Subsections

Physiology

Research and intensive supervision of food has widened the knowledge about the physiology of nutrition. The activity of newspaper, broadcasting and television searching for sensational news have mobilized the food industry in order to optimize their products.
The interest of the industry on nutrition physiology developed a great know how in the sector of laboratory analysing methods, in processing technologies, in packaging material and in storage.
All these efforts resulted in better quality and safety.
The consumer, however needs more information. Many basic rules for healthy nutrition are not known and misleading information are spread by commercials seeking sales increase resulting sometimes in extreme reactions of certain groups of consumers.
Failure of nutrition is responsible for most of our diseases and rotten health. Diets are a wide field of incomprehensible efforts to correct mislead nutrition.

The classic function of diets are to reduce body weight.
A great number of women try diets to reduce their weight. They are looking for better health or want to improve aesthetics. Body culture is getting important in actual society.

Weight reduction should only be considered if there are clinical reasons. Body weight is genetically controlled. If one feels good with a certain weight everything no diet should be considered. Much outdoor exercise keeps you healthy. There are some ways to determine normal weight[102]:


The Broca normal-weight

The Broca normal weight is given in kg and is defined as body size in cm minus 100 for man.
For women the body size minus 100 minus 5 to 10% is used. Over- and underweight in relation to broca normal weight is given in percent. The Broca-Indexis the quotient of the actual weight and the Broca normal-weight.


Table of the American life insurance companies

With this table the actual weight is put in relation to the normal weight for the corresponding age and body size.


The Bodymass Index BMI

The Bodymass index is the quotient of the body weight and the square of the body size (kg/m$^2$). This index gives best informations about the mass of the body fat. It is less used as Broca because it is less informative for the patient.

Age Bodymass index (kg/m$^2$)
19 - 24 years 19 - 24
25 - 34 years 20 - 25
35 - 44 years 21 - 26
45 - 54 years 22 - 27
55 - 64 years 23 - 28
over 65 years 24 - 29


(National Research Council 1989)
  Grade of overweight BMI(kg/m$^2$) Broca-overweight(%)
       
Normal weight 0 20 up to 24,9 -
Moderate overweight I 25 up to 29,9 0 up to 20 (-40)
Strong overweight II 30 - 40 20 - 70 (-80)
Extreme overweight III $>$ 40 $>$ 70 ($>$80)


Classification of overweight in adults according to BMI

[1941]
Joint WHO/FAO Expert Consultation 2003
Classification BMI (kg/m$^{2}$) Risk of comorbidities
Underweight $<$18.5 Low (but risk of other clinical problems increased)
Normal range 18.5-24.9 Average
Overweight $\geq25.0$  
Pre obese 25.0-29.9 Increased
Obese class I 30.0-34.9 Moderate
Obese class II 35.0-39.9 Severe
Obese class III $\geq$40.0 Very severe


These BMI values are age-independent and the same for both sexes. However, BMI may not correspond to the same degree of fatness in different populations due, in part, to differences in body proportions.The interpretation of BMI gradings in relation to risk may differ for different populations. Both BMI and a measure of fat distribution (waist circumference or waist : hip ratio (WHR)) are important in calculating the risk of obesity comorbidities.

The consultation considered that, to achieve optimum health, the median BMI for the adult population should be in the range 21-23 kg/m$^{2}$, while the goal for individuals should be to maintain BMI in the range 18.5-24.9 kg/m$^{2}$.

Waist circumference:

Waist circumference is a convenient and simple measure which is unrelated to height, correlates closely with BMI and the ratio of waist-tohip circumference, and is an approximate index of intra-abdominal fat mass and total body fat.

Furthermore, changes in waist circumference reflect changes in risk factors for cardiovascular disease and other forms of chronic diseases, even though the risks seem to vary in different populations. There is an increased risk of metabolic complications for men with a waist circumference $\geq$102 cm, and women with a waist circumference $\geq$588 cm. [1930]

Dubious Pharmaceutical industry and flat magazines recommend all kind of diets. There are made increasing turnovers in this field, not always without damage of health of the consumer.
Advertising uses terms like"slim", "calorie reduced", "light", "Du darfst"(You may), "fat reduced" and others to promote selling of their products.
With great publicity campaigns in magazines, TV and radio appetite of the group of overeaters is stimulated rather then reduced. The result of these products are therefore negative.
Examples of diets lacking any scientific background[752]:


Lowcarb diets

Lowcarb diets are low in carbohydrates and rich in protein and fat. The most prominent lowcarb diets are the Atkins diet, the Southbeach diet, the Ketogen diet the Anabole diet and the LOGI diet (Low Glycemic Index) from Dr. Nicolai Worm.

Vegetarian food with animal ingredients

Many vegetarian labelled foods of industrial origin do contain animal ingredients such as bovine suet, lard, restaurants prepare their meals labelled as vegetarian with meat broth and marine oil. [802].

Psychology of diet plans

Diet plans and diet systems to be successful must observe some basic psychological rules:
  1. At the beginning of a diet plan the dangers of overweight are enumerated. This is the most dangerous part of the plan as those who do not succeed with the diet will later on create a deeper psychological conflict. Their real problems which took them to overeat will then be boosted. Such an introduction should always be banned from a diet plan as it frightens the reader, it increases the inferiority complexes. Instead of telling the reader how bad its life is, a diet plan should make its introduction enumerating the benefits.
  2. The promise that overweight can be reduced to normal values using a specific diet is not honest. As weight reduction is coupled to intake and output of calories over the whole life, the necessary modification of life style cannot be achieved in one or two weeks of sometimes strange procedures which lack any explanation of how it should work. The explanations should be short and come to the point precisely. If the principles are unknown this part should be omitted completely.
  3. Reference of people who were successful with the diet. Usually well known people of the public life and TV stars are cited. This increases the desire to participate of the life of these persons. Awaking from the fairy tales the monotony of the daily round will be more sad then before.
  4. Certainty that everyone can succeed with the diet is a claim which is untrue.
    Many people are unsuccessful and have great psychological distress failing in what is told to be easy for everyone.
  5. Explanation of the foundations of the diet should only be given based on well known statements. If there is no explanation available no comment suggesting miracles should be given.


The cause of failure of diet plans and how to do it better

Mislead diets are not caused by alteration of the basic metabolism. The real cause is the lack of learn effect to adapt the life Style to a healthy way of life and to correct the bad habits.
Wolfgang Stabel [807], during a course to get rid of smoking habit said:
"Mankind can live 170 seconds without air, 12 days without water and 46 days without food. Without tobacco it can live a whole life."
To this statement one can add: one can live without chocolate, without candies and hamburgers.
The essential message of diet plans should be to change the life habits: How to to it better[810]:
  1. Drink 2 litre of water per day, eat fibre rich food.
  2. Do not bother about calories, but spare fat and alcohol.
  3. Eat on regular hours, do not eat in between.
  4. Eat enough vitamins, minerals and proteins
  5. Noting is forbidden, you can eat everything, but always without excesses
  6. Enjoy a small dish. Eat always with attention.
  7. Act against stress with physical activity and relaxation exercise and not with eating junk food
  8. Stay realistic. Set small scores. Distrust crash-diets and miracle-diets. Do it the safe way changing food habits.
  9. Activate the fat break down with physical activity. The more muscles you activate more calories are burned.
  10. Money back guarantee in case of failure of the diet is a bad trick. Less than 10% complain in case of failure. The majority does not dare to do it. Who wants to admit to have failed when it is being told that all other do succeed ?
The National Weight Control Registry (NWCR)[808]
The National Weight Control Registry (NWCR), is a research study from the University of Colorado that seeks to gather information from people who have successfully lost weight and kept it off for long periods of time.

The findings of this study are:
A little over one-half of the sample lost weight through formal programs (such as Weight Watchers, or professional assistance, such as Overeaters Anonymous, a psychologist or a registered dietitian; the remainder lost weight on their own.

Both groups reported having used both diet and exercise to lose weight and nearly 77% of the sample reported that a triggering event had preceded their successful weight loss. Mean (+/-SD) current consumption reported by registry members was 5778 +/- 2200 kJ/d, with 24 +/- 9% of energy from fat, Members also appear to be highly active: they reported expending approximately 11830 kJ/wk through physical activity.

Surprisingly, 42% of the sample reported that maintaining their weight loss was less difficult than losing weight. Nearly all registry members indicated that weight loss led to improvements in their level of energy, physical mobility, general mood, self-confidence, and physical health. [809]

Diet pills and powders

[810]
Many pills and powders are sold in super market in health stores and in pharmacies. They promise wonders for much money without success:


L-carnitin:

Bodybuilder were the first to use L-carnitin as fat-burner.
L-carnitin works only with long time persistent muscle training, together with fat reduced food. L.carnitin under these condition can act as a biocarrier in the energy system of the mitochondria of the muscle cells.
Without physical activity fat is not burned. Even carnitin cannot change that. Oxygen must burn the fatty acids and the resulting energy must be used.
L-carnitin can be obtained by the body through synthesis using methionine and lysin in liver and kidneys.
Carnitin is present in bovine and in sheep meat. That is the etymology of carnitin (Carne-latin=meat).
Vegetarians could get an undersupply of carnitin. However there are no signs of over weight because vegetarians eat less fat. The use of pills containing carnitin is therefore unnecessary.


Tyrosine

Tyrosine is an hormone of the thyroid gland. It is supposed to stimulate burning of food components. Tyrosine is sometimes prescribed by physician to compensate an insufficient function of the thyroid gland gland. In normal persons the use of tyrosine can lead to hyperfunctioning of the thyroid gland gland causing insomnia, restlessness, heart throbbing, tachycardia, trembling, fear and overexcitability as well as intensive sweat.
Instead of using tyrosine normal persons should have more activity.


Genistein

Genistein is a phytoestrogen (plant hormone) found in soybeans being of great importance in human and in animal nutrition. The fertility of sheep and birds were found to be reduced by high amount of genistein. It may be a natural defence of plants against natural enemies.
Genistein has reduced affinity to estrogen receptors and thus a reduced activity compared with estrogen.
As the use of soy beans in nutrition is increasing high levels of genistein in blood stream is to be expected. Importance has the nutrition in Asia which has 50 times in normal nutrition and 400 times more genistein in baby food with soy bean diet than European baby food and normal nutrition respectively. It is however interesting that there have been no reports on negative activities with these nutrition. A certain protection against women Breast cancer is brought into combination with an interference of genistein in the hormone household of hormones which enlarges the menstrual cycle of Asiatic women. [1285]

Genistein stimulates the enzyme which regulates the vascular tone and reduces hipertension

[811]
Hongwei Si and Dongmin Liu studied the effect of genistein, an isoflavone from soy. They found that dietary supplementation of this phytoestrogen may increase levels of endothelial nitric oxide synthase (eNOS)wich is an enzyme linked to higher endothelial-derived nitric oxide (NO) which regulates the vascular tone and atherogenesis, improving vascular health in hipertensive rats.

Hypertension, blood pressure higher than 140 and 90 mmHg, is a major risk factor for cardiovascular disease Nitric oxide NO is a messenger molecule by which the endothelium of blood vessels communicates with the vessel's muscles to relax. Blood pressure and the risk of infarction and strokes are reduced.

The authors concluded that genistein improves hypertension by excerting direct genomic effects on the vascular wall leading to increased synthesis of enzyme eNOS improving vascular health and reducing hypertension.

New animal model to evaluate drug efficacy of genistein

[812]
Raymond Bergan and colleagues found that genistein inhibits prostata cancer cell detachment and cell invasion in vitro by blocking activation of p38 MAP kinases molecules.

The authors developed and animal model to evaluate the antimetastatic drug efficacy of genistein. Usind this model genistein was found to decreased metastases by 96%, but did not alter tumor growth. Dietary concentrations of genistein can inhibit prostata cancer cell metastasis. Studies of antimetastatic efficacy in man are warranted and are under way.

Natural dietary approaches to menopause disorders: The natural hormone replacement therapy concepts came about as a result of population studies in Asia. The outcomes of these studies were that many menopausal disorders of Western civilisation (1 to 5 mg/day of soy isoflavones) were absent in the East due to large amount of soybean products (daily soy isoflavone intake of estimated 50 mg/day) associated with a low fat intake.

Entering menopause a diet is being recommended being moderate in protein and complex carbohydrates, with 15 to 20 % of the calories coming from fat. Saturated fat from animal products should be low, unsaturated fats should come from cold water fish (salmon, tuna, mackerel and herring). A good portion of the diet should come from soybean products, such as tofu. To keep bowel bacteria in balance Lactobacillus acidophilus should be included in the program.

Isoflavone intake amounts: The US National Guideline Clearinghouse (NGC) suggests the following isoflavone intake amounts: [2939]

Optimal cholesterol reduction seems to require approximately 50 mg/day of isoflavones; this amount would be found in approximately 25 g/day of soy protein.

For effects of arterial compliance amounts of 40-80 mg/day isoflavones are needed.

For antioxidant effect on lipids 10 mg/day may be effective.

For bone health a minimum of 50 mg/day of isoflavones are needed.

For hot flashes and vasomotor symptoms 40-80 mg/day of isoflavones were used in studies.

More evidence that soy isoflavones and proteins reduce cholesterol levels

[2940]
In eleven studies selected for a meta-analysis Kyoko Taku and colleagues 2007 found that soy isoflavones significantly reduced serum total and LDL cholesterol but did not change HDL cholesterol and triacylglycerol. The authors concluded that soy protein containing enriched or depleted isoflavones also significantly improved lipid profiles. Reductions in LDL cholesterol were larger in hypercholesterolemic than in normocholesterolemic subjects, but no significant linear correlations were observed between reductions and the starting values.

Antinutritional factors of soy and faba beans

[]
Anti nutritional factors of soy are trypsin inhibitors, glysinin, B-conglysinin, oligosacarides, saponines, and lectines. These factors are reduced during crushing and processing of the soy beans.

According to El-Shemy and colleagues 2000, antinutritional factors such as trypsin inhibitors, phytic acid, and tannins were detected in soy bean and faba bean seeds They report that phytic acid content and trypsin inhibitor activity were higher in soy bean seeds than in faba bean seeds. The authors found that removing the cortex a high concentration of antinutritional factors such as tannins could be removed turning soy bean and faba bean suitable for human diet or industrial products.


Iodine and algae

Algae (Fucus vesiculosus)are sometimes used to increase the supply of iodine. and are sometimes added to diet pills and diet powders.
Iodine is needed for the synthesis of thyroid gland hormones which regulate the energy household. Iodine can be obtained from marine fish, iodised kitchen salt, and food prepared with iodinated salt.
The daily intake of 180 to 200 mcg is recommended. Increasing the intake over this value no further activity on the fat burning machine is takes place.


Appetite depressant

Ephedrine, Norephedrine, Fenfluramine can cause heart throbbing, restlessness, insomnia, and hypertension. They can cause addiction.


Laxatives

Long time use of laxatives leads to an important loss of potassium ions which on its turn increases the intestinal inactivity.
Laxatives increase the problems. More physical activity and enough water during meals can solve it.


Cynarine

The bitter constituent and enzyme of chicory can promote the production of biliary acids which act on the digestion of fatty acids.
Cynarine does not destroy fat as often is being told. Physical training is better than cynarine.


Bromelain and papain

These enzymes are found in tropical fruits such as pineapple, papaya and mango.
They help the digestion of food increasing the absorption. In this way these enzymes do not reduce or destroy fat. As a matter of fact the assimilation of the food is optimized. This has nothing to do with weight reduction.


Herbal metabolism boosters:

Some herbal metabolism boosters can temporarily cause weight drop. However, they do not eliminate excess of fat. Most of them contain stimulants which increase the central nervous system and decrease appetite. They are mild diuretics . They can cause unpleasant side effects such as dizziness, nausea, and frequent urination. As soon the administration of these drugs is ended the weight returns to its original height.

How to avoid diet pills:


The separation diet of Dr. Howard Hay

Dr. Howard Hay was during his life attacked by a renal insufficiency. To help himself Dr. Hay studied the composition of the body noting that it was built of 80% of alkaline material and 20% of acid material. Starting from this hypothesis Dr. Hay divided food in alkaline generator and in acid generators. He introduced the following modification in his nutrition:
Acid generators : Great part of the proteins and part of carbohydrates.
Alkaline generators: Vegetables, fruits and salads. According to Dr. Hay the the alkaline generators may neutralize acid elements, helping their excretion.
Dr. Hay augmented the amount of vegetables being half cooked and the other half raw.
Dr. Hay says that the failure of balance between the acid generator food and the alkaline generator food is responsible for diseases like obesity, insomnia and depression.
Dr. Hay separated the protein rich food from the carbohydrate rich food, putting them in different meals. This gave the name to his diet.
Dr. Hay established the rules to his diet:

Good diets

Low Fat - 30 Diet: It is a weight reduction program for all who want to reduce their weight together with a group. Participation is for the time being limited to Germany.
The most important facts about low fat nutrition is given in small groups. Meals should not contain more than 30% of calories coming from fat. You should eat only when feeling hungry. At the first sign of satiation one should finish the meal. The diet is based on points. Minimum amounts of foods are given. Once a week brochures on special topics are given.
A long-lasting modification of the nutritional habits are essential in order to avoid overweigh
Natural Weight Program: This program was developed by Dr. Doris Wolf She herself had been overweighted and tried to amend it using here knowledge as a psychologist and psychotherapist developing the Natural Weight Program.

Putting on weight because of emotional problems and stress are the main reasons for many people to skip all good intentions of an healthy nutrition. Frustration, anger and other negative emotions are compensated by eating. Alternatives to get emotionally balanced other than overeating are strategies of modern psychology. How to to handle one's emotions and how to accept one's own body not as an enemy, but as a fried, are important subjects of the Program. The negative attitude towards their body must be changed.

According to Dr.Doris Wolf all kind of diets are unsuitable for the majority of persons. There are biological and psychological reasons which are responsible for the fact that only 2 to 5 per cent of those who follow a diet register lasting weight reduction.

Dr. Wolf uses four principles as basis for her Program:

The four principles:
1 - Eat only when you are physically hungry and not when mental hungry.
2 - Eat what you like for the moment.
3 - Eat consciously, being aware of what you eat and how your body reacts.
4 - Stop eating when you feel satisfied

The risks of bad diets


The potential risks of low-carbohydrate diets

The American Heart Association, the American Dietetic Association and the American Kidney Fund warn about the potential risks from the long-term use of low-carbohydrate, high-protein diets.
Low-carbohydrate diets, like Atkins diet avoid carbohydrates (starches or sugar) reducing or even eliminating the intake of fruit, fruit juices, starchy vegetables, beans, bread, rice, cereals pasta and other grain products. This leads to a nutrition consisting mainly of fat and proteins. Permitted are meat, cheese, non-starchy vegetables. Everything else is limited to a minimum. Later on the carbohydrate restriction is reduced but high fat and proteins persists. Despite initial weight loss higher than rob obtained with other diets, low-carb diets however have a net weight loss after one year which is not significantly different from other diets in comparison.

Many nutritionists attack the Atkins weight loss regime for its high fat content, increasing the risk of clogged arteries heart attack, diabetes, stroke and several types of cancer in the long term.

Deleterious effects on cardiovascular disease risk factors were demonstrated by Larosa [2762] in a study of 24 obese individuals who followed the Atkins diet for 3 month. Caloric Intake declined, but LDL cholesterol levels rose despite the weight loss. Most of the weight loss occurred in the first few weeks, which suggests the combined effects of fluid loss and potential anorectic (reduction of desire to eat) effects of induced ketosis.

The American Heart Association does not recommend high-protein diets because they restrict foods that provide essential nutrients. An undersupply of vitamins and minerals, as well as potential cardiac, renal, bone and liver abnormalities may result.

A new study carried out at the University of Oxford demonstrates a direct affect on the heart caused by this diet. The results were presented at the American Heart Association conference in November 15, 2005, in Dalas.
According to this study, the energy stores in the heart were reduced by an average of 16 per cent as a result of the Atkins diet recommendations. One of the authors , Dr. Damien Tyler says that similar patterns in a more severe form in patients with heart failure, and type 2 diabetics also suffer from low energy stores.

Evaluation of High-Protein Diets

[2761] Evaluation of high-protein diets must be done ensuring that the American Heart Association Dietary Guidelines regarding eating patterns [2763] and the primary prevention for coronary Omega 6 from the National Cholesterol Education Programme [2764] are observed:

1 - Total Protein intake should not be excessive (average 50 to 100 g/d) and should reasonably proportional (around 15% of kilocalories per day) to carbohydrate (around 55% of kilocalories per day) and fat (around 30% of kilocalories per day) intake.

2 - Carbohydrates should not be omitted or severely restricted. A minimum of 100 g carbohydrate per day is recommended to ensure overall nutritional adequacy through the provision of a variety of healthful foods.

3 - Selected protein foods should not contribute excess total fat, saturated fat, or cholesterol.

4 - The diet should be safely implemented over the long term, i.e. it should provide adequate nutrients and support dietary compliance with a healthful eating plan to prevent increases in disease risk.

The AHA summarises: "Successful weight loss occurs most frequently when a nutritionally adequate diet that allows for caloric deficits (around 500 kcal/d for each 1 lb lost per week) is tailored according to individual food preferences.

A minimum of 1200 kcal/d for women and 1500 kcal/d for men should be provided.

Total energy deficit has the greatest overall impact on weight reduction, especially when coupled with increased physical activity and behaviour modification to maintain negative energy balance. Over the long term, diet composition should be consistent with a balanced eating plan that supports weight maintenance and lowers chronic disease risk.

The Dietary Intervention Randomized Controlled Trial (DIRECT) says that weight-loss diets can be tailored to personal preferences

[2758]
Dr Iris Shai and colleagues 2008 studied the effects of three diets: low-fat/restricted-calorie diet; Mediterranean/restricted-calorie diet; or low-carbohydrate diet, with no restriction on calories.

- The low-fat diet used the AHA guidelines with intake of 1500 kcal for women and 1800 kcal for men daily, with 30% of energy from fat, 10% from saturated fat, and 300 mg of cholesterol daily.
- The Mediterranean diet had a high vegetable and low meat content with poultry and fish and similar amount of energy daily.
- The low-carbohydrate diet provided 20 g of carbohydrate daily for 2 months with an increase to 120 g per day.

Weight loss occurred in all three groups over the 24 months but was greater in the Mediterranean and low-carbohydrate groups. In men weight loss was greatest in the low-carbohydrate group, whereas women appeared to lose more weight on the Mediterranean diet.

Dr. Shai says that Mediterranean diet makes it easier to reduce calories because moderate fat consumption is permitted.
Low-carbohydrate diet such as Atkins diet defines carbohydrate foods so the dieter can avoid them without counting calories. Craving in this diet is reduced, compared to other diets, it offers higher satiety, and it provides an encouraging immediate response of the body weight.

The authors concluded that Mediterranean and low-carbohydrate diets are effective alternatives to low-fat diets. They call for individualized tailoring of dietary interventions.

Mediterranean population change from healthy traditional Mediterranean diet to unhealthy diets high in meat and fast foods

[2760]
According to a paper of the FAO, compiled by Josef Schmidhuber, the Mediterranean population is shifting from their traditional healthy diets, rich in cereals, fruits, vegetables, nuts, whole grains, fish and olive oil, to diets with more meat, saturated fats and time-saving processed foods.

Studies say that the Mediterranean diet has benefits for arthritis, Alzheimer' s disease, hearth health and blood pressure, diabetes, asthma, lung disease, and allergies.

Schmidhuber studied the compliance of the diets in relation to protein, total lipids, fatty acids, carbohydrates, total dietary fibre, sugar, cholesterol, sodium chloride/sodium, and fruits and vegetables in the period of 1961 to 2003 compared with the recommendations of the WHO/FAO. The author blames the European agricultural policies as one of the main culprits, generating not only high costs for consumers and taxpayers when subsidies are paid to farmers, but even higher costs when consumers and taxpayers have to bear the health burden of over-consumption encouraged by these subsidies.

The diet has become too fat, too salty and too sweet, calories rising by 20 per cent from 2960 kcal to 3340 kcal in the last 40 years for Europe and even by 40 per cent in the countries around the Mediterraean Sea. Spain had the highest shift to fatty foods from 25 percent of fat to 40 percent of the diet.

Schmidhuber also stresses that in general the rise in supermarkets, changes in food distribution systems, and calorie needs declining as people lead more sedentary lifestyles are factors of the dietary shift in Europe. More women have jobs outside the home and convenience foods are preferred.

Non-EU Mediterranean countries adhere to diets higher in carbohydrates. Egypt is cited with a diet of 400 g of glycaemic carbohydrates per person per day.

The position of AHA

[2759]
The American Heart Association (AHA) commenting the study said that the outdated 2000 AHA guidelines had been used for the low-fat diet. The Association stresses that dietary fat restriction at 30% of calories is no longer part of the AHA guidelines 2005. The saturated-fat content has been reduced from 10% to 7% and the cholesterol content from 300 to 200 mg/day. The AHA does not support the Atkins diet. AHA remains firm in its proposition to reduce saturated fats stating that they raise LDL cholesterol. This is consistent with the National Cholesterol Education Program guidelines, the American Diabetes Association, and the US Department of Agriculture USDA.

The American Diabetes Association stated in January 2008 that low-carbohydrate diets should be considered for a maximum of one year.


Fit for Live

The book "Fit for Life " describes a separation diet like that of Dr. Atkins.
It gives an additional recommendation not to eat simultaneously products rich in proteins together with dietary fibres.

Arguments against the diet of Dr. Atkins and the book "Fit for Live"

Traditional physiology does not agree with the diet of separation of Dr. Atkins. Meat does not have dietary fibres. It is therefore necessary to eat meat together with vegetables and fruits. The fibres absorb rests of digestion.
Protein digestion starts in the stomach with chloridric acid, together with pepsin. In the intestines there are proteases such as produced by the pancreas and by the gall bladder.
Important proteasesare: trypsin peptidase elastase ribonuclease and others.
As the external layer of the intestines is also composed by proteins the danger of proteases to digest his own meat. Nature protects against an own digestion secreting a protective layer of mucus made of mucopolysaccharides . This is the origin of the denomination"mucous membrane" which is not attacked by proteases.
Sometimes however particles of enzymes get through the mucus barrier. damaging mucous cells which can regenerate rapidly.With protein rich nutrition there are more proteolytic enzymes secreted as in case which should of a normal nutrition.
Fibres of vegetables, fruits and cereals absorb excesses of enzymes.Fibres also accelerates passage of not digestible material through the intestines.
The diet of Dr. Hay advises the ingestion of proteins at night when the body rests permitting the enzymes to stay longer in the intestines.
The danger of intestinal cancer and other gastric malfunctions are possible.

Other low-carbohydrate diets

Zone diet: The Zone Diet was developed by Barry Sears, a former researcher in biotechnology at the Massachusetts Institute of Technology.
It is based on the control of insulin by balancing protein and carbohydrate at each meal (1-4). The American Heart Association notes that food must be eaten in required proportions of protein (40), fat (30), carbohydrates (30). Menues are not appealing. Vegetable portions are very large. Food is low in copper. Theories and long-term results are not validated. Couuld result in weight maintenance if carefully followed. [2761]

Protein Power: The Protein Power diet was developed by Michael R. Eades, M.D., and Mary Dan Eades, M.D. The principle of Protein Power is the restriction of carbohydrates - in particular refined ones.[2765]
The American Heart Association notes that this diet is not practical for long term. Rigid rules must be observed. The diet is low in calcium, fibre, pantothenic acid, copper, manganese. It has limited food choice and is not practical for long term. It is high in total fat and saturated fat. No long term, validated studies are published.[2765]

Low-Carbohydrate diets, like the Atkins diet may reduce beneficial gut bacteria

[2776]
Sylvia Duncan and colleagues 2007 found in a study that prolonged use of very low-carbohydrate weight-loss diets may decreased concentrations of butyrate and butyrate-producing bacteria (mainly bifidobacteria) in faeces.

According to the authors butyrate production is determined by the content of fermentable carbohydrate in the diet. Other studies had found that butyrate stops cancer cells from growing, and so helps prevent colorectal cancer.

The authors stress that plenty of sources of fibre found in fruit and vegetables are important to provide the right sort of carbohydrates for the beneficial bacteria if low carbohydrate diets are to be consumed for long periods of time.
Other critics concerning this type of diet is the higher risk of clogged arteries and heart attack in the long-term.

Sugar Busters:[2777] Sugar busters involves eating high fibre vegetables and whole grains. Fruits are encouraged and discourages saturated fats and transfats. It is important to eat three regular meals daily. Moderation in portions size is most important. Exercise is also on the program.
The American Heart Association notes that Sugar Buster eliminates many carbohydrate foods. Discourages eating fruit with meals. It is low in calcium, vitamin D, vitamin E, pantothenic acid, copper, potassium. [2765]

Stillman Diet[2778] It is a severe form of ketogenic diet. Nothing is permitted if it is not mentioned in a list. The american Heart Association notes that Stillman diet is low in fibre, vitamin A, thiamine, vitamin C, vitamin D, folate, pantothenic acid, calcium, copper, magnesium, manganese, potassium. There are no long-term, valid studies published. There are extreme limitations in food choice, and very little variety. [2765]

Study comparing the Atkins, Zone, Ornish, and LEARN diets the A to Z Weight Loss Study recommends Atkins diet for weight loss

[2766] [2767]
Gardner and colleagues 2007 compared Atkins, Zone, Ornish and LEARN weight-loss diets representing a spectrum of popular low to high carbohydrate intake for effects on weight loss and related risks. These diets have challenged recommendations advising a low-fat, high-carbohydrate diet for weight loss. The authors report weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months: Atkins, -4.7 kg , Zone, -1.6 kg , LEARN, -2.6 kg , and Ornish, -2.2 kg. The metabolic effects of Atkins diet were comparable or more favourable than those found in the other diets.

The researchers recommend a low-carbohydrate, high-protein, high-fat diet such as Atkins diet for weight loss. However, long-term effects and mechanisms are still unknown.

Ketosis and the ketogenic diet [2768]
Elevated levels of ketones in the blood is called ketosis. It can occur during fasting, during a very high fat diet or during a long lasting deficiency in carbohydrate supply. This is the principle of the ketogenic diet. Atkins diet, which is used basically as low-glycemic index diet, may also cause ketosis. There are three ketones formed under hunger (also called " ketone bodies"): acetoacetate, acetone and beta-hydroxybutyrate (BHBA). [2769]

The fatty acids with participation of glucagon are digested in the liver to ketone compounds in order to liberate the needed energy. This is to see in opposition to the formation of D-glucose from carbohydrates to liberate energy. Ketones are burned in muscle and other tissues. High levels of ketones in tissue reduce the pH level. This is called ketoacidosis. One ketone is acetone which may cross the blood/brain barrier and, if in high concentration, causes central nervous disorders.

Deficiency of insulin in diabetics may lead to ketosis.

It seems that fasting or high fat diet known as ketogenic diet is appropriate to induce ketosis for medical treatment of a specific neurological disorder. It should not be used as a body weight reducing diet.

Triglycerides used in ketogenic diets
Medium-chain triglyceride ketogenic diet for adults is being suggested by Schiff and colleagues. The researchers recommend a therapeutic trial of the ketogenic diet in intractable epilepsy for all ages. [2770]
Foods used in the diet include high - triglyceride dairy products (e.g., butter, cream), mayonnaise and peanut butter. Carbohydrates, found in bread and starches, are eliminated in the diet, and liquid and calorie intake are often restricted as well in order to aid ketone accumulation.

Dr. Richard Veech at NIH in a study, concludes that ketone bodies increase metabolic efficiency, while decreasing production of free radicals, may treat neurological diseases such as Alzheimer's and Parkinson's disease, and the heart and brain operate 25% more efficiently using ketones as a source of energy. [2771] [2772]

Alternative sources of ketones to avoid high fat diet for Alzheimer's and Parkinson's patients [2773]
Richard Veech and colleagues (2000) found that the elevation of ketones may offer neuroprotection in the treatment or prevention of both Alzheimer's disease, where therapy is lacking, and Parkinson's disease, where therapy with L-dopa is time limited. The researchers recommend alternative sources of ketones, produced biotechnologically to overcome the atherogenic potential of the high-fat ketogenic diet used in childhood epilepsy.

The Mayo diet

The Mayo diet has no connection with the famous Mayo-Clinic of USA. It is a protein rich and fat reduced diet (1.000 to 1.500 kcal)
The diet includes 3 eggs every day, meat, fruits and vegetables.
The diet is not well balanced. It is very high in cholesterol, and even for short time not suitable.


Ovo-lacto-vegetarian diets


Bircher-Benner diet

It is the ovo-lacto-vegetarian diet from Dr. Max Bircher-Benner which according to Dr. Bircher-Benner

The diet contains minimal amount of food

The diet contains lacto-vegetable food, at least 70% food of vegetable origin as muesli, fresh fruits, vegetable, salads, only moderate heat is used to prepare food. All ingredients should be of ecological origin.
No potatoes and no fish is allowed
The Birchner-Benner diet avoids meat and meat products being therefore low in animal fatty acids, cholesterol and purine. This is positive in case of gout, coronary diseases and disorder of the fatty acid metabolism.
Like every lacto-vegetarian diet undersupply of iodine and iron can take place.


Evers diet from the physician Josev Evers

The Evers Diet was at first developed to be applied in case of Multiple sclerosis.
It is a moderate ovo-lacto-vegetarian diet with germinated cereals (containing high level of polyunsaturated fatty acids.) Ingredients should be of natural, unmodified origin. " Denaturated" food resulting from industrial processing was considered as being the reason for diseases of industrial era.
The diet has different levels to be applied on different diseases:

Comment

The ban of potatoes is unreasonable. Potatoes are low in calories, and dietary fibres and vitamin rich.
Ground, unheated meat is a danger to weak patients because of possible bacterial hazard.


Waerland diet, Waerland, Sweden

This diet was established to clean intestines, to balance acid and base metabolism.
Regulate the intestinal flora. Useful bacteria from milk and plants are in confrontation with harmful bacteria from meat, eggs and fish. The diet has low amount of food. Raw vegetable meals are followed by cereals meals. Milk, fruits and vegetables are considered as alkaline food. Instructions about sleeping and working time are given. In the morning 1/2 litre of potato-vegetable soup is taken followed by warm bed rest lying on stomach.
The Waerland diet cannot be explained. Meat, eggs and fish cannot be considered as harmful and many claims are not true.

Danger of sudden changes of nutrition
Increasing Salads and other vegetables increase intake of certain vitamins like folate, vitamin A and K.

Decreasing high caloric foods like dairy products, red meat, salad oil or eggs reduces intake of minerals such as calcium zinc and selenium, vitamin D, E, B12 and essential fatty acids.


Anthroposophical nutrition

It was established by Rudolf Steiner. It should develop consciousness, to live in reconciliation with nature, nutrition as part of the holistic doctrine.
Ovo-lacto-vegetable nutrition with low content of meat. Avoid potatoes as they destroy instinct and promote materialism. Ban of use of pressure cooking and frozen food as they are "enemies of life".

Comment

Many of the doctrines of anthroposophy cannot be followed. The ban of potatoes, pressure cooking and frozen food is not tenable.


Macrobiotic nutrition according M.Kushi

Macrobiotic nutrition was founded by G.Ohsawa, Japan. His nutrition was dangerous and some people died using this diet. In USA macrobiotic nutrition according Ohsawa was prohibited.
M.Kushi modernized the content of macrobiotic nutrition. A short use of this nutrition is harmless. It is harmful and not indicated to be followed for a log period. Macrobiotic nutrition is a part of Zen-Buddhism a kind of philosophy of life.
Life energy comes from vegetable nutrition, cereals in the highest form.
Contrast from passive to active, from night to day, from feminine to masculine, is the principle of Yin and Yang which were transferred to food by Kushi. No milk, and milk products, no meat and tea are consumed.

The Jo-Jo effect reviewed

Two important studies recently reviewed the knowledge about the Jo-Jo effect, following a diet. These studies received much attention in 2007 following the effort to tackle the obesity problem in large parts of the population of developed countries.

Rena Wing and James Hill of the University of Colorado started in 1994 " The National Weight-Control Register". [2775]

In Germany Joachim Westenhöfer of the Hamburger Hochschule für Angewandte Wissenschaften started years ago the "Lean Habits Study". [2774]

The strategy: Both studies agreed with foregoing studies in the strategy to counter overweight: The physiology of overweight and Jo-Jo effect
The authors stress the fact that a variety of reasons account for overweight and a jo-jo effect following a diet. The body reacts to weight loss due to famine or diet with defence mechanisms such as increased hunger and reduced energy consume.This makes weight-reduction and to keep it down so difficult,
The studies clearly state that overweight is not bound to a genetic code, what is settled is the individual energy output. Seven strategies are recommended:

1 - Stay mobile: Sport and mobility during work reduces the risk of overweight. The main goal of sport and mobility is to keep, or build muscle mass. Walking, swimming or biking are recommended by the authors. 2 - Never say "never": Trying to avoid everything brings frustration the moment you make a small error. You may have a nice fatty dinner as long you compensate it the next day with vegetables or you insert an extra sport session.

3 - Don't loose the rhythm: Eat always at the same time. Take your time for your meals. Do not eat in a hurry. Do not miss your breakfast.

4 - Control is necessary: Weigh yourself once a day or at least once a week, so you can take countermeasures as soon as your weight rises.

5 - Be stingy with fat: You can do without butter, fatty cheese, heavy sauces and fatt pork. Instead of this you can eat vegetables and fruits instead.

6 - Fresh vegetables:You can eat as much vegetables and salad. as you wish. You get enough dietary fibre and have a low calorie intake. Eat small portions of fruits spare with banana, raisins, grapes and dates.

7 - Join a weight club: You may feel strong in company of kindred spirit in a weight club. Avoid people who seduce you to eat the wrong foods.

Special nutrition


Adventists of 7 Days

Nutrition of Adventists is reduced in proteins and may chose between 3 types:
  1. Rigid vegetable nutrition (veganism)
  2. Ovo-lacto-vegetable nutrition (approximately 50% of adventists follow this nutrition)
  3. Conventional nutrition low in meat, avoiding completely the intake of pork and his derivatives, molluscs and blood.
    Every meal should have many grains of cereals, fruits and vegetables. Strong spices are avoided,
    Old cheese and spicy cheese such as roquefort as well as alcoholic beverages or caffeine are not allowed.
    There are only three meals each day without any coffee break.
It is interesting that there is a smaller number of cancer of adventists and Mormons as found in other groups. There is no doubt that the different nutrition of adventists and Mormons is one important factor of lower cancer rate.


Batiste

They have moderate meals and negation of alcohol.


Buddhists

Nutrition generally veganic, no bulb vegetables are eaten(onions, garlic etc). Ban of alcohol and caffeine.


Hare Krishnas

Vegetarian nutrition, raw meals. Veganic nutrition is seldom followed. Ban of alcohol and caffeine.


Hindus

  1. Lower castes: Mixed nutrition with little meat, sheep, lamb, goats, pork, chicken and fish. Bovine and buffalo meat are not eaten
  2. High castes (Brahmans): Lacto-vegetal nutrition with exclusion of any kind of meat and fish, often exclusion of eggs. The nutrition avoids bulb vegetables (onions, garlic and leek). Alcohol is forbidden.


Mormons

Mormons are moderate in nutrition. They eat fruits and vegetables and have a moderate consumption of meat.
Such moderate nutrition is reduced in fat, albumin, cholesterol and purines. Vitamins and dietary fibres are higher as found in normal nutrition.
Mormons and adventists have lower cancer rate as other groups. There way of life and their nutrition seems to be the reason for favorable statistics.


Jews

Jews try to avoid any kind of excesses. There are detailed rules concerning consume of meat. The animals are chosen and killed ritualistic by a butcher which is determined by the community. Bovine meat is permitted, as well as goats, lamb, poultry (excluding carnivorous birds) fish with scales and fins.
Forbidden is pork, meat of horses, camels, rodents, carrion eating animals, bird of prey, eel, octopus, Crustacea, milk and eggs of forbidden animals, blood and meat with rests of blood, fatty acids from organs such as kidneys, sciatic nerve.
Supply of meat and derivatives is made by communities.
Milk and meat are not consumed together. Milk has to be taken immediately before meals containing meat, or 5 to 6 hours after. Milk substitutes of vegetable origin have no restriction.
Milk and milk products in soups, margarine, ice cream and chocolate must always be taken in consideration.
Food containing milk are to be kept and handled separated from food containing meat and their derivatives. This refers also to utensils such as pots, knifes, forks and spoons, plates, napkin have to be used only for one type of food. Dish washing of both types of food must be separately.
Fish, eggs and vegetable food can be consumed together with meat. There is no restriction.
During Passah (the Jewish eastern) unleavened bread is eaten.


Kosher Foods

The food scares in Europe and in US shows a great need of further food quality control through official governmental ruled authorities.
Industry and retail service are engaged in a catastrophic price war in the struggle for might and power. That is why the level of assessment between good and evil in the practice of business world is being lowered and gives chances to outlaw practices in food industry.
In this struggle ethics are put aside, unfortunately also by governments such as the case of BSE meat being forced to be sold in the European Community by directives of the Commission of the European Community. It is that why US consumer starts to buy kosher foods in the hope to get food produced under strictly controlled environmental technologies.

In US the market of kosher food is growing by over 10% each year and even over 40% of all grocery items are kosher certified in the Northeast America. Religion is not the only motivation for these customers.
Over 60 % of kosher food buyers are not Jewish. Muslims, Seventh Day Adventists, vegetarians, people with specific allergies and consumer seeking extra quality look for food labelled as kosher[1030].

What is Kosher Food ? Kosher means "fit" and is regarded as prepared in accordance with Jewish food laws.
The laws are biblical in origin coming from the five books of the Bible. Interpretation and extentions were made by rabbits in order to include new foods and new processes such as new technologies.

Slavery of desires and emancipation of animal inclinations an the role of moral laws such as kosher dietary laws

[1370] Rabbi Grunfeld wrote in 1972 an essay about why Jews follow kosher dietary laws: ''Holiness or self sanctification is a moral term; it is identical with moral freedom or moral autonomy. Its aim is the complete self-mastery of man.''
''To the superficial observer it seems that men who do not obey the law are freer than law-abiding men because they can follow their own inclinations. In reality however, such men are subject to the most cruel bondage; they are slaves of their own instincts, impulses and desires. The first step towards emancipation from the tyranny of animal inclination in man is , therefore, a voluntary submission to the moral law. The constraint of law is the beginning of human freedom...Thus the fundamental idea of Jewish ethics, holiness, is inseparably connected with the idea of law; and the dietary laws occupy a central position in that system of moral discipline which is the basis of all Jewish laws.''
''The three strongest natural instincts in man are the impulses of food, sex, and acquisition. Judaism does not aim at the destruction of these impulses but at their control and indeed their sanctification. It is the law which spiritualises their instincts and transfigures them into legitimate joys of life.''

Certification of kosher food
In USA an organization makes an audit on the production line of the food which is going to be certified as kosher. Ingredients and technology is examined in order to see if it is in accordance to the Jewish law. With a contract the producer signs an obligation to avoid any change.
European certification is done by a rabbi which visits the plant. He alone decides if the product is kosher. There is no contract being made and the company can therefore change its produce after the rabbi has gone. This is a matter of ethics. A good company will maintain the rules imposed by the rabbi. Bad ethics will follow the way which is the best to it.
In London the Beth Din companyis specialized in certification of kosher food plants all over Europe.

Kosher laws
Jewish religion laws are the basis of kosher laws. It seems that the rules based on the Old Testament of the Holy Bible developed from experiences such as diseases coming from pork which was contaminated by Trichinella spiralis. Eating pork with trichinosis could cause disease thus proving that pigs were impure animals.


Kashrus

The Kashrus magazine lists foods and ingredients which are certified as kosher, as well all kosher certification agencies of the world down to single Rabbis

Kosher Status Of Mars Products

[1371]
According London Beth Din Kashrut Division Announcements articles in the UK press in 2007 say that whey derived from animal rennet is contained in Masterfoods (Mars) confectionery. Whey can be a by product of cheese-making and animal rennet can be used in cheese manufacture. Since whey derived from this source contains only trace amounts of rennet, it is permitted according to halacha.

There is therefore no problem with any of the Masterfoods (Mars) products that are currently on the London Beth Din approved list.


Kosher laws

First law: Allowed animals
Allowed are mammals which chew their cud and have a split hoof. So cows are permitted. Pigs and horses are forbidden.
Birds: Chicken, ducks and goose are allowed. Ostrich and Emu are forbidden.
Fish: All fish with fins and easily removable scales ( without tearing the skin ) are allowed.
Molluscs and crustaceans: This includes shrimps lobsters and oysters are forbidden, such as lard, chitin and porcine lipase.
Ingredients: All ingredients derived from not kosher foods are forbidden. Ingredients such as gelatin, tallow or lard, chemicals derived from animal fat such as glycerol or monoglycerides are prohibited.
Emulsifiers such as used in the production of margarine containing mono and diglycerides are of great concern as their plant or animal origin are often unknown.

Second law: Animal blood Blood is considered to be a special fluid inherent to life. Consumption is forbidden. Slaughter must be performed by a trained person in a way to eliminate the blood from the remaining meat. Slaughter must therefore follow a specific procedure.
Heat, hot water and various acids to prevent microbial contamination are forbidden at this stage of processing. Inspection of the meat must guarantee that there are no specific defects. After that the meat is soaked and salted to remove last remains of blood. The second law does not apply to fish.

Third law: Separation of dairy products from meat products and equipment used
The third law says that all kosher foods, ingredients and equipment are classified in three categories:
1.- Dairy products
2.- Meat products
3.- Pareve: Here are included all vegetable foods fish, eggs and honey. Pareve food and their ingredients must be dairy free.
People with allergies to milk and their derivates, allergies to egg proteins and vegan vegetarians welcome the third law as they can find the separation of these three categories which are not being observed by any other food laws. Pareve may contain a certain amount of milk and their derivates as it is sometimes not to be avoided. This may be tolerated for religious purposes but should be kept in mind of those who are very sensitive.

Ingredients allowed for pareve foods: Agar-agar, Carrageen, dextrose, gum arabic (Acacia), lecithin Chocolate may also contain milk and milk derivates. The technical equipment used for milk chocolate must be cleaned carefully before producing pareve chocolate. European chocolate may have up to 5% of other fats than cocoa fat. These fats can be of vegetable and of animal origin.

Fourth law: Ban of leavened products made from grains of wheat, oats, rye, barley and spelt during the Passover week
Permitted is matzo which is a specifically prepared unleavened bread, matzo meal and matzo cake flour.
Many baked products are available completely grain free giving persons with grain allergies such as coeliac disease to get foods which are free of certain allergens.

Grain-like materials

Rabbis in Europe have extended the prohibition of the grain rules to other grain-like materials such as legumes, corn, rice mustard and sesame seeds.
Sugar and corn syrup are avoided as ingredients of many products during Passover The third rule supports the theory that the deep roots of the Jewish religious laws regarding kosher foods were unconciously based on veterinary and epidemiological experiences which had summed over centuries under the classification " this is good and that is bad".

Kosher technology

The production and marketing of kosher food require: 1.- A reputable rabbinical supervision agency (or a single Rabbi in Europe) must be contacted.
2.- All ingredients are checked are included in the Kashrus. The equipment and their material must be examined to be kosher. There are restrictions on account of parts made of rubber ceramics and some plastics.
3.- All ingredients must be completely labelled on kosher food thus providing a complete information for sensitive people, whereas normal food regulation use class names and exceptions allowed to hide some of the ingredients.

Ingredients which require kosher supervision: Casein, emulsifiers fats, fatty acids, lipids and whey.


Moslems

\includegraphics[width=260.00bp,height=250.00bp]{library/Stadt5.ps} Mosque in Kuwait city

Halaal food:
Halaal food means permitted, allowed lawful or legal for Muslims. The opposite of Halaal is Haraam meaning prohibited, not allowed, unlawful, illegal. Halaal is a set of Islamic dietary laws guided by the Qur'an the Holy Book and the teachings of Allah's profet Muhammad, may peace and blessing be upon him. Nutrition of Muslims differs from one region to another. There is a strong negation of pork and his derivates, gelatine, meat of dogs, birds of prey, frogs and snails.
Killing of animals are ritually. Alcohol is forbidden. Consume of blood is not allowed. The use of animal fat in baking is forbidden. Gelatine is not allowed.
Exceptions are allowed only in emergencies.
The rules for Halaal are very similar to those of kosher foods
The most important rules for Halaal are:
1.- Meat must be slaughtered in a particular way.
2.- Only certain animal products are allowed
3.- Technological processing , like Processing aids, cleaning materials and equipment used in production must be free from prohibited food traces.
These restrictions are based on the Quran (The revealed book)and Sunna
The Islamic dietary laws which rule the production of Halaal foods is a religious matter which can be handled only by a Muslim expert. The Quran is the holy book of Muslims, being the last testament and revealed from God (Allah) as the Holly bible.

The Quran says:
Sura five ( The table) ( Al - Maida ) verse 4 to 5. "(4) It is forbidden to eat: From which has died by himself, blood and meat of swine and of that by whose slaughter another name as Allah has been invoked, and of that which has been suffocated dead by beating or which has fallen to death or which has been killed by the horns of other animals or have been killed by other wild animals, (except the animal which has been wounded by wild animal came to your hands still alive and you have finally killed it by yourself), and this what has been slaughtered in honour to wrong idols."
Other quotations are:
The Hadith (sayings of the last Prophet, Muhammad
The figh (jurisprudence) of the Muslim Jurists Hanafi, Shafii, Maliki and Hanbali.
The Muslim Food Board ( UK ) is one company which investigates and certifies Halaal foods.Heat, hot water and various acids to prevent microbial contamination are permitted.
Technology and science has deeply changed production, ingredients and packaging enhancing shelf life, food colour and texture. Global spread of exotic foods and rapid changing of nutritional habits make it important to verify the lawfulness of food in compliance with the commands of the Islam.
Muslims are allowed to eat food prepared by people who are of other beliefs ( 5:5) and Muslim food is permitted to be eaten by them, on condition that these foods are pure and permitted foods. (5:88). This permits an interchange and living together of Muslims with other groups all over the world. This is very important for the functioning of our global world.

However some precautions should be made:
'Do not eat unless Allah's name has been taken and this (not taking Allah's name) practice is transgression' (Qur'an 6:121)
The Ahlul-kitaab of today are recognized by name, less faith. There is no guarantee that they take the name of Allah/God when slaughtering an animal. Furthermore, they cannot be anymore trusted in matters pertaining to Halaal/haram. Unless there is certainty that the Ahlul-kitaab read the 'Tasmiyah' i.e. take the name of God when slaughtering an animal, only then the meat will be permissible. It was suggested that the Muslims in the U.S.A. and U.K. slaughter the animals themselves. This will make them independent from Christian/Jewish sources.
The meat sold on the market such as supermarkets should be packed, sealed and stamped by a Muslim organisation consisting of reliable scholars and Úlama who have proper Islamic knowledge of the principles pertaining to Halaal/haram.
Intoxicants, such as alcohol are forbidden because they are harmful substances.(2:219) (5:91) Consume of blood is not allowed. The use of animal fat in baking is forbidden.
Exceptions are allowed only in emergencies, such as being forced by hunger, without intention to practice sin (2:175, 5:5)
The classification of new foods and their ingredients in Halaal and haram, based on the commandments of the Qum'ran the Holy Book can only be done by an Muslim expert. The Islamic religion does not have a central religious head which dictates latest findings but some authorities are accepted in their leadership, such as the mufti of the Al Azhar University of Cairo. Due to different translations of the Koran the local interpretation of its content differs from country to country.
Some experts which can classify food as Halaal or haaram are: halalexplorer.com; muslimconsumergroup.com;somalitalk.com; Joe M. Regenstein, Cornell University, USA; M. Chaudri, IFANCA International: Masood Khawaja, The Halaal Food Authority.

Haram ingredients:
Any product or by-product (including any product used temporarily as a substitute) which contains any one or more of haram products in however minute quantity, whether as an ingredient or sub-ingredient or as a processing aid or as a releasing agent or as a glazing agent or as an additive or as a colour or in any other form, is haram.

HALAAL          
INGREDIENTS -A-          
Acacia gum E414 Ammonium carrageenan   Antioxidants (BHA and BHT)  
Acetic acid   Ammonium chloride   Arachidonic acids  
Adipic acid (acidulant) E355 Ammonium sulfate   Artificial colour  
Agar E406 Amylase   Ascorbic acid E300  
Algin/calcium alginat E404 Amylose   Aspartame  


HALAAL          
INGREDIENTS -B-          
Baking soda   BHT Butylated hydroxytoluene E321 Sparrow, emu  
Benzoate of soda E211 Bird, exclude bird of prey   Ostrich  
Benzoic acid E210 Chicken, duck, turkey, goose   Butyric acid  
BHA Butylated Hydroxyyanisole E320 Pigeon, dove, partridge, quail      


HALAAL          
INGREDIENTS -C-          
Calciferol (Vitamin D$_{3}$)   Calcium sorbate E203 casein  
Calcium acid phosphate   Carbohydrates (natural)   Cellulose E460  
Calcium carrageenan   CMC Carboxymethylcellulose E466 Cellulose gum  
Calcium disodium EDTA   Carotenoid   Cholecalciferol  
Calcium carbonate   Carrageenen E407 Choline from yeast, soy  
Calcium propionate E282 Carrot oil   corn meal,corn starch  
Calcium saccharin E954 Carrageenin E407 Corn syrup  
Calcium silicate E552 Carotene E160a Cultures,living microbes  


HALAAL          
INGREDIENTS -D-          
Dextrin E1499 Diglyceride (plant)   Disacharides  
Dextrose   Dipotassium phosphate      
Dicalcium phosphate   Disodium inosinate E631    


HALAAL          
INGREDIENTS -E-          
Erythorbic acid E315 Ergosterol   Enzyme (plant)  
Ergocalciferol          


HALAAL          
INGREDIENTS -F-          
Farina   Ferrous sulfate   Fructose  
Fatty acids (plant)   Fibre   Fumaric acid E297  
Ferric orthophosphate   Ficin   Fungal protease enzyme  
Ferrous gluconate E579        


HALAAL          
INGREDIENTS -G-          
Galactose   Glutamic acid   Glyceerol/Glycerin (plant) E422
Gallic acid   Gum acacia   Glycine, sodium salt (plant) E640
Gliadin/ Gluten   Glyceride (plant)   Guar gum E412
Glucose       Gum arabic E414


HALAAL          
INGREDIENTS -H-          
Hemicellulose   Honey   Hydrogenated oil  
Hormones (plant)   Horse meat (sometimes)   Hydrolysed vegetal protein  


HALAAL          
INGREDIENTS -I-          
Inulin   Invertase   Isopropyl citrate  
Invertase   Iodine      


HALAAL          
INGREDIENTS -L-          
Lactic acid (synthetic)   Lactostearia   Lecithin (soy or plant) E322
Lactose   Leavenings   Lysin  


HALAAL   INGREDIENTS -M-      
Malt   Mannitol   Monocalcium phosphate  
Malic acid E296 Mannosan   Monoglycerides (plant) E471
Malt diastase   Methionine   Monosaccharides  
Maltic acid   Methylcellulose E461 MSG (monosodium  
Maltodextrin   Methylsilicone   glutamate) E621
Maltose/ maltitol E965 Molases from Halaal source      


HALAAL
INGREDIENTS -O-
Oxalic acid


HALAAL          
INGREDIENTS -P-          
PABA(para-aminobenzoic   Pectin E440 Potassium bromate  
acid) from plants   Phospholipi (plant)   Potassium citrate E332
Papain   Propionate   Potassium phosphate E340
Partially hydrogenated   Propionik Acid   Potassium sorbate E202
vegetable oil   Propyl gallate   Propyl gallate E310
Pectic material   Potassium benzoate E212 Propylene glycol E1520


HALAAL
INGREDIENTS -R-
Roughage


HALAAL          
INGREDIENTS -S-          
Silicon dioxide E551 Sodium erythorbate E318 Stannous chloride  
Smoke flavourings   Sodium hexametaphosphate   Sucrose  
Sodium acid          
pyrophosphate E450 Sodium phosphate E339 Suet  
Sodium alginate E401 Sodium propionate E281 Sulphur dioxide E220
Sodium aluminum sulfate   Sodium propionate E281 Sweetener (natural)  
Sodium ascorbate E301 Sodium silicon aluminate   Sodium bisulfite E222
Sodium benzoate E211 Sodium sorbate E201 Sodium caseinate E469
Sodium bicarbonate E500 Sodium sulfite E221 Sorbitol E420
sodium caseinate E469 Sorbic acid E200    
Sodium citrate E331 Soybean lecithin      


HALAAL          
INGREDIENTS -T-          
Tannic acid   Tartaric acid E334 Titanium dioxide E171
Tapioca   From grape only,not from wine   Tricalcium phosphate  


HALAAL  
INGREDIENTS -V-  
Vanilla acid, Vanillin Vitamines Tablets (A, D, E, C


HALAAL
INGREDIENTS -Z-
Zinc
 


Vinegar produced from alcohol: Vinegar Fermentation is only permitted when vinegar as final product is wanted. A rest of 0,5% alcohol is permitted.

Shubhah (Mushbooh)

Shubhah or Mushbooh means "suspected" and is applied for foods or drinks from which it is not known to be Halaal or haram. Shubhah or Mushbooh foods, being doubtful foods or drinks should not be consumed.

MUSHBOOH    
INGREDIENTS    
Acetic acid ester of Mono- Alanine Animal fat
diglycerides (animal) E272a    
Beta-carotene, apocarotenal Bile salts Broth (animal)
using animal based gelatine    
Brilliant blue E133 Carcium stearoyl lactylate E482 Charcoal (animal)
Chelate Cholesterol Chymotrypsin
Citric acid ester of Mono- Cobalamine Cochineal E120
Diglycerides (animal) E272c    
Coloring extract Cures Cystein
Cystine Diglyceride (animal) Disodium guanilate
Dissodium inosinate Dripping (animal) EDTA
Enzyme (animal) Etoxylated mono-/diglyceride Fatty acids(animal)
Folic acid Glyceride (animal) Glycerol/glycerin
Glycerol stearates Glycogen Gum traganth E413
Histamine Hormones (animal) Hydrolysed animal protein
Inositol Insulin Keratin
     
Lactic acid ester of Mono- Lactose made from whey Lipids
diglyceride (animal) E272 which is produced from  
  animal rennet  
     
Monoglycerides (animal) Monopotassium tartarate E336i Niacin
  (tartar Cream) from wine  
     
Oleic acid Oxysterin Para amino benzoic acid
Pepsin (animal) Phenyl alanine Phospholipid (animal)
Phosphoric acid E338 Polysacharides-glycogen Polysorbate 60 E435
     
Polysorbate 80 E433 Polyunsaturated (animal) Propylene glycol
    alginate E405
     
Propylene glycol monostearate Quinoline yellow E104 Renin/rennet (unless it is
  if animal glycerol is use of plant/microbial/synthetic
    origin)
     
Riboflavin Rum flavour Saccharine E954
Shortening(animal) Sodium lauryl sulfate Sodium stearate(animal)
Sodium stearoyl-2-lactylate E481 Sorbitan monostearate E491 Sodium nitrate E251
Sweetener-Aspartame Sweentener-Cyclamate Sweetener-Saccharine
Stearate Stearic acid Sunset yellow E110
     
Sucroglycerides E474 Tartaric acid E 334 Tartaric acid ester of Mono-
  from wine diglycerides (animal) E272d
     
Tartazine E102 Thiamin Tonic
Trypsin    




HARAM    
INGREDIENTS    
Alcohol Animal fat Alcoholic beverages
Animal shortening Bacon (pork) Boar
Carmin E120 CochinealCollagen (pork)  
     
Carnivorous animal (Lion,tiger, Cider (alcohol) Cocaine
cheetah, dog, cat)    
     
Codeine Fermented malt Gelatin
Lipase(animal origin) Kosher gelatin l-cysteine (if from human hair)
Monkey Pepsin (Hog) Pork
Rennet Sodium nitrite E250 Uric acid
Snakes Tallow Vanilla extract (alcohol)
     
Wine Whey (unless the rennet  
  used is plant/microbial/  
  synthetic  

The consumer does not understand the meaning of Halal and Kosher foods.

[669] [670]
According to a reports from Packaged Facts and from Mintel the majority of American consumers buy kosher and/or halal foods foods expecting higher quality and safety, compared with normal foods. They are not motivated by religious or ethnic reasons. The reports stress that these products present best marketing conditions exploring the kosher or the halal certification label inducing safety image. This may be deceiving for the consumer.

Understanding Kosher and Halal Food

[671]
Both ethnic foods do not mean that safety or quality is better than normal foods. They differ from western food because they are manufactured according to religious believes. Their principles are not based on science, but on rules found in the Holy Bible and in the Holy Quran.

- Ritual slaughter by cutting the throat of the animal.
- Negation of pork.
- Kosher foods forbid mixing dairy products and meat.
- Alcohol is strictly forbidden for Halal, and vanilla is not allowed because it may be produced using alcohol extraction. Some liquor and wine are kosher if made only by Jews. - Gelatine is forbidden because it may come from pork.

Certification of Kosher and Halal food: Certification can be made by private entities and varies according to the religious expert who emits the label. In some cases HACCP enquiries are added to the certification procedure, but this is not an essential part of the meaning of Halal or Kosher. Complying with HACCP standards and hygiene requirements are demanded by food regulation such as the Article 21. FDA and every food must comply with them and is not a speciality of ethnic food.

Muslims say Walkers Crisps Muslims are not Halaal

[672]
UK Muslims are upset on Walkers crisps containing traces of alcohol. The Muslim Council of Britain says that consuming food with alcohol in it is not permitted by the Muslim faith. Walkers should make ingredients such as alcohol clear on the packaging. Walkers have stated that only a minimal amount of alcohol is used in some products to extract flavour added to the crisps.

The food industry, however should select flavourings which were extracted by other methods as using alcohol. Such methods are for instance, supercritical carbon dioxide extraction. This is a way to keep the list of ingredients small and satisfy all consumers.

Flavour containing alcohol as a solvent

[673]
According to Halapreneur some Islamic Scholars considered a non Halal food product if it is made with flavour containing alcohol as a solvent. But the others considered it Halal because they said the small or large quantity of the product does not intoxicate a person.

According to Masood Khawaja, of the Halal Food Authority labelling issues and alcohol flavouring had been raised with Walkers before. He says that the company should have solved it instead of hiding behind labelling regulations, because it does not matter what percentage of alcohol is involved. Snacks that are likely to be boycotted by Muslims are Sensations Thai Sweet Chilli, Doritos Chilli Heat Wave and Quavers Cheese.

Ritual slaughter

The Sunna describes the ritual slaughter. All animals should be slaughtered according to this Islamic ritual with exception to animals shot during hunting. Ritual slaughter should be done invoking the name of Allah and cutting the throat, artery and gullet with one stroke of a sharp knife. The animal must be alive at the moment of slaughter in order to allow total bleeding because consumption of blood is forbidden.
Blood is therefore used as meal for animal feeding or dried together with the content of stomach and intestines as agriculture fertilizer.(Buckenhüskes et al.,1996][680] In Germany the Islamic ritual slaughter is not allowed (BVerwG,Urt from 15.06.1995-BVerwG 3 C 31.93 German resolution against ritual slaughter without stunning). According German veterinary rules animals have to be made unconscious before bleeding. The University Al Azhar of Cairo has accepted stunning with electro shocks.This however is not according to the opinion of the majority of Moslems which consider such slaughter as haraam. [680]

Animal slaughter research

At the University of Hanover, Germany Professor Schultz and Dr. Hazim used Electroencephalograph (EEG) and electrocardiogram (ECG) to compare the pain caused by Islamic slaughter and western method using captive bolt stunning.
According to both scientists the Halaal method caused no change in the graph of the EEG the first 3 minutes after cutting the throat of the animal according to Islamic ritual. The next tree minutes showed a condition of deep sleep, followed by a zero level.The heart was still pumping and convulsion of the animal due to a reflex of the spinal cord driving maximum quantity of blood out of the body.
Islamic slaughter was therefore classified as humane and hygienic method.
Western method by captive bolting stunning showed in the graph of the EEG signs of severe pain. The heart stopped beating retaining much blood in the body.
The western method was therefore classified by the authors as unhumane and unhygienic for the consumer because of increased amount of blood being retained in meat. Schultze Hazem 1978

Physiologic reactions during the slaughter of cattle and sheep with and without stunning

[675]
Kallweit and colleagues 1989 report two trials concerning reaction during slaughter of cattle and sheep:

The first trial tested the cortical activity of cattle and sheep using electrocorticogram (EcoG). Stunned animals had a shorter phase until the ECoG disappearsafter sticking, but had a prolonged time until disappearance of the EcoG signals between stunning and the cervical state. However, this could not be statistically confirmed, and the authors concluded that the different slaughter methods could be regarded equivalent.

The second trial with adult cattle included an extended ECoG and measuring visually and somatosensorically evoked potentials.

Captive-bolt stunning resulted in shorter intervals until disappearance of cortical activities, and variance was much lower compared with ritual slaughter.

The authors stress that after captivebolt stunning absolutely no evoked potentials could be registrated, whereas these potentials lasted for 77 seconds (somatosensorically evoked potentials) and 55 seconds respectively (visually evoked potentials) after the ritual slaughter cut. A nervous conduction was measured up to 126 seconds in the extreme cases after ritual slaughter.

The authors wrote that their results do not permit the conclusion whether or not pain sensitivity occurred in the animals.

Animal welfare slaughter regulation

[676]
The animal welfare regulation on the slaughter of animals, existing only as a draft for the time being, is designed not only to transpose EC-legislation into national law but also to update and strengthen preconstitutional national legislation on this matter. For a wide area related to the slaughter or killing of animals, animal welfare requirements are put in concrete terms. Among the topics belonging to this area are the theoretical and practical knowledge of the personnel, the handling of animals before slaughter or killing, stunning, the control of its efficacy and the permessibility of certain stunning or killing methods. Not only livestock but also, for example, fur animals and fish are concerned. In practice it will take some efforts in order to attain compliance with the provisions of the animal welfare slaughter regulation.

Status of law-making on animal welfare

[677] The Commission has introduced a directly operative animal welfare legislation by adopting EC Regulation 1/2005 [678] on the protection of animals during transport. Since the first animal welfare conference of the International Office of epizootics (OlE) in February 2004 in Paris, two very comprehensive codes on slaughter of animals and on animal transport were adopted.

Ritual slaughter in Brazil is found to be painful

[679]
Roberto de Oliveira Roca 2002 cites the problem with the Jewish ritual of cattle slaughter in Brazil is the restraint system, which is not efficient, and does not takes into consideration that most of the cattle is Zebu, which is more excitable than European cattle. According to Oliveira Roca the restraint and crude throat-cutting cause severe stress in the animals slaughtered by the Kasher method. This is evident observing the reactions of the animal, which show front leg flexure and contraction of the muscles of the face soon after throat cutting and hoisting, animals.

For humane and safety reasons, slaughter plants performing Jewish slaughter must have modern equipment for vertical restraint. The practice of hoisting live cattle or sheep must be eliminated. Roca points to schemes and restraint equipment which are recommended by the American Society for the Prevention of Cruelty to Animals (ASPCA) .

Recommended restraint cabinet: The apparatus consists of a narrow cabinet with a front opening for the animal's head. After the animal enter the cabinet, a gate pushed it forward and an abdominal lifter is placed under the chest. The head is restrained by a face lifter, so the rabbi can cut the throat. The movement of the abdominal lifter must be restricted to 70 cm so that the animal is not lifted from the floor. The gate pushing the rear must be equipped with a separate pressure regulator, allowing the operator to regulate the pressure on the animal.

Ritual slaughter

The most important rules for Halal foods are:
1.- Meat must be slaughtered in a particular way. Zibah
2.- Only certain animal products are allowed.
3.- Technological processing , like processing aids, cleaning materials and equipment used in production must be free from prohibited food traces.
The Islamic dietary laws which rule the production of foods is a religious matter which can be handled only by a Muslim expert.
Animals should be slaughtered according to Islam ritual. Exceptions: animals shot during hunting and regulations for wild life.

Rules for ritual slaughter
-Licensed Muslim slaughterer should slaughter invocating the name of Allah.
-The animal must be alive and healthy at the moment of slaughter.
- Animal skin or fur or feathers must be clean prior to slaughter, free of faeces, mud or other unhygienic substances
-Cut the throat, jugular vein, carotid artery and gullet with one stroke without damage of the the spinal cord stunning is not permitted
- Flowing blood drain out by natural convulsion

The major concern during ritual slaughter are the stressful and cruel methods of restraint (holding) used in some plants such as hanging live animals upside down. Devices to hold the animal in a comfortable, upright position should be used.

Mechanical slaughter

Mechanical transportation but manual slaughter:

Chickens are transported to the place of slaughter through a conveyer belt and are manually slaughtered. If there is certainty that the chicken is alive and the Muslim slaughterer recites the name of Allah upon slaughtering, then the chicken is Halal. In this case, only the transportation is mechanical but the slaughtering is manual. This procedure is unanimously permissible and recommended.

Mechanical transportation and slaughter:

Chickens are transported by means of the conveyer belt to the mechanical slaughter blade. Once the mechanical plant comes into operation, the blade also comes into operation and cuts the chicken. This procedure is not permissible.

Stunning

Austria:

Muslims must stun prior to slaughter. Exemption in some areas for Jews.

Belgium:

Muslims must stun prior to slaughter. Exemption in some areas for Jews.

Denmark:

Exemption for Jewish slaughter, but have to stun cattle after the throat is cut. Muslims stun cattle with captive bolt pistol. Lambs, goats and poultry do not have to be stunned.

Finland:

Animals must be stunned immediately after they have been cut.

France:

Exemption from stunning

Germany:

The Islamic ritual slaughter is not allowed (BVerwG,Urt from 15.06.1995-BVerwG 3 C 31.93 German resolution against ritual slaughter without stunning). According German veterinary rules animals have to be made unconscious before bleeding. Religiously slaughtered meat is only for consumption by local communities and cannot be exported.

Greece, Italy, Ireland, Luxembourg, Netherlands, Portugal and USA:

Exemption from stunning.

Spain:

All animals except goats and sheep have to be stunned before their throats are cut.

Sweden:

l992 decision by the Swedish Board of Agriculture to uphold its ban on slaughter without stunning.

Norway:

All animals must be stunned prior to slaughter.

Egypt:

The University Al Azhar of Cairo has accepted stunning with electro shocks. This, however, is not in accordance with the opinion of the majority of Moslems which consider such slaughter as haram.

European Union:

The Council Directive 93/119/EEC lays down the standards for killing animals. It states that "on animal welfare grounds, stunning methods should render animals unconscious until death supervenes through bleeding."

United Kingdom:

In the UK specifically, the law is laid down in (The Welfare of Animals (Slaughter or Killing) Regulations 1995).
All mainstream slaughter is supposed to involve stunning the animals before their throat is cut. The methods used are as follows with the main concerns as stated by the Scientific Veterinary Committee of the EU :These rules apply to all mainstream slaughter. In fact animals have had to be stunned before slaughter in the UK since 1919. Religious or ritual slaughter is exempt.

When the cut is done correctly, the animal appears not to feel it. There are a lot of publications which underpin this affirmation and refuse the arguments of FAWC.

Switzerland:

Religious slaughter is forbidden on conscious animals (except poultry).

Denmark:

Muslims accept the stunning of cattle with the captive bolt pistol.

Finland:

Religious slaughter is only permitted if the animals are stunned immediately after they have been cut.

New Zealand:

is the world's largest exporter of halal-slaughtered sheep meat. All sheep are given a head-only electrical stun. In promotional literature, the New Zealand Meat Producers Board says that, "the slaughter methods adopted have been favourably commented on by delegations from the Islamic Republic of Iran, Malaysia, Kingdom of Saudi Arabia, Kuwait, Egypt, Syria and Jordan."

Mechanical Methods of stunning in mainstream slaughter

Captive bolt:

This stunning method is widely used for all farm animals and rabbits. Gun powder (cartridge), compressed air and spring under tension drive bolts through the skull of animals.

Main EU concerns: in approx. 10% of cattle the bolt is not applied correctly; animals remain conscious or regain consciousness because the bolt is not applied at the right part of the head; unsuitable cartridges used.

Concussion stunning:

A mechanically operated instrument delivers a blow to the brain and concusses the brain. Used for cattle, sheep, calves, rabbits.

Main EU concerns:

"The prevalence of miss-stuns under abattoir conditions is a major concern." Animals are not stunned properly and so are often fully conscious when their throat is cut.

Free bullets:

Used for animals difficult to handle such as wild pigs, bison, deer, horses or in emergencies. Main EU concerns: Shooting in the chest or neck causes severe pain and distress (animals are supposed to be shot in the head); wrong strength of bullet used for a particular species.

Gas stunning

Carbon dioxide:

Carbon dioxide is used to stun pigs in the UK and other EU countries. Pigs exposed to 90% CO2 die within approx. 5 minutes, but times vary and can be significantly longer.

Carbon dioxide and argon:

This gas mixture is used for stun/kill chickens and turkeys.

Electrical stunning

Head-only stunning:

An electric current is applied to the head which is supposed to cause temporary loss of consciousness.

Cardiac arrest stunning:

An electric current is either sent through the head and body at the same time to span the brain and heart or is sent though the head first and then across the chest.

Waterbath stunning:

Used for poultry. Birds are shackled upside down on a moving conveyor which carries them to an electrified water bath into which their heads are supposed to be immersed.

The Law
Muslims interpret these commands differently. Some say that regarding:

Gassing strangulation:

Are considered as cruel and unlawful in Islam, therefore chemical gassing should not be used as a stunning method.

Concussion:

Animals that die from a violent blow - that although this rule was intended to stop animals being killed by a stick etc., some Muslims argue that today it means that electrical stunning and the bolt pistol should not be used.

Captive bolt pistol, water bath:

Animals that die from a fall - some Muslims have interpreted this command to mean that if an animal has died from concussion or drowning (as a cow falling in a well would be killed by drowning) it is forbidden. Therefore, they say, the captive bolt pistol or concussion stunner should not be used as it may cause the animal to die from concussion and killing chickens in electrified water baths may be unlawful as it causes death "partly by drowning"

Legal or not legal: Electrical stunning, Islam experts interpretation

Dr Abdel Aziz El Khayat, Dean of the Faculty of Islamic Law, University of Jordan

Some say it is legal so long as the animal is still alive when slaughtered and so long as the motive is to ease suffering and quicken the process; others say it is forbidden because the shock can cause pain; quickens decay of the flesh; causes haemorrhaging so diseases can't be checked for and may kill the animal outright.

Van de Wals and Warrinton:

All stunning methods trigger a massive secretion of epinephrine.

New Zealand and Australia:

New Zealand has developed an electrical stunning apparatus that met a Muslim standard. Head-only electric stunning prior to Muslim slaughter is used in almost all sheep slaughter plants in New Zealand and Australia.

Dr Ahmad Sakr, expert on Halal certification in USA:

He says it is not Halal because of the effect electric shock has on blood drainage. Using electric shock means that all of the animal's blood does not leave its body, because electric shock affects the central nervous system.

Captive bolt stunning, Islam experts interpretation

Sheikh Aboul Yusr Abdin former Syrian Mufti:

Many Muslims do believe (and many do not!) that stunning is permitted so long as the animal is killed by cutting the throat. It is more acceptable to stun cows to speed up throughput but much less so to stun smaller animals which are easier to handle.

Dr Abdel Aziz El Khayat:

He says that most Muslims allow the captive bolt.

Australia, New Zealand and Ireland:

Non-penetrating concussion stunning prior to slaughter has received approval from some Muslim authorities.

The Talmud:

The Talmud contains an entire section on slaughter and the subsequent inspection of animals to ensure that they are religiously "clean". The text includes detailed anatomical information what is to be done during slaughter and the subsequent post-mortem inspection.

The Jewish religious codes require that allowed animals be slaughtered by a specially trained Jewish male called "shochet" using a special knife, called the "chalef".

While the Muslims allow any believing Muslim man or women, to slaughter allowed animals.

Halal slaughter of animals and birds in abattoirs
The abattoir or factory must be under the close and constant supervision of a Halal Certifier. The premises, machinery and equipment must be cleansed according to Islamic Sharia (law) before any production takes place.
The slaughterer must be a mature and pious Muslim of sound mind who understands fully the fundamentals and conditions relating to Halal slaughter and be approved by the religious authorities. Only acceptable live animals and birds can be slaughtered.

The slaughter must be done manually using a stainless steel knife.
Facilities must be available for rinsing the knife after each kill.
The slaughterer must sever the respiratory tract, oesophagus and jugular vein.
The animal must be completely dead before skinning takes place.
Only Halal animals and birds are Halal Slaughtered.
Evaluation of religious slaughter
Evaluation of religious slaughter is being done on three basic fields: - Stressfulness of restraint methods. - Pain perception during the incision. - Latency of onset of complete insensibility. Restraint

Europe:

The casting pen inverts cattle onto their backs, being more stressful than upright restraint devices. Cattle resist inversion and twist their necks in an attempt to right their heads.

Weinberg casting pen:

It is very stressful

Facomia pen:

It is less stressful than Weinberg pen but upright restraint would be better.

US:

poorly designed upright restraint boxes apply excessive pressure to the thoracic and neck areas of cattle. Time to lose consciousness

Sheep and goats:

2 to 15 seconds

Cattle:

immediately to 30 seconds. Calm cattle will usually collapse within 10 to 15 seconds.

Upright restraint Good upright restraint equipment is available for low stress, comfortable restraint of sheep, calves and cattle

According to Grandin excessive bending of the neck,should be avoided. For that, the bovine's forehead should be parallel to the floor. This positions the throat properly for ritual slaughter and stretches the neck skin minimizing discomfort.

A relaxed, calm animal has improved bleedout and a rapid onset of unconsciousness. Excited animals are more likely to have a slower bleedout. The use of a comfortable upright restraint device would be advantageous from a religious standpoint because rapid bleedout and maximum loss of blood.

Welfare aspects of slaughter
Many welfare concerns are centred on restraint, driven by their concerns about forceful immobilisation and clamping of cattle. Proper design and operation of restraint devices can alleviate most of these concerns with cattle and sheep.
Restraint devices are used for holding animals both for ritual slaughter and for conventional slaughter where animals are stunned. The use of a head restraint will improve the accuracy of captive bolt stunning. In large beef slaughter plants without head restraint captive bolt stunning has a failure rate of 3 to 5, a second shot is required.

Technological processing

Slaughter by machines:

Several supermarket chains have sold chicken slaughtered by machines with Halal labelling. Consumers do not agree with that.

Product change on line:

Changing between different products of the same category with meat and vegetarian products on a same line is cost intensive with regard to loss of product and off-production time cleaning and disinfection. Changing product without cleaning is practised in actual food industry.

However, changing from meat product to a vegetarian one, haram meat and animal fat can contaminate this product


Ramadan, the fast-month

Consumption of food and beverages during daytime. There is only one meal right after sunset and one meal before sunrise. This rule is very difficult to be followed by hard workers, persons exposed to high temperatures and travelers.

Halaal (lawful) food product definition

The Muslim Food Board (U.K.) [680] gives the following definition of food for Moslems [680]:
Halaal food is defined as any food product that is free from all of the following:
Any product or by-product derived from:
a) Pig
b) Blood
c) Carnivorous animals (except fish]
d) Reptiles and insects
e) Any marine animals except fish
f) The bodies of dead animals
g) The bodies of Halaal animals (i.e. Buffalo, Cow, Sheep, Lamb, Goat, Deer, Rabbit, Chicken etc.) which are not slaughtered according to the Islamic Law.
h) Wine,Ethyl Alcohol or Spirits, where these remain in their original chemical form.
Vinegar, produced from alcohol.

Fermentation is only permitted when vinegar as final product is wanted. A rest of 0,5% alcohol in the vinegar is permitted. A natural content of alcohol in fruit juices is tolerated even by deep religious people [680].

Any product or by-product (including any product used temporarily as a substitute] which contains any one or more of the above products in however minute quantity, whether as an ingredient or sub-ingredient or as a processing aid or as a releasing agent or as a glazing agent or as an additive or as a color or in any other form, is Haraam (unlawful) for Muslims.
Some examples of Halaal food products are as follow:
1. Milk (Cow, Sheep and Goats)
2. Honey
3. Eggs
4. Fish
5. Edible plants (including sea plants), which are not intoxicant
6. Edible fresh or naturally frozen vegetables
7. Edible fresh or dried fruits
8. Edible nuts like peanuts,cashew nuts, hazel nuts, Walnuts etc.
9. Edible grains such as wheat, rice, rye, barley, oats etc.
10.Edible condiments such as cardamom, clove, sage leaves, turmeric, chilli, curcumin etc.

Some common examples of Haraam (unlawful,forbidden) food products are as follows:

1. Bone stocks or animal fats (e.g.: Lard, suet, dripping, gelatine, aspic, glycerol, stearates, stearic acid, proteins, amino acids, bone, charcoal, pepsin, animal renet etc. )
At the beginning of 1998 the Al Azhar University of Cairo redefined gelatine as Halaal. According to the University of Cairo is gelatine a food ingredient which is so strongly hydrolysed that there is no connection left with the original pig. This new point of view is official granted but not everywhere accepted by all Moslems. The industrial use of gelatine should therefore be avoided.
The Islamic religion does not have a central religious head which dictates latest findings but some authorities are accepted in their leadership, such as the mufti of the Al Azhar University of Cairo.
Due to different translations of the Koran the local interpretation of its content differs from country to country[680].

2. Any additive or color derived from animals:
E 120 Cochineal
E 104 Quinoline yellow (if glycerol is used)
E 153 Carbon black (if animal charcoal is used)
E 471 Mono and diglycerides of fatty acids (if animal products is used)

E 472 (a to e) Acetic ,lactic, citric, tartaric acid esters of mono and diglycerides of fatty acids (if animal product is used)

E 474 Sucroglycerides (if animal product is used)
E 476 Polyglycerol esters of polycondensated fatty acids of castor oil (if animal product is used)
3. Production of whey powder or whey solids using animal based rennet.
4. Lactose made from whey which is produced using animal rennet.
5. Lining of containers with animals or alcohol products as used in baking of bread, cakes etc.
6. Production of beta-carotene and apocarotenal using animal based gelatine.
7. Use of animal based glycerine as a coating for raisins or as a flower improver.
8. Vitamins A, D and beta-carotene which is protected in a matrix that do not conform to the above Halaal Food Production definition. The above are some examples of Halaal and Haraam food products,the list is by no means complete. 9.- Plants which can cause drug addiction and cause doping.[680] Not permitted foods are called Haraam. The hypothesis that certain kinds of food were forbidden because of hygienic reasons was made by Lück in 1966 and Saleh in 1972. This hypothesis is nowadays denied unanimously.It is believed that all rules have strict religious origin[680]. A food does not lose his halaal character when it proves to be allergic to a small part of the population.
Toxic foods such as containing aflatoxins are haraam because they are harmful [680]


Definition of Halaal Food according to the Codex Alimentarius second edition:Food labeling 1998(General Guidelines for use of the term "halal")

[1032]
Muslim halal dietary laws are found in the Qumramand the books of Hadith ( the Traditions). Interpretation of these laws are made by Muslim scholars over the years to make an update to modern nutritional knowledge including new processes which are being used in modern technology.The basic principles of the Islamic laws should however not be altered. Because of the growing global Moslem population the committee of the Codex Alimentarius has set up rules for a global definition of Halaal Foods. According to the Codex Alimentarius are Halaal Foods those which are conforming with the Islamic laws. They do not contain anything which is forbidden by the Islamic laws. They were handled stored and free of any forbidden materials.During their production they were kept away from other food which are not conforming with Islamic laws.
The processing or storage of halaal foods is allowed in the same room where not halaal food is being processed or stored when it is absolutely sure that any contact between both foods are avoided.
It is allowed to prepare Halaal foods which equipments which have been used to prepare not halaal foods when cleaning of the equipment according to Islamic laws have been performed.


Basic foods which are Halaal according to the Codex Alimentarius

All foods are considered as Halaal with exception of specific animal origin or containing products or derivates from not law conform origin.


Haraam animal food


Haraam vegetable foods

All poisonous and dangerous plants are considered as Haraam, unless the poison or the danger is being discarded during processing.


Haraam beverages

All alcoholic beverages are haraam as well all forms of poisoning and dangerous beverages.


Haraam additives

All additives which originate from the foods cited before are considered as Haraam.


Halaal slaughter


Labeling of Halaal food according to the Codex Alimentarius

If Halaal characteristics are mentioned in relation to food the term " Halaal" should be declared on the label. Claims suggesting that Halaal foods are more nourishing or healthier than other foods should be avoided.

What is behind a brand


Halaal chocolate confectioneries:

[101] Confectionery is commonly forbidden as ingredients as gelatin, enzymes and emulsifiers are considered Mashbooh because he origin of the ingredients is not known. Tesco, however wants to introduce the Ummah Foods chocolate range, being free of animal fat. "Ummah" means "the Muslim community" Ummah Foods already supplies the Halaal orange and caramel chocolate bars to Islamic bookshops, newsagents and universities in UK in 2006.

Launching his products among the Muslim population of East-London, Mr.Kahlid Sharif, director of Ummah Foods, believes that winning over the Muslim customer base, rather than targeting a broader "ethical" market, is the key to success. Mr. Sharif says "You cannot put a Muslim name on a product and not expect the core customers to be Muslim". With Tesco targeting the ethnic foods, changes this marketing strategy.


Qibla Cola:

[101] The brand has a presence as far as England, Canada, Pakistan and Africa. Since Qibla is an Islamic word used to describe the direction in which Muslims face to pray, one could think that the cola is aimed at Muslims. However, according to the producer the target is everyone who wants to make a conscious decision to buy an ethical brand.


Quakers

Quakers don't have a set of rules about anything including nutrition. Their principle is moderation in all things.


Rosacrucis

Lacto-vegetable, renunciation of alcohol.
Not to be mistaken by A.M.O.R.C. Antiquus Misticus Ordae Rosae Cruzis who smoke, drink alcohol, all forms of nutrition are allowed.


Sikhs

Meat of bovines and alcohol are not allowed.

Weight Reduction

Daily intake of energy

The only way to treat overweight is to bring the daily intake of energy down to the level of the daily output of energy. None of the above mentioned wonder diets have brought a durable weight reduction[102]
"Eat half of what you eat now" can reduce intake of calories to an acceptable amount. Formula diets [320] Formula diets such as Cambridge-diet, Day-fit , Slimfastor Herbalife according to DGE (Deutsche Gesellschaft für Ernährung ) are expensive, reduce life quality and destroy environment.
Formula diets in Germany have to be in accordance to the Diet-directrix which prescribes the concentration of nutritional components.
The amount of dietary fibres of formula-diet is often to low, so fibres and pellets of peelings and hull of cereals are added.


Formula diets for weight reduction according to Codex Alimentarius, second edition,1994 part 3

Formula Foods for weight reduction diets are foods which are ready to serve or must be prepared according to instructions and are intended to replace one or more meals of the day.

Formula foods to replace all daily meals They should have at least 800 kcal(3.350 kJ) and not more than 1.200 kcal (5020 kJ).for a day, divided in three or four meals with equal amount of calories.
Formula foods to replace one or more mealsTo replace one or more meals they should have at least 200 kcal(835 kJ) and not more than 400 kcal (1.670 kJ) for each meal.
If the formula foods are claimed to replace main meals they should not have more than 1.200 kcal (5.020 kJ). The formula diet system is not a safe system to reduce body weight. As soon as one comes back to former nutritional habits the overweight returns. This is called Jo-Jo-effect.
Publicity campaigns using words like flavour and delicious meals were prohibited in relation to formula diets because of their monotonous flavour which becomes disgusting being used for a long period.
To reduce body weight the DGE says to return to normal balanced nutritional habits.
There should be no struggle with the body.
A permanent bad conscience leads to stress. A good feeling is to achieve having no feeling of guilt.
As an orientation about the amount of energy which is necessary in normal life a table of the daily required energy is given below. This table does not replace weighing. It is not possible to calculate the real daily intake of energy and there is not possible to determinate the ideal intake of energy because each individual has its own basal metabolism and has different jobs and do different sports requiring different amount of energy.
The determination of nutritive value of carbohydrates and proteins in relation to their content in calories are calculated using calorie tables when recipes are known.
If recipes are not available the content of fat by means of solvent extraction are determined. Proteins are measured by means of the Kjeldahl method using the factor of 6,25 for conversion of nitrogen to protein. The content of fibres and water are determined at 105 \ensuremath{{^\circ}}C. Carbohydrates are calculated as being the rest of it. The energy of 100 g of food is calculated using the following values:

Ingredient kJ kcal
1 g protein 17 kJ 4 kcal
1 g fat 37kJ 9 kcal
1 g carbohydrate 17 kJ 4 kcal




Calorimetry
Calorimetry burning the food in a closed system and measuring the rise of temperature is a method which is seldom used.

Age kCal/day(man/women) cJoules/day (man/women)
0 to 2 month 550 2.200
2 to 5 month 750 3.100
6 to 11 month 850 3.600
1 to 3 years 1.100 4.500
4 to 6 years 1.500 6.500
7 to 9 years 1.900 8.000
10 to 12 years 2.300 / 2.200 9.500 / 9.000
13 to 14 years 2.700 / 2.500 11.500 / 10.500
15 to 18 years 3.000 / 2.400 12.500 / 10.000
19 to 35 years 2.600 / 2.000 11.000 / 9.000
36 to 50 years 2.400 / 2.000 10.000 / 8.500
51 to 65 years 2.200 / 1.800 9.000 / 7.500
$>$ 65 years 1.900 / 1.700 8.000 / 7.000
Pregnancy + 300 + 1.200
Breath-feeding + 700 + 3.000




This table is made for people with normal activities. For hard workers please add:

The Weight Loss Maintenance Behavioral Intervention

[376]

Jack F. Hollis and colleagues from the Weight Loss Maintenance Trial Research Group in a randomized trial reported successfull short-term weight loss in a diverse population of high-risk patients. The Weight Loss Maintenance behavioral intervention was based on combined emphasis on dietary intake and physical activity to achieve short- and long-term weight-loss goals,

The intensive weight-loss program was based onreduction of 500 calories per day, exercise for a total amount of 180 minutes each week, consumption of 2400 mg or less of sodium per day, and adherence to the DASH diet. Participants were encouraged to lose up to 2 pounds per week to achieve a total weight loss of at least 4 kg for 20 weeks.

According to the authors behavioral strategies to modify health behaviors are important components of weight-loss interventions because the ability to monitor and regulate behavior, and help to overcome barriers of initial weight loss and long-term maintenance.

Drugs to fight bodyweight

[377] The classic diets and fasting are seldom long lasting. The pharmaceutical industry is conscious of the growing market of drugs to reduce weight without changing once life habits.
H. HAUNER [378] writes:"For the moment being there are no convincing drugs for treatment of overweight. The majority of authorized Drugs act on the neurotransmitter noradrenalin or serotonin.
Suppressant of appetite like derivates of amphetamines should be used very seldom because of their side reactions (such as rise of heart beat frequency and rise of blood pressure, insomnia, pulmonary hypertension), their short time of activity and the danger of habit formation.
A long-time effect every overweight therapy are disappointing. Only less than one third of patients can hold their weight after a diet."

Obesity drug treatment

[895] [896]
Antiobesity treatment is recommended for selected patients in whom lifestyle modification is unsuccessful. In US there are only two antiobesity drugs licensed.

Orlistat:

is a gastrointestinal lipase inhibitor, reduces weight and decreases progression to diabetes in high-risk patients; adverse gastrointestinal effects are common. Orlistat works by inhibiting pancreatic lipase, an enzyme that breaks down triglyzerides in the intestine into absorbable free fatty acids. Fat is excreted undigested.

Sibutramin:

(with the generic name Merida in Europe and Reductil in US) is a monoamine-reuptake inhibitor which results in weight losses, but is associated with increases in blood pressure and pulse rate. Sibutramine acts by increasing serotonin and norepinephrine levels in brain. The serotonergic action, in particular, is thought to influence appetite.

Rimonabant:

It is the first of the endocannabinoid receptor antagonists, reduces weight and improves waist circumference and concentrations of HDL cholesterol and triglyceride. It works by blocking the CB1 receptors in the brain.

In Europe, it is indicated for use in conjunction with diet and exercise for patients with a body mass index greater than 30 kg/m$^{2}$or patients wih a BMI greater than 27 kg/w$^{2}$ with associated risk factors, such as type 2 diabetes or dyslipidaemia. However, an increased incidence of mood-related disorders has been reported. Generic names are Acomplia in Europe, and Riobant, Slimona, Rimoslim in India. In United States, it is intended to be marketed under the name Zimulti.

The FDA concluded in 2007 that Sanofi-Aventis failed to demonstrate the safety of rimonabant and voted against recommending the anti-obesity treatment for approval. The main concern was over suicidality, depression and other related side effects associated with use of the drug.


Anti-obesity drug Acomplia: German health insurance does not pay for acomplia and scientist issues warn for late-effects

[897]
The Lower House of the German Parliament (Bundestag) decided that German health insurance will not pay for Acomplia classifying the drug as lifestyler. Rimonabant is the active ingredient of Acomplia. The drug was banned in USA because of depression and suicide side effects, but is approved in France, Germany and UK. [898]

Acomplia acts on the central nerve system, blocking certain receptors. This is of concern for the neurobiologist Andreas Zimmer from the University Bonn, Germany. He found that a special type of mice which received Acomplia had a reduced lifespan, presented epilepsy and a loss of nerve cells in the brain was found.

The producer of the drug, Sanofi-Aventis, argues that effects in animals cannot be translated to human physiology. Zimmer says that the 2 an 3 years studies presented by Sanofi-Aventis were to short to show late-effects. The company expects revenues from Acomplia of up to 5 billion Dollar/year.

Fluoxenti (Prozac):

It is an antidepressant which is also licensed for bulemia nervosa and is therefore sometimes classified as antiobesity drug.

Other antiobesity drugs acting on the central melanocortin pathway, are far away from clinical use.

A meta-analysis of trials by the international Cochrane Collaboration concluded in 2007 that in diabetic patients Fluoxetine, orlistat, and sibutramine can achieve statistically significant weight loss over 12 to 57 weeks. The magnitude of weight loss is modest, however, and the long-term health benefits remain unclear. The safety of sibutramine is uncertain. There is a paucity of data on other drugs for weight loss or control in persons with type 2 diabetes. [899]

Raj S. Padwal and colleague criticise all antiobesity drug trials because they have been limited by their high attrition rates and lack of long-term morbidity and mortality data. The authors suggest that the assessment processes of new antiobesity drugs should include both surrogate endpoints such as weight loss, and clinical outcomes such as major obesity-related morbidity and mortality, to insure that the putative benefits of such drugs outweigh their risks and costs. [900]

Xenical, the antifat drug

Xenical is a drug containing the substance orlistat . It can reduce bodyweight up to 10% without serious side effects.
Xenical can help when used for a long period together with a change of life habits. Its activity takes place in the intestines. It reduces the absorption of fat up to 30 percent. Xenical is being produced by Hoffmann la Roche , Grenzach, Swiss.

Orlistat

Orlistat is a synthetic substance resulted from the research regarding lipstatin which had been found in bacteria which live in the soil of Mallorca, the Island in the Mediterranean Sea. Lipstatin was found to slow down the absorbtion of fat. This took the research of Roche to the discovery of orlistat. Xenical was liberated on the European market in august 1998.

Vinegar medicinal uses, antiglycemic effect and weight reduction

[901]
Johnston and Gaas 2006 write that scientific investigations do not support the use of vinegar as an anti-infective agent, reduced risk for hypertension and cancer.

Vinegar ingestion, however, reduces postprandial responses of blood glucose and insulin, and increased satiety. Ostman and colleagues 2005 point to thr potential of fermented and pickled products containing acetic acid. [902]

Future investigations,however, are needed to explain how vinegar alters postprandial glycemia and to determine whether regular vinegar ingestion favourably influences glycemic control. Johnston and Gaas calls for more studies to determine whether vinegar is a useful for the therapy of diabetes or prediabetes.

Kondo and colleagues 2009 studied the effect of 0.3 or 1.5% acetic acid on the prevention of obesity in high-fat-fed mice. The administration inhibited the accumulation of body fat and hepatic lipids without changing food consumption or skeletal muscle weight.

The authors suggest that weight reduction where due to the effect of the acetic acid increasing fatty oxidation and thermogenesis in the liver through PPAR-alpha. The acetic acid upregulated the expression genes for PPAR-alfa and fatty-acid-oxidation-related enzymes in the liver. [903]

Amphetamines

Amphetamines were used in war to keep soldiers awake during combat.Later amphetamines were found to act as appetite suppressant and being sold as such. Very soon the selling was canceled because of heart complaints, Angina-pectoris tremble and nervosity.

Phentermin and norephedrine

Phentermine is the active substance of Adipex N and norephedrine was used in Antidiapositum X 112 Fugoa N and Regenon. They are appetite suppressant. They have the same side reactions noted by amphetamines. Phentermin was prohibited in Germany because of the high blood pressure of the pulmonary artery. In Austria it is still being sold under the name Adipex.

Aminorex

Aminorex was used as active substance of the drug Menocil. Its selling was canceled because of irreparable high pressure at the pulmonary artery.

Phenfluramine

Phenfluramine is an appetite suppressant which stimulates serotonin presenting the same side reactions described above as well as depressions.

Sesame seed and oil and control of high blood pressure: Researches at the Osaka University of Pharmaceutical Sciences and Taiwanese researchers have demonstrated vasodepressing properties which help to control high blood pressure.

Sesamin, a supplement made from sesame exerts action on nitric oxide production and its ability to inhibit ET-1 production from endothelial cells. ET-1 constricts blood vessels.

Publications biased by own understanding of their authors or editorss [904]
James R Marshall and Zhao Chen argue that epidemiologic patterns of disease-exposure associations must be interpreted in light of the profound imprecision of exposure assessment that characterizes nutritional epidemiology. The authors highlight the imposition of publication bias: the failure of researchers to submit and of editors to publish findings that do not fit well with the their own understanding. The information extracted from assays of associations between exposure and disease is always estimated with serious imprecision or bias.

Physiology of hunger

Hunger has different phases:

Phase 1:

The seat of the centre of hunger is located in the hipothalamus. Tiny sensors situated on the walls of the stomach and intestines communicate with the hipothalamus. They send informations about quantity of food filling the stomach and the intestines.
Other biochemical sensors control the concentration of the different substances such as glucose, the amino acids and the concentration of fatty acids in blood. These informations are also send to the hipothalamus.
When the level of glucose drops the hipothalamus sends signals to the brain where old habits related to the search for food are located.

Phase 2:

If the body does not react on these signals the hipothalamus intensifies the signals of hunger.

Phase 3:

If these strong signals of hunger does not work the hipothalamus changes his tactic and starts to burn fatty acids, situated in the centres of reserve.

Phase 4:

If this phase is also overcome the hipothalamus erases the signals of hunger.
Hunger artists and Fakirs can overcome long periods of hunger. These people report that hunger vanishes after 2 to 3 days of starving being replaced by a feeling of wellnes which may escalate to euphoria.

Appetite to specific foods

The body can show unspecific hunger but also increase the desire to specific foods, for example:
Noradrenalin, insulin and the neuropeptide Y are responsible for the desire to eat bread or noodles.
Galanin is responsible for the desire to fatty food. As serotonin rises the desire for carbohydrates decreases increases the appetite to food rich in proteins such as fried meat. After a meal rich in proteins the blood level of serotonin decreases. The next meal will then be rich in carbohydrates.

Well-fed

The feeling of well-fed comes slowly. The first signals come from the walls of the stomach and intestines indicating the stretch of these organs. These informations are centralized in the brain.
The feeling of well-fed depends not only from the amount of food which had been eaten but also from the quality of food. One litre of water does not kill hunger.
The seat of the feeling of well-fed is located in the hipothalamus controlling also the level of nutrient substances in blood.
Noradrenalin and cholecystokinin are responsible for the informations of sufficient quantity of energy being stored. Other substances such as serotonin modulate the informations with emotions.
Serotonin is being produced in the brain and transported along the spinal cord to the neurons where it produces the feeling of well-fed.

Reductil, a suppressant of appetite

Reductil is being sold in the USA under the name of MERIDIA . It acts in the brain reducing appetite. The active substance of Reductil is sibutramin Reductil is being produced by BASF-Knoll (Badische Anilin und Soda Fabrik) . The drug has been liberated by the FDA (Food and Drug Administration) in USA only after a long time. A similar drug, the appetite suppressant REDUX with its active part the dexfenfluramin presented dangerous secondary reactions. In Germany and in Austria Redux had been sold under the name of Isomeride. Redux has caused damage of cardiac valves as well as pulmonary hypertension. After many tests it has been proved that Reductil does not have these side reactions.

Reductil or Plenty makes serotonin stay for a longer time between the neurons. By this mean the appetite is suppressed. The neurotransmitter serotonin transmits the feeling of well-fed in the sinapsis from one neuron to another. after some time serotonin is slowly catabolized and partially reabsorbed by the neurons.
Reductil with sibutramine closes the way which exists in the cell membrane of the neurons in the region of the sinapsis avoiding serotonin being absorbed. Serotonin can therefore transmit for a longer time the feeling of well-fed.
At the end of the decade of the 80 the WHO (World Health Organization) had obesity declared as being a worldwide epidemic.
The FDA ( Food and Drug Administration) being conscious of the gravity of the problem had speeded the registration and the approval of weight reducing substances. This caused a flood of new drugs, fibres to fill the stomach, laxatives, teas, special diets and appetite suppressants.
All these products don't work or have serious side reactions.

Chinese slimming capsules contain sibutramine leading to serious side effects

[905][906]
The Chinese slimming pills "Meizitanc” declared as a food supplement are on sale over the Internet. They are labelled to contains herbal substances, however, high levels of undeclared sibutramine (10 mg/capsule) were found in these pills. Sibutramine resembles amphetamine which inhibits the reuptake of serotonin and noradrenaline in the brain. Sibutramine is

According to Dieter Müller et al. 2009, persons taking these pills are poisoned. They complain about nausea, tachycardia, headache, agitation, dyspnea, and insomnia, acute confusion and psychosis, mainly in combination with other drugs.

On December 22, 2008, the Food and Drug Administration issued an alert to consumers naming 27 different products marketed as "dietary supplements" for weight loss, that illegally contain undisclosed amounts of sibutramine [907] [908].

The authors take for granted that the consumption of food supplements containing sibutramine is much greater than has been recorded. The authors urge that manufacturers should be obliged to declare ingredients.

Xenical, The fight against fat

Digestion of fat takes place with help of bilear acids and pancreatic lipases, which hydrolyzes the fat molecules enables thus the absorbtion by the gastric mucose.
Xenical by means of its active substance orlistat blocs the lipases of pancreas avoiding 30% of fat to be hydrolysed in smaller parts. Fat which is not hydrolysed cannot be absobed by the gastric mucous. It remains in the faeces causing diarrhea when to much fat is consumed. This causes an educational effect which lead to a reduced intake of foods rich in fat.
Xenical acts slowly. It is necessary to take the drug for a long period. It helps only in combination with a diet, together with a change of its nutritional habits towards a healthy composition: much fruits and vegetables, little meat, less fat accompanied by physical activities such as sport or garden work. One cannot escape the following overweight equation:
(Absorbed energy) - (Basal metabolism energy + physical activities energy) = Body fat
To reduce body weight it is necessary to eat less, to reduce fat intake, and practice more physical activities.
All efforts to reduce overweight with drugs, even surgery of the adipose tissue are not lasting when they are not accompanied by a change of the nutritional habits.

Basal Metabolic Rate: The Basal Metabolic Rate (BMR) is the number of calories burned in a 24 hours period while lying down, but not sleeping in a comfortably warm environment.

Active Metabolic Rate: The Active Metabolic Rate (AMR) is estimated by adding the caloric cost of all activities throughout the day to the BMR.

A person should not eat less than their BMR but not more then their ANR.


Serotonin

Serotonin is a neurotransmitter which together with more than 100 other substances are active in the brain where nerve cells (neurons) link.
Serotonin is 5-Hydroxytryptamine. Besides its biochemical activities in the neurophysiology it is also active as biogenic amine produced by bacteria. Serotonin is part of the blood clotting, being released by the trombocytes[909]. Serotonin causes a strong contraction of blood vessels resulting in an increase of blood pressure [910]

\includegraphics[width=200bp,height=200bp,angle=0]{library/Serotonin}
Tryptophane is basis for serotonin. It is broken down by monoamineoxidase The Institute of Technology of Massachusetts discovered that a high level of serotonin provides good mood and avoids uncontrolled hunger and continuous desire to sweet food. Serotonin is therefore also known as " Good mood hormone". Serotonin should be present in a steady concentration of about 10 mg.
Some foods are rich in serotonin such as pineapple, banana, tomatoes. Other foods are rich in trytophan which can be used by the body to synthetize serotonin. These foods should therefore build the basis for a long lasting diet to reduce overweight.

Foods rich in serotonin and/or Tryptophan:[894]
Fruits: Pineapple,avocado, banana, date, fig, papaya.
Vegetable: Lamb's lettuce, carrot, round lettuce, leek, parsley, beetroot, spinach, tomato, onion.
Meat: Chicken, veal, beef, pork, turkey breast.
Seafood: Perch, catfish, trout, shrimp, herring, codfish, carp, salmon, spiny lobster, mackerel, mussel, sardine, haddock, plaice, pollack, sole, tuna.
Cereals: Rolled oats, rice, rye bread, white bread, rusk.
Milk and eggs: Buttermilk, eggs, fresh cheese, yoghurt, low fat curd cheese, milk.
Nuts: Cashewkernel, peanuts, hazelnut, almond, Brazil nut, walnut.


Overweight

The Body-Mass-Index (BMI) is used to indicate overweight.
BMI = Body weight divided by the square of body length in meters
International classification of BMI ( Please see also BMI at the beginning of the chapter "Physiology":

  Grade of overweight BMI(kg/m$^2$) Broca-overweight(%)
Normal weight 0 20 up to 24,9 -
Moderate overweight I 25 up to 29,9 0 up to 20 (-40)
Strong overweight II 30 - 40 20 - 70 (-80)
Extreme overweight III $>$ 40 $>$ 70 ($>$80)


Slimming ingredients:

The slimming ingredients are based on the following mechanisms of action:

Use of Xenical in case of low body weight (BMI below 30)

Xenical and Reductil were not developed to adjust cosmetic effects.They are drugs .0 to be used when there are clinical indications.
Physicians and authorities of health departments refuse prescription of both drugs because new drugs may have serious side effects which are seen only after many years. It is necessary to compare the unknown risk of a new drug with the risk of obesity.
The greatest effect of weight reduction with Xenical are due to reduction of fat in the food using the diet which should accompany the use of the drug. Chocolate, fat sausages, cheese with high fat content and similar food should be banned from the table when weight should be reduced. Reducing fat causes the weight return to normal in a healthy way without dependence on drugs.

Food with reduced fat

Curd cheese can be used in place of butter or margarine as bread spread.
Avoid all white sauces like mayonnaise, use vinegar or sauces made with diluted yoghurt. Be careful not to use Sauces with yoghurt from the supermarket. they contain small amount of yoghurt together with a lot of oil in order to increase self life.
Avoid peanuts, sunflower nuts and other nuts. They contain much oil.
Avoid fried potatoes and all fast food.

Medical prescription of Xenical in case of BMI 30 to 40

In Germany Xenical is being sold only with medical prescription. The BMI must be at least 30 (obesity degree I and higher).

Use of Xenical in case of BMI over 40

In case of overweight with a BMI over 40 the use of Xenical should not be used. The loss of weight would be to slow. In these cases the use of the Optifast program is indicated or even a surgical reduction of the stomach.

Xenical, the drug of the rich society

The use of Xenical is very expensive. The medication of one month with Xenical costs 200 Dm in Germany [377] and 300 Reais in Brasil[379]. The use of Xenical for two years costs 2.400 Dm.

Dexfenfluramin

Dexfenfluramin acts on the brain reducing appetite. It was recalled from market because of serious side reactions such as coronary problems. Dexfenfluramin had been sold under the name of Redux and is an example of serious side effects which are noted only after years of use. One of such horrible markers of the history of pharmacy Contergan which produced anatomical modifications on unborn. Other drugs which are being studied as possible weight reduction are leptin , neuropeptide Y inhibitor, and CCK hormone . CCK hormone is produced by the small intestine and acts as message substance telling the brain that there is enough food which has been taken in. [379].
Instead of praising a new era of wellness-drugs (Viagra from Pfizer, Prozac from Eli Lilly an antidepressant, Propecia from Merck Sharp and Dohme for better hairs, Xenical from BASF to fight overweight and Reductil from Roche an appetite suppressant) one should come back to the real values of life.

Industry asking to tighten the rules on weight-reduction drugs

[380]
It is hard to believe but it is true, GlaxoSmithKline, owner of Alli weight-reduction OTC drug, instead of pledging for soft rules, issued a petition to the Food and Drug Administration (FDA) to ban dietary supplements from making weight loss claims.

Dietary supplements and weight-loss aids aren't subject to the same rigorous standards as are prescription drugs or medications sold over-the-counter. They can be marketed with limited proof of effectiveness or safety. Vendors can make health claims about products based on their own review and interpretation of studies without the authorization of the FDA.

GSK says that the tria supporting botanical and other ingredients in benefit of weight loss are not rigorous enough, or numerous enough. Classifying weight-loss products as prescription drugs or medication could eliminate nasty competitors which could not present clinical studies of their claims.

The Mayo Clinic cites over the counter weight-loss drugs, all of them presenting serious inconveniences: Bitter Orange, Chitosan, Chromium, Conjugated linoleic acid (CLA), Country mallow (heartleaf), Ephedra, Green tea extract, Guar gum, Hoodia. [384]
Consumer interest in weight management is stronger than ever as obesity-related problems have increased.

Drug for weight loss, limited efficacy and safety concerns.

[381]
Alli acts as a fat blocker by preventing up to 25 percent of fat eaten from being digested. Alli has half the amount found in prescription Orlistat (Xenical). A low-fat (no more than 15 grams of fat per meal) and a reduced-calorie program must be followed.

In April 2006, the consumer group Public Citizen petitioned the FDA to block Alli because of concerns of two studies suggesting that Xenical can cause these precancerous growths. [382] [383]

Mayo Clinic says Alli provides only modest results

[384]
According to Donald Hensrud, M.D., a preventive medicine and nutrition specialist at Mayo Clinic, Rochester, Minn Alli could conceivably result in an average of 3 pounds lost in a year in addition to the approximately 8 pounds you could expect to lose from diet and exercise alone.

Spices and obesity[385]
Magriet Westerterp-Plantenga and colleagues found that consumption of spiced foods or herbal drinks leads to greater thermogenesis (heat generation) and in some cases to greater satiety. In this regard, capsaicin, black pepper, ginger, mixed spices, green tea, black tea and caffeine are relevant examples.

The authors conclude that thermogenic ingredients may be considered as functional agents that could help in preventing a positive energy balance and obesity.

Active Capsaicin of red chilli pepper boosts heat generation by the body. More energy is therefore burned, reducing fat deposition.
Gingerols and shogaols of ginger have thermogenic properties.
Mixtures of of black pepper, red chilli, turmeric, cumin, ginger and other spices could therefore become interesting to help against obesity.

Piperine of black pepper, is said to bind to so-called Transient Receptor Potential Vanilloid (TRPV1)receptors in the brain and other parts of the nervous system.

Capsaicin from red pepper may avoid obesity [386]

Chin-Lin Hsu and Gow-Chin Yen of Taiwan have found that capsaicin,from red pepper cause apopteosis (death) of immature fat cells, the pre-adipocyte cells called 3T3-L1from mice. These cells differentiate into mature adipocytes and increase fat mass, causing obesity. Capsaicin also decreased the amount of intracellular triglycerides and glycerol-3-phosphate dehydrogenase activity in 3T3-L1 adipocytes. According to the authors, capsaicin inhibited the protein expression of PPARγ which regulate several genes involved in the formation of fat cells, as well as making body fat. These results demonstrate that capsaicin efficiently suppresses adipogenesis in 3T3-L1 pre-adipocytes and adipocytes. Red chilli pepper was also linked to inhibit the growth of pancreatic cancer cells. [387]

However, high intake of hot chillies has been linked with increased risk of stomach cancers in the populations of India and Mexico. [388]

Body Clock linked by enzyme pathway to Metabolism

[389] [390]
The circadian rhythms is the body clock which regulates energy levels in cells. It is linked with the body's day-night patterns and metabolism, and ensure that cells function properly and remain healthy. These findings open the pathway to new treatments for diseases caused by cell energy deficiencies.

Circadian rhythms of 24 hours govern physiological functions all over the organism. According to Sassone-Corsi, Professor at the University of California, disruption of these rhythms can profoundly influence human health and has been linked to obesity, diabetes, insomnia, depression, coronary heart diseases and cancer.

The researchers found that CLOCK[], an essential molecular gear of the circadian machinery interacts with a protein, SIRT1, which senses cell energy levels and modulates aging and metabolism. The link between the circadian clock and metabolism is maintained by metabolic proteins which send signals called the NAD+ salvage pathway where NAMPT helps to control CLOCK levels, If balance of this pathway is disrupted cells cannot function properly.

Sassone-Corsi and colleagues found that the core circadian regulator, CLOCK, is a histone acetyltransferase whose activity is counterbalanced by the NAD(+)-dependent histone deacetylase SIRT1. Proper sleep and diet may help maintain or rebuild the balance between CLOCK and SIRT1 and the NAD+ salvage pathway. Lack of rest or disruption of normal sleep patterns can also increase hunger, leading to obesity-related illnesses and accelerated ageing.

Fat tissue negative feedback to the brain may be important in obesity understanding

[391]
Readily available energy storage in form of glycogen may be worn off by exercise or by hunger periods. Burning fat is then activated. The sympathetic nervous system, used to regulate functions of the body, independent of concious thoughts, communicates with the adipose cells to initiate, continue or stop the fat burning.

It already had been known that peripheral pseudounipolar dorsal root ganglion sensory cells innervate fat tissue and play a role in the short-term burning of fat. The central nervous system projections of the white adipose tissue were now studied by the authors.

Following their data, the authors suggest the existence of a sensory adipose tissue pathway to the brain important in the negative feedback control of lipid mobilization. This pathway stops lipolysis when no more energy is needed. This process seems to be involved with the long-term burning of fat and obesity.

Transient receptor potential or TRP:

[392]The phrase Transient receptor potential or TRP is appended to at least three classes of ion channels which mediate the response of a cell to external stimuli (electrical charge, substances, and forces) by increasing or decreasing its selective permeability to particular ions. The effect of this change is to modify the potential difference between inside and outside of the cell. Hence "receptor," for sensitivity to the environment, and "potential" for this difference. TRPV1 to TRPV4 can basically be seen as thermometers on a molecular level, and are activated by various means. When TRPV1 gets activated, it turns up the heat by boosting heat production by the body. TRPV1 is activated by noxious heat, acidic pH and capsaicin.

These new findings should not lead to a higher consumption of chilli con carne. Obesity is the result of many biochemical psychological and environmental occurrences. Seasoning could be a small contribution to tackle the obesity problem.

Diet in the preconceptional phase influences foetal sex

[393]
Dr. Mathews, Johnson and Neil in 2008 presented a report which says that foetal sex is associated with maternal diet at conception.

High caloric intake and cereals at breakfast in the preconceptional phase favour the birth of male child with odds of 56 %. High energy intake and breakfast cereal consumption around conception is associated with glucose. In vitro, glucose enhances the growth and development of male conceptuses while inhibiting that of females. Skipping breakfast extends the normal period of nocturnal fasting, depresses circulating glucose levels and may be interpreted by the body as indicative of poor environmental conditions.

For many nutrients, circulating levels are highly dependent on recent intakes and not on stored fat reserves. Glucose levels are influenced bythe glycaemic index of foods. This supports the assumption that sex ratio is linked more directly to diet than to maternal condition.

The intake of sodium, and potassium was also a factor which affected gender. As possible explanation the researchers suggest that salty diet alter the acidity of the vagina to favour male sperm.

Women in the study who had girls had low caloric food reduced cereals at breakfast in the time before conception.

The authors also point out that these findings may help to explain the falling proportion of boys born in developed countries, where low-calorie diets are preferred by young women.


The Conference on Preventing Childhood Obesity, December 8, 2003

Rising childhood obesity were highlighted at the Conference trying to find out how additional increases in obesity could be prevented.
Matthew Gillman, MD, Harvard Medical School, Boston, Massachusetts, pointed out some of the highlights of the conference: factors in foetal development and the first six month of life According to Dr. Gillman differences in birth weight as well as subsequent BMI may be determined by some the prenatal and postnatal environments In addition, genes that cause birth-weight differences may also determine BMI differences.

Alterations in the foetal environment: Transfer of fatty acids, leptin, and other hormones, foetal hyperinsulinemia, and the functioning of the foetal/placental unit are here included.

Other speakers pointed out:
Breastfeeding is protective against obesity and should be encouraged to be practiced during the first year of life.

Foods and beverages that are energy dense and nutrient poor like soda and french fries should not be fed to infants as young as 7 months of age as they alter taste preferences.

Authoritative versus permissive parenting styles and their role in childhood obesity should be subject of further research.

Relationship of birth weight and childhood
According to Dr S. Kramer from the McGill University, Montreal, Quebec, like the United States, Canada is experiencing an epidemic of obesity, not only among 6- to 17-year-old individuals but even in the toddler and preschool periods.

During the course of life, exposures that determine obesity may be attributable to environmental, social, behavioural, or biological factors.

He examined relationship of birth weight to weight in childhood data from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Tennessee, and found that the 3.0- to 3.5-kg birth-weight grouping most closely approximated that value at 5 years of age. The lightest infants (1.0-1.5 kg) and the heaviest infants (4.5-5.0 kg) had the most extreme weight-for-age and height-for-age scores initially but moved to less extreme values within about 12 months.

Overweight status at 7 years of age tended to increase as birth weight increased, with the greatest increase in prevalence in the highest birth-weight (3.61-5.56 kg).

Obesity during pregnancy linked to high birth weight [1135]
Dr. Kramer examined a Swedish study linking women's weight in early pregnancy and their own birth weights. There was a statistically significant increased risk of having a BMI of over 25 during pregnancy among women who were born large for gestional age.

The effect of high birth weight may become more important as birth-weight distributions move toward higher weights.

Breathfeeding and obesity [1135]
The relationship between breastfeeding and obesity data was also discussed by Dr Kramer. He found that high maternal BMI is associated with reduced breastfeeding initiation and duration. Therefore, the higher weight status of bottle-fed infants could be attributable to selection of children of higher-weight mothers, who were both less likely to have breastfed and more likely to have higher-weight children.

In addition, highly controlling bottle feeding practices at 18 month may interfere with the child's ability to self-regulate energy intake, an effect that may be long-lasting.

Dr Kramer concluded that there is probably a small protective effect of breastfeeding on child obesity but is not of major public health importance. Neither birth-weight changes nor breastfeeding explains the obesity epidemic.

Decreased physical activity as key role to the obesity epidemic [1135]
Dr Kramer believes that a decrease in physical activity to be the main reason for the obesity epidemic and less the higher energy intake.

Influences on the nutritional behaviour of children [1134]
Barbara Devaney, PhD, Mathematica Policy Research, Princeton, New Jersey According to Dr Devaney reported energy intakes of infants and toddlers are exceeding estimated requirements. The transition in infant feeding from true infant foods to more adult foods occurs during a long period but begins mostly at 9 to 11 months. As infants start to make the transition, the adult diet has a significant influence on what children eat. With the importance of table foods in the diets of children through the second year, changing what toddlers are eating may require changing what adults and older siblings are eating.

Nutritional and flavour programming early in life [1135]
According to Dr. Julie Menella, of the Chemical Senses Center, Philadelphia, Pennsylvaniathe eating preferences of children are guided by their senses and not cognitive decisions. These senses are well developed in utero but continue to change during development. There is mounting evidence of nutritional and flavour programming early in life.

Infants can detect a diversity of flavours in amniotic fluid and mother's milk. They accept new foods, such as cereals, more readily if they are prepared with their mother's milk. The flavour profile of human milk reflects the mother's diet and the culture in which the infant is born and is similar to the flavour profile experienced in utero.

These findings are the first experimental demonstration that prenatal and early postnatal exposure to a flavour enhances the acceptance and enjoyment of that flavour during weaning. Dr. Menella concludes that the more varied the mother's diet is during pregnancy and lactation, the more likely it is that the infant will accept new flavours, and that these very early flavour experiences may provide the foundation for cultural and ethnic differences in cuisine. Understanding both the causes of and likely solutions to poor food habits and choices requires attention to the complex interactions of our genes, experiences, and lifestyles.

Parental feeding styles and children's eating and weight [1136]
Dr Jane Wardle of the University College, London, presented an overview about the relationships between parental feeding styles and children's eating and weight, and came to the conclusion that greater control is probably associated with slightly lower weight and lower weight gain.

Breathfeeding and the time of introduction of solids [1137]
Dr Andrew Ness, from the University of Bristol, Bristol, England, presented results from the Avon Longitudinal Study of Parents and Children (ALSPAC).

The associations of breastfeeding and introduction of solids with obesity risk were examined. Breastfeeding appeared to be protective against obesity in unadjusted models, but these associations did not remain after adjustment. Some models examined the effect of the timing of the introduction of solids. There was a suggestion in the unadjusted odds that the later introduction of solids reduced the risk of obesity, but this was not the case after adjustment.

Family characteristics [1137]
Dr. Ness found that for children whose mother's BMI was $>$30, there was a 4.5-fold increase in obesity risk, which was reduced to 4.2-fold after adjustment. For children whose father's BMI was $>$30, there was a nearly 3-fold increase in obesity risk, which was reduced to 2.7-fold after adjustment. If both parents had BMIs of $>$30, then the child's risk was increased 11.7-fold. Children with no siblings had an increased risk of obesity, with an OR that increased to 2.2 and became statistically significant with adjustment. None of the other family factors was a significant predictor of obesity risk.

Effects of activity, several characteristics of children's lifestyles [1135]
Dr. Ness noted that the effect of activity measured at 38 month showed that watching television more than 8 hours//week increased obesity risk, compared with less than 4 hours/week. Obesity risk was increased if less time was spent asleep overnight. More active children sleep better in opposition to those who are sitting and eating in front of the television

Defining obesity: Obesity is defined according to sex- and age-specific BMI cut-off points proposed by the International Obesity Task Force and Dietary Recommendations for Children and Adolescents: A Guide for Practitioners; Pediatrics, February 1, 2006 from the American Heart Association. [1138]

Meal frequency and obesity [1139] André Michael Toschke from the Ludwig-Maximilians-University Munich, Germany and colleagues assessed the relationship between meal frequency and childhood obesity. An inverse association between meal frequency and the prevalence of obesity in adulthood had been related in previous studies.

The scientists found that prevalence of obesity decreased by number of daily meals: three or fewer meals, 4.2%; four meals, 2.8%; and 5 or more meals, 1.7%.

They concluded that the protective effect of an increased daily meal frequency on obesity in children appeared to be independent of other risk factors for childhood obesity, and might be due to a modulation of the response of hormones such as insulin.

Frequency of meals

The hunger hormone Ghrelin defends against depression and anxiety of chronic stress but increases obesity.

[1141]
Zigman and Lutter found that the "hunger hormone" ghrelin might also defend against symptoms of stress-induced depression and anxiety, but also increases food intake and body weight.

Ghrelin is produced in the gastrointestinal tract, ion and weight loss could have an anti-depressant effect and be reinforcing for this illness. [1142]

A single large daily meal is associated with elevated fasting glucose levels and delayed insulin response

[1140]
Marc P. Mattson and colleagues 2007 evaluated the influence of reduced meal frequency without a reduction in energy intake on glucose metabolism in normal-weight, healthy male and female subjects.

The authors found that consuming 1 meal per day elevates morning fasting plasma glucose levels, is associated with greater and more sustained elevations of plasma glucose concentrations, delayed insulin response in the oral glucose tolerance test, and elevated ghrelin levels compared with 3 meals per day. The impaired glucose tolerance was reversible.

Reduction of meal frequency may increase cardiovascular risks

[1143]
Researchers found that some rodent and monkey had an extend lifespan when meal frequency was reduced. Mark P. Mattson and colleagues 2007 in a follow article report the outcomes on humans of such a meal reduction frequency.
They found that normal-weight subjects are able to comply with a 1 meal/d diet with no significant effects on heart rate, body temperature, or most of the blood variables measured. However, hunger was significantly increased, blood pressure and in total, LDL-, and HDL-cholesterol concentrations increased ; and cortisol significant decreased.

They concluded that Normal-weight subjects are able to comply with a 1 meal/d diet. However of concern were some cardiovascular disease risk factors, and hematologic variables.

Overweight increases risk of cancer

[2946] Andrew G. Renehan and colleagues 2008 assess the strength of associations between BMI and different sites of cancer and associations between sex and ethnic groups.

The authors found a strong associations between a 5 kg/m2 increase in BMI and endometrial, gallbladder, oesophageal adenocarcinoma, and renal cancer, but a weaker association between BMI and postmenopausal breast, pancreatic, thyroid, and colon cancers in women.

In man the positive associations between increased BMI and rectal cancer and malignant melanoma in men was weak. The association between BMI and leukaemia, multiple myeloma, and non-Hodgkin lymphoma in both sexes was weak.

The authors concluded that increased BMI is associated with increased risk of malignancies, and differs between sexes. The risk of premenopausal and postmenopausal breast cancer is increased in the Asia-Pacific population.

Breath feeding and intelligence [2947]
Several studies suggest a positive association between breastfeeding and intellectual development in childhood.
Mortensen and colleagues noted in a study published in 2003, that test scores suggested a dose-response relationship for breastfeeding during the first nine months of life and adult intelligence. The researchers found a significant positive association between duration of breastfeeding and intelligence. They conclude that duration of breastfeeding may correlate with maternal intelligence and with the quality of mother-child interaction, and that nutrients in breastmilk may have long-term positive effects on cognitive and intellectual development.

Early Nutrition Programming Project EARNEST [2948]

The Early Nutrition Programming Project EARNEST is an European collaborative investigation into the long-term consequences of early nutrition by metabolic programming and will work until 2010 being coordinated by Professor Koletzko of the Children's Hospital, University of Munich, Germany.

It investigates early nutrition programming to enable a better understanding of the extent to which nutritional influences in early life can programme a person's development and metabolism in adulthood, and studies the consumer attitudes to early nutrition programming and their economic importance.

Important questions are targeted such as beneficial effects of maternal diet on visual, motor and cognitive development, and cardiovascular risk factors, including obesity propensity and type II diabetes for the child.

Also on the agenda is the safety of prenatal docosahexaenoic acid (DHA) supply with regard to growth, infection rates, and occurrence of other potential adverse effects, the relation between prenatal (maternal) and postnatal (infant) dietary factors and how they predict early disease markers and risk factors for chronic diseases, including chryptorchism, early growth patterns, psychomotor developmental milestones, atopic diseases and cognitive development.

One point is the importance of promotion of breastfeeding, together with the development of the right composition of infant formula and the appropriate complementary food. The Program also wants to determine when are the critical windows during early development when maternal nutrition programmes can influence one or more of the following chronic degenerative diseases; obesity, cardiovascular disease, metabolic syndrome, diabetes, renal disease, immune function and cancer. A possible genotype dependence of these outcomes is to be elucidated.

Combined analysis of European Databases: EARNEST also assesses the combined analyses of the Danish National Birth Cohort (DNBC) and Norwegian Mother and Child Cohort (NMCC) databases.

Analysis of the information sources used by parents: The aim is to determine the information sources used by parents to acquire knowledge about matters related to infant care and nutrition in selected EU countries, and evaluate the accuracy of available information on early nutritional programming.

Improved dietetic producs and commercial application: The knowledge generated by EARNEST has great potential for application in new and improved dietetic products and thus for creation of wealth and employment in Europe, and studies the modification of infant formulae for commercial application. Such as innovative approaches to inulin-type oligosaccharides and a recombinant human protein, both of which are natural constituents of breast milk.

Height, predictors of C-peptide and cancer risk in men [1144] Giovannucci and colleagues in a study, found that excessive energy intake tends to increase circulating levels of insulin and free insulin-like growth factor-1 (IGF-I), which may increase risk of some cancers that are common in Western countries. Greater body mass index, lower physical activity, and a Western dietary pattern were independent predictors of higher plasma C-peptide levels . A C-peptide score, based on these variables, was positively related to risk of Western-related cancers, but not to other cancer types. Height was also only related to Western-related cancers.

The authors concluded that maximal growth in the pre-adult period and hyperinsulinaemia during adulthood may largely underlie the excess risk of some cancers that are common in Western populations. A substantial proportion of these cancers may be modifiable in adulthood, through alterations in body weight, sedentary behaviour, and dietary patterns that stimulate hyperinsulinaemia. The risk for Western cancers could be cut by about 50% if the entire population had an adult height and C-peptide score comparable to those values seen in the lowest decile of the population.

A classification and regression trees analysis on risk factors for childhood overweight (CART analysis)

[1145] André Michael Toschke and colleagues used high weight gain, parental overweight and obesity, lack of breastfeeding, parental education under 10 years, high birth weight, having older siblings, ethnic affiliation, and maternal smoking in pregnancy as predictors for later overweight or obesity.

The classification and regression trees (CART) was used as predictive analytical method. They found that identifying children at high risk for overweight at school entry by means of predictors detectable at 2 years of age the authors found that the Weight gain $>$10,000 grams and obese parents accounted for the best reliable positive predictive value of 40%. In this subgroup of 4% of the entire population, two of five children will be overweight at school entry.

These results reflect an improved but still insufficient identification of high-risk children even with an optimal set of of predictors. Toschke came to the conclusion that positive predictive values might be insufficient to allow for decision-making regarding specific interventions targeted at high-risk children: Most children would undergo an unnecessary intervention with potential side effects if intervention were based on the sets of predictors assessed in this study.

Classification and regression trees (CART) [1146] Predictive analytics is an area of statistical analysis that deals with extracting information from data and using it to predict future trends and behaviour patterns. The core of predictive analytics relies on capturing relationships between explanatory variables and the predicted variables from past occurrences, and exploiting it to predict future outcomes. Such predictions rarely take the form of absolute statements, and are more likely to be expressed as numbers that correspond to the odds of a particular event or behaviour taking place in the future.

Classification and regression trees (CART) CART is a non-parametric technique that produces either classification or regression trees, depending on whether the dependent variable is categorical or numeric, respectively.

Predictive values are essential for objective evaluation of the predictive potential of tests under consideration for the general population or test results on the individual level. Furthermore, decision trees provide a useful and precise tool for decision-making in the physician's daily routine by simple visual assessment of disease probability without the need of any calculations.


Dietary fibre

Dietary fibre are a variety of carbohydrates which are not hydrolysed by the digestive system of the small intestine. They comprise polysaccharides which are not starch, Oligosaccharides and lignin. They are found in vegetables, fruits, wheat bran, oat bran, sugar beet pulp, Guar gum, locust bean gum, gum arabic, Psyllium, carrageenan,gum tragacanth (Astragalus spec., alginic acid, xanthan gum, dextran, lactulose, karaya gum ( Sterculia urens) )
Dietary fibre have great nutritional values for intestinal bacteria in the colon.
Dietary fibre have influence in the metabolism of the carbohydrates, lipids and minerals they act protective against colon cancer.
Recommended daily intake of dietary fibre: at least 30 g/day.
European and other industrial countries daily intake of dietary fibre is around 20 g/day. The intake of food rich in dietary fibre should therefore be increased.
Recommended composition of the dietary fibre:
- 20 g macromolecular dietary fibre of polysaccharides of not starch type. 5 g of them should be insoluble.
- 15 g of resistant starch
- 3-4 g oligofructose
Mango dietary fibre [1147]
Interest in dietary fibre has been increasing with scientific studies linking increased intake to reduced risks of cancers such as colorectal, and cardiovascular disease. According to the Columbia University showed the average intake in the US was about 12.5 grams a day, instead of 32 grams recommended by the US National Fibre Council.

According to Nely Vergara-Valencia from the Centro de Desarrollo de Productos Bioticos del IPN Mango dietary fibre might be an alternative for development of products with balanced dietary fibre components and low glycaemic response, aimed to people with special carbohydrate/energy requirements. Unripe mangoes have promising chemical composition, soluble and insoluble fibre content, antioxidant activity and of extractable polyphenols.

The concentrated extract of mango was tested in cookies and bread with a better balance of soluble and insoluble dietary fibre compared to control bakery products.

The new products had higher total dietary fibre that respective controls, and the products maintained significant antioxidant capacity associated to their extractable polyphenols.

Discarded mango peel is a valuable source of antioxidants and dietary fibre

[1148]
Mango peel from mango products processing is being discarded whilst being a valuable source of antioxidants. Prasada Rao and colleagues 2007 studied the improvement in the nutraceutical properties of the biscuits with added mango peel powder.

The wheat flour incorporated with mango peel powder showed an increase in water absorption, and the biscuits incorporated with 10 per cent mango peel presented a high content of total and soluble dietary fiber, increased polyphenols and carotenoid content, and improved antioxidant properties. The authors concluded that mango flavoured biscuits produced with wheat flour and mango peel powder are dietary fibre enriched have improved a

Dietary fibres, resistant starch and phenolic compounds in pasta and backery. Banana flour increases undigestible carbohydrate content of pasta

[1149]
Maribel Ovando-Martinez and colleagues 2008 point out that unripe banana, with a high proportion of undigestible compounds, such as resistant starch and non-starch polysaccharides, might be used as flour to increase resistant starch and antioxidant phenolics contents of pasta (spaghetti) of high quality.

The resulting spaghetti had an increased indigestible fraction and antioxidant capacity, and low rate of carbohydrate enzymatic hydrolysis with low-glycaemic index,compared with traditional products. According to the authors the high antioxidant properties of unripe banana is due to its condensed tannins or proanthocyanidins.

The authors stress that this would also create a new use for the excess of production and large quantities of bananas which are otherwise lost.

USDA Database for Proanthocyanidins 2004

[1150]
Proanthocyanidins, also known as procyanidin oligomeric proanthocyanidin (OPC), pycnogenol, leukocyanidin and leucoanthocyanin, they are flavanols. Proanthocyanidins are polymers of flavan-3-ols, also referred to as "Condensed Tannins", with astringent flavour. Their free radical scavenging properties may reduce the risk of cardiovascular diseases, cancer, blood clotting and certain types of trimeric PAs may protect against urinary tract infections. USDA provides a database for proanthocyanidins for epidemiologists and health researchers to estimate the intakes and to investigate relationships between intakes and reduction in the risks of various diseases.

The database contains values for 205 food items for proanthocyanidins listed as monomers, dimers, trimers, 4-6 mers (tetramers, pentamers and hexamers), 7-10 mers (heptamers, octamers, nonamers and decamers) and Polymers (DP$>$10).

Synergistic effect of polyphenols from skind and seed from grape inhibit platlet aggregation

[1151]
Polyphenols composed of more than one phenol unit or building block per molecule. Polyphenols are generally divided into hydrolyzable tannins (gallic acid esters of glucose and other sugars) and phenylpropanoids, such as lignins, flavonoids, and condensed tannins. (See chemical formulas at http://en.wikipedia.org/wiki/Polyphenolics)

Reed and colleagues 2002 found that combining extracts of grape seed and grape skin, rich in grape polyphenolics, individually shown to inhibit platelet aggregation, might enhance their individual antiplatelet effects. Feeding the extracts individually did not affect platelet aggregation, whereas feeding them in combination in combination as found in in red wine, grape juice exhibit a greater antiplatelet effect than when present individually.

Anticancer and urinary antibacterial properties of cranberry fruit

[1152]
Catherine C. Neto reviewed the existing research on the anticancer properties of fruit of cranberry (Vaccinium macrocarpon). The author found that polyphenolic extracts rich in proanthocyanidins inhibit the growth and proliferation of breast, colon, prostate, lung, and other tumors, as do flavonols, proanthocyanidin oligomers, and triterpenoids isolated from the fruit. The unique combination of phytochemicals found in cranberry fruit may produce synergistic health benefits. The proanthocyanidins of cranberry also prevent urinary tract infections, inhibiting the adhesion of Escherichia coli bacteria. Also inhibition of the adhesion of Helicobacter pylori to human gastric mucus was noted, reducing the risk of gastric cancer.

Grape seed procianidins reduces liver cancer risk

[1153]
Quesada and colleagues 2007 found that procianidins inhibit the metallothionein gene expression in the liver by 70 per cent. Inhibition of the metalothionein genes expression was found dose dependent to grape seed procyanidins extract used in the study. The authors stress that metallothione in genes are direct targets of procyanidins action, both in vivo and in vitro, in hepatic cells. The authors elucidate the mechanisms how procyanidin achieves the beneficial effects.

Metallothionein plays an important role in transcription factor regulation. Increased expression of metallothioneins were found in some cancers of the breast, colon, kidney, liver, lung, nasopharynx, ovary, prostate, mouth, salivary gland, testes, thyroid and urinary bladder. Lower levels of metallothioneins were found in hepatocellular carcinoma and liver adenocarcinoma. [1154]

Grape seed extracts protect from cardiovascular diseases

[1155]
Woodward and colleagues 2004 stress that the French have a lower incidence of cardiovascular disease than Americans. Researchers say this is an effect of grape polyphenolic of red wine consumed by French. The authors, however do not recommend red wine, neither red grape juice, because of the pro-oxidant and pro-inflammatory effect of alcohol in wine and the high sugar content of the juice which might harm diabetic or promote obesity. The authors recommend therefore polyphenolic extracts of grapes as an alternative to wine or purple grape juice.

Grape seed extract have anti ageing effect and are potent antioxidants

[1156]
John Shi and colleagues 2003 point out that grape seeds contain 5-8 per cent of polyphenols, proanthocyanidins including flavonoids, such as gallic acid, the monomeric flavan-3-ols catechin, epicatechin, gallocatechin, epigallocatechin, and epicatechin 3-0-gallate, and procyanidin dimers, trimers, and more highly polymerized procyanidins. The antioxidant effect of Proanthocyanidins is 20 times greater than vitamin E and 50 times greater than vitamin C. The most abundant phenolic compounds isolated from grape seed are catechins, epicatechin, procyanidin, and some dimers and trimers.

Seeds and marcs from the mao plant are a good source of proanthocyanidins

[1157]
Puangpronpitag and colleagues 2008 analysed the seeds and marcs of Antidesma thwaitesianum Müll. Arg. or mao which, a waste product of the production of juice and wine in Thailand. The authors looked on the polyphenolic content and their radical scavenging activities of the polyphenols and proanthocyanidins. The researchers found that the protective effect of seeds and marcs of mao on lipid peroxidation is as strong as grape seed proanthocyanidin extract, and stress that mao waste products may be a good source of polyphenolics.

Marjoram volatile oil and grape seed extract are strong antioxidants

[1158]
El-Ashmawy and colleagues 2007 studied the antioxidant effect of Marjoram volatile oil (Origanum majorana L., Lamiaceae) and grape seed extract (Vitis vinifera L., Vitaceae), when simultaneously administratedwith ethanol. They found that the ethanol toxicity induced significant alterations in the histological structures of the testis, liver and brain, an increase in lipid peroxidation and decrease in the level of glutathione in the testis, liver and brain. The co-administration of marjoram volatile oil and grape seed extract reduced significantly the effects of ethanol toxicity on male fertility, liver and brain tissues. The authors concluded that the extracts of both plants are indicated to control oxidative damages.

Proanthocyanidins of grape seed prevent skin cancer

[1159]
Meeran and Kativar report that dietary grape seed proanthocyanidins prevent photocarcinogenesis in mice. The authors stress that grape seed proanthocyanidins possess chemotherapeutic potential against human epidermoid carcinoma cells in vitro. They call for more studies to verify the chemotherapeutic effect of grape seed proanthocyanidins in skin cancers.

Polyphenols of red grape skin and grape seed extracts prevent cardiovascular diseases

[1160]
Hanne Frederiksen report that polyphenols in red grape skin and seed extract had positive effect on the development of atherosclerosis. In their study the authors found that grape skin and seed extract had no significant effects in females rabbits but was associated with transient less hypercholesterolemic response to semisynthetic diet. The development of aortic atherosclerosis in males was retarded.

Non-nutrient dietary constituents may present useful bioactive effects

[1161]
Rosemary Carpenter and colleagues 2006 determined the concentration of compound that inhibited cell growth by 50% (IC50) of a range of phytochemicals and plant extracts and to investigate their antioxidant and genoprotective effects. The authors found that resveratrol presented the highest IC50 value of 13.7 $\mu$g/mL, and Echinacea the lowest at 9,400 $\mu$g/mL. Oxidative stress was strongly reduced by olive leaf extract and bearberry, grapeseed polyphenols and bearberry strongly protected against H2O2- and DNA damage. The authors concluded that non-nutrient dietary constituents may present important bioactive effects. Extracts of bearberry, grapeseed polyphenols, and olive leaf extract, protect against oxidative stress.

Apple fruit skin powder may add nutritional value of muffins

[1162]
Vasantha and colleagues 2008 used blanched, dehydrated, and ground apple fuit skin to improve the nutritional value of muffins. The apple skin powder used by the authors contained 41% total dietary fibre and high content of antioxidants.

The authors stressed that apple fruit skin, a by-product of apple processing, is a rich source of dietary fibre and phenolics such as quercetin glycosides, catechins, chlorogenic acid, phloridzin, and cyanidin galactoside. Using apple skin powder in bakery may turn apple skin from by-product to a valious nutritional enhancer.


Pectin

Pectin can:
- Bind and help the excretion of steroid compounds reducing thus blood level of LDL- cholesterol[1163].
- It increases viscosity and reduces the availability of nutritional energy.
- It reduces the peak of glucose after meals.
- It binds water and increases volume of faecis.
- Pectin has anionic groups which can be used as a transport medium of special drugs which should act in colon. On the other side it should always taken under consideration if medication should be taken during meals or between meals as the in some cases important parts of the drug may be absorbed by pectin and other dietary fibre.
-Pectin can cause modification of the mucosa. Increase of the weight of ileum and colon of mice was found by Schmehl[1164].
Low esterified pectin had great activity. Even with no limits established by food law the use of pectin should be kept in a reasonable level as the high viscosity may reduce resorption of important food components.


Dietary fibre and inflammation

[1165] C-reactive protein (CRP) is produced in the liver and is a known marker for inflammation. Increased levels of CRP are a good predictor for the onset of both type-2 diabetes and cardiovascular disease.

Yunsheng Ma and colleagues suggest that a diet high in fibre may play a role in reducing inflammation and, thus, the risk of cardiovascular disease and diabetes, and that dietary fibre is protective against high CRP. 20 to 35 grams of fibre per day, including both soluble and insoluble fibre are being recommended.

It was suggested that dietary fibre could reduce the oxidation of fats and that soluble fibre act as prebiotics improving gut health diminishing inflammatory conditions.

Dietary natural agents and cancer

Lupeol from fruits and vegetables
Lupeol, a triterpene present in fruits and vegetables is being studied as dietary natural agent to slow tumour progression in prostate cancer.

Lupeol treatment resulted in significant inhibition of cell viability in a dose-dependent manner and caused apoptotic death of prostate cancer cells. Among all death receptor targets examined, Lupeol specifically caused a significant increase in the expression of Fas receptor.

The small interfering RNA-mediated silencing of the Fas gene and inhibition of caspase-6, caspase-8, and caspase-9 by their specific inhibitors confirmed that Lupeol specifically activates the Fas receptor-mediated apoptotic pathway in androgen-sensitive prostate cancer cells.

The treatment of cells with a combination of anti-Fas monoclonal antibody and Lupeol resulted in higher cell death compared with the additive effect of the two compounds alone, suggesting a synergistic effect. Because early clinical prostate cancer growth is an androgen-dependent response, the results of the present study suggest that Lupeol may have a potential to be an effective agent against prostate cancer. [1166]

Green tea
Green tea polyphenols , a mixture of various polyphenols inhibit the growth and progression of prostate cancer in TRAMP mice. Epidemiologic reports support that green tea may reduce prostate cancer risk in humans. During the course of prostate cancer development and progression the effectiveness of green tea is not yet certain in humans. However, based on the study, it is suggested that green tea in general and polyphenols present therein may prove to be a useful supplement in the prevention or slower progress of prostate cancer in humans. [1167] The IGF-I/IGFBP-3 signalling pathway is a prime pathway for green tea polyphenol mediated inhibition of prostate cancer that limits the progression of cancer through inhibition of angiogenesis and metastasis. [1168]

Chemopreventive and chemotherapeutic activity of C3G compound from blackberry [1169] Min Ding an colleagues say that epidemiological data suggest that consumption of fruits and vegetables has been associated with a lower incidence of cancer. Cyanidin-3-glucoside (C3G), a compound found in blackberry and other food products, was shown to possess chemopreventive and chemotherapeutic activity in the present study.

They conclude that a purified compound of anthocyanin inhibits tumor promoter-induced carcinogenesis and tumor metastasis in vivo.

Antioxidant-rich foods and essential fatty acids slows down brain decay

[1170]
Willis, Shukitt-Hale and Joseph 2009 report that increased oxidative stress and modifications in brain lipid composition cause damage and dysfunction of the ageing brain. The authors stress that inclusion of antioxidant-rich foods and essential fatty acids in the diet can slow the age-related progression of cognitive and behavioural decline.

Moderate consume of walnuts protects brain from ageing

[1171]
James A. Joseph and colleagues 2009 found that adding a moderate, 7 to 9 walnuts/day to an otherwise healthy diet improves motor and behavioural skills middle-aged individuals. Polyphenols, other antioxidants and essential fatty acids are the content of walnut which cause the beneficial neurological effects. However, higher doses of walnut impaired performance in the rodent study. The authors concluded that walnuts, eaten in moderation protect the neural tissue from ageing.

Blackberry improves cognitive function in aged rats

[1172]
Joseph and colleagues 2009 write that polyphenols from fruits and vegetables increasing antioxidant and/or anti-inflammatory levels, or by direct effects on signalling, in the brain retard and even reverse age-related decrements in motor and cognitive performance.

The authors report that increased dietary intake of 2% blackberry-supplemented diet improved balance and co-ordination working, or short-term, memory performance in aged rats.

Genistein
Studies in vitro suggest that osteopontin (OPN), an extracellular matrix protein secreted by macrophages infiltrating prostate tumours, and by tumour cells, may have a role in the transition from clinically insignificant tumours to metastatic prostate cancer.

Studies are consistent with the possibility that dietary genistein may delay the progression from benign to malignant tumours by inhibiting OPN expression. Our earlier studies in Transgenic Mouse Prostate adenocarcinoma (TRAMP) mice showed that genistein, an isoflavone found in soybeans, lowered the incidence of advanced PC. This suggested that lower intake of dietary soy may be one possible cause for higher incidence of advanced prostate carcinome in Western men. [1173] [1174]

Green Tea and weight reduction

Nestlé and CocaCola advertising weight control ENVIGA [1175]
Servane Rudelle and colleagues 2007 studied the effect on weight control of a beverage containing Epigallocathechin gallate EGCG, green tea and caffeine. The authors found an increase in 24-hour energy expenditure of 100 kcal/d on account of this beverage.

The weight gain of the American population is slightly less than 1 kg/yr, which represents a median excess energy of 15 kcal/d, and because energy is stored with 50% efficiency, a negative energy balance of 100 kcal/d would be sufficient to prevent weight gain in most of the U.S. population The authors conclude that consuming this type of beverage regularly together with exercise, may be helpful in weight control.

Based on this study Nestlé and CocaCola launched its ENVIGA product with the advertising adds: Benefits: "burn more calories" "drink negative" [1176]

The Center for Science in the Public Interest CSPI Says "Calorie Burning" and Weight Loss Claims Illegal [1190]
The Federal Trade Commission (FTC) should take enforcement action against Coca-Cola and Nestlé for their unlawful deceptive advertising for Enviga, their green-tea-flavored diet soda, according to a complaint filled with the agency on May 2007 by the nonprofit Center for Science in the Public Interest (CSPI). At issue is the companies' claim that Enviga burns more calories than the five calories per can it delivers, which, CSPI says, strongly implies weight loss.

Obesity control reducing energy density of foods

[1178]
Julia Ello-Martin and colleagues 2007 assessed as reduction diet the reduction of fat in comparison to the reduction of fat together with higher intake of fruits and vegetables during 1 year.

For both groups no goals for energy or fat intake were assigned; the participants could eat ad libitum.

The low fat and high intake of fruits and vegetables group, had a lower dietary energy density,a higher weight loss (7,9 kg/1 y), and less hunger than did the low fat group (6,4 kg/1y) with variation of +- 0,9 kg for both. The authors concluded that the reduction of dietary energy density, combining increased fruit and vegetable intakes with decreased fat intake, is an effective strategy for managing body weight.

Commentary of OurFood: Reducing fat in dairy products, convenience foods and fried products such as french fryies fish sticks, croissants, forget about oily dressings and sugar-glucose energy bars to sweeten your calories, adding fruits and vegetables to your menu is the right way.

Instead of roasting lean beef or chicken breast in your pan using plenty of oil, you can cook it using water and zero oil. Gourmet add some wine instead of water. If you add a tomato salad on vinegar you meet the Juilia Ello-Martin specifications.

Long-term consumption of green tea [1179]
According to Yung-hsi and colleagues 200, long-term consumption of green tea may decrease the incidence of obesity and, perhaps, green tea components such as EGCG may be useful for treating obesity. The authors point out, however, that oolong tea was found to reduce obesity in mice, despite having much less EGCG that green tea does. The authors calls for studies with purified components to identify the active componentsof tea.

Oolong tea [1180]
According to Han and colleagues 1999 oolong tea has anti-obesity effects in high-fat diet-treated mice which might result from an enhancing effect of caffeine isolated from oolong tea The auithors suggest that oolong tea may be effective in treatment of obesity and fatty liver caused by a high-fat diet.

Effect of tea catechins on obesity [1181]
Murase and colleagues 2002 studied the effects of long-term feeding with tea catechins, which are naturally occurring polyphenolic compounds widely consumed in Asian countries, on the development of obesity in mice. They found that the anti-obesity effects of tea catechins might be caused by the stimulation of the hepatic lipid metabolism They suggest that long-term consumption of tea catechins may help to suppress diet-induced obesity, and it may reduce the risk of coronary diseases.

Reduction of abdominal fat in humans [1182]
Long-term feeding of tea catechins suppressed body fat accumulation in high-fat diet-induced obesity in mice, and that their effects might be attributed, at least in part, to the activation of hepatic lipid metabolism. Consecutive intake of tea catechins (588 mg/day) reduced body fat, especially abdominal fat in humans. These results demonstrate that intake of tea catechins is beneficial for body fat accumulation.

Epigallocathechin gallate (EGCG) and fat-reduction effect [1183] Wolfram and colleagues 2005 examined the antiobesity effect of tea epigallocatechin gallate (EGCG), in mice fed with high-fat diet.

They found that food intake was not affected but faeces energy content was slightly increased by EGCG, indicating a reduced food digestibility and thus reduced long-term energy absorption, and conclude that d ietary EGCG attenuated diet-induced body fat accretion in mice. EGCG apparently promoted fat oxidation, but its fat-reducing effect could be entirely explained by its effect in reducing diet digestibility.

TEAVIGO [1184]
Wolfram and colleagues 2005, in a study from DSM Nutritional Products Ltd found that epigallocatechin gallate (EGCG), in a pure form, present in the commercial product TEAVIGO inhibited adipocyte differentiation in vitro, and concluded that supplementation with EGCG, abolishes diet-induced obesity, and should be considered as a valuable natural treatment option for obesity.

Antimitogenic effect of green tea epigallocatechin gallate [1185]
Pei-Fang Hung and colleagues 2005 investigated the pathways of EGCG's modulation of the mitogenesis(cell- division) of preadipocytes. They found that EGCG inhibited preadipocyte 3T3-L1 proliferation.

The authors demonstrate the ERK- and Cdk2-dependent antimitogenic effects of EGCG, and that EGCG was more effective than epicatechin, epicatechin gallate, and epigallocatechin in changing the mitogenic signals. The signal of EGCG in reducing growth of 3T3-L1 preadipocytes differed from that of 3T3 fibroblasts. Hung and colleagues conclude that reduction of obesity caused by EGCG may be linked to the inhibition of fat-cells division.

EGCG inhibits proliferation of fat-cels and induces autodestruction of fat-cells [1186]
Green tea catechins have been shown to promote loss of body fat and to inhibit growth of many cancer cell types by inducing apoptosis. Ji Lin and colleagues 2005 studied the influence of epigallocatechin gallate (EGCG) on adipocytes to inhibit adipogenesis and induce apoptosis using mouse 3T3-L1 preadipocytes and mature adipocytes. The researchers found that EGCG had no effect on either viability or apoptosis of preconfluent preadipocytes. EGCG also did not affect viability of mature adipocytes; however, EGCG increased apoptosis in mature adipocytes and inhibited lipid accumulation in maturing preadipocytes.

The authors concluded that EGCG can act directly to inhibit differentiation of preadipocytes and to induce apoptosis of mature adipocytes and, thus, could be an important adjunct in the treatment of obesity.

EGCG downregulates the fat hormone Resistin expression by reducing the amounts of phospho-ERK1/2 proteins. [1187]
Resistin is a hormone discovered in 2001 and is a response of leucocytes to inflammation and participates in the inflammatory response, and this may be the link to insulin resistnce. According to Hang-Seng Liu and colleagues 2006 resistin is an adipocyte-specific secretory hormone that can cause insulin resistance and decrease adipocyte differentiation, and epigallocatechin gallate (EGCG) of green tea, have been reported to act against obesity and diabetes.

The study suggest that EGCG may modulate the distribution of resistin protein between the intracellular and extracellular compartments. EGCG reduced the amounts of phospho-extracellular signal-related kinase-1/2 proteins (phospho-ERK1/2 proteins). The researchers conclude that EGCG downregulates Resistin expression via a pathway that is dependent on the ERK pathway.

Resistin controversy [1188]
Most all findings (many times elucidated under the same experimental conditions) reported by groups opposing the resistin link theory are the exact opposite from what those groups who support the theopry have observed. The idea that resistin links obesity to type 2 diabetes mellitus is now under even more scrutiny as recent investigations have confirmed a rather vast expression of resistin in many tissues rather than those only characteristic of obesity such as adipocytes.

With nearly as many scientists against this theory as those scientists who seem to support it, the likelihood that resistin will ever be viewed as the key node linking obesity to type 2 diabetes mellitus in the near future is very low. The very extent to which these two views oppose each other raises questions about the synchrony and methodology used in these respective groups which resulted in polar opposite results.

Insufficient data of EGCG human trials [1189]
Wolgang, Wang an Thielecke 2006 write that studies conducted with human subjects report reduced body weight and body fat, as well as increased fat oxidation and thermogenesis related to green tea. However, according to the authors, there is still a need for well-designed and controlled clinical studies to validate the studies. According to Wolfgang and colleagues specific effects of EGCG of green tea on obesity should be investigated in human trials.

Tea-catechins together with swimming reduces obesity gain by 20 percent [1190]

The effects of long-term intake of tea catechins in combination with regular exercise on the development of obesity in mice was investigated by Murase and colleagues 2006. Tea-Catechins intake in combination with swimming exercise suppressed high fat diet-induced body-weight gain by 18 and 22%, respectively, compared to Exercise and tea-Catechins intake on their own. These results indicate that intake of tea Catechins, together with regular exercise helps to reduce diet-induced obesity. This effect might be attributed, at least in part, to the activation of whole-body energy metabolism.

Green tea reducing cancer risk

Green tea is supposed to reduced risks of breast, lung, prostate and ovarian cancer. Black tea does not present cancer protective effect.

The meta-analysis of Can-Lan Sun and colleges from the Cancer Center of the University of Minnesota indicates a lower risk for breast cancer with green tea consumption. Available data suggest a possible late-stage, promotional effect of black tea on breast carcinogenesis. [1191]

Administration of green tea to SKH-1 mice, via the drinking fluid, was found to significantly reduce the incidence and volume of ultraviolet B (UVB) radiation-induced skin tumors in a study by leading author Q Liu. [1192]

Epigallocatechin Gallate is an anti-oxidant polyphenol flavonoid isolated from green tea. Its possible benefit as a nutritional chemopreventive agent for cancer, atherosclerosis, and neurodegenerative diseases is generating increased scientific interest.

The protection from breast cancer by tea is related specifically to the catechin content, specifically epillocatechin.

According to Joshua D. Lambert and Chung S. Yang a typical cup of brewed green tea contains, by dry weight, 30-40% catechins including epicatechin, epigallocatechin, epicatechin-3-gallate, and epigallocatechin-3-gallate. Through fermentation, a large percentage of the catechins are converted to oligomeric theaflavins and polymeric thearubigins in black tea. The resulting brewed black tea contains 3-10% catechins, 2-6% theaflavins and $>$20% thearubigins. [1193]

The catechins have been demonstrated to undergo considerable biotransformation and to have low bioavailability. The theaflavins are even less bioavailable. This poor availability confounds attempts to correlate in vitro findings with cancer prevention in animal models. Cell line studies typically require concentrations of compound in the 5-100-micro mol/L range. Such concentrations are typically not observed systemically. [1193]

Japan Public Health Center-based Prospective Study Group: Green tea polyphenols may increase stomach cancer in men but reduces the risk in women

[1194]
Shizuka Sasazuki and colleagues 2008 investigated the effect of the tea polyphenols on the risk of gastric cancer in a nested case-control study.

The authors found an increased risk of gastric cancer for men, when a high plasma level of (-)-epigallocatechin was measure. For women, a high plasma level of (-)-epicatechin-3-gallate (ECG) of 9.3 ng/mL and up, decreased risk of gastric cancer by 73 per cent compared with ECG not detectable cases.

The effect of ECG plasma levels below 9.3 ng/ml was not significant. The authors suggest that cigarette smoking to play a role as an effect modifier observed between men and women.

Dietary supplementation with green tea extract, epigallocatechin gallate EGCG as a contribution to anti-diabetic nutritional strategies [1195]
Swen Wolfram and colleagues in a study found that dietary supplementation of epigallocatechin gallate (high purity green tea leaf extract] resulted in improved oral glucose tolerance, blood glucoses levels, lower free fatty acid plasma concentrations, as well as increasing plasma insulin concentrations in mice and rats. The researchers wrote that EGCG downregulated genes involved in gluconeogenesis, as well as genes involved in the synthesis of fatty acids, triacylgycerol, and cholesterol.

The authors conclude that EGCG beneficially modifies glucose and lipid metabolism in H4IIE cells and markedly enhances glucose tolerance in diabetic rodents. Dietary supplementation with EGCG could potentially contribute to nutritional strategies for the prevention and treatment of type 2 diabetes mellitus if the findings can be translated to humans.

Plasma glucose concentration at 1 hour during the oral glucose tolerance test to predict the risk for type 2 diabetes

[8]
Muhammad A. Abdul-Ghani and colleagues 2008 assessed the efficacy of 1-h plasma glucose concentration and the metabolic syndrome in predicting future risk of type 2 diabetes. The authors suggest the use of the plasma glucose concentration at 1 hour during the oral glucose tolerance test to predict the risk of type 2 diabetes. A plasma glucose higher than 155 mg/dl, and the Adult Treatment Panel ATP III criteria for the metabolic syndrome was found useful to classify nondiabetic patients into three risk groups: low, intermediate, and high risk.

Vegetables but not fruits protect against type 2 diabetes

[9]
Raquel Villegas and colleagues 2008 examined associations between fruits and vegetables intake and the incidence of type 2 diabetes. They found that vegetables in general and as individual groups were inversely associated with type 2 diabetes. Fruit intake did not reduce the risk of diabetes.

In this study consumption of about 430 grams vegetables per day, was associated with a 28per cent lower risk of diabetes compared with low consumption of about 129 grams per day.

The authors suggest that the hight content in fibre, antioxidants, magnesium and a low glycemic index in vegetables were responsible for the decreased risk of type 2 diabetes, but could not entirely explain it, other compounds such as phytates, lignans, isoflavones, vitamin E and C, but not beta-carotene might have an additive or synergetic effect.

The authors concluded that vegetables, but not fruit consumption may protect against the development of type 2 diabetes.

Bamboo leaves extract: [1198]
The active compounds, include flavone, phenolic acid, lactone, polyose, amino acid, and microelements of bamboo extract and are, according to Carol Cheow from Cactus Botanics, linked to protection of blood vessels, the liver, improving sleep quality, protection against cancer, and anti-age, having positive impacts on the health and longevity of human beings.

Bamboo shoots, fruit, vegetables and honey are rich in xylooligosaccharides which have beneficial effect on gut health

[1199]
Chung and colleagues evaluated the effects of xylooligosaccharides on the intestinal microbiota, gastrointestinal function, and nutritional parameters of elderly people. In the study 4 grams of xylooligosaccharides for three weeks significantly increased the population of bifidobacteria, increased the faecal moisture content, and decreased the faecal pH value due to increased production of short chain fatty acids such as butyrate and proprionate.

In this study the supplementation of xylooligosaccharides was found more effective than prebiotics like inulin and fructooligosaccharides in promoting the intestinal health.

Effective daily dosage of oligosaccharide for humans

[1200]
Fructooligosaccharides (FOS) = 3.0 g
Xylooligosaccharides = 0.7 g

Green tea and cognitive function: [1201]
According to Kuriyama from the Tohoku University Graduate School of Medicine, Japan, considerable experimental and animal evidence shows that green tea may possess potent activities of neuroprotection, neurorescue, and amyloid precursor protein processing that may lead to cognitive enhancement, no human data are available. That is why Kuriyama analysed the consumption of green tea, black tea, oolong tea and coffee)

Green tea is a rich source of catechins, compounds suggested to play a beneficial role in weight loss, cardiovascular and oral health, such as epigallocatechin gallate which is said to be brain permeable . Its protection of the brain is proposed to be due to mechanisms other than its antioxidant and iron-chelating properties. Modulation of cell survival and cell cycle genes and promotion of neurite overgrowth activity are cited as possible mechanism.

This may be the reason why Kuriyama found that drinking more than two cups of green tea a day could cut the risk of dementia by half in elderly Japanese subjects. Kuriyama concluded that a higher consumption of green tea is associated with a lower prevalence of cognitive impairment in humans.

Kuriyama found only a weak or null relation between consumption of black or oolong tea or coffee and cognitive impairment.

The authors, however point out the limitations of the study noting that healthier and more active individuals might have more opportunities to consume green tea which might promote higher cognitive function.

Green tea catechin Polyphenols reduces oxidative stress in sleep-disordered breathing

[1202]
Obstructive sleep apnea is a breathing problems during sleep where soft tissue in the rear of the throat collapses and closes during sleep increasing risk of oxidative stress and changes in the brain tissue in areas involved in learning and memory. This sleep-disordered breathing is characterised by intermittent hypoxia which impairs spatial learning and increases NADPH oxidase activity and oxidative stress in rodents. [1203]

Isabel C. Burckhardt and colleagues 2008 studied the effect of oral supplements of green tea-derived polyphenols to reduce the neural susceptibility to intermittent hypoxia during sleep in rodents.

The authors write that green tea catechin polyphenols (GTPs) may attenuate intermittent hypoxia-induced neurobehavioral deficits by reducing intermittent hypoxia-induced NADPH oxidase expression, lipid peroxidation, and inflammation.

Following the results of their study the authors conclude that oral GTP attenuates intermittent hypoxia-induced spatial learning deficits and mitigates intermittent hypoxia-induced oxidative stress through multiple beneficial effects on oxidant pathways.

The authors suggest further studies on the therapeutic role of green tea catechin polyphenols in sleep-disordered breathing to reduce oxidative processes underlying neurocognitive deficits associated with these sleep disorders.

Habitual snoring are also associated with impair of neurocognitive functions

[1204]
Michael S. Urschitz and colleagues found in 2003 that habitual snoring (i.e., snoring frequently or always) was associated with poor academic performance in these primary school children. This was only partially related to intermittent hypoxia. Urschitz concluded that primary snoring and/or upper airway resistance syndrome rather than obstructive sleep apnea-hypopnea syndrome were the cause cognitive impairments.

The authors stress that habitual snoring (i.e., snoring frequently or always) without intermittent hypoxia, up to now largely considered benign, may impair neurocognitive functioning in children and, thereby, their performance at school.

The findings of Urschitz and colleagues extend the possible potential benefits of green tea polyphenols also to habitual snoring.

Three major competing hypotheses exist to explain the cause of the Alzheimer disease (AD)

[1205]
The cholinergic hypothesis, proposes that the disease is caused by reduced synthesis of the neurotransmitter acetylcholine. However, treating acetylcholine deficiency is not effective. Other cholinergic effects have also been proposed, for example, initiation of large-scale aggregation of amyloid leading to generalised neuroinflammation.

The amyloid hypothesis says that amyloid beta deposits are the fundamental cause of the disease. The gene for the amyloid beta precursor (APP) is located on chromosome 21, and people with trisomy 21 (Down Syndrome) who thus have an extra gene copy almost universally exhibit AD by 40 years of age. Also APOE4, the major genetic risk factor for AD, leads to excess amyloid buildup in the brain before AD symptoms arise.

The tau hypothesis says that the hyperphosphorylated tau protein begins to pair with other threads of tau. Eventually, they form neurofibrillary tangles inside nerve cell bodies. When this occurs, the microtubules disintegrate, collapsing the neuron's transport system ending in the death of the nerve cells. However, epidemiological studies have proposed relationships between certain modifiable factors, such as diet, cardiovascular risk, pharmaceutical products, or intellectual activities among others, and a population's likelihood of developing AD. Only further research, including clinical trials, will reveal whether, in fact, these factors can help to prevent AD.

The components of a Mediterranean diet, which include fruit and vegetables, bread, wheat and other cereals, olive oil, fish, and red wine, may all individually or together reduce the risk and course of Alzheimer's disease. Several vitamins such as B12, B3, C or folic acid have been found in some studies to be related to a reduced risk of AD but other studies indicate that they do not have any significant effect on the onset or course of the disease and may have important secondary effects. Curcumin from the curry spice turmeric has shown some effectiveness in preventing brain damage in mouse models.

There is still no conclusive therapy for the disease. Much research is being done on this disease.

Omega-6 arachidonic fatty acid may increase risk of Alzheimer's disease

[1206]
Rene O Sanchez-Mejial and colleagues 2008 suggest that raised levels of the omega-6 fatty acid arachidonic acid may be linked to Alzheimer's disease, according to the study in a mouse model.

Fatty acids, such as arachidonic acid are part of the phospholipids that form the protecting membranous barrier from the nerve cells.

The researchers found an increase in arachidonic acid and related metabolites in the brain of Alzmeimer mice. Arachidonic acid is released in the brain from phospholipids by enzymes of the phospholipase A2 (GIVA-PLA2) which were found to be elevated in the memory centre located in the hippocampus of diseased mice.

Reduction, or removal of the PLA2 enzyme in Alzheimer's mice by genetic engineering prevented memory deficiency and other behavioural abnormalities in these mice. The authors believe that arachidonic acid cause is likely to cause  excitation and neurons dysfunction. Normal function of the neurons may be restored by lowering the levels of arachidonic acid.

The study suggests that reducing dietary omega-6 fatty acids from intake of  poultry, cereals, eggs, nuts, vegetable oils and evening primrose oil, and developing medication to reduce the PLA 2 enzime activity may benefit treatment and prevention of Alzheimer's disease.

Glutaminyl cyclase

[1207]
Dr Hans-Ulrich Demuth of the company Probiodrug. Steffen Roßner from the University of Leipzig and colleagues 2008 studied the enzyme glutaminyl cyclase which is responsible for the production of the protein that cause blockages in the brain of Alzheimer's patients. The researchers want to shut off production of the glutaminyl cyclase enzyme to stop the production of these proteins. The authors added an enzyme inhibitor to the food of diseased mice which started to produce up to 80 per cent less build-up of Alzheimer-causing proteins in their brains.

Gamma-secretase modulators

[1208]
A new class of drugs, gamma-secretase modulators (GSM) is told to reduce harmful long proteins and promote levels of shorter protein elements protecting against the disease.

Reduction of risk of age-related neurodegenerative pathologies[1209]
Beta-amyloid deleterious role in the Alzheimer's disease: Bastianetto and colleagues found that green and black tea extracts and flavan-3-ols were neuroprotective active against toxicity induced by beta-amyloid-derived peptides.

Strong activity: Strong active flavan-3-ol were found to be gallic acid, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG) being the strongest of them.

ineffective: Bastianetto and colleagues found epicatechin and epigallocatechin ineffective in the same range of concentrations.

According to this study the catechin gallates (through the galloyl moiety) contribute to the neuroprotective effects of both green and black teas, reducing age-related neurodegenerative diseases, such as Alzheimer disease. The content of catechins of green tea is about 70 mg per 100 mL. Black tea contains only about 15 mg per 100 mL. Green tea should therefore be given preference.

Increased intake of folate by diet and supplements may decrease risk of Alzheimer's disease. [1210]
Luchsinger and colleagues studied the role of higher intake of folate, vitamins B$_{6}$ (pyridoxine hydrochloride) and B$_{12}$ (cyanocobalamin) in decreasing the risk of Alzheimer disease (AD) through the lowering of homocysteine levels.

The authors concluded that higher folate intake from both dietary and supplements decrease the risk of Alzheimers's disease about 50%, and that the effect of folate was independent of other risk factors and levels of s B$_{6}$ and B$_{12}$.

The authors point out that dietary folate nor supplements alone were significantly linked to Alzheimer's disease risk; only the two in combination appeared to produce an effect, and that vitamin B$_{12}$ and B$_{6}$ levels were not associated with Alzheimer's disease risk.

Lower homocysteine levels were found in the group of higher folate intake. Homocystein is involved in the accumulation of amyloid proteins in the brains causing Alzheimer disease.

The authors call for clinical studies before the decision to increase folate intake to prevent Alzheimer's disease can be made. The results of the ongoing "B-Vitamin Treatment Trialist's Collaboration" addressing the link between B-vitamins, homocysteine levels, and cognitive function should be waited for.

Hypothesis says that vitamin D may reduce risk of dementia

[1212]
Wiliam B. Grant hypothesises that vitamin D can reduce the risk of developing dementia based on observational evidences that vitamin D deficiency, associated with increased risk for cardiovascular diseases, diabetes mellitus, depression, dental caries, osteoporosis, and periodontal disease, may also be a risk factor for dementia. The laboratory evidence included findings of neuroprotection and inflammation reduction related to vitamin D.

The author calls for observational studies of incidence of dementia with respect to prediagnostic serum 25(OH)D or vitamin D supplementation.

Vitamin E supplementation in Alzheimer’s Disease may prevent loss of cognition in some individuals, in others it may be detrimental.

[1213]
Ana Lloret and colleagues 2009 studying vitamin E prevention of oxidative stress and loss of cognition in Alzheimer's Disease found that some individuals responded to a supplementation of 800 IU of vitamin E per day for six month. The blood oxidized glutathione (GSSG) levels were lower after the treatment and scores on the cognitive tests were maintained. No prevention of oxidative stress, however, was found at other individuals which presented a detrimental effect of cognitive functions.

The authors recommend, therefore, that supplementation of Alzheimer's Disease patients with vitamin E should be monitored by determining the oxidative stress indicator GSSG in each patient.

Omega 3 fatty acids increase the protein SorLA/LR11 which reduces the expression of Alzheimer's disease

[1214]
According to Greg M.Cole and colleagues found in a study that omega-3 docosahexaenoic acid (DHA) could increase the production of LR11, a protein key to the clearance of enzymes in the brain that make the beta amyloid plaques that cause Alzheimer's disease.

Curcumin reducing Alzheimer's risk

[1215]
Inflammation in Alzheimer's disease is characterized by increased cytokines and activated microglia. Long-term use of nonsteroidal anti-inflammatory drugs are used the reduce the risk of Alzheimer's disease. The authors found curcumin promising to reduce excessive use of nonsteroidal anti-inflammatory drugs which can cause gastrointestinal, liver, and renal toxicity.

Curcumin significantly lowered oxidized proteins and interleukin-1 Beta, a proinflammatory cytokine elevated in the brains of these mice. The authors concluded that curcumin spice may be promising for the prevention of Alzheimer's disease.

A diet rich in omega 3 fatty acids reduces amyloid burden in an aged Alzheimer mouse

[1211]
According to Greg M. Cole and colleagues in 2005 increased intake of the omega-3 (n-3) polyunsaturated fatty acid (PUFA) docosahexaenoic acid (DHA) is associated with reduced risk of Alzheimer's disease. DHA levels are lower in serum and brains of Alzheimer's disease patients, which could result from low dietary intake and/or PUFA oxidation.

In a mouse study the authors found that DHA-enriched diets significantly reduced total beta-amiloid by $>$70% when compared with low-DHA or control chow diets. They concluded that dietary DHA could be protective against beta -amyloid production, accumulation, and potential downstream toxicity. LR11 increase beta-amyloid production and may be a significant genetic cause of late-onset Alzheimer's disease. The authors concluded that DHA increases SOR/LR11 levels and may play an important role in preventing late-onset Alzheimer's disease.

Can commercial green tea extract ward of Alzheimer and other diseases?

[1216]
Antioxidants of green tea may reduce oxidative stress induced by a build up of beta-amyloid protein deposits and brain cell damage and death induced by Alzheimer's disease.
Haque and colleagues 2008 report that green tea extracts in the form of Mitsui Norin's commercial Polyphenon E composed of 63% of epigallocatechin-3-gallate, 11% of epicatechin, 6% of (-)-epigallocatechin and 6% of (-)-epicatechin-gallate prevents cognitive impairment in rats.

A solution of 0.5 per cent of the green tea extract was fed to rats. Haque says that humans with a body weight of 50 kg must drink 3 litres/day of such solution to have a similar dose of antioxidants used in the study. However, one litre could be sufficient if other antioxidant rich foods such as high in vitamins A, B, C and E as well as polyphenols were in the every day's diet.

The authors concluded that long-term administration of this commercial green tea extract prevents cognitive deficits caused by oxidative stress, beta-amyloid-induced in rats. The authors stress that it is not known if same positive effects may result in humans.

The food industry eager to present new functional qualities which may be hailed in marketing strategies, is increasingly focused on green tea as ice tea, energy bars, dairy products and backery products. Microencapsulation is being used to hide the bitter note of commercial green tea extracts.

In his study Hague and colleagues point to the fact that a high amount of 15 to 25 gram/day for a normal person of such commercial extracts are needed to produce the Alzheimer protective effects.

Adding traces of such extracts to all kind of foods, drinks and confectioneries will decisively improve the performance of the product on market but its health benefits may be challenged.

The consumer should be aware that these functional products cannot replace drinking green tea , having a diet rich in vegetables and fruits, reducing intake of lean calories and fat.

The role of tea in wound healing, cardiovascular-related diseases and cancer

[1217]
Restricted oxygen supply (hypoxia) such as found in altitude sickness when oxygen supply to tissue or the whole body is restricted apoptosis takes place meaning that cells die. According to Hae Jeong Park, it is an important factor in wound healing, cardiovascular-related disease and certain cancers. EGCG was found to have a beneficial effect against hypoxia-induced apoptosis for human haematoma cells.

According to Park EGCG probably prevents the expression of a certain enzyme called caspase 3, which plays a important role in programmed cell death.

FDA report on possible anti-cancer effect of green tea

[1218]
The origin, risk factors, diagnosis, and treatment for each type of cancer are unique. Since each form of cancer is a unique disease based on organ site, risk factors, treatment options, and mortality risk, each form of cancer must be individually evaluated in a health claim petition.

As a result, the agency considered whether the studies supported the potential substance - disease relationship for any type of cancer.

Two studies do not show that drinking green tea reduces the risk of breast cancer in women, but one weaker, more limited study suggests that drinking green tea may reduce this risk. According to FDA it is, therefore, highly unlikely that green tea reduces the risk of breast cancer and concludes that existing evidence does not support qualified health claims for green tea consumption and a reduced risk of any other type of cancer.


Cannabinoids

[1219]
Cannabinoids are the active components of Cannabis sativa Linnaeus (marijuana) and their derivatives. Cannabinoids received renewed interest in pharmacology in recent years due to their diverse activities such as cell growth inhibition, anti-inflammatory effects and tumour regression.

Results of studies suggest that WIN-55,212-2 or other non-habit-forming cannabinoid receptor antagonists could be developed as novel therapeutic agents for the treatment of prostate cancer.


Black Tea and post-stress recovery

[1220]
Andrew Steptoe and colleagues in a study concerning black tea, found that 6 weeks of tea consumption leads to lower post-stress cortisol and greater subjective relaxation, together with reduced platelet activation. Black tea may have health benefits in part by aiding stress recovery. Speeding the recovery following acute stress may reduce risk of chronic illnesses such as coronary heart disease.

50 minutes after a stress situation, lower cortisol levels, a lower blood platelet activation, and a greater degree of relaxation in the recovery period were found in a tea drinking group, compared with a not drinking tea group.

Because of the complex composition of tea comprising catechins, polyphenols, flavonoids and amino acids, no compound, either independently or acting in synergistic could be identified to be responsible for these positive effects,

Green Tea has better health benefits than black tea
Green tea contains between 30 and 40 per cent of water-extractable polyphenols, while black tea contains between 3 and 10 per cent. Epigallocatechin gallate (EGCG), epigallocatechin, epicatechin gallate, and epicatechin are being found in fresh tea leaves and are subject of numerous researches.

Green tea and rheumatoid arthritis

[1705]
Salah-uddin Ahmed and colleagues in a study evaluated the efficacy of Epigallocatechin-3-gallate (EGCG), a polyphenol extracted from green tea on in multiple myeloma (MM). The authors found that the tea extract may suppress the inflammatory products in the connective tissue of people with rheumatoid arthritis due to its ability to modulate growth factor-mediated cell proliferation.

EGCG induced both dose- and time-dependent growth arrest and subsequent apoptotic cell death in MM cell lines also led to significant apoptosis in human myeloma cells grown as tumors in SCID mice.

EGCG activates distinct pathways of growth arrest and apoptosis in MM cells by inducing the expression of death-associated protein kinase 2 rising hope for therapies using the specific antimyeloma activity of EGCG.

Synovial fibroblasts - cells that form a lining of the tissue surrounding the capsule of the joints - from patients with rheumatoid arthritis , under the influence of pro-inflammatory cytokine interleukin-1 beta (IL-1beta), produced molecules of interleukin-6 (IL-6) and cyclooxygenase-2 (COX-2) which is linked to joint destruction during rheumatoid arthritis. With EGCG the production of IL-6 and COX-2 was not observed.

Epilocathechin-3 gallate and multiple myeloma [1706]
Masahiro Kisaki and colleaugue (2005) found that epigallocatechin-3-gallate from green tea has potential as a novel therapeutic agent for patients with B-cell malignancies including multiple myeloma via induction of apoptosis mediated by modification of the redox system, and enhances. As2O3-induced apoptosis in human multiple myeloma cells.

Green Tea reduces colorectal cancer risk in women

[1707]
Tea and its constituents have shown anticarcinogenic activities in in vitro and animal studies. Epidemiologic studies, however, have been inconsistent.

Green tea contains between 30 and 40 per cent of water-extractable polyphenols, such as epigallocatechin gallate, epigallocatechin, epicatechin gallate, and epicatechin, while black tea contains between 3 and 10 per cent.

Gong Yang assessed green tea consumption and colorectal cancer risk and rectal cancers. The researchers found an inverse dose-response relationship between the amount of tea consumed and duration in years of lifetime tea consumption This study suggests that regular consumption of green tea may reduce colorectal cancer risk in women.

Benefits of Mediterranean diet [1708] [1709] [1698] Studies published in 2006 suggest that Mediterranean diet, rich in fruit, vegetables and olive and sparing in red meat and dairy products has been associated with a lower risk for several diseases and risk factors, including cancer, obesity, high cholesterol, high blood pressure and problems with processing glucose that may lead to diabetes, coronary heart disease, reduction of the risk of Alzheimer disease. According to the studies, the diet should contain turmeric and omega-3 fatty acids.

Celiac disease

[1699]
Celiac disease, coeliac disease or sprue, is a condition in which genetically predisposed people have an autoimmune reaction to gluten proteins found in all wheat types and closely related cereals such as barley and rye. These autoantibodies destroy of the villi in the small intestine, which results in malabsorption of nutrients.

This autoimune reaction is caused by a response to gliadin, a gluten protein found in wheat (and similar proteins of the tribe Triticeae which includes other cultivars such as barley and rye).

Upon exposure to gliadin, the enzyme tissue transglutaminase modifies the protein, and the immune system cross-reacts with the bowel tissue, causing an inflammatory reaction that leads to flattening of the lining of the small intestine, which interferes with the absorption of nutrients. The only effective treatment is a lifelong gluten-free diet.

Increased risk of colorectal cancer recurrence associated with The high calorie, low fibre dietary pattern

[1700]
Jeffrey Meyerhardt and colleagues from the Dana-Farber Cancer Institute, studied the association of dietary pattern and risk of cancer recurrence in stage III colon cancer patients. They found that a diet characterized by higher intakes of red and processed meats, sweets and desserts, French fries, and refined grains increases the risk of cancer recurrence and decreases survival.
The authors say that eighty per cent of colorectal cancers may be preventable by dietary changes.

The researchers compared dietary pattern characterized by high intakes of fruits and vegetables, poultry, and fish with the Western pattern, characterized by high intakes of meat, fat, refined grains, and dessert.

The researchers found that a diet with a higher correspondence to the Western dietary pattern after cancer diagnosis were at a significant increase in the risk of cancer recurrence or death. The top 20 per cent of people with the greatest Western-style diet were 3.3 times more likely to have cancer recurrence or death that those with least Western-style diet.

The European Prospective Investigation into Cancer and Nutrition (1993-2000)

[1701]
A study by E. Kesse and colleagues concerning the data of the European Prospective Investigation into Cancer and Nutrition (1993-2000), linked people with a "Western" diet pattern to a significantly increased risk of the cancer.

The study made a comparison between four dietary patterns:
"Healthy": (Vegetables, fruit, yogurt, sea products, and olive oil). This diet was found to have the lowest recurrence risk of all other diets.
"Western": (Potatoes, pizzas and pies, sandwiches, sweets, cakes, cheese, cereal products, processed meat, eggs, and butter). An increased risk of adenoma with high scores of a higher risk of colorectal tumors was observed.
"Drinkers": (Sandwiches, snacks, processed meat, and alcoholic beverages). High risc of found.
"Meat eaters": (Meat, poultry, and margarine). It was positively associated with colorectal cancer risk.

Western diet and high fructose diet blamed as "toxic environment"

[1702]
Robert Lustig from the University of California blames the "toxic environment" of Western diets to cause hormonal imbalances that encourage overeating by its increased energy density, high-fat content, high glycemic index, increased fructose composition, decreased fiber, and decreased dairy content.
Lustig blames in particular, too much fructose and not enough fiber as the cornerstones of the obesity and diabetes epidemic.


No difference in the acute effects on vascular reactivity between conventional fast-food and "healthy fast-food"

[1703]
Tanja K Rudolph and colleagues 2007, in a study from the University Hospital Hamburg-Eppendorf, Germany looked for the acute effects of conventional and alternative fast-food meals on vascular function investigating the flow-mediated endothelium-dependent dilatation (FMD) and cardiovascular disease risk markers before and after a conventional beef burger meal and healthier choices.

The researchers found that a conventional beef burger meal with French fries, ketchup and soda, did not differ significantly in their acute effects on vascular reactivity. compared with a vegetarian burger with French fries, ketchup and soda and the vegetarian burger with salad, fruit, yogurt, and orange juice The authors attribute the postprandial decline in FMD in part to a postprandial increase in baseline arterial diameter.

Fast-food remains unhealthy. Addingvegetables and orange juice does not present the variety of Mediterranean diet, according to the findings of the Melbourne Collaborative Cohort Study:


The Melbourne Collaborative Cohort Study: The combination of the ingredients of the Mediterranean diet and not vegetable and fruit considered separately reduce heart disease risk [1704]

The Mediterranean diet has higher intake of plant foods and fish, moderate intake of wine and lower intake of animal products. It includes garlic, cucumber, olive oil, salad greens, capsicum, legumes, tomato, feta and ricotta cheeses, olives, onion, watermelon, steamed fish and boiled chicken. It is therefore a rich source of antioxidants reducing oxidative damage, monounsaturated fat that help to lower cholesterols, omega- 3 fatty acids believed to stabilise the heart rhythm, and fibre, and relatively low in saturated fats which in combination may help to reduce cardiovascular disease.
Despite increased cardiovascular disease risk factors, migrants to Australia from Mediterranean countries have lower mortality than do native-born Australians.

The researchers found for the Mediterranean-style diet 41 per cent reduction, while for vegetables and fresh fruit considered separately, only 31-34 per cent mortality from cardiovascular disease (CVD)risk reduction was observed.

The authors concluder that frequent consumption of traditional Mediterranean foods is associated with reduced cardiovascular mortality after controlling for important risk factors and country of birth.


Vegetarian nutrition

Vegetarian nutrition may lead to undersupply of iron, proteins, calcium, vitamin D and vitamin B12.
Iron can be got from wholemeal bread and green vegetable such as broccoli or kale (Brassica oleracea sabellica). Proteins are get from vegetables wholemeal bread, cereals, legumes, nuts, milk, cheese and yoghurt. Calcium, vitamin D and vitamin B12 can be supplied by milk and milk products.

Calcium supplementation is usually found in vitamin and mineral supplement formulas as calcium hydrogen phosphate. Gadot Biochemical company, however, offers a citrate based calcium compound, designed to supplement liquid food products conveniently with a readily absorbable form of calcium. The company claims the product to be suitable for soy milk and other soy based products, rice milk and other dairy alternative beverages fortification. According to Gadot specification it is free of raw materials from bovine origin and any food allergens according to annex 3a of EU directive 2003/89.

Although soymilk is recognized as a nutritious beverage, it contains much less calcium than cowmilk (20-30 mg/100 ml vs. 100-120 mg/100 ml), so fortification is essential.

Potassium, the major intracellular cation in the body, is required for normal cellular function. Severe potassium deficiency is characterized by hypokalemia. Moderate potassium deficiency, which typically occurs without hypokalemia, is characterized by increased blood pressure, increased salt sensitivity, an increased risk of kidney stones, and increased bone turnover (as indicated by greater urinary calcium excretion and biochemical evidence of reduced bone formation and increased bone resorption).

An inadequate intake of dietary potassium may also increase the risk of cardiovascular disease, particularly stroke. On the basis of available data, an Adequate Intake (AI) for potassium is set at 4.7 g (120 mmol)/day for all adults. This level of dietary intake (i.e., from foods) should maintain lower blood pressure levels, reduce the adverse effects of sodium chloride intake on blood pressure, reduce the risk of recurrent kidney stones, and possibly decrease bone loss.
It is generally agreed that the bioavailability of Organic Calcium is much higher than Inorganic Calcium. From the litreature it appears that the bioavailability of Organic Calcium is 2 to 5 times higher than Calcium Carbonate.
On the other hand, the various organic forms of calcium show more or less the same bioavailability with slight advantage to Calcium Citrate. In addition, potassium/calcium combination may enhance calcium absorption. GADOCAL K contains therefore 15 % calcium and 6 % potassium. [1034]

Salt intake and hypertension

He and Mac Gregor 2004 assessed the effect of the modest reduction in salt intake recommended by WHO 2003, SACN 2003 and Whelton 2002, and looked at the magnitude of the reduction in blood pressure in relation to the magnitude of the reduction in salt intake.

The authors concluded that a modest and long-term reduction in population salt intake could reduce strokes, heart attacks, and heart failure, and there is a correlation between the magnitude of salt reduction and the magnitude of blood pressure reduction. They suggest a daily intake range of 3 to 12 g/day. [1041]

Heikki Karppanen and Eero Mervaala in 2006 wrote that the level of sodium is very high, whereas that of potassium, calcium, and magnesium is low compared with the level in diets composed of unprocessed, resulting in hypertension. The authors stress that reductio of salt intake, both alone and particularly in combination with increases in intakes of potassium, calcium, and magnesium, is able to lower average blood pressure levels substantially. [1042]

He, Marrero and MacGregor in a study in 2007 note that an increase of 1 g/day in salt intake was related to an increase of 0.4 mm Hg in systolic and 0.6 mm Hg in pulse pressure. Their study provides further support for a reduction in salt intake in children and adolescents. [1043]

Alderman commenting the study of He and colleagues 2007 point to the fact that measures of discretionary sodium use did not correlate with blood pressure, supporting the Cochrane Collaboration conclusion that there was not sufficient evidence for a general dietary recommendation to reduce sodium intake.

Alderman writes that the findings in adults are probably true for youngsters as well. However, lowering sodium intake increases sympathetic nerve activity, reduces insulin sensitivity, increases the activity of the renin-angiotensin system, and increases aldosterone secretion.

The author of the comment asks the question if these or other changes occur in children and call for solid knowledge based on evidence of benefit and risk preceding any clinical or public health intervention. The outcomes of such interventions should be tested in clinical trials to avoid doing harm. [1044]

He, Marrero and MacGregor reviewed the evidence that relates salt intake to blood pressure and cardiovascular disease. They concluded that reducing salt from the current intake of 10-12 g/day to the recommended level of 5-6 g/day will have a major effect on blood pressure and cardiovascular mortality. [1047]

Table grape reduced salt-sensitive hypertension

[1046]
According to Seymor and colleagues 2008 eating grapes reduce salt-sensitive hypertension in elderly people. In this strudy a high salt diet with grape powder lowered blood pressure and improved cardiac function, compared with a high salt diet without grape powder supplement.The grape powder diet reduced systemic inflammation; reduced cardiac hypertrophy, fibrosis, and oxidative damage; and increased cardiac glutathione.

The authors concluded that intake of phytochemical such as table grape powder reduce salt-sensitive hypertension and diastolic dysfunction.


Low birth weight is associated with salt sensitivity

[1045]
Dr Giacomo Simonetti and colleagues 2008 found that children aged between 7 and 15 who had low birth weights are more likely to be salt sensitive, have increased blood pressure with higher intakes of salt, than children of the same age with normal birth weights, and are more likely to develop hypertension, cardiovascular disease, and renal disease later in life. Salt sensitivity was present in 37% and 47% of all of the low birth weight and small for gestational age children, respectively, kidney length.

The authors believe that that smaller kidneys leading to salt sensitivity is probably one reason of that. They recommend that low-birth-weight infants avoid a lifelong excessive salt intake. They stress that fast food may also be harmful to these persons. Infants with low birth weights frequently come from complicated pregnancies. A healthy lifestyle during pregnancy is therefore beneficial for mother and newborn. They call for more studies on this subject.

Conversion salt and sodium
Sodium is responsible for elevated blood pressure, heart diseases and stroke.
UK Food Standards Agency recommends not to eat more than 6g salt a day and provides a salt calculator at http://www.salt.gov.uk/how_much_is_6.shtml

In 1994, the Committee on Medical Aspects of Food and Nutrition Policy (COMA) recommended reducing the average salt intake of the population from 9g to 6g a day because of the link between high salt intake and high blood pressure.

National guidance regarding salt varies in Europe. Belgium recommends less than 8.75 grams a day. Portgual recommends less than 5g and countries such as Greece and Hungary advice people to avoid salt and foods rich in salt.

The WHO intake goal: It is less than 5g per day and is contained in the joint WHO/FAO report on diet, nutrition, and the prevention of chronic diseases.

The Expert Report's specific recommendations on diet include limiting fat to between 15 and 30 percent of total daily energy intake and saturated fats to less than 10 percent of this total. Carbohydrates, the report suggests, should provide the bulk of energy requirements - between 55 and 75 percent of daily intake and free sugars should remain beneath 10 percent. Protein should make up a further 10-15 percent of calorie intake and salt should be restricted to less than 5 grams a day. Intake of fruit and vegetables should be plumped up to reach at least 400 grams a day. [1035]

Australia, New Zealand, Canada and U.S. have a guidance of less than 6g salt intake/day.

Singapore recommends less than 5g/day and Japan has a guidance of less than 10g salt/day. Brazil has a guidance of less than 5g salt intake/day all other countries of South America have no guidance on this matter, remaining a lot of work to be done by WHO to convince these countries to tackle the problem of salt-reduction.

Consensus Action on Salt and Health: This organization urges consumers to boycott foods that contain either more than 1.25g of salt (0.5g of sodium) per 100g or more than 2.4g of salt per serving, forcing manufacturers to reformulate excessively salty foods. World Action on Salt and Health (WASH) was established in 2005 and is a global group with the mission to improve the health of populations throughout the world by achieving a gradual reduction in salt intake. [1036]

Salt reduction- Lower Sodium Intake Recommendations to Adults

USA

[1037]
According to the CDC actually about 70 percent of American adults fall into categories (African Americans, people over 40, and people with existing hypertension) of people who should consume no more than 1,500 mg of sodium per day. But to achieve recommended intakes, even most of the remaining 30 percent of adults should cut back, too.

CDC says that the average sodium consumption for people aged 2 and over is about 3,400 mg per day. Recommended are a maximum of 2,300 mg daily for people who aren't in the categories above. The Center for Science in the Public Interest notes that the 3,400-mg figure comes from a national survey that does not include salt added at the table or during home cooking and does not correct for the participants' underreporting of foods eaten. Actual average consumption is probably closer to 4,000 mg. [1038]

UK

[1039]
The Food Standards Agency has set a target of reducing the average salt consumption of adults to 6g a day by 2010. The Scientific Advisory Committee on Nutrition (SACN) also set lower recommended maximum levels of salt intake for babies and children for the first time.

European Food Safety Authority

[1040]
Mean daily sodium intakes of populations in Europe range from about 3-5 g (about 8-11g salt) and are well in excess of dietary needs (about 1.5 g sodium/day in adults). The main source of sodium in the diet is from processed foods (about 70-75% of the total intake), with about 10-15% from naturally occurring sodium in unprocessed foods and about 10-15% from discretionary sodium added during cooking and at the table.

Claims

[1962]

Low Sodium/Salt:

A claim that a food is low in sodium/salt, and any claim likely to have the same meaning for the consumer, may only be made where the product contains no more than 0,12 g of sodium, or the equivalent value for salt, per 100 g or per 100 ml. For waters, other than natural mineral waters falling within the scope of Directive 80/777/EEC, this value should not exceed 2 mg of sodium per 100 ml.

Very Low Sodium/Salt:

A claim that a food is very low in sodium/salt, and any claim likely to have the same meaning for the consumer, may only be made where the product contains no more than 0,04 g of sodium, or the equivalent value for salt, per 100 g or per 100 ml. This claim shall not be used for natural mineral waters and other waters.

Sodium-Free or Salt-Free:

A claim that a food is sodium-free or salt-free, and any claim likely to have the same meaning for the consumer, may only be made where the product contains no more than 0,005 g of sodium, or the equivalent value for salt, per 100 g.

Labels:

Sodium is usually listed in the nutritional information on food labels. If salt is listed, sodium chloride is meant.

Conversion Salt to sodium and sodium to salt Conversion Potassium chloride and potassium Salt replacer
Blends of KCl (potassium chloride), sugar, yeast extract, and flavours are being developed to hide the bitterness of potassium chloride,with salty perception but does not work against the active yeast of a dough system.

Gender/Age Fibre, g Sodium, mg Potassium, mg
1-3 y 19 $<$1500 3000
4-8 y      
Female 25 $<$1900 3800
Male 25 $<$1900 3800
9-13 y      
Female 26 $<$2200 4500
Male 31 $<$2200 4500
14-18 y      
Female 29 $<$2300 4700
Male 38 $<$2300 4700


Prehypertension in young adulthood increases risk of atherosclerosis

[1221]
Prehypertension is defined as systolic blood pressure (BP) 120 to 139 mm Hg or diastolic BP 80 to 89 mm Hg. Recently, attention is driven to the fact that prehypertension, blood pressure levels lower than those usually considered abnormal might still be harmful. The effect of prehypertension on risk for heart attacks and strokes is not entirely clear. However, studies found that hypertension increases coronary artery calcium which is associated with heart attacks and strokes. Coronary calcium can be detected by computed tomography scan.

In a study, using data of the Coronary Artery Risk Development in Young Adults (CARDIA), Mark J. Pletcher and colleagues 2008 found that prehypertension during young adulthood is common and is associated with coronary atherosclerosis 20 years later.

The authors recommend to keep systolic pressure below 120 mm Hg before age 35 years to avoid ailments in advanced age. Pletcher points to the national guidelines, which say that people with prehypertension should work on diet, exercise, and lifestyle modifications in order to prevent hypertension

Dietary fibre recent studies on colorectal cancer
Denis Burkitt proposed in 1971 the link between colorectal cancer and dietary fibre. Inconsistent results of studies could not back this theory.

A new study of Elizabeth Jacobs from the Arizona Cancer Center, however considered the sex of the participants and found a significant benefit of fibre for men, but not for women. This may explain the discrepant results of the Wheat Bran Fibre Trial and the Polyp Prevention Trial. [1222]

The Wheat Bran Fibre Trial assessed the effect of a high wheat bran fibre supplement against a low wheat bran fibre supplement men and women, randomly assigned to the supplements. The Polyp Prevention Trial studied the effect of a low-fat, high fibre diet, rich in fruit and vegetables on the recurrence of pre-cancerous polyps in the colon and rectum.

Both studies reported that the high-fibre diets had no effect of the recurrence of colorectal polyps.

The Arizona researchers from the Arizona Cancer Center re-evaluating the data of both studies observed statistically significant reduced odds of recurrence for men, but no significant association for women. [1222]

The recently published results of the Women's Health Initiative (WHI) trial also reported no link between a diet low in fat, and high in fruit, vegetables and whole-grain intake. This study was restricted to women and appears to agree with the results from Arizona. Poor compliance with the dietary intervention in the WHI trial do, however, raise questions about the validity of these results. [1223]

Limitations of the two studies (Wheat Bran Fibre Trial and the Polyp Prevention Trial): 1.- Both had very short follow-up periods of only two to four years The latency period of the cancer is between 10 and 20 years, 2.- The use of polyps as a marker for actual cancer was criticized as questionable by Dr. Arasaradnam from Northern General Hospital in Sheffield in 2004. [1224]

Concorde grape:
Vitis labrusca (Fox grape) is a specific grape native in the northeast of the United States. It is the source of many grape cultivars, including concord grapes. The characteristic "foxy" musk of V. labrusca is inherited by the Concorde grape. [1225]

A study performed by lead author Barbara Shukitt-Hale the Human Nutrition Research Center on Aging at Tufts University relate improved results on behavioural tests and enhanced motor performance on rats fed with Concorde grape juice, which is rich in polyphenoles. The study suggests that the effects of Concorde grape juice may be more effective than any one single Hopes are rising that component of grape juice may reverse brain aging. [1226]

Concord grapes may have many health benefits such as reducing hypertension and the negative effects of second-hand smoking, but these results are tentative. [1227]

Cardiovascular protection of red wine and white wine

[1228] M. Falchi and colleagues found that the flesh of grapes are equally cardioprotective as skin, and antioxidant potential of skin and flesh of grapes are comparable with each other despite of the fact that flesh does not possess any anthocyanin activities.

Recent studies have documented that grapes and grape juices are equally cardioprotective as red wine. despite vastly differing polyphenol content.

Several studies have linked regular consumption of red wine to reduced risk of heart disease. The skin of red grapes is a rich source of red coloured anthocianine. Red grapes are usually crushed whole, meaning the anthocyanines are transferred to resulting wine and juice, on the contrary, most white wine or white grape juices are prepared by discarding the grape skin, nourishing the belief that red wines and red grape juice are healthier than white.

M. Falchi fed three groups of rats with water only (control), grape skin extract, or grape flesh extract. The increase of malondialdehyde (MDA), a reactive carbonyl compound related to oxidative stress, was measured under ischemic and myocardial infarction conditions.

No difference was observed between the flesh and skin extracts, both groups had significantly reduced heart attack size compared with water control group.

Quantification of the polyphenol content confirmed that, while the skins had anthocyanin concentrations of about 128 milligrams per 100 grams, the flesh contained no such compounds.

However, the radical scavenging abilities of both the flesh and skin extracts were found to be the same. The flesh of the grapes did contain polyphenols but not of the anthocyanin type of grape skin. Furthermore caffeic acid, caftaric acid, and coutaric acid have been reported which are also present in white grape varieties.

Red wine and reduction of atherosclerosis [1229]
Tony Hayek and colleagues studied the effect of consuming red wine, or its major polyphenol constituents catechin or quercetin, on the development of atherosclerotic lesions, in relation to the susceptibility of plasma LDL to oxidation and to aggregation in mice.

They found that the inhibition of LDL oxidation by polyphenols could be related, at least in part, to a direct effect of the polyphenols on the LDL, since both quercetin and catechin were found to bind to the LDL particle via the formation of an ether bond.

The authors conclude that dietary consumption of red wine or its polyphenolic flavonoids quercetin and, to a lesser extent, catechin leads to attenuation in the development of the atherosclerotic lesion, and this effect is associated with reduced susceptibility of their LDL to oxidation and aggregation.

Concentrated red grape juice reduces risk of cardiovascular disease [1230]
The aim of the study was to study the effects of dietary supplementation with concentrated red grape juice, a source of polyphenols, on lipoprotein profile, antioxidant capacity, LDL oxidation, and inflammatory biomarkers.

The authors concluded that dietary supplementation with concentrated red grape juice improves the lipoprotein profile, reduces plasma concentrations of inflammatory biomarkers and oxidized LDL, and may favor a reduction in cardiovascular disease risk.

Importance of polyphenols in meals

[1231]
Polyphenols were found to prevent cardiovascular disease, but their mechanisms of action are not understood. Gorelik and colleagues investigated the impact of red wine polyphenols on postprandial cytotoxic lipid peroxidation products urine malondialdehyde (MDA) levels in humans, resulting from fat digestion. MDA is known as a risk of cardiovascular disease and other illnesses.

The authors found that red wine polyphenols exert a beneficial effect by the novel new function, absorption inhibition of the lipotoxin MDA. These findings explain the potentially harmful effects of oxidized fats found in foods and the important benefit of dietary polyphenols in the meal.


Nutrition claims in the Philippines

The US company Procter & Gambler has launched on the Philippines market a concentrated orange powder "NutriDelight". This orange juice in form of a dehydrated powder is enriched with vitamin A, iron and iodine.
This product is claimed to " let children grow stronger, taller, and smarter.
According to P&G director Durk Jager the undersupply of these three elements is one of the most outstanding problem of worldwide nutrition. The "Nutridelight" according to Jager has been developed in cooperation with Health departments and UNICEF and was tested in Tanzania. This product may have importance in the nutrition of a wide population in case of undersupply during catastrophes where international associations try to feed people of a limited region to overcome a short period of calamity. It not suitable for the nutrition at normal times. The population which has no money to buy a balanced natural nutrition will certainly have not the possibility to achieve orange juice powder enriched with food supplements from Procter & Gambler.
Health authorities should try to get the population educated in a way to get a well balanced nutrition with local fruits,vegetables, fish and meat.
Getting back to the elementary balanced nutrition helps although the local industry, fishery and agriculture bringing jobs and the most important of all: It gives thousand and thousand all other components which are necessary to our nutrition avoiding synthetic food from pills and pharmacy.

Complete low caloric servings

Low caloric serving "pro figur" are servings of 250 g of yoghurt enriched with vitamins, pineapple, cereals vitamins and minerals. The servings are to small to avoid hunger. Artificial sweetener are used not being in consent to an organic food. The amount of cereals should be increased. the flavouring of the product is very intensive turning it very soon to be felt awful. Intensive flavouring should always be avoided in products which are supposed to be used over a long time.
It is advisable to go back to the recommendations of the health departments and associations like the DGE in order to reduce or to avoid overweight:
1.- Increase the amount of vegetables and fruits.
2.- Reduce fat
3.- Eat fish
4.- Practice sport to burn excessive calories.
These recommendations lead to normal weight without synthetic modified foods. The main goal which Nestlé tries to achieve with "profigur" is to boost sails taking out sails from drugstores where low caloric ready servings are well sold. However even there these servings have proven to bring no success on lasting weight reduction.


Low fat nutrition

[914] Low fat nutrition has proved to be suitable to reduce body weight.
The Ernärungsphychologische Forschungsstelle in Göttingen[914] (Nutrition Psychology Research Center in Göttingen) has made a study related to body weight reducing diet changing from high fat to low fat nutrition. High fat sausages and cheese types were exchanged by low fat foods. Milk and yoghurt with 1,5 % fat were taken in the nutrition plan. Whipped-cream gateau was exchanged with fruit tart with a bottom of yeast pastry. Foods based on carbohydrates such as vegetables and fruits were unlimited allowed.
The result of this study was successful. In 8 weeks weight reduction of 1,5 up to 2,9 Kg took place. This nutrition should be used to body weight reduction instead of pills or special foods which cannot be consumed a whole life.
The low fat nutrition keeping the old nutrition habits can be followed for an unlimited period. It is therefore an alternative to the reduction diets which can be followed only during short time ending in the jo-jo effect.

Two-part drink to promote satiety

[915]
Pelkman and colleagues designed a two-part beverage (a solution of alginate-pectine and a solution of calcium) producing a stable, high-fibre gel in the stomach, thereby avoiding adverse palatability of the highly viscous fibre. The drinks were administered twice a daily. A significant reduction in food intake was observed.

According to the authors the gel delays the absorption of nutrients stimulating the formation of incretins, which are gastrointestinal hormones, like glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP), that cause an increase in the amount of insulin released from the beta cells of the islets of Langerhans after eating. They also slow the rate of absorption of nutrients into the blood stream by reducing gastric emptying and may directly reduce food intake. [916]

The authors concluded that foods designed to enhance satiety may be an effective adjunctive therapy for weight loss and call for more studies on this subject.

Recommended Dietary Allowance (RDA) and Dietary Reference Intakes (DRI)

History of RDA [103]
The RDA was developed during World War II by lydia J. Roberts, Hazel K. Stiebeling and Helen S. Mitchel under the auspices of the National Research Council. The National Research Council determined that a set of dietary standards were needed, especially given the possibility that rations would be needed during the war.

The standards would be used for nutrition recommendations for the armed forces, for civilians, and for overseas population who might need food relief. Roberts, Stiebeling, and Mitchell surveyed all available data, created a tentative set of allowances, and submitted them to experts for review. The final set of allowances were accepted in 1941. The allowances were meant to provide superior nutrition for civilians and military personnel, so they included a "margin of safety."

The RDA was established by the Food and Nutrition Board of the (US) National Academy of Sciences.

In 1997 at the suggestion of the Institute of Medicine of the National Academy RDA became one part of a broader set of dietary guidelines called the Dietary Reference Intake used by both the United States and Canada.

RDA inclusion in DRI family [104]
The Recommended Dietary Allowances (RDAs) had been valid from 1941 until 1989, the RDAs to evaluate and plan menus that would meet the nutrient requirements of groups as well as other applications such as interpreting food consumption records of populations, establishing standards for food assistance programs, establishing guidelines for nutrition labelling, to name a few. The RDAs were created to prevent nutrient deficiencies. They were not intended to evaluate the diets of individuals.

Dietary Reference Intakes (DRIs) family In 1997, the Food and Nutrition Board of the National Academy of Sciences created the Dietary Reference Intakes (DRIs) after a extensive revision of the RDAs. The new family of nutrient reference values is organized in four types of DRI reference values:
  1. Estimated Average Requirement (EAR): A daily nutrient intake value that is estimated to meet the requirement of half of the healthy individuals in a life stage and gender group. EAR is used to assess dietary adequacy and as the basis for the RDA.
  2. Recommended Dietary Allowance (RDA):The average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97 to 98%) healthy individuals in a particular life stage and gender group.
  3. Adequate Intake (AI): a recommended intake value based on observed or experimentally determined approximations or estimates of nutrient intake by a group (or groups) of healthy people, that are assumed to be adequate. AI is used when an RDA cannot be determined.
  4. Tolerable Upper Intake Level (UL): The highest level of daily nutrient intake that is likely to pose no risk of adverse health effects for almost all individuals in the general population. As intake increase above the UL, the potential risk of adverse effects increases.
These dietary reference values were intended to prevent nutrient deficiencies and to reduce the risk of chronic diseases such as osteoporosis, cancer, and cardiovascular disease.

Critical Issues in the Application of Dietary Reference Intakes [105] [106]
Dr. George Beaton, University of Toronto, examining application of the Dietary Reference Intakes (DRI) among individuals and groups comes to the conclusion that the RDA lacks an acceptable scientific basis and suggests that dietary advice for both groups should be achieved through critical DRI reference values.

According to Beaton, tradition and the DRI reports themselves have created an erroneous impression that the Recommended Dietary Allowance (RDA) is intended for use with individuals, while the Estimated Average Requirement (EAR) is to be used with populations.

He concludes that the median requirement and Tolerable Upper Limit (UL) are the critical reference values for both individuals and populations. The RDA is both unneeded and lacking a sound scientific basis.

Defending RDA [107]
According to Murphy, Barr, and Yates, Dietary each DRI category has specific uses in dietary assessment and/or planning for groups or individuals. For example, the RDA is "intended to be used as a goal for daily intake by individuals as this value estimates an intake level that has a high probability of meeting the requirement of a randomly chosen individual." The DRI paradigm is being used as a model for nutrient standards worldwide. The authors argue in favour of keeping the present thinking about it the uses of nutrients.

Beaton replied that we now live in an era of increasing demand for evidence-based nutrition and stresses the necessity of revising previous thinking and approaches as it becomes apparent that they lack evidence of validity.

Actual dietary references set from US Food and Drug Administration FDA

DVs (Daily Values): The use of Dvs on the food label started in 1994, following the US Nutrition Labelling and Education Act of 1990. [108]

It is made up of two sets of references, DRVs and RDIs. But, according to Paula Kurtzweil from FDA, these two sets are "behind the scenes" in food labelling; only the Daily Value term will appear on the label to make label reading less confusing.[108]

The labelling act from 1990 requires nutrition label information to be conveyed in a way that enables the public to observe and comprehend the information readily and to understand its relative significance in the context of a total daily diet. [108]

According to Christine Lewis from FDA's Office of Food Labelling, the DV does that in two ways: First, it serves as a basis for declaring on the label the percent of the Daily Value for each nutrient that a serving of the food provides. [108]

For example, the Daily Value for fat, based on a 2,000-calorie diet, is 65 grams (g). A food that has 13 g of fat per serving would state on the label that the "percent Daily Value" for fat is 20 percent. Second, it provides a basis for thresholds that define descriptive words for nutrient content, called descriptors, such as "high fibre" and "low fat." For example, the descriptor "high fibre" can be used if a serving of food provides 20 percent or more of the Daily Value for fibre - that is, 5 g or more. [108]

URLs (Daily Reference Values): a set of dietary references that applies to fat, saturated fat, cholesterol, carbohydrate, protein, fibre, sodium, and potassium.
RDIs (Reference Daily Intakes): a set of dietary references based on the Recommended Dietary Allowances for essential vitamins and minerals and, in selected groups, protein. The name "RDI" replaces the term "U.S. RDA."
RDAs (Recommended Dietary Allowances): a set of estimated nutrient allowances established by the National Academy of Sciences. It is updated periodically to reflect current scientific knowledge.

References on dietary references and dietary supplements

For more informations on US FDA dietary references, please go to their homepage of http://www.fda.gov/fdac/special/foodlabel/dvs.html

For more informations on dietary supplements please go to http://vm.cfsan.fda.gov/dms/supplmnt.html

Vitamins and essential elements

The WHO (World health Organization of the United Nations) has recommended the Daily Allowance(RDA) of vitamins and minerals given in the table below.
Linus Pauling and a group of his followers claim higher doses.
The table draws a comparison between WHO and other recommended doses.
The recommendations of WHO should be followed as the doses marked ***are likely to be considered as overdose when used for long time.
You may find the table of RDA useful to compare with the labeling of your food complements.
Vitamin or mineral RDA minimum daily maximum
Vitamin C (ascorbic acid) 60 mg 500 2000 10.000
Vitamin E (d-alfa tocopherol) 10 I.U. 400 600 1.000
Beta carotene   0 mg 15 15
Vitamin B1 (thiamine) 1,0-1,4 mg 10 50 100
Vitamin B2 (riboflavin) 1,2-1,7 mg 10 50 100
Vitamin B3 (niacinamide) 18 mg 10 50 100
Vitamin B6 (pyridoxine) 2,2 mg 10 50 50
Pantothenic acid 4-7 mg 50 100 200
Folic acid   400$\mu$ 1.000 5.000
Biotin 100-200$\mu$g 0 300 300
Vitamin D 200-300 I.U. 0 200 400
Vitamin K 70-120$\mu$g 0 0 120
Selenium   100$\mu$g 150 200
Chrome picolinate   200$\mu$g 200 400
Zinc   15 mg 15 30
Calcium   500 mg 1.000 1.500
Magnesium   200mg 400 600
Iodine 150$\mu$g 150 150 300
Bioflavonoid   0 200mg 1.000
Garlic   0 600 mg 900
Concentrated fish oil   0 1.000 mg 2000
Glutathione   0 50 mg 100
Glutamine   0 2.000 mg 8.000
Coenzyme Q10   0 30 mg 240
Ginkgo biloba Egb 761   0 120 mg 120
Iron 0-18 mg 0 0 5
Copper 2-3 mg 0 2 3
Manganese 2,5-5,0 mg 0 2,5 5,0
Molybdenum 0,15-0,5 mg 0 0,15 0,5
Fluor   0mg 0 0
Vitamin or mineral RDA minimum daily maximum


Vitamin B6 overdose

Heavy overdose of vitamin B6 (pyridoxine can cause alterations of mobility, psychological alterations and reactions like those of Contergan in new born.
The Committee on Toxicity of Chemicals in Food Consumer Products and the Environment (COT) gives the advice not to exceed daily 10 mg. Supplier of vitamin B6 are meat, fish, eggs, cereals and some vegetables.
Some food complements contain dose up to 100 mg. COT tries to establish a voluntary limit of vitamin B6 in food complements between manufacturers and include more informations on the label. The commission has great concern with possible about damages of the nervous System in case of over dose[109].

Other components of nutrition


The nutritional value of fats

Oils and fats have high nutritional value as they are rich in energy and act as transport medium of liposoluble vitamins. Some fatty acids cannot be synthetize by human body, they are called essential fatty acids (arachidonic acid, linoleic acid and linolenic and linolenic acid) . They are important parts of the synthesis of the hormone prostaglandin and are part of the structure of cell membrane[110].
The intake of fat, however is to high. Adults should reduce the intake of fat
There is a connection between the amount of fat consumed and arterial diseases, as well as duodenal cancer and mammal cancer.
It is advisable to reduce fat an to chose fat with high amount of polyunsaturated fatty acids.


Daily intake of fat

The European population has a daily intake of 130 to 150 gram/person/day. This should be reduced to 60 gram with maximum of 90 gram.


Recommended composition of fats

According to the DGE (Deutsche Gesellschaft für Ernährung) and WHO the intake of fat should be constituted by on third of saturated fatty acids, one third of monounsaturated fatty acids and one third of polyunsaturated fatty acids. (This rule is called "The one third rule".
The amount of saturated fatty acids in nutrition is to high.
The main source of saturated fatty acids is found in meat, sausages milk product, cakes and biscuits. This should be reduced.
Total fat intake: should not be over 30% of total energy by people with light manual work, and not over 35% of total energy by people for people with heavy manual work.
Long chain saturated fatty acids: should not be over 10% of total energy.
Polyunsaturated fatty acids: should be about 7% of total energy and up to 10% when the amount of saturated fatty acids lies over 10%.
Relation between linoleic acid (n-6) and linolenic acid (n-3): the relation should be 5:1. Monounsaturated fatty acids: can fill up to the total amount of total energy. Trans-fatty acids: should be less than 1% of total energy[1335]


Recommended intake of Cholesterol

The European daily intake is 500 to 800 mg/person/day. This should be reduced to a maximum of 300 mg/day.
Every health organization supports the theory of an excess of animal food rich in cholesterol and saturated fatty acids being the main cause of high levels of blood fats and arteriosclerosis.
Saturated fatty acids rise the blood cholesterol, accelerating the formation of arteriosclerosis.
Polyunsaturated fatty acids may help to reduce blood cholesterol.

The TRANSFACT Study says natural trans fatty acids not as detrimental to health as industrial once

[1336]
Jean-Michel Chardigny and colleagues comparing the effect of trans fatty acids (TFAs) from industrial with those of natural source found that TFAs from natural sources significantly increased HDL cholesterol increases in LDL-cholesterol concentrations in women but not in men. Large HDL and LDL concentrations were modified by TFAs from natural sources but not by those from industrially produced sources.

The authors concluded that TFAs from industrially produced and from natural sources have different effects on CVD risk factors in women. The HDL cholesterol-lowering property of TFAs seems to be specific to industrial

The position of the European Dairy Association (EDA)

[1337]
These finding were effusively belauded by the the European Dairy Association (EDA) as it came in support of the trans fatty acids of dairy. Based on the results of TRANSFACT the participants of the European Dairy Association's TFA Policy Conference in Brussels, 13 February 2008 concluded that there is no evidence on negative health effects from dairy TFA and EDA stated that dairy TFA should therefore not be taken into consideration for labelling or nutrient profiling for claims.

The Willett and Mozaffarian position

[1338]
According to Willett and Mozaffarian 2008 to reduce the intake of industrial TFA is ideally being done by replacing them with cis unsaturated fatty acids. The Danish government and the New York City have shown that the legislation to limit the use of partially hydrogenated vegetables oils in foods is feasible and effective.

Multiple committees concluded that TFA intake should be as low as possible, and continued efforts to eliminate the consumption of partially hydrogenated vegetable oils are strongly warranted. The authors stress that despite small differences between the metabolic effects of industrial and ruminant TFA, there is no compelling evidence to exclude natural TFA from the total TFA on food labels.


Blood levels of Cholesterol

It is therefore important to stop smoking, to have a healthy nutrition and practice sports.
According to the WHO healthy nutrition should have 45 to 55% complex carbohydrates, 30% of oils and fats having more than half of her fatty acids unsaturated. (Some say 10% saturated, 10% monounsaturated and 10% polyunsaturated fatty acids.) The intake of cholesterol should be under 300 mg/day and less than 5 gram of salt /day. This means nutrition rich in pasta, fish, olive oil, vegetables and fruits. The daily sport should be 30 minutes biking or walking. Infarct risk and diabetes II can so be reduced significantly. It is important to consider the fat intake not in percentage of calories but as grams of fat.[266]

Report 2008 on global tobacco control efforts

[267]
According to Dr Margaret Chan, Director-General of WHO virtually every country needs to do more to reduce tobacco consumption. The WHO Report of the Global Tobacco Epidemic presented six strategies to reverse this growing menace.

No country fully implements all of the MPOWER policies and 80% of countries don't fully implement even one policy. While tobacco control measures are sometimes controversial, they save lives and governments need to step up and do the right thing.

The six MPOWER strategies are: According to the report tobacco epidemic is shifting to the developing world.

Salt intake, Recommendations of the American Heart Association [265]
According to the American Heart Association physicians recommend keeping salt intake below 2,300 milligrams sodium (mg)(one teaspoon of salt) per day. For people with heart failure, recommended sodium intake is no more than 2,000 mg per day.

Sodium is present not alone in salt also in sodium alginate, sodium sulfite, sodium caseinate, disodium phosphate, sodium benzoate, sodium hydroxide, monosodium glutamate, sodium citrate and other ingredients.

High salt intake is the major reason of raising blood pressure, responsible for strokes and heart attacks.

Current intake in Europe varies between 10 and 15 grams/day,WHO which recommends no more than 5 grams of salt intake per day for every adult in the world.

The Consensus Action on Salt and Health, together with the UK's Specialist Advisory Committee on Nutrition, which advises the FSA, say that consumers should reduce their consumption to 6g a day.

About 80 per cent of salt is consumed through the consumption of processed food. Salt makes the product cheap, tasteless food edible, and more water to products can be added because it acts as a binder.

Robert Speiser, director of EuSalt, however, says that there is scientific evidence to suggest that reducing salt may not necessarily be in the interests of all consumers.

He says that two recent studies that concluded that there was no need to reduce salt among healthy people were neglected by regulators. According to Speiser the UK Food Standards Agency (FSA) is the only official authority to propose a signposting initiative that says it is necessary to reduce salt. The scientific evidence for this doesn't exist. Salt intake should remain determined by the needs of the individual.
The National Health and Nutrition Examination Surveys ( NHANES)1960 to 1994 shows that the intake of fat in percent has decreased but the average body weight has increased. This was caused by a steady increase of all other components of food.
The NHANES paper shows that lowering fat intake lowers total cholesterol, lowers low density lipoprotein (LDL) cholesterol, reducing cardiovascular risks, but it also reduces the high density lipoprotein (HDL) cholesterol, increasing cardiovascular risk if it drops below 35 mg/decilitre. Trevor Smith says that a blanket condemnation of saturated fats is unwise. [266]. It has been shown by Scott Grundy that stearates (saturated fatty acids) does not raise blood cholesterol.[268] Lowering fat intake often lowers HDL cholesterol.
According to Trevor Smith it is sufficient to limit the fat intake to an average of one gram per kilogram of body weight, or target body weight per day. There is no need to count calories having a normal balanced diet. In addition one should limit animal fat intake avoid hydrogenated fats entirely, pefer olive and rapeseed oil, increase the consumption of fruits, vegetables, whole grains and prevention of excessive weight increasing physical activity like walking three miles a day at least five days a week, or an hour a day [269].

Salt consumption [398]
The UK Food Standards Agency recommends for adults not to eat more than 6 gram salt a day. The daily recommended maximum for children depends on their age: These are the recommended maximums for children. It is better for them to have less.

The Agency advises to look at the nutritional information on the label:
High salted foods have 1.25g salt or more per 100g (0.5g sodium or more per 100g).
Low salted foods have 0.25g salt or less per 100g (0.1g sodium or less per 100g
The FSA classifies foods between high and low, as moderate salted foods.

Salt calculatorhttp://www.salt.gov.uk/salt_calculator.shtml

Nutritional habits
According to FSA, the taste buds get used to high levels of salt and may not notice the saltiness of some foods. Getting used to eating less salt the taste buds become more sensitive and can find out how salty foods taste which had been considered as not salty before.

Eating foods with less salt one gets used to this nutritional habit and they will become more tasty because lots of salt can hide more subtle flavours.

If children have too much salt, this could affect their health and give them a taste for salty food, being more likely to continue eating too much salt when they grow up. [399]

Blood LDL cholesterol should be treated in order to level with:

Traditional blood cholesterol values

Isolated values of total blood cholesterol does not give safe informations for therapy control. Below values are cited as being traditional:


Adults $<$ 30 years total cholesterol $<$ 180 mg/dl (4,66 mmol/l)
Adults $>$ 65 years total cholesterol $<$ 240 mg/dl (6,21 mmol/l)
Children total cholesterol $<$ 160 mg/dl (4,14 mmol/l)
Diet necessary total Cholesterol $<$ 200 mg/dl (5,17 mmol/l)
  LDL/HDL quotient $<$ 5,0

Dietary measures to lower blood cholesterol

The following measures lower the blood cholesterol in great number of cases.

The omega-3 egg

In Germany there are being made efforts to produce eggs with high level of omega-3 fatty acids. Hens are being fed with a special type of grains. This gets eggs rich on polyunsaturated fatty acids of the omega-3 type. The daily intake of omega-3 fatty acids should be 0,5% of total calories (with a diet of 2.200 kcal/day = approximately 1 g omega 3 fatty acids)(information from EIVIt Fischer Weppler GmbH PB 100572 76486 Baden-Baden). Rise of amount of fibres in nutrition Reduction of the amount of meat in nutrition Reduction of Broca Index below 1,0.
Broca Index Body weight in Kg = Body length in cm-100 Body Mass Index $<$ 25
Body Mass Index = Body weight in Kg : (Body length in meters)$^2$ Before medication is used a 6 month cholesterol lowering diet should be tried.
An immediate medication together with a diet is needed when LDL-cholesterol $>$ 350 mg/dl= 9,1 mmol/l.

New AAP policy on heart health in children recommendations

[401]
According to the American Academy of Pediatrics cholesterol-reducing medications should be considered for children who are more than eight years old and who have high LDL concentrations. Younger patients with elevated cholesterol readings should focus on weight reduction and increased activity while receiving nutritional counseling. According to the new policy diets with reduced-fat dairy products, such as two percent milk should be considered for overweight children as young as one year of age.

Some critics on this policy came from Stephen Daniells, science editor of Foodnavigator. He argues that diet is better than controlling cholesterol in kids with statins. Changing eating habits and lifestyle of obese kids should consider plant sterols at a daily amount of 1,5 to 3 grams/day, oatmeal and beta-glucan from oats, soy,rich in omega-3 rich oils, and even garlic , says Daniells. [402]


Controversy about Statins

[403]
Some scientists take a skeptical view of the need for many people to require statin treatment. Given the wide indications for which statins are prescribed, and the declining benefit in groups at lower baseline risk of cardiovascular events, the evidence base for expanded statin use has been questioned by some researchers. Some groups claim that statins are not as beneficial or safe as suggested.

Approval of products in EU: Regulation (EC) No 258/97 concerning novel foods and novel food ingredients
Before any new food product can be introduced on the European market it must be rigorously assessed for safety. In the UK the assessment of novel foods is carried out by an independent committee of scientists appointed by the Food Standards Agency, the Advisory Committee on Novel Foods and Processes (ACNFP).

Lower hurdles for novel foods?

[404]
Industry on both sides of the Atlantic are calling to reduce the hurdles for the approval of new foods and new supplements. In Europe such a movement was spurred on by a recent decision by the UK's Food Standards Agency (FSA) to refer Cargill's vegetarian glucosamine hydrochloride ingredient to further review by EFSA prior to granting novel food status. This matter should, however, be analysed very carefully, according to a comment of Stephen Daniells, from Food Navigator.

Novel food and supplements are approved to be marketed in USA by the FDA and in Europe by the EFSA following the Novel Foods Regulation EC 258/97. [405]

This ingredient was widely used as dietary supplement since 2004, and has been approved in USA under the less strict way of its self-affirmed GRAS (Generally Recognized As Safe) for certain food and beverage applications, which Cargill proclaimed in March 2007. It may be used in a variety of specific mainstream foods and beverages. Cargill stresses that glucosamine added to orange juice helps to protect cartilage and joints from the stresses of normal daily activities. [406]

The UK Food Standards Agency, alleging that it is unknown how the ingredient affects glucose metabolism, asked the EFSA to review it considering diabetic concerns. The industry, leaded by the Confederation of Food and Drink Industries of the EU (CIAA) and he Alliance for a Competitive European Industry (ACEI) intensified lobbying for laxer regulations pointing to America to boost innovations.

European Commission would be well advised not to ease regulations, adopt the US GRAS system, or charging fees for processing dossiers so as it is being done there.

There is an unhealthy movement in the USA going on. It puts economic development in front of safety. This is most painfully noted in the case of strategy to avoid climate change last month at the APEC Conference in Australia and in the President Bush's Climate Conference in Washington denying clearly any activity which could hinder the economy. This works in opposition to the Kyoto Protocol, backed by European Countries. Failure of the next climate conference at Bali in December will endanger staple food supply of Africa and Asia. Prices will increase on account of the competition of biofuel versus food.

The FDA finds itself amidst the interests of the industry and does weaken in relation to safety, such as the approval of GRAS.

The Contergan story and food safety

[407]
A sad anniversary of Thalidomide is being commemorated in Germany. It was sold under the generic name Contergan, by the German pharmaceutical company Grünetal. Approximately 10,000 children were born with severe malformities, because their mothers had taken thalidomide during pregnancy. Phthalimidoglutarimide was obtained by heating the peptide phthaloylisoglutamine.

High doses did not kill rodents, rabbits, cats or dogs, nor show any other side effects. The Grünenthal research team began to describe thalidomide as "nontoxic", with no teratogenicity tests (tests on pregnant animals), no clinical trial plans, and no scientific rationale.

European food regulators and the European Commission should stick to food safety policy and never forget the lesson of Contergan where low hurdles and profit caused horrible malfomities.

UK novel foods committee
The Advisory Committee on Novel Foods and Processes (ACNFP ) is an independent group of experts who advise the Agency on any matters relating to novel foods and novel processes. Varied fruit juices have been subjected to approval, some of them enriched with plant sterols. [408]

Pomegranate juice reverse proatherogenic effects of disturbed arterial flow [409]
According to F. de Nigris and colleagues, atherosclerosis is enhanced in arterial segments exposed to disturbed flow. Perturbed shear stress increases the expression of oxidation-sensitive responsive genes (such as ELK-1 and p-JUN) in the endothelium. Evidence suggests that polyphenolic antioxidants contained in the juice derived from the pomegranate can contribute to the reduction of oxidative stress and atherogenesis.

In their study, the authors conclude that the proatherogenic effects induced by perturbed shear stress can be reversed by chronic administration of pomegranate juice.

Heart UK and Coronary Heart Diseases
Heart UK, the Cholesterol Charity specialises in patients who inherit high cholesterol, with particular concern for those who remain undiagnosed with the condition called Familial Hypercholesterolaemia (FH), or inherited high cholesterol (IHC)

The Charity maintains relationships with companies whose product is beneficial to a healthy diet particularly within the field of high cholesterol, approving those products like pomegranate juice and others with evidence to support their heart health benefits. [410]

Supplementary juice product made from blackcurrants and blueberries, rich in antioxidants and vitamin C are being investigated on their effects on cardiovascular diseases.

The Heart UK Charity stresses that diet is central to the treatment of hyperlipidaemia. Lipid-lowering drugs are generally only prescribed when treatment goals are not met through dietary change alone. For those who do require drug therapy, following a pattern of healthy eating is strongly encouraged. [410]

The OPTILIP study concerning ischemic heart disease

[411]
Sanders and colleagues measured the effect of low dietary ratio of n-6 to n-3 polyunsaturated fatty acids (n-6:n-3) (3:1)on high risk factors of ischemic heart disease. The risk factors are known to be elevated fibrinogen, activated factor XII (FXIIa), and factor VII coagulant activity (FVIIc). The authors concluded that decreasing the n-6:n-3 to 3:1 by increasing the intake of EPA and DHA lowers fasting and postprandial plasma triacylglycerol concentrations in older persons but does not influence hemostatic risk factors.

Wild blueberries as protective factor against strokes citeKalea GalAGs
Dorothy Klimis-Zacas and colleagues investigated the effects of wild blueberries (Vaccinium angustifolium) on functional and structural molecules in the walls of the aorta of rats.

The study was focused on glycosaminoglycans (GAGs), which are carbohydrate molecules in the blood vessel walls that are directly or indirectly involved in a variety of functions, including lipoprotein metabolism, blood coagulation, and organization of the extracellular matrix.

The increased intake of polyphenols may provide protection against coronary heart disease and stroke.

Blueberries (Vaccinium angustifolium) are one of the richest sources of antioxidants among fruits and vegetables. Phenolic compounds from berry extracts inhibit human low density lipoprotein and liposome oxidation.

Glycosaminoglycans (GAGs) and proteoglycans (PGs) are structural components of aortas interacting with compounds such as enzymes, cytokines, growth factors, proteins and lipoproteins and their subsequent role in degenerative diseases.

The presence of three GAG populations were studied: hyaluronan (HA), heparan sulfate (HS) and galactosaminoglycans (GalAGs).

The study demonstrated that increased galactosaminoglycans (GalAGs) content, together with a lower concentration of oversulfated disaccharides in both HS and GalAG populations in the aortas of rats fed with a supplement of Blueberries was found to be a protective factor.

The authors conclude that a diet rich in blueberries results in structural alterations in rat aortic tissue GAGs, affect cellular signal transduction pathways and biological function of GAG molecules within the vascular environment.

Mangosteen

Mangosteen (Garcinia mangostana)is a fruit of south east Asia. It is rich in mangostin, one of a family of active compounds known as xanthones. Mangosteen inhibits the oxidation of LDL-cholesterol and the activity of PGE2, COX-1, and COX-2 (prostaglandin E2 and cyclooxygenases-1 and -2) - key factors involved in inflammatory conditions.

Mangostin is a natural organic compound isolated from various parts of the mangosteen tree. It is a yellow crystalline solid. Mangostin and a variety of other xanthones from mangosteen have been investigated for biological properties including anti-bacterial, anti-inflammatory, and anticancer activities. [413]

The extract of the mangosteen plant has a strong inhibitory effect on Propionibacterium acnes and Staphylococcus epidermidis. Therefore, it could become a possible alternative treatment for acne according to Chomnawang. It also provides in-vitro antibacterial activity against staphylococcus aureus [414] [415]

The active substances of the crude extract of the fruit hull of mangosteen were identified as alpha-mangostin and gamma-mangostin. The structures of alpha-mangostin and gamma-mangostin is free from nitrogen atom. It does not resemble to the common structures of histamine and serotonin receptor antagonists. These compounds may therefore become novel types of lead compounds for histamine and serotonin receptor antagonists, helping to fight allergies and inflammation. [416]

Other components of Garcinia mangostana: Three new xanthones, mangostenol (1), mangostenone A (2), and mangostenone B (3), were isolated from the green fruit hulls of Garcinia mangostana, along with the known xanthones, trapezifolixanthone, tovophyllin B (4), alpha- and beta-mangostins, garcinone B, mangostinone, mangostanol, and the flavonoid epicatechin. [417]

Four new compounds of Garcinia mangostana were isolated byYang YL and col: Three minor xanthones, garcimangosone A (1), garcimangosone B (2), and garcimangosone C (3), and a benzophenone glucoside, garcimangosone D (4). [418]

Mangostin inhibition of the oxidative modification of lipoprotein LDL: The oxidation of low density lipoprotein (LDL) may play an important role in atherosclerosis. Mangostin, isolated from Garcinia mangostana was found to act as a free radical scavenger to protect the LDL from oxidative damage in vitro system. [419]

Cancer chemoprevention of mangostin: Researches with crude methanolic extract from the pericarp of Garcinia mangostana using human breast cancer (SKBR3) cell line as a model system suggestes that the methanolic extract from the pericarp of Garcinia mangostana had strong antiproliferation, potent antioxidation and induction of apoptosis. According to Moongkarndi the results of the study indicates that this substance can show different activities and has potential for cancer chemoprevention which were dose dependent as well as exposure time dependent. [420]

Ischemic heart disease, epidemiological studies [421] [422] [423] [424] [425] [426]
Epidemiologic studies Western countries linked dietary factors such as total fat, saturated fatty acids (SFAs), polyunsaturated fatty acids (PUFAs), n-3 series fatty acids, and cholesterol with the incidence of ischemic heart disease.

The most relevant studies were the Western Electric Study, the Zutphen Study, the Honolulu Heart Program, the Puerto Rico Heart Health Program, the Ireland-Boston Diet-Heart Study, and the Seven Countries Study. A total fat intakes of 35-40% of energy had been found in Western countries. Recommended dietary fat allowance in Western countries: Fat intake should be less than 30% of energy come from fat to prevent fat-related diseases.

Effect of dietary fatty acids on atherogenesis

[427] According to many studies saturated fat from foods, such as meat products, hard cheese, cream and palm oil, increase serum cholesterol.

Studying the effect of dietary fatty acids on atherogenesis lead researcher, Dr. David CelermajerStephen, J. Nicholls and colleagues found that consumption of a saturated fat reduces the anti-inflammatory potential of HDL and impairs arterial endothelial function. In contrast, the anti-inflammatory activity of HDL improves after consumption of polyunsaturated fat. They found mechanisms by which different dietary fatty acids may influence key atherogenic processes due to anti-inflammatory properties of high-density lipoproteins (HDL) and vascular function.

Raised levels Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were found to be a response of the immune system which results in inflammation of the vascular endothelian.

A saturated fat meal made HDL-cholesterol to be less effective at inhibiting the expression of both ICAM-1 and VCAM-1 and polyunsaturated meal caused HDL to have increased inhibitory activity compared HDL from fasting plasma.

Labelling of the content of saturated fat and trans fatty acids could help to reduce the risk of hear disease by choosing products with reduced content of saturated fatty acids. Depression and lower levels of omega-3 fatty acids[323] In order to examine whether depression was associated with lower levels of omega-3 FAs in serum phospholipids cancer patients were divided in three groups: major depression group a minor depression group and a nondepression group.

There were no differences between the major depression group and nondepression group in any FAs. The minor depression group had higher mean levels of docosahexaenoic acid.
These results suggested that serum FAs are associated with minor, but not major, depression in lung cancer patients.

Omega 3 fats and prostate cancer[324] The Omega-6 poly-unsaturated fatty acid, Arachidonic acid, has been shown to enhance the proliferation of malignant prostate epithelial cells and increase the risk of advanced prostate cancer.

Invasion of the human bone marrow takes place. This invasion is mediated by the arachidonic acid metabolite prostaglandin E$_{2}$.

Mick Brown and colleagues found, however, when Omega-3 poly-unsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid at a ratio of 1 : 2 Omega-3 : Omega-6 were present the spread of cancer cells was stopped.

N-3 polyunsaturated fatty acids and reduction of mortality due to myocardial infarction [325]
A meta-analysis of Heiner Bucher and colleagues suggests that dietary and nondietary intake of n-3 polyunsaturated fatty acids reduces overall mortality, mortality due to myocardial infarction, and sudden death in patients with coronary heart disease.

Lack of benefit of dietary advice concerning fruits and oily fish [326]
In this study 3114 patients with angina were distributed in four groups:
  1. advised to eat two portions of oily fish each week, or to take three fish oil capsules daily;
  2. advised to eat more fruit, vegetables and oats;
  3. given both the above types of advice;
  4. and given no specific dietary advice.
A study of Burr and colleagues found that the advice to eat more fruit resulted in no detectable effect on mortality. Men advised to eat oily fish, and particularly those supplied with fish oil capsules, had a higher risk of cardiac death. The result is unexplained, but caused a high repercussion in non-medical press like "Der Spiegel" denying any protection again cancer and are of no help against depression. [327]

Health benefits of oats and oats-based products

[328]
Mark B. Andon and James W. Anderson assessed the literature of the last 10 years concerning oats and oats-based products. They found that all concluded that consumption of oats and oat-based products significantly reduces total cholesterol and low-density lipoprotein cholesterol concentrations without adverse effects on high-density lipoprotein cholesterol or triglyceride concentrations, extending it to other health benefits, such as reduce the risk for increased blood pressure, weight gain, and type-2 diabetes, reduce LDL cholesterol as part of a weight-loss programme, and turn LDL cholesterol less susceptible to oxidation, and that Beta-glucan from oats may be responsible for decreases to LDL-C levels.

The authors concluded that the consumption of oats and oat-based products should be encouraged as part of an overall lifestyle medicine approach for the prevention of cardiovascular disease.

The Collaboration Review

[329]
Despite the consistency of effects seen in trials of wholegrain oats, the positive findings should be interpreted cautiously. Many of the trials identified were short term, of poor quality and had insufficient power. Most of the trials were funded by companies with commercial interests in wholegrains.

There is a need for well-designed, adequately powered, longer term randomised controlled studies in this area. In particular there is a need for randomised controlled trials on wholegrain foods and diets other than oats.
The authors point to a lack of studies on other wholegrains or wholegrain diets.

Long chain and shorter chain omega 3 fats discredited[330]
Hooper and colleague in a meta-analysis of randomised control trials and cohort studies concluded that long chain and shorter chain omega 3 fats do not have a clear effect on total mortality, combined cardiovascular events, or cancer. Trial results were inconsistent and showed no strong evidence of reduced mortality or cardiovascular events in participants taking additional omega 3 fats.

It is not clear whether long chain or short chain omega 3 fats (together or separately) reduce or increase total mortality, cardiovascular events, cancer, or strokes. The findings do not rule out an important effect of omega-3 fats on total mortality, as robust trials at low risk of bias reported few deaths. There is no evidence that the source (dietary or supplemental) and dose of omega-3 fats affected the effectiveness of long chain omega-3 fats.

Hooper looked for an explanation why the study by Burr et al contradict the other large studies by not suggesting a benefit of omega-3. The authors examined the harmful cumulative effects of methylmercury in the long Burry trial, the fact that a specific angina patient group was chosen, and if oily fish could have a different effect as fish oil supplements, but no explanation was found. It is therefore not clear why the results of Burr et al differ from the other large studies on fish based omega- 3. The authors conclude that the effect of omega 3 fats on cardiovascular disease is smaller than previously thought, or that its beneficial effect is limited to a specific group not represented in the study by Burr et al.
The authors add as final recommendation that UK guidelines encourage the general public to eat more oily fish, and higher amounts are advised after myocardial infarction (supported by trials after myocardial infarction). This advice should continue at present but the evidence should be reviewed regularly. It is probably not appropriate to recommend a high intake of omega 3 fats for people who have angina but have not had a myocardial infarction.

Health recommendations conflict concerning oily fish and omega-3 fat supplements [522]
In an editorial in 2006 Brunner states that for the general public some omega-3 fat is good for health. Long chain omega 3 fatty acids are structural components of neuronal and other cell membranes, and they modulate the production of eicosanoids and inflammatory cytokines. Whether omega-3 fat prevents cognitive impairment and dementia is currently being tested in trials. Extreme nutritional deficiency of these fats results in a neuropathy that can be reversed with rapeseed oil or other vegetable oils containing alfa-linolenic acid (18:3 omega 3). Alfa-Linolenic acid is a precursor of long chain omega-3, but endogenous conversion to eicosapentaenoic acid (20:5 omega-3) and docosahexaenoic acid (22:6 omega-3) is limited and inefficient.

Benefits of omega fatty acids supplementation outweighs any likely hazard of fish oils[336]
Hooper et al. address the risks and benefits of omega-3 fats mentioning contaminants such as methylmercury, dioxins and dioxin like polychlorinated biphenyls (PCBs).

Michael J. James and colleagues analysed the anti-inflammatory effects of fish oil advising patients to take 15mls fish oil daily on juice (equivalent to 14 standard capsules daily) Third party analysis showed dioxins and indicator PCBs, which can be reduced by molecular distillation during processing of fish oil, to be below the level of detection and mercury present at 0.006mg/kg. Analysing mercury levels in both urine and blood in patients who had taken fish oil 15ml/day for at least 3 years low levels within the normal reference range and in most cases at or below the limit of detection were found.

In evaluating the risks of fish oil one needs to consider the hazards of treatments it displaces. This collateral damage clearly outweighs any likely hazards associated with fish oil use.

Very high levels of marine-derived n-3 fatty acids reduce heart disease risk

[331]
Akira Sekikawa and colleagues 2008 report that Japanese born and living in Japan had two-fold higher blood omega- 3 levels and lower atherosclerotic events compared with a population of white and Japanese living in the US which presented low levels of blood omega-3 and high coronary diseases. According to the authors marine-derived n-3 fatty acids at low levels are cardioprotective through their antiarrhythmic effect.

The authors concluded that the diet in Japan rich in fish, with men consuming an average of 100 grams every day, result in high levels of omega-3 fatty acids which may help to prevent the buildup of cholesterol in the arteries.

The authors stress that increasing fish intake to two times a week for healthy people is currently recommended in the U.S. The study shows that much higher intake of fish observed in the Japanese may have strong anti-atherogenic effect, which are lifestyle and not genetic differences related.

High yields of DHA (docosahexaenoic acid) from microalgae [332]
With the introduction of Advanced BioNutrition's DHA from microalgae rather than from fish meal and oil, there is the added benefit of the fish fed with these microalgae to bee a completely renewable and contaminant-free resource which can be certified as organic.

The fermentation process for the production of plant DHA uses the microalgae Crypthecodinium cohnii as well as some other microalgae.

DHA and ARA are used infant formulas. The best source of DHA, an omega-3 fatty acid, has traditionally been fish oil.

DHA from microalgae avoids mercury contamination of fish oil. Other vegetarian sources such as flax oil are considerably less bioavailable.

Other publications on this matter are:
Clarke R, Frost C, Collins R, et al. Dietary lipids and blood cholesterol: quantitative metaanalysis of metabolic ward studies. Brit Med J. 1997;314:112-7.
Mensink RP, Zock PL, Kester ADM, et al.: Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled studies. Am J Clin Nutr. 2003;77:1146-55.

Supercritical CO2 extraction for omega-3 fatty acids: Fish oil fractioning

[333]
Ana Paula Antunes Corrêa and colleagues 2008 verified the possibility of using supercritical CO2 to concentrate polyunsaturated omega-3 fatty acids in the form of natural fish oil. The authors found that 7.8 MPa and 301.15 K were the best oil fractioning conditions. Eicosapentaenoic acid (EPA) could not be fractionalized.

Omega-3 fatty acids supplements obtained by supercritical extraction

[334]
Espinosa and colleagues 2008 studied the thermodynamics, the simulation and the optimization of supercritical extraction of fish oil fatty acid ethyl esters with ethane as alternative solvent to carbon dioxide for the production of pharmaceutical grade concentrates of eicosapentaenoic acid (EPA) and docohexaenoic acid (DHA) esters, which are the most valuable omega-3 polyunsaturated fatty acid esters. The study included ethane-ester interaction parameters. The authors found a higher solubility of fatty acid ethyl esters in ethane, as well as a slightly better selectivity to EPA and DHA.

Supercritical fractioning of fish oil to improve the EPA/DHA ratio

[335]
Perretti and colleagues 2007 used supercritical fractionation of fish oil fatty acid ethyl esters to obtain a lipid fraction enriched in ω-3 fatty acids and modified EPA/DHA ratio. The authors found supercritical fluid fractionation to be useful to change the composition of lipids. The use of proper fractionation temperatures and pressures along the column influenced the solvent-to-feed ratio to obtain fractions with suitable EPA/DHA ratio for market requirements.

Omega-3 fatty acids levels in fresh beef from feedlots
A feedlot or feedyard is a type of concentrated animal feeding operation (also known as factory farming) which is used for fattening livestock, notably beef cattle, prior to slaughter. Aside from ethical and environmental concerns, feedlots have come under criticism for human health reasons. The tissues of feedlot-raised cattle have far more saturated fat than that of grass-fed cattle, some sources say up to 500 percent more. Feedlot-raised beef may after long periods on feed have reduced healthy omega-3 fatty acids because of the corn-and-grain diets of the cattle. [515]

Maddock and colleagues assessed the effects of flax addition and flax processing on feedlot performance and carcass characteristics. The researchers found that feeding 8% flax to feedlot heifers increased gain and efficiency, and processing flax increased available energy and resulted in increased efficiency of gain and increased levels of n-3 fatty acids in fresh beef. [521]

Importance of n-3 fatty acids in health and disease [337]
William E. Connor in a supplement in 2000 states that n-3 Fatty acids favorably affect atherosclerosis, coronary heart disease, inflammatory disease, and perhaps even behavioural disorders.

Omega-3 fatty acids and biomarkers of inflammation and endothelian activation in women [338]
Lopez-Garcia and colleagues found in 2004 that the intake of alfa-linolenic acid was inversely related to plasma concentrations of C-reactive protein (CRP), and E-selectin. (n-3) fatty acids (eicosapentaenoic and docosahexaenoic) were inversely related to soluble intracellular adhesion molecule (sICAM-1) and soluble vascular adhesion molecule (sVCAM-1). Total (n-3) fatty acids had an inverse relation with CRP, E-selectin, sICAM-1, and sVCAM-1.

The researchers conclude that dietary (n-3) fatty acids are associated with levels of these biomarkers reflecting lower levels of inflammation and endothelial activation, which might explain in part the effect of these fatty acids in preventing cardiovascular disease.

The effects of diet on inflammation [339]
Giugliano in a review in 2006, states that the incidence of coronary heart disease may be reduced with a diet comprising adequate omega-3 fatty acids intake, reduction of saturated and trans-fats, and consumption of a diet high in fruits, vegetables, nuts, and whole grains and low in refined grains. Prudent dietary patterns may reduce inflammation associated with the metabolic syndrome.

Omega-3 fatty acids and serum C-reactive protein [340]
The intake of n-3 polyunsaturated fatty acids or fish is inversely associated with serum C-reactive protein (CRP) concentrations.

K. Niu and colleagues, studying in 2006 the effect of high intake of of omega-3 fatty acids from a diet rich in marine products, found that greater intake of n-3 PUFAs was independently related to a lower prevalence of high C- reactive protein concentrations in an older Japanese population with a diet rich in marine products, suggesting that even very high intakes of n-3 PUFAs may lower serum C- reactive protein concentrations.

n-3 Fatty acids and cardiovascular disease[341]
Jan L. Bleslow in 2006 writes that fish oil containing the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is associated with decreased cardiovascular death, whereas consumption of the vegetable oil-derived n-3 fatty acid alfa-linolenic acid is not as effective.

At doses $>$3 g/d, EPA plus DHA can improve cardiovascular disease risk factors, including decreasing plasma triacylglycerols, blood pressure, platelet aggregation, and inflammation, while improving vascular reactivity. The American Heart Association recommends that everyone eat oily fish twice per week and that those with coronary heart disease eat 1 g/d of EPA plus DHA from oily fish or supplements.

Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes

[342]
Wang and colleagues 2006 systematic reviewed the literature of the effect of dietary n-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) from fish compared with alpha-linolenic acid on cardiovascular disease outcomes and adverse events.

The authors report that most cohort studies found that increased consumption of n-3 from fish or fish-oil supplements, but not of alpha-linolenic acid, reduces the rates of all-cause mortality, cardiac and sudden death, and possibly stroke. The evidence for the benefits of fish oil is stronger in secondary- than in primary-prevention settings.

Fish consumption and cognitive decline [343]
In a prospective cohort study Morris and colleagues examined whether intakes of fish and the omega -3 fatty acids protect against age-related cognitive decline.

The results of the study were a 10% and 13% slower decline among persons who consumed 1 fish meal per week and 2 or more fish meals per week, respectively, compared with the cognitive decline of persons who consumed fish less than weekly.

The authors concluded that fish consumption may be associated with slower cognitive decline with age. Further study is needed to determine whether fat composition is the relevant dietary constituent, as there were little evidence that the omega-3 polyunsaturated fatty acids were associated with cognitive change.

Balancing benefits and risks of seafood study 2006 [344]
The 2006 study "Seafood Choices: Balancing Benefits and Risks" sponsored by the National Oceanic and Atmospheric Administration's (NOAA) Marine Fisheries Service and the FDA, supports public health guidelines.

According to this study the contamination coming from seafood counts only for only 9 per cent of the PCBs in the diet. The rest come from meat and dairy. According to this study, which was conducted by the US National Academies of Science, Institutes of Medicine, the levels of dioxins and polychlorinated biphenyls are low, and potential cardiovascular and other effects are outweighed by potential benefits of fish intake.

The findings of the study is backed up by the results of the study of Dariush Mozaffarian and Eric B. Rimm [345]

Fish intake, the risks and the benefits [345]
Searching reports published through April 2006, Dariush Mozaffarian, and Eric B. Rimm found evidences that modest consumption of fish (eg, 1-2 servings/wk), especially species higher in the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), reduces risk of coronary death by 36% and total mortality by 17% and may favourably affect other clinical outcomes. Intake of 250 mg/d of EPA and DHA appears sufficient for primary prevention.

Women of childbearing age and nursing mothers should consume 2 seafood servings/wk, limiting intake of selected species.

A variety of seafood should be consumed; individuals with very high consumption ($>$5 servings/wk) should limit intake of species highest in mercury levels. Levels of dioxins and polychlorinated biphenyls in fish are low, and potential carcinogenic and other effects are outweighed by potential benefits of fish intake.

the benefits of fish intake exceed the potential risks. For women of childbearing age, benefits of modest fish intake, excepting a few selected species, also outweigh risks.

Recommendations of the National Heart Foundation [346]
Reduce saturated fat (SF) (and -fatty acids) to reduce CVD risk. Replace SF and trans-fatty acids with polyunsaturated fatty acids (PUFAs), and monunsaturated fatty acids (MUFAs).
Identify food sources of different fats i.e. SF (and trans fats), mono and poly. Promote consumption of at least 2 fish meals per week.

The Northern Osteosporosis and Obesity Study (NO2 Study) linking omega-3 fatty with increased bone build up in young men

Magnus Högström and colleagues in a Sweden study known as the Northern Osteosporosis and Obesity Study (NO2 Study) measured fatty acids in the serum phospholipids fraction in healthy men and their association with bone mineral density and bone accrual. They found that n-3 fatty acids, especially docosahexaenoic acid (DHA, 22:6n-3), are positively associated with bone mineral accrual and with peak bone mineral density in young men around the age of 16 to 22 years. In an earlier study higher ratio of n-6 to n-3 fatty acids was negatively associated with bone build up in elderly men and women. [347]

Chaim Vanek and William Connor suggested that the healt benefit of n-3 fatty acids on bone health might result from affecting expression of the role of peroxisome proliferators-activated receptor gama (PPAR-gama). Overexpression of this protein is linked to lower bone mass, therefore eicosapentaenoic acid EPA and docosahexaenoic acid DHA may protect bone mass. The authors call for more research on this matter. [348]

The essential fatty acids

The essential polyunsaturated fatty acids (PUFAs) comprise 2 main classes: n-6 and n-3 fatty acids.

The most common source of n-6 fatty acids is linoleic acid is found in vegetable oils. Arachidonic acid n-6 fatty acid, is obtained largely by synthesis from linoleic acid in the body.

The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid are found in fish and fish oils. The beneficial health effects of these two n-3 fatty acids were first described in the Greenland Eskimos, who consumed a high-seafood diet and had low rates of coronary heart disease, asthma, type 1 diabetes mellitus, and multiple sclerosis. These positive health attributes of n-3 fatty acids include reduction of risc of cancer, inflammatory bowel disease, rheumatoid arthritis, and psoriasis. [337]

Significant benefits of dietary supplementation with fish oils were found in several inflammatory and autoimmune diseases in humans, including rheumatoid arthritis, Crohn's disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches. [349]

Psoriasis:

Psoriasis is a disease of the skin showing sharply defined red patches covered with silvery scales in the regions of the elbows and knees, genitals, perianal region, in the scalp and rarely in the eyelids. Treatment with preparations of Anacardium, Carica, Cassia, Thespesia, or topical application of Dithranol (Cignolin or Anthralin) is used together with sunlight, artificial UV light, steroids, coal tar, salicylic acid, and synthetic Vitamin D analogues.

Psoriasis was considered to be an epidermal disease. Recently it was found that drugs like cyclosporin which suppress the activity of T-cells (white blood cells)and the immune system, reduced the severity of psoriasis. This underlines the importance of T-cells in the etiology of the disease. [350]

Australian regulations for mercury in fish [351]
The Australia New Zealand Food Standards Code prescribes maximum level for mercury of 1.0 mg mercury/kg for swordfish, southern bluefin tuna, barramundi, ling, orange roughy, rays and shark. and a level of 0.5 mg/kg for all other species of fish, crustacea and molluscs.

The U.S. Environmental Protection Agency (EPA) has issued two major reports on mercury the Mercury Study Report to Congress (1997) and the Utility Hazardous Air Pollutant Report to Congress (1998). In those reports, fossil-fuel power plants, especially coal-fired utility boilers, were identified as the source category that generates the greatest Hg emissions, releasing approximately 40 tons annually in the United States.

Methylmercury

[352] The major pathway for human exposure to methylmercury is consumption of contaminated fish. Dietary methylmercury is almost completely absorbed into the blood and is distributed to all tissues including the brain; it also readily passes through the placenta to the foetus and foetal brain.

Major Health Effects of Methylmercury Epidemics of mercury poisoning following high-dose exposures to methylmercury in Japan and Iraq demonstrated that neurotoxicity is the health effect of greatest concern, such as effects on the foetal nervous system, mental retardation, cerebral palsy, deafness, blindness, and dysarthria in utero and in sensory and motor impairment in adults.

The studies in the Seychelles Islands, New Zealand, and the Faroe Islands were designed to evaluate childhood development and neurotoxicity in relation to foetal exposures to methylmercury in fish-consuming populations. No adverse effects were reported from the Seychelles Islands study, but children in the Faroe Islands exhibited subtle developmental dose-related deficits at 7 years of age. These effects include abnormalities in memory, attention, and language. In the New Zealand prospective study, children at 4 and 6 years of age exhibited deficiencies in a number of neuropsychological tests.

Other studies were conducted in the Amazon; Ecuador; French Guiana; Madeira; Mancora, Peru; northern Quebec; and Germany. Effects of methylmercury on the nervous system were reported in all but the Peruvian population.

The EPATissue Residue Criterion is 0.3 mg methylmercury/kg fish. This is the concentration in fish tissue that should not be exceeded based on a total fish and shellfish consumption-weighted rate of 0.0175 kg fish/day. The risks posed by pollutants such a methylmercury, and polychlorinated biphenols (PCBs) is outweighed by the benefits of fish consumption, like omega-3, protein,mineral content, and essential vitamins such as vitamin D where a 150 g serve of fish will supply around 3 micrograms of vitamin D.

EPA is proposed to function by increasing blood flow in the body, to affect hormones and the immune system, and is involved in the membrane of ion channels in the brain, making it easier for them to change shape and transit electrical signals. Outstanding publications on this matter are:

The Pregnancy Outcome and Community Health (POUCH) Study: A diet high in ocean fish poses risk of premature birth. [353]
A study leaded by Fei Xuein and published in 2006, reinforced previous findings suggesting that fish consumption is a major source of mercury exposure for pregnant women. The greatest fish source for mercury exposure appeared to be canned fish, both because it was consumed more and, per meal, it was among the fish categories associated with the highest levels of mercury in maternal hair. The observed relationship between elevated mercury levels and increased risk of very preterm delivery is a new finding and requires caution in interpretation.

Major strengths of the present study include the large number of pregnant women participating, the prospective design, and the use of hair as an index of methylmercury exposure. Hair levels of total mercury represent a longer window of exposure than those of blood levels. Mercury levels in hair ranged from 0.01 to 2.50 ppm (mean = 0.29 ppm, median = 0.23 ppm). The study is the first to report an association between delivery at less than 35 weeks' gestation and maternal hair mercury levels at or above 0.55 ppm

The Seychelles Islands study finds no threat coming from diet high in ocean fish [354]
Philip W. Davidson and colleagues in a ten-year study of over 700 children in the Seychelles Islands found that the mean maternal hair total mercury level was 6.8 ppm and the mean child hair total mercury level at age 66 months was 6.5 ppm. No adverse outcomes at 66 months were associated with either prenatal or postnatal MeHg exposure. The authors concluded that consumption of a diet high in ocean fish appears to pose no threat to developmental outcomes through 66 months of age. The Seychelles Islands study is significant as the studied population eats 12 fish meals a week, There is no home made mercury pollution.

Omega-3 fatty acid function of brain neurons [355]
Docosahexaenoic acid (22:6n-3), one of the main structural lipids in the mammalian brain, plays crucial roles in the development and function of brain neurons.

The function of DHA in neurogenesis and learning was examined in a study conducted by Kawakita, Hashimoto and Shido Ohese. The researchers demonstrated that docosahexaenoic acid effectively promotes neurogenesis both in vitro and in vivo, suggesting that it has the new property of modulating hippocampal functionregulated by neurogenesis. Maintaining brain DHA concentrations may be an important part of prevention of neurodegeneration with ageing.

Fish oil reduces pro-arrhytmic effects of saturated fats

[356]
According to Pepe and McLennan fish oil modifies cardiac membrane phospholipid fatty acid composition to confer increased efficiency of oxygen utilization and antiarrhythmic effects. Studying the effect on rats the researchers found that fish oil rich in EPA and DHA. at a dose as low as 3% of total fat dietary supplement effectively reversed the high oxygen requirements, reduced the coronary release of creatine kinase and reduced the pro-arrhythmic effects of a continued consumption of (9%) saturated fatty acids-rich diet in rats.

The studies on omega-3 fatty acids started with Dr. Jörn Dyerberg Hans Olaf Bang and Aase Brondum Nielsen studying the blood lipids of the Inuit Eskimos of the north-west coast of Greenland in 1970. Despite their high fat diet the Inuits had a low rate of 5,3 per cent from cardiovascular disease, compared with 40 per cent found in USA. The researcher s found low blood lipids levels and high levels of eicosapentaenoic acid (EPA) acid and docosahexaenoic acid (DHA) in the Inuit blood serum. [357] [358]

EPA and DHA ratio of 3:2 is indicated, but not essential because the fatty acids can be interconverted by the body.

Overfishing the oceans will limit the resources of omega fatty acids from fish. Algae culture and genetic engineering of plants may overcome the shortage of EPA and DHA.

Improvements in blood lipid levels, a reduced tendency of thrombosis, blood pressure and heart rate improvements, and improved vascular function. Survivors of myocardial infarction fatty fish (300 g/week, or 0.35g n-3 polyunsaturated fatty acids daily) reduced overall mortality by 29% and mortality from coronary heart disease by a third. A reduced intake of saturated fat with a proportional increased intake of polyunsaturated fat and a high fibre diet were ineffective. [359]

Summary of current dietary recommendations concerning lipids

[360]
Alice H Lichtenstein in a research paper summarizes the actual dietary recommendations as follows:

Different types of dietary protein or individual amino acids have little effect on lipoprotein patterns. Saturated fatty acids increase LDL and HDL cholesterol, whereas trans fatty acids increase LDL but not HDL cholesterol. Unsaturated fatty acids decrease LDL and HDL cholesterol, polyunsaturated more so than monounsaturated.

Dietary carbohydrate tends to increase plasma triglyceride when it displaces fat, accompanied by a decrease in HDL cholesterol concentrations.

Short-term data favour substituting protein and fat for carbohydrate, whereas long-term data have failed to show a benefit for weight loss. During an active weight loss period low-carbohydrate diets more favourably affect triglyceride and HDL and less favourably affect LDL cholesterol concentrations. The author calls for more research on macronutrients. Fish advisories in United States [361]
Each state sets its own criteria and decides which bodies of water to monitor. Fish advisories are voluntary state recommendations and are not governed by federal regulations.

Frequently, when a fish advisory is issued it is because of pollutants that have lingered in the environment for long periods, sometimes decades, even though they are no longer used or their use has been significantly curtailed. These pollutants include PCB's, chlordane, DDT, mercury and dioxin.

EPA has made considerable progress toward reducing the occurrence of these contaminants in the environment: EPA issued first-ever regulations to control mercury emissions from the power sector by 70 percent, the Clean Air Mercury Rule. Production of PCBs for use ceased in 1977; chlordane was banned in 1988; DDT was banned in 1972; and known and quantifiable industrial emissions of dioxin in the United States are estimated to have been reduced by approximately 90 percent from 1987 levels.

General Dietary Advice: [361]
FDA recommends that consumers eat a balanced diet, choosing a variety of foods including fruits and vegetables, foods that are low in trans fat and saturated fat, as well as foods rich in high fibre grains and nutrients. Fish and shellfish can be an important part of this diet.

WHO guidelines for mercury in fish
The World Health Organization's guidelines maintain that the lowest level that could possibly be harmful to humans is 5 parts per million (ppm).This level is based on scientific results from the 1960s that placed the level at which risk begins at 50 ppm for most people; WHO then applied a safety factor of 10, deciding that a level of 5 or less is safe for even the most vulnerable populations.

EPA has recommended that a person ingest no more than 30 micrograms of mercury per day. Based on estimates of U.S. fish consumption, FDA recommended that only commercial fish with less than 1 ppm of mercury be sold. Later on the EPA recommended to Congress that the tolerable daily intake of mercury be dropped to just one-fifth the current allowable level, to about 6 micrograms per day.

The FDA supports statements that it is safe to eat fish and shellfish twice a week and that one should always eat a variety of species.

Morrissey stresses that pregnant women should stick with current FDA recommendations of about 12 ounces (340 grams) per week. Do not eat shark, swordfish, King Mackerel, Tilefish. The rest of the population should be eating fish four to seven times per week. [362]

US FDA List of Mercury Levels in Commercial Fish and Shellfish Recent US FDA data of mercury levels in fish and shellfish are available at: http://www.cfsan.fda.gov$~$frf/sea-mehg.html and Mercury Concentrations in Fish: FDA Monitoring Program (1990-2004)
http://www.cfsan.fda.gov/$~$frf/seamehg2.html

EPA and FDA fish consumption advice for pregnant women and young children [370]
EPA and FDA advice not eat: Shark, Swordfish, King Mackerel, Tilefish. They contain high levels of mercury.

EPA and FDA recommend to eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury. Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish.

EPA and FDA says to be carefully with albacore ("white") tuna which has more mercury than canned light tuna. No more than 6 ounces (one average meal) of albacore tuna fish from local lakes, rivers, and coastal areas. per week should be eaten and no other fish during that week.

EWG recommendation in addition to FDA [369]
Recommendation of the Environmental Working Group (EWG) and the U.S. Public Interest Research Group (U.S. PIRG) published in Brain Food: What Women Should Know About Mercury Contamination of Fish:

Mercury Levels in High-End Consumers of Fish [367] Jane M. Hightower and Dan Moore tested mercury levels in blood and hair of frequent fish eaters. They found mercury levels ranging from 2.0 to 89.5 $\mu$g/L for the 89 subjects. The mean for 66 women was 15 $\mu$g/L, and for 23 men was 13 $\mu$g/L. The authors concluded that high blood levels of mercury could be reduced by abstaining from eating fish for more than 21 weeks. Mercury levels in tested women averaged in this study 10 times the levels recommended by the U.S. Environmental Protection Agency and the National Academy of Sciences. Levels in men were close behind, while some of the children tested were found to have levels 40 times those recommended. Nearly 90% of those tested were above the recommended levels.

Environment and power plants [363]
Concern over mercury contamination has led government agencies to warn consumers not to eat bass, trout and other sport fish caught in over a thousand lakes and streams across 40 U.S. states.

Coal-burning power plants are the single largest source of mercury pollution, and the only major source the government does not regulate. Mercury is an extremely volatile metal that can be transported great distances after spewed into the atmosphere. Once it reaches an aquatic environment, mercury is transformed into methylmercury, a potent neurotoxin, which accumulates in top predator fish and the people and wildlife who eat them. When ingested by pregnant women, methylmercury readily crosses placenta and targets the developing brain and central nervous system. Even relative tiny amounts can produce serious developmental delays in walking, talking hearing and writing. Infants can also be exposed to high levels of methylmercury during breastfeeding.

Mercury emissions from the power sector was reduced by 70 percent, following the EPA Clean Air Mercury Rule of 2005. [366]

Fatty acids with trans configuration

Most of the unsaturated fatty acids in nature have a cis configuration. The trans configuration results mainly during chemical hydrogenation of polyunsaturated fatty acids.

In February 1995 the first part of the Euromic-Study was published in The Lancet. This part of the study was mainly concerned with trans fatty acids and diseases of the coronary vessels. The second part of the study was related to intake of TFA and cancer.

Approximately 2 to 3% of the fat of the milk and derivates have a cis configuration being elaidinic acid ( C18:1 trans) responsible for most of the trans fatty acids of milk.

In some cases the amount of trans fatty acids in milk and derivates can be as high as 5%.

Dairy trans fatty acids should be included in labelling or nutrient profiling for claims says EDA

[364]
During a conference of the European Dairy Association (EDA) on 12th February 2008 in Brussels the speakers concluded that there is no scientific evidence on negative health effects from TFA of natural origin found in dairy and ruminant meat. EDA therefore stated that dairy TFA should not be taken into consideration for labelling or nutrient profiling for claims. The association stresses that consumption of dairy products should rather be promoted for their significant contribution to the nutrient supply such as high quality protein and several key minerals and vitamins.

EDA underlines in a position paper that science indicates that: Therefore, EDA is of the opinion that:

The action of the margarine industry

The International Federation of Margarine Association (IFMA) and the IMACE (Association of Margarine Industry of the EC Countries)indexAssociation of the Margarine Industry of the EC Countries (IMACE) recommended to lower the amount of TFA (Trans Fatty Acids) in margarine to a maximum of 5% of fat.

Margarine to be used as spread or cooking should have less than 1%.[371]

The trans fatty acids can be reduced during refining by reducing the temperature of the process. This however means a longer time the oil or fat has to spend in the system an therefore higher operation costs. The increased costs should be accepted in change of a healthy product.

The deodorization of vegetable oils during refining using temperatures over 230$^{o}C$ results more than 3% of trans fatty acids. Using temperatures under 230$^{o}C$ a maximum of 0,5% trans fatty acids are formed. This can be tolerated.
A real great amount of trans fatty acids are formed by partial hydrogenation of soy oil.
A melting point of 36 to 37$^{o}C$ of soya oil very commonly used in the production of margarine as well as deep frying fat and products for bakery results in up to 50% of trans fatty acids. Trans fatty acids are therefore hidden in cakes, cookies, creams and margarine and all kind of fried product.
In USA partially hydrogenated oil is used almost everywhere. The trans fatty acids represents therefore a great menace to health because they act as saturated fatty acids and may cause arteriosclerosis.
Trans fatty acids can be avoided during industrial processing of oil using entirely hydrogenated oil.
If all double and triple bindings of the molecule of the fatty acids are saturated the trans stereoisometric configuration ceases to exist and there is no negative physiological activity left.
To obtain the same consistence of partially hydrogenated oil it is necessary to add more liquid oil and esterified the whole compound. This implies in higher production cost. All efforts to get healthy products should however be made, including the acceptance of a small increase of price of the final product in order to get margarine, fats, creams and bakery products having less than 5% of their fatty acids in trans configuration.

Reduction of trans-fatty acids may contribute to the prevention of prostate cancer

[372]
According to Jorge Chavarro and colleagues 2008 blood levels of trans isomers of oleic and linoleic acids are associated with an increased risk of non-aggressive prostate tumours. Trans fatty acids are also known to raise serum levels of LDL-cholesterol, reduce levels of HDL-cholesterol, can promote can cause endothelial dysfunction, and influence other risk factors for cardiovascular diseases.

This study backs food scientists and heath professionals and NGOs like CSPI which call for a worldwide ban of trans-fatty acids so as already in force in Europe. Partial hydration of edible oil can be avoided using fractions of palmoil. U.S., however has great plantations of soy, therefore the oil industry does not import palmoil which is more expensive. Deep-frying oil and margarine are still high on unhealthy trans-fatty acids.

Snacks, fast foods and restaurant meals should phase out unhealthy fats

[373] Marie-Pierre St-Onge and colleagues 2007 in a study found that replacing low-fat and high-fat snacks with snacks rich in polyunsaturated fatty acids (PUFAs) and low in saturated and trans fatty acids improves cardiovascular health.

The authors found in their study that the reduction of LDL- and total cholesterol concentrations were greater with the low-fat and the high-PUFA diets than with the high-fat diet The high-PUFA diet tended to reduce triacylglycerol concentrations, and this change was greater than that with the low-fat and high-fat diets. In addition the PUFA diet was the only one that tended to reduce triacylglyerol concentrations. However this that low fat diets may lead to reduction in high density lipoprotein (HDL /good cholesterol), and increase triacylglycerol concentrations. Some high fat foods such as nuts and avocados are therefore considered as healthy.

The authors concluded that snack type affects cardiovascular health. Consuming snack chips rich in PUFA and low in saturated or trans fatty acids instead of high-saturated fatty acid and trans fatty acid or low-fat snacks leads to improvements in lipid profiles concordant with reductions in cardiovascular disease risk.

According to the authors the consumption of snacks above balanced meals should not be promoted as healthy, but this research adds to the evidences that snacks, fast food and restaurant meals should be reformulated to reduce unhealthy trans fatty acids and to increase polyunsaturated fatty acids. Organisations like the Center for Science in the Public Interest (CSPI) are working hard on this issue

Fats and margarine for bakery

Fats and margarine for bakery must have special stability, structure and melting point. Therefore special hydrogenated oils and fats are needed.

Palm oil, hydrogenated melting point 45/46$^{o}C$ 40%
Soybean oil, hydrogenated melting point 36/38$^{o}C$ 35%
Rapeseed oil, liquid melting point 5$^{o}C$ 25%

This fat blend has a content of trans-fatty acids of 20 to 25%.

Melting points of fats found in nature: Coconut fat melting point 24-28$^{o}C$ Palm oil melting point 37-39$^{o}C$ Palmkernel oil melting point 26-30$^{o}C$ These melting points are to low for the production of pastry margarine.
To avoid hydrogenated oils and fats for bakery it is possible to fractionate fats leaving it at specific temperature to permit the hard components (stearin) to crystallize. Filtration separates the low melting components (olein).
Industry still uses hydration instead of fractionated fats because of the the higher prices of fractionated fats. For the sake of health the higher price should be accepted by the consumer in order to get healthy food.
Bakery products bear a lot of hidden fats and are a great source of trans fatty acids with arteriosclerotic and carcinogenic activity.

Bakery margarine, pop-corn and waffels high on trans-fatty acids

[216]
The researcher Gerhard Jahreis from the university of Jena, Germany, analysing more than 800 foods, found up to 20 percent to have trans fatty acids varying from low to very high. He calls for clear labelling of trans fatty acids on foods. Denmark stiff regulations on trans fatty acids give a limit of maximal 2 percent. Germany does not have any such binding limits on foods.

Jahreis found that meanwhile tube margarine had low trans levels,backers margarine, especially margarine for puff pastry, used in croissants, however, had extreme high content of trans fatty acids. He stresses that other foods like microwave-popcorn and waffles also vary strongly in the level of the coronary diseases risking fatty acids. Feeding on snacks, like cookies, chips and others, the daily intake of trans fats may easily reach of 10g, where 2 g are considered as safe.

Oxidative stress induced by trans fatty acids

[217]
High consumption of trans fat has been associated with high oxidative stress in humans, which could increase the risk of the development or acceleration of several diseases, such as atherosclerosis, cancer, and type 2 diabetes.

Jahreis and colleagues monitored several urinary and blood biomarkers of oxidative stress induced by a diet of 6g/day of trans fatty acids:

Free radical-induced lipid peroxidation:

high concentration of urinary 8-iso-PGF2alfa were found.

Cyclooxygenase-mediated inflammatory response:

The concentrations of 15-keto-dihydro-PGF2alfa was not affected by the diet.

Oxiddative DNA damage:

measured as urinary 7,8-dihydro-8-oxo-2'-deoxy-guanosine was not affected by the diet.
The authors conclude that prolonged diet of $>$5.0 g/d of trans fats could be relevant to the development of disease, as seen on an increase in urinary 8-iso-PG configuration being consumed about 30 to 40 gram a day make the total blood cholesterol and LDL cholesterol to rise. HDL cholesterol is reduced by trans fatty acids.
In countries with high consume of partially hardened soya oil like USA there is an increase of heart diseases like heart infarct.
Industrial manufactured oils and fats cannot avoid completely trans fatty acids.
By using proper technologies the content of trans fatty acids however can be reduced to a tolerable amount of maximum 5%.

A daily intake of 4 to 6 gram of trans fatty acids are told to be harmless. All effort should be made by the industry to reduce the amount of trans fatty acids.

Trans fat claims, FDA proposal

[218] In its November 1999 proposal, FDA proposed a definition for the nutrient content claim "trans fat free" and proposed limits on the amounts of trans fat wherever saturated fat limits are placed on nutrient content claims, health claims, or disclosure and disqualifying levels.

With regard to the specific definitions, FDA proposed that "trans fat free" and "saturated fat free" should be defined as less than 0.5 g trans fat and less than 0.5 g saturated fat per reference amount and per labelled serving; "low saturated fat" as 1 g or less of saturated fat and less than 0.5 g of trans fat per reference amount and not more than 15 percent of calories from saturated fat and trans fat combined; "reduced saturated fat" as at least 25 percent less saturated fat and at least 25 percent less saturated fat and trans fat combined; "lean" as 4.5 g or less of saturated fat and trans fat combined; and "extra lean" as less than 2 g of saturated fat and trans fat combined. In addition, cholesterol claims were allowed only on foods containing 2 g or less of saturated fat and trans fat combined, and disqualifying and disclosure levels were set at 4 g or less of saturated fat and trans fat combined. FDA did not propose to define "low trans fat."

Quantitative declaration of trans fat in the Nutrition Facts panel [218]
The Food and Drug Administration (FDA) amended its regulations on nutrition labelling to require that trans fatty acids be declared in the nutrition label of conventional foods and dietary supplements on a separate line immediately under the line for the declaration of saturated fatty acids.

FDA is revised Sec. 101.9(c) by adding paragraph Sec. 101.9(c)(2)(ii) to require the quantitative declaration of trans fat in the Nutrition Facts panel. This new paragraph requires the listing of trans fat on a separate line under the statement for saturated fat. As is the case for all subcomponents of total fat, it is to be indented and separated by a hairline, with the amount expressed as grams per serving to the nearest 0.5 g increment below 5 g and to the nearest gram increment above 5 g. If the serving contains less than 0.5 g, the content must be expressed as 0, except when the statement "Not a significant source of trans fat" is used. In addition, the agency is clarifying that the word "trans" may be italicized to indicate its Latin origin.

Not a significant source of... [218]
Section 101.9(c) requires that information on mandatory nutrients, such as saturated fat and trans fat, be included in all nutrition labelling unless otherwise excepted from such labelling as provided for in specified paragraphs.

Special provisions within Sec. 101.9(c) allow for shortened formats that provide manufacturers flexibility to omit noncore nutrients (i.e., mandatory nutrients other than calories, total fat, sodium, total carbohydrate, and protein) that are present in insignificant amounts from the list of nutrients and group them in a summary statement at the bottom of the label that states -Not a significant source of-(see 58 FR 2079 at 2083, Comment 8, January 6, 1993). These special provisions are found in Sec. 101.9(c)(1)(ii) for calories from fat, Sec. 101.9(c)(2)(i) for saturated fat, Sec. 101.9(c)(3) for cholesterol, Sec. 101.9(c)(6)(i) for dietary fibre, Sec. 101.9(c)(6)(ii) for sugars, and Sec. 101.9(c)(8)(iii) for vitamin A, vitamin C, calcium, or iron. For consistency with the labelling scheme for these other noncore mandatory nutrients, new Sec. 101.9(c)(2)(ii) provides that if the trans fat content is not required and, as a result, not declared, the statement -Not a significant source of trans fat- must be placed at the bottom of the table of nutrient values.


Physiology of saturated fatty acids

Saturated fatty acids rise the blood level of LDL cholesterol.


Claim to lower risk of heart disease with soy products

[917] U.S. Food and Drug Administration has approved to label foods containing at least 6,25 grams of soy protein per serving touting a link between eating soy and lower risk of heart disease.
6,25 grams of soy proteins are one-fourth of the 25 grams of soy protein daily which are supposed to be needed to show a significant cholesterol-lowering effect.
The claim was requested by Protein Technologies International, a subsidiary of DuPont Co, which is a manufacturer of isolated soybean protein.
Foods which may be qualified for this claim are soy beverages, tofu, soy-based meat alternatives and some baked goods.

Tofu found to be a risk of brain decay in elderely persons

indexTofu [918]
Cell culture studies suggest that phytoestrogens, abundant in soy products such as tempe and tofu, could protect against cognitive decline. However, the Honolulu Asia Aging Study reported an increased risk for loss of memory and dementia with high tofu intake. [919]

Phytoestrogens may protect the brains of younger and middle-aged people from damage, however, increase the risk of dementia in old persons. [920]

Eef Hogervorst and colleagues 2008 found that high tofu consumption was associated with worse memory while high tempe consumption (a fermented whole soybean product) was independently related to better memory, particularly in participants over 68 years of age. Fruit consumption also had an independent positive association.

The authors say that tofu is rich in phytoestrogens which tended to promote unhealthy growth among cells in the ageing brain. High doses of estrogens may release free radicals damaging nerve cells. It is also possible that toxic effects of formaldehyde which is sometimes used in Indonesia as a preservative, might have influenced the results of the Honolulu Study. Hogervorst, however, stresses that moderated consume of tofu does not pose heath risks.

According to the authors tempe contains high levels of phytoestrogens, however, it also presents high folate levels which may exert protective effects. Vitamin B9 from tempe is responsible for brain protection of old persons.

Soy protein may reduce cholesterol levels, and promote weight loss

[921]
Cope, Erdman and Allison reviewed studies related to weight reduction induced by soy protein, They concluded that the weight loss was equivalent when using soy protein, dairy milk meal replacements, beef or pork at equal calorie levels.

Suggestion were found that soy protein may decrease short-term appetite and calorie intake. There were limited data of some evidence of soy isoflavones to improve the blood glucose and insuline levels, stopping fat tissue built up and enhancing fat breakdown. The cholesterol-lowering benefits of soy, and reduction of bone loss in women was also supported by the review.

The authors concluded that soy foods are as good as other protein sources for promoting weight loss and there is a suggestive body of evidence that soyfoods may confer additional benefits, but results must be carefully interpreted and additional evidence is needed before making firm conclusions concerning soyfoods and weight loss.

Black soy bean useful in weight reduction and improvement of LDL/HDL ratio in serum

[922]

Shin Joung Rho and colleagues 2007 found that a diet of black soy bean peptide (Rhynchosia volubilis Lour.) given to mice reduced total cholesterol concentration and low-denslipoprotein/high-density lipoprotein ratio in serum, lowered the level of hepatic triglycerides, and excretion of faeces was higher compared with a casein diet.

The authors concluded that black soy peptide can be a potent nutraceutical component for anti-obesity and hypolipidaemic benefits.


Omega-3 fatty acids claims

The major source of omega-3 fatty acids is dietary intake of fish, fish oil, vegetable oils (principally canola and soybean), some nuts such as walnuts, and, dietary supplements.

The Oxfor-Durham Study concerning Omega-3 fatty acids and DCD[923]
Alexandra J. Richardson and colleagues studied the effect of dietary supplementation with omega-3 and omega-6 fatty acids on children with developmental coordination disorder (DCD). This disorder affects 5% of school-aged children. They present deficits in motor function associated with difficulties in learning, behaviour, and psychosocial adjustment.

The authors found significant improvements in reading, spelling, and behaviour, however, no effect of treatment on motor skills was apparent. They concluded that fatty acid supplementation may offer a safe efficacious treatment option for educational and behavioural problems among children with DCD.

The British company Dairy Crest relying on these results claimed that her omega enriched milk could enhance children's ability to concentrate and learn. The Britain's Advertising Standards Authority requested to stop this claim alleging that children would have to drink more than five litres of that milk every day to get the same amount of omega-3, being thus misleading. [924]

Britain's Joint Health Claims Initiative (JHCI) has approved a generic health claim that foods containing omega-3 benefit heart health, but not learning ability or concentration. The JHCI offers pre-market advice and a code of practice for the food industry, enforcers and consumers, to ensure that health claims on foods are both scientifically truthful and legally acceptable.[924]

UK's Food Standards Agency, concerning omega fatty acids said that there is insufficient quality evidence to reach firm conclusions on the effect of nutrition and dietary changes on learning, education or performance for all schoolchildren. The Agency maintains their advice to a diet lower in fat, sate and sugar but high in fruits, vegetables and complex carbohydrates, in addition to being physically active.

Omega-3 fatty acids and brain function[925]
Omega-3 fatty acids were proposed as having an important role in mental health, because up to 60% of the adult brain is composed of lipids (dry weight). Thirty five percent of the lipids are phospholipids comprised of unsaturated fatty acid such as docosahexaenoic acid (an omega-3 fatty acid) and arachidonic acid (an omega-6 fatty acid) acids.

Omega 3 and psychiatric disorders[925]
Disorders of mental health are becoming increasingly common in the US. It is estimated that in a given year, 22%, or one in five American adults, suffers from a diagnosable mental health disorder.[926] These disorders, including major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder, account for four of the ten leading causes of disability in the US and other developed countries. Many people suffer from more than one mental disorder at a given time.[927]

Schachter, and colleagues co authors of the Oxford-Durham study write that overall, other than for the topics of schizophrenia and depression, few efficacy or safety studies were identified.

Only with respect to the supplemental treatment of schizophrenia is the evidence even somewhat suggestive of omega-3 fatty acids' potential as short-term intervention. Additional research might reveal the short-term or long-term therapeutic value of omega-3 fatty acids.

One study demonstrating a significant clinical effect related to 1 g/d E-EPA given over 12 weeks to 17 patients with depressive symptoms cannot be taken to support the view of the utility of this exposure as a supplemental treatment for depressive symptomatology or disorders.

Nothing can yet be concluded concerning the clinical utility of omega-3 fatty acids as supplemental treatment for any other psychiatric disorder or condition, or as a primary treatment for all psychiatric disorders or conditions examined in the review. Primary treatment studies were rare.

Much more research is needed before the possible utility of (foods or supplements containing) omega-3 fatty acids as primary prevention for psychiatric disorders or conditions can be ascertained. Studies of omega-3 fatty acids' primary protective potential in mental health could be "piggybacked" onto longitudinal studies of their impact on general health and development.

UK parliamentary inquiry on the effect of nutrition on behaviour

[928]
A report by the Associate Parliamentary Food and Health Forum, calls for more research and funding into the role of essential fatty acids on the mind. The forum does not recommend fatty acid fortification of foods, but recognizes functional effects of certain essential fatty acids such as Arachidonic Acid (AA) and Docosahexaenoic Acid (DHA), which form an important part of the cellular structure of the brain and in maintaining its normal functions.

The forum stresses that deficiency of omega-3 EFAs is associated with certain mental and behavioural disorders, such as ADHD, depression, dementia, dyspraxia, greater impulsivity and aggressive behaviour, but the association is still only partly understood.

Behaviour

[929]
Bernard Gesch of Natural Justice leads a study on the effect of nutritional diet in young offenders' institutes on behaviour and mental health of prisoners. The study is being funded by Welcome Trust

Learning and behavioural difficulties

[930]
The parliamentary forum recommended that the UK's Committee on Nutrition to look upon the optimum intake of omega-3 polyunsaturated fatty acids (PUFAs) in different stages of life, especially for pregnant women and children.

Deficiency of omega-3 can lead to a decreased ability to focus attention, which is vital for sequencing letters and numbers, skilled movements, and detecting facial and emotional expressions such as tone of voice and gestures.

The Durham Research

[931]
The Durham Research 2004 studied the treatment effect on Conners' Attention-deficit Hyperactivity Disorder (ADHD). Dramatic results were seen within just 3 months of the trial. The children in the active group supplementing with fatty acids saw significant improvements in reading, spelling and behaviour, compared to the placebo group where no overall improvement was made.

During the 3-6 month period when the placebo group crossed over to fatty acid supplementation, considerable improvements were shown in the same areas, with an average reading gain of 13.5 months and an average spelling gain at over 6 months.

The Sustain statement, however, points out that there is no published research evidence showing that omega-3 can help to improve a normal child's behaviour or school performance. The research done so far has been with children who have specific learning and behavioural difficulties. However, this has not prevented the supplement companies from benefiting massively from association with the research.

An investigation of Sustain of fish-oil supplemented foods on market such as omega-3 milk although it uses the omega-3 research as a marketing hook - neglects to note that a child would need to drink two and a half litres of it to get the same dose as used in trials. The same situation is present in products such as omega-3 enriched yoghurts, omega-3 eggs, omega-3 orange juice and omega-3 margarine. Sustain questions that they provide any real benefit.

Depression:

According to the forum there is a high prevalence of depression, including childhood depression and there is some evidence that omega-3 fatty acid supplements may be helpful in the treatment of depression. The inquiry,however, does not recommend universal fatty acid supplementation or fortification until recommended daily intakes for adults and children have been established.

Sustain has carried out work specifically on the issue of food and mental health for over three years through its Food and Mental Health Project. The principle of nutrient interaction states that even though every nutrient has a specific function, no nutrient works alone, anything that it does, it does with the assistance of a series of other processes, only made possible by the presence of other nutrients. Sustain says it is deceptive to consider nutrients as independent entities.

Whatever benefit omega-3 provides, it must be considered in the context of the entire diet. Certain minerals are necessary for the successful incorporation of omega-3 into the body and the presence of other fatty acids may interfere, research or supplementation programmes that ignore this key factor risk providing inaccurate perceptions of the effect of omega-3 rich foods on the body.

Sustain advocates two or three fish meals per week, and calls for policies that help and encourage every individual to eat a balanced, healthy diet, incorporating all of the necessary nutrients for brain health. FSA Systematic review of the effect of nutrition, diet and dietary change on learning, education and performance of school children carried out by the University of Teeside [932]
The UK's Food Standards Agency has published the results of a systematic review of the effect of nutrition, diet and dietary change on learning, education and performance of school children aged 4 - 18 years, covering already published studies.

The Government and those involved in education are committed to improv