The latest key findings in nutrition, health, and edible schoolyards

Edible schoolyards are coming to Sacramento as soon as the schoolyard vegetables are ready to harvest. Check out the article, Stuart Leavenworth: Alice Waters eyes Sacramento for next edible schoolyard project. In today's Sacramento Bee, an article by Anne Gonzales, "Manager reviews chef's 'Edible Sac High' project," you see how renowned Berkeley, California chef, Alice Waters wanted to take her concept of edible schoolyards, planting vegetables in school lawn areas to the rest of the country. The beneficiary now is a school in the Oak Park area of Sacramento. Check out the website about the Edible Schoolyard Network. Planting edible gardens is one way to motivate students to eat healthier foods at school and take the idea home with them.

Just a few months ago, the Edible Schoolyard Project began at Sacramento Charter High School, modeled after the edible school garden built 16 years ago in Berkeley by Alice Waters. After grants, fundraising, and donations came in, Mayor Kevin Johnson's Greenwise clean-technology initiative coordinates the program.

The garden involves about 100 students building and running the edible garden at the Oak Park school, where eventually not only a vegetable garden will bloom, but students also will run a campus cafeteria serving vegetables grown in the garden, preparing food, and taking cooking classes which will give the students additional job skills after high school. The project is called Edible Sac High. Right now, Sacramento High School is the only "edible schoolyard" program for a high school across the nation. It's a pilot program for other high schools nationwide. There's even a full-scale working kitchen classroom.

Will chefs and food manufacturers ever reduce the amount of excess salt put in processed foods for taste?

There's too much salt being added to processed foods. On top of that conclusion by scientists, there are also too many antibiotics being fed to cattle and other animals such as certain types of poultry that people consume. See, Unchecked antibiotic use in animals may affect global human health. Meanwhile in a new study from the American Heart Association, researchers found that less sodium in the U.S. diet could save 280,000 to 500,000 lives over 10 years, according to new research in the American Heart Association journal Hypertension.

Also see the results of another study, "High blood pressure during pregnancy may signal later heart disease risk." Women who have high blood pressure during pregnancy may later face higher risk of developing heart disease, chronic kidney disease, and diabetes. Healthcare providers should monitor these women's long-term for risk factors and be prepared to treat heart issues, according to the National Institutes of Health.

And regarding vitamin supplements, another study, Analysis finds vitamin D potency varies widely in dietary supplements revealed that vitamin D supplement potency varies widely, and the amount of vitamin D in over-the counter and compounded supplements does not necessarily match the amount listed on the label, according to a research letter published in the journal JAMA Internal Medicine.

In the study on how salt affects the health of humans, using computer simulations and models researchers projected the effects of small (about 5 percent of a teaspoon of salt per person per day), steady annual reductions of sodium consumption in the U.S. diet, reducing sodium consumption by 40 percent to about 2,200 mg/day over 10 years.

Key findings include the following results:

  • A gradual reduction in sodium consumption by 40 percent to about 2,200 mg/day over 10 years is projected to save hundreds of thousands of lives – between 280,000 and 500,000 depending on the modeled assumptions.
  • About 60 percent more deaths could be averted over this time period if these same reductions could be achieved more quickly (500,000 to 850,000 lives).

The increasing production and use of antibiotics, about half of which is used in animal production, is mirrored by the growing number of antibiotic resistance genes, or ARGs, effectively reducing antibiotics' ability to fend off diseases -- in animals and humans.

Three research groups contributed to the study, each using a different approach for their simulation. One approach used observational cardiovascular outcome follow-up data, while the other two based their projections on established evidence that salt reduction lowers blood pressure. These two groups inferred the cardiovascular effects of reducing sodium from data about the relationship of blood pressure to cardiovascular disease.

"The research groups used the same target populations and baseline death rates for each projection, and our study found that the different sources of evidence for the cardiovascular effects of sodium led to similar projected outcomes," said Pamela Coxson, Ph.D., lead author of the study and a mathematics specialist in the department of medicine at the University of California San Francisco (UCSF), according to a February 11, 2013 news release, "Reducing sodium in US may save hundreds of thousands of lives over 10 years."

"It is helpful when three research groups use different approaches and come up with similar results," said Kirsten Bibbins-Domingo, Ph.D, M.D., senior author of the study and associate professor of medicine at UCSF and director of the UCSF Center for Vulnerable Populations, according to the news release.

The three approaches included a gradual reduction of sodium by 40 percent; instant reduction of sodium by 40 percent or instant reduction of sodium to no more than 1500 mg/day. According to the researchers, only the first scenario — gradual population-wide reduction of sodium by 40 percent over ten years — is a potentially achievable public health goal.

Processed foods contain most of the excess salt

You buy almond milk, for example, in a container only to find out that per cup 180, 170, or 160 mg of salt is added to unsweetened milk substitute, but not to the sweetened variety of the same brands of almond milk. Why do you need all that salt? You're going to mix it with fruit or your smoothie or your cereal and puddings. You don't need to add 180 or so mg of salt per cup of almond milk. You don't add that when you make your own almond milk. You just use nuts and water. Also, most of the brands of nondairy milk substitute add vitamin D2, not vitamin D3 which is better. The D3 is the natural omega-3 source of vitamin D you want, not the D2, but it's added.

And most almond milk producers also add calcium carbonate, the cheapest, least-absorbable form of calcium, not calcium citrate and magnesium citrate, to the various brands of unsweetened almond milk. Yet you have many salt-sensitive people with high blood pressure who buy nondairy milk substitute as part of their vegan diet for reversal of clogged arteries, theorized by many naturopaths and various physicians who suggest diets tailored to the individual needs of patients, many of them elderly and trying to eat healthier and cut down on salt, sweeteners, and synthetic vitamins or other additives to processed foods.

It's difficult to choose lower sodium foods when salt is put in for taste to make you come back and buy more

Currently the U.S. food supply makes it difficult for Americans to choose lower sodium foods and achieve recommended daily levels. Americans consume an average 3,600 mg of sodium a day, with about 80 percent coming from commercially prepared and processed foods, according to the researchers.

Excessive sodium intake contributes to high blood pressure, which increases the risk of heart attacks, strokes and other cardiovascular diseases. In the U.S, cardiovascular disease is the leading cause of death, and nearly half of these deaths are related to high blood pressure.

"These findings strengthen our understanding that sodium reduction is beneficial to people at all ages," Coxson said in the news release "Even small, gradual reductions in sodium intake would result in substantial mortality benefits across the population."

"Such gradual reductions could be achieved through a combination of consumer education and food labeling, but should likely also include regulation to assure that lower sodium options are available for US consumers," said Bibbins-Domingo.

The American Heart Association recommends consuming less than 1,500 mg of sodium daily, and has called on the Food and Drug Administration to lower the daily value for sodium and set limits on the amount of sodium foods can contain. The association also favors robust sodium standards for foods served in schools and purchased by governments and encourages the food industry to make meaningful efforts at reducing sodium which would provide consumers with greater choice in foods and a healthier overall food environment. There are a number of healthy recipes and tips for helping you reduce salt in your diet. Unless you're an athlete such as a person running marathons in hot weather, your salt intake doesn't have to be "sky-high."

Co-authors of the study are: Nancy Cook, Sc.D.; Michel Joffres, M.S.P.H., M.D., Ph.D.; Yuling Hong, M.Sc., M.D., Ph.D.; Diane Orenstein, Ph.D. and Steven Schmidt, Ph.D. Author disclosures are on the manuscript. The Centers for Disease Control and Prevention and the American Heart Association Western States Affiliate funded the study. For the latest heart and stroke news, follow us on twitter: @HeartNews. For the updates and new science from the Hypertension journal follow @HyperAHA.

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at the Corporate Funding website for, Heart.org.

Too many antibiotics in animals

In a new study from Michigan State University published in the current issue of the Proceedings of the National Academy of Sciences, unchecked antibiotic use in animals may affect global human health. The increasing production and use of antibiotics, about half of which is used in animal production, is mirrored by the growing number of antibiotic resistance genes, or ARGs, effectively reducing antibiotics' ability to fend off diseases -- in animals and humans. The study shows that China – the world's largest producer and consumer of antibiotics – and many other countries don't monitor the powerful medicine's usage or impact on the environment.

The increasing production and use of antibiotics, about half of which is used in animal production, is mirrored by the growing number of antibiotic resistance genes, or ARGs, effectively reducing antibiotics' ability to fend off diseases – in animals and humans. On Chinese commercial pig farms, researchers found 149 unique ARGs, some at levels 192 to 28,000 times higher than the control samples, said James Tiedje, Michigan State University Distinguished Professor of microbiology and molecular genetics and of plant, soil and microbial sciences, and one of the co-authors.

"Our research took place in China, but it reflects what's happening in many places around the world," said Tiedje, according to the February 11, 2013 news release, "Unchecked antibiotic use in animals may affect global human health." Dr. Tiedje is part of the research team led by Yong-Guan Zhu of the Chinese Academy of Sciences. "The World Organization for Animal Health and the U.S. Food and Drug Administration have been advocating for improved regulation of veterinary antibiotic use because those genes don't stay local."

Antibiotics in China are weakly regulated, and the country uses four times more antibiotics for veterinary use than in the United States. Since the medicine is poorly absorbed by animals, much of it ends up in manure – an estimated 700 million tons annually from China alone. This is traditionally spread as fertilizer, sold as compost or ends up downstream in rivers or groundwater, taking ARGs with them. Along with hitching rides in fertilizer, ARGs also are spread via international trade, immigration and recreational travel.

Daily exposure to antibiotics in animal feed lets microbes carrying antibiotic resistant genes (ARGs) thrive

Daily exposure to antibiotics, such as those in animal feed, allows microbes carrying ARGs to thrive. In some cases, these antibiotic resistant genes become highly mobile, meaning they can be transferred to other bacteria that can cause illness in humans. This is a big concern because the infections they cause can't be treated with antibiotics.

Antibiotic resistant genes(ARGs) can reach the general population through food crops, drinking water and interactions with farm workers. Because of this undesirable cycle, ARGs pose a potential global risk to human health and should be classified as pollutants, said Tiedje, an MSU AgBioResearch scientist.

"It is urgent that we protect the effectiveness of our current antibiotics because discovering new ones is extremely difficult," Zhu said in the news release, Unchecked antibiotic use in animals may affect global human health. "Multidrug resistance is a global problem and must be addressed in a comprehensive manner, and one area that needs to be addressed is more judicious use and management of wastes that contain ARGs." Additional MSU researchers contributing to the study include Timothy Johnson, doctoral researcher, Robert Stedtfeld, civil and environmental engineer, and Syed Hashsham, civil and environmental engineering professor.

Analysis finds vitamin D potency varies widely in dietary supplements

A new Kaiser Permanente analysis finds consumers may not be getting the amount of vitamin D they expect. Vitamin D supplement potency varies widely, and the amount of vitamin D in over-the counter and compounded supplements does not necessarily match the amount listed on the label, according to a research letter published in the journal JAMA Internal Medicine.

The analysis showed that the amount of vitamin D in these supplements ranged from 9 percent to 146 percent of the amount listed on the label. Not only was there variation among different brands and manufacturers, but also among different pills from the same bottle.

"We were surprised by the variation in potency among these vitamin D pills," says Erin S. LeBlanc, M.D., MPH, lead author and investigator with the Kaiser Permanente Center for Health Research in Portland, Oregon, according to the February 11, 2013 news release, Analysis finds vitamin D potency varies widely in dietary supplements. "The biggest worry is for someone who has low levels of vitamin D in their blood. If they are consistently taking a supplement with little vitamin D in it, they could face health risks."

According to a recent editorial in the New England Journal of Medicine, more than 100 million Americans spend a combined $28 billion on vitamins, herbs, and supplements each year. The U.S. Food and Drug Administration is considering new safety guidelines for some supplements but, for the most part, the industry remains unregulated.

Who is watching and testing the manufacturers' supplements to see whether what's on the label is what's in the container?

Some manufacturers participate in a voluntary quality verification program operated by the U.S. Pharmacopeial Convention (USP)—an independent, nonprofit organization that sets public standards for the quality of dietary supplements. In order to receive the USP verification mark, manufacturers' facilities undergo annual good manufacturing practice audits, and their products are tested for quality, potency, and purity. LeBlanc and her colleagues included one supplement from a USP Verified manufacturer in their sample. They found the amount of vitamin D in pills from that bottle was generally more accurate than the other bottles tested.

"The USP verification mark may give consumers some reassurance that the amount of vitamin D in those pills is close to the amount listed on the label," said Dr. LeBlanc, according to the news release. "There are not many manufacturers that have the USP mark, but it may be worth the extra effort to look for it."

The researchers tested 55 bottles of over-the-counter vitamin D from 12 different manufacturers. The over-the-counter vitamin D pills used in the analysis were purchased at five different stores in Portland, Ore. The compounded vitamin D was made by a compounding pharmacy in Portland. The analysis was conducted by an independent lab in Houston.

Authors include Erin S. LeBlanc, M.D., MPH; Nancy Perrin, Ph.D.; and Teresa Hillier, M.D., MS, from the Kaiser Permanente Center for Health Research in Portland, Ore.; and Jeffery D. Johnson Jr., Ph.D., and Annie Ballatore, MS, from Eagle Analytical Services in Houston.

High blood pressure during pregnancy may signal later heart disease risk

How do you change long-term risk in people genetically predisposed to develop high blood pressure and heart disease or diabetes later when they've only had a transient rise in blood pressure during a normal pregnancy? Is it a change of diet, lifestyle, supplements, green juices, or drugs that alter the progress of the predisposition?

In a new study published in the journal Circulation: Journal of the American Heart Association, high blood pressure during pregnancy holds a risk of developing heart disease and/or diabetes. The question is what can be done to lessen that risk as far as diet, lifestyle, exercise, and lowering stress levels?

Women who have high blood pressure during pregnancy may later face higher risk of developing heart disease, chronic kidney disease and diabetes. Healthcare providers should monitor these women's long-term for risk factors and be prepared to treat heart issues, according to the study from the National Institutes of Health.

High blood pressure during pregnancy — even once or twice during routine medical care — can signal substantially higher risks of heart and kidney disease and diabetes, according to new research in the American Heart Association journal Circulation.

"All of the later life risks were similar in pregnant women who could otherwise be considered low-risk — those who were young, normal weight, non-smokers, with no diabetes during pregnancy," said Tuija Männistö, M.D., Ph.D., lead author of the study and a postdoctoral fellow at the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development in Rockville, Maryland, according to the February 11, 2013 news release, "High blood pressure during pregnancy may signal later heart disease risk."

Studies have shown higher heart and kidney disease risk in women with preeclampsia, a serious pregnancy-related disease marked with high blood pressure and measurable protein in the urine. In the new study, researchers looked at less serious forms of high blood pressure that are much more common in pregnant women.

For 40 years, they followed Finnish women who had babies in 1966. They calculated the risk of heart or kidney disease or diabetes in later life among women with high blood pressure during pregnancy, comparing them to women with normal blood pressure during pregnancy.

They found the following results:

  • One-third of the women had at least one high blood pressure measurement during pregnancy.
  • Women who had any high blood pressure during pregnancy had 14 percent to over 100 percent higher risk of cardiovascular diseases later in life, compared to women with normal blood pressure during pregnancy.
  • Women who had any high blood pressure during pregnancy were 2 to 5 times more likely to die from heart attacks than women with normal blood pressure during pregnancy.
  • Women who had high blood pressure during pregnancy and healthy blood pressure levels after pregnancy had a 1.6- to 2.5-fold higher risk of having high blood pressure requiring medication or hospitalization later in life.
  • Women who had high blood pressure during pregnancy had a 1.4- to 2.2-fold higher risk of having diabetes in later life.
  • Women who had transient high blood pressure with and without measurable protein in the urine had a 1.9- to 2.8-fold higher risk of kidney disease in later life, compared to women with normal blood pressure during pregnancy. Transient high blood pressure is temporary high blood pressure that later returns to normal.

"According to our findings, women who have had high blood pressure during pregnancy or who are diagnosed with high blood pressure in pregnancy for the first time might benefit from comprehensive heart disease risk factor checks by their physicians, to decrease their long-term risk of heart diseases," Männistö said in the news release, High blood pressure during pregnancy may signal later heart disease risk.

Do changes in diet and lifestyle during pregnancy affect the risk of developing high blood pressure or heart disease later in life?

Future research should estimate how lifestyle changes during pregnancy, such as diet, affect the risk of developing high blood pressure during pregnancy, Männistö said in the news release. Studies also should focus on how lifestyle changes and clinical follow-up after pregnancy could change these women's long-term health.

Because the study was limited to non-Hispanic Caucasian Finnish women, researchers said they aren't sure if results would be the same for other racial and ethnic groups. Co-authors of the new study are Pauline Mendola, Ph.D.; Marja Vääräsmäki, M.D., Ph.D.; Marjo-Riitta Järvelin, M.D., Ph.D.; Anna-Liisa Hartikainen, M.D., Ph.D.; Anneli Pouta, M.D., Ph.D.; and Eila Suvanto, M.D., Ph.D. Author disclosures are on the manuscript. The Intramural Research Program of the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development and Academy of Finland funded the study.

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, Sacramento Nutrition Examiner

Nutrition, health, and media culture writer, Anne Hart is the author of more than 4,000 online articles, 91 paperback books, including numerous novels, and holds a graduate degree in English/creative writing.

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