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Fluoride and Hip Fractures

There is much hype about fluoridation of water, particularly on the Internet. Now, a research study published in the American Journal of Epidemiology reports that there may be a concern for women regarding risk of hip fractures.

This study was conducted in Finland with over 144,000 elderly rural people with hip fractures. Women who were exposed to natural fluoride levels greater than 1.5 mg/L or less had more hip fractures than women exposed at levels of 0.1mg/L or less.

The Environmental Protection Agency (EPA) has set the maximum contaminant level for fluoride at 4 mg/L to prevent skeletal fluorosis, a crippling condition.

In the U.S., the Centers for Disease Control and Prevention reports that in 1996, there were 340,000 hospital admissions for hip fractures. Women sustain about three-fourths of these.

It will be interesting to see if additional studies corroborate these findings, since another recent study reported no link between fluoridation and hip fracture risk. Stay tuned.

Reference: Am J. Epidemiol, 150:1999.

Vitamin E and Coronary Heart Disease (CHD)

Vitamin E intake has been associated with reduced risk of coronary heart disease (CHD). A recent study found no effect of vitamin E supplementation on risk of cardiovascular events, including myocardial infarction (heart attack) or stroke.

Men (6,996) and women (2,545) at risk for cardiovascular events were randomly assigned to receive 400 IU vitamin E or placebo. There were no significant differences between the groups in number of myocardial infarctions or strokes, and no difference in number of deaths. Vitamin E had no adverse effects, and the study is being continued to evaluate effects of vitamin E on cancer incidence.

Reference: New England J. Med, 342:154-60, 2000.

For Your Information

Caution: Dangerous Foods

CAUTION: DANGEROUS FOODS

8 foods account for 90% ofallergic reactions

1. Milk
2. Eggs
3. Peanuts
4. Tree Nuts
5. Wheat
6. Soy
7. Fish
8. Shellfish

Reprinted from: Florida Spotlight, A Publication of Food and Nutrition Management, Florida Department of Education, Vol. 5, Winter 2000.

Obesity: Prevention Better Than Treatment

In an editorial in the New England Journal of Medicine in 1998, Kassirer and Anzell stated "Until we have better data about the risks of being overweight, we should remember that the cure for obesity may be worse than the condition. We need to promote healthy lifestyles and focus on improved eating and exercise behaviors rather than body weight."

Reference: The New England Journal of Medicine, October 1999.

NOTE: I recently sent a letter to USDA expressing a similar concern and opinion, and supporting programs and policies that promote healthful diets and physical activity for young people (LBB)

Food Label on Dietary Supplements: Pregnancy Claims

To ensure that careful consideration is given to concerns recently raised regarding how the structure/function rule relates to pregnancy, FDA today (2/9/2000) is advising dietary supplement manufacturers not to make any claims related to pregnancy on their products based on the agency's recently issued structure/function rule. FDA will issue a Federal Register notice shortly describing these concerns in more detail, stating the agency's intention to fully review these concerns, hold a public meeting related to potential pregnancy related safety concerns, and then issue further guidance. FDA urges all pregnant women to consult their health care provider before taking any dietary supplements or medication.

Source: Food and Drug Administration Press Release, February 9, 2000.

Tips When Using Herbals

Dr. Judith Stern, Co-director of the UC-Davis Center for Complementary and Alternative Medicine suggests the following guidelines if you choose to use herbals:

1. Herbals can be a part of your overall health maintenance plan that includes good nutrition, exercise, vitamins, and minerals.
2. Do your homework to find out which herbs are best for you.
3. Consult your healthcare professional with questions. Let your doctor know which herbs you use.
4. Stick with recommended dosages - follow label directions.
5. Look for herbals that have standardized ingredients.

It's best to purchase herbs from a trusted brand. They are more likely to provide a safe and reliable product.

Source: Electronic Food Rap, 10(5), March 10, 2000.

American's Eating Habits

According to an economist with the Economic Research Service, "We are a nation of meat eaters." The per capita supply of meat in 1998, 195 pounds boneless, trimmed weight, was the highest ever. Despite recommendations by nutrition educators, consumption of legumes is still only 1¾ servings per week. Some other trends:

• Overall liquid milk consumption is down.
• Consumption of 1% and fat free milk is increasing.
• Cheese consumption is 2½ times higher than in 1970.
• We consume 200 lbs. per capita of flour and cereal products - but, less than 2% of the flour we use is whole wheat!

The cost of poor eating habits (high fat, low fiber, low fruits and vegetables) is estimated at $71 billion. Clearly there is a need for nutrition education in this country!

Source: Talk presented by Judy Putnam, ERS, at SNE, July 24, 1999.

Herbals and Anesthesia May Not Mix

After conducting a survey of presurgical patients, anesthesiologist Dr. Charles McLeskey recently presented his findings to the American Society of Anesthesiologists in Dallas. Seventeen percent of the patients reported that they took at least one herbal medicine, according to a survey of 979 patients. But just as some prescription medicines can be dangerous if taken before surgery, so can some commonly used herbs. Ginkgo biloba, garlic, ginger, and ginseng are anticoagulants, which means they can keep the blood from forming clots and could cause excessive blood loss during surgery. The anti-depressant St. John's wort and relaxant kava-kava can extend the sedative effects of anesthesia. [Consumers must let their doctors know of any herbal or other supplements they take if they are going to have a surgical procedure. LBB]

Source: Electronic Food Rap, 10(5), March 10, 2000.

Sources of Added Sugar

Soft drinks contribute one-third of the added sugars in the U.S. diet, and fruit "drinks" add another 10 percent. Intake of sugar continues to rise.

Reference: Continuing Survey of Food Intake by Individuals 94-96.Source: Susan Krebs-Smith talk at SNE, July 27, 1999.

Marketing Costs of Foods Rise

Americans' desire for convenience foods-meats cut up, marinated, and ready for the grill; entrees in microwavable packaging; individual juice boxes for bag lunches; and the large portion of our meals prepared by foodservice companies-translated into $466 billion worth of marketing costs in 1998.

Marketing costs accounted for 80 percent of the $585 billion consumers spent for domestic farm foods, not including imported foods, in 1998. The remaining 20 percent, or $119 billion, represents the gross return paid to farmers.

The cost of providing marketing services beyond the farm gate continues to be the most persistent source of rising food expenditures. Once again, the marketing bill outpaced the general inflation rate of 1.6 percent in 1998. The marketing bill grew $21.2 billion in 1998, an increase of 4.8 percent, following a similar rise in 1997. The farm value for domestic farm foods fell 2.5 percent in 1998, while consumer expenditures for these foods grew by 3.2 percent.

The cost of marketing U.S. farm foods has increased considerably over the years, mainly because of the rising costs of labor, transportation, food packaging materials, and other inputs used in marketing, and also because of the growing volume of food and the increase in convenience and service provided with the food. These rising costs have been the principal factor affecting the rise in consumer food expenditures. From 1968 to 1998, consumer expenditures for farm food rose $186 billion. Roughly 88 percent of this increase resulted from an increase in the marketing bill.

Source: FoodReview 22(3), September-December, 1999.

U.S. Food Supply

Providing More Food and Calories

All three major per capita food supply measurements-food available for consumption, nutrients available for consumption, and the food supply adjusted for spoilage and other loses in the home and marketing system-suggested that Americans in the 1990's are consuming more food and several hundred more calories per person per day than did their counterparts in the late 1950's (when per capita calorie consumption was at the lowest level in this century), or even in the 1970's.

Meanwhile, as calorie-intake levels have risen, physical activity levels appear to have declined among the majority of Americans. More than 60 percent of adults are not active at all, according to the U.S. Centers for Disease Control and Prevention. Increasing physical activity is a formidable public health challenge in a technologically advanced society. Few occupations today require significant physical activity, and most people use motorized transportation to get to work and to perform routine errands and tasks. Even leisure is increasingly filled with sedentary behaviors, such as watching television, "surfing" the Internet, and playing video games.

Not surprisingly, the trend in the prevalence of overweight and obesity is upward. About 97 million adults in the United States-55 percent of the population-are overweight or obese, based on data from the third National Health and Nutrition Examination Survey (NHANES III; 1988-94). These individuals face increased risk of illness from high blood pressure, high cholesterol, diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, and certain cancers. The total costs attributable to obesity-related disease approaches $100 billion annually, according to the National Institutes of Health.

Some of the observed increases in caloric intake may be associated with the increase in eating out. Data from USDA's food intake surveys show that the food-away-from-home sector provided 34 percent of total food energy consumption in 1995, up from 19 percent in 1977-78. The data also suggest that, when eating out, people either eat more or eat higher calorie foods-or both-and that this tendency appears to be increasing.

Foods of low nutrient density such as cakes, cookies, soft drinks, syrups, jams, potato and corn chips, and popcorn are major contributors to intakes of energy, fats, and carbohydrates. Continued intake of these foods compromise intake of more nutritional foods.

Source: Food Review, 22(3), Sept.-Dec., 1999.

Americans Eating Out

The share of food dollars spent away from home climbed to an all-time high of 47 percent of food expenditures in 1998.

Food spending in the United States rose 3.6 percent to $756.2 billion between 1997 and 1998. Total expenditures for eating out (food away from home) rose 4.6 percent, to $354.4 billion in 1998. Retail food expenditures (food at home) increased at a lower pace than 1997's 4.1 percent rise, up 2.8 percent to $401.8 billion.Source: Food Review (22)3, September-December, 1999.

Contacting The Experts

Need information on trends or historical data on food consumption, spending, food assistance programs, food trade, or other food topics? The Food and Rural Economics Division of USDA's Economic Research Service has economists, social scientists, and other specialists who can help. Use this list as your guide to contact specialists directly, by e-mail or by phone.

Child Nutrition Programs
Linda Ghelfi (lghelfi@econ.ag.gov)
(202) 694-5437

Diet and Health Economics
Fred Kuchler (fkuchler@econ.ag.gov)
(202) 694-5468 and

Paul Frenzen (pfrenzen@econ.ag.gov)
(202) 694-5351

Diet and Nutrition
Betsy Frazão (efrazao@econ.ag.gov)
(202) 694-5455,

Biing-Hwan Lin (blin@econ.ag.gov)
(202) 694-5458 and

Jay Variyam (jvariyam@econ.ag.gov)
(202) 694-5457

Food and Nutrition Research Program
David Smallwood (dsmallwd@econ.ag.gov)
(202) 694-5466 and

Mark Prell (mprell@econ.ag.gov)
(202) 694-5408

Food Assistance and Nutrition Programs
Margaret Andrews (mandrews@econ.ag.gov)
(202) 694-5441 and

Betsy Frazão (efrazao@econ.ag.gov)
(202) 694-5455

Food Away From Home
Charlene Price (ccprice@econ.ag.gov)
(202) 694-5384 and

Mark Jekanowski (markj@econ.ag.gov)
(202) 694-5394

Food Consumption
Judy Putnam (jputnam@econ.ag.gov)
(202) 694-5462 and

Jane Allshouse (allshous@econ.ag.gov)
(202) 694-5414

Food Insecurity and Hunger
Craig Gundersen (cggunder@econ.ag.gov)
(202) 694-5425 and

Mark Nord (marknord@econ.ag.gov)
(202) 694-5433

Source: Food Review (22)3, September-December, 1999.

Organic Standards Alert

The USDA will be announcing proposed national standards for organic labeling in the near future. The standards will be much stronger than originally proposed in 1997. They exclude the use of genetically modified ingredients, antibiotics, irradiation, and the application of sewage sludge. The USDA welcomes comments; it received over 275,000 during the last round.

Comments can be sent to the USDA via the National Organic Programs Web site: http://www.ams.usda.gov/nop/indexNet.htm

Source: USDA National Hunger Clearinghouse "What's "Moo" at the Clearinghouse" newsletter, March 2000.