Which is Better Omeprazole or Esomeprazole?

Esomeprazole (Nexium) and omeprazole (Prilosec) and are two of the most popular prescriptions for GERD (gastroesophageal reflux or acid reflux), but which one is better?

Why they’re prescribed?

Omeprazole and Esomeprazole are both PPIs and as such, they used to treat gastric acid-related conditions, including GERD, heartburn, esophagitis, or inflammation or erosion of the esophagus, duodenal ulcers caused by Helicobacter pylori, or nonsteroidal anti-inflammatory drugs (NSAIDs).

They have also been prescribed for the treatment of Zollinger-Ellison syndrome, a disease in which tumors cause the production of excessive stomach acid, Multiple Endocrine Adenomas, Several stomach ulcers, and Systemic Mastocytosis.
Both drugs can be gotten on prescription and over-the-counter (OTC). Omeprazole is available in tablet and capsule forms. While Esomeprazole can be gotten in tablet, capsule, and as liquid suspensions.

How do They Work?

Omeprazole and Esomeprazole belong to the class of drugs known as proton pump inhibitors (PPI). Proton pumps line the cells of the stomach and are responsible for producing hydrochloric acid (the main constituent of stomach acid). By inhibiting these proton pumps, Omeprazole reduces the amount of acid produced in the stomach.

These type of drugs have been used since 1981. They’re considered the most effective medication for reducing stomach acid. They work best when you take them an hour to 30 minutes before a meal. You’ll need to take them for several days before they’re fully effective.
By reducing the production of acid in the stomach, they stop the excess acid flowing back into the food pipe (esophagus) and so relieve painful heartburn symptoms associated with acid reflux. Omeprazole medication also allows the esophagus to heal if it has been damaged by the acid.

What is the Difference Between Omeprazole and Esomeprazole?

Omeprazole and Esomeprazole are remarkably similar. However, there are minor differences in their chemical makeup. The differences are more prominent in their branded variants. For example, Prilosec contains two isomers of the active ingredient omeprazole, while Nexium only contains one isomer.

While this may not be the biggest difference, it alters how drugs work. In Nexium (Esomeprazole), its ingredients are made to be processed more slowly than Prilosec (Omeprazole) in your body. This means that levels of the drug are higher in your bloodstream and that esomeprazole may decrease acid production for a longer period of time.

For this reason, Esomeprazole tends to work slightly faster than omeprazole in relieving symptoms. Esomeprazole is also created to be broken down by the liver, so as to reduce interaction with other drugs. Furthermore, pharmaceutical companies may add different inactive ingredients in producing branded variants of these drugs.

Omeprazole or Esomeprazole, which is Better?

Both drugs have undergone years of clinical trials, and results indicate that Omeprazole and Esomeprazole may offer some advantages to people with treating certain conditions.

An older study from 2002 found that esomeprazole provided more effective control of GERD than omeprazole at the same doses. According to a later study in 2009, esomeprazole offered faster relief than omeprazole in the first week of use. After one week, symptom relief was similar.

In 2007, American Family Physician published an article questioning some of the results of clinical trials. According to the article, the size of the studies, the condition of patients, the amount of active ingredients used in the studies, among other factors affect the results of clinical results.

After analyzing 41 studies on the effectiveness of PPIs, the article concluded that there’s little difference in the effectiveness of PPIs, especially when used for extended periods.

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Let’s Talk Nutrition: The Six Essential Nutrients

A framework for understanding vitamins starts with a definition of the umbrella under which these vital compounds are but one piece of the puzzle-nutrition. Any number of textbooks can provide a working definition, some more inclusive than others, but most would agree on that provided by the Council on Food and Nutrition of the American Medical Association:

Nutrition is the science of food, the nutrients, and the substances therein, their action, interaction, and balance in relation to health and disease, and the process by which the organism ingests, digests, absorbs, transports, utilizes, and excretes food substances.

Quite a mouthful, and if you haven’t guessed, we are the organisms in question, along with any other species on earth that biologists consider to be alive. That definition is good for showing the scope of the science of nutrition, but it leaves out the more human factor of food behavior. And it is food behavior, or the food choices we make on a daily basis and why we make them, which determines how nutrition affects our health. Another way to say this is, once we know which foods and in what amounts are beneficial to our health, why don’t we eat those foods in those amounts?

Of course that’s the proverbial million-dollar question, and it doesn’t lend itself to easy answers. Cynics might respond that humans are inherently lazy and hedonistic, seeking after pleasure first and foremost. While that may explain it for some of us, a more enlightened response would be that our food behavior is influenced by culture, beliefs, heritage, socioeconomic status, lifestyle, and a host of other equally important factors. It’s no surprise, then, that simply knowing which foods are more health promoting doesn’t mean people actually eat those foods. But awareness is the first step, and only after acquiring correct information can a person choose to change his or her behavior.

A growing number of people are frustrated by what they perceive as conflicting information. Nutrition is a young science compared to other scientific disciplines, which means that nutrition studies got a late start and have continued to boom in the past few decades. In addition, as new reports came out, other researchers followed the scientific method and tried to repeat the same experiments. If the results of a study can be reproduced in similar studies, the conclusions are more reliable.

A good example is the recent flap about beta-carotene and lung cancer. Many studies have shown that people who eat lots of fruits and vegetables had lower rates of several different types of cancer (among these, lung cancer). Trying to figure out just what it is in fruits and vegetables producing the beneficial effect, however, is fairly complicated. Some subsequent studies have suggested that beta-carotene was the likely magic bullet, and researchers designed a special type of study to test that theory.

What they found was that smokers who took beta-carotene supplements actually had a higher risk for lung cancer! Since then, another study showed the same results. While even more studies would really convince everyone, the fact that the first results were reproduced in another study would suggest that smokers should avoid taking beta-carotene supplements. A look at the different types of studies that nutrition researchers do will help explain another reason for sometimes conflicting reports on diet and health, and will also prepare you for the upcoming chapters on vitamins, which focus on the latest research.

Why a Rat and Not a Person?

Another reason for the seeming contradictions in new nutrition information has to do with the different types of studies and the fact that the media tend to report results as soon as they are published, sometimes sooner. Because of this, no filtering occurs, which might help to put each single study in a broader context of what has come before and how to interpret the results. Research results can be difficult for experts to decipher, let alone a newspaper reporter who has no background in science. Yet this is how most Americans come by their nutrition information. Little wonder that each new report seems to add to consumer confusion instead of resolving it.

Scientists use four basic types of studies, each with its own strengths and weaknesses, to either prove or disprove a hypothesis, or a guess they may have about something. The first, and most familiar, is the laboratory study, which can include animals or simply test tubes. Lab studies can provide details on why a specific effect occurs, such as how vitamin C boosts immune function. One reason for doing this is that animals can be dissected after the study, in sharp contrast to human subjects.

Laboratory Study

Another strength of a lab study is the control that the researchers have over their experiments. They can use a specific breed of rat, knowing all the physiologic background of the strain, and are assured that all subjects will be extremely similar. In contrast, a group of seemingly similar humans presents many more variables than 100 “Sprague Dawley” rats Finally, researchers can use as many rats or rabbits as they can afford, and the greater the number of subjects, the more valid the results.

The major weakness of lab studies is obvious, however; just because a study works a certain way in a rat doesn’t mean the same applies to a human being. When the media report the latest research results, people often do not pay attention to the fact that it was an animal study and that applicability to humans remains to be proven. In addition, researchers have to be on their toes to use an appropriate animal model in a particular study because different species vary in how similar they are to humans with regard to a specific function. As an example, ferrets are the best animal for studying the absorption of beta-carotene, since their physiology most closely resembles humans in this regard.

Case Study

This type of study focuses on one individual, usually someone who has exhibited an interesting trait. A somewhat recent example comes to mind: a few years back, the New England Journal of Medicine reported that a man in his nineties, who had been eating an average of a dozen eggs a week, had the blood cholesterol levels of a healthy teenager. This obviously surprised his physician and countless nutrition professionals who read the published report, because age and male gender are both risk factors for high cholesterol. To add a dozen eggs a week, which conventional wisdom of the time implicated as raising blood cholesterol, was unthinkable! While these reports are intriguing and can lead to further research, the effect of diet on one individual is not significant.

Epidemiologic Study

So if one person isn’t enough, what about an entire population? Epidemiologic, or population, studies compare disease rates among groups of people around the world, and look for correlations between disease and dietary habits. It was this type of study that led researchers to the association between a Mediterranean-type diet and a lower risk for heart disease. Epidemiologic studies are useful in pointing to a possible connection between diet and disease, laying the groundwork for further studies. Unfortunately, these studies can only show a statistical association, but not cause and effect. In other words, just because a study reports that people who eat a high-fiber diet tend to get colon cancer less often, the study doesn’t prove that dietary fiber prevents the disease. It might just be that something else about the high-fiber diet, or the kind of people who eat that way, is protecting against colon cancer.

Intervention/Clinical Trial Study

An intervention study compares the effects of a treatment, or intervention, on a group of people or subjects, called the experimental group, to another group, who received no treatment, called the controls. The control group is sometimes called the placebo group, which simply means that they received a fake treatment or “sugar pill” instead of the real treatment. The intervention study is by far the most powerful of all research designs because it demonstrates the effect of a given treatment. Recent examples include the Physicians’ Health Study, which proved that a small daily dose of aspirin reduced the risk for heart attack in men.

So if this type of study is so good, why isn’t it used all the time? It’s very expensive to conduct clinical trials, partly because humans are involved, requiring longer periods of time for treatment than animal subjects. In addition, blood draws and other assessment methods require trained personnel, which adds to the cost. But even with powerful intervention studies, the results are only as good as another study’s ability to duplicate the results.

The Last Word?

The next time a news headline screams, “Broccoli Causes Cancer!” take a few minutes to evaluate the study. Look at a few simple criteria, such as whether it was a human or animal study. If it was a human study, how many people participated? Was it an intervention study or an epidemiologic study? And finally, if the results contradict research that has preceded this study, remember that reproducibility of those results will be necessary before taking the information too seriously. Researchers are just doing their job by continually asking questions; generally, they end up with many more questions after doing a study than answers to the first question they asked. Smart consumers will wait before acting on the results of a new study.

Six, Count ‘Em: The Essential Nutrients

Nutrition concerns itself with the study of foods and the numerous compounds they contain. However, some preferential tre,atment is in order for the essential nutrients. The word essential refers to the fact that we have to ingest these compounds through our diet; our body can’t make them. We need these substances to grow and maintain our bodies. Adults don’t tend to grow as do infants and children, but they still need to repair and replace body tissues.

As an example, red blood cells have a limited life span of four months. After that time, the body has to make new ones. To do that, it needs specific nutrients. You might consider nutrients to be building blocks for all forms of life. In some ways, we are not too different from an ear of corn or a bowl of rice. Although the comparison isn’t exactly flattering, it illustrates that the human body is made up of similar components as the foods we eat, which is why those foods are nutritious to us!

The six essential nutrient groups which we must obtain through our diet are water, carbohydrate, fat, protein, minerals, and vitamins. Within each group, we need several nutrients. For example, we need thirteen vitamins and fifteen minerals. Water is by far the most vital: you can get by without vitamin C for a few months, but a shortage of water will be life threatening within days. This is generally true for all the nutrients, with a deficiency of some adversely affecting us sooner than others. Another important principle is that only fat, carbohydrate, and protein provide energy in the form of calories. Each of the billion cells in our bodies is a small microcosm of the whole, and while each needs all the essential nutrients, the most critical in the short term are water and energy.

Each essential nutrient has a particular function in the body which can’t be performed by any other nutrient. Overall, water, vitamins, and minerals help convert the energy nutrients, fat, carbohydrate, and protein into energy the body can use. Aside from the obvious need for energy to fuel our physical activity, the body uses energy to build and maintain its components such as muscle, bone, and blood. A chemist once described the human body as a mini-chemistry lab forced to conduct millions of chemical reactions every day. A fairly apt metaphor, and the vitamins are among the industrious little chemists working to change the food we eat into fuel, glue, bricks, and other building materials to keep the main building in good repair.

Quick Notes on Each Nutrient Group

This book, and especially the next three sections, focuses on vitamins, but a quick summary of each essential nutrient group’s functions is in order.

Carbohydrates

Although this group has sometimes gotten a bad rap, it includes a variety of compounds which have implications for health, with the basic function of providing energy for the body’s needs. Our main source is green plants, which convert water and carbon dioxide in the air to carbohydrate, with the help of sunlight and chlorophyll. Carbohydrates are either simple or complex, with simple carbohydrates consisting of sugars. The most common form of sugar, glucose, is the energy currency that travels in our blood to keep thecells fed.

Complex carbohydrate refers to starch and fiber, and of the two, humans can only digest and derive energy from starch. Although we don’t have the needed enzymes to break down fiber, it helps the body in other ways. The fact that we can’t break it down means that it keeps moving along the intestinal tract, stimulating bowel function and keeping it healthy. There is good evidence that a high-fiber diet can lower the risk for colon cancer. Friendly bacteria that live in the colon can break it down, and the by-products appear to have a healthful effect on colon function and in lowering cholesterol.

You can see that the bad rap is undeserved: far from being “fattening” additions to the diet, a generous intake of complex carbohydrate may actually help with weight control by replacing higher-calorie fats. Aside from its potential health benefits, fiber also makes a person feel full (called satiety), which may reduce calorie intake. The key is to emphasize complex carbohydrates, and use sugars only moderately. And finally, complex carbohydrates are one of the best ways to obtain the B vitamins, with whole grains being an excellent source.

How much is the right amount? That depends on you and your total energy needs in a day. Remember, the type of carbohydrate is everything. Load up on food sources such as fruits, vegetables, whole grain breads, cereals, and other grain products. Cut back on sources which are mainly desserts such as cookies, cakes, pies, candy, and sweetened drinks. To ensure that you get enough fiber in your diet, you might even consider limiting your intake of added sugars and processed grain products that offer no fiber. These include white bread, presweetened cereals, and crackers, muffins, and bagels that are not whole grain. Shoot for 50 to 60 percent of your total calories to eat as carbohydrates. If your daily calorie intake is around 2,000, you should take in slightly more than half, or 1,000 calories, as carbs. Illustrates a healthy example focusing on carbohydrate choices.

Fat

Most people think of fat as something to avoid in their daily diets to prevent heart attacks and keep from becoming obese. But as with carbohydrate, the reputation is largely undeserved, with different types of fat serving many vital roles in the body. The type of fat we carryon our bodies, triglyceride, is the same type we eat in foods. While we may complain about how fat we are, if we had to store our energy reserves as carbohydrate, we’d be huge! Fat takes up roughly half the space, in chemical terms, as carbohydrate. The reason for fat being the perfect form of reserve energy in the body actually accounts for its higher calorie value-9 calories per gram, compared to carbohydrate and protein at 4 calories per gram.

Fat is also useful as an insulator against temperature extremes, and it protects vital organs by cushioning them. On a smaller scale, fat molecules make up the protective membranes surrounding individual body cells and other important structures. The fat in foods adds to flavor, texture, and mouth feel;’ which is a food technologist’s term to describe the creamy sensation in your mouth when you eat a food containing fat. Fat also contributes to a feeling of satiety, a feeling of fullness after a meal. This may be one reason why people who dramatically cut back on their fat intake can’t seem to get enough food.

Getting back to vitamins, several of them require the presence of fat in foods to be properly absorbed and used by the body. Some people who have conditions causing difficulty in fat absorption end up becoming deficient in the fat soluble vitamins (those requiring fat for absorption). In addition, certain fatty acids, the compounds which form triglycerides by combining in groups of three, are essential nutrients linoleic and linolenic acids, found in plant oils.

While everyone is still worried about reducing fat intake, the evidence suggests that it is the type of fat you eat, rather than the amount, which determines the impact on health. Currently, a diet that is moderate in fat, around 30 percent of total energy, and emphasizes monounsaturated fat is considered the healthy choice. Saturated fat, the type which predominates in animal products, is associated with higher blood cholesterol levels, which in turn increase the risk for heart disease. shows the sample diet we used for the carbohydrate count, adding in foods which add fat, and substitutions for those that usually do, in the recommended amounts.

Protein

This nutrient had been the darling of the diet world starting in the 1960s and continues to hold the interest of bodybuilders and other athletes. The basis for their interest is not too farfetched: lean body mass, and specifically muscle tissue, is composed primarily of protein. While we say that protein is an essential nutrient, it is more accurate to say that the body requires specific amino acids, the building blocks of protein. Different protein-containing foods provide a mix of the various amino acids.

Protein is different from its other two energy-yielding partners, fat and carbohydrate, in that it contains the element nitrogen. A protein can contain twenty different amino acids, and when we eat protein, we get a mix of them. The body can make eleven of them on its own, but we have to eat protein containing the other nine, which are called essential amino acids.

Protein in the body is, by and large, functional. In other words, we don’t have extra protein taking up space for reserve, as we do with fat. Body protein is structural, as in muscle, the inner parts of bone and hair, tendons, and other body components. But it also works, forming enzymes which pave the way for chemical reactions, immune system compounds such as antibodies, and carrier molecules (that ferry things such as vitamins in the blood). In addition to carrying nutrients in the blood, a major blood protein, albumin, is responsible for keeping the body’s fluid in balance.

It’s obvious, then, how important protein is. What you might not know is that the average American takes in twice as much protein as he or she needs. The recommended amount of daily protein intake is based on a person’s weight. Of course, you don’t add extra protein if you have excess weight. The recommended amount is 36.4 percent of body weight. A moderately active woman who weighs 120 pounds needs 43 grams of protein every day. The sample diet, at about 2,000 calories, probably works for many people and provides more than twice the amount this woman needs. This amount of excess shouldn’t pose a problem for the average person, unless there is kidney disease, but you can see how calls for higher protein intakes are off base.

Vitamins

These compounds are the stars of the nutrition world, and it was their discovery, probably more than anything else, that fueled the explosion of research into human nutrition. The current list of vitamins, thirteen to be exact, have been known to be essential for human life for several decades. However, scientists continue to study these intriguing nutrients to learn more about them-everything from how the body absorbs them from different foods to possible interactions within the body’s cells. One thing is certain: as new facts unfold, new questions arise.

Although nutrition researchers still study vitamins to learn about what they do, we know some of their general roles. Some act like hormones in the body, sort of chemical messengers. Others are a part of enzymes, vital compounds that control metabolic reactions in the body. Many of the enzymes vitamins team up with can’t function unless they combine with specific vitamins, called coenzymes.

A useful way to sort vitamins is into two groups: those that dissolve in fat (fat soluble) and those that dissolve in water (water soluble). This gives you some idea of how the vitamins function and how they’re,handled by the body. In addition, solubility determines if a vitamin can be stored in the body and how easily it’s lost from the body as well as from foods during processing or preparation. And finally, knowing whether a vitamin dissolves in fat or water can give you a rough idea of which foods contain it.

You don’t need much of any of the vitamins-it works out to about an ounce if you add up all the vitamins you need for a day. But scientists use different units of measure for vitamins, including mg and micrograms. Just to get an idea of how little a microgram is, one of these tiny units is equivalent to one-millionth of a gram, and a gram is about one-thirtieth of an ounce! Retinol equivalents (RE), and sometimes International Units (IU), are the measurements used in industry for vitamins A and E.

Since there are thirteen essential vitamins (fourteen, if you count the newcomer choline), our sample meal would get a bit complicated, so we’ll look at two key vitamins that many Americans don’t get enough of vitamins A and C. What you’ll notice is that with few exceptions, most of the significant sources of both vitamins are fruits and vegetables. One important distinction is that even in these foods, there is a wide variability in the amounts notice that a banana and an apple provide negligible amounts of either nutrient. But the sample meal is perfectly balanced and provides our reference female with almost four times the recommended amount of vitamin A and more than seven times the vitamin C.

Minerals

Minerals are the most enduring of nutrients; that is, long after the human body has decomposed, and actually forever, the minerals in that human body will remain unchanged. Their indestructible nature tells us that cooking heat and other forms of food processing don’t lower the amounts of needed minerals in our foods. However, minerals are water soluble, so prolonged contact with water will leech them out of foods. In contrast to the complex forms of the other nutrients, minerals are the basic chemical elements familiar to us in useful things other than food, such as copper pipes and iron railings.

The minerals fall into two major categories, major and trace minerals. The difference between them is a matter of amount: the body contains major minerals in amounts greater than 5 grams and less than this amount of trace minerals. This gives you an idea of the amounts you’ll need to consume as well. As an example, compare the need for 800 mg of calcium, a major mineral, to that of 12 mg for the trace mineral zinc-a major difference! is a list of both groups.

The roles of the minerals are diverse, with many of these nutrients doing double and triple duty. As an example, sodium, familiar as the partner to chloride in table salt, helps to maintain the proper amount of acid in the blood and fluid balance outside the cells. In addition, sodium is involved in muscle contraction and nerve transmission, both vital functions considering that the heart is a muscle and has to keep beating.

As mentioned, the amount we need of each essential mineral varies depending on whether it is a major or trace mineral. Some minerals continue to prove challenging for some Americans to consume in the recommended amounts. As for toxicity, many minerals can prove fatal in excess amounts. A deadly example is copper, which because of its potential toxicity, was the drug of choice years ago for people in India wishing to commit suicide. One reason for easy toxicity has to do with the body’s handling of a particular mineral. Some minerals readily excrete into the urine when excess amounts arise, while others, such as iron, tend to accumulate in the liver, posing a considerable health risk.

If we go back to our sample day’s intake and consider two minerals which pose problems for many American women, calcium and iron, we’ll see that only certain types of foods provide significant amounts of each. And our sample menu again stands up to the test, providing our reference woman with about 20 percent more than the recommended amounts for calcium and iron. A final note that isn’t apparent just by looking at the numbers: for several minerals, and especially for calcium and iron, the body appears to better absorb and use those nutrients from animal sources compared with grains and vegetables.

Water

Although water is so essential to life that even a few days without it can kill a person, most people don’t give much thought to this vital nutrient. And while everyone knows the importance of vitamins and minerals, people may not realize that water, along with those nutrients and fat, carbohydrate, and protein, together make up the six nutrients essential for human life.

Water is a very simple compound from a chemical standpoint, consisting of only two atoms of hydrogen and one of oxygen. However, its simplicity gives rise to functions which support every aspect of human physiology, the most basic being a near perfect solvent and the medium for most of the body’s chemical reactions. In addition, water brings nutrients to each cell and carries away the cell’s waste products. It is part of the chemical structure of cells, tissues, and organs. Water also acts as a lubricant and cushion for joints and lubricates the digestive tract and other mucosal tissues. Another important role is in body temperature regulation because of its ability to change temperature slowly.

The need for water is based on caloric intake, and therefore body size. Under normal conditions, the average adult needs about one milliliter for every calorie consumed, or about 13.6 milliliters per pound of body weight. However, fluid requirements are affected by factors such as internal and external temperature, physical exertion, and environmental humidity level. In addition, several compounds and certain conditions can act as diuretics to promote fluid loss or cause retention of body fluid.

Naturally occurring diuretic compounds include caffeine, alcohol, and chemicals found in certain vegetables such as asparagus. Compounds which promote retention of water include high salt intake and the body’s production of certain hormones, such as antidiuretic hormone and vasopressin. A person’s age also influences the need for fluid, with infants requiring a higher proportion because their body composition includes a higher amount of water.

Many people believe that they need to drink eight glasses of water every day to maintain proper fluid balance, which is an erroneous assumption based on overlooking the fluid contained in foods. Most foods consist of 50 to 90 percent water, which provides about 60 percent of the adult need for water. Foods such as fruits and vegetables contain the most fluid, so depending on intake, fluid provided by foods can vary. Additionally, although drinking plain water can be beneficial, it is not essential, since other beverages contain water. Exceptions include coffee and other caffeine-containing beverages and alcohol, which because of their diuretic effect tend to deplete fluid beyond the amount they provide.

Our reference woman who eats the sample menu is taking in about 2,000 calories. This means her fluid need is 2,000 mI, or 66.6 ounces. Looking at the water contained in just the beverages, two cups of milk and one cup of juice, she has already consumed 21.6 ounces, since both milk and juice are about 90 percent water. If we only give her credit for her apple, banana, and carrots, now she’s up to about 30 ounces, which doesn’t include the additional water from other foods. Another four and a half cups of any liquid, including water, puts her where she needs to be.

Anything Else in There?

By now, you may be wondering about some of the other substances you’ve heard of in the news lately: fiber, phytoestrogen, flavonoids, and many more. Scientists refer to these as nonnutrients, of which the phyto chemicals are one type. The word nonnutrient simply means that the compound is not one of the known nutrients which we need, while phytochemicals have some kind of activity in the body. There is increasing evidence that some of these compounds may be beneficial in preventing chronic diseases. But not all of these nonnutrients are helpful: cabbage and other plants contain compounds called goitrogens that interfere with the thyroid hormone, possibly causing a goiter. Fortunately, the heat from cooking destroys these compounds, so it’s not normally a problem. Scientists who study toxins (toxicologists) tell us that plant foods are rife with potentially toxic substances.

Most of the consumer excitement regarding phytochemicals may seem recent, but food scientists have known for some time of their existence. Other nonnutrients have been acknowledged for several decades, such as dietary fiber. Although evidence continues to mount that different types of fiber are beneficial for human health, from aiding normal bowel function to preventing colon cancer, strictly speaking, fiber is not an essential nutrient. In other words, humans could theoretically survive without it. Quality of life, however, might be another matter!

The consideration of nonnutrients seems to pose another question: How do nutrition scientists figure out if something is an essential nutrient? Part of the answer relates to the history of vitamin discovery, which we’ll save for upcoming chapters. But more recently, scientists have used a combination of the various types of studies to determine essentiality. Animal studies are the most obvious choice because of the method researchers use. To find out if a nutrient is essential, they feed the animal a diet, usually a formula, devoid of that compound but containing all the other nutrients they know to be essential. If the animal can grow, develop normally, and not suffer any ill effects, the compound is not essential. If the animal shows signs of deficiency, the compound is an essential nutrient.

Human case studies have also proved invaluable, usually the result of trial and error. In the not too distant past, say, forty years ago, scientists developed methods of feeding people who couldn’t eat normally. Eating normally means taking food through the mouth and all the way through the intestinal tract. Doctors had to figure out another route for feeding people who had a problem somewhere in the intestinal tract. Over the years, they’ve refined the methods by feeding people either through a tube inserted somewhere into the intestinal tract or, for people with a nonfunctioning intestine, directly into the bloodstream. You can see, then, that they learned fairly early on what nutrients had to be added to the formulas to prevent nutrient deficiencies. Although technology has advanced greatly, some questions remain about other compounds the formulas still might need.

How Does Your Diet Add Up?

To get the most out of this book, you may want to consider doing a bit of detective work about your diet. Completing the following form will enable you to do the “How Your Diet Adds Up” quiz at the end of each section relating to a specific vitamin. The first rule of thumb for keeping a food record is to do as many days as possible. It’s best to do a minimum of three, and consider two weekdays and one weekend day. The more days you evaluate, the more likely your intake for that time is representative of your diet in general. The reason for including a weekend day is that most people eat differently then. Try to avoid using a day that is not typical for you, such as a special occasion (a wedding or a party).

Precautions For Penis Enlargement Tool Users

For men who use penis enlargements, some warnings and precautions have been circulated. One major concern is in the use of certain devices used to help lengthen or widen your member.

Warnings you may hear of extend to such tools such as steel ball bearings, plastic pellets, toothpaste caps, and precious stones. Gold bars, studs, and rings are also used and inserted, usually near or through the glans.

One of the reasons why these objects or tools are used is because they are said to increase sexual pleasure for a woman. However, they could possibly cause injury in both the man and the woman.

Another problem is that these objects or tools inserted into or placed on a man’s penis can also cause infection. After much concern about certain methods men (and their partners) are looking for new ways to bring pleasure and satisfaction into their relationship.

Alternatives

Sometimes men instead use various male enhancement and penis enlargement exercises. Various moves can work a man’s PC (a.k.a. Kegel) muscles in order to help him not only increase his endowment (penis length and width) but also his stamina and energy.

Other moves that a man might do would stretch his member. This can help him prevent injury before he moves on to the more advance routines as described above.

Certain moves can also help increase libido and sex drive. They can also help straighten out a curved penis.

However, sometimes in order to encourage permanent size gains they also may take pills to enhance. However, a man is advised to use caution concerning these as well because otherwise he could cause a rash or other irritation if he uses a formula that causes an allergy.

Therefore, if a man needs some exercise enhancement help he might prefer using one of a variety of stretching programs at https://phalogenics.co.za/. This can help a make more efficient gains as he searches for the right way to enhance sexual experiences and/or feel more confident.

Conclusion

There are pros and cons to each type of solution that a man uses. However, if he really wants to make progress he might want to consider more natural approaches, without medication.

However, it is to each their own regarding penis enlargement and male enhancement. Some men prefer just to use exercises alone while others prefer to use supplements and exercises.

Sometimes a man may also use devices along with the supplements and exercise routines. One way a man can be sure of the methods he should use is to consult a doctor and ask him or her for an opinion.

Why is Nail Fungus Tough to Beat?

Mycosis a fungal infection is a common condition affecting the skin and the lungs. The fungi spreads in the air with the help of tiny spores which when inhaled from the air or when these fungi’s fall on the skin they affect people who have a low immune system causing infection though most of these fungi’s are harmless.

Reason for being attacked by nail fungus

A fungus or a microorganism known as dermatophytes attacks the skin when there is a cut on the nail bed, most of the times this cut goes unnoticed which further deepens due to constant pressure from the shoes you are wearing or sometimes due to the in grown nails etc. These microorganisms reproduce rapidly in the humid atmosphere due to lack of air circulation aggravating the problem.

The early signs of nail fungal infection are a slight discoloration of the fingernail or the toenail as they tend to develop yellow or white spots under the nail tips. As the infection increases there is further discoloration of the entire nail making it thicker and brittle. In some cases the infected nail causes a lot of pain.

 nail fungal infection

Mode of nail fungus treatment

Is the nail a breeding ground for these microorganisms or fungus?

Most of the funguses grow in dark and humid places. These funguses are parasites devoid of chlorophyll. The human foot is the place for these parasites to thrive as it is directly exposed to climatic changes. Often it has been seen that nail fungus infects a person with sweaty feet, working near swimming pools and wet houses. Nail fungus disorder also affects people with a weak immune system.

There are various kinds of mycoses like the subcutaneous mycoses and cutaneous mycoses but then to treat a person affected by nail fungus infection is very tough. The nail plate protects the fungus acting like a shield preventing direct sunlight, trapping moisture and creating an environment on which the fungus can easily thrive on. This nail plate also prevents the direct contact of the medication on the infected area further increasing the infection.

Due to the pain and non availability of proper topical treatment people believe in getting rid of the infected nail plate with the help of surgery. The removal of the nail plate does not solve the problem as the infection still remains in the nail bed. The need to use anti-fungal nail solution or oral medications for a long period of time is important.

What are the chances of re-infection?

Most of the anti-fungal treatments available in the market don’t guarantee permanent cure to help get rid of the infection as there are chances of re-occurrence of the infection.

If you are suffering from nail infection then you need to take extra care to build up your immune system by eating good and healthy food, exercising is also important. Eating yoghurt is the best home remedy to increase your resistance power to fight against the fungus.

The need to wear protective footwear is important; avoid walking on the floor with bare feet especially when using public baths, gyms, pools, showers etc. Washing your hands and feet with anti fungal soap and drying them are the best way to avoid the spread of the infection.

Benefits of Noni Fruit Drink

Which has improved benefits of noni fruit drink?

Most of the Tahitian noni fruit drink customers and producers would disagree that in contrast with its Polynesian counterpart, Hawaiian Noni fruit drink, the Tahitian is much enhanced in terms of nourishment. Tahitian natural noni customers fight that as measured up to the Hawaiian edition, the Tahitian is much enhanced sustenance and even flavor wise. They utter that Tahitian noni fruit drink is not only a healthy food drink but as well has medical values as it can in fact heal many kinds of diseases.

Merely the same, whether Hawaiian or Tahitian

As a result, if Tahitian is enhanced, what does it formulate of Hawaiian Noni fruit drink? Customers of the Hawaiian edition speak otherwise, challenging that theirs is the unique edition of the noni drink. The truth is that whether it is Tahitian or Hawaiian, both are prepared of the equivalent noni fruit as well as healthful elements. Manufacturers and producers may make use of the noni crop from Tahiti or in Hawaii, but the concluding juice that will be manufactured consists of the similar noni fruit drink benefits that customers can get pleasure from. In locations where it is more common it is in use as unfermented in sugary form. This piece of writing takes a glance at the various methods the fruit drink is extorted and made obtainable for eating. Most of the Noni grows in weathers that are free of contamination.

Noni fruit drink has same healthful elements everywhere

There must be no quarrel and the truth remains that the Tahitian, Hawaiian or any other trademark of noni goods they more or less have the same elements and producers are not supposed to declare that theirs is the greatest. On the whole, what’s inarguable is the truth that the noni fruit drink is highly advertised as a very nourishing food drink appendage which is rich in precious minerals as well as nutrients that our bodies can take advantage of.

Benefits of Noni fruit drink are mostly supplemental to good health

One of the most important health benefits of noni fruit drink is the aptitude of the fruit drink to give relief to different skin conditions such as allergies and rashes. It is as well supposed as healing to some illness even though it is preeminent that you confer with your doctor or health supplier when you intend to make use of noni fruit drink for medical reasons.

Towards the end of the day, whether we make use of Tahitian or Hawaii organic noni fruit drink, we will yet have the benefit of all the noni fruit drink health benefits that these goods provide if simply because they come from the similar source that is the noni. What ever brand it may be either Tahitian noni fruit drink or Hawaiian fruit drink, it must have the medical values as it can in fact heal many kinds of diseases.

Ten Of The Best Hgh Vitamins

To get the most effective HGH vitamins is really difficult as you need to take into consideration quality, price and the brand name too. Listed below are some effective and quality HGH vitamin products that are easily available and sold across the counter. As you know that vitamins play an important role in the proper functioning of the body and they are essential for the overall growth and development of the body.

Repair Gold: As the name suggests it has the highest value added potential formula to help the speedy recovery of the body along with increasing the blood circulation in the body.

Virastop: A complex HGH vitamin containing 8 most essential components which help break cellular residues, unwanted proteins and destroying the toxins in the blood thus helping the body’s immune system.

Lypo Gold: An excellent HGH supplement to help the proper absorption and digestion of all the digestive fats and helps maintain the proper functioning of the metabolic activities of the body and is very essential vitamin to help maintain the healthy functioning of the cardiovascular functioning in the body.

Serra Gold: Contains serraptiopeptides which help the speedy recovery of the tissues which are broken due to continuous wear and tear due to sudden jerks, stretch etc. They also help relieve respiratory related problems, alleviate joint pains and help support cardiovascular functioning.

HGH Plus Anti-Ageing Supplement: As the name suggests it helps slow down the ageing process thus reducing many ailments related to ageing. It has proved its effectiveness by improving the energy level in the body, sexual performance, inducing proper and peaceful sleep and the most important being the proper functioning of the immune system.

Natto K: The main use of this HGH Vitamin is it helps to break down fibrinas it contains an enzyme called nattokinaze which has antioxidant properties.

HGH Plus IGF-1 and IGF-2: Both these vitamins contain bio identical hormones that are necessary to boost the level of the body’s immune system increasing the muscle mass, it also increases lung efficiency, increases the mental retention and helps reduce the swelling of the arthritic nerves.

Ningxia Goji Capsules: Helps increase the blood circulation in the body, reduces hypertension, diabetes and helps protect the liver and the kidney gets all the required nutrition through these capsules. Known to increase the resistance power to fight against micro-organisms they are boosters of the immune system. A rich source of carotenoids they protect the body from muscular degeneration and problems like dry eyes and cataract.

Energy and Stress Liquid: Contains a mega dose of Siberian ginseng, B-Vitamins and potassium and it boosts the energy level in the body naturally.

Perfect Whey Protein: Combination of two proteins having a high quality protein supplement i.e. whey protein concentrate and whey protein isolate both of which are low in lactose, fats and carbohydrates.

Vita Complete: A whole nutritional food supplement that gives the body complete health. This supplement supports all the major body organs as it contains all the required nutrition’s found in natural liquid form.

These are some of the best HGH vitamins but then you need to consult your family physician before taking these vitamins.

Dietary Standards and Recommendations

How Do We Know How Much?

His gaze was direct and almost a challenge as this athletic, business-suited yuppie uttered a demand before we had even sat down to our first nutrition counseling session. “Look, just tell me what I gotta eat and how much to get my cholesterol down by fifty points-fast.” I had never quite mastered the inscrutable “counselor” look: my overly expressive Italian face usually reflects my emotional response, which, in this case, ran the gamut of surprise at his fierce determination to more than a bit of annoyance at his obvious disdain for the complexity of making lasting nutritional changes. But in the next few seconds, I decided that I admired his faith in both nutrition science and a dietitian’s ability to deliver the goods. It also shows the public’s desire for specific recommendations and guidelines on a healthy diet.

Most members of generation X are too young to remember when there were only four basic food groups. That phrase harkens back to the days when junior high students, at least girls, were taught to cook and admonished to memorize the “Basic 4.” As the focus shifted from nutritional deficiency to excessive intake linked to chronic disease, however, new paradigms for recommendations became vital. The starting point for dietary recommendations, the Recommended Dietary Allowances (RDAs), have evolved, often contentiously, over the last half of this century. In fact, they are currently being updated and renamed Dietary Reference Intakes (DRIs).

The RDA have been and continue to be the best yardstick we have to evaluate dietary intake. Their objective is to suggest a level of intake for many essential nutrients that is as close to adequate as possible for as many people as possible. You can probably see the difficulty inherent in coming up with one number, say for vitamin A, that is appropriate for an entire nation! This is an unavoidable design flaw, and one that should be taken into account, but not one that should preclude confidence in and use of the RDA.

In addition to a yardstick for adequacy, we also need something that translates the latest scientific knowledge about nutrition and disease into understandable and usable guidelines. As research continued to accumulate, the government stepped up to the plate and issued the Dietary Guidelines for Americans. These seven simple recommendations have since been revised and expanded on, and have spurred other health organizations to develop their own dietary guidelines; we have recommendations from the American Heart Association, the American Cancer Society, and a few others for good measure. Contrary to some public opinion, dietary recommendations from the government and most health agencies seem to converge on similar themes.

DRIs and RDAs: How Do They Come Up with These Things?

Currently, the newly revised recommendations, DRIs, cover the following nutrients: calcium, phosphorus, fluoride, magnesium, vitamin D, and the B vitamins. The RDAs for the remaining essential nutrients will be updated in the next year or so and we still need to use the old RDA until the update is complete. So we’ll talk about both DRIs and RDAs, which you can consider almost one and the same.

The RDA for vitamins and the other essential nutrients are established by a subcommittee of the Food and Nutrition Board (FNB) of the National Research Council (NRC) and the National Academy of Sciences (NAS). The current DRIs are being updated by the Institute of Medicine. The NAS is a government agency, but the DRI committee, like the RDA committee before it, is made up of independent researchers representing various specialties in the field of nutrition. That’s important, not just because a lot of people don’t trust the government, but because the people who generate the RDA have broad expertise and experience and bring an unbiased view to the table.

The committee reviews the current information available from animal, human, and population studies and develops recommendations for nutrient intake. A recommendation is made for each nutrient in terms of the daily amount different groups of people need; the current DRI groups, which will cover all nutrients within the next few years, include:

  • pregnant and lactating women (different age groups within each)
  • infants: 0 to 6 months; 6 months to a year
  • children: 1 to 3 years; 4 to 8; 9 to 13
  • males: 14 to 18; 19 to 30; 31 to 50; 51 to 70; over 70
  • females: 14 to 18; 19 to 30; 31 to 50; 51 to 70; over 70

The RDA for a nutrient includes what’s called a “margin of safety,” to account for individual human variation and differences in how well the body is able to absorb the nutrient from various food sources. Most experts believe that the RDAs, which are only applicable to healthy people, probably cover up to 95 percent of the American population. A small number of people will not get enough of a particular nutrient if they take in the RDA, and others will get more than they need.

So where does that leave you? The best use of the RDA is to plan or evaluate diets for groups of people, such as in a nursing home or school. But as long as we recognize their limitations, it is reasonable to use the RDA to assess an individual’s diet. In fact, dietitians do it all the time; we just need to remember that while the RDA is our best estimate, that’s all it is.

Not all nutrients have an official RDA; some have other classifications. For example, the RDAs are not necessarily optimal intakes, but they aren’t minimum intakes, either. In other words, they are not set at a level to simply prevent a deficiency; they include an ample margin of safety. But for sodium, chloride, and potassium, an “Estimated Minimum Requirement” is set at a level which is the minimum you need with no margin of safety. Nutrients with an RDA under the 1989 RDA or the new DRI include protein and the vitamins and minerals.

If studies show that a nutrient is essential but the experts feel that there isn’t enough information to set an RDA, they suggest a range of intake with a special name. The 1989 RDA used the term Estimated Safe and Adequate Daily Dietary Intake (ESADDI). The nutrients still covered in this category include the trace minerals chromium, molybdenum, copper, and manganese. When the committee revises recommendations for these nutrients in the future, more research may provide solid evidence for establishing an RDA. The new DRI uses a similar category called Adequate Intake (AI), and has used that term for several nutrients which received updated recommendations.

The first RDAs were published in 1943, and the plan was to revise them every five years. In 1985, the RDAs were scheduled for revision, but because of scientific controversy, the update didn’t appear until 1989. The word controversy doesn’t do justice to the brouhaha which stormed across universities and research centers around the country, resulting in several lawsuits! The new DRls evolved from years of proposals and revisions for updating the RDAs and differ in two important ways. The first change is that the DRls represent one combined set of North American recommendations. Previously, Canadians had their own guidelines, similar to our RDAs. The second important change is that where the previous RDAs were designed to prevent deficiency, the new recommendations reflect current knowledge of nutrient amounts needed to promote optimal health and prevent chronic disease. The plan calls for revision of all nutrient recommendations in a seven-step process, by groups of nutrients. As mentioned, new numbers were recently issued for nutrients involved in bone health-calcium, magnesium, phosphorus, vitamin D, and fluoride, as well as the B vitamins.

The DRIs include different categories, just as the RDAs, to account for the more tenuous nature of the research for certain nutrients. In addition, they will continue to include the margin of safety, but with the DRI showing that value in the new AI category. The AI consists of the average intake that covers half the needs of those within a specific gender and age group. Another new category will address the increasing use of nutrient supplements and food fortification, by indicating the upper level of safety for some nutrients.

DRI Categories

Estimated Average Requirement (EAR)

Intake that meets the needs of half the individuals in a specific group. This figure is used to develop new RDAs for some nutrients.

Recommended Dietary Allowance (RDA)

These values are derived from EARs. The RDAs are the EAR with an added amount that accounts for the variation in nutrient needs within life-stage groups (margin of safety). The RDAs will meet the need for almost all healthy individuals within a life-stage group.

Adequate Intakes (AI)

For many nutrients, the research data are not available to estimate an average nutrient requirement. For these nutrients, the DRls give an AI recommendation which appears adequate to sustain a desired indicator for health.

Tolerable Upper Intake Level (UL)

Widespread use of supplements and food fortification has prompted the NAS to include a value that represents the best estimates of maximum intakes that do not pose risks of adverse health effects in healthy individuals within a life-stage group.

One final note about the DRls/RDAs is that, in addition to specific nutrients, there is an RDA for daily energy or caloric intake. Because of the problem of obesity in this country, the energy RDA does not include a margin of safety. Instead, the RDAs are set at average levels for each age and gender group plus or minus 20 percent to account for either situations of higher need, as with increased physical activity, or periods of lower needs, such as occur in aging. What this means for you is that if you’re average for your age and gender, in body size and activity level, the energy RDA is probably close to your actual energy needs. The reference woman at age 19 to 24 is 5’5″ and weighs 128 pounds, while the reference man is 5’10”, weighing 160 pounds.

The Dietary Guidelines: Can We All Agree?

The Dietary Guidelines first appeared on the scene back in 1980. The purpose was to help Americans make food choices that would prevent poor diets which research began linking to chronic diseases. These nutrition recommendations were a joint effort of two government agencies, the U.S. Departments of Agriculture and Health and Human Services (USDA, USDHHS). Since their inception, they’ve been both applauded and panned, but the guidelines have endured to be revised most recently in 1995.

The latest guidelines appear to be a bit more relaxed, cutting Americans some slack on previously frowned-on food ingredients such as sugar and salt. This left some nutrition advocates jeering. But in the words of one USDHHS official, the new Dietary Guidelines promote “moderation over marathons” and suggest that Americans consider realistically attainable health and dietary goals.

The U.S. Dietary Guidelines for Americans

  • Eat a variety of foods.
  • Balance the food you eat with physical activity. Maintain or improve your weight.
  • Choose a diet with plenty of grain products, vegetables, and fruits.
  • Choose a diet low in fat, saturated fat, and cholesterol.
  • Choose a diet moderate in sugars.
  • Choose a diet moderate in salt and sodium.
  • If you drink alcoholic beverages, do so in moderation.

The major changes in the evolution of the Dietary Guidelines involve an emphasis on the benefit of vegetarian diets, which is included in the text for the first guideline, the more realistic focus on weight maintenance rather than attainment of ideal weight, and a more positive wording for the guidelines on salt and sugar. Another change came not in the wording of the guideline concerning alcohol, but in the accompanying text, which points to recent studies that tout the possible benefits of moderate alcohol consumption. Also in the text of the publication is another reference to recent research promoting the importance of folic acid for pregnant women.

The revised Dietary Guidelines evoked this less-than-positive characterization of the government’s role from one nutrition advocate: “It’s laissez-faire or do-nothing behavior. Guidelines should tell people what’s the best possible diet and urge them to move in that direction. These don’t.”

Others, however, have commented more positively on specific aspects of the guidelines which emphasize the importance of physical activity in weight maintenance. The new guidelines recommend that Americans engage in thirty minutes of moderate physical activity every day, providing examples such as gardening, housework, or brisk walking. The rationale for this guideline follows the general tenor which stresses a more realistic approach rather than ideal goals.

While the new Dietary Guidelines for Americans may be too moderate for everyone, the USDHHS secretary’s summarizing comments may be welcomed by consumers who’ve been overburdened with stringent preaching: “We Americans should eat a wide variety of foods, balance diet with physical activity, and use good judgment in our consumption of sugar, salt, and alcohol.”

Food Labeling: Putting the Guidelines to Use

Pick up a package of fudge cookies and you’ll get more information than you probably want to know: the label will probably tell you that if you eat two servings, you’ll use up your fat allotment for the entire day! If you’re like most people, you’ll eat the cookies anyway, but at least you’re informed. That didn’t used to be the case. Prior to 1993, the food labeling laws hadn’t kept pace with nutrition research.

Just as the RDAs had centered on adequacy and preventing nutrient deficiency, so too did the food label. You’d have information on riboflavin, thiamin, and a host of other nutrients that aren’t the problem of the average American, but not a word on saturated fat and salt. In addition, manufacturers. didn’t have to include nutrition information unless they made a product claim. Under prodding from Congress, the Food and Drug Administration (FDA) came up with a new food label, Nutrition Facts. The FDA fixed most of the problems with the old labels, especially by mandating that virtually all food products had to include nutrition information. The exceptions include raw, single ingredient foods, fresh fruits, vegetables, and raw fish, which have voluntary nutrition information at the grocery store shelf.

It’s worth taking a close look at Nutrition Facts, because you can use it to make decisions about the products you buy and how to integrate them into a healthy diet. The food label highlights key nutrients, especially those linked to prevention of chronic disease, including vitamins such as C and A. The nutrient amounts in your cookies show up as percentages of what you should eat in one day, called Daily Values.

Daily Values, in turn, consist of two sources which don’t show up on the label, Reference Daily Intakes (RDIs) and Daily Reference Values (DRVs), but it’s important to know what they represent. RDIs are the old u.s. RDAs which used an even older source, the 1968 RDAs. The DRVs are specific recommendations for nutrients which didn’t have an RDA, highlighting those linked to disease, either positively or negatively: fat, saturated fat, salt, fiber, sugars, and others.

These are the nutrients which manufacturers must include on the label; they were selected because of current health issues:

  • total calories
  • calories from fat
  • total fat
  • saturated fat
  • cholesterol
  • sodium
  • total carbohydrate
  • dietary fiber
  • sugars
  • protein
  • vitamin A
  • vitamin C
  • calcium
  • Iron

If a claim is made on the label about other nutrients not on the mandatory list, such as potassium or monounsaturated fat, the manufacturer must provide the information. In addition, if the product contains a nutrient either by fortification or enrichment, it must include that information.

One of the main gripes from critics is the fact that the DRV s are based on a daily intake of 2,000 calories. This is obviously a compromise, since caloric needs vary greatly from one group of the population to another. However, one of the reasons for settling on 2,000 is that increasing the energy level would increase the fat allowance, possibly encouraging higher fat intakes.

Nutrition Facts shows standardized serving sizes for various types of products for the first time. In past years, the manufacturer decided on what serving size to base the nutrient analysis. This led to what appeared to some consumers as a slightly deceptive practice, when, for example, a serving size of cereal equaled one-fourth of a cup. It was true that there were only 5 grams of fat in a serving, but most people would tend to eat four times that amount, thus acquiring a hefty 20 grams of fat at almost a third of the daily allotment.

The FDA has also restricted the use of product health claims for a list of seven nutrient/disease relationships. The claim must also be worded in such a way as to accurately reflect the relationship between the nutrient, the,disease, and the nutrient’s relative importance in the total diet. The approved relationships include:

  • calcium and osteoporosis
  • fat and cancer
  • saturated fat and cholesterol and heart disease
  • fiber-containing fruits, vegetables, and grain products and cancer
  • fiber-containing fruits, vegetables, and grain products and heart disease
  • sodium and hypertension
  • fruits and vegetables and cancer

Food Guide Pyramid: A Practical Guide to Putting It All Together

The story began rather innocuously in 1988 when the USDA began development and testing of a graphic tool for use in communicating the messages of the Dietary Guidelines for Americans. But what followed seemed more like the shootout at the O.K. Corral than anything else. After the smoke had cleared, a pyramid loomed on the American horizon with the battle lines still drawn.

Some bystanders wondered what all the fuss was about since government agencies had been issuing dietary recommendations for years, beginning with the RDAs and culminating in the revised Dietary Guidelines for Americans. After all, the triangular figure with suggested serving sizes and attractive clips of foods seemed innocent enough. But it was the very shape of the image and the message it projected that sent trade industry groups to the battlefront. The intent of the pyramid was to emphasize certain food groups, such as grain products and fruits and vegetables, while deemphasizing other groups, such as meat and dairy products, and conveying a sense of what proportions the groups should represent in one’s diet.

The USDA stated that a graphic image was needed to reinforce the messages of the Dietary Guidelines. The Dietary Guidelines call for increased consumption of complex carbohydrates and reduced intake of fats, saturated fats, cholesterol, sugar, and salt. Because animal sources contain predominantly saturated fat and cholesterol, these foods are deemphasized in a diet based on the guidelines.

In response, industry groups marketing these foods cited the availability and promotion of newer low-fat versions of old American staples, such as extralean ground round and nonfat dairy products. They pointed to the nutrient density of these products and challenged their position on the new pyramid, which had placed animal-derived foods directly below the fats and sweets group at the tip of the structure. The message of the pyramid is that grain products such as bread, cereal, and rice should form the bulk of the diet, accounting for most of the calories provided. Next are the fruits and vegetables, providing key vitamins and minerals. Toward the top are the foods which should be eaten more reservedly-the meat and dairy group. At the very top are the fats and sweets, with the admonition “to be used sparingly.”

Actually, the pyramid is not an American invention, having first appeared in Sweden in the mid-1980s and later in Australia in 1987. Both of these countries used the figure to convey their very similar versions of dietary guidelines. Critics had complained that the shape of the pyramid would confuse people because the top of something is usually the best. In the case of the “Eating Right Pyramid,” as it was later coined, in the top position were the foods to avoid. Some educators proposed that the pyramid be inverted to avoid this confusion. However, the USDA reported having conducted exhaustive testing and evaluation of the graphic with individuals and focus groups, much the same as marketing experts do in the business world. They stated that there were no significant findings related to shape inversion.

Although the pyramid has many supporters, some groups still are not convinced that it can be effective and not misrepresent certain foods. The unveiling took longer than expected, more because of objections from the food industry than efforts to test and polish the pyramid. Some critics have come up with their own pyramids: the Mediterranean Diet Pyramid, the Asian Pyramid, the Vegetarian Pyramid, and the Oldways Pyramid, which is based on plant foods. The USDA Center for Nutrition Policy and Promotion recently issued informational fact sheets outlining the differences between its pyramid and new ones on the scene in an effort to resolve consumer confusion. It pointed to its chief advantages over its competitors-broader choices of foods and specific suggestions for number of servings from each group.

One of the long-term goals for the pyramid is widespread recognition among American consumers, and a recent survey showed that awareness increased from 58 to 67 percent of Americans within the past few years. Countless nutrition educators, those working with groups from children to the elderly, have found it to be a fun and effective teaching tool in imparting the nutrition and health recommendations of the Dietary Guidelines for Americans.

To find out if your diet stacks up to the pyramid, you need to know how many calories you should be taking in. For this, you’ll need to fill in the form at the end of this section. At the end of the chapter, you’ll need to review your diet record sheets to evaluate your current intake compared to the recommendations in this chapter.

No one is sure how much someone should weigh to promote health, since being either too thin or too fat are both associated with health risk.

Other Dietary Recommendations

The government isn’t the only group to issue nutrition recommendations; a host of public and private agencies have thrown their hats into the ring. We’ll look at diet guides from a private agency, the American Heart Association, and a joint effort, the 5-a-Day program.

American Heart Association Recommendations

The American Heart Association (AHA) recently released updated guidelines for Americans in its battle to prevent cardiovascular disease (CVD), diseases of the heart and blood vessels such as heart attack, high blood pressure, and stroke. The new guidelines build on previous recommendations, especially the Dietary Guidelines for Americans.

The AHA points out in the preamble to its guidelines that although its focus is the prevention of CVD, the recommendations are consistent with those issued for the prevention and treatment of other major killers such as some forms of cancer, kidney disease, and diabetes. The recommendations are geared toward reducing well established risk factors for CVD, which include:

  • the elimination of cigarette smoking
  • appropriate levels of caloric intake and physical activity to prevent obesity and reduce weight in those who are overweight (especially abdominal or upper body fat)
  • consumption of 30 percent or less of the day’s total calories from fat
  • consumption of 8 to 10 percent of total calories from saturated fatty acids
  • consumption of up to 10 percent of total calories from polyun saturated fatty acids
  • consumption of 15 percent of total calories from monounsaturated fatty acids
  • consumption of less than 300 mg per day of cholesterol
  • consumption of no more than 2,400 mg per day of sodium
  • consumption of 55 to 60 percent of calories as complex carbohydrates
  • consumption of alcohol (those for whom alcohol is not contraindicated) should not exceed two drinks, or 1 to 2 ounces of ethanol, per day

5-a-Day

What was that old-fashioned saying about an apple a day? It may have been closer to the mark than we thought, but in this case, more is better! As nutritionists have recommended shifting away from the traditional basic food groups approach to a healthy diet, various suggestions on which foods and how much have been proposed. When the Pyramid was introduced last year, amid much opposition, along with it came the 5-a-Day program focusing on fruits and vegetables. Consumers had heard a multitude of information on the benefits of increasing their consumption of these foods, but the number seems to have gotten lost in the shuffle.

The 5-a-Day program was developed in 1988 by the California Department of Health Services. The targets included retail, media, and government agencies to spread the message about the healthfulness of eating fruits and vegetables. The program proved highly successful, with more than 1,800 retail operations, agencies, and industry groups participating. At just about the same time, evidence began to mount connecting high fruit and vegetable intake to a reduced risk for several diseases. More recently, the National Cancer Institute has borrowed the California theme and promoted the 5-a-Day program as part of a national health promotion focused on reducing the risk of cancer and heart disease.

Several key national authorities, such as the National Academy of Sciences, the U.S. Department of Health and Human Services, and the USDA, have recommended that people should eat at least five servings of fruits and vegetables daily. In fact, the Dietary Guidelines for Healthy Americans actually recommend up to nine daily servings. The basis for these recommendations is the burgeoning number of epidemiologic studies which suggest that people who eat greater amounts of fruits and vegetables, in particular those which are high in the antioxidant nutrients vitamin C and beta-carotene, have a lower risk for the two major killers in the United States, cancer and heart disease.

Other researchers have been quick to point out that there are a myriad of compounds in fruits and vegetables besides vitamin C and beta-carotene which may be wholly or partially responsible for the risk reduction. Some of these include the other carotenoids: alphacarotene, lutein, lycopene, and beta-cryptoxanthin. Additionally, fiber has been suspected of offering protection against these diseases based on several population studies. And the compounds known as indoles and dithiolthiones, from the cruciferous vegetables, such as broccoli, cauliflower, and brussels sprouts, have piqued the interest of cancer researchers in recent years.

The results of a recent study of almost 87,000 nurses point to why scientists have had difficulty in identifying a single compound which is responsible for possible protective effects. Researchers analyzed the food intake of subjects and found that those who ate five or more servings of carrots a week were 68 percent less likely to have a stroke than those who ate one serving a month at most. Apparently spinach conferred protection as well, although not to the extent that carrots did. While both carrots and spinach are high in beta-carotene, they also contain other carotenoids and fiber. In addition, other compounds in the vegetables, as yet undiscovered, could be in,volved in risk reduction.

The studies to date have been somewhat conflicting, with most showing reduced cancer and heart disease risk in populations with high fruit and vegetable intake, but with others not supporting this conclusion. In addition, some scientists believe that the levels needed of the antioxidant nutrients and other protective compounds to significantly lower disease risk can only be achieved with nutrient supplements. Data from one recent study support this view. Subjects had a significant reduction in risk for heart disease only when supplementing their diet with vitamin E, with dietary intake exerting no significant effects.

Failure to pinpoint the exact protective compound is the reason for encouraging an increase in fruit and vegetable consumption with the 5-a-Day campaign. In addition, most of the studies so far which have shown reduced risk for chronic disease were based on analysis of dietary intake of fruits and vegetables. However, the recommendations seem to fall on deaf ears, with a recent survey reporting fully 77 percent of Americans falling short and only 8 percent achieving the goal. Perhaps more alarming is the low percentage of Americans who are aware of the recommendation for fruit and vegetable daily intake: 34 percent thought it was one serving, 32 percent thought two servings, and 25 percent thought three to four servings.

The National Cancer Institute and other health organizations are hoping to increase awareness of the 5-a-Day recommendation. At this point, it isn’t clear why Americans haven’t taken to this simple advice, but the experts will keep plugging away at this worthwhile goal.

Let’s Take a Closer Look at Your Diet

Now it’s time to see how your diet stacks up against all of the recommendation we’ve just considered . It is important to remember that even a three-day intake record is not truly representative of the foods you eat over a longer period of time; but at least it’s a start we’ll use a quiz format in this chapter and upcoming ones to compare the average of your three-day intake to the various recommendation.