nutrition spotlight

SPRING 2013

IN THIS ISSUE

• ExtremeFadDiets• IsRawMilkSafe?• TheTransFatBan:TheAftermath

• EatTwinkies,GetTwiggy• SayCheese!TheRiseofPhotographicFoodJournaling

Omega-3: Three Fishy

Ways to Get Strong and

Improve Physique

Extreme Fad Diets

Vitamin Supplements

Omega-3: Three Fishy Ways to Get Strong and Improve Physique

Say Cheese! The Rise of Photographic Food Journaling

Eat Twinkies, Get Twiggy

Is Raw Milk Safe?

Trans Fat Ban: The Aftermath

INSIDE THIS ISSUE

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2 Nutrition Spotlight Spring 2013

AllarticlesarewrittenandsubmittedbyDieteticInternsfromDoisyCollegeofHealthSciencesatSaintLouisUniversity.FormoreinformationonSLU’sDieteticInternship,pleasevisitND.SLU.EDU.

About Saint Louis University’s Dietetic internship

The Saint Louis University (SLU) Dietetic Internship Program was established in 1934 and is one of the oldest and most well established programs in the nation. It is a 10-month, post-baccalaureate certificate program designed to meet the minimum competencies for professional practice in dietetics, and provide preparation for the dietetic registration examination. Over the past five years, 93% of SLU Dietetic Internship graduates have successfully passed the registration examination on their first attempt.

Class of 2013


Extreme Fad Diets: CautiousCounselingforDangerousDietsEstiAsherandKellyHouston

As wedding season approaches, brides-to-be will undoubtedly begin to research the agonizing task of how to look their “best” for their big day. With people typically focused on fast results rather than health, many may resort to extreme diets with the hope of a quick fix. In order for us to counsel most effectively, it is important for dietitians to stay abreast of current diet trends. Several of the most extreme diets are outlined below:

The K-E (Ketogenic Enteral Nutrition) Diet • Nasogastric feeding tube is placed

in dieter for 10 days; the feeding is said to include 800 kilocalories made up of solely fat and protein; however, the exact composition of the feedings has not been disclosed

• Can lose up to 10% of starting body weight

• After the 10 days, low carbohydrate diet is to be followed

(Lenneman, 2012)

The Five Bite DietDr. Alwin Lewis, medical practitioner and author of Why Weight Around, created the five bite diet. This diet includes five rules:• The dieter may drink as much of

any drink that he/she wants as long as it does not contain any calories

• Take 5 bites of any food at lunch• Take 5 bites of any food at dinner• Take one multivitamin every day• Consume a small amount of protein

(quantity is not mentioned)

The hCG DietHuman chorionic gonadotropin (hCG) is a hormone that is secreted during pregnancy to ensure that the fetus obtains necessary nutrients. This diet claims that if it is followed for 45 days

straight, the dieter’s metabolism will improve, and an average of 1-3 pounds per day will be lost. The general rules of the diet are as follows:• 500 calories per day• hCG injections or serum drops

under the tongue

The Baby Food Diet• Classic example of portion control

taken to the extreme• Tracy Anderson is a celebrity trainer

and the creator of the diet• Breakfast and lunch are replaced by

14 jars of baby food, ranging from about 25 to 75 calories each

• A “sensible adult meal” may be eaten for dinner

The Physiology of a Calorie Deficit During a state of starvation (taking in fewer calories than the body needs) or a low-carbohydrate diet, the body’s glucose and glycogen stores are depleted. With no carbohydrate coming in to restock these common forms of quick energy, there are only two sources remaining from which to supply the brain and body with energy: fat and protein (Mahan, 2012).

Fat is used for energy by the process of lipolysis, which breaks down triglycerides into free fatty acids, and

then into ketones. Ketone bodies are able to supply the brain with energy (Mullins, Hallam, & Broom, 2011), but the process of switching over takes a few days. During this time, patients on a low-carbohydrate or very-low-calorie diet, may feel as though their brains are a bit foggy. Protein used for energy can come from either the diet, or, in extreme cases, the muscles of the body. The process of using protein for fuel is known as gluconeogenesis. This can be extremely dangerous in the long-term because everything from skeletal to cardiac muscle is used. Depletion of cardiac muscle can cause heart failure in patients consuming very-low-calorie diets for an extended period of time (Mahan, 2012). Psychology of Extreme DietingWith today’s media obsessed with the constantly rising and falling weights of celebrities, people may think that it is normal to gain or lose weight quickly, or maintain a weight far below their ideal body weight. While these unsafe weight-loss practices may be practiced by all, it has been shown that women who read fashion magazines often are more likely to participate in drastic dieting measures (Neumark-Sztainer, Hannan, & Haines,


2007). Due to the intensity and extreme calorie deprivation of many of these diets, followers will likely see rapid weight loss, leading them to believe they have “found the answer”. There is also the point to consider: will people stop a bizarre, non-sustainable eating plan once he or she has reached their goal weight, or will this lead to further disordered eating?

What Can We Do?As nutrition professionals, it is important for us to tackle the misinformation propagated by the media by continuing to assure clients and the general public that:1. Fat loss takes time (1-2 lbs per week

is ideal)2. An intentional calorie deficit of

500-1,000 calories/day is ideal for weight loss

3. Balance in dietary choices is key to achieve optimal nutrients for healthy living (Academy of Nutrition and Dietetics, 2012)

REFERENCES

1. Academy of Nutrition and Dietetics. (2012). Recommendations summary: Adult weight management (AWM) Reduced calorie diets. Evidence Analysis Library. Retrieved from http://www.adaevidencelibrary.com/template.cfm?template=guide_summary&key=622

2. Baby Food Diet - Shape Magazine. (n.d.). Shape Magazine - Diet, Fitness, Recipes, Healthy Eating Expertise. Retrieved August 24, 2012, from http://www.shape.com/weight-loss/weight-loss-strategies/baby-food-diet-should-you-try-hollywoods-newest-trend

3. Foster, J. (n.d.). The 5 Bite Diet . Diet Blog. Retrieved August 24, 2012, from http://www.diet-blog.com/08/the_5_bite_diet.php

4. Lenneman, F. (2012). Latest fad diet? A feeding tube. Retrieved from http://www.eatright.org/ Public/content.aspx?id=6442471460#.UETzP6M8qK5

5. Mahan, L.K., Escott-Stump, S., Raymond, J.L. (2012). Krause’s food and the nutrition care process. St. Louis, MO: Elsevier Saunders.

6. Mullins, G., Hallam, C. L., & Broom, I. (2011). Ketosis, ketoacidosis and very-low-calorie diets: putting the record straight. Nutrition Bulletin, 36(3), 397-402. doi: 10.1111/j.1467-3010.2011.01916.x

7. Neumark-Sztainer, D., Hannan, P. J., & Haines, J. (2007). Is dieting advice from magazines helpful or harmful? Five-year associations with weight-control behaviors and psychological outcomes in adolescents. Pediatrics, 119(1), e30-37.

8. The Truth About hCG for Weight Loss. (n.d.). WebMD - Better information. Better health. Retrieved August 24, 2012, from http://www.webmd.com/diet/features/truth-about-hcg-for-weight-loss



Vitamin SupplementsKaelyMcDougallandSarahBerglind

Achieving optimal nutrition and preventing the occurrence of chronic disease is as easy as popping a daily multivitamin, right? Not so fast. Multivitamins are amongst the most widely purchased supplements in the US today. This comes as no surprise as the packaging on these supplements often boasts chronic disease prevention and health promotion – but is that really the case? There is no doubt that certain micronutrients play a role in the prevention of disease, but are multivitamins the best source? Many recent studies have shown multivitamin use having a less than expected effect on disease prevention and health.


An observational study completed by the Women’s Health Initiative found that multivitamin use had little or no effect on heart disease, common cancers or skeletal health in postmenopausal women. The study included 161,808 women between the ages of 50 and 79, of which, 41.5% used multivitamins (4).

According to a US Government Study, more than half of American adults take at least one dietary vitamin.Despite the potential ineffectiveness of multivitamins, the National Health and Nutrition Examination Survey collected data from adults in the U.S. to assess multivitamin consumption and found that people were continuing to take pills. The results showed that 52% of Americans have taken a dietary vitamin in the past month and 35% of Americans are regular multivitamin supplement users. Researchers surveyed individuals from a wide range of age groups, ethnicity, gender, education level, and physical activity. Interestingly, the results showed that the individuals taking a multivitamin generally had a healthier diet than those who were not taking a multivitamin (1).

The Nutrition Journal conducted another study that assessed the use of a multivitamin in 2007. This study surveyed health professionals (physicians and nurses) about their intake of a multivitamin. The survey included 900 physicians and 277 nurses from around the country and asked them about types of multivitamins they took and if they were a seasonal, occasional, or regular user of the vitamins. The results indicated that 89% of nurses and 72% of the physicians used a multivitamin supplement sometime throughout the year. The survey also asked if these health professionals recommended a multivitamin to patients and the results were that 82% of nurses and 79% of physicians would suggest their patients take a multivitamin(3).

For the most part, the majority of health professionals still recommend the use of multivitamins and a large portion

of the population still consumes them. While there are no significant health benefits associated with vitamin use, there are also no significant drawbacks to vitamin consumption, provided upper limits (ULs) are not reached. However, there are certain populations who would benefit greatly from vitamin supplementation, namely the elderly, women seeking to become pregnant, pregnant and lactating women, individuals with diseases or malabsorption conditions.

Sorting through the conflicting articles on vitamin use can be confusing, so when deciding on whether or not to include a multivitamin in your diet, it is important to consult your doctor. Also, look at reliable sources when researching information about different vitamins. The Academy of Nutrition and Dietetics (formerly American Dietetics Association) states: “the best nutrition-based strategy for promoting optimal health and reducing the risk of chronic disease is to wisely choose a wide variety of nutrient-rich foods” (2). The bottom line: get your nutrients through a diet rich in fruits, vegetables, whole grains and low fat dairy, and supplement if you feel your diet is inadequate or it is recommended by your doctor or registered dietitian.

REFERENCES

1. Rock, C. L. (2007). Multivitamin-multimineral supplements: who uses them?. The American Journal of Clinical Nutrition, 85, 277S-279S. Retrieved from http://ajcn.nutrition.org/content/85/1/277S.long

2. Marra, M. V., & Boyar, A. P. (2009). Position of the american dietetic association: nutrient supplementation. Journal of American Dietetics Association, 109(12), 2073-85.

3. Dickinson, A., Boyon, N., & Shao, A. (2009). Physicians and nurses use and recommend dietary supplements: report of a survey. Nutrition Journal, 8(29), Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714854/

4. Neuhouser, M., Wassertheil-Smoller, S., Thomson, C., Aragaki, A., Anderson, G., Manson, J., Patterson, R., & Rohan, T. (2009). Multivitamin use and risk of cancer and cardiovascular disease in the women’s health initiative cohorts. Archives of Internal Medicine, 169(3), 294-304. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleid=414784

Omega-3: Three “Fishy” Ways to Get Stronger and Improve PhysiqueJoelCookandScottMarler

No longer a secret weapon in the battle for good health, sale and consumption of omega-3 polyunsaturated fatty acids have risen in recent years. Known best for their heart healthy benefits, numerous studies have linked omega-3s to improved joint health, cognitive state, and lower incidence of cancer. They even have powerful anti-inflammatory properties comparable to over-the-counter medications such as Aleve and Advil, but are significantly safer for long-term use. With these significant functions, there is consensus that omega-3s can benefit a wide variety of people. One such group in this range is one that is not immediately thought of: weightlifters; novice and expert alike. Those engaging in intense muscle training are well-known for depleting the protein powder inventory of supplement stores, but some recent studies have shown that the same omega-3s used widely in the general population can help resistance trainers improve their strength, increase muscle size, speed up their recovery, and cut body fat.


Omega-3s are not typically seen as an enhancer of muscle size, but a 2010 study published in the American Journal of Clinical Nutrition showed the supplement to do just this. Previous animal studies had been positive: enriched feed given to steers increased the building up of muscle proteins, and a omega-3 supplementation was shown to prevent muscle loss in guinea pigs (Smith, 2010). The human study looked primarily at older adults and examined rates of muscle protein synthesis after omega-3 supplementation, compared to supplementation of corn oil. While the corn oil group had no appreciable changes in the creation of muscle proteins, the omega-3 group showed a significant increase in the building of muscle proteins, when also infused with amino acids (the bare-bones of proteins) and insulin. More research needs to be done, particularly research that looks at younger subjects, but the Smith study yields positive thinking in regards to the usefulness in omega-3s to those looking to build lean muscle.

A groundbreaking 2011 study, also published in the American Journal of Clinical Nutrition, uncovered a potential link between omega-3 supplementation and muscle strength (Rodacki, 2011). The study examined the torque generated by the muscles of elderly women performing strength training. The subjects were divided into two groups, with only one being given omega-3 supplements. While both groups saw an increase in muscle torque when measured pre and post-training, the omega-3 group saw a greater increase in the power their muscles were able to generate. Similarly to the Smith study on muscle protein synthesis, more research needs to be performed, and on a variety of subjects. However, this study provided a strong baseline for the belief that omega-3 supplementation can lead to strength gains in human subjects.

Among the many beneficial effects of omega-3 fatty acids are those related to the cardiovascular system. It has been shown that an intake, greater than 3g/day, of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is associated with the reduction of several cardiovascular disease risk factors, including the reduction of inflammation. (Yang, Chan, Hu, Walden, & Tomlinson, 2011). It is well documented that inflammation plays a major role in strength training and recovery. However, while regular exercise has been shown to combat age-related muscular inflammation, the same exercise may cause inflammation, delaying the recovery process. More specifically, Interleukin-6 (IL-6), an inflammatory cytokine, causes a loss in strength and may lead to a prolonged recovery time when elevated in the body. (Dunn-Lewis et al., 2011).

Therefore, it is evident that the impact an omega-3 supplement can have may be quite significant. However, remember to incorporate the supplement into a well-balanced diet high in nutrient-rich foods to unleash its full health-promoting, anti-inflammatory powers.

REFERENCES

1. Dunn-Lewis, C., Kraemer, W. J., Kupchak, B. R., Kelly, N. A., Creighton, B. A., Luk, H. Y., Volek, J. S. (2011). A multi-nutrient supplement reduced markers of inflammation and improved physical performance in active individuals of middle to older age: A randomized, double-blind, placebo-controlled study. Nutrition Journal 10: 90. doi: 10.1186/1475-2891-10-90

2. Rodacki, et all (2011). Fish oil supplementation enhances the effects of strength training in elderly women. American Journal of Clinical Nutrition

3. Smith, et all (2010). Dietary omega-3 fatty acid supplementation increases the rate of protein synthesis in older adults: a randomized controlled trial. American Journal of Clinical Nutrition (93)2 402-12

4. Yang, Y., Chan, S. W., Hu, M., Walden, R., & Tomlinson, B. (2011). Effects of some common food constituents on cardiovascular disease. IRSN Cardiology. doi: 10.5402/2011/397136


Say Cheese!Photographic Food JournalingEmilyEdwardsandCassieDorschner

As smartphone companies like Apple and Droid increase the resolutions of their camera features, their sales and demand continue to increase. Simultaneously, the sales of major digital camera companies such as Canon, Sony, and Nikon continue to decrease rapidly (1). The ease of snapping a picture on a cell phone has never been easier. This convenient capability has led to several popular programs such as Instagram, Pic Stitch, and Vintique. These programs are capturing much more than memories with loved ones. The younger generation has created a new trend: taking pictures of food. New food products, meals created at home, or visual stunners presented at a gourmet restaurant; they all have equal camera time, no discrimination here. What’s the quickest way to share your culinary delights with the world? Snapping a picture, of course.

The nutrition world has jumped on this trend as well. First introduced in 2010 at the American Dietetic Association (ADA) Food and Nutrition Expo, Meal Logger was presented as an innovative piece of technology that would provide food journaling and nutrition advice on the go. What is MealLogger®?MealLogger® is a mobile app that allows individuals to record their food, exercise and sleep patterns, and share them with a registered dietitian. The steps to register are:

• A Registered Dietitian (R.D.) creates an account on the MealLogger® website. They have the option of choosing between a package that allows them to have five clients at a time or a package that has unlimited clients. The prices reflect the number of patients.

• Next, the patient creates an account and sets up a username. The R.D. will then add the patient by searching for their username. The patient then downloads the program onto their smartphone.


• Patients will then snap photos of their meal, snack, or anything they eat and sync their photos to their online accounts.

• The R.D. has the opportunity to give direct feedback via text message, or in the comment box in regards to the food choices the individual made.

It is important to note that the pictures uploaded will only be seen and commented on by the R.D. seeing the patient. Other features include: tracking exercise activity as well as recording weight and other biometrics, such as sleep and pedometer step counts (2). What is in it for the patient?The patient is able to quickly communicate with the Registered Dietitian about the food choices they are making and ask advice from the professional. This is a big change from the usual 24- hour recall method or food frequency surveys. MealLogger® is also user friendly for the patients that will be using this program. It is ideal for the technological savvy, but it is also very easy to teach the patient how to use the program. It takes minimal effort and uploads to the R.D. to assess within minutes. Also, the program is usually free. This program is generally covered by the Registered Dietitian to better assist you in meeting your nutritional goals.

What is in it for the Registered Dietitian?Registered Dietitians are faced with the usual struggle of relying on their patients to recall accurate food history. Patients often are not well educated on portion sizes and all the ingredients that go into the foods they eat. It is not uncommon for a patient to forget what they ate for breakfast less than 24 hours ago. MealLogger® addresses this problem head on. The dietitian is able to accurately determine the portion size their client is consuming as well as trends in their client’s diet based on the pictures the client uploads. Overall, this increases the accuracy of the process. The dietitian can physically see what the patient is eating, how much they are eating, and when they are eating. A Dietetic Intern’s PerspectiveComing from a generation that spends a substantial amount of time on their cell phones and computers, staying technologically relevant is key in this modern era. MealLogger® allows the field of Dietetics to branch out into the virtual world while at the same time keeping their credibility as nutrition professionals. This is a constant battle for our profession. There is a preconceived notion that Registered Dietitians only see patients with preexisting conditions who need nutritional intervention. As future dietitians, we would promote people

to use programs such as MealLogger® who are simply seeking additional basic nutrition advice and education. This type of advancement may be utilized while grocery shopping, trying new restaurants, or cooking new recipes. Ultimately, this tool may help identify the diverse roles a dietitian may play in everyday life.REFERENCES

1. Johnson, K. (2012, March 19). Digital camera sales decline due to smartphone cameras and photography apps. Retrieved from http://velositor.com/2012/03/19/digital-camera-sales-decline-due-to-smartphone-cameras-and-photography-apps/

2. (2010). Wellness coaching, made simple. DOI: tp://www2.meallogger.com/about-meallogger

Screen shot of MealLogger®


Eat Twinkies, Get TwiggyEllenGipsonandSydneyMessick

It seems almost daily that we are bombarded with a new miracle obesity cure. With information coming at us from every possible source, it is no wonder that we are confused, really confused. Are carbohydrates bad? Will gluten kill me? Are all calories equal? Drink more wine? Yes, please! Researchers are working to understand the relationship between nutrient quality, composition of foods and the role they may play in weight loss or weight gain. As nutrition professionals, we advocate the “all foods fit” model where no foods should be labeled as “bad” or “good”. Instead, we promote weight loss through a balanced diet of fruits, vegetables, whole grains, lean proteins, and low-fat dairy combined with physical activity. However, some have challenged this philosophy by asserting that weight loss can be achieved by caloric restriction alone, regardless of diet quality. So, can you get twiggy on Twinkies? If yes, then how can we explain this phenomenon to our clients?

A personal experiment conducted by Dr. Mark Haub, a Kansas State University professor, aimed to challenge the nutritional question “Are calories really all that matter?” His expedition became known as the “Twinkie Diet.” The plan? Cut back on calories, but rely on Little Debbie snacks as the

majority of this restricted daily caloric intake for the initial four weeks. The general structure of his diet was as follows: approximately 1,000 kcals from “snack cakes” (about 4-5) per day, approximately 500 kcals per day from whole or 2% milk or protein shakes, a daily multi-vitamin or multi-mineral supplement, and approximately 100 kcals from a vegetable source, like a can of green beans, 3-4 stalks of celery, or a tomato. Essentially, he wanted to know - is calorie restriction alone enough to support weight loss? Will a middle-aged man consuming roughly 1,600 kcals/day of pure junk lose weight and possibly GAIN health?He quickly began to see results. Good results. And he wanted more. He followed the original “Twinkie Diet” for four weeks, followed by six weeks in which he began to incorporate a daily dinner meal with his family, which in turn increased energy intake by approximately 200 kcals per day. At the end of his ten week experiment, and against all logic and nutritional assumptions, his weight had dropped from 200.8lbs to 174.2lbs, a 26.6 pound difference. His percent body fat, measured using DEXA, slid down from 33.4% to 24.9%. Not only did he physically lose weight, but also astonishingly enough he GAINED health! His baseline cholesterol had dropped from 214mg/dl to a healthy 184mg/dl and HDL increased from 37mg/dl to 46mg/dl. Fasting blood glucose levels plummeted from 94mg/dl to 75mg/dl. No one could have predicted for this experiment to succeed as it did; and he had reached uncharted territories.

These surprising results began to gain attention throughout the department and the news media, and everyone wanted to learn the secret behind the “Twinkie Diet.” However, as a bearer of bad news, there is no secret. A calorie is a calorie. Necessary weight lost is health gained. As dietitians, should we recommend Twinkies at every

meal for optimal weight loss? Some may wish, but there is more to overall health than one’s weight. However, Dr. Haub’s experiment proves that there is room in one’s diet for a little bit of “junk” - the key is moderation. It is our responsibility as health care professionals to help people navigate through the flood of weight loss information circulating throughout society and help them find a balanced diet that is maintainable for them. If that is 1,800 calories per day of fruits, vegetables, and whole grains, great, but if it is 1,800 calories of fruits, vegetables, and a little junk food, then clearly that works too, and elliminates the feeling of deprivation often associated with “dieting”.

Can you lose weight by eating a calorie-restricted diet of pure junk? Yes. However, these dietary habits are not sustainable and there is no way of knowing the long-term side effects of a constant junk food diet. Encourage clients that all food can be consumed in moderation and that enjoying a little junk food isn’t the end of the world, but focusing on those foods rich in vitamins and minerals will leave them feeling their best.

REFERENCES

1. Personal interview from Dr. Mark Haub received from Sydney Messick on August 21, 2012.

2. Nutrition & Exercise class powerpoints. Kansas State University. Fall 2011.


Is Raw Milk Safe?Amelia Karges and Melissa Chapnick

“Is this safe?” we thought to ourselves mid-sip as we stood amidst several large dairy goats, the source of the milk in our dixie cups. A culinary adventure brought us face-to-face with this claimed-miracle-food. Raw milk, or milk consumed without pasteurization, returns its drinkers to an era when the majority of people lived in rural areas and cared for their own dairy animals. During that time, farmers seized the short period from “farm-to-table” and used the milk in their homes, providing their families with a versatile, home-grown ingredient they used to make cheese, butter, cream, and other dairy products.

As time progressed, people moved away from farms and into cities, causing industrial milk processing plants to emerge, meeting the demand for milk. Milk-borne illness became a major problem in the mid to late 1800’s as unhygienic milk factories spread typhoid and tuberculosis to many innocent milk drinkers. In response, a milk commission was founded to oversee milk production to ensure safety and commercial pasteurization machines were introduced by Louis Pasteur. By 1917, pasteurization was required by law, dramatically reducing the number of milk-borne illnesses.

So, knowing milk’s progression over the years, why then would we turn our back on our friend, Louis, and flock to unpasteruized or “raw” milk? Well, with chronic diseases showing progressively stronger associations with consumption of processed foods, many consumers have begun reaching for food that is unprocessed or, essentially, in its “natural state”. Raw milk is one such food. Consumers are looking for the “farm-to-table” benefits of the good old days.

Taste, health benefits, and application of the new “green” philosophy all draw consumers to risk illness and even death for the sake of consumption of raw products (NY Times). Raw milk advocates attribute its medicinal properties to “good” bacteria and enzymes, which have been claimed to improve everything from GI distress to asthma. So, why don’t we get this beneficial bacteria from all milk? Faithful raw milk drinkers claim that once milk is clenched by the jaws of industrial processing, it is stripped of all benefits during the pasteurization process and becomes part of the monotonous outflow of modified food products. Raw milk, they believe, is an eco-friendly alternative.

However, despite claims to contrary, raw milk is actually a breeding ground for disease, and should not necessarily be considered a safe food item. In fact, it is right up there with raw meat, eggs and fish in terms of food safety concerns. The list of offending bacteria in raw milk include Salmonella, E. coli, Listeria and more, causing diseases such as listeriosis, typhoid fever, tuberculosis, diphtheria, and brucellosis. While everyone is susceptible to infections by these bacteria, certain individuals, including children, older adults and immunocompromised patients, are at an even higher risk.

A man interviewed on the topic by the New York Times stated, “ [raw milk] is richer in calcium, richer in everything else.” Well, yes, yes it it rich in everything else ... including harmful bacteria that can potentially cause illness - or worse. So while the benefits of raw milk seem enticing, they may not be worth the risks associated with raw milk consumption. So, rather than think of pasteurization and milk processing as a component of the jaws of the industrial world, consider them - in this case - a means of enjoying milk safely.

Photo by by Ambro/FreeDigitalPhotos.net


Trans Fat Ban: The Aftermath LoriSinclairandCateDallas

In 2006, New York City became one of the first cities in the United States to pass a regulatory restriction on trans fat. According to the Journal of the American Dietetic Association, trans fats have been shown to adversely affect lipoprotein metabolism, resulting in higher lipid profile results (1). The purpose of this ban is to help control trans fat intake with the ultimate goal of reducing the prevalence of cardiovascular disease in the city. This regulation “restricts all food service establishments, including both chain and non-chain restaurants, from using, storing, or serving food that contains partially hydrogenated vegetable oil and has a total of 0.5 g or more trans fat per serving” (Angell, Cobb, Curtis, Konty, & Silver, 2012). The ban itself has raised many controversies; however it may be working for New York City.

Before this ban was imposed, only minimal regulations were required for trans fat. The regulations were placed solely on labeling in which any amount above 5 grams must be recorded to the nearest gram, any amount below 5 gram musts be recorded to the nearest 0.5 gram, and anything below 0.5 grams is not required to be printed on the label. Because of this lack of regulation, New York City’s ban brought to light the concerns of trans fat in the diet and advocated for an increase in cardiovascular health and an overall healthier lifestyle (Food Labeling, 2003).

A recent study conducted by the New York City Department of Health and Mental Hygiene, looked at five fast-food chain restaurant groups to determine the effects of the trans fat ban. They found that mean trans fat consumption amongst consumers dining at these hamburger, sandwich, pizza and Mexican chains decreased by 2.4 g per purchase, with three of chains showing a statistically significant decrease in the amount of trans fat consumed. As trans fats have been phased out of the restaurants, some fear that saturated fat may be making its comeback. While the study did find a “slight overall increase in saturated fat content per purchase, trans fat and trans plus saturated fat decreased, indicating a net health benefit(Angell et al., 2012).”

Although these statistics seem impressive, there are still no metrics in place to measure the primary goal of the ban: a decrease cardiovascular disease and improvement in overall health (Angell, Silver, & Goldstein, 2010). The ban has succeeded in decreasing the average consumption of trans fat during lunch hours at fast food restaurants, but is currently lacking data to support its claim for improving cardiovascular health. More evidence gathered from a wider

variety of restaurant types would add more data making the study more significant. Even though the study seems inconclusive at the moment, it has opened doors for many opportunities to improve public health. The New York City ban on trans fat has brought public awareness to dietary fat, and health professionals, including dietitians, can use its publicity to educate patients and consumers on current regulations and dietary practices.

REFERENCES

1. Angell, S. Y., Cobb, L. K., Curtis, C. J., Konty, K. J., & Silver, L. D. (2012). Change in Trans Fatty Acid Content of Fast-Food Purchases Associated With New York City’s Restaurant RegulationA Pre–Post Study. Annals of Internal Medicine, 157(2), 81-86. doi: 10.7326/0003-4819-157-2-201207170-00004

2. Angell, S. Y., Silver, L. D., & Goldstein, G. P. (2010). Determining the Benefits of the New York City Trans Fat Ban. Annals of Internal Medicine, 152(3), 194-195. doi: 10.7326/0003-4819-152-3-201002020-00018

3. Food Labeling: Trans Fatty Acids in Nutrition Labeling, Nutrient Content Claims, and Health Claims Small Entity Compliance Guide. (2003, August). U.S. Food and Drug Administration. Retrieved August 20, 2012, from http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/FoodLabelingNutrition/ucm053479.htm

4. Remig, V., Franklin, B., Margolis, S., Kostas, G., Nece, T., & Street, J. C. (2010). Trans Fats in America: A Review of Their Use, Consumption, Health Implications, and Regulation. Journal Of The American Dietetic Association, 110(4), 585-592. doi:10.1016/j.jada.2009.12.024


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