FDNS 4600/6600 Module 8 PDF

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Required module 8 for FDNS 4600/6600. ...

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Module 8: Red Meat, Nitrates, and Nitrites – Benefits and Safety Concerns

Activities and Time Needed = up to 6 hours ☐ Download Module from elc in “Content” which will be available 1 week before Module due date. ☐ For the Module, answer questions and complete any other required activities. Submit to elc Assignment Dropbox by due date. Name file: LastnameFirstnameMod8 (max 25 characters) ☐ Quiz online in elc, 15 minutes

Due Friday 3/8

Points Max

Grade Book

40

8-M

15

8-Qe

9 pm 2:45-3:15 pm

**DO NOT REMOVE ANY PART OF THIS MODULE and ENTER NAME HERE: Caroline Jones Module reminders  Total points for each Module’s activities (assignment and quiz) is 55 points (out of total of 825 pts).  It is required to answer the numbered questions. -5 points for each skipped question.  Questions with “o” are self-assessment or reflections that don’t need written answers in this Module, but questions may be used in quizzes.  The links to articles and Youtube videos that you will need to complete your module assignments have been updated in this Word document. They may NOT be updated on the Powerpoint slides or videos of the slides. Use the links in this Word document to access the articles and Youtube videos to answer your assignment questions. There may be additional links in the PowerPoints that you may find interesting if you want more indepth information on the topics.  If you find a link listed in this Word document that does not open, you may need to copy and paste it in your browser.  Submit entire Module assignment (as a Word file) to the elc Assignment area. If any information is removed, then -50%.  -50% for late for submission of Module to the elc Assignment area. This means if due Friday, but submitted on Saturday, then maximum is 50% of points; if submitted Sunday or later, then 0 points. Late submissions can be submitted to the “Late Submission” Assignment area and may or may not be graded.  Quizzes are timed and open book. There are no make-up quizzes.  See last page on how to access peer-reviewed journal articles from the scientific and medical literature, e.g., PubMed or UGA Library. Learning objectives 1. Describe the biological functions and sources of nitrates, nitrites, nitric oxide, and nitrosamines 2. Explain the health benefits and concerns about red and processed meats 3. Compare the recommendations of the DGA, DGAC and other stakeholders regarding health concerns about red and processed meats 4. Produce talking points about nitrates, nitrites, nitrosamines, and red and processed meats for consumers

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Self-assessment (no written answers required) o o

What do you already know about this topic? What are some of your uncertainties about this topic?

Introduction Dietary nitrates, nitrites, nitrosamines, red meat, and processed meats differ in their health benefits and health risks. This Module will help you understand the terminology, what we know, and what is still unclear. By the end of this Module you’ll be able to produce talking points to guide consumers toward making food and ingredient choices that align with their food choices values and with policies from the Dietary Guidelines for Americans (DGA) and other reliable recommendations from health organizations. Part 1. Biological functions and food sources of nitrates, nitrites, nitric oxide, and nitrosamines Time: 1.5 hour Nitrogen-containing compounds differ in their biological effects and relationships with each other: o Nitrites can be converted to  nitrosamines (also called N-nitrosamines) o Nitrosamines are carcinogenic o Nitrates (NO3-)  nitrites (NO2-)  nitric oxide (NO) o

Nitric oxide is naturally produced in the body, with many health benefits. The figure shows how nitrates, nitrites, and nitric oxide are related and have health benefits, Machha and Schechter (2012), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489477/

Nitrates: o Although often regulated as “dangerous,” nitrates have a balance of risks and benefits o Rarely used as a food additive o Mostly excreted from the human body (people can’t use the N to make amino acids)

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o o o o

Very high levels (e.g., from contaminated well water) can cause methemoglobinemia in infants In fertilizers, so occurs in plants grown in fertilizer, in agricultural runoff, and in some drinking water Provides essential source of nitrogen (N) for plants (plants need N, while people need amino acids) Naturally in cereals, fruits, vegetables, e.g., green leafy (spinach) and root vegetables (e.g., beets)

o

Highest nitrate content vegetables include celery, lettuce, radish, red beetroot, rocket (rucola), spinach, Swiss chard (>250 mg/100 g fresh wt), https://www.ncbi.nlm.nih.gov/pubmed/22646129 May have health benefits, such as these. Not totally clear when benefits are from nitrates or from something else in nitrate-containing foods: o Athletic and physical performance, https://www.ncbi.nlm.nih.gov/pubmed/25412154

o

o

Lowering blood pressure, https://www.ncbi.nlm.nih.gov/pubmed/23596162

Nitrites: o o o

o o o

Nitrite occurs naturally in mouth, saliva, and stomach Can be made from nitrates and converted to nitric oxide Used as a food additive, mainly in cured meats, to prevent growth of the Clostridium botulinum bacteria that produce a deadly toxin (yes, deadly toxin) o Before it was known that nitrite is antibacterial, nitrates were used to cure meat, and it was the conversion to nitrites that accounted for antibacterial properties in curing meat o Cured meats can be made from many meats, e.g., red meat, beef, pork, poultry, and fish, includes bacon, fermented sausage, hot dogs, bologna, salami, corned beef, ham o Makes cured meats pink, and contributes unique flavor and texture o Nitrites used along with a food additive “erythorbate” which acts as antioxidant, stabilizes the nitrites, and slows down conversion of nitrites to nitrosamines Regulated by USDA (cured meat and poultry) or FDA (smoked or cured fish) Must be on the food label and maximum amount in the cured food is 200 micrograms/gram food See how cured, uncured, and “naturally cured” meats are labeled below (2017 links not active)

http://www.homesteadnaturalmeats.com/product/All-Natural-Hickory-Smoked-Bacon/bacon

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http://www.bigy.com/OurStores/Deli/WCTC/assets/honeyMapHLabel.png Nitrosamines: o Known carcinogens and from many sources, e.g., tobacco (#1), beer, tanning, food o Can be formed in foods cooked at high temperatures, e.g., grilled meat o Research identified the lowest amount of nitrites plus other food additives that prevent growth of C. Botulinum and minimizes nitrosamines, and are used in FDA’s regulations for processed meats o Nitrosamine formation in the gastrointestinal tract is decreased by consuming more vitamin C and vitamin E, but is increased by bacteria in the gi tract and other organs (e.g., bladder) o Estimated oral intake of nitrosamines is about 1.1 microgram (ug) per day per person in US, https://www.ncbi.nlm.nih.gov/books/NBK232623/ o Eating 100 g of a food with 10 ug nitrosamines/kg food = intake of 1 ug of nitrosamines that day o The problem of high amounts in some German dark beers was “solved with some haste,” http://www.sciencedirect.com/science/article/pii/S1383574299000150

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o

Griesenbeck et al. (2010) reported intake in women (NH, non-Hispanic); know main points in tables below, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848640/pdf/1476-069X-9-10.pdf Nitrate (%)

Nitrite (%)

Nitrosamines (%)

Vegetables

61

11

0

Fruit

20

5

2

Dairy

2

3

44

Grains

3

12

2

Meat

11

61

49

Beans

1

8

1

Fats, Oils, Nuts, Sweets

2

2

-

Alcohol

-

-

2

READ: 



Nitrat e (mg)

Nitrit e (mg)

Nitrosamine s (ug)

Whites, NonHispanic

46

1.6

0.55

Blacks, NonHispanic

68

1.9

0.53

Hispanics

57

2.3

0.53

Asian/Pacifi c Islander

88

2.1

0.50

Other

60

1.9

0.51

All

52

1.8

0.54

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University of Wisconsin, Extension, What’s the Deal with Nitrates and Nitrites Used in Meat Products? May need to copy and paste link, http://fyi.uwex.edu/meats/files/2012/02/Nitrate-andnitrite-in-cured-meat_10-18-2012.pdf OPTIONAL (not required), North American, Media Myth Crusher, Meat Curing and Sodium Nitrite, https://www.pork.org/blog/sodium-nitrite-mythcrusher/ and then click to read article

☐ ANSWER in up to 50 words each, depending on the complexity of the question. 1.1. Briefly discuss a health benefit and/or a health concern for each of these: nitrates, nitrites, nitric oxide, and nitrosamines (two facts for each chemical). Nitrates are thought to have health benefits like increasing athletic/physical performance and lowering blood pressure, though results are relatively inconclusive. Very high levels, however, can cause methemogloinemia in infants. Nitrites are used in meat curing to prevent the growth of Clostridium botulinum bacteria, which produces deadly toxins. Their use in cured meat and poultry is regulated by the USDA and in smoked and cured fish by the FDA. Nitrosamines are known carcinogens found in sources like tobacco and food (i.e. meat) cooked at high temperatures. The formation of nitrosamines in GI tract can be decreased by consuming more vitamin C and vitamin E. Lastly, niitric oxide is a gas that acts as a signaling molecule in the cardiovascular and circulatory system. It helps to dilate the arteries, increasing circulation and improving cardiovascular health.

Part 2. What are the health benefits and concerns about red and processed meats?

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Time: 1 hour According to the Dietary Guidelines for Americans, the health benefits of red meats include being good sources of protein, zinc, and iron, and red meat is the best source of the highly bioavailable heme iron. In the US the main sources of red meat are beef, pork, lamb, veal, goat, and nonbird game (e.g., venison, bison, and elk). Processed meats, poultry, and fish (e.g., sausages, luncheon meats, bacon, and beef jerky) are products preserved by smoking, curing, salting, and/or the addition of chemical preservatives. Other animal foods with similar nutrient composition to meat includes poultry and fish.

☐ READ 

Dietary Guidelines for Americans, About meats and poultry, page 25 (and search whole document for clarifications regarding the statements below), https://health.gov/dietaryguidelines/2015/resources/2015-2020_Dietary_Guidelines.pdf

The Dietary Guidelines for Americans states: o Healthy dietary patterns includes a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products o Lower intakes of meats, including processed meats; processed poultry; sugar-sweetened foods, particularly beverages; and refined grains have often been identified as characteristics of healthy eating patterns o Choices within the healthy eating patterns may include processed meats and processed poultry as long as the resulting eating pattern is within limits for sodium, calories from saturated fats and added sugars, and total calories o Meats and poultry should be consumed in lean forms o Lean meats can be part of a healthy eating pattern, but average intakes of meats, poultry, and eggs, a subgroup of the protein foods group, are above recommendations in the Healthy U.S.-Style Eating Pattern for teen boys and adult men o After reviewing all of the above statements, what specifically does the DGA recommend about o Protein intake? o Eating meat? o o o

Eating lean meat? What kinds of meats can be processed? Eating processed meat?

In the next Part, we’ll review health concerns about cancer and red and processed meats from the Dietary Guidelines Advisory Committee (DGAC), the WHO’s International Agency for Research on Cancer, and other stakeholders. REMINDER: no written answers needed for Part 2, but every “o” may be asked on quizzes.

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Part 3. Compare the recommendations of the DGA, DGAC and other stakeholders regarding health concerns about red and processed meats Time: 1.5 hours The DGA’s recommendations focus mainly on the nutritional benefits of meats and selecting lean meats that keep our overall dietary pattern healthy. Concern about potential health problems of red meat and processed meat have been expressed by other groups, such as WHO’s International Agency for Research on Cancer. The main health concern is about colorectal cancer, which occurs in the colon or rectum of the large intestine; the lifetime risk of developing colorectal cancer is: about 1 in 21 (4.7%) for men and 1 in 23 (4.4%) for women, https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html (statistics are from website in 2017). Most research about these foods and cancer or CVD are from longterm cohort studies (weaker research design), rather than RCTs (stronger design). ☐ READ, WATCH and be able to answer questions such as these on quizzes:

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Dietary Guidelines Advisory Committee, find the 1 page needed by searching for “ Table D2.3.” https://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015Dietary-Guidelines-Advisory-Committee.pdf o What does DGAC conclude about cardiovascular disease and red and/or processed meat? o What does DGAC conclude about colorectal cancer and red and/or processed meat? IARC, WHO, IARC Monographs evaluate consumption of red meat and processed meat, 2015, Press Release Number 240, 2 pages, https://www.iarc.fr/en/media-centre/pr/2015/pdfs/pr240_E.pdf o What does IARC conclude about red meat and cancer? o What does IARC conclude about processed meat and colorectal cancer? o American Institute for Cancer Research, Red and Processed Meats http://www.aicr.org/reduce-your-cancer-risk/diet/red-and-processed-meat.html o AICR is one of the few research and education groups that recommends specific amounts to eat of red meat and processed meat. What exactly do they recommend per week? Center for Science in the Public Interest, Cancer Warning Label Urged for Processed Meat & Poultry, 2016, https://cspinet.org/news/cancer-warning-label-urged-processed-meat-poultry-20161201 o CSPI recommends what warning label for what types of processed meats? o CSPI reminds us to pay attention to what other risk factors for colorectal cancer? HealthCare Triage, Red Meat and Cancer? PANIC!, 6 min, https://www.youtube.com/watch? v=aOVBOwbqcT8 o How well does the “Red Meat and Cancer” video reflect the scientific evidence about processed and cancer? OPTIONAL (not required), CNN’s playlist about the WHO report on processed meat (6 videos), about 1 to 5 minutes each, http://www.cnn.com/videos/health/2015/10/26/who-processed-red-meatwarning-pleitgen-pkg-wrn.cnn/video/playlists/who-report-on-processed-meat /

REMINDER: no written answers needed for “o”, but every “o” may be asked on quizzes.

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☐ ANSWER in about 20 to 50 words each, depending on the complexity of the question. 3.1. After reflecting on all of these readings and videos, based on the scientific research what would you tell consumers about how much red meat is safe to eat? I would explain to consumers that eating red meat is safe in moderation. The International Agency for Research on Cancer classified red meat as “possibly carcinogenic to humans based on limited evidence,” so it is unlikely that the average American would experience negative consequences from eating red meat. I would advise consumers to base their servings of protein per week off of the U.S.Style Healthy Eating Pattern found in the 2015 DGA. The guidelines recommend that someone who eats 2,000 calories per day consume 26 ounce-equivalents of meat/poultry/eggs per week. They recommend that these 26 oz-eq be reached by consuming lean meats, poultry, and eggs, but that red meat may be included in one’s protein intake as long as overall sodium and calorie intakes do not exceed the recommended limits. I would urge consumers to aim for 3 portions (12-18 oz) of red meat per week, in accordance with the American Institute for Cancer Research’s recommendation.

3.2. After reflecting on all of these readings and videos, based on the scientific research what would you tell consumers about how much processed meat is safe to eat? Scientific research has shown a correlation between the consumption of processed meat and the development of cardiovascular disease colorectal cancer. The International Agency for Research on Cancer, American Chemical Society, and World Cancer Research Fund have all concluded that eating one 50-gram serving of processed meat per day increases one’s risk of colorectal cancer by about 18%. Due to these findings, I would recommend that consumers limit their intake of processed meat to at most one serving a day (a typical serving is two ounces, or about 55 grams), but preferably only a few servings per month.

3.3 Discuss two specific issues that make it difficult to make science-based recommendations to consumers about the amount of red meat and processed meat that are safe to eat? First, it is difficult to make recommendations regarding red and processed meat intake due to the nature of the studies that have been done on the topic. The most influential evidence supporting the idea that eating processed meat increases risk of colorectal cancer comes from a number of large prospective cohort studies conducted over the last 20 years. These studies have a weaker research design than, say, RCTs, which would provide more conclusive evidence. Second, it is difficult to distinguish between the effects of red or processed meat and the effects of other lifestyle choices on health problems such as cardiovascular disease and colorectal cancer. For example, an individual participating in a cohort study on this topic might eat 2 servings of processed meat per day, drink heavily, and have very low fiber intake. Compare him to another subject who eats the same amount of processed meat but maintains diet high in fruits and veggies, exercises, and doesn’t drink or smoke. Thus, it would be difficult to make a concrete conclusion about the effects of eating processed meat on the health of these two individuals. In turn, this makes it hard to make recommendations to consumers regarding their meat consumption.

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Part 4. Produce talking points about nitrates, nitrites, nitrosamines, and red and processed meats for consumers Time: 1 hour Next, you’ll apply what you’ve have learned to help others make safe, nutritious and economical food choices regarding whether to eat red meat or processed meat, and if so, how much. Choose one scenario below and produce four talking points to guide advising the specific individual’s or agency’s concerns. Your talking points must be science-based, reflect current government policies, incorporate food choices available in the marketplace, and, as appropriate to the scenario, other factors such as health guidelines, costs or food preferences. As needed, modify your talking points from earlier in this Module to address the scenario. Answer in about 25 to 50 words in the fillable box prov...