Chapter 1 – Title of Chapter - Nutrition Gardener



Chapter 19 – Consumer Concerns about Foods and Water

Learning Objectives

1. Discuss foodborne infections and intoxications and common pathogens in each classification.

2. List methods to prevent foodborne illness during food production and service.

3. Discuss food irradiation, including benefits and risks.

4. Identify environmental contaminants in the food supply and methods to reduce risk.

5. Discuss the health hazards associated with pesticides, pesticide monitoring techniques, and the risks and benefits of organic foods.

6. Discuss common additives in the food supply and the risks and benefits of each.

7. Discuss intentional food additives and indirect food additives and their risks and benefits in food.

8. Describe sources of drinking water, harmful contaminants, and methods to ensure water safety.

9. Discuss the risks and benefits of genetic engineering.

10. Identify the role of the FDA in bioengineered foods.

Lecture Presentation Outline

I. Foodborne Illnesses (also known as food poisoning)

Millions of people suffer the symptoms of foodborne illnesses when an outbreak occurs. According to the CDC, millions of people are infected with foodborne illnesses every year. Most can be prevented by storing and cooking foods at their proper temperatures and preparing them under sanitary conditions. The FDA and other agencies focus on the potential hazards of food, the toxicity levels, and the potential risk posed to human beings. Safety standards are set. The USDA protects the food supply.

A. Foodborne Infections and Food Intoxications

1. Foodborne Infections

a. Eating foods contaminated with infectious microbes.

b. Two of the most common pathogens are Campylobacter jejuni and Salmonella.

2. Food Intoxications

a. Eating foods containing natural toxins or microbes that produce toxins.

b. Most common is Staphylococcus aureus; most famous is Clostridium botulinum.

3. Foodborne illnesses, diseases, organisms, onset, and symptoms and prevention methods.

B. Food Safety in the Marketplace

1. Industry Controls

a. Pasteurization inactivates many of the microorganisms in food. Spoilage bacteria are still present.

b. Hazard Analysis Critical Control Points (HACCP) requires food manufacturers to identify points of contamination and implement controls.

2. Consumer Awareness

a. Wash hands with hot, soapy water before meals.

b. Expect clean tabletops, dinnerware, utensils, and food preparation sites.

c. Expect cooked foods to be served piping hot and salads to be fresh and cold.

d. Refrigerate carry-out foods within two hours.

C. Food Safety in the Kitchen

1. Guidelines (see “How to Prevent Foodborne Illnesses”)

a. Keep a clean, safe kitchen.

b. Avoid cross-contamination by separating raw eggs, meat, and seafood from other foods.

c. Keep hot foods hot.

d. Keep cold foods cold.

2. Safe Handling of Meats and Poultry

a. Cook meat thoroughly and use a thermometer.

b. Read labeling instructions.

c. Recommended safe temperatures

1. Poultry breast and well-done meats: 170˚ F.

2. Stuffing, ground poultry, and reheated leftovers: 165˚ F.

3. Medium-done meats, raw eggs, egg dishes, pork, and ground meat: 160 ˚F.

4. Medium-rare meats, roasts, veal, and lamb: 145˚ F.

5. Foods should not be kept between 40˚ F and 140˚ F for more than 2 hours.

6. Refrigerator temperature: 40˚ F.

7. Freezer temperature: 0˚ F.

3. Mad Cow Disease

a. Can cause neurological damage to cows and humans.

b. Ground beef and sausage are more of a concern.

c. Wild game questions.

4. H1N1 Virus

a. Life-threatening vital infection.

b. Transmitted by coughing and sneezing, not through the consumption of pork.

5. Safe Handling of Seafood

a. Undercooked or raw seafood can cause problems such as hepatitis, worms, parasites, viruses, and other diseases.

b. Sushi may contain raw or cooked ingredients.

c. Raw oysters may be a concern.

d. Water pollution must be controlled.

e. Processing facilities must be clean, and temperatures should be controlled.

6. Other Precautions and Procedures

a. Abnormal odors with seafood – should smell fresh.

b. Be mindful of safe refrigeration temperatures ((40( F) and storage times.

7. Foods most commonly implicated in foodborne illnesses

a. Frequently unsafe

1. Raw milk and milk products.

2. Raw or undercooked seafood, meat, poultry, and eggs.

3. Raw sprouts and scallions.

b. Occasionally unsafe

1. Soft cheeses.

2. Salad bar items.

3. Unwashed berries and grapes.

4. Sandwiches.

5. Hamburgers.

c. Rarely unsafe

1. Peeled fruit.

2. High-sugar foods.

3. Steaming-hot foods.

D. Food Safety While Traveling

1. Traveler’s diarrhea

a. Different microbes.

b. Different standards for food and water.

2. How to achieve food safety while traveling

a. Wash hands. Use antiseptic wipes or hand gels.

b. Eat only well-cooked and hot foods.

c. Wash fruits and vegetables in purified water and peel.

d. Use bottled water or purified water.

e. Refuse dairy products unless properly pasteurized and refrigerated.

f. Bring anti-diarrheal medications.

E. Advances in Food Safety

1. Irradiation

a. Protection

1. Controlling molds in grains.

2. Sterilizing spices and teas for storage at room temperature.

3. Controlling insects and extending shelf life in fruits and vegetables.

4. Destroying harmful bacteria in fresh and frozen beef, poultry, lamb, and pork.

b. Difference between irradiation and ultrahigh temperature (UHT) treatment.

c. Supported by FAO and WHO.

d. Foods approved

1. Eggs.

2. Raw beef, lamb, poultry, and pork.

3. Spices and tea.

4. Wheat.

5. Iceberg lettuce, fresh spinach, potatoes, tomatoes, and onions.

6. Strawberries, citrus fruits, and papaya.

7. Oysters, clams, mussels, and scallops.

2. Consumer Concerns about Irradiation

a. Negative emotions associated with the term radiation.

b. Confusion with radioactive particles.

3. Regulation of Irradiation

a. Labeling symbol.

b. The FDA has regulations regarding specific uses and doses.

4. Other pasteurizing systems are high-intensity pulsed light or electric beams.

II. Nutritional Adequacy of Foods and Diets

The marketplace provides consumers with nutrition facts and guidelines. At home, consumers can minimize nutrient losses through proper food handling and cooking guidelines.

A. Obtaining Nutrient Information

1. Nutritional labeling regulations.

2. USDA’s Dietary Guidelines.

3. MyPyramid.

B. Minimizing Nutrient Losses

1. Keep fruits and vegetables refrigerated.

2. Keep cut fruits and vegetables and juices in airtight containers in the refrigerator.

3. Steam or microwave to prevent losses during cooking.

III. Environmental Contaminants

Concerns of environmental contamination are many, but hazards are relatively small. It is important to be an informed consumer, keep alert to the possibility of contamination, and listen to public health announcements. Eating a variety of foods is an effective defensive strategy.

A. Harmfulness of Environmental Contaminants

1. Depends on its persistence.

2. Each level of the food chain has a greater concentration then the one below, known as bioaccumulation.

3. Heavy metals and organic halogens can enter the food supply.

4. Methylmercury

a. Can result in blindness, deafness, and lack of coordination, affects the intellect, and can cause death.

b. Fish can become contaminated with methylmercury.

c. Infants born to pregnant women who consume methylmercury can be affected.

5. PBB and PCB

a. Polybrominated biphenyl (PBB) was mixed with livestock feed in Michigan and caused nervous system problems and liver disorders in those who consumed the meat of the livestock.

b. Polychlorinated biphenyls (PCB) were found in rice oil in Taiwan and resulted in fertility problems in men and women who had children with developmental issues.

B. Guidelines for Consumers

1. Hazards appear to be small.

2. Regulated by the FDA.

3. Health agencies provide advisories (mercury).

4. The EPA regulates commercial fishing.

5. States test and monitor their own lakes and rivers.

IV. Natural Toxicants in Foods

Many foods contain natural toxicants. It is the quantity consumed and the chemical structure of the contaminant, not the source, that makes it hazardous.

A. Poisonous mushrooms.

B. Goitrogens in some vegetables.

C. Cyanogens that produce cyanide.

D. Solanine in potatoes.

V. Pesticides

Pesticides can be safe when used appropriately, but leave residue on foods. When used inappropriately, they can be hazardous. Consumers can minimize exposure to pesticides in foods by following specific food preparation guidelines. Pesticides can improve crop yields. Alternative farming methods are being explored.

A. Hazards and Regulation of Pesticides

1. Hazards of Pesticides

a. Tolerance level set by government.

b. People with weakened immune systems may be vulnerable.

2. Regulation of Pesticides

a. EPA and FDA keep within safe limits.

b. Enforces the law.

3. Pesticides from Other Countries

a. Policies must be established.

b. Imported foods contaminated with our banned pesticides that were sold outside the U.S. (circle of poison).

B. Monitoring Pesticides

1. Food in the Fields

a. Monitoring programs.

b. Certifications with periodic inspections.

2. Food on the Plate

a. Survey research to determine how much is consumed.

b. The Total Diet Study estimates pesticide consumption.

C. Consumer Concerns

1. Minimizing Risks

a. Trim fat and remove skin.

b. Select fruits and vegetables without holes.

c. Wash fresh produce with a scrub brush and rinse.

d. Use a knife to peel.

e. Discard outer leaves.

f. Peel.

g. Eat a variety of foods.

h. Consider buying certified organic foods.

2. Alternatives to Pesticides

a. Natural pesticides.

b. Genetically altered plants; crop rotation.

c. Using organisms to kill pests.

d. Alternative farming methods.

3. Organically Grown Crops

a. Produce and market organic crops.

b. USDA labeling for organic foods.

1. 100% organic ingredients may claim 100% organic and use seal.

2. 95% organic ingredients may claim organic and use seal.

3. 70% organic ingredients may list up to three ingredients on the front of the package.

4. Less than 70% organic ingredients may list them on the side panel but not make claims on the front of the package.

VI. Food Additives

Many of the food additives used are preservatives. The FDA regulates the use of intentional additives. Consumers are concerned about the incidental additives.

A. Regulations Governing Additives

1. The GRAS (generally recognized as safe) List

a. Additives that have been in use a long time.

b. Believed to be safe based on current scientific evidence.

c. Ongoing review.

2. The Delaney Clause

a. Additives that have not been shown to cause cancer in animals or humans.

b. Criticism of being too strict and inflexible.

c. No more than 1 in a million risk.

3. Margin of Safety

a. Determined by experimental research.

b. 100 times below the lowest level that is found to cause harm.

4. Risks versus Benefits

a. Use the lowest amount needed to get the effect.

b. Cannot disguise faulty or inferior foods.

c. Cannot deceive consumers.

d. Cannot be used where nutrients are significantly destroyed.

e. Cannot be used where their effects can be achieved by economical, sound manufacturing processes.

B. Intentional Food Additives

1. Antimicrobial Agents

a. Salt and sugar.

b. Nitrites and nitrates.

c. Nitrites can be converted to nitrosamines in the human body.

d. Bacteriophages can be added to ready-to-eat meat and poultry to destroy disease-causing bacteria.

2. Antioxidants

a. Vitamin C (erythorbic acid, sodium ascorbate).

b. Vitamin E (tocopherol).

c. Sulfites (sulfur oxide, sodium sulfite, sodium bisulfate, potassium bisulfate, sodium metabisulfite, and potassium metabisulfate)

1. Prevent oxidation in many processed foods.

2. Adverse reactions in people.

3. Declare on the label.

4. Inhibit use on raw foods.

5. Destroy thiamin.

d. BHA and BHT

1. Prevent rancidity in baked goods and snack foods.

2. Cancer link – protect in small amounts, harm in larger amounts.

3. Colors

a. Natural colors include annatto, caramel, carotenoids, dehydrated beets, and grape skins.

b. Artificial colors include blue #1 and #2, green #3, red #40 and #3, and yellow #5 and #6.

4. Artificial Flavors and Flavor Enhancers

a. Natural flavors include spices, herbs, essential oils, fruits, and fruit juices.

b. Artificial flavors include artificial sweeteners.

c. Flavor enhancers include MSG or monosodium glutamate.

1. Used in Asian foods, canned vegetables, soups, and processed meats.

2. MSG symptom complex has adverse reactions in some people.

3. Must be listed on the label.

5. Sugar Alternatives

a. One of the most widely used flavor additives.

b. Saccharine appears to be safe for most people.

c. Those with phenylketonuria (PKU) should not consume aspartame.

d. The Acceptable Daily Intake (ADI) is the safe intake level for artificial sweeteners.

6. Texture and Stability

a. Common emulsifiers – for stabilization

1. Lecithin.

2. Alginates.

3. Mono- and diglycerides.

b. Common gums – to thicken and gel

1. Agar, alginates, and carrageenan.

2. Guar, locust bean, and psyllium.

3. Pectin.

4. Xanthan gum.

5. Gum Arabic.

6. Cellulose derivatives.

7. Nutrient Additives

a. Appropriate uses

1. Correct dietary deficiencies.

2. Restore nutrients to levels prior to storage, handling, and processing.

3. Balance vitamin, mineral, and protein content of a food in proportion to its energy content.

4. Correct nutritional inferiority.

b. Common Nutrient Additives

1. Thiamin, niacin, riboflavin, folate, and iron in grain products.

2. Iodine in salt.

3. Vitamins A and D in milk.

4. Vitamin C and calcium in fruit drinks.

5. Vitamin B12 in vegetarian foods.

C. Indirect or incidental food additives enter food through harvesting, production, processing, storage, or packaging.

1. Acrylamide

a. Causes cancer and nerve damage in high doses.

b. Found in potatoes cooked at high temperatures (french fries and potato chips, breakfast cereals, and cookies).

c. Also classified as a genotoxicant – a substance that mutates or damages genetic materials.

2. Food Packaging

a. Active packaging is where the packaging components migrate into food.

b. Passive packaging is where the package simply holds the foods but components can migrate into food at high temperatures.

c. Test empty glass or ceramic containers in microwave for 1 minute:

1. If hot, do not use.

2. If warm, it is safe for short-term heating.

3. If cool, it is safe for long-term cooking.

3. Dioxins

a. Chemical pollutants created as by-products of chemical manufacturing, incineration, chlorine bleaching of paper pulp, and other industrial processes.

b. Found in coffee filters, milk cartons, paper plates, and frozen food packages in minute quantities.

4. Decaffeinated Coffee

a. Methylene chloride found in decaffeinated coffee.

b. Depends on the decaffeinating process used.

5. Hormones

a. Bovine growth hormone (BGH) in cattle to produce leaner meats and dairy cows to produce more milk.

b. All cows make this hormone naturally.

c. Food levels are regulated and monitored.

d. Digested by the human body.

e. Still controversy.

6. Antibiotics

a. Given to animals and residues remain in meat and milk.

b. People with sensitivities may suffer allergic reactions.

c. Antibiotic resistance is a problem.

VII. Consumer Concerns about Water

Water may contain infectious microorganisms, environmental contaminates, pesticide residues, and additives. The EPA monitors the safety of public water systems. Many consumers are choosing home water treatment systems or drinking bottled water.

A. Sources of Drinking Water (potable water)

1. Surface water

a. Sources include lakes, rivers, and reservoirs.

b. Readily contaminated through acid rain, runoff from highways and urban areas, pesticide runoff from agricultural areas, and industrial wastes.

c. Refreshed by fresh rain, aeration, sunlight, plants, and microorganisms.

2. Ground water

a. Sources include underground aquifers.

b. Supplies rural areas and pumped by wells.

c. Contaminated more slowly but more permanently.

d. Especially susceptible to contamination from hazardous waste sites, dumps, landfills, underground tanks storing gasoline and other chemicals, and improperly discarded household chemicals and solvents.

B. Water Systems and Regulations

1. Home Water Treatments

a. Shop carefully.

b. Advantages and disadvantages.

c. Determine the quality of home water first.

2. Bottled Water

a. FDA has quality and safety standards.

b. Expensive.

c. Water source must be identified.

d. Refrigerate after opening.

e. May contain contaminants.

VIII. Highlight: Food Biotechnology

Biotechnology, with proper safeguards and controls, provides opportunities to overcome food shortages, improve the environment, and eliminate disease.

A. The Promises of Genetic Engineering (also called genetically modified [GM] or genetically engineered [GE] foods)

1. Extended Shelf Life – A tomato can be genetically modified to stay ripe longer.

2. Improved Nutrient Composition – Biofortification is the addition of nutrients during processing.

3. Efficient Food Processing

a. Bacteria can be used to mass produce rennin for cheese making.

b. Cloning may allow for an increased production of food or pharmaceuticals.

4. Efficient Drug Delivery – Biopharmacy is the use of plants and animals to produce drugs.

5. Genetically Assisted Agriculture – Plant pesticides grown by the plant itself.

6. Other Possibilities

B. The Potential Problems and Concerns

1. Disruption of natural ecosystems.

2. Introduction of diseases.

3. Introduction of allergens and toxins.

4. Creation of biological weapons.

5. Ethical dilemmas.

6. Rigorous testing and labeling.

C. FDA Regulations

1. Many foods are already genetically altered through selective breeding.

2. Many foods are not substantially different.

3. Foods that are substantially different require labeling to identify that difference.

4. Allergy-causing substances must be labeled.

5. Can these regulations ensure an improved food supply?

Case Study

Stephanie is a 27-year-old professional woman who had a recent bout of what she describes as the “24 hour flu” after eating out with friends one weekend. She reports feeling an upset stomach at work on Monday with an increase in symptoms that evening. She then developed abdominal cramps, nausea, vomiting, and severe diarrhea that lasted all night. She called her doctor the next morning and reported what she had eaten the day before she developed symptoms: 2 glasses of wine, broiled rare steak with mushroom sauce, baked potato with sour cream and butter, and salad from the salad bar where she was dining with friends. Earlier in the day at home, she had eaten a leftover pork chop and spinach salad from dinner the night before. She also had a glass of milk from a local dairy.

1. Based on information in Table 19-1, what symptoms would make you suspect that Stephanie had a food-borne illness rather than the flu?

2. What foods did Stephanie ingest that are common causes of food-borne illness?

3. Based on the most frequent sources of food-borne illness listed in Table 19-1, what questions would you want to ask Stephanie regarding her recent food intake?

4. Besides calling her doctor for persistent symptoms, what dietary measures are important for Stephanie’s recovery?

5. Knowing that she prefers to eat rare-cooked meat, what precautionary advice could you offer Stephanie in reference to Figure 19-5?

6. Based on this experience, give one practical action from each of the four simple rules outlined in the “How To” section that Stephanie can take to protect herself from food-borne illness in the future, at home or eating out.

Answer Key:

1. Severe gastrointestinal symptoms such as upset stomach, diarrhea—including bloody diarrhea—nausea, vomiting, abdominal cramps.

2. Potentially contaminated raw produce, undercooked meat, salads, possibly undercooked pork.

3. Was the milk from the local dairy pasteurized? What was pork undercooked? What was the condition of cleanliness at the restaurant? Was the hot food served piping hot? Were the salad bar items fresh and cold?

4. Drink clear liquids to replace fluids lost through vomiting and diarrhea.

5. Order medium or medium-rare steaks that are cooked to a minimum of 145 degrees F and served at 140 degrees F or higher. Cook ground meat, pork, eggs, and other meat dishes to 160 degrees. Do not keep food between 40 and 140 degrees for more than 2 hours or more than 1 hour if the temperature outside is greater than 90 degrees.

6. Keep a clean kitchen: Wash hands with hot, soapy water before food preparation and meals. Avoid cross-contamination: Separate raw foods from those that have been cooked. Keep hot foods hot: Serve hot foods at 140 degrees F or higher and expect cooked foods in a restaurant to be served piping hot. Keep cold foods cold: Keep cold foods at 40 degrees F or less and avoid raw foods in restaurants that are not fresh or kept cold. (Students may come up with other ideas as well.)

Critical Thinking Questions

1. Foodborne illnesses can be very debilitating for an individual. Patients in what might be considered higher risk groups such as infants, pregnant women, and the elderly or individuals with chronic illnesses can be devastated and could die from an infection by a bacterium, virus, or parasite that was a result of poor food handling. Discuss your multidimensional food safety educational program for a mother of an infant, a pregnant mom, and a caretaker for an elderly parent.

Answer: Infants: These little individuals, whether they be newborn or almost approaching the one year mark, are quite susceptible to all viruses, bacteria, etc. as they are still developing after their birth. These several months after the birth are critical to the infant and their overall mental and physical health and anything and everything that the parents can do that helps to optimize the infant’s health status is critically important.

Given that the infant is small, growing, and does not have all their systems in full functioning order, any infection can be devastating to the infant. An infection that can multiply very rapidly in the adult is an even greater danger to an infant that is several times less the size of the adult and is still continuing to develop several systems within the body. An infant’s body can shut down within a matter of hours as compared to a number of days for the adult body.

Parents are best educated on steps to avoid contamination and spread of pathogens or infection. As repeated so many times, the role of hand washing can never be over emphasized. The hands touch everything, including those of an infant, and washing their hands is equally important. Using warm (watch the temperature for the infant), soapy water and vigorous scrubbing to help remove any contaminants is the best course of action.

Keep all areas where the infant is playing clean and disinfected as much as possible. Remind parents that breastfeeding does add an additional layer of immune protection for the infant, which is a great bonus. Parents should also be assisted to understand what temperatures hot and cold foods need to be at for the infant once they begin to eat cereals and solid foods.

Pregnant Woman: The pregnant mom is nourishing herself as well as her unborn baby, which is a large responsibility. Pregnant moms feel this responsibility; therefore, do not underplay any question, no matter how small.

Because pregnancy brings on many body changes and accompanying food cravings, remind the moms that all foods need to be completely cooked and consumed at a temperature appropriate for the food they are eating. Pregnant moms should understand that as long as food cravings are satisfied with foods that are properly prepared and at the proper temperature, there is nothing wrong with unusual combinations. Pregnant moms should not eat raw foods or any food that has been left out for over two hours or is of questionable temperature.

Hygiene is also important. Pregnant moms can become very tired if they are working and have other children at home; these mothers can be in a constant state of exhaustion. In these situations, attention to detail may be forgotten and it will be important to remind mom to cleanse all surfaces, wash hands and those of her children, or have them help each other. The larger the house, the greater the potential for spread of infection, and if mom is doing multiple things she is most probably run down and is what one would call “compromised” or more likely to contract an infection. Depending on the type of infection, some can be transmitted to baby. While the placenta is very good at keeping the baby healthy, there are some contaminants that can make their way through to baby. Mothers must always be reminded to care for themselves and their babies, particularly in our fast-paced world. When available, dads can be very helpful in assisting mom with cleansing all surfaces of the house and ensuring that any children present maintain good hygiene.

Caretaker: When taking care of a parent with dementia or a chronic disease, a reverse in roles from being the one cared for to being the caretaker can be very difficult. Taking care of our parents is a rewarding experience that truly reminds one of “the circle of life.” However, when taking care of a parent, it is far different from any patient, client, or child because one is taking care of the person that gave birth to you and raised you and now requires care, at times like a child and at times very independent. The challenges are maximal and the rewards are beyond the confines of this manual. Our parents continue to teach us much, even through their aging years, however frustrating.

The aging patient requires a caregiver to be attentive to the times when they require assistance and the times when they require independence, and to allow them their dignity throughout the process of aging. Aging parents may be quite able to understand the detail of hygiene, but some may not. The children of these parents generally understand their parents well enough to determine the appropriate course of action. Because sight, respiratory function, and cardiovascular function may modify the parent’s ability to clean countertops and surfaces appropriately, it is important to check surfaces to make sure that they are clean. The elderly also have fairly thin skin that can be easily burned by hot water. When washing hands or cleaning surfaces, make sure that the water is not too hot for the aging parent, as they can be easily burned.

Whatever the course of action, it is important to impress upon the family that in the aging population, the patient can be more prone to infection, depending on nutrient and hydration status as well as presence of chronic illnesses. Any and/or all of these factors can impact the patient’s nutritional status, which in turn can increase the patient’s risk for infection. Assist the caregiver in helping to optimize the parent’s nutrient and hydration status as much as possible as this will help to maximize their immune function.

Work with both the elderly parent and caregiver regarding the temperature of foods, both hot and cold. Because the elderly are much more sensitive to temperature extremes, they may try to keep foods at a room temperature, which can be a problem for many foods. Help both parties understand what foods can be kept at room temperature and what foods must be kept at cold or heated prior to eating. A chart that can be kept on the wall for the parent can be helpful because they can refer back to this chart when alone and the caregiver can remind the parent when present by asking the parent, “at what temperature does this food need to be” when they are present in the house.

2. Discuss the concept of “Bioaccumulation of Toxins in the Food Chain.” What role to you believes that you play as a future RD in helping to prevent the continued growth in the bioaccumulation of toxins in the food chain?

Answer: As outlined in Figure 19-1, the bioaccumulation of toxins in the food chain is a cumulative process whereby toxins that are deposited into our water supply by manufacturers rest at the bottom of the lake, river, ocean, etc. and become part of the microorganisms and small animal world that the small fish feed on. As a result of the toxins inhabiting the beds and bottoms of our water resources and becoming part of the ground food supply, the small fish that feed on these microorganisms and small animals contaminate the smaller fish that then will contaminate the much larger fish that will eventually eat them. These fish eventually become part of the food supply that are sold to individuals for consumption. Or at a lower level, the smaller fish are caught and eaten by fisherpersons. These smaller fish may contain even higher concentrations of toxins that are found in the beds of our water resources.

The student/RD has a role to play in making their voice heard in legislation for clean air and water or any resource that affects our food supply. Having a voice means writing a letter to a congressperson or being actively involved in the political process and/or making sure that their clients understand the issues that affect our environment and food supply and work to protect it. Each RD can select their own role where they believe they can make the most impact. Have each student define their role in protecting of our food supply.

3. Describe five environmental contaminants and/or pesticides that gain access to our food supply and suggest alternatives to minimize the risk they pose.

Answer: Methyl mercury: Intense manufacturing education programs and very heavy fines for any person or industry that contaminates the environment.

PBB, PCB and DDT: Same as above, as well as awards and protection for individuals that report known industrial/personal contamination of the environment.

Pesticides: Garden organically if possible. Minimize the use of pesticides as much as possible. If not purchasing organically, thoroughly wash all produce to remove any pesticides and contaminants.

Natural toxins: Poisonous mushrooms, goitrogens, and cyanogens. Generally not harmful and demonstrates the use of foods for medicinal purposes. If one is going to pick and utilize mushrooms from the environment, study and some guidance are advised.

Students should be encouraged to add to this list and be creative in their ideas for minimizing the access of environmental contaminants into the food chain. The above list is simply a template the students can expand upon.

4. Food additives are believed to provide benefits to our food supply and, as indicated in Chapter 19, are regulated by the FDA to protect the food supply from harmful practices. Discuss five types of food additives and the rationale for their use in the food supply. Then provide your perspective on whether you believe that food additives offer advantages overall to the food supply or have the potential of causing more harm given the potential for human error and business fraud.

Answer: Additives provide many benefits to the foods we eat. Because our food supply is much more global than local, additives are used to protect the food from spoilage and enhance quality, especially when processing has depleted some of the product’s natural nutrients. Additives may also be added for stability, flavor, or texture.

To protect foods against microorganisms, salt or nitrites are utilized in food processing. Sugar is also a common agent.

To protect foods from oxidation, antioxidants such as vitamins C and E, sulfur, or BHA and BHT (in baked goods) are added. Because sulfur can be problematic for some individuals, the others are more frequently utilized; however, the levels of sulfur used in most products should not cause a problem for most individuals.

Many nutrients are added to the foods we eat. There are many reasons for these additives. The following is a partial list of those nutrients: thiamin, niacin, riboflavin, folate, iron, iodine, and vitamins A and D as well as C and B12.

To thicken some foods that would naturally be a thinner consistency and less stable to ship, emulsifiers or gums are added. These include lecithin, carrageenan, guar, psyllium, pectin, gum Arabic, cellulose derivatives, and locust bean.

Many processed foods do not appear to have “curb appeal”; therefore, the manufacturers add coloration to enhance their appeal. The colors can come from natural or artificial sources. Dehydrated beets, grape skins, carotenoids, caramel, and annatto are all the natural colors, and artificial colors include indigotine, erythrosine, and tartrazine.

Finally, flavor may need to be enhanced due to processing; flavors added include salt, sugar, spices, MSG, and artificial sweeteners.

The following was partially taken from Table 19-6.

The second part of this question is a philosophical question for the student to consider as they work toward their practice in dietetics. Several times throughout this manual, I have posed questions for the students to ponder about their philosophical perspective of their practice. These are all important points to consider as they prepare to become professionals in the field of dietetics.

This question poses some very interesting thought processes or could be a very interesting discussion for the class as a whole. If our food supply were to become more localized, consumers would go back to eating from fresher food sources and forgo the additives and may gain a stronger source of vitamins and minerals that are native to their local region. However, these individuals would not have the benefit of the vast cultural food supply that we currently enjoy as Americans nor would we be able to get all sorts of foods all times of the year.

Continuing to enjoy our global food supply requires the need for additives for foods that are shipped from afar. However, individuals can eat predominantly locally and enjoy the global food perspective on occasion, thereby reducing their dependence on foods with additives and foods with potential contamination.

As we have discussed so many times throughout the course of this manual, most often it comes down to a matter of moderation. At least that appears to be the most reasonable approach. Have the students strategize on their ideas as a group and on their own. The student will need to understand where they stand on this issue as their clients will be asking them and looking to them for leadership and direction.

5. The human body is over 65% water. A changing climate appears to be resulting in vast changes in our glaciers and important ice formations, causing scientists real concerns about the changing temperatures on our planet and our water resources. As noted in Chapter 19, contamination of water resources is a concern and consumers have reacted to potential contamination of water with an increased consumption of bottled water. However, as you are aware, bottled water is often not the best choice both budget wise and with regard to local minerals found in the soil that can be healthful. What are some steps that your clients can take to increase their consumption of water instead of carbonated beverages or other high-fructose corn syrup drinks? How might you educate them or convince them that tap water is a better alternative to bottled water or other options?

Answer: As we discussed earlier in this text, bottled water may not be the best and certainly not the most cost effective alternative to getting one’s daily supply of water. However, individuals frequently turn to bottled water because they fear contamination of the public water system and believe that bottled water is better for them than other water sources, and because bottled water has become convenient for the consumer to purchase, carry with them, and consume all day long.

The RD that works with a client is wise to remind the client that the public water supply is safe and provides the consumer with a quality water source and a good source of nutrients that the bottled water does not. We often forget that water does contain minerals that are important to our health. In fact, in my local area, which retains many minerals in the water, a local community decided to further process the water to remove more of the minerals as the water in the area is considered “hard water.” Over time, it was noted that the prevalence of cardiovascular disease and heart attacks increased after the further purification of the water in this one village. After some study, it was determined that the loss of the minerals led to the increased prevalence of the heart problems; therefore, the village went back to their original water processing system and the prevalence of health attacks and cardiovascular disease decreased.

As noted, bottled water is convenient for the consumer to carry and drink all day long and this is the outcome we are looking for in our clients. Therefore, there are many options the RD might suggest to their clients. Purchasing sports bottles or something similar that is easy to carry and keeps the water cold during the day is important. Depending on the client’s taste, the client can keep the water bottle filled by the tap at the office, adding ice if they prefer the water nice and cold. One suggestion is to fill a container part-way with water and freeze. Remove a couple for a day of work and over the course of the day they will thaw and provide very cold, refreshing water for your client. If clients prefer some flavor in their water, they can add some slices of lime or lemon or oranges to the water. This is extremely refreshing. To make it easier, the client can bring a plastic lime bottle and add lime juice in that manner.

To assure the client consumes 6-8 glasses of water daily, the client can make a game of it by either bringing that many water bottles or refilling and keeping score. Flavors can change with each glass if need be. Remind clients that sometimes what they think is hunger is actually thirst and that they might make sure that they are hydrated before they try to eat something.

Finally, it is important to stress to the consumer that tap water provides important nutrients that bottled water cannot (unless fortified). While there is nothing wrong with bottled water, it is an expensive alternative to a public source of water. Also, water is in demand in our world. As we have discussed, part of protecting our environment is protecting surface water. Remind all of your clients the importance of taking care of it.

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