nitrite
    L-arginine-NO synthase pathway
    Sources of Nitrites
  84. Cigarette smoke
    Car exhaust
    Sources of N-Nitroso
  85. Bacteria in the oral cavity reduces from nitrate to nitrite
    A non-enzymatic reduction of nitrite to NO occurs in the gastric acid
    Nitrate and remaining nitrate are absorbed in the intestine
    Nitrate is excreted by the kidneys
    Nitrate and nitrite in blood originate from the food and from systematic NO production
    An active uptake of nitrate from the blood occurs in the salivary glands
    Circulation of Nitrate in the Body
  86. Direct Food Additive
    Processed meats
  87. Indirect Food Additive
    Packaging
  88. Ischemia
    Restriction in blood supply with resultant damage or dysfunction of tissue
  89. Do Nitrates/Nitrites cause cancer?
    • Can result in formation of nitrsoamines, which are carcinogenic
    • Gastric cancer & nitrate intake à Inconclusive evidence
  90. Nitrate Supplements and Teens
    • Similar to amount found in 150-250g green leafy vegetables
    • Significant reduction in resting blood pressure
    • Similar bp reduction as DASH diet controls
    • Modulate risk to cardiac and liver ischemia
  91. Methemoglobinemia and Agriculture
    Soil with nitrates infects well water
  92. Methemoglobinemia Symptoms
    • Oxygen deprivation with cyanosis
    • Cardiac dysrhythmias
    • Circulatory failure
    • Progressive central nervous system effects (Mild dizziness and lethargy to coma and convulsions)
  93. Methemoglobin
    • Nitrite combines with hemoglobin (Fe2+)
    • Cannot carry oxygen
    • Most common in infants < 4 months of age, but can be diagnosed up to 1 year
    • -Does not affect breast fed babies
  94. World Cancer Research Fund & American Institute for
    Cancer Research
    Limit intake of red meat and avoid processed meats
  95. Red Meat and Processed Meat
    • Increase colorectal cancers
    • Convincing evidence
  96. Cantonese-Style Salted Fish
    • Increases nasopharynx cancers
    • Probable evidence
  97. Red Meat, Processed Meat, and Fish
    • Foods containing iron, smoked foods, and grilled (broiled) or barbecued (charbroiled) animal foods increase several cancers in digestive tract, lung, pancreas, prostate, and endometrium
    • Fish and foods containing vitamin D decrease colorectal cancers
    • Limited suggested evidence
  98. AICR and Processed Meats
    Any meat that has been cured or has food additives
  99. 300 g (11 oz) red meat
    Little to no processed meat
    Public recommendation amount of red and processed meats per week
  100. 500 g (18oz) red meat
    Little to no processed meat
    Personal recommendation amount of red and processed meats per week
  101. Meat Intake & Mortality Study
    • 545,000 participants
    • Ages 50-71 (AARP members)
    • 10 year follow-up
    • Evaluated red, white and processed meats as risk factors for mortality, including cancer and CVD
  102. Cancer 22%
    CVD 27%
    Red Meat Increased Risks for Males
  103. Cancer 20%
    CVD 50%
    Red Meat Increased Risks for Females
  104. Cancer 12%
    CVD 9%
    Processed Meat Increased Risks for Males
  105. Cancer 11%
    CVD 38%
    Processed Meat Increased Risks for Females
  106. Results of Meat Intake & Mortality Study
    • High white meat associated with a small decrease in total and cancer mortality
    • Limit red and processed meat intake to decrease cancer risk
  107. Total meat consumption
    Processed / Salt meat consumption
    Total saturated fat intake
    What needs to be reduced in the world?
  108. Benefits of Meat Consumption
    No benefit to most processed meat consumption (aside from tastes)
  109. Red meat, white meat, processed meat, and dairy
    Increased Global Demand of Animal Foods
  110. China and India
    Who consumes the most meat?
  111. Wheat and corn prices doubled
    Livestock use 15-23% of global water
    55% of erosion process
    37% of pesticides applied
    50% of antibiotics consumed
    33% discharge N & P to surface water
    Livestock produce 18% of greenhouse gases
    Problems with Global Consumption of Meat
  112. Vegetables
    Some water supplies (municipal and well)
    Nitrates Main Source
  113. Host defense against GI pathogens (immunity)
    Modulator of platelet activity (blood clotting)
    Nitrate Benefits
  114. Tongue naturally has bacteria that convert nitrate to nitrite
    Nitrite is concentrated in the saliva
    Ascorbic acid presence
    Speeds up nitrate to NO conversion
    Hinders nitrosamine production
    NO (nitric oxide) is produced which is beneficial
    Nitrate Metabolism
  115. Methaemoglobinaemia
    Carcinogenesis
    Nitrate Possible Harms
  116. Methaemoglobinaemia
    • Occurs in infants exposed to too much nitrate
    • Usually from bacteria-contaminated well water in agricultural areas
    • Rare in children and adults
  117. Carcinogenesis
    • By being converted to nitrite, then nitrosamines
    • BUT, main source of nitrate is vegetables, which are protective against cancers
    • Studies not always consistent
  118. Nitrate to Nitric Oxide
    Potent vasodilator, inhibits platelet aggregation, important in cell signaling, antimicrobial activity
  119. Nitrate to Nitrate Host Defense
    • Acid alone is bacteriostatic (not killed)
    • Acid + nitrite is bacteriocidal (dead)
  120. E. coli 0157
    Became a major human pathogen AFTER regulations to prevent addition of nitrate to foods
  121. Nitrate and Cardiovascular Disease
    • Fruits and vegetables
    • Vitamins, minerals, but maybe “NO” helps, too
    • When converted to “NO” or converted further to “thiols” may be potent vasodilator and inhibits platelet aggregation
  122. Nitrate and Gastroprotective
    • (when converted to “NO”)
    • Enhanced gastric emptying
    • Promotes microcirculation in stomach
    • Natural defense against H. pylori
  123. AICR/WCRF
    Limit intake of red meat and avoid processed meat
  124. Sinha R et al
    These results complement the recommendations by the American Institute for Cancer Research/World Cancer Research Fund to reduce red and processed meat intake to decrease cancer incidence
  125. Popkin B
    • Consume small to moderate amounts of red meat
    • Moderation in consumption
  126. 2010 DGA
    Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry
  127. Triglycerides: 95% of lipids in foods
    Phospholipids: example: lecithin
    Sterols: example: cholesterol
    3 Types of Fat (Lipids)
  128. Soybean, cottonseed, corn, palm
    Main sources of fat (lipids)
  129. Fat Soluble Vitamins
    Vitamins D, A, K, E
  130. Essential Fatty Acids
    Linoleic and linolenic
  131. Triglycerides
    Esters of glycerol and fatty acids
  132. Monounsaturated Fats
    • Good fats
    • High oleic sunflower
    • Vegetable oil
  133. Steeric Acid
    • Cholesterol neutral
    • One good saturated fat
  134. Chemical Properties of Fat
    • Length of carbon chain
    • Degree of unsaturation
    • Distribution of fatty acids
    • Cis-trans configuration
    • Crystal state of fat
  135. Physical Properties of Fat
    • Rheological properties
    • Thermal properties
    • Processing behavior
    • Post-processing and shelf stability
  136. Rheological Properties
    • Viscosity, plasticity, spreadability, hardness, stringiness
    • Used pie crusts and biscuits (plasticity)
  137. Thermal Properties
    • Melting, softening point
    • Chocolate melts at body temperature
  138. Processing Behaviors
    • Heat stability, viscosity, crystallization, aeration
    • Liquid oils won’t hold up in certain foods
  139. Post-Processing and Shelf Stability
    • Physical, chemical, microbiological
    • Saturated fats last
  140. Approval of Fat Replacers
    • GRAS petitions to FDA (most)
    • Food Additive (e.g. Olestra originally)
    • Requires extensive data on safety and intended use, and can take decades
  141. Carbohydrate Based Fat Replacers
    Carrageenan, cellulose, gelatin, gellan gum, gels, guar gum, maltodextrins, polydextrose, starches, xanthum gum, modified dietary fibers
  142. Protein Based Fat Replacers
    Whey protein concentrate, microparticulated egg white and milk protein (Simplesse)
  143. Fat Based Fat Replacers
    Caprenin, salatrim (Benefat), mono- and diglycerides, olestra (Olean)
  144. Examples of Carbohydrate Based Fat Replacers
    Baked goods, cheeses, frozen desserts, gravies, mayonnaise, processed meats, puddings, salad dressings, sauces, sour cream, yogurt
  145. Examples of Protein Based Fat Replacers
    Baked goods, butter, cheese, frozen dairy desserts, mayonnaise, salad dressings, sour cream
  146. Examples of Fat Based Fat Replacers
    Baked goods, cheese, chocolate, chocolate, confections, margarine, salted snacks, sour cream, spreads
  147. Direct Fat Removal
    • First used in rush to comply with nutritional recommendations in 80’s
    • OK for milk, some dairy products, some processed meat… but not much else
  148. Formulation Optimization
    • Water replaces fat in higher fat products
    • Optimization with functional ingredients to stabilize product
  149. Processing Technology
    Vary processing conditions (time, temp, pressure, etc.) to cause interactions in ingredients or change functionalities
  150. Holistic Approach
    No single replacer can do it all
  151. Fat Replacer
    Overall term for any ingredient used to replace fat
  152. Fat Substitute
    • Synthetic compound used as direct 1-for-1 replacement
    • Similar chemical structure to fat but resists digestion in gi
  153. Fat Mimetic
    • Non-fat substance requiring high water content
    • Replace some (not all) functions of fat in products
  154. Low-Calorie Fat
    Synthetic triglyceride combining unconventional fatty acids resulting in reduced calorie content
  155. Fat Extender
    System of ingredients used in combination with standard fats or oils to achieve fat reduction
  156. Passive Fat Replacing
    • Just mix in (whole milk to 2%) no need for fillers or emulsifiers
    • Adjust protein, water, carbohydrate ratio
    • Add low levels of texture modifying ingredients
  157. Active Fat Replacing
    • Aggressively mix in
    • Substitute or mimetic
    • Physical replacement
    • Modify nonfat comp.
    • Control moisture
  158. Water
    • Cheap
    • Label friendly
    • Usually free from regulatory constraints
    • Doesn’t affect calories from fat
    • Often used with fat mimetics to give smoother body (proteins/carbohydrates)
    • Can shorten shelf-life
    • Supplemented with high water binding ingredients (maltodextrin, polydextrose, emulsifiers)
    • May require preservatives
  159. Lipase
    • Enzyme that digests foods
    • The more carbons, the less energy received
    • Can’t break of fatty acid, therefore no digestion of it
  160. Olestra
    • “Sucrose fatty acid polyester”
    • Formed by chemical reactions of sucrose with 6 to 8 fatty acids
    • Made from edible fats and oils
    • Different types of fatty acids give the fat different properties (e.g., solid vs. liquid)
    • Can use for frying
    • Approved for “savory” products first
    • Not absorbed or metabolized (no calories)
    • Just passes through
    • Potential to cause GI problems (cramping, reduce absorption of nutrients)
    • Old label states: GI problems AND vitamin additions
    • NEW label: only states vitamin additions
  161. Olestra and Vitamins
    • Must add for each 10 grams of Olestra in a food:
    • –0.34 x RDA for vitamin A
    • –0.3 x RDA for vitamin D
    • –0.04 x RDA for vitamin E
    • –1.0 x RDA for vitamin K
    • Doesn’t affect absorption of carbohydrates, proteins, or water-soluble vitamins and minerals
    • Also, not toxic, genotoxic, teratogenic
    • Approval controversial, however
  162. Olestra and Vitamins Study
    • 90 adults, RCT, double-blind, parallel
    • Olestra: 0, 8, 20 or 32 g/day for 8 week
    • With nutritionally adequate diet
    • Also, gave 20 ug vitamin D (800 IU), so difficult to assess changes in vitamin D status
    • Measured effect on blood levels of vitamins
    • –Carotenoids and vitamin E most effect
    • Measured GI symptoms
  163. Trans Fats
    • Hard to replace
    • Especially in “shortening” (solid fat)
    • –Solid fats desirable in baked products
    • –Saturated fats replaced by hydrogenated fats when health issues surrounding sat fat became known
    • Increase heart disease risk
    • –Increase LDL cholesterol levels, lower HDL
    • Major source of dietary is partially hydrogenated vegetable oils
  164. FDA
    Who regulates color additives?
  165. Color Additive
    Any dye, pigment or substance that can impart color when added or applied to a food, drug, cosmetic or to the human body
  166. Color Additives and FDA
    • NOT OK to use color additives to mask quality or deceive consumer
    • Deems “synthetic colors” safe, but consumer groups feel most not safe, are mainly in “junk food,” so avoid
  167. Color Additives in 1900
    About 80 man-made additives in foods, but no regulations regarding purity or uses
  168. 1906 Food and Drug Act
    Permitted 7 man-made color additives; voluntary certification program
  169. 1938 FD&C Act
    Made certification process mandatory for color additives
  170. 1960 Color Additive Amendment
    Delaney Clause deems products with color additive with carcinogenic effect in laboratory tests can’t be approved for use
  171. 1990 Nutrition Labeling and Education Act
    Certifiable color additives must be listed by its common name
  172. Certifiable
    Exempt from Certification
    Color Additives are classified as either...
  173. Certifiable Color Additives
    • Synthetic color additives
    • Each batch chemically tested by manufacturer and FDA --known as “color additive certification”
    • Approval process assures safety, quality, consistency and strength of each batch prior to use in foods
    • 9 colors approved for use (7 used in foods)
  174. Exempt from Certification
    • Come from a “natural” source, don’t have to go through the process of FDA
    • Include pigments derived from natural sources
    • -Vegetables, minerals or animals, herbs, spices, man made counterparts of natural derivatives
  175. Certified Color Additives
    • More intense colors than most naturally derived color additives
    • –Can be added in smaller quantities
    • More stable
    • Provide better color uniformity
    • Easier to produce and less expensive
    • Available in wide range of hues
    • Generally do not impart undesirable flavors to foods
    • Not “natural” concerns some consumers
  176. Red No. 40- Allura Red
    • Most commonly used
    • Not carcinogenic or teratogenic
  177. Red No. 3- Erythrosine
    • 4 iodine atoms
    • Low toxicity because poorly absorbed
    • Side effects- thyroid problems because of iodine not color
  178. Yellow No. 5- Tartrazine
    • Second most commonly used
    • Hypersensitivity reactions (asthma, hives, migraine)--elevates histamine
  179. Yellow No. 6- Sunset Yellow
    Some hypersensitivity
  180. Blue No. 1- Brilliant Blue
    Poorly absorbed
  181. Blue No. 2- Indigotine
    • Actually occurs in nature
    • Poorly absorbed
  182. Green No. 3- Fast Green
    • Used very little
    • Poorly absorbed
  183. Orange B
    Used in sausage & hot dog casing
  184. Citrus Red No. 2
    • Used on skins of oranges
    • Carcinogenicity concerns
    • Do not use orange zest
  185. Annatto and Other Cartenoids
    • Annatto used in dairy and other foods
    • Crocetin found in spice saffron
    • Capsanthin from paprika
    • Turmeric has some safety concerns
    • –Yellow
    • Orange/Yellow/Brown color
  186. Cochineal
    Red color extracted from certain insects
  187. Cartenoids
    • May act as anticarcinogens
    • Margarine, cheese, baked goods
  188. Anthocyanins
    Fruit juices & grape skin extracts
  189. Betacyanins
    • Beets, chard, cactus fruits and pokeberries
    • Pink lemonade
  190. Chlorophyll
    • Green from leaves, veggies, and fruits
    • Not generally allowed in US
  191. Carbohydrate Browning
    • Caramel color
    • Most widely used of all food colors
  192. Safety of Color Additives
    • Classification has no bearing on overall safety
    • Both classifications are subject to rigorous standards of safety prior to approval for use in foods
    • –No huge concerns
    • Uncertified colors may lack precise chemical definition and composition, so difficult to test toxicity
  193. Labeling of Color Rules
    • “Artificially colored” or “artificial color added”
    • Sometimes can use common name of color
    • “Colored with _____” or “_____ color”
    • “Natural” cannot be used, even if color from nature; lets consumer know product has some color added, certified or uncertified
    • Don’t want consumers to think it is safer just because it says natural
  194. Approval Process for Food Additives
    • First petition FDA for approval
    • Must provide convincing evidence that the additive performs as intended
    • Often includes animal studies using large doses for long periods
    • Human studies may also be submitted
  195. Toxicity Testing
    • 1. One subchronic feeding study of 90 days duration in a non-rodent species
    • 2. Acute toxicity in rats
    • Give a lot in a short period of time
    • 3. Chronic feeding studies in at least two animal species
    • 4. One teratology test
    • 5. One multigeneration reproduction study using mice
    • 6. One mutagenicity test
  196. Approval Decisions
    • 1. Composition and property of the substance
    • 2. Amount likely to be consumed
    • 3. Probable long-term effects
    • 4. Safety factors
    • Once approved, FDA issues regulations that may include:
    • Types of foods allowed in
    • Maximum amounts
    • How identified on food labels
  197. Adverse Reaction Monitoring System
    • Computerized database operated by FDA
    • Monitors and investigates complaints believed to be related to food and color additives; specific foods; or vitamin and mineral supplements
    • Officials decide whether reported adverse reactions represent a real public health hazard
  198. Caramelizing, smoking, roasting, braising of meat
    Types of Food Flavoring
  199. Food Flavors
    • 1000s of chemicals (fresh, processed foods)
    • Chemical names not listed on food labels
    • US labeling
    • –Natural flavors, natural flavoring
    • –Artificial flavors, artificial flavoring
    • –Spice
  200. FEMA, recommendations accepted by FDA (GRAS)
    JECFA, International
    EUROPE EU-SCF/FSA
    Who regulates food flavorings?
  201. FEMA and GRAS
    • Evaluation criteria
    • -Chemical structure
    • -Structure-activity relationships
    • -Human exposure
    • -Known inherent toxicity
    • -Metabolic fate
    • -Natural occurrence
    • Review and publish data in scientific journals
    • -Food and Chemical Toxicology
    • Some flavors banned
  202. Metabolic Fate
    How the food goes through your body and how long it stays there
  203. Challenges of Safety of Food Flavorings
    • 1000s of flavor chemicals
    • Many types: nature identical, synthetic xenobiotic (active in the body) and natural food complexes
    • How to assess “exposure”
    • Lack of toxicological data on each flavor
    • Intake of some so low à no economic base to support comprehensive safety testing
    • $2 M to test one flavor > $$ billions to test all
  204. History of use
    Consumption ratio if applicable (synthetic divided by natural intake)
    Intake
    Toxicological data on the chemical or on structurally related chemicals
    Metabolism: known or forecast on basis of structurally related compounds
    What goes into safety assessment of food flavorings?
  205. China- 3200
    Japan- 3000
    US- 2000
    Which country has the top amount of food flavorings?
  206. Disappearance in the market place
    Food surveys
    Over- or under-estimate?
    How to assess expose (intake) of food flavorings?
  207. Infants, “mint-eaters,” diabetics
    Populations of Concern Consuming Food Flavorings
  208. Glutamate
    • ¨Needed for normal digestion and GI function, receptors in taste buds, gi tract (e.g., stomach)
    • ¨Naturally in protein-foods
    • ¨Seaweed and other plants, fermentation processes
    • ¨Body uses same as “natural” glutamate (amino acid)
  209. Sodium salt of glutamate (common amino acid)
    MSG=
  210. 0.55 g/day
    Taiwan: 3 g/day
    Average US Intake of Glutamate
  211. GRAS since 1958; many studies document safety
    Who regulates glutamates?
  212. Meats, poultry, seafood, snacks, soups, stews
    Flavor enhancer, “umami,” savory, meaty taste, helpful in reduced-sodium or reduced-fat products
    What are glutamates added to?
  213. Tomatoes, peas, parmesan cheese, and corn
    What can be avoided to lower "free glutamate intake"?
  214. American College of Allergy, Asthma, and Immunology said NO
    ¨Study by Simon, double-blind, placebo-controlled 65 subjects w/ chronic uticaria consuming 2.5 grams (2,500 mg) MSG daily- NO positive allergy reactions
    Is MSG a food allergen?
  215. Link in poorly controlled studies
    BUT … well-designed double-blind challenges:
    None found positive reactions to MSG
    FASEB & FDA reviews found no data supporting asthma-MSG link
    Is MSG related to asthma?
  216. False Facts About MSG and Children
    • Children metabolize MSG slower than adults
    • Role in ADHD, other behavior disorders
  217. Research in Iowa: Children and MSG
    • Children as young as 1 yr. metabolized MSG as well as adults
    • No increase in blood glutamate levels in children (at 0, 25, 50 mg/kg)
    • No effect found on ADHD or other behavior problems
  218. MSG and Pregnancy
    • Amino acid concentrations are higher in fetus regardless of mothers’ intake
    • Regulated by placenta and fetal liver
    • Difficult for diet to increase blood glutamate
    • But injections of MSG increase blood levels (e.g., animals)
    • During lactation (breast feeding) consumption of 100 mg per kg of body weight per day
    • No increase in glutamate in breast milk
    • No effects on infant consumption of glutamate
  219. Pitkin Study of MSG and Pregnancy
    • Pregnant monkeys injected up to 220 mg MSG per kg
    • But no increase in fetal glutamate levels
    • Placenta helps block glutamate entry
  220. American Academy of Pediatrics Committee on Drugs (1993)
    MSG has no effect on lactation and is no risk to infants
  221. Glutamate and the Brain
    • Glutamate involved with neurotransmitters
    • Inhibit or excite nerve or target cells (endocrine, muscle cells)
  222. Studies of Glutamate and the Brain
    • Injections of 0.5 to 4 grams/kg body weight= brain lesions in rats, but extremely high doses not typical of human intake
    • Many other studies: No harmful effects on brain even at high dietary doses
    • Review of 20 studies by Fernstrom: Dietary glutamate does not impair brain function
    • FASEB report: NO serious long-term neurological problems
    • e.g.: Huntington’s, Lou Gehrig’s or Alzheimer’s Disease
  223. Chinese Restaurant Syndrome
    • Coined by: Robert Kwok in 1968
    • Anecdotal symptoms- numbness in back of neck, pressure in face and upper chest, abdominal pain, headache
    • CDC: <1% of food related complaints
    • Many studies conducted since 1968
    • Many targeted those who believe to have MSG reactions in past
  224. MSG Challenge Study
    Multicenter, double-blind, placebo-controlled, multiple-challenge evaluation of reported reactions to monosodium glutamate.
  225. Single-Blind
    • Researcher knows but patient doesn’t
    • Problem may be researcher might slip up saying what the patient is taking
  226. Methods for MSG Study
    • Recruited people
    • Newspaper adds in Boston, Chicago and LA
    • Prior reaction to Asian food
    • Telephone screening:
    • Reported >2 of 10 symptoms typical of CRS
    • 18-60 years old
  227. Design of MSG Study
    • Multi-center, double blind, placebo, cross-over design, multiple-challenge evaluation
    • Outpatient clinics, 3 cities
    • 4 Protocols: A,B,C, and D
    • Positive response: 2+ symptoms in each phase
    • Response reproduced in separate challenges
  228. Data Collection of MSG Study
    • MSG packages/pills randomized and sent to each site
    • Physical Exam:
    • BP, pulse, skin inspected, every 30 minutes
    • Respiratory rate in those with symptoms
    • A and B: if positive, then symptoms recorded every 15 minutes for 2 hours
    • C and D: blank sheet for patient to record symptoms every 15 minutes for 2 hrs.
    • Monitor for 2 to 4 hours depending on symptoms
  229. Protocol A in MSG
    • N = 130 people, overnight fast, start 8-9 am
    • 0 or 5 g MSG, citrus flavored beverage
    • Random: MSG or placebo over 2 days
  230. Protocol B in MSG
    • N = 69, had 2+ symptoms in Protocol A
    • 4 challenges randomly assigned on 4 different days in a citrus drink:
    • 0, 1.25, 2.5 or 5 g of MSG
  231. Protocol C in MSG
    • 2+ positive reactions to 5 g MSG in A and B but not to placebo
    • Purpose: Reproducibility of results
    • Eliminate possible bias
    • 2 sets of challenges for 4 days
    • 2 days: placebo pill (sucrose)
    • 2 days: 5 g MSG pill
  232. Protocol D in MSG
    • Determine # of symptoms to 5 g MSG with food
    • In those with consistent positive previous responses to MSG but not placebo
    • Only 2 people qualified
    • 6 challenges, diff. days
    • 3 capsules 5 g MSG
    • 3 capsules of placebo
    • With breakfast, water
    • RESULTS: 0 reproducible symptoms (see last column)
  233. Findings for Protocol A in MSG
    • Statistically significant difference between placebo and MSG
    • But, problems with placebo:
    • Inconsistency: those given placebo first responded more
    • Taste of MSG not disguised well
  234. Protocol A and B in MSG
    • Only 19 responded only to MSG in both A and B (16%)
    • Half of those who responded in A
    • Suggests inconsistency of MSG response
  235. Protocol C and D in MSG
    • Few subjects (C n=12, D n=2)
    • C: tested with pills to ensure no taste bias
    • D: With light meal
    • Inconsistent findings
  236. MSG responses higher than placebo when given without food
    Responses not consistent
    Reactions not persistent or serious
    Does 5 g of MSG create reproducible symptoms for those who believe themselves reactive?
  237. Caffeine
    • —1958, FDA identified it as GRAS substance
    • —1987, FDA reaffirmed the intake is safe for moderate consumption and has no increased risk for poor health
  238. Coffee
    —Cocoa beans
    —Kola nuts
    —Tea leaves
    —Chocolate
    —Coke (added)
    —Some headaches medications and pain remedies
    Sources of Caffeine
  239. 120 mg/day
    Primarily through coffee, tea
    Caffeine Intakes for Adults
  240. 14-22 mg/day
    Primarily chocolate and soft drinks
    < 2.5 mg/kg body weight per day
    Caffeine Intakes for Children
  241. <300 mg a day
    Moderate Consumption of Caffeine
  242. General toxicity
    Cardiovascular effects (heart)
    Behavioral changes
    Increased cancer risk
    Lower fertility
    A healthy dose of caffeine has no effect on..
  243. Safe: < 150 mg/day or < 1.5 cups coffee/day
    Concern: > 300 mg/day or > 3 cups coffee/day
    Caffeine Intake for Women of Childbearing Age
  244. Caffeine increased risk of fetal growth restriction
    —Tea major source of caffeine for most women
    —Food Standards Agency issued policy statement recommending < 200 mg caffeine/day during pregnancy
    Caffeine and Pregnancy
  245. —Maximum blood level reached by 1-1.5 hrs after ingestion
    —Distribution in tissues
    Across blood-brain barrier and placenta
    Throughout the body, including blood, breast milk, and urine
    Metabolism of Caffeine
  246. Adenosine
    Binds to certain receptors in the brain, that can cause drowsiness by slowing down the activity of nerve cells; in the brain the blood vessels dilate, perhaps allowing more oxygen in the brain while we sleep
  247. Caffeine and the Brain
    • To a nerve, caffeine resembles adenosine
    • Except when caffeine binds to a nerve cell it blocks adenosine, so we don’t the calming effect; rather the nerve cell stays in more active mode and causes alertness; caffeine also causes the blood vessels to constrict
  248. Opening of the bronchials tubes (more breathing)
    Heart beats fasters
    Blood vessels increase flow to the muscles
    Blood pressure can rise
    Muscle become more ready for action
    Side Effects of Caffeine
  249. 3-7 hours
    Half-Life of Caffeine
  250. Newborns: 50-100 hrs
    Oral contraceptives: half-life doubles
    Longer Caffeine Half Life For...
  251. Smokers: elimination rate doubles
    Females: 20-30% shorter than males
    Shorter Caffeine Half Life For...
  252. Steady increase
    4 hrs in first trimester to 18 hrs in third trimester
    Half-Life of Caffeine and Pregnancy
  253. Toxicity Symptoms of Caffeine
    • Nervousness
    • Irritability
    • Insomnia
    • Tachycardia
    • Diuresis
    • Elevated respiration
  254. Toxicity of Caffeine
    • —Rarely results in death
    • —Acute lethal dose ~ 10 g/day for adults
    • Literature cites varying levels of toxicity for individuals
    • 0.040 g/12 oz soda x 250 sodas = 10 g
    • 0.2 g/diet pills x 50 diet pills = 10 g
  255. CHD and Caffeine
    • Control groups show caffeine is related to this
    • Over time though, not much of a relationship between caffeine and this
  256. Cholesterol
    • Caffeine not responsible for increase
    • Filtered coffee does not change cholesterol levels
    • Boiled coffee does change cholesterol levels- retains a lot of the chemicals in coffee
  257. Caffeine and Pregnancy Problems
    • Difficulty conceiving
    • Spontaneous abortion
    • Fetal growth
    • Preterm delivery
    • Birth defects
    • Lactation (<1 c/day)
  258. Safe: < 150 mg/day
    < 200 mg/day (FSA, 2008)
    —Concern: > 300 mg/day
    Safe and Harmful Amount of Caffeine for Pregnant Women
  259. Attention Test & Caffeine
    Modest consumption of 32 mg of caffeine increased alertness and cognitive function among well-rested individuals
  260. Mental Performance of Caffeine
    • —75-150 mg of caffeine improved performance after acute sleep restriction
    • —200-600 mg of caffeine improved mental performance after one or more nights without sleep
  261. Rowing & Caffeine
    • 6 mg of caffeine per kg of body weight resulted in fastest rowing times during a 2000 meter trial
    • Dose-dependent improvements of female athletes
  262. Cycling
    • Double-blind study
    • Replaced sports drinks with commercial soft drinks
    • Small doses of 1.5 mg/kg are beneficial
  263. 1 Tablet of No doze
    8 oz Red bull
    8 oz Haagen-Dazs Coffee Ice Cream
    12 oz Coke
    • Rank these from most to least caffeine
    • Haagen-Dazs Coffe Ice Cream
    • Red bull
    • Coke
    • Tablet of no doze
  264. Micronutrients in Coffee
    • Magnesium
    • 1-5% RDA for adult men
    • Potassium 1-2% AI for adults
    • Niacin
    • 6-18% RDA for adult men
    • Vitamin E
    • 0.1% RDA for adults
  265. Caffeine in Coffee
    • Metabolized in liver
    • Stimulatory
    • —Cafestol and kahweol
    • -Cholesterol-raising factors
    • -Boiled coffee versus filtered coffee
    • —Chlorogenic acid (ester of caffeine)
    • Antioxidant activity in vitro
    • More research needed for in vivo
  266. Long Term Effects of Coffee
    • Consumption of coffee and decaffeinated coffee can reduce the risk of diabetes
    • Caffeine consumption may increase metabolic rate up to 24 hours after consumption
    • May help individuals achieve weight loss, which may reduce the risk of diabetes
  267. Short Term Effects of Coffee
    • Negative effects of caffeinated coffee include:
    • Pressor effect (increased systolic and diastolic BP)
    • Decrease in glucose tolerance and insulin sensitivity
  268. Parkinson's Disease
    • —2nd most common neurodegenerative disorder
    • —1% of people 60+ years old
    • —May decrease risk in men, but not women
    • Caffeine (or other chemicals in coffee) may protect against neurotoxicity
    • Animal studies show caffeine protects neurons against damage from various chemicals (e.g., pesticides)
    • Caffeine may protect dopaminergic neurons from degenerating
    • May improve motor function
    • More research will provide more answers
  269. Coffee and Miscarriages
    • Coffee consumption and nausea
    • Results from increasing hormone levels in a normal pregnancy
    • Self-regulating mechanism
    • Link between caffeine consumption and miscarriage might be a misconception
  270. ADHD
    • Developmentally inappropriate
    • Impulsive
    • Hyperactive
    • Neurobiological disorder
    • >9% “ever” in school age children
    • Persists childhood through adolescence
  271. Statistics of ADHD
    • 5.4 million children 4-17 years of age have ever been diagnosed with ADHD (2007)
    • Diagnosis of ADHD increased an average of 3% per year from 2003 to 2007.
    • Higher in boys
    • Higher with poverty, other adverse social conditions
  272. Symptoms of ADHD
    • Fidgeting
    • Interrupts or intrudes upon others
    • Difficulty staying seated, waiting, taking turns
    • Run, climb, talk excessively
    • Difficulty doing activities quietly
    • Acts as driven by a motor
  273. Diagnosis of ADHD
    • No one test
    • Comprehensive evaluation
    • –Rule out other causes
    • –Determine presence/absence of co-existing conditions
    • History and clinical assessment
    • Parents
    • Teachers
    • Child
    • Clinicians (checklists for rating symptoms)
  274. DSM-IV
    Who decides ADHD
  275. Predominantly hyperactive-impulsive
    Most symptoms (six or more) are in the hyperactivity-impulsivity categories
  276. Predominately Inattentive
    The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present
  277. Combined hyperactive-impulsive and inattentive
    • Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present
    • Most children have the combined type of ADHD
  278. Genetics
    Low birth weight
    Pregnancy and/or delivery complications
    Risk Factors for ADHD
  279. Toxins: lead, mercury, polychorinated biphenyls (PCBs)
    Fetal exposure to alcohol and maternal smoking
    Psychosocial adversity
    Environmental Risk Factors for ADHD
  280. Criteria to Evaluate Studies of ADHD
    • 1.Homogeneity of sample
    • 2.Randomization to treatment
    • 3.Crossover designs with subjects serving as own control
    • 4.Counterbalanced treatment/challenge order
    • 5.Double-blind/placebo-controlled challenges
    • 6.Placebo and challenge indistinguishable
    • 7.**Verification of effectiveness of blinding particularly for behavioral raters
    • 8.Appropriate control outcome measurements
    • 9.Age-appropriate outcome measures
    • 10.Use validated measures (i.e. detect behavior differences/sensitive to treatment)
    • 11.**Confirmatory sources of outcome data (parents, teachers, testing, etc.)
  281. Food Additives and ADHD
    • DB PC RCT, crossover design, additives in beverages (300 ml or 625 ml/day)
    • Children aged 3 yr and 8/9 yrs
    • Mix A: 20 or 25 mg of colors, 45 mg sodium benzoate
    • Mix B: 30 or 62 mg of colors, 45 mg sodium benzoate
    • Placebo: beverage
    • During 6 wk study kids avoided the additives in their usual diet
    • Wk1 withdrawal
    • Wks 2, 4 and 6 – A, B, or placebo in various orders
    • Wks 3 and 5 “washout”
    • Some ratings tests assessed kids only 14-24 minutes/week
    • Rating tests done by teachers, parents, and kids
  282. Azorubine (Carmoisine)
    • Delisted in 1963 because no party was interested in supporting the studies needed to establish safety
    • This color additive has never been approved by FDA for use in food
  283. Quinoline Yellow
    US is D&C Yellow No. 10 and is approved for use in coloring drugs, cosmetics, and contact lenses, but not food
  284. Ponceau 4R
    Not been approved by FDA for any use
  285. Allura Red
    FD&C Red No. 40 approved for food, drugs, and cosmetics
  286. Tartrazine
    • In the U.S., this color is certifiable as FD&C Yellow No. 5 and is approved for use in coloring food, drugs, and cosmetics
    • Known to cause allergic-type reactions (e.g., hives) in small subset of population; must be declared as an ingredient when used to color food
  287. Sunset Yellow
    FD&C Yellow No. 6 and is approved for use in coloring food, drugs, and cosmetics
  288. Sodium Benzoate
    A preservative (antimicrobial), US is GRAS
  289. Study Results of Food Additives and ADHD
    • Mix A had greater effect in 3 yr old compared to 8/9 yr old children
    • No significant result for Mix B in 3 yr old children
    • Adverse effect found in 8/9 yr old children with Mix B
    • Artificial color and/or preservative increased hyperactivity in children
  290. Problems with Food Additives and ADHD Study
    • 1.Used additives not approved in US (UK study)
    • 2.All additives given together (not in isolation)
    • 3.Beverage not well described
    • 4.Placebo beverage not described
    • 5.No rationale for amounts of additives
    • 6.Extensive data analyses and manipulations that can’t really be followed
    • 7.Measure of “global hyperactivity aggregate” not a widely used or known measure
    • 8.European Food Safety Authority found data analysis flawed
    • Review for FDA (2011) also found study flawed
  291. Flaws with Food Additives and ADHD Study
    • 1. Questionable accuracy of teacher pre-study behavioral ratings recalling behavior over a period of 6 months
    • 2. Questionable use and accuracy of pre-study behavioral ratings by participating parents
    • 3. Disproportionate increases were made in levels of artificial colors in the mixes (A and B) used for the 8/9YO children relative to the mixes (A and B) used for the 3/4YO children, and no adjustments were made to levels of sodium benzoate in either Mix A or B for either age group of children
  292. Flaws with Food Additives and ADHD
    • 4. Composition of placebo is unclear
    • 5. Parents were not asked about the blinding
    • 6. Timing of juice consumption at home
    • 7. Precision of recall data in conduct of weekly parent/teacher ratings and availability of standard ratings
    • 8. Reliability of modified Classroom Observation Code (COC) used in 3/4YO children is unclear
  293. Flaws with Food Additives and ADHD Study
    • 9. Questionable adequacy of duration used for classroom observation
    • 10. Model 1 is not useable for analysis of data.
    • 11. In the “acute challenge phase” of this study the disaggregated behavior measures comprising the Hyperactivity Index (HI) were not analyzed separately
    • 12. The Mixed Model analyses of the “acute challenge” data did not appear to control for potential confounding factors
  294. Biofeedback & ADHD
    • Visual and auditory stimuli provide information about psychophysiological process
    • Some evidence for efficacy
    • Some families might prefer over medications
    • Requires high motivation
    • –Large burden on families
  295. Play Attention & ADHD
    • Computer-based video game-like system to improve learning, behavior, etc
    • –Learning forms new neural networks
    • Expensive, requires large amount of training
    • Efficacy not clear
  296. Diet Modification & ADHD
    • Feingold/additive free diet; oligoantigenic diet; sugar restriction diet. Appealing for parents.
    • This article reviews only PC DB RCT with clear outcome measures
    • –Cross-over design
    • –Separate comparison group
  297. Feingold/Additive Free Diet
    • Diet uses no artificial colors, flavors, additives, and preservative diet
    • Greater physiological activity in hyperactive children after ingesting a food additive drink.
    • Older studies not as well designed
    • Newer studies: select children with history of atopy (allergy): see ↑ behavior symptoms with challenge to artificial colors (tartrazine) and preservatives (calcium propionate)
    • High drop out rates a concern
  298. Oligoantigenic diet (OAD)
    • Hyperactivity results from food allergy or other condition (celiac disease)
    • No additives, dyes, dairy products, wheat, corn, yeast, soy, citrus, egg, chocolate, and nuts
    • Studies usually have 3 or 4 phases
    • 1.4 weeks of this
    • 2.Excluded foods gradually reintroduced
    • 3.Placebo-controlled, crossover food challenge for reproducible
  299. Sugar Elimination Diet
    • Refined sugars have an adverse effect on behavior??
    • Very few studies support this
    • Tension-fatigue syndrome:
    • –Hyperactivity resulted from allergy to refined sugar (can’t be allergic to sugar!)
  300. Fatty Acid Supplementation
    • AA, DGLA, EPA, DHA in neuronal membrane
    • Deficiencies in certain unsaturated fatty acids may be associated with ADHD
    • Evidence mixed on benefits of supplements.
    • Different baseline, doses, diagnoses in children, small studies
    • May need long-term or high dose of supplementation (or deficient children)
  301. Emerging Controversial Therapies for ADHD
    • Homeopathy – poor evidence
    • Yoga
    • Massage
    • Green outdoor settings
  302. Research in Future for ADHD
    • Understand biochemical mechanisms
    • Identify multiple food-related problems (e.g., allergies and/or specific additives)
    • Realistic doses
    • Methods: quality laboratory based and parental and teacher rating scales
    • Qualified research team
  303. Bisphenol A (BPA)
    • Industrial chemical
    • In polycarbonate plastics and epoxy resin
    • Avoid containers marked #7
  304. Polycarbonate Plastics
    • Hard, clear plastics
    • Baby bottles, reusable water bottles, sports equipment, medical and dental devises, dental fillings/sealants, household electronics
    • Heat resistant and durable
  305. Epoxy Resins
    Inside coating of food and beverage
  306. Exposure of BPA
    • Mainly food and drinking water
    • Smaller amounts:
    • Some dental fillings/sealants, skin contact, inhaling
    • Skin contact and inhalation usually from occupation
  307. Who is exposed to BPA
    • > 2 million metric tons worldwide each year
    • NHANES 2003-2004: > 90% of peopled exposed
    • Most exposed to levels less than the 50 µg/kg/day tolerable daily intake (TDI) set by FDA and EPA
    • Infants, children most concern
  308. Health Effects of BPA
    • Large amounts acutely toxic
    • Low exposure --> controversial
    • Endocrine disruptor: synthetic chemicals that disrupt body’s natural hormones
    • Humans, wildlife
  309. Infants
    • Most at risk
    • Fetuses, infants, and children excrete BPA less efficiently than adults
    • BPA can cross placenta
    • Irreversible endocrine disrupting events happen before birth
    • BPA in linings of formula containers and bottles
  310. How to Avoid BPA
    • Discard worn or scratched plastic baby bottles, cups, or food containers
    • Do not put very hot liquid into products that contain BPA
    • Check labels on bottles and food containers to ensure they are microwave and dishwasher safe before using them in that capacity
  311. 1
    Polyethylene Terephthalate (PET)
  312. 2
    High Density Polyethylene (HDPE)
  313. 3
    • Some have BPA
    • Polyvinyl Chloride (Vinyl)
  314. 4
    Low Density Polyethylene (LDPE)
  315. 5
    Polypropylene (PP)
  316. 6
    Polystyrene (PS)
  317. Powdered Infant Formula
    • No detectable BPA in powdered formula
    • Bottles: The six major U.S. manufacturers of baby bottles and infant feeding cups confirmed to FDA that as of January 2009, they have not manufactured these products using BPA for the U.S. market
    • -These manufacturers represent more than 90% of U.S. market
  318. FDA's Steps to Reducing Exposure of BPA
    • Supporting industry’s actions to stop producing BPA-containing baby bottles and infant feeding cups for U.S. market
    • Facilitating the development of alternatives to BPA for the linings of infant formula cans
    • Supporting efforts to replace BPA or minimize BPA levels in other food can linings
    • Supporting a shift to a more robust regulatory framework for oversight of BPA
    • Seeking further public comment and external input on the science surrounding BPA
  319. NIH, FDA, CDC, NTP, NIEHS
    • $30 M research funding
    • Physiologically based pharmacokinetic modeling studies: rodents and nonhuman primates
    • Rodent subchronic studies
    • Rodent behavioral/neuroanatomical studies
  320. BPA and Type-2 Diabetes
    • Major BPA metabolite, mono-glucuronide, is formed in liver
    • Estradiol is important for insulin sensitivity and for b-cell function (related to diabetes)
    • BPA may induce oxidative stress, which has been liked to insulin resistance
  321. Methods of BPA and Health Study
    • NHANES 2003-2004 data, age 20+ years
    • Measured BPA in urine samples
    • Self-reported chronic diseases
    • Analyzed blood serum: Total cholesterol, triglycerides, LDL, HDL, glucose
    • Measured b-cell function and insulin resistance
  322. Results of BPA and Health Study
    • Individuals in highest urinary BPA quartile were nearly 2.5 times more likely to have diabetes than those in lowest quartile
    • Higher urinary BPA associated with abnormal liver enzyme concentrations
  323. Conclusions of BPA and Health Study
    • Even low-dose exposure may have adverse health effects
    • BPA may cause more health problems than previously thought
  324. Results of Chemicals and Oxidation Stress Study
    • Blood sugar higher in those at the 90th percentile for BPA (vs. < 90th percentile)
    • Some associations of BPA with chemical markers of “oxidant stress” (urinarymalondialdehyde and 8 hydroxydeoxyguanosine)
  325. Conclusions of Chemicals and Oxidation Stress Study
    • Exposure to environmental chemicals is associated with oxidative stress, which is related to insulin resistance
    • Maybe: Exposure to environmental chemicals may be contributing to worldwide epidemic of metabolic syndrome and diabetes
  326. BPA and Diabetes
    • Diabetes among fasted growing and costly chronic diseases
    • In US in past 10 yrs: prevalence more than doubled
    • $116 billion in direct medical costs
    • $58 billion in indirect medical costs:
    • Lost productivity, premature death, disability
    • 7th highest cause of death
    • Affects all body systems
  327. Negligible Concern for Toxicity of BPA
    Reproductive toxicity in adult men and women and malformations of newborns
  328. Minimal Concern for Toxicity of BPA
    Developmental toxicity for fetuses, infants, and children (effects on the mammary gland and early puberty in females, and reproductive toxicity in workers)
  329. Some Concern for Toxicity of BPA
    Developmental toxicity for fetuses, infants, and children (effects on the brain, behavior, and prostate gland)
  330. Seafood
    • Large category marine animals, live in sea, freshwater lakes, rivers
    • Examples: tuna, trout, salmon, halibut
  331. Shellfish
    Shrimp, crab, oysters, etc
  332. USDA, USDHHS, DGA
    Who regulates mercury levels in fish?
  333. Omega-3 Fatty Acids
    Fish best source of this and higher intakes of fish and fish oils linked to less heart disease
  334. Methylmercury
    • Toxic, but unavoidable, so keep low as possible by avoiding certain fish
    • High in mercury: Mackerel, swordfish, tilefish, shark
    • Low in mercury: Snapper, carp, trout, crab
    • May reduce CVD benefits of fish
  335. Fish Nutrition
    • Low in calories
    • Low in total fat and saturated fat
    • High polyunsaturated fat
    • High in omega-3 fatty acids
    • High in protein
  336. Omega-3 Fatty Acids
    • Fewer platelets clog/stick to artery walls.
    • Less hardening of vessel walls.
    • Mainly in higher fat, cold water fish:
    • Mackerel, albacore tuna, salmon, sardines, and lake trout
  337. Toxic Levels of Omega-3
    • Impair the immune
    • Prolonged bleeding times
    • Hemorrhagic stroke
    • Vessel has burst- quick action clotting
    • Oxidative damage
    • FDA recommends intake of EPA and DHA from food and supplements be < 3 g/d.
    • Only recommended for patients with heart problems and high triglycerides
    • Americans not at risk of overconsumption from seafood
  338. Mercury
    • Natural metal
    • Manmade sources
    • Released into the air and water
    • 3 Forms: elemental, inorganic, or organic (predominantly methyl)
    • Organic: fish eat methyl in water
  339. Methylmercury and Fish
    • Nearly all have traces
    • But, larger fish that have lived longer are highest
    • Swordfish, shark, king mackerel and tilefish
  340. Absorption and Distribution of Mercury
    • 95% of this in fish absorbed by GI tract and goes to all tissues (lipophilic and binds to protein)
    • 1-10% of absorbed oral dose of this in blood and 90% of blood of this in RBCs
    • A lot ends up in blood
    • Crosses placental and blood-brain barriers
    • Estimated half-life in humans 44 to > 80 days
  341. Lipophillic
    Can get into all of our fat tissues
  342. Risks of Mercury
    • Mercury collects in brain, central nervous system, and kidneys
    • Very young children and fetuses most susceptible
    • High levels can cause visual and learning problems in infants
  343. Neurodevelopmental Effects of Mercury
    • Mental retardation, cerebral palsy, deafness, blindness, and dysarthria (speech problems) with in utero exposure
    • Chronic, low-dose prenatal mercury exposure from maternal consumption of fish -> more neurotoxicity in children
    • Sensory and motor impairment in exposed adults
    • Developing and adult cardiovascular system problems
    • Blood-pressure regulation, heart-rate variability, heart disease
  344. AHA Recommendations of Fish
    • Adults without CHD eat a variety of oily fish at least twice a week and include oils and foods rich in alpha-linolenic acid (flaxseed, canola, and soybean oils, flaxseeds, and walnuts)
    • Equivalent to 0.3 to 0.5 g/d of EPA and DHA
    • Adults with CHD eat 1 g/d of EPA and DHA preferably from oily fish
    • Supplements could be considered (consult physician)
  345. FDA and EPA Recommendations for Fish
    • Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury
    • Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish caught from local waters, but don't consume any other fish during that week
  346. USDA, USDHHS, DGA Recommendations for Pregnant/Lactating Women
    • 8 to 12 ounces seafood per week, variety
    • Limit white (albacore) tuna to 6 ounces per week and do not eat tilefish, shark, swordfish, or king mackerel
  347. Commercial Fish and Pregnancy
    • FDA suggests that a moderate amount of other fish, about 12 oz of cooked fish a week, can safely be eaten
    • Shellfish
    • Canned fish
    • Smaller ocean fish
    • Farm-raised fish
  348. Freshwater Fish and Pregnancy
    • EPA and DNR
    • Stricter recommendations than FDA
    • Limit consumption of all freshwater fish to one meal per week due to mercury and other contaminants
    • Except for fish with “1 meal/ month” and "Do Not Eat” recommendations
    • 6 oz cooked fish for adults; 2 oz cooked fish for children
  349. How to Reduce Risk of Mercury
    • Eat smaller, younger gamefish (within legal limits): bass, walleye
    • Eat panfish: bluegill, perch, stream trout and smelt. Less likely to have pollutants
    • Eat less fatty fish: lake trout, bottom feeders such as carp and catfish
    • Eat smaller portions and vary type of fish eaten
  350. Less Fatty Fish
    Helps lower organochlorine contaminants, PCBs
  351. Biotechnology
    The use of organisms or their components in the production of products
  352. Genetic Modification
    Process of alter the genetic make-up of organisms
  353. Genetic Engineering
    New characteristics or traits into organisms have been introduced
  354. Recombinant DNA Technology
    • Confers the ability to move one gene, the inherited instruction for specific traits, from one organism to another and omiting the undesirable traits
    • Allows food producers to obtain animal and crop improvements in a much more precise, controlled and predictable manner
  355. Herbicide Tolerant
    • Glyphosate (Roundup) one of safest herbicides, breaks down fast
    • Glyphosate targets the enzyme 5 enolpyruvylshikimate-3-phosphate synthase (EPSPS)
    • EPSPS is in plants and helps make aromatic amino acids
    • HT-plants have an EPSPS gene that resists glyphosate
    • So glyphosate kills weeds, but not the HT-plants
  356. Insect Resistance
    • Bacillus thuringiensis (Bt) provides a gene makes natural toxin that kills insects
    • Toxin does not harm plants or people and is easily digestible if eaten
  357. Animal Hormones
    • Bovine somatotropin (BST) & bovine growth hormone (BGH)
    • Recombinant rBST (Posilac, Monsanto) & rBGH
    • ×Improves milk production (>10%) and feed efficiency
  358. Genetic Modification (GM)
    70-75% of processed foods in US may contain these ingredients
  359. GM Foods
    Sugar beets, potatoes, corn, tomatoes, squash, rice, soybean, animal feed, wheat, canola, and cotton
  360. Enhanced Input Traits of GM Crops
    • Herbicide tolerance, insect and virus protection, tolerance to environmental stressors (drought)
    • Most common
  361. Value Added Output Traits
    • Corn with phytase or more lysine for animal feed, or vegetable oils with more omega-3 fatty acids
    • Nutrition for animals and people
    • Low use of this at this time
  362. Positives of GMs and Crops
    • Enhanced taste and quality
    • Reduced maturation time
    • Increased nutrients, yields, and stress tolerance
    • Improved resistance to disease, pests, & herbicides
    • New products and growing techniques
  363. Positives of GMs and Animals
    Increased resistance, productivity, hardiness, and feed efficiency, and improved animal health and diagnostic methods
  364. Positives of GMs and Environment
    Conservation, bioprocessing, natural waste management, and “friendly" bioherbicides and bioinsecticides
  365. Positives of GMs and Society
    Increased food security for growing populations
  366. Negatives of GMs
    • Safety
    • Gene transfer & cross-pollination
    • Access and intellectual property
    • Ethics– tamper with nature, animal stress
    • Labeling– not mandatory in US
    • Society– rich countries might benefit most
  367. FDA, EPA, and USDA
    Who regulates GMs?
  368. FDA and GMs
    • Foods made from these plants (or with rBST) are safe for humans and animals to eat
    • Same safety standards for conventional and genetically engineered food
    • If food does not meet safety standards, then they can remove the food from the market.
    • Publishes safety testing guidelines, establishes consultation process with industry, and seeks expertise of scientists
  369. USDA and GMs
    Plants are safe to grow & monitor animal health
  370. EPA and GMs
    Pesticides introduced to plants are safe for human and animal consumption and for the environment
  371. Milk Biotechnology
    • Federal Pasteurized Milk Ordinance (PMO)
    • Milk production, hauling, pasteurization, product safety, equipment sanitation, labeling
    • <1% of foodborne illness in US now involve dairy products
    • Bovine Somatotropin (BST)
    • Dairy Food Safety (including BST)-National Dairy Council
  372. Milk Pasteurization
    • Kill bacteria without affecting taste or nutritional value
    • In US, pasteurized milk must be heated to a minimum of 145°F for 30 minutes or to 161°F or more for 15 seconds
    • CDC, FDA, other organizations support pasteurization
  373. Antibiotic Free Milk Supply
    • Antibiotic treated cow removedfrom milking herd and not put back in herd until milk testsfree of antibiotics
    • Every tank load of milk tested for animal drug residues
    • If tanker tests positive then destroyed, never reaches public
  374. BST/rBST Usage in Milk
    • Protein hormone made naturally by pituitary gland
    • rBST is synthetic
    • Regulates metabolism, growth, & milk production
    • Injected into dairy cattle, ↑ milk production by >10%
    • About 1/3 of US cows are injected
    • Considered safe by FDA and other regulators
    • Species-specific:
    • Bovine = cow
    • Biologically inactive in humans
    • Pasteurization destroys 90% of BST
    • Trace amounts of BST digested into inactive fragments by enzymes in human GI tract
  375. NAS Recommendations for GE
    • Analyze composition changes
    • Federal agency determine if evaluation of new GM foods for potential adverse health effects is needed
    • If yes, then do safety assessments prior to commercialization
    • More detailed testing, such as detecting unintended changes in GM foods, and using CSFII and NHANES to identify groups with high exposures
    • When need arises, develop methods to track use of GM foods by humans
    • Improve methods for detecting unintended consequences
    • Develop new tools to assess potential for unintended consequences
  376. Inherent toxicity of the novel gene
    • We eat & digest RNA & DNA everyday (0.1-1 g/day)
    • GM foods add 1/250,000 of typical intake
    • Toxicity scenario:
    • Gene would have to survive digestion
    • Be preferably absorbed over other gene fragments
    • Our cells would have to actually use the gene fragment, e.g., insert it into our own DNA
  377. Intrinsic toxicity of transgene product
    The Bt toxins, which are the most common gene products from current GM foods, is not toxic in mammalian systems (easily digested)
  378. Allergenicity
    • 200 of 100,000s of food proteins are allergenic (“Big 8”)
    • Avoid using genes that make allergenic proteins
    • Protein testing:
    • Overall structural similarity and homology in amino acid sequence to known allergens
    • Serological identity: see if IgE antibodies from sensitized people recognize the protein
    • Proteolytic stability: want proteins easily digested
    • Testing in animal models
    • Know protein identity, source, previous exposure from diet, effects of processing and cooking
  379. Changes in Nutrient Composition
    • Nutritional testing required:
    • Nutrient content
    • Digestibility
    • Testing in livestock fed corn, etc
  380. Unintended Effects
    • Pleiotropic effects (e.g., gene effects several different metabolic pathways, new metabolic reactions)
    • Insertional mutagenic effects (e.g., gene gets inserted randomly somewhere causing potentially cancer causing problems)
    • Avoid and/or test by using KNOWN proteins:
    • Test the physiology of the GM plant
    • Rigorously identify the protein product
    • Animal studies (similar to new food additives)
  381. Foodborne Illness
    • More than 250 foodborne diseases
    • Annually:
    • 48 million cases gastrointestinal
    • 128,000 hospitalizations
    • 3,000 deaths
    • Salmonellosis is most commonly diagnosed and reported foodborne illness
    • Rates for Vibrio infections dramatically increased in 2009
    • E. coli O157:H7 gastroenteritis decreased in 2009
  382. Foodnet
    • Surveillance network
    • Started under Pres. Clinton’’s Food Safety Initiative–
    • Collaborative project of the CDC, ten surveillance
    • sites (incl. Georgia), USDA and FDA
    • –Active surveillance for foodborne diseases and related epidemiologic studies designed to help public health officials better understand the epidemiology of foodborne diseases in the United States
  383. Purpose of FoodNet
    • Determine the burden of foodborne illness in the United States
    • •Monitor trends in the burden of specific foodborne illness over time
    • Attribute the burden of foodborne illness to specific foods and settings
    • •Develop and assess interventions to reduce the burden of foodborne illness
    • Active surveillance for all laboratory- diagnosed cases of bacterial pathogens cases and parasitic organisms, including Campylobacter, E. coli O157, listeria, and salmonella
  384. Outbreaks of Foodborne Illnesses
    • Majority is from food preparation, either foodservice or home, and not commercial food supply
    • High profile exceptions in the past few years with produce and processed peanut products
  385. FDA, USDA, CDC, EPA
    Who regulates food system and foodborne illnesses?
  386. USDA
    • Responsible for inspection and quality grading of:
    • –Meat and meat products
    • –Poultry
    • Dairy products
    • Processed egg products
    • Fruit and vegetables shipped across state lines
  387. FDA
    • Inspects:
    • Foodservice operations that cross state borders (planes, trains, etc.)
    • Food manufacturers and processors
    • Ensures food processing plants meet standards of purity, wholesomeness, and labeling requirements
  388. Person must seek medical help
    Doctors must confirm source
    Doctors must report to health depts
    To become investigated...
  389. PulseNet
    • National network of public health and food agency labs
    • Coordinated by CDC
    • Detect food borne disease case clusters by DNA fingerprinting
    • PFGE: Pulsed-field gel electrophoresis
    • –Molecular subtyping
    • Distinguishes strains of organisms, such as E. coli, Salmonella, etc.
    • •DNA fingerprints are submitted electronically to a CDC database
  390. Pulsed-Field Gel Electrophoresis
    • Bacteria have unique fingerprints, just like people
    • Unique DNA makes up a pattern of bands called a
    • fingerprint
    • Fingerprints also known as PFGE patterns
  391. Importance of PulseNet
    • Allows investigation, for example, by saying:
    • A case in X outbreak is
    • –– infection with Y bacteria with a PFGE pattern
    • –– matching one of the three outbreak patterns in a person residing in the United States
    • –– with symptom onset on or after Z date
    • –– 2,500 serotypes of Salmonella can cause illness
  392. Is Produce Safe?
    • There is always some degree of risk from agricultural products
    • •Media attention to recent large-scale outbreaks points out some of these problems
  393. E. coli O157:H7
    Spinach and cantaloupes
  394. Salmonella
    Tomatoes, mustard cress, sprouts, cantaloupes, watermelon
  395. Shigella
    Onions
  396. Listeria
    Cabbage, sprouts
  397. Cyclospora
    Raspberries (Guatelmalan)
  398. Produce Contamination
    • Improper hygiene of workers in fields
    • •Contaminated irrigation water or water used in processing
    • Contact with contaminated surfaces
  399. Reducing or Eliminating Contamination
    • Proper hygiene of workers in the fields
    • Clean irrigation water or water used in processing
    • Clean surfaces –– trucks, crates, etc.
    • Practices in place to prevent intentional contamination
    • •GAPS, GMPS, HACCP
  400. Spinach Outbreak Statistics
    • 199 confirmed cases from 29 states
    • 102 hospitalized
    • 141 (71%) female/58 male (29%)
    • 22 (11%) children <5 years old
    • 3 deaths
  401. Spinach Outbreak
    • 13 packages tested
    • 11 had lot codes from a single manufacturing facility on a particular day
    • 2 did not have lot codes available, but were same brand
    • All matched the outbreak strain
  402. Spinach Outbreak Conclusions
    • E. coli O157:H7 found in environmental samples near fields that provided the spinach
    • Isolates from only one field matched the outbreak strain
    • Organism identified in river water, cattle feces, and wild pig feces just a mile away from field
    • Land used for cattle grazing
  403. E. coli O157:H7
    • Causes 73,000 illnesses in the US annually
    • Over 2,100 hospitalizations, 61 deaths
    • An important cause of acute renal failure in children
    • Illness name: hemorraghic colitis
  404. Breakdown of E. coli O157:H7
    • "O" and "H" designate antigens:
    • -O is the somatic antigen (cell wall)
    • -H is the flagella antigen
    • -Antigens are related to the hosts immune responses
    • O157 makes it a certain serotype
    • Non-pathogein E. coli help digest food and help make Vitamin K in large intestine
  405. Hemorrhagic Colitis
    • Shiga toxin producing
    • Ground beef (raw and undercooked)- diarrhea
    • Contaminated produce- abdominal cramps, kidney failure (in severe cases)
  406. Preventing Hemorrhagic Colitis
    • Control time and temperature
    • Cook food to internal temperatures
    • Prevent cross-contamination
    • Don't let people with diarrhea handle food
    • Wash hands
    • Don't use fresh manure to fertilize vegetable gardens
    • Don't drink untreated water
  407. Hemolytic uremic syndrome
    • Usually in children under 10 years
    • Renal failure, blood clots in kidney cause build-up of wastes in blood
  408. Thrombotic thrombocytopenic purpura
    • Occurs mainly in adults (mainly elderly)
    • Less renal damage than HUS
    • Central nervous system damage
    • Blood clots in brain
    • Seizures and strokes are common
  409. Preventing Outbreaks: Buying
    • Buy produce free of damage
    • Buy fresh cut only if refrigerated or surrounded by ice
    • Bag produce separately from meat, poultry, seafood, eggs, etc
  410. Preventing Outbreaks: Storage
    • Perishable fresh produce should be refrigerated
    • Pre-cut or peeled produce should be refrigerated
    • Store in protected drawer or above raw meats, poultry, etc
  411. Preventing Outbreaks: Preperation
    • Wash hands
    • Cut away damage
    • Wash under cool, running water
    • Scrub firm produce
    • Dry with clean towels
  412. Salmonellis
    • Poultry and eggs- diarrhea
    • Dairy products- abdominal cramps
    • Produce- vomiting, fever
    • 1.4 M cases estimated each year
    • > 500 cases fatal
    • 2% cases complicated by chronic arthritis
    • Half of all are caused by 2 serotypes: S. enteriditis and S. typhimurium
    • Third most frequent is S. newport
  413. Preventing Salmonellosis
    • Prevent cross-contamination
    • Cook poultry and eggs to internal temperatures
    • Keep people with it from handling food
  414. Salmonella in Peanut Products
    • Peter Pan and Great Value
    • Most likely source= jars or equipment
    • 628 cases- maybe 700+
    • 47 states
    • Same serotype found in open and closed jars, and in plant environmental samples
    • Salmonella Tennessee
    • Salmonella Typhimurium
    • Ordinarily sensitive to heat and high acidity
    • Resistance increases at lower water activities
    • Peanut butter and peanut paste are very low in water
  415. Pest
    Organisms damage crops (FOOD), humans, animals: insects, mice, other animals, unwanted plants “weeds”, fungi, bacteria, viruses
  416. Pesticide
    • Any substance or mixture that prevents, kills, repels or mitigates any pest
    • Agriculture and many other uses
  417. Concerns of Pesticides
    Infects food, water, environment
  418. Food Quality Protection Act, 1996, amends:
    FIFRA: Federal Insecticide, Fungicide, and Rodenticide Act
    Pesticide regulation and use
    Food, Drug, and Cosmetic Act
    Food safety and tolerances
    Environmental Protection Agency
    Must interpret and enforce FQPA
    Who regulates pesticides?
  419. Food Quality Protection Act of 1996
    • Sets stricter stands
    • Mandated review of all pesticides
    • “Reregistration”: some pesticide uses have been stopped
    • Extra safety factor for children
    • Endocrine disrupters, more attention
    • Exposure from ALL sources:
    • Food + Water + Environment
  420. Tolerances for Pesticides
    • Set by EPA
    • “Registered” for use
    • > 400 chemicals
    • > 9,000 specific pesticide for specific food (given ppm in food, ug/g or mg/kg)
    • Considers estimated daily amount per person for 70 years without significant health risk
    • FDA, USDA monitor food levels
    • See Code of Federal Regulations (40 CFR 180)
  421. EPA and Pesticides
    • Reviews studies submitted by companies
    • Determines if it “will not pose unreasonable risks” to human health or environment
    • Licenses, registers pesticide for strict use,
    • e.g., certain plants, pests; sets limits:
    • Amounts and when used
    • Residue: amount that can remain on food
    • Tolerance: maximum amount remaining after maximum allowable usage
    • Standards for workers
  422. Reregistration for Pesticides
    • About 1,150 pesticide active ingredients organized into 613 "cases" or related groups
    • 229 of cases were cancelled in early years
  423. Pesticide Health Problems
    • Birth defects, nerve damage, cancer with LONG or very HIGH exposure, depends on AMOUNT
    • Hard to extrapolate to low doses people eat
    • Different chemicals have different risks
    • MAIN problems with farm workers, accidental exposures
  424. Pesticides and Infants
    • Organs still developing and maturing
    • Eat and drink more per body weight than adults
    • Lawns or floors, put things in mouth increase their exposure
    • Accidental poisoning
    • Interfere with nutrient metabolism, not excreted efficiently, critical growth periods (e.g., brain)
    • More focus on foods eaten by children:
    • Apples/juice, oranges/juice, potatoes, tomatoes, soybean oil, sugar, eggs, pork, chicken, beef
    • Extra safety factor added for tolerances to consider children (e.g., additional 10x)
  425. Birth Defects and Pesticides
    • High levels concern in animals, but typical food exposures not clear
    • Human studies, epidemiological, observational, mixed, many types, other risks: alcohol, diabetes, low folate
    • Some evidence for occupational exposure of men or women and risk of birth defects in offspring
  426. Monitoring Residues of Pesticides
    • FDA: Total Diet Study, Other
    • Helpful to find WHAT pesticides in foods
    • USDA: Pesticide Data Program
    • State and local governments
    • Independent laboratories
    • NOTE: farms and/or each “batch” of food NOT
    • tested for pesticides (rather just a few)
  427. California Residues
    • 3429 from > 180 kinds of commodities
    • ~ 60% domestic, ~40% imported
    • Could detect > 200 pesticides and breakdown products
    • 73.4%: no residues detected (better than 2006)
    • 24.2%: residues within EPA tolerance
    • Most < 10% of EPA tolerance
    • 2.4% had illegal residues:
    • 12.3% > EPA tolerance
    • 87.7% residues of a pesticide not authorized for use on the commodity
  428. Tomatillo, Taro Root, and Chili Peppers
    Foods with high illegal residues
  429. FDA Pesticide Monitoring Study
    • About 5,000 foods
    • Buy several times yearly across US
    • ~300 foods represent ~3,500 foods (e.g., apple pie represents all fruit pies and pastries)
    • Prepare as table ready
    • Analyze pesticides, radionuclides, industrial chemicals, toxins, minerals, folic acid, other
    • Use along with USDA food consumption data to estimate dietary intake of pesticides
  430. Imports had more residue that exceeded the tolerance
    Domestic vs Import Pesticides
  431. Guatamala
    Country of Concern with Pesticides
  432. Methods of Organic Food for Children Study
    • Recruited 23 children, ages 3 to 11 yrs
    • Public and Montessori schools in Seattle, WA
    • Informed consent
    • Questionnaires about household pesticide use
    • 15-consecutive days, 3 phases, urine collected throughout
    • 1-3 d: Conventional diet
    • 4-8 d: Organic food substituted for most of conventional foods
    • 9-15 d: Conventional diet
  433. Cancer Risks of Pesticides
    • Animal studies mixed, takes really high doses
    • Human studies, epidemiological, observational, mixed
    • Don’t know mechanism or target organ for each pesticide for cancer causation – so don’t know what to look for in humans
  434. Cancer Risks and Pesticides Study
    • Different ways to estimate risk
    • Intake estimates/assumptions, use:
    • EPA tolerance (high)
    • Actual dietary intake (low or zero)
    • Difference can range from infinity to 100,000 times difference
    • Interpretation of animal studies
    • Differences can range from 0.5 to 490,000 times
  435. Pest Management
    • Use less pesticides
    • Monitor fields more
    • Mechanical trapping, natural predators, insecticides growth regulators, pheromes
    • “Chemicals” as last resort
    • “IPM” – not regulated like “organic” foods
    • Residues between conventional and organic
  436. Organically Grown Produce
    • No synthetic fertilizers, pesticides
    • OK: biological pesticides
    • USDA: National Organic Standards
    • 100% organic
    • Made with organic ingredients
    • Low residues, but can still have residues
    • Drift
    • Persistent (e.g., DDT); test fields
  437. Biologically-based pesticides, such as pheromones and microbial pesticides, often safer than traditional chemical pesticides
    Are some pesticides safer?
  438. Grouping of Pesticides
    • Type of pest
    • Chemical group
    • Other
    • Chemical
    • Biopesticide
    • Antimicrobial
    • Pest control device
  439. Organophospate Insecticides
    • Nervous system, acetycholinesterase inhibitors (“nerve agents”), insecticides, low persistence
    • Chemical pesticide
  440. Carbamates
    • Acetycholinesterase inhibitors
    • Chemical pesticide
  441. Organochlorine Insecticides
    • High persistence, many banned (e.g., DDT, still in food)
    • Chemical pesticide
  442. Pyrethroid Pesticides
    • Synthetic version of natural pyrethrin (chrysanthemums), more stable in environment, can be toxic to nervous system
    • Chemical pesticide
  443. 3 Main Classes of Biopesticides
    • Microbial
    • Plant-incorporated protectants
    • Biochemical pesticides
  444. Microbial Biopesticides
    • Very specific target, e.g., fungi for certain weeds, fungi for certain insects:
    • Most used is Bacillus thuringiensis “Bt”
    • Each bacterial strain makes different mix of proteins that kill different insect larvae; e.g., moths or flies or mosquitoes
    • Bt-toxin binds to gut receptor, causing death
    • Also, “Bt” gene put in “GMO” foods, producing Bt-toxin leads to less chemical pesticides used
  445. Plant-Incorporated Protectants
    • Gene put in plant to make pesticide
    • Bt-gene put in plant to make Bt-toxin, “GMO”
    • Protein and genetic material, but not the plant, are regulated by EPA
  446. Biochemical Pesticides
    • “Natural,” kill by non-toxic mechanisms:
    • Insect sex pheromones, interfere with mating
    • Scented plant extracts that attract insects pests to traps
    • Special committee decides when chemical should be classified this way, how to regulate
  447. Organic
    • Food produced without:
    • Most conventional pesticides
    • Fertilizers with synthetic ingredients
    • Sewage sludge-based fertilizers
    • Bioengineering
    • Ionizing radiation
    • Can have “food additives,” added fat, added sugars, artificial sweeteners, etc
  448. Organic
    • Animals raised with:
    • Organic feed
    • No antibiotics
    • No growth hormones
    • Produced by farmers who:
    • Emphasize use of renewable resources and conservation of soil and water for future generations
  449. 100% Organic
    Only organic ingredients
  450. Organic
    • At least 95% organic ingredients
    • Both may display USDA Organic Seal
  451. Made with Organic Ingredients
    • Contains at least 70% organic ingredients
    • No USDA seal
  452. USDA Seal
    Does not have to be put on food labels
  453. OFPA and NOP
    Who regulates organic foods?
  454. Organic Food Production Act of 1990
    • USDA to develop national standards for organic products
    • Part of the 1990 Farm Bill
  455. National Organic Program
    • Developed national organic standards and established organic certification program
    • Marketing program
    • Regulations prohibit genetic engineering, ionizing radiation, and sewage sludge in organic production
    • Standards Regulated:
    • Production and handling
    • Labeling
    • Certification
    • Accreditation
    • Imported agricultural products
  456. Organic Practices
    • Various methods to enhance/maintain soil fertility
    • Crop rotation, tillage and cultivation practices, cover crops, and natural products
    • No synthetic materials unless the materials are on the Natl. List of Allowed and Prohibited Substances
    • Minimize air, soil, and water pollution
  457. Converting to Organic Farming
    • No prohibited substances for 3 y before harvest
    • Animal herds
    • 80% organic for 9 mo
    • Followed by 3 mo of 100%organic feed
    • 100% organic feed à sold as organic
    • Vitamin and mineral supplements -> OK
  458. 1990 Farm Bill
    • Establish standards for marketing organically produced products
    • Assure consumers that organic products meet a consistent standard
    • Facilitate interstate commerce
  459. Organic Legislation and Regulation
    • Natl. Organic Standards Board
    • Natl. List of Allowed and Prohibited Substances
    • Natl. Organic Program Standards
    • Natl. Organic Cost-Share Program
  460. European Commision
    • Imported organic products must comply with EU standards or equivalent guarantees
    • US accepts products from countries that have equivalent guarantees (e.g., EU)
  461. Pesticides and Organic Food
    • OK to use synthetic substances on Natl. List
    • Fewer pesticide residues in organic crops
    • Maximum residue limits (MRLs)
    • Majority of detected residues having levels well within the allowable ranges
  462. Pesticides US Reference Dose (RfD)
    • Not a toxicological threshold
    • The most sensitive toxicological effect observed in animal studies by determining the highest dose level that does not cause an effect and dividing that level by a factor of 100 or more
  463. Pesticides European Commission: acceptable daily intake (ADI)
    Minimal level of toxicological concern
  464. Nutritional Quality of Organic Food
    • 50 yrs of research papers à 52,000+ studies à 137 crop studies + 25 livestock products à 55 “satisfactory” research quality
    • Conventional crops higher N
    • Organic crops higher phosphorus and acid
    • Livestock – no differences in nutrients examined
  465. Organic vs Conventional Food
    • Different fertilization methods change plant metabolism
    • Synthetic fertilizers easier for plant to use so may accelerate growth
    • So plant might “grow more” and make fewer nutrients
  466. Organic Food and Phytochemicals
    • Organic plants are more stressed, because of more damage from insects, weeds, plant pathogens (diseases)
    • Stress increases amounts of defensive chemicals (e.g., polyphenols)
  467. Nitrates
    Organic foods have lower levels of this
  468. Naturally Occurring Toxins in Organic Foods
    • May be higher – again because plants under stress
    • Example glycoalkloids
    • Potatoes and tomatoes
    • Insect resistance
    • Linear furanocoumarins
    • Celery plants
    • ↑ Stressful conditions (fungal attack and acidic fog)
    • Contact dermatitis, carcinogens
    • Pesticides can help reduce mycotoxins
    • -Less when pesticides used
    • Pesticides can help reduce aflatoxins
    • -Common on corn and peanuts
    • Aflatoxins mutagens, carcinogens, and teratogens
  469. Microbiology Safety of Organic Foods
    • No guarantee that organic foods are microbiologically safer
    • Prohibition of antibiotic use in organic animal production may decrease problems with antimicrobial resistance
  470. Transmissible spongiform encephalopathie (TSE)
    • Fatal brain disease, many species
    • —Diseases with spongy degeneration of brain
    • —Incurable neurological problems
    • Scrapie in sheep, goats
    • BSE in cattle (bovine)
    • Mink, North American mule deer, elk (CWD, chronic wasting disease; concern about eating these)
    • Cats, ruminants and felines in zoos (most cases in UK)
    • Humans (CJD and vCJD)
  471. Bovine Spongiform Encephalopathy (BSE)
    • Disease in cattle
    • Worldwide
    • North America (we get cattle from Canada)
    • Fatal, affects brain and spinal cord of cattle
    • —4 to 5 yr incubation (animals seems healthy)
    • —Death within weeks to months of onset
    • First appearance in UK (1986)
    • Cases in 1970’s, but mimicked other diseases
    • —Highly stable, resisting freezing, drying, and heat at normal cooking temperatures
  472. Creutzfeldt-Jakob Disease (CJD) and variant CJD
    • Disease in humans
    • Linked to eating meat with BSE
  473. Source of Bovine Spongiform Encephalopathy
    • —Epidemiological studies from UK -> source of BSE was cattle feed prepared from bovine tissues
    • —Appearance of disease agent in cattle -> spontaneous* (current thinking favors spontaneous) or through carcasses of sheep with scrapie entering food chain
    • —*Spontaneous amplified through the food chain by feeding rendered products to cattle
  474. Prions
    • —Infectious agent made of protein
    • —Infect and propagate by refolding abnormally -> convert normal proteins into abnormal structures
    • —Forms plaques in CNS known as amyloid
    • —Plaques disrupt normal tissue structure
    • Proteins naturally in brain
    • Normally, harmless, but when misshapen -> BSE diseases
  475. Symptoms of BSE
    • —Convulsions
    • —Dementia
    • —Ataxia (balance and coordination dysfunction)
    • —Behavioral or personality changes
    • —Malformed protein accumulates in brain and looks spongy, visible under microscope
  476. Cause of BSE
    • —BSE affects brain and spinal cord of cattle
    • Prions spread from intestines to nerves
    • —BSE prions can reach brain in 24 months

    —
  477. Source of BSE Epidemic
    • —UK source was cattle feed prepared from cattle (Meat and Bone Meal)
    • Sheep have similar disease, scrapie
    • Disease jumped “species barrier” through contaminated feed
    • Infected cattle slaughtered and “recycled” animal carcasses put in cattle feed
    • Disease spread due to rendering (recycling animal protein as an ingredient in animal feed)
  478. Measures to Prevent Spreading of BSE
    • UK banned use of ruminant proteins animal feed
    • Use of high risk bovine offals banned in UK
    • EU banned feeding mammalian meat and bone meal (MBM) to ruminants
    • Ban on feeding mechanically recovered meat to humans
    • Bans preventing sale of beef over 30 months of age from UK to other countries
    • Finally EU totally bans feeding of MBM to all farm animals to end continued risk of cross contamination
  479. TSE
    • —Human TSE – comes in 3 forms:
    • Genetic predisposition (mutations), 5-10% of cases
    • Sporadic, 85-90% of cases, unknown cause
    • Iatrogenic, < 5%, accidental from contaminated neurosurgical equipment, transplants (cornea or dura mater), natural human growth hormone (so best to use rHGH)
    • —Rare disease, occurs in 1/ 1,000,000 people every year
    • —Affects people aged 45-75 (most frequently 55-65 yoa)
    • —In 85% of cases duration of CJD is less than one year after onset of symptoms
  480. VARIANT Creutzfeldt-Jakob Disease (vCJD)
    • —New form of human TSE
    • —1st case 1996 in UK
    • —vCJD vs CJD
    • Affected individuals much younger (~26)
    • Average duration 13 months vs. 4 months
    • EEG activity of the brain in vCJD patients was abnormal (slowed) but not typical of classical CJD
    • Changes in brain tissue were similar to CJD, but different in that there were larger aggregates of prion protein plaque
    • —Exposure probably through food
  481. WHO Recommendations for BSE
    • —Prohibit ruminant tissues in animal feed
    • —All countries should do risk assessments
    • —Skeletal muscle not infective
    • Milk and milk products safe
  482. USDA and FDA Recommendations for BSE
    • —Aggressive surveillance of highest risk cattle going to slaughter US
    • —Tallow and gelatin safe if processed properly
    • —Avoid using bovine materials and other animal products from species in which BSE naturally occur (e.g., cosmetics)
    • Emergency Response
    • Plans and recalled meat implemented as soon as BSE identified
    • —Organs containing infectious prions removed at slaughter and were not present in marketplace
  483. Supplements
    • Yes - FDA
    • —FDA prohibits use in human food, including dietary supplements, of cattle materials with highest risk of having BSE infectivity
    • —Applies to imported and domestic dietary supplements and their ingredients
    • —Most ingredients in supplements come from cattle slaughtered at < 30 months old (so little risk of being BSE-positive)
  484. vCJD in US
    • CDC surveillance for CJD and vCJD
    • —As of March 1, 2010, 1 case each from Canada, and Italy, and 3 in the United States
    • —All but 2 had lived in UK during exposure period of the U.K. population to BSE agent
    • —Florida resident lived in UK > 10 yrs
    • —2 other cases in US
  485. BSE Testing
    • —Focus on rapid tests for surveillance and confirmation
    • —> 20 tests available
    • —Detects mishapen proteins
Author
JerrahAnn
ID
74330
Card Set
Food & Nutrition
Description
Final
Updated