“Healthy” Food Panel Sept. 24, 2013 Deborah M. Pearsall Professor Emerita Department of Anthropology pearsalld@missouri.edu In the discipline of Anthropology, “healthy” food means . . . Food that contributes to: physical health, mental, emotion, spiritual health good functioning of social system sustainable functioning of the food and nutrition system Traditional Food and Nutrition Systems • What is a traditional food and nutrition system? – food, knowledge, practices in cultural and environmental context http://www.woodlandindianedu.com/storagefoods.html Food preparation methods Fish prepared with fermented breadfruit balls • What parts are eaten? – Differ in nutrients • What variety is eaten? – Differ in nutrients • How are foods prepared? – Effects nutritional content • What is eaten together? – Complementary foods • • • • • • • • Common traditional management practices Burning Digging and tilling Pruning, coppicing, and pollarding Weeding and cleaning Transplanting Selective harvesting and replanting Enclosures Mulching and fertilizing Burned forest Productive swidden Fruit orchard Forest garden Forest management • Maya example • Techniques employed: – Burning to open forest – Weeding and low intensity burning to reduce weeds, release nutrients from litter – Encouraging useful trees/removing undesirable ones – crop rotation – Attracting seed dispersers and pollinators Documenting TREM (traditional resource and environmental management) • Practices are interrelated, must be studied in cultural context • Combining ethnography and ecology to understand management • Archaeology and paleoecology provide time depth Agriculture in the Americas • In 1492, millions of Native Americans were agriculturalists Planting in Florida Planting potatoes in Peru • Plant domestication began 10,000 years ago in the early Holocene • multiple domestications of plants needed for nutritionally balanced meals The major kinds of American crops: – Pseudocereals, grains, oil seeds • amaranth, chenopod, knotweed, maize, maygrass, sunflower – Legumes (pulses) • Common bean, lima bean, jack bean, lupine, peanut – Squashes and gourd • pepo, pumpkin, bottle gourd – Roots and tubers • arrowroot, llerén, manioc, potato, sweet potato, yam – Fruit trees • avocado, cacao, guava, papaya, peach palm, soursop – Spices, stimulants, fiber • chile peppers, coca, cotton, tobacco Domesticated Plants at Real Alto, 2800 BC • • • • • • • • • maize (Zea mays) achira (Canna) arrowroot (Maranta) llerén (Calathea) manioc (Manihot esculenta) cucurbits (Cucurbita and Lagenaria siceraria) cotton (Gossypium barbadense) jackbean (Canavalia plagiosperma) chile pepper (Capsicum) a, b, c, e, f: maize; d: arrowroot Karol Chandler-Ezell, D. Pearsall, J. Zeidler 2006 What are the impacts of agriculture? • Environmental impacts – Slash and burn indicators – Intensive agriculture • Impacts on human populations –Population growth –Profound social changes –Health and nutrition Impacts of agriculture on health • Poorer dental health (1.3% 10.4% caries) – Caries, tooth loss (increased carbs, especially sugars, soft gruels, beers) • Poorer growth and development – Dietary stress leading to interrupted growth, increased morbidity • Increased rates of anemia (reduced access to protein) • Health challenges from higher population densities: parasites, disease transmission, conflict • Health challenges from environmental changes: water and mosquito-borne diseases Review of Main Points • “healthy” food is viewed as part of a food and nutrition system • Traditional knowledge of food practices is as important as traditional varieties • Agriculture sustains large populations but presents health and environmental challenges Deborah M. Pearsall Professor Emerita Department of Anthropology pearsalld@missouri.edu References • • • • • Chandler-Ezell, Karol, Deborah M. Pearsall, and James A. Zeidler. 2006. Root and tuber phytoliths and starch grains document manioc (Manihot esculenta), arrowroot (Maranta aundinacea), and llerén (Calathea sp.) at the Real Alto site, Ecuador. Economic Botany 60:103-120. Fowler, Catherine S. and Dana Lepofsky. 2011. Traditional and environmental management. Pp. 285-304 in Ethnobiology, edited by E. N. Anderson, D. M. Pearsall, E. Hunn, and N. Turner. John Wiley and Sons. McClune, Letitia M. and Harriet V. Kuhnlein. 2011. Assessments of Indigenous Peoples’ traditional food and nutrition systems. Pp. 249-266 in Ethnobiology, edited by E. N. Anderson, D. M. Pearsall, E. Hunn, and N. Turney. John Wiley and Sons. Pearsall, Deborah M. 2000. Paleoethnobotany. A Handbook of Procedures. Left Coast Press. -----. 2008. Plant Domestication. Pp. 1822-1842 in Encyclopedia of Arcahaeology. Academic Press. Kevin L. Fritsche, Ph.D. Professor of Animal/Human Nutrition University of Missouri – Columbia Division of Animal Sciences, Dept. of Nutrition & Exercise Physiology Email: fritschek@missouri.edu In the discipline of “healthy” food means . . . , On-line Medical Dictionary says… “Any food believed to be ‘good for you’, especially if high in fiber, natural vitamins, fructose, etc.” “Healthy foods may reduce cholesterol, reduce atherosclerosis and risk of stroke, help control glucose, halt progression of osteoporosis, and reduce the risk of infections, cancer.” Current dogma… “There are no good or bad foods, only bad diets.” However, the “all foods can fit” framework has undermined the establishment of standards for defining nutritional quality of individual foods. unHealthy foods… 1. Refined grains, fats, and sweets are inexpensive, palatable, and convenient. 2. The terms energy-dense and nutrient-poor are commonly used to characterize foods perceived as unhealthy and to distinguish them from more nutritious options. “Nutrient-poor vs. nutrient-rich” • Widespread agreement on what qualifies as a “nutrient-poor” food. • In contrast, little agreement exists about what a nutrient-rich food is… ..it is more than “sugar-free” or “low-fat” Nutrient profiling The science of ranking and/or classifying foods based on their nutrient composition has become known as nutrient profiling. What’s up with nutrient profiling? • A number of existing nutrient profile models or nutrition quality indices have recently been developed by academic researchers, regulatory bodies, and the food industry. • Some of those indices are based on only nutrients to encourage, others on only nutrients to limit, or on some combination of both. Validation is ongoing… • In 2009 several nutrient-rich foods (NRF) indices were validated against the Healthy Eating Index (HEI), an accepted measure of diet quality. • One particular index, based on 9 nutrients to encourage (protein, fiber, vit. A, C, E, calcium, iron, magnesium, potassium) & 3 nutrients to limit (sat fat, added sugar & sodium), performed well. (Fulgoni et al. 2009, J. Nutr. 139: 1549) The long-term goal… • Continue to validate and implement one or more nutrient-density indices of individual food items in the marketplace. • This should help consumers to identify and select nutrient-dense foods while permitting some flexibility where discretionary calories are concerned. • Outreach & education will be needed. Organic vs. conventional foods? • Demand for organic food continues to expand, in part, because some consumers believe these foods are more nutritious. • A recent systematic review of the evidence on this topic concluded: There are no meaningful differences in the nutrient profiles between organic vs. conventionally produced/grown foods. (Dangour et al, 2009 Am J Clin Nutr 90: 680) Review of Main Points ①“Foods are not good or bad, only whole diets” is not a helpful approach; ②Nutrient profiling for scoring individual foods is coming; ③Organic foods are NOT more nutritious. Thanks for your attention! Kevin L. Fritsche, Ph.D. Email: fritschek@missouri.edu Role of Beef in a Healthy Diet Carol L. Lorenzen Professor and Meat Extension Specialist Division of Animal Sciences University of Missouri In the discipline of Animal Science, “healthy” food means _________ • A complete protein delivered in a tasty and appealing manner. • Animal based products that are produced in an efficient and sustainable manner. Nutritional Reasons to Eat Red Meat • • • • • • • Packed with nutrients at an affordable price. Complete protein Bioavailable iron B vitamins Zinc Thiamine CoQ10 National Cattleman’s Beef Association Comparison of Beef, Pork and Chicken 3 oz Cooked Serving Calories Total Fat (g) Saturated Fat (g) Cholesterol (mg) Skinless Chicken Breast 139 3.1 0.9 73 Skinless Chicken Thigh 177 9.3 2.6 81 Pork Top Loin Chop, bnls 173 5.2 1.8 61 Pork Tenderloin 120 3.0 1.0 62 Beef Top Sirloin 162 8 2.2 76 Beef Top Loin 168 7.1 2.7 65 Beef Tenderloin 175 8.1 3.0 71 Adapted from USDA Nutrient Database, 2006 Role of a Meat Proteins in Offsetting Age Related Muscle Loss • Dietary protein intake plus resistance exercise can maintain muscle mass in older people Phillips, 2012, Meat Science Role of Meat Proteins in Offsetting Age Related Muscle Loss • Red meat is effective in increasing muscle protein synthesis compared to plant proteins. Role of High Protein Meals in Appetite Control Reference Hunger Fullness Stubbs, 1999 Decrease Increase Stubbs, 1996 Decrease Increase Leidy, 2009 Decrease Increase Latner, 1999 Increase Blom, 2006 Decrease Bowen, 2006 Decrease Increase Bowen, 2006 Decrease Increase Leidy, 2011 Decrease Increase Leidy, 2010 Decrease Increase Marmonier, 2000 Decrease Increase No difference Increase Leidy, 2010 Smeets, 2008 Increase Leidy, 2012 Decrease Increase Leidy, 2007 Decrease Increase Adapted from Leidy, 2012, Reciprocal Meat Conference Role of Meat in Cognition • Iron’s role in cognition – Required by enzymes involved in specific brain function • Zinc’s role in cognition – Implicated in central nervous system development National Cattleman’s Beef Association Animal Science Reasons to Eat Red Meat • Ruminant animals have the ability to convert cellulose into meat, milk and fiber. Ruminants Role in the Food System 1/3 of the Earth’s surface is land (34 billion acres) 4% 10% Urban 41% 15% Cultivated Non-productive Forrest Range 30% D. C. Church. 1993. The Ruminant Animal Efficiency of Livestock Production • Pounds of beef produced has increased 12.3% between 1977 and 2007 (Capper, 2011, Journal of Animal Science). • Number of beef cattle has decreased 43.0% between 1977 and 2007 (Capper, 2011, Journal of Animal Science). Efficiency of Livestock Production -22.9% 80000 70000 60000 50000 40000 -8.7% 1977 30000 -9.4% -49.3% 20000 2007 -13.8% 10000 0 Total energy Feedstuffs requirement (kg x 106) (MJ x 107) Land (ha x 103) Water (L x Fossil Fuel 109) Energy (BTU x 109) Adapted from Capper, 2011. Journal of Animal Science Efficiency of Livestock Production 60000 50000 -23.3% -14.0% -11.5% 40000 1977 30000 2007 20000 10000 0 Manure (kg x 106) N excretion (kg x 104) P excretion (kg x 103) Adapted from Capper, 2011. Journal of Animal Science Efficiency of Livestock Production -22.9% 80000 70000 60000 50000 40000 -19.5% -12.3% 30000 1977 2007 20000 10000 0 Methane (kg x 104) Nitrous Oxide (kg x 103) Carbon Footprint (kg of CO2 x 106) Adapted from Capper, 2011. Journal of Animal Science Changes in Carcasses Composition Trait 1974 2011 % Change Fat Thickness, cm 1.58 1.30 -21.5% Hot Carcass Wt., kg 308 374 +21.4% Ribeye area, cm2 76.3 88.8 +16.4% USDA Yield Grade 3.4 2.9 -17.2% Small+ Smallo -9.8% Marbling Score Adapted from 1974 USDA Market Consist Report and Moore et al., 2012, Journal of Animal Science a Carol L. Lorenzen Professor and Meat Extension Specialist Division of Animal Sciences University of Missouri “Healthy” Food Panel Sept. 24, 2013 Does Food Play a Role in the Development of Chronic Diseases? David E. Goldstein, M.D. Professor Emeritus University of Missouri Health Sciences Center 1 Hospital Drive, Columbia, MO 65212 goldsteind@health.missouri.edu www.endodoc.org In the discipline of medicine, “healthy” means . . . food that does not contain ingredients or contaminants known to contribute to adverse health outcomes. Question: Can we actually define what are "healthy foods? Answer: "No clear standards exist to define foods as good or bad, healthy or not healthy." USDA-Food and Nutrition Service, March 1, 2007. FACT: We in the U.S. are fat and sedentary, and the rest of the world is following our lead. www.hsph.harvard.edu Flegal KM et al: Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012;307:491-97. Ogden CL et al: Prevalence of obesity and trends in body mass index among US children and adolescents. JAMA 2012;307:483-90. www.cdc.gov/healthyyouth/obesity THE GOOD NEWS: The steadily rising prevalence of obesity in the U.S. over the past 50 years seems to be reaching a plateau. THE BAD NEWS: We are still fat and sedentary. O'Conner A: "Is the public health message that we are too fat and too sedentary sinking in?" NYT,09/16/2013, A12 Question: Why are we so fat? Simple Answer: We consume more food than we burn up. Bruni F: "Hard truths about our soft bodies." NYT, 09/17/2013, A23 Question: Why are we so fat? Complicated Answer: Genetic and non-genetic factors Genetic Factors (the bad news) Many different genes exert strong influences on body weight. Sims E et al: Endocrine and metabolic effects of experimental obesity in man. Recent Prog Horm Res 1973;29:457-96 (Vermont prisoner studies) Stunkard AJ et al: The body-mass index of twins who have been reared apart. N Engl J Med 1990;322:1463-7. Non-genetic factors (the potentially good news) Obesity is not inevitable in people who possess genes that promote obesity (e.g., the Pima Indians) Gladwell M: The Pima Paradox. The New Yorker, February 2, 1998, p43-57. What's the big deal about being overweight? Obesity is a powerful risk factor for the development of serious chronic diseases such as cardiovascular disease, diabetes, cancer, and arthritis. To what extent diet composition plays a role in the development of these chronic diseases independent of obesity is unclear. Tirosh A et al: Adolescent BMI trajectory and risk of diabetes versus coronary artery disease. N Engl J Med 2011;364:315-25. Mozaffarian D et al: Components of a cardioprotective diet: new insights. CIrculation 2011;123:2870-91. Estruch R et al: Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013;368:1279-90. Kotchen TA et al: Salt in health and disease-a delicate balance. N Engl J Med 2013;368:1229-37. Question: What should we do (part 1)? Answer: I'm not sure. Although we know a great deal about obesity and its health effects, we do not have particularly effective ways to prevent and/or treat obesity other than bariatric surgery. I do not believe we can legislate healthy eating. On the other hand, public policy can promote the benefits of healthy eating and physical activity. Patel AI, Rithie L: Striving for meaningful policy to reduce sugar-sweetened beverage intake in young children. Pediatrics 2013;132:566-68.Med 2013;368:1229-37. Question: What should we do (part 2)? Answer: In the end it is more about personal choice rather than anything else. Casazza K et al: Myths, presumptions, and facts about obesity. N Engl J Med 2013;368:446-54. Review of Main Points A. The food system provides ample food which is more or less healthy and relatively inexpensive. B. There is no consensus among "the experts" on what constitutes healthy vs. unhealthy food. But, I believe there is at least a majority view on what constitutes a healthy diet. C. The single biggest challenge our society faces with respect to food, is how to develop effective ways to prevent and to treat obesity. Success will require major changes in public policy regarding food issues and in personal foodrelated decisions. David E. Goldstein, M.D. Professor Emeritus University of Missouri Health Sciences Center 1 Hospital Drive, Columbia, MO 65212 goldsteind@health.missouri.edu www.endodoc.org Laina Fullum RD, LD Nutrition Services Department Columbia Public Schools 573-214-3480 lfullum@columbia.k12.mo.us In the discipline of Dietetics, “healthy” food means . . . …foods that provide essential nutrients, energy and building blocks to support the human body at an optimal level for disease prevention….But • Each individual has their own healthy food beliefs and focus which is influenced by their present state of being, personal desire, and past experiences Feeding Programs at CPS • National School Lunch Program (program est. 1946) – After School Snack Program – Seamless Summer Feeding Option • School Breakfast Program (program est. 1975) • Special Milk Program • Donated Foods Program • Fresh Fruit and Vegetable Program • Cater dinner to a community organizations Nutrition Services • Serve 29 kitchens for 33 sites – CPS Enrollment 17,722 • 155-165 employees • Free and Reduced Price Eligible: 38% – About 6,700 students (2011-2012) • Average Daily Participation – Over 8,300 students eating a reimbursable lunch and 3,200 for breakfast Number of Lunches Served • 2012-2013 1.67 mil. lunches 17,722 students • $8.6 mil budget • Nutrition Services is self supporting – Federal – State – Lunch Prices – A la carte sales New Regulation Focus • • • • • • • • • • Calories Total Fat Saturated Fat Protein Vitamin A, C, Calcium Iron Cholesterol Fiber Sodium • • • • • • • • • All nutrients on the left Vitamin E B vitamins 6 and 12 Zinc Magnesium Potassium Phosphate Folate Research based nutrition Mission All students and staff of Columbia Public Schools will have access to fresh, flavorful and nutritious meals daily while promoting local sustain-ability. Healthy Food? • • • • • • • • • Very strict new USDA regulations Varied socioeconomic background Newer push for updated healthier food Exposure & Opportunity Nutrition education Food safety We read the labels and provide foods kids will eat Limit influence by popular trends and social outcry Better programs – FFVP, Farm to School, utilization of chefs • Commodities are getting better Challenges • Balance what’s palatable for all children to eat – Varied backgrounds • Stigma of the lunch program • Budget constraints affect quality – It isn’t just food, its labor, utilities, permits, inspections… • New regs predicted to cost $450,000 the first 2 years • Many student do not like the new food • Time constraints • Building infrastructure • Staff constraints • Low interest in healthy foods Review of Main Points • • • • • • • Program shift: low income vs. student health Funding has not kept pace Discouraging level of interest in healthy food Budgets are tightening We cannot afford organic We cannot source 100% local We can provide color, variety, safety and exposure • Great new initiatives that need fine tuning Laina Fullum RD, LD Nutrition Services Department Columbia Public Schools 573-214-3480 lfullum@columbia.k12.mo.us Contact Donna Mehrle, MPH, RD, LD MU Food Systems Network Co-coordinator mehrled@missouri.edu Or Mary Hendrickson, PhD MU Food Systems Network Co-coordinator hendricksonm@missouri.edu