|
| Nutrition per serving | Original | Modified |
| Calories | 229 | 192 |
| Fat | 15.0 g | 10.0 g |
| Cholesterol | 70 g | 61 mg |
| Sodium | 499 mg | 320 mg |
| Percent of calories from fat | 59 | 46 |
Benefits of Bacteria in Yogurt
Yogurt has long been consumed for its taste as well as its potential benefits to health. The healthful nature of yogurt can result from its nutritional and microbiological properties. The focus of this article , however, is on the healthful attributes of microbes used in the production of yogurts.
Microbiology of Yogurt
Bacteria are added to milk during yogurt manufacture for two purposes. First, the yogurt bacteria serve as agents of fermentation. Strains of Streptococcus salivarius ssp. thermophilus and Lactobacillus delbrueckii ssp. bulgaricus are normally used for these applications. These bacteria metabolize milk sugar, lactose, to produce lactic acid, ethanol, acetaldehyde and extracellular polysaccharides. Lactic acid provides the clean tart acid flavor of yogurt. It also leads to the acid coagulation of milk protein, forming a soft gel. Ethanol and acetaldehyde are produced in small quantities and, in the proper ratio, provide characteristic yogurt flavor.
Second, bacteria added to yogurt can be added to promote overall health. Bacteria added for this purpose are termed probiotic bacteria. Probiotic bacteria are expected to exert a positive influence during their travels through or residence in the intestinal tract. Intestinal species of Lactobacillus (including L. acidophilus, L. gasseri, L. casei and others) and Bifidobacterium (including B. longum, B. adolescentis, B. bifidum and others) are normally present in yogurts, not for their fermentative ability but for their ability to promote human health. These bacteria are normally found in the intestinal tract of man and strains isolated from these sources are purified, characterized and provided by culture manufacturers for use in some fermented dairy products.
Lactose Intolerance
Ingested lactose which is not digested in the small intestine due to a lack or a deficiency of lactose will reach the large intestine where it is metabolized by the resident microflora or, if in excess, excreted. This situation can lead to a variety of unpleasant symptoms in the lactase-deficient person, including increased bowel motility, gas, abdominal pain, bloating and diarrhea. Yogurt has approximately the same lactose content as milk. However, it has been frequently observed that, in equal quantities, yogurt consumption is less likely to result in lactose intolerance symptoms than milk consumption. The effectiveness of yogurt cultures in promoting lactose digestion is perhaps the best documented health effect of the bacteria associated with yogurt.
Diarrhea
Numerous studies on the effect of lactic cultures preventing or alleviating diarrhea have been conducted. The data, in large part, are either not positive or are suspect due to poor experimental design. However, there are a few studies which suggest strongly that certain strains can positively influence the course of some diarrheal illnesses.
Influence on Metabolic Activities of Intestinal Flora
One of the most interesting areas of research on the ability of L. acidophilus to influence harmful intestinal activities has been conducted in patients with chronic kidney failure. The altered physiology of these patients results in small bowel overgrowth, a condition due to bacteria present in the large intestine overgrowing the normally sparsely populated small bowel. Although treatable with nonabsorbable oral antibiotics, chronic use of these drugs is not recommended. This condition is reflected in high blood levels of dimethylamine (a toxin) and nitrosodimethylamine (a carcinogen). Levels of these compounds were substantially reduced when patients were fed a freeze-dried L. acidophilus strain, designated NCFM. Accompanying improvement in general nutritional status of the patients was also evident. These well-controlled experiments provide objective measurements of inhibition of harmful metabolic activities of intestinal microbes.
Vaginal Infections
Some limited evidence
suggests that ingested yogurt can prevent vaginitis.
Candidal vaginitis is a common cause of vaginal
infection, especially in women on antibiotic therapy.
Hilton studied the effect of daily ingestion of L.
acidophilus yogurt (containing 108 L. acidophilus/ml) on
Candida infection in women with recurrent candidal
vaginitis. The average number of infections was 2.5 in
the control group and 0.38 in the group consuming yogurt.
These results were highly significant (P<0.001). the study was a crossover design but not blinded to patients and sterile yogurt was not administered as a control. eight women in the study refused to participate as controls in the study due to clinical improvement. this study shows the potential importance of some l. acidophilus strains for maintenance of vaginal health and the potential for oral supplementation to provide these bacteria. Immune System
Stimulation
Some interesting results have been generated recently on the ability of yogurt cultures and intestinal lactic acid bacteria to stimulate the immune response. A variety of model systems are under investigation, mostly using experimental animals or cell culture. IgA and/ or IgG secretion, microbial translocation across the gut and survival of animals challenged with pathogens have been tested for response to administration of lactic acid bacteria or their cell components. Studies which confirm any positive effects in humans are rare. However, one recent study has reported an increase in lymphocyte gamma interferon production in adults consuming two cups of yogurt daily for four months. Although this observation is consistent with the hypothesis that yogurt consumption may be associated with an improved immune defense, research to date does not conclusively define the effect of oral doses of lactic cultures on the immune response in humans, but it warrants continued investigation into their role in keeping the immune system primed to fight infection and tumor generation. (JD)
Source: Contemporary Nutrition, Vol 18, No 5, 1993
Considering the recent conflicting reports on caffeine; one day it's OK to consume, the next day it's not, you may have had nagging doubts about the health effects of your favorite caffeine-containing beverage.
Although people have consumed caffeinated foods and beverages for hundreds of years, questions persist about its potential effects on women's health. But according to leading medical and scientific experts, caffeine consumed in moderation produces no adverse health effects.
Physiological Effects
Depending on the amount consumed, caffeine can be a mild, central nervous system stimulant. Since caffeine does not accumulate in the body over the course of time, it is normally excreted within several hours of consumption. Any pharmacological effects of caffeine are brief, usually passing within hours.
People differ greatly in their sensitivity to caffeine. With regular use, tolerance develops to many of the effects of caffeine. For example, a person who consumes caffeine on a regular basis may drink several cups of coffee in a few hours and notice little effect, whereas a person who isn't a regular coffee drinker may feel some stimulant effect after just one serving.
When regular caffeine consumption is abruptly stopped, some people may experience symptoms, such as headaches, fatigue or drowsiness. These effects usually are temporary, lasting for a few days, and often can be avoided if caffeine cessation is gradual.
Caffeine and Pregnancy
Today, with increased attention to maternal nutrition, many women wonder if it's safe to consume caffeine-containing foods or beverages during pregnancy. While some studies have shown conflicting results, the weight of scientific research continues to indicate that moderate caffeine consumption does not affect fertility or cause adverse health effects in the mother or child.
Fertility
Since many women are delaying pregnancy, more research has focused on identifying the factors that may affect fertility, including caffeine.
In 1990 researchers at the Centers for Disease Control and Prevention and Harvard University examined the association between the length of time to conceive and consumption of caffeinated beverages. The study involved more than 2,800 women who had recently given birth and 1,800 women with the medical diagnosis of primary infertility.
Each group was interviewed concerning caffeine consumption, medical history and life-style habits. The researchers found that caffeine consumption had little or no effect on the reported time to conceive in those women who had given birth. Caffeine consumption also was not a risk factor for infertility.
Miscarriages
The association between caffeine and miscarriages continues to be researched. A research team from the U.S. National Institute of Child Health and Human Development conducted a study of 431 women. The researchers monitored the women and the amount of caffeine they consumed from conception to birth. After accounting for nausea, smoking, alcohol use and maternal age, the researchers found no relationship between caffeine consumption of up to 300 mg per day and adverse pregnancy outcomes, including miscarriage.
Additionally, in 1992, researchers analyzed the effects of cigarettes, alcohol and coffee consumption on pregnancy outcome in more than 40,000 Canadian women. Although alcohol consumption and smoking tended to have adverse effects on pregnancy outcome, moderate caffeine consumption was not associated with low birth weight or miscarriages.
Birth Defects and Low Birth Weight
Studies published during the 1980s also support the conclusion that moderate caffeine consumption during pregnancy does not cause early birth or low birth-weight babies. A review of more than 20 studies conducted since 1980 found no evidence that caffeine consumption at moderate levels has any discernible adverse effect on pregnancy outcome.
Major studies over the last decade have shown no association between birth defects and caffeine consumption. Even offspring of the heaviest coffee drinkers were not found to be at higher risk of birth defects. FDA has evaluated this scientific evidence and concluded that caffeine does not adversely affect reproduction in humans. However, as with other dietary habits, the agency continues to advise pregnant women to consume caffeine in moderation.
Breast Feeding
Women should also take note of what they eat while breast feeding to ensure healthy milk production. Though caffeine can permeate into breast milk, nursing mothers can safely consume up to 300 mg of caffeine (2-3 cups of coffee or several cans of cola) without passing on a significant amount of caffeine to the baby.
The American Academy of Pediatrics Committee on Drugs has reviewed the effects of caffeine on breast feeding and reported that moderate caffeine consumption has no effect on breast feeding.
Fibrocystic Breast Disease
Caffeine was first discussed in relation to breast disease in the late 1970s. An informal study suggested that abstinence of caffeine might alleviate the symptoms of fibrocystic breast disease, a condition of benign fibrous lumps in the breast. Though caffeine was not linked to development of the disease, some subjects reported feeling less breast tenderness when they eliminated caffeine from their diets. However, the findings were based on anecdotal reports from a small number of women, rather than clinical testing, making the conclusions unreliable.
A larger study conducted by the National Cancer Institute (NCI) involved more than 3, 000 women. This 1986 study showed no evidence of an association between caffeine intake and benign tumors, fibrocystic breast disease or breast tenderness.
Both the NCI and the American Medical Association's (AMA) Council on Scientific Affairs have stated there is no association between caffeine intake and fibrocystic breast disease.
The Cancer Question
The concern raised about caffeine and fibrocystic breast disease led to a concern about possible association between caffeine consumption and breast cancer. However, extensive research conducted to date has shown no association between caffeine consumption and the development of any cancer.
Osteoporosis Boning up on Health
Given the recent awareness about the incidence of osteoporosis in post-menopausal women, the relationship between caffeine and bone health is a relatively new area of investigation. Because caffeine intake often causes an increase in calcium loss, it has been suggested as a risk factor for osteoporosis. Yet studies show that adequate calcium consumption offsets the potential effect of caffeine on bone density.
This is illustrated in a recent study that examined the lifetime intake of caffeinated coffee in 980 post-menopausal women. The researchers found no association between lifetime caffeinated coffee intake (equivalent to two cups per day) and reduced bone mineral density among women who drank at least one cup of milk a day during their adult lives.
Caffeine and Heart Disease_Matters of the Heart
Caffeine and heart disease is another area that has been extensively examined, and no causal relationship between caffeine consumption and heart disease, high blood pressure or irregular heart beat has been shown.
While most studies investigating heart disease in large populations involve men, two studies have included women. Researchers of the recent Scottish Heart Health Study conducted a study of 10,359 men and women aged 40-59. Their analysis showed no relationship between coffee consumption and heart disease; in fact, they found that coffee may actually protect against heart disease. (JD)
Source: Caffeine and Women's Health, AWHONN & IFIC Foundation
Eating Alone and Poor Nutrition
Eating alone is the most common factor behind poor nutrition among older people. That's according to a survey of nearly 700 volunteers from age 60 through their 90's_the latest of several studies to show this association. Other factors identified that contributed to poor nutrition, in order of their impact, were low education level, belonging to a racial minority, living in a low-income neighborhood, smoking, wearing dentures and taking multiple medications. To determine these factors, researchers ran statistical analyses on the survey volunteers who reported diets that met one or more or the following criteria: less than two-thirds of the Recommended Dietary Allowances for calories, vitamins or minerals; more than 40 percent of calories from fat; or more than 15 percent of calories from saturated fat. A low-calorie intake was the most frequent deficit among the women and was linked to eating alone, belonging to a racial minority and taking multiple medications. A high-fat or high-saturated-fat intake was the main liability among the men and was linked to eating alone, low education level and smoking. Smoking was also associated with a high-fat intake among the women. (MC)
Source: Food & Nutrition Research Briefs, USDA, July-Sept. 1993
Taste is the most important attribute of food that determines what people eat. Convenience, availability, perceived health benefit and cost are also important. When it comes to adjusting diets to more nearly meet dietary guidelines and the Food Guide Pyramid, all of these factors come into play in varying degrees. It depends upon the value a person places on healthful eating, his or her life-style, resources (time, skills, money), etc.
A new study published in the May-June 1994 Journal of Nutrition Education looks at the cost of a healthful diet for a variety of groups in Australia including low income, pregnant and lactating women, adolescents, and four different calorie levels for adults ranging from 5.5 MJ to 9.5 MJ [1315 kcal to 2270 kcal].
The researchers also compared similar diets using generic and branded products for "healthful" and "less healthful" diets. Of the 229 food items, 49 food items had healthier alternatives i.e. lower in fat or salt, higher in fiber, etc. There were 74 generic products with just 24 of them having a healthier version. One of the authors' observations was that diets using food manufacturers' healthier products high in fiber, lower in fat or refined sugar tended to be more "sodium dense," i.e. the sodium content per 1000 calories was a little higher than the average diet. Some of the same trends can be noted in products processed and marketed in this country. Processors often add more salt to improve the taste.
The Australian Government's Better Health Commission Dietary Targets are similar to our Dietary Guidelines. Their Targets suggest an intake of salt less than 2300 mg (US recommendations are for a 500 mg sodium minimum or 1100 to 3300 mg sodium as "safe and adequate"), fat less than 33% (compared with our 30%); refined sugar less than 12% (ours say "in moderation," 300 mg or less cholesterol and less than 10% saturated fat (the same); and fiber greater than 30 g per day (no amount recommended but some authorities suggest at least 20 to 25 g per day). They also have the 12345+ Food and Nutrition Plan similar to our Food Guide Pyramid.
Only 3.3% (72 out of 2178 people studied) conformed to these dietary guidelines and were labeled "conformers" in the study. The authors noted that "conformers" tended to be older women who consumed fewer calories than the average. In comparing costs of healthful with average or nonconformer diets, this lowered calorie intake was taken into account.
Does eating a healthful diet cost more?
Generally not, especially at the higher calorie levels, according to this survey. The main cost increases in the diet plans were for adolescents and pregnant and lactating women who have higher meat and dairy group servings. Otherwise, increased calories can be met by increasing the number of bread and cereal servings.
If people adopted the substitution approach, that is buying a healthier product in place of their usual purchase,_then the diets tended to cost more to get products with less fat and sugar and more fiber. The authors state, "Unfortunately, it is generally easier for people to understand and adopt a substitution approach rather than it is to basically restructure their diets. They also receive encouragement to adopt this substitution approach to healthful eating not only from food manufacturers who, understandably, wish to promote specific `healthful' products, but also from much of the educational literature designed by health professionals."
While this study was designed to look at the potential for saving money while eating a healthful diet, there are obviously other "costs" to be considered. One must also have healthful food choices available; the skills, time and facilities for selecting and preparing appetizing alternatives; plus that all-important motivation. A similar study would be useful in this country particularly with respect to low income groups. Most people assume that healthful eating is expensive. This study suggests otherwise. (MC)
Source: McAllister, M, K Baghurst, and S Record. Financial Costs of Healthful Eating: A Comparison of Three Different Approaches. J Nutr Educ 1994; 26: 131-139.
Update on Breast Cancer, Especially Diet
What, if anything, does diet have to do with breast cancer? The causes and promoters of breast cancer are generally puzzling, but it's especially true for diet and diet-related influences. So far, the best supported factors for increasing the risk for breast cancer are 1) older age, 2) being female and 3) having close relatives who develop breast cancer. Most breast cancer gets diagnosed in women after menopause. Many more women than men develop breast cancer and having a close relative, e.g. a sister or mother with breast cancer, increases a person's risk. But only 15 percent of women with breast cancer have relatives who also have had it. These factors are all uncontrollable, something you can't do anything about.
Many studies have been looking at possible controllable factors. Women who delay childbirth until they are older are at greater risk than those bearing children while young. Some studies have linked the use of oral contraceptives and estrogen replacement therapy with increased risk for breast cancer. Also teenage girls with earlier menarche are known to be at higher risk later in life than those who start menstruation later. The sex hormones, particularly the various estrogen compounds, are somehow involved in breast cancer etiology.
One of the early dietary leads was the possible association of high fat diets with increasing risk. An epidemiological study across many countries showed that Orientals were at much lower risk than westernized Caucasians in developed countries with one of the most significant associations occurring between the amount of dietary fat and breast cancer risk. But then there were also beautiful correlations between breast cancer rates and animal fat, percent of calories from fat, total calories, and even the number of telephones in a country. Of course, linking telephones with breast cancer is nonsense but suspecting diet and other life-style factors is not.
In large, well-controlled studies in this country, the fat hypothesis has not held up. According to Dr. Regina Ziegler with the National Cancer Institute, cancer, fat and calories have been surprisingly non-existent or show just small differences. One explanation is that the U.S. population is too homogeneous ranging from 32 to 42 percent calories from fat whereas Orientals traditionally consume only 15 to 20 percent of their calories as fat. High fat intake can be correlated with obesity and excess weight may be part of the problem. Other recent findings suggest that abdominal obesity and the timing of adult weight gain is associated with greater risk. The most common timing for a woman's weight gain occurs as excess weight retained after childbirth or weight put on during menopause. Besides ovaries, body fat can be a source of active estrogens. Considerable evidence from many sources supports the conclusion that high blood estrogen levels, for whatever reason, increase risk for breast cancer.
However, some of the most surprising and intriguing findings are associating legumes, especially soy products, with decreased risk for breast cancer. Vegans, vegetarians (those who consume only plant foods, not even dairy products or eggs) ordinarily have diets high in soy and other legumes. Soy products are high in phytoestrogens (plant estrogens) such as lignans and isoflavonoids. Weak cancer-promoting pytoestrogens can replace the active estrogen hormones, such as estrone, estrone-sulfate, and estradiol, at estrogen-binding sites in breast tissue. Furthermore, fiber and phytoestrogens from many different plant foods inhibit colon reabsorption of active estrogens and increase their fecal excretion, thus possibly lowering breast cancer risk.
Other dietary factors explored include omega-3 fatty acids, alcohol, antioxidants (beta-carotene, vitamins C and E), vegetarian diets, fiber and alcohol. At this point, the best evidence is against alcohol, even just two drinks daily, has been consistently associated with increased risk for cancer.
Sources: George M. Briggs Nutrition Science Symposium. Nutrition, Hormones, and Breast Cancer. Presentations by Regina Ziegler, PhD, MPH and Margo Woods, D Sc at the annual meeting of the Society for Nutrition Education, July 18 1994, Portland Oregon, Lampe, J.W. et al. Urinary ligan and isoflavonoids excretion in premenopausal women consuming flaxseed powder. AMJ Clinical Nutrition 1994; 60: 122-28
To help combat the conflicting reports on caffeine's effect on women's health the Association of Women's Health, Obstetric and Neonatal Nurses and the IFIC Foundation developed an educational brochure, Caffeine and Women's Health to distribute free to consumers and health care providers. For a summary see article, Caffeine and Women on page 4.
Single copies of this brochure are available by sending a self addressed stamped business-sized envelope to: Caffeine and Women's Health, P.O. Box 1144, Rockville, MD 20850. (JD)
K-State Research and Extension is a short name for the Kansas State University Agricultural Experiment Station and Cooperative Extension Service, a program designed to generate and distribute useful knowledge for the well-being of Kansans. Supported by county, state, federal and private funds, the program has county Extension offices, experiment fields, area Extension offices and regional research centers statewide. Its headquarters is on the K-State campus, Manhattan.