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Foods masquerading as something else — a more nutritious something else — have been big news in the past two years. Chinese food companies in particular have been blamed for making deadly alterations to dairy, baby and pet foods by adding melamine. The chemical makes it appear that the food or beverage has the required level of protein.

But what about food producers in this country? What fraudulent foods do U.S. consumers have to fear from American companies?

Experts say dangerous U.S.-produced foods are comparatively few, but producers have been known to practice “economic adulteration” — adding a little to their bottom line by padding, thinning or substituting something cheap for something expensive.

So in a caveat emptor world, what should consumers look out for?

Fish is the most frequently faked food Americans buy. In the business, it’s called “species adulteration” — selling a cheaper fish such as pen-raised Atlantic salmon as wild Alaska salmon.

When Consumer Reports tested 23 supposedly wild-caught salmon fillets bought nationwide in 2005-2006, only 10 were wild salmon. The rest were farmed. In 2004, University of North Carolina scientists found 77% of fish labeled red snapper was actually something else. Last year, the Chicago Sun-Times tested fish at 17 sushi restaurants and found that fish being sold as red snapper actually was mostly tilapia.

“It’s really just fraud, plain and simple,” says Gavin Gibbons of the National Fisheries Institute, an industry group.

One thing consumers don’t need to worry about is scallops. Tales of skate wings cut into circles and sold as scallops are common. But Randolph says the FDA has never found an actual case of it.

Salmon is tricky. Randolph does have one tip, though. Farmed salmon gets its coloring from dyes added to food pellets the fish are fed, while wild salmon gets it from the plankton they eat.

Olive oil

This luxury oil, touted for its heart-health properties and taste, has become a gourmet must-have. Americans consumed about 575 million pounds of the silky stuff last year, according to the North American Olive Oil Association. Sixty-three percent was the higher-grade extra virgin, which comes from the first pressing of the olives.

There are no national figures on olive-oil fakery. But after complaints, Connecticut began testing two years ago. “We were coming across a lot of products labeled as extra-virgin olive oil that contained up to 90% soybean oil,” says Jerry Farrell Jr., Connecticut’s commissioner of consumer protection.

Most name brands were fine, Farrell says. It was often off-brands sold in discount stores that were the problem.

Connecticut was so concerned that in November, it became the first state in the nation to set standards for olive oil, enabling officials there to levy fines and pull adulterated products off store shelves. California is set to create its own standards this year. Reports from panels of testers have found as much as 60% to 70% of the olive oil sold as extra virgin in the state is a lower-quality olive oil, says Dan Flynn of the Olive Center at the University of California-Davis.

The easiest thing is for fakers to add 10% vegetable oil in extra virgin, says Stutsman. “It will still smell as it should, but you’ve saved 10% of the cost.”

Bob Bauer, president of the North American Olive Oil Association, says it’s more of a problem in restaurants than in supermarkets.

Honey

An expensive natural product that’s mostly sugar, honey is easily faked. It used to be that cane sugar or high-fructose corn syrup was mostly used to thin out honey. But chemically, that was easy to spot.

So counterfeiters got wily and started using beet sugar. Its profile is similar to honey.

Maple syrup

Maple syrup is another high-value item that can be adulterated. In these tough economic times, Vermont, the USA’s largest supplier to flapjacks everywhere, may up its testing programs.

The boiled-down sap of the sugar maple tree can be diluted with water or sugar by sellers “trying to get more bang for the buck,” says Kristin Haas, food safety director in the state’s Agency for Agriculture, Food and Markets.

Vermont’s testing program has found fraud only three times in the past 17 years, says Haas, but it’s not taken lightly. “A couple of years back, there was a gentleman who actually went to prison because of this issue.”

When times get tight, the incentive to cheat can rise like sap in the spring, so the state may have to work harder to keep its premier product pure.

Vanilla

A product of the tropics, vanilla pods can be soaked in milk or stored in sugar to impart a delicate vanilla scent to foods. More commonly, they’re soaked in alcohol that is then used as a flavoring.

But vanillin (pronounced VAN-ah-lynn), a chemical copy of the richly organic vanilla flavor, was created in the laboratory in the 19th century. When used in foods, it’s supposed to be labeled as an artificial flavor and usually is.

One “too good to be true” product to watch out for is really inexpensive vanilla extract sometimes sold in Mexico and Latin America. It’s often made with coumarin, a toxic substance that has been banned in U.S. foods since 1954.

Coumarin is chemically related to warfarin, a blood thinner, and can be dangerous.

The number of deaths from coronary heart disease among Japanese men is less than half that of American men. Whether this effect is due to genetic, dietary or other factors has not been confirmed. In the first international study of its kind, published in the August 5, 2008, issue of Journal of the American College of Cardiology, University of Pittsburgh Graduate School of Public Health assistant professor of epidemiology Akira Sekikawa, MD, PhD, and colleagues evaluated data from 868 men aged 40 to 49 enrolled in the ERA JUMP (Electron-Beam Tomography, Risk Factor Assessment Among Japanese and U.S. Men in the Post-World War II Birth Cohort) Study. Two hundred eight-one of the current study’s subjects were from Japan; 306 were Caucasian men from Pennsylvania; and 281 were Japanese-American men living in Hawaii. Blood tests measured total fatty acids and the omega-3 fatty acids eicosapentaenoic, docosahexaenoic and docosapentaenoic acids which are commonly obtained by consuming fish. Ultrasound examination assessed carotid artery intima-medial thickness (IMT), which is used to evaluate atherosclerosis. Coronary artery calcification (CAC) in the heart’s arteries, which also identifies heart disease, was assessed via electron-beam CT scanner.

Dr Sekikawa’s team found that although total fatty acid levels were similar among all subjects, the percentage of fish-based omega-3 fatty acids was twice as high among Japanese men compared with Americans of both European and Japanese descent. Japanese men had significantly less atherosclerosis, as indicated by lower average intima-media thickness and coronary artery calcification. Among Japanese men, intima-media thickness values declined with rising omega-3 fatty acid levels, a phenomenon that was not observed in either American group.

“The death rate from coronary heart disease in Japan has always been puzzlingly low,” Dr Sekikawa observed. “Our study suggests that the very low rates of coronary heart disease among Japanese living in Japan may be due to their lifelong high consumption of fish. Our study clearly demonstrated that whites and Japanese-Americans have similar levels of atherosclerosis, which are much higher than in the Japanese in Japan. This indicates that much lower death rates from coronary heart disease in the Japanese in Japan is very unlikely due to genetic factors.”

“Our study suggests that very high levels of omega-3 fatty acids have strong properties that may help prevent the buildup of cholesterol in the arteries,” Dr Sekikawa stated. “Increasing fish intake to two times a week for healthy people is currently recommended in the U.S. Our study shows much higher intake of fish observed in the Japanese [approximately 3 ounces daily] may have strong anti-atherogenic effect.”

“While we don’t recommend Americans change their diets to eat fish at these quantities because of concerns about mercury levels in some fish, increasing intake of omega-3 fatty acids in the U.S. could have a very substantial impact on heart disease,” he added.

 A new study from the University of Colorado Denver’s School of Pharmacy has found that a simple educational intervention provided by a pharmacist can make a significant impact in the amount of vitamin D intake in geriatric outpatients, resulting in increased serum, or blood levels of this key nutrient. Surprisingly, the study also found that the overall increase in serum levels in the patients who received the intervention were still not in the target range, indicating that current national recommendations for vitamin D intake may be insufficient. The study is published this month in the July/August issue of the Journal of the American Pharmaceutical Association.“The educational intervention was simple to administer and can be reproduced by pharmacists in a variety of settings, including a community pharmacy or a clinical practice site,” said Joseph Vande Griend, PharmD, assistant professor in the Department of Clinical Pharmacy at the UC Denver School of Pharmacy and lead author of the paper. “Geriatric patients are at risk of medical complications from vitamin D insufficiency, including osteoporosis, and pharmacists, physicians, and other point-of-contact health care representatives can make a difference by recognizing vitamin deficiencies in their patients and taking the time to talk about the importance of key nutrients like vitamin D.”The Pharmacist’s Findings and an Educational Intervention Vitamin D concentrations were studied in older adults, ages 65 to 89 years, during clinic visits to the University of Colorado Hospital from December 2005 to January 2006. Eighty patients completed the study and 59 of them, 74 percent, were found to have vitamin D insufficiency. The majority of patients who were vitamin D insufficient consumed more than the recommended 400 to 600 IU per day of vitamin D.

The UC Denver pharmacists practicing in geriatric medicine then created a vitamin D informational sheet that was given to those geriatric outpatients who had insufficient vitamin D intake. A pharmacist reviewed the sheet with the participant during a 15-minute, one-on-one educational session about vitamin D, in which it was recommended the participant consume a total of 1,200 IU per day of vitamin D. A recommendation of 1,200 IU was chosen because the amount was estimated to increase patient serum levels to the study-defined sufficient vitamin D concentration of 32 ng/mL. The 1200 IU per day of vitamin D is also easy to obtain from over-the-counter resources; it is higher than the current Institute of Medicine recommendation (400 IU/day under age 70 and 600 IU/day over age 70) but below the upper daily intake limit (2,000 IU/day).

The handout covered the importance of vitamin D in maintaining good health, provided a listing of food sources with vitamin D, and a listing of over-the-counter supplements containing vitamin D3 along with their general cost. The handout is available online at http://www.japha.org/ .

At the conclusion of the educational session, the clinical pharmacist helped the participant choose which foods and/or supplements to use to increase daily vitamin D intake and provided the participant with a written, personalized plan to consume 1,200 IU per day of vitamin D. No supplements were provided to the study participants.

Two weeks after the educational session, the pharmacist followed-up with participants via telephone. During the call, the importance of vitamin D in maintaining optimal health and the details of the personalized vitamin D plan were reiterated. Participants were then asked whether they had obtained the agreed upon vitamin D product(s) and whether they were actually using the products. If not, the recommendation was reviewed and the participant was encouraged to obtain the product(s) and try to increase vitamin D intake.

The Outcome of the Educational Intervention After 12 weeks, a higher proportion of participants in the educational intervention group (55 percent) achieved the desired vitamin D blood level concentration of 32 ng/mL compared with the nonintervention group (24 percent). The change in dietary and over-the-counter vitamin D intake was also evaluated. Self-reported total vitamin D intake increased by a mean of 647 IU/day in educational intervention participants and 67 IU/day in the nonintervention group. Participants in the educational intervention group reported consuming an average of more than 1,400 IU/day vitamin D.

NEW YORK, July 18, 2008 /PRNewswire via COMTEX/ — Drinking four to five cups of tea a day may help maintain a healthy mind and body, according to new research published in a supplement to the August issue of the Journal of Nutrition. One study’s results suggest that four to five cups of tea a day may improve attention and focus. This and other studies on tea polyphenols, including research on neurological health, genetic susceptibility to cancer, and insulin sensitivity are included in the Proceedings of the Fourth International Scientific Symposium on Tea and Human Health. The supplement also provides an update on the evidence in support of tea’s role in cardiovascular health, and the bioavailability of its beneficial flavonoids.

“This supplement highlights many of the new frontiers being investigated regarding black and green tea’s potential public health benefits,” said Tea Symposium co-chair, Jeffrey Blumberg, Ph.D., Professor, Friedman School of Nutrition Science and Policy and Director, Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston. Lenore Arab, Ph.D., Professor of Internal Medicine at the University of California, Los Angeles and Blumberg’s partner as Tea Symposium co-chair adds that, “There are tremendous advancements to better understand the mechanisms by which tea may reduce risk for heart disease, certain cancers, type II diabetes, and help maintain neurological function.”

Theanine in Tea Increases Attention and Focus

The results of a new human, placebo-controlled, trial published in the Proceedings of the Fourth International Scientific Symposium on Tea and Human Health found that theanine, an amino acid present almost exclusively in the tea plant, including black, green, and oolong varieties, actively alters the attention networks of the brain. “Our results show that after having theanine, individuals had significant improvements in tests for attention, and that activity in cortical regions responsible for attention functions was enhanced,” said author John Foxe, Ph.D., Professor of Neuroscience, Biology and Psychology at City College of the City University of New York. “What’s more, we have seen that just 20 minutes after consuming theanine, the blood concentrations increase and the brain’s alpha waves are impacted. It lasts about three to four hours, which we have speculated may be why people tend to drink a cup of tea every three-to-four hours during the day,” added Dr. Foxe.

The new research from Dr. Foxe and his team used electrophysiological measures to monitor brain activity after individuals drank solutions containing a placebo, 50 mg caffeine, an amount of theanine equivalent to five to six cups of tea, or a combined treatment. The subjects were asked to complete a variety of attention-related computerized tasks.

The results from Dr. Foxe’s laboratory, the Cognitive Neurophysiology Laboratory at the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, New York, supported by the Lipton Institute of Tea, suggest that the effects of theanine in combination with caffeine are even greater than with either one alone in improving attention. Theanine may work synergistically with caffeine to help induce a more calming, relaxed state, but one that allows the mind to focus and concentrate better at tasks Theanine is known to be absorbed by the small intestine and cross the blood-brain barrier where it affects the brain’s neurotransmitters, and increases alpha brain-wave activity. This alpha brain rhythm is known to induce a calmer, yet more alert, state of mind. A cup of brewed tea typically contains between 10 and 20 mg of theanine.

Tea May Protect Aging Brains from Alzheimer’s and Parkinson’s Diseases

Newly published study by Sylvia Mandel, Ph.D., of the Eve Topf Center for Neurodegenerative Diseases in Israel, show that the active flavonoids in tea may have multiple mechanisms of action on a cellular level on maintaining neurological health. Mandel, who has been studying the effects of tea on brain functions in laboratory and animal models for over a decade, looked at animal models of neurological diseases such as Parkinson’s and Alzheimer’s. An amount of purified EGCG equal to about two to four cups of green tea per day was provided to animals with induced Parkinsonism as part of their diet to evaluate how their symptoms improved or progressed. They found that when the animals are fed green tea EGCG, the polyphenol appeared to prevent brain cells from dying, and showed improvements in reducing compounds that lead to lesions in the brains of animals with Alzheimer’s disease.

“In the past, it was thought that once brain cells were damaged, there was no way to repair them. Not only may the EGCG help prevent brain cells from dying, it appears that the polyphenol may even rescue the neurons, once they have been damaged, to help them repair,” says Dr. Mandel.

While numerous studies have concluded that diets rich in fruits and vegetables support the body in fighting neurological decline through antioxidant mechanisms associated with their high flavonoid content, the importance of tea’s polyphenolic flavonoids in supporting healthy brain cells appears to go beyond the simple oxygen species scavenging, involving pleiotropic effects on numerous biological pathways to help keep human brain cells from dying and even help repair them when they are subjected to insults that damage the cells’ DNA.

Human epidemiological and new animal data from around the world suggests that drinking tea — especially those rich in flavonoids named catechins — may help support the brain as we age. Recent publications from earlier this year also contribute to the growing body of research on the potential neuroprotective benefits of tea polyphenols. Tan et al found an inverse association between black tea and Parkinson’s disease, based on a 12 year prospective study of over 63,000 men and women, that was due to black tea ingredients separate from its caffeine content. A retrospective study, by Kandinov et al, of nearly 300 patients with Parkinson’s disease found that drinking three or more cups of tea per day delayed motor symptoms by 7.7 years. In addition to epidemiological data, results from recent animal studies showed that tea polyphenols may improve memory in Alzheimer’s disease (Rezai-Zadeh et al), and be neuroprotective against oxidative stress (Hague et al).

Tea May Alter Cancer Genetics

Results from a tea intervention on the role of green tea on the prevention of cancer provided insights into the cutting-edge field of nutri-genomics, or how gene susceptibility toward chronic diseases can be altered through dietary interventions. Iman Hakim, M.D., Ph.D., M.P.H., Professor and Dean of the Mel and Enid Zuckerman College of Public Health and Professor at the Arizona Cancer Center, University of Arizona, has conducted several human clinical trials over the past decade on the role both green and black tea may play in certain cancers. Her latest human clinical trial suggests that bioactive compounds in tea have a significant effect on genes that impact cancer susceptibility and repair from environmental insults.

“The good news is that we are seeing that green tea is impacting genes that play a role in cancer, but we cannot pinpoint who will be responders versus non-responders at this time,” noted Dr. Hakim. “In addition, our recent preliminary data show a beneficial effect of green tea on lipid profile among smokers and former smokers. Since there are no known negative effects of consuming tea, and it may be beneficial, there’s no reason not to recommend drinking it.” Dr. Hakim recommends at least four cups per day.

Growing Body of Evidence

The Proceedings of the Fourth International Scientific Symposium on Tea and Human Health provides the latest scientific update from key research scientists from top medical institutions in North America, Europe, the Middle East and Asia, based on their clinical, laboratory, and epidemiological studies related to the role of tea in promoting healthfulness and reducing the risk of disease. The ongoing scientific exploration of the health benefits of drinking tea has led to a growing body of research that points to tea as an important contributor to overall health. The Proceedings extends the base of credible, published data supporting the health benefits of tea, encouraging the scientific community to continue exploring this exciting area.

It’s just before noon, and the emergency room already is filling with patients.

John Whitcomb, a lanky, high-octane physician, scurries from exam room to exam room, keeping pace with an onslaught of people coming in with chest pain, ankle injuries, seizures and stomachaches. The ER at Aurora Sinai Medical Center in Milwaukee isn’t the most likely place to get a friendly lecture about vitamin D.

But Whitcomb, one of a small but growing number of physicians who think deficiency of the sunshine vitamin is its own public health emergency, preaches to anyone who will listen.

A growing body of research suggests that inadequate vitamin D can substantially increase the risk of a variety of diseases, including several cancers, heart disease, high blood pressure, diabetes, depression and multiple sclerosis as well as the risk of falling and infections.

In northern regions like Wisconsin, where vitamin D levels are low, the concern is even more pronounced because of a lack of ultraviolet radiation during much of the year.

Now pockets of physicians here and around the country are making vitamin D a high priority.

Steve Trapp, 38, was on a bus from Chicago to Seattle last month when he began vomiting at the Milwaukee bus station. He was taken to the ER at Aurora Sinai. Whitcomb diagnosed the problem as a bout of stomach flu and dispensed nausea medicine — and an ample dose of vitamin D advice.

As Trapp lay in an exam room, Whitcomb rattled off a few recent research findings on how vitamin D can reduce the risk of various diseases. He told the couple how there really is no food source that can provide ample levels of the vitamin.

He said the sun’s angle drops in winter, and with that shift, vitamin D levels in the blood decrease from an average of about 40 nanograms per milliliter to less than 20 ng/ml.

“When the level drops below 32, many of the body’s functions don’t work right,” he said.

Only supplements or ultraviolet light can prevent that from happening.

Over the past two years, Whitcomb estimates that he has talked to more than 1,000 patients about vitamin D in the ER or other urgent care facilities in the area. He’s written about vitamin D in newsletters and given talks to other doctors.

He’s even tested the blood of ER patients to find out their vitamin D levels. Invariably, the levels are extremely low.

While there is not unanimous agreement on what is the optimal vitamin D blood level, many researchers say it should be at least 30 ng/ml and preferably between 40 and 60.

No large clinical trials

Exposure to intense sunlight was mostly a year-round occurrence for our prehistoric ancestors who, for thousands of years, existed naked near the equator.

It has been only in relatively recent human evolutionary history that people moved north, began wearing clothing and spent more time indoors, resulting in vitamin D deficiencies.

The vitamin actually is a hormone that plays a role in the regulation of more than 100 genes, many of which are involved in preventing diseases.

However, while that theory sounds attractive to vitamin D advocates, much of the research pointing to the vitamin’s disease-preventing ability is observational in nature. While most of those studies show a benefit, some do not.

Nevertheless, observational studies pointing to potential health benefits from the vitamin continue to pile up.

A study released late last month found higher rates of death from all causes and from cardiovascular disease among a group of 3,258 heart patients with low levels of vitamin D in their blood, compared with heart patients with higher levels of vitamin D.

Also in June, a study involving 18,225 men found that those with vitamin D levels below 15 ng/ml were 2.4 times more likely to have a heart attack than those with levels above 30 ng/ml.

Last year, an analysis involving 1,760 women found a 50% reduction in breast cancer risk in those whose vitamin D levels were more than 52 ng/ml, compared with levels of less than 13.

After reading a variety of vitamin D studies, Tara Rakowski, an east side family practice physician with Columbia St. Mary’s, began testing for the vitamin in her patients. In more than 60% of the approximately 500 patients, vitamin D levels were less than 20 ng/ml, she said. Now, “there isn’t a patient I don’t check it on,” she said.

Typically she will put patients with low vitamin D levels on a prescription regimen of 50,000 international units of vitamin D a week. After that, they usually take 2,000 IU a day in the form of vitamin D3, which is inexpensive. That’s the dose many vitamin D proponents now are recommending, although it is considerably more than the current recommended intake, which ranges from 200 IU in children to 600 IU in the elderly.

Rakowski said her patients often feel better after boosting their vitamin D levels.

Jaishree Hariharan, an internal medicine physician who practices at Froedtert Hospital, said she had checked vitamin D levels in about 200 patients in the past year. Most have levels below 20 ng/ml, she said.

“The big misnomer that most physicians are worried about is vitamin D toxicity,” said Hariharan, an associate professor of medicine at the Medical College of Wisconsin. However, with doses of 2,000 IU a day, “there is no downside,” she said.

Upping her dose

Alice Carter, a 63-year-old from Milwaukee, is lying on a bed with chest pain in the ER at Sinai Medical Center.

After Whitcomb determines the Milwaukee woman is having a bout of angina, he begins telling her about vitamin D.

He seems pleasantly surprised when she tells him that she started taking 1,000 IU a day about a year ago, but he says she should up the dose to 2,000.

“Your skin pigment protects you from sunburn, but it also means you need to get three to four times as much sunlight to make the same amount of vitamin D,” he tells Carter, who is African-American.

He tells her that many African-Americans he has tested have vitamin D levels of less than 10, but blacks living near the equator in Africa have levels near 60, he says.

“So are you saying I need to move down South?” she jokes.

Whitcomb says that won’t be necessary if she increases her summertime dose to 2,000 IU and her wintertime dose to 4,000.

The majority of men with androgen deficiency may not be receiving treatment despite having sufficient access to care, according to a report in the May 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals (see also JAMA and Archives Journals).

Androgen deficiency in men means the body has lower than normal amounts of male hormones, including testosterone, according to background information in the article. Although prescriptions for testosterone therapy for aging men have increased in recent years, treatment patterns for androgen deficiency are not clearly understood in community-dwelling U.S. males.

Susan A. Hall, Ph.D., of New England Research Institutes, Watertown, Mass., and colleagues examined data collected from 1,486 Boston-area men (average age 46.4) from April 2002 to June 2005 to estimate the number of men receiving treatment for androgen deficiency, to explain how treated and untreated men varied in seeking care and to understand potential barriers to health care. Specific symptoms of androgen deficiency include low libido, erectile dysfunction and osteoporosis and less-specific symptoms include sleep disturbance, depressed mood and tiredness.

A total of 97 men met the criteria for having androgen deficiency. Eighty-six men were symptomatic and untreated, and 11 were prescribed testosterone treatment. “Men were using the following: testosterone gel (n=1), testosterone patch (n=3), testosterone cream (n=1), testosterone cypionate [an injectable form of testosterone] (n=1) or unspecified formulations of testosterone (n=5),” the authors write. “All of the unspecified forms of testosterone used were self-reported as administered in intervals defined in weeks, which suggests that these were injectable formulations.”

“Men with untreated androgen deficiency were the most likely of the three groups to have low socioeconomic status, to have no health insurance and to receive primary care in an emergency department or hospital outpatient clinic,” the authors write. However, all men with treated and untreated androgen deficiency were more likely to report receiving regular care than those without the condition and reported visiting their doctor more often throughout the year (with averages of 15.1 visits for those with untreated androgen deficiency, 6.7 visits for those without the condition and 12 visits for those with treated androgen deficiency).

“Under our assumptions, a large majority (87.8 percent) of 97 men in our groups with androgen deficiency were not receiving treatment despite adequate access to care,” the authors conclude. “The reasons for this are unknown but could be due to unrecognized androgen deficiency or unwillingness to prescribe testosterone therapy.”

Jul. 9–Vitamin D deficiency has been linked in recent studies to problems ranging from a greater risk of heart attack among men to a lower likelihood of survival among women with breast cancer. Now a new finding suggests that low levels of vitamin D for pregnant mothers may translate to more cavities for their babies.

Canadian researchers measured vitamin D levels of 206 pregnant women and then examined their infants at a followup appointment. Ninety percent of all the mothers in this largely aboriginal group had inadequate vitamin D concentrations; various other studies have estimated that perhaps half of all Americans are deficient.

About a third of the 135 babies in the study had cavities when they were examined at an average 16 months of age. When the researchers looked back at pregnancy records, they found that the mothers of those infants were significantly more likely to have had lower levels of vitamin D.

Baby teeth begin developing as early as six weeks in utero, and vitamin D is known to be involved with the formation of protective tooth enamel, lead author Robert Schroth explained in a phone interview yesterday. And although that enamel disappears when adult teeth come in, there is evidence that poor dental health follows children into adulthood.

Cognizant of a huge run on vitamin D tests in Canada, Schroth, an assistant professor on the dentistry faculty at the University of Manitoba, does not automatically recommend screening. But he does advise pregnant women to raise the issue with their doctors, to take prenatal vitamins, drink milk fortified with vitamin D and get a “small amount” of sunlight. “I think mums should be aware that prenatal diets can go a long way toward improving [infants'] dental health,” Schroth said.

The study was presented at the recent International Association for Dental Research annual meeting in Toronto. It was funded by several government and medical organizations and the Dairy Farmers of Canada.

Jun. 18–It’s hard to miss all the buzz about omega-3 fatty acids. In the grocery store the other day, I noticed that omega-3 fatty acids have been added to some brands of orange juice. Consumers now also have the choice of buying eggs and peanut butter fortified with omega-3 fatty acids.

In general, fats are described based on the predominant fatty acid present. Fatty acids are of two basic types: saturated (such as in butter) or unsaturated (such as in liquid vegetable oils). Unsaturated fatty acids, in turn, are classified as monounsaturated or polyunsaturated. Omega-3s are a type of polyunsaturated fatty acid.

The most common omega-3 fatty acids are eicosapentaenoic (EPA), docosahexaenoic (DHA) and alpha-linolenic (ALA) acids. At this time, the national dietary standards known as the Dietary Reference Intakes do not include recommended intakes for all omega-3 fatty acids. But an adequate intake has been set for ALA at 1.6 and 1.1 grams per day for men and women, respectively.

ALA is found in plant oils, including flax, canola and soybean. DHA and EPA are found in the tissues of cold-water fish such as salmon, mackerel, tuna, herring, sardines and even oysters. Cod liver also is a rich source of these omega-3s. My mother may have been right in forcing us to choke down that spoonful of cod liver oil each day.

Strong evidence exists that consumption of fish oil reduces serum lipid levels and reduces inflammation, which are both associated with cardiovascular disease risk.

In fact, many health problems are linked to chronic inflammation: cardiovascular disease, asthma, at least some types of cancer, type 2 diabetes and obesity. The anti-inflammatory effects of omega-3s are mediated by changes in the production of bioactive substances called cytokines by our white blood cells.

Evidence also suggests that consuming omega-3s may improve the body’s sensitivity to its own insulin, thus helping to maintain a healthy body weight and reducing risk for type 2 diabetes. Recent studies conducted by French researchers found that consuming 1.8 grams of EPA/DHA per day resulted in a significant loss of body fat after just two months.

While DRIs have not been established for all of the omega-3s, several expert groups have recommended increases in the amounts and types of omega-3s in the diet. Recommendations have varied from 0.5 to 1.6 grams per day (combined EPA/DHA), to 1 percent to 2 percent of total calories a day (for total omega-3’s). For a person consuming a 2,000-calorie-a-day diet, this would translate to 20 to 40 calories or 2 to 4 grams of omega-3s each day. This level of omega-3 intake can be achieved using fish oil supplements. Since a single 1-gram capsule of fish oil contains about 30 percent EPA/DHA, this would require consuming two to six capsules each day.

Another approach is to include plant sources of ALA in your diet. One of the richest sources of ALA is flax — grown right here in North Dakota. Flax oil is about half ALA. Other edible seed oils contain lesser amounts of ALA. For example, canola (also grown in North Dakota) oil has about 12 percent ALA, and soybean (again, produced here) oil contains about 7 percent.

ALA can be converted to EPA by our tissues, but that conversion provides only small amounts of EPA. One study indicated that one would need to consume 7 grams of ALA to get the same effect as 1 gram of EPA/DHA. This means one would have to consume 14 grams (1 tablespoon) of flax oil (50 percent ALA) to get the same effect.

Unlike fish oil, flax and flax oil can be incorporated into many foods without great effects on flavor, texture and other characteristics. For this reason, consumers are being presented choices of foods fortified with omega-3s from plant oils. This trend is bound to continue as more evidence emerges about the health benefits of ALA.

Each month, scientists at the Grand Forks Human Nutrition Research Center write a column about their work and how their work affects people’s lives on a daily basis. This month’s column is written by Wesley Canfield, research medical officer, who received his medical degree from the State University of New York Health Sciences Center at Upstate.

The June 23, 2008 issue of the American Medical Association journal Archives of Internal Medicine published the discovery of Austrian and German researchers that men and women with higher serum levels of vitamin D have a reduced risk of dying from all causes as well as specifically from cardiovascular disease over a seven year period, compared with individuals whose blood levels are low.

Harald Dobnig, MD, of Medical University of Graz, Austria, and colleagues evaluated data from 3,258 participants scheduled for coronary angiography who enrolled in the Ludwigshafen Risk and Cardiovascular Health Study between 1997 and 2000. Serum levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamn D, which is converted from 25-hydroxyvitamin D in the body, were measured in blood samples collected prior to the angiographic procedure.

Over an average 7.7 years of follow-up, 737 deaths occurred, of which 62.8 percent were from cardiovascular causes. Approximately two-thirds of the patients were found to have low serum 25-hydroxyvitamin D levels of under 20 nanograms per milliliter. Cardiovascular risk markers, including C-reactive protein levels and interleukin 6 levels (which evaluate inflammation), oxidative burden, and cell adhesion markers, were greater among individuals with lower serum 25-hydroxyvitamin D levels than in those whose levels were higher. Participants whose serum 25-hydroxyvitamin D levels were among the lowest one-fourth of participants, at a median of 7.6 nanograms per milliliter, had an adjusted risk of dying from all causes or cardiovascular disease that was twice that of subjects whose levels were among the highest fourth at 28.4 ng/mL. When 1,25-dihydroxyvitamin D levels were evaluated, similar associations were found.

“This prospective cohort study demonstrates for the first time, to our knowledge, that low 25-hydroxyvitamin D and 1,25-dihyroxyvitamin D levels are associated with increased risk in all-cause and cardiovascular mortality compared with patients with higher serum vitamin D levels,” the authors write. “Apart from the proved effects that vitamin D has on bone metabolism and neuromuscular function, appropriate serum levels (that may also be higher than in the present investigation) are associated with a decrease in mortality. Although not proved, it seems possible that at least part of this effect may be due to lowering of a risk profile promoting atherosclerosis and preventing cardiovascular end points.”

“Based on the findings of this study, a serum 25-hydroxyvitamin D level of 20 nanograms per milliliter or higher may be advised for maintaining general health,” they conclude.

Diabetes linked to advanced breast cancer
TONY EASTLEY: An international study has established a link between Type-2 Diabetes and advanced breast cancer.

It’s been known for a while that being overweight puts post-menopausal women at greater risk of breast cancer, but now it’s been found that women who are resistant to insulin, or who are overweight, are 50 per cent more likely to be diagnosed with the cancer and only when it’s in its advanced stages.

The finding comes after an international research team followed more than 60,000 Swedish women over 20 years.

Dr Anne Cust from the University of Melbourne is a collaborator in the study and she is preparing to present the findings at a medical conference in Brisbane today.

Dr Cust is speaking here with AM’s Simon Lauder.

ANNE CUST: We found that women who were overweight or who have signs of insulin resistance which is a precursor to Type-2 Diabetes were more likely to be diagnosed with an advanced breast cancer.

SIMON LAUDER: So if a woman is overweight or has early signs of Type-2 Diabetes, how much more likely is she to get advanced stage breast cancer?

ANNE CUST: About 50 per cent more likely so they are less likely to get an early stage tumour but more likely to get a more advanced stage breast tumour.

SIMON LAUDER: For overweight or diabetic women, it doesn’t necessarily mean they are more likely to get breast cancer but they are less likely to be diagnosed early?

ANNE CUST: Yes, our study was looking particularly about the stage of breast cancer, the diagnosis and we found that they were, women who were overweight or with insulin resistance were more likely to get it, be diagnosed with an advanced stage of breast cancer.

We don’t know the exact reasons why that might be. It might be that the cancer is growing more quickly or that it wasn’t diagnosed early but we need to do more research to find out exactly why that might be.

SIMON LAUDER: Is there a hypothesis as to why overweight or diabetic women aren’t diagnosed earlier with breast cancer?

ANNE CUST: It may be that the hormones that are involved, that are linked with being overweight or having insulin resistance, might be making the tumour grow more quickly but we need to do more research to find out exactly why that might be the case.

SIMON LAUDER: Does it mean that women who are at risk of Type-2 Diabetes should be screened for breast cancer more often?

ANNE CUST: Not necessarily I think. The question of screening is something that would need to be looked at separately but I think it is just providing another indication that being overweight is linked to lots of different health problems and this is another reason to get off the couch and try to stay active and maintain a healthy weight.

And also, the link with insulin resistance may provide a new avenue of research for looking at the causes of breast cancer and possibly new treatments.