|
May 2003
By Sharon Gerdes Advice on eating and health once was as simple as An
apple a day keeps the doctor away. But now consumers are deluged
with sometimes-conflicting information about foods and their impact
on health. In the midst of all the confusion, one thing is certain:
since 1918, heart disease has been the leading cause of death in the
United States. The Atlanta-based Centers for Disease Control and Prevention
(CDC) states 710,760 individuals died from heart disease in the United
States in 2000. Current data shows that more than 60 million Americans
have one or more types of cardiovascular disease, and more than 98 million
Americans, roughly 52% of all adults, have high cholesterol. Formulators are increasingly faced with the daunting challenge
of developing healthful, good-tasting foods that also make a profit.
Fortunately, a wide variety of heart-healthy ingredients can aid them
in this task. FDA has issued a heart-health claim for a sizable list of ingredients. In December 2002, FDA loosened its health-claim requirements so that claims do not need to meet the standard for significant scientific agreement. Rather, the scientific evidence in support of the claim must outweigh the scientific evidence against the claim. In lieu of this new ruling, quite a few more claims might appear on the horizon. Research reveals heart-health benefits for many other ingredients that dont currently carry FDA health claims.
While experts have long considered diets high in
total fat and saturated fat as risk factors for heart disease, newer
research reveals that the effect of trans
fatty acids on the ratio of LDL (bad) cholesterol to HDL
(good) cholesterol is double that of saturated fatty acids.
Epidemiologic studies have also linked trans
fatty acids to increased risk of coronary heart disease. FDA announced proposed labeling of trans
fatty acids in November 1999, and the industry is still awaiting a final
ruling. In anticipation of a final FDA rule, many food companies have
already begun to replace some trans
fats with alternate fats. Preliminary information from FDA indicates
that products with less than 0.5 grams of trans
fat can bear the claim No trans
fat. Trans-fat
levels will also affect claims for saturated fat and cholesterol, as
well as the requirements for many heart-health claims. Emerging research indicates that not all trans
fatty acids have the same biological effects. Trans
fatty acids from hydrogenated vegetable oil, which consist of trans
double bonds in the 8 13 carbon positions, have been associated
with an increased risk of cardiovascular disease. Trans
fat from ruminant fat, which consist mostly of a trans
fatty acid with the double bond in the 11 carbon position, have not
been associated with an increased risk of coronary heart disease,
notes Peter Huth, director nutrition research and scientific affairs,
Dairy Management, Inc., Rosemont, IL. This trans
fatty acid, trans
vaccenic acid, is a precursor of cis-9, trans-11
conjugated linoleic acid, a trans
fatty acid found in milkfat which has been shown to inhibit the early
stages of atherosclerosis in animal models. A variety of alternative oils are currently available, including olive oil, rice-bran oil, amaranth oil and specialty sunflower oils. The USDA Agricultural Research Service in Fargo, ND, notes that oat oil is rich in phospholipids and glycolipids, and manufacturers could add the oil to bread to improve its health attributes and texture. ADM Kao LLC, Decatur, IL (a joint venture between Archer Daniels Midland Company [ADM], Decatur, IL, and Kao Corporation, Tokyo) manufactures Enova oil, a healthful oil containing diacylglycerol (DAG). This vegetable sterol prevents the body from completely absorbing cholesterol after a meal, resulting in lower blood cholesterol, especially LDL cholesterol.
Scientists have proposed a DHA and EPA intake of
at least 0.22 grams/ day, but in most Western countries, fish and seafood
consumption is low. A gaping nutritional imbalance in the American
diet is in the quantitative and qualitative consumption of edible oils.
The overabundance of omega-6 oils in the diet exasperates the insufficiency
of long-chained omega-3 fatty acids that would otherwise have a dramatic
cardiovascular benefit, notes Herb Woolf, Ph.D., technical manager,
nutraceuticals, BASF Corp., Mt. Olive, NJ. DHA and EPA are frequently added to foods, but several
issues arise when supplementing with fish oils. High levels of these
oils can carry an unpleasant fish taste, and storage or heating subjects
them to oxidation. One solution is microencapsulation, which stabilizes
and protects the oils. Another option is to use high-quality oils at
moderate levels to determine organoleptically acceptable omega-3 levels
in specific foods. One study addressed supplementing soft spreads made
from butter and vegetable oil with omega-3 fatty acids. Angela Tsetsis, executive director of marketing,
Martek Biosciences Corp., Columbia, MD, notes: Our company is
currently developing an emulsified form and a powder form (of DHA) to
allow for use in other products. Dairy products, such as yogurt, milk
and cheese, are good candidates for DHA supplementation. We find these
products to be already viewed as healthy choices, and adding a healthy
ingredient would be a natural fit. Also, the nutritional-bar market
is growing rapidly and offers another opportunity for DHA inclusion. Interestingly, hemp oil is rich in omega-6 and omega-3 fatty acids, and it contains a favorable 3:1 ratio of these essential fatty acids. Hemp oil contains 80% polyunsaturated fatty acid (PUFAs), the highest ratio of any vegetable-seed oil.
Modified designer eggs containing increased amounts of omega-3s and vitamin E are now on the market. A regular egg yolk contains approximately 15 mg to 30 mg of DHA. Once the chicken is fed algae rich in DHA, the yolk contains over 150 mg of DHA, notes Tsetsis.
DeLio adds that soy products are particularly important
and targeted to women after menopause. After menopause, womens
risk of heart disease increases. More women die of heart disease each
year than men, and they have different symptoms. So adding soy to the
diet is an important part of a healthy lifestyle at that stage of life. The latest research on soy notes that soy
isoflavones are involved in cholesterol reduction and decreased LDL
cholesterol, says Bonnie Gorder-Hinchey, culinary director of
the Hazelnut Council and the United Soybean Board (USB). Soy protein
isolate (SPI) is the most versatile of the soy protein products and
is used in many food products, including cereals, smoothies, energy
bars, breads, cookies and dairy-type products, to enhance nutrition.
It has physicochemical and functional properties that include hydrophobicity,
water-holding capacity, solubility, emulsion and foaming. This
makes SPI well-suited for applications requiring emulsification and/or
emulsion stabilization, water and fat absorption, and adhesive and/or
fiber-forming properties. Soy protein isolates which absorb five
times the water to their weight are used in meat, seafood and
poultry products to add juiciness, viscosity, and cohesiveness,
adds Gorder-Hinchey. They can be used to enhance the flavor and
nutrition of tough meat, and help improve the sensory attributes. The
isolates, which can be used to supplement or replace milk powder, are
also used in dairy-type products, including imitation cheeses, frozen
desserts and beverages. She also comments that SPIs do not alter
the flavor of food. Nearly three-fourths of Americans perceive soy as
healthy, according to a 2002 USB soybean-checkoff-funded survey on health
and nutrition. The survey reveals an overall increase in consumer awareness,
attitudes and perceptions of soy-based food products. Another 2002 USB
study revealed 39% of consumers understand that soy has heart-health
benefits. Since FDA granted soy a heart-health claim, consumer awareness
of soy has increased. Soy sales have increased 15% per year to more
than $3 billion annually, making it one of the fastest-growing ingredient
categories. As soy becomes more mainstream, major growth areas include
soymilk, veggie burgers, breakfast cereal, nutrition bars and pasta. To qualify for the heart-health claim, food
manufacturers must use 6.25 grams of soy per serving, says DeLio.
This is easy for some foods, but difficult or impossible for others.
When the serving size is very small, sometime it is not possible to
fit 6.25 grams of soy into a serving, for example a chocolate chew.
It is certainly possible to fit this amount into a 50-gram candy bar.
So far, no one has been able to fit 6.25 grams of soy into one slice
of bread, but it is possible to fit this amount into two slices of bread.
The other option is to declare that a product contains 3 grams of soy,
which lets consumers know that the product contains soy and is still
a significant source of soy protein. Soy is frequently incorporated into beverages. Generally,
an isolated soy protein is used because it has the cleanest flavor.
In liquid beverages, soy protein requires proper hydration, and both
homogenization and stabilizers can be critical components of formulation.
DeLio notes that adding the required amount of soy to meet a health
claim in a low-solids beverage is difficult, but is possible in a smoothie. Soy also puts less strain on the renal system than certain other protein sources. Soy can also be used in combination with other heart-healthy ingredients, including soluble fiber and phytosterols, says DeLio. There seems to be a synergy in that soy blocks synthesis of cholesterol in the liver, while phytosterols block the sites on the intestine that absorb cholesterol.
Oats provide the best source of beta-glucan, but
barley and rice also contain this fiber. Rice-bran oil contains unsaponifiable
fractions, which lower total blood cholesterol and have an even greater
effect in decreasing LDL cholesterol. Rice bran itself has the added
advantage of increasing loaf volume and humectancy in bakery items. Psyllium has a specific FDA heart-health claim,
and extensive research reveals individuals consuming four daily servings
of psyllium containing 1.7 grams of soluble fiber had an average 5%
reduction in total cholesterol and a 9% reduction in LDL cholesterol.
Psyllium is frequently added to cereals and may be used as a laxative
supplement. Flax, a good source of soluble fiber that helps
lower blood cholesterol, also contains omega-3 fatty acids. The lignans
in flaxseed also provide a positive heart-health effect. These antioxidative
substances are capable of balancing natural hormone levels. Flax is
particularly rich in lignans, providing up to 800 times more than other
plants. Lignans are associated with the fiber fraction of
flax; however, while both the lignans and the fiber are present in flax,
most legumes are not found in the refined oil. Although whole flaxseed
is rich in lignans, they are not completely released during digestion.
Using a concentrated source of flax lignans provides a solution to that
problem. This stable ingredient, unlike traditional flax ingredients,
resists oxidation, making it ideal for use in a variety of foods, such
as nutrition bars. Amaranth is another good grain-based fiber source. There is renewed interest in this ingredient, once grown by the Incas and Aztecs, since processing developments now make it suitable for inclusion in breads, muffins, cereals and snacks.
Compared to other popular nuts, hazelnuts
contain the highest levels of monounsaturated fatty acids (MUFAs) per
serving and are one of the lowest in saturated-fat content. And because
they originate from a plant source, hazelnuts are cholesterol-free,
comments Gorder-Hinchey. In addition to being an excellent source
of dietary MUFAs, hazelnuts are also a rich source of other beneficial
nutrients, such as arginine, an amino acid that relaxes blood vessels;
folate and vitamin B6; heart-healthy B vitamins; and the blood-pressure-lowering
minerals calcium, magnesium and potassium. Nuts also contain phytosterols,
which can inhibit fatty-acid absorption in the arteries. A preferred nut in the popular Mediterranean diet,
hazelnuts are delicious and healthful. Hazelnuts, also known as
filberts, have an exotic flavor that is a rich addition to a variety
of foods. Along with their sweet and nutty flavor, hazelnuts add a crunchy
texture to bakery products such as breads, muffins, cookies, brownies
and biscotti, adds Gorder-Hinchey. They also add richness to confections,
salads, dressings and sauces, and serve as a tasty and nutritious addition
to snack foods. Almonds reduce LDL blood-serum cholesterol levels
without affecting HDL levels, thus lowering heart-attack risk. There
is good reason to expect that eating a handful of almonds four to five
times per week would reduce the occurrence of coronary heart disease
by 50%, reports Gary Fraser, M.D., Ph.D., director for the Center for
Health Research, Loma Linda University (LLU), Loma Linda, CA. Almonds add taste and crunch, and have the broadest
consumer popularity of any tree nut. According to a survey of 500 food
technologists by the Modesto, CA-based Almond Board of California, specific
advantages for almond use in formulations include lower rancidity, shelf-life,
allergy and microbiological-load concerns. Almonds, diced almonds or
almond meal can make a great addition to dipping sauces for chicken
nuggets and popcorn shrimp. Almond meal or oil gives a gourmet taste
to coffee and espresso drinks. Sliced or slivered almonds add pizzazz
to stir-fry mixes. Several suppliers now offer flavored almonds to add
a little something different to muffins, breads, salad toppings and
snacks. Walnuts are high in polyunsaturated fats: they contain 18 grams of fat/oz., but 16 grams is unsaturated. Just 2 oz. of walnuts provide 5 grams of omega-3 fatty acids. Results from a LLU study showed a 12.4% decrease in serum cholesterol levels of subjects fed walnuts as part of their diets.
In February 2003, FDA expanded the use of the phytosterol
heart-health claim to a broader range of foods and beverages, giving
the food industry opportunities to incorporate phytosterols into more
commercial products. Fred Shinnick, manager of regulatory and scientific
affairs, Cargill Health & Food Technologies, Minneapolis, says this
is a significant step toward propelling science-based functional foods
and beverages into the mainstream. Products making the claim need 0.65
grams of phytosterol esters or 0.40 grams of free phytosterols per serving. In February 2003, FDA also issued a health-claim
letter that permitted the use of the phytosterol heart-health claim
on Reducol wood-derived phytosterol products. Unlike vegetable
sterols, wood phytosterols are not derived from genetically modified
organisms (GMOs), an advantage in many international markets. Many consumers
and food manufacturers worldwide have shown a preference for non-GMO
products. Teriaka Ltd.s Diminicol® features plant sterols in a unique microcrystalline structure. This ingredient, proven to significantly reduce cholesterol, and available for use in functional foods, recently received GRAS status. Designers can incorporate the sterol into margarines, spreads, some baked goods and dairy products, health and snack bars, salad dressings, and mayonnaise.
Individuals with Syndrome X are at greater risk
of developing type 2 diabetes and heart disease. Komorowski adds: An
estimated 60 to 75 million Americans are believed to have Syndrome X.
This is a condition where the body becomes resistant to its own insulin.
Individuals with this condition then secrete excess insulin, which causes
the body to store fat. Chromium is a trace mineral which functions as a
cofactor for insulin, and is often hard to get from the diet. In
research studies, a daily dosage of 200 to 400 mcg of chromium as chromium
picolinate shows efficacy, adds Komorowski. Previously used primarily in dietary supplements,
chromium picolinate was recently affirmed GRAS, allowing its use in
a variety of nutritional bars and beverages. The low dosage required
has no effect on the taste, color or stability of the finished product.
Chromium picolinate is frequently added to a nutrient mix and then blended
into the finished product. A recent population-based study, Coronary
Artery Risk Development in Young Adults (CARDIA), reported that
diets characterized by increased consumption of dairy foods were found
to be strongly associated with reducing the risk of Syndrome X in overweight
adults regardless of race or gender, notes Huth. The study noted
that each daily occasion of dairy consumption was associated with 21%
lower odds of Syndrome X. Many studies suggest that calcium and potassium
may help lower the risk of hypertension and stroke. An association between
lower dietary magnesium intake and higher blood pressure may also exist,
although direct clinical evidence is lacking. The nutrients contained
in dairy products, including calcium and potassium, help to lower blood
pressure by widening blood vessels, and increasing water and sodium
loss from the body. The risk of stroke-related deaths is inversely related
to potassium intake over the entire range of blood pressures, and the
relationship appears to be dose-dependent. Based on expert conclusions by the National Academy
of Sciences, manufacturers can use a health claim on food products that
qualify such as fat-free milk and orange juice to promote
the relationship of potassium-containing foods, and lower blood pressure
and stroke risk. Tropicana, now a part of Gatorade/Tropicana North America,
Bradenton, FL, promoted potassiums heart-health benefits in its
orange juice, and its market share rose significantly, proving that
a heart-healthy message helps sell additional product. Dietary Approaches to Stop Hypertension (DASH),
a landmark clinical research study, evaluated the effects on blood pressure
of a diet rich in fruits, vegetables and low-fat dairy products, and
reduced in fat and saturated fat. Subjects consuming the DASH
diet, containing three servings of dairy foods, and eight to nine servings
of fruits and vegetables, showed significant reduction in blood pressure,
notes Huth. A follow-up study reaffirmed that the DASH diet significantly
lowers blood pressure, and that the magnitude of reduction is similar
to that seen in subjects on antihypertensive medications. Blood-pressure
reductions of this magnitude are estimated to reduce the incidence of
coronary-artery disease by 15% and stroke by 27%. Most dairy products
in DASH were lowfat, but full-fat products were also used, demonstrating
that a healthy diet can incorporate some higher fat products. Other research on potential health benefits of dairy foods has also incorporated three servings of dairy foods per day. Huth adds that emerging research suggests that components contained in dairy products, including calcium, may enhance body-weight and fat loss. In a recent clinical study, subjects on weight-control diets that consumed three servings per day of milk, cheese and yogurt lost more body weight and body fat than those on a diet low in dairy products or one low in dairy and high in elemental calcium. These findings are consistent with outcomes on the association of dairy foods and weight from the CARDIA study. Further research to confirm these findings is currently underway sponsored by the National Dairy Council.
A recent research study revealed that a particular
whey protein isolate, BioZate® 1, reduced both systolic and diastolic
blood pressure in untreated borderline hypertensives, notes Polly
Olson of Davisco Foods International, Eden Prairie, MN. A dosage of
10 grams provided a significant effect, so products may use the structure-function
claim, has been found to reduce blood pressure if they contain
10 grams of this specific whey ingredient. This product is relatively bland and easy to incorporate in beverages, including chocolate milk, adds Olson. It also can be added to pudding, applesauce and other foods. Whey proteins also contribute to water-binding, gelling and emulsification in foods. Depending on the choice of whey ingredients, formulators can develop either clear or opaque products. Their clean flavor profile and excellent solubility at lower pHs make whey proteins well-suited for fruit-flavored beverages, and they are especially popular in sports-nutrition products.
Apples can join the heart-health mix, too. A clinical study revealed that consuming 1-1/2 cups of 100% apple juice or two fresh apples daily slowed the oxidation process of LDL cholesterol. Oxidation of LDL cholesterol can clog arteries, a precursor of coronary heart disease, according to Scott Summers, director of quality and technical services at Tree Top, Inc., Selah, WA. Apples, even in the dried state, contain high levels of vitamin C, potassium and fiber. They are also rich in flavonoids and contain quercetin, a phytochemical found to have a stronger antioxidant effect than vitamin C.
Commercial betaine is extracted from sugar-beet molasses and is a natural ingredient. Betaine has a mild taste, no color issues and is extremely stable, which makes it easy to add to a broad array of products. Betaine is often used with B vitamins and folic acid in heart-healthy formulas for supplements, bars and beverages.
Vitamin E is an oil-soluble vitamin commercially
available as a dispersion in vegetable oils. According to Woolf, these
oils are miscible with other oils in foods, or designers can incorporate
them into the lipid fraction of a formulated food, such as mayonnaise,
spreads or salad dressings. Vitamin E is also formulated in a water-dispersible
powder that enables incorporation into aqueous-based foods and beverages.
Vitamin C is one of the most common nutrients used
to fortify foods. Epidemiological studies are consistent with
numerous prospective studies, which indicate that low levels of plasma
ascorbate are associated with increased risk of cardiovascular disease,
comments Woolf. In-vitro studies show promise for a synergistic
effect between vitamin E and vitamin C, but this synergy has not yet
been consistently demonstrated in human clinical studies. Beta-carotenes benefits for cardiovascular
health are indisputable upon review of large-scale observational studies,
but this is not so clearly demonstrated in clinical studies, adds
Woolf. The complexity of action and the interrelation with other
important carotenoids, such as lycopene and lutein, makes this conclusion
less obvious. The consensus to date is that beta-carotene for nonsmokers
offers a potential cardiovascular health benefit. Beta-carotene
adds a pleasing golden color to various dairy and baked items. Almost 90% of the American population does not consume, on a daily basis, enough of the USDA Food Guide Pyramids recommended amounts of fruits and vegetables. These foods are rich sources of the essential phytonutrients such as antioxidant vitamins beneficial for maintenance of a healthy cardiovascular system. Fortified foods help balance the nutritional equation.
In a study presented to the AHA, 21 participants ate 46 grams per day of either Dove dark chocolate or a milk-chocolate bar. Researchers found that the subjects who ate the flavanol-rich dark chocolate showed blood-vessel dilation two hours after eating the candy. (They did note that chocolate should be used in moderate amounts in a heart-healthy diet.) Flavanols are also believed to inhibit oxidization of lipids, specifically LDL cholesterol. Sharon Gerdes writes and consults for various food-industry clients, with an emphasis in dairy products, baked goods and nutrition-specialty items. Gerdes holds a B.S. in food science and nutrition from Kansas State University, Manhattan. 3400 Dundee Rd. Suite #100 |