ENAFS Connection Newsletter

LINKING RESEARCH AND EDUCATION FOR FLORIDA'S ELDERS

June 2000

This project is possible thanks to funding by the Florida Department of Elder Affairs in partnership with state, county, and local agencies.

 

HIGHLIGHTS

Herbal Recall

A recall has been placed on the herbal products Diabetes Hypoglucose Capsules and Pearl Hypoglycemic Capsules produced by Chinese Angel Health Products. This is due to the presence of the undeclared drug Glyburide. Glyburide is a drug used to lower blood sugar. People who have low blood sugar or those with diabetes run the risk of serious or life threatening complications if they consume these products. Consumers should stop using these products and seek medical advice, especially if they are currently being treated with other anti-diabetes drugs or if they have symptoms of fatigue, excessive hunger, profuse sweating, or numbness of extremities. Consumers who use these products can receive a dangerously high amount of Glyburide. Consumers should return the herbal medication to the place of purchase for a full refund or destroy the remaining product immediately. Anyone who has questions may contact Yung Stevens at (310) 876-0664. LAM

Food or Medicine?

An estimated one in five Americans over the age of 65 lives at or near the poverty level. This causes approximately 1.9 million Americans to face the impossible choice of buying food or buying needed medication each year. While many elders live on a fixed income, the prices for prescription medications in the U.S. are soaring. A study conducted by Families USA determined that prices for medicine taken by elders rose as much as four times faster than inflation last year. According to research conducted by the Administration on Aging, most elders have at least one chronic condition and many have multiple health conditions. In most cases, these conditions add up to multiple prescription drugs. There are many programs throughout the state of Florida that can help elders deal with hunger and prescription drug issues. Please contact your local Area Agency on Aging for more information. LAM

Fast Facts

  • In 1957, the average movie popcorn was 3 cups. Today, a medium popcorn is 16 cups.
  • Nearly 20% of elders live in or near poverty.
  • Obese patients are at an increased risk for developing many medical problems, including insulin resistance and type 2 diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease, stroke, sleep apnea, gallbladder disease, hyperuricemia and gout, and osteoarthritis.

Clinical Cornerstone, 1999.

Nutrition Therapy Among Elders

Eighty-six percent of older Americans have diabetes, hypertension, dyslipidemia, or a combination of these chronic diseases (NHANES III, 1997). All of these conditions have adverse outcomes that can be ameliorated or reduced with nutrition therapy. In 1999, the Institute of Medicine appointed an expert committee to evaluate available data on the relationship between provision of quality nutrition services and quality-of-life outcomes. The following is a summary of the committee's report. The summary includes the source of the evidence that supports the use of nutrition therapy as well as specific recommendations based on available evidence and standards of care of professional organizations.

Diabetes

Source of evidence: Randomized clinical trials, which include data on individuals over 65 years old.

Recommendation: Nutrition therapy is recommended in addition to exercise, medication, and blood glucose monitoring.

Dyslipidemia

Source of evidence: Observational studies and randomized trials.

Recommendation: Nutrition therapy is recom-mended for persons on medications as well as those who are not on cholesterol-lowering therapy.

Hypertension

Source of evidence: Trials conducted in the elderly and studies conducted in other populations.

Recommendation: Nutrition therapy is an effective means to reduce blood pressure in people with hypertension, in addition to medication. In selected individuals, medication step-down and medication withdrawal are feasible with nutrition therapy.

Heart Failure

Source of evidence: Clinical trials and observational studies.

Recommendation: Nutrition therapy is an integral component of multidisciplinary programs to prevent readmission for heart failure, reduce subsequent length of stay, and improve functional status and quality of life.

Pre-Dialysis Kidney Failure

Source of evidence: A randomized clinical trial and two meta-analyses.

Recommendation: Nutrition therapy may have a beneficial effect in delaying the progression of kidney disease and should be included in the management of chronic renal insufficiency.

Osteoporosis

Source of evidence: A considerable body of evidence including multiple randomized controlled trials.

Recommendation: Enhanced intake of calcium and vitamin D for both prevention and treatment of osteoporosis in the at-risk elderly population. PW

Source: Institute of Medicine, books.nap.edu/html/role_nutrition/summary.pdf

Web Sites - Check It Out!

Sugar Substitutes

Almost 144 million American adults consume low-calorie, sugar-free products such as artificially sweetened sodas and desserts. Sugar substitutes can help lower consumers' daily caloric intake and are alternative sweeteners for diabetics. The following table describes sugar substitutes that have been approved for use in the United States by the Food and Drug Administration.

Name Saccharin Aspartame Sucralose Acesulfame-K
Brand name(s) Sweet'n Low™ Nutra Sweet™
Equal™		 Splenda™ Sunett™
Less than 5 calories per serving Yes Yes Yes Yes
Can be used for baking Yes No Yes Yes
Requires warning label

Yes

(high doses caused bladder cancer in male rats; typical intakes for adults are recognized as safe)

Yes

(should not be used by people with phenylketonuria; pregnant women and people with advanced liver disease may have trouble metabolizing the substance)

 No No

Blends of two or more sweeteners are becoming more common in the United States. Blends allow food manufacturers to use sweeteners that are suited for the manufacturing and storage conditions of particular foods and beverages. Also, some sweeteners enhance each other's effects. This allows manufacturers to use a smaller amount of each. An example of a blend that is now used in gelatin, ice tea, and soft drinks (such as Pepsi One ™) is the aspartame-acesulfame-K blend. PW

Source: Diabetes Spectrum Vol. 12, 1999

ADA Position on Food Irradiation

Food irradiation has been recognized as a safe technology to decrease the incidence of foodborne illness. Recently The American Dietetic Association (ADA) revised its position on food irradiation stating that "food irradiation enhances the safety and quality of the food supply and helps protect consumers from foodborne illness." The ADA recommends that the government, food manufacturers, food commodity groups, and food and nutrition professionals work together to educate consumers about food irradiation and to help make this option available in the market. LAM

Source: Journal of American Dietetic Association 2000; 100: 246-253.