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Got Food?

Recent Advances in Food Science and Technology

~~~~~~~~~~~~ An e-book co-authored by the Class of 2013 Massachusetts Academy of Math and Science ~~~~~~~~~~~~

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Chapter 14 Chapter 15

Diet and Nutrition

Ann Ming Samborski, Amanda Stevens, and Ingrid Marko

3 19 31 44 55 62 70 82 94 105 116 130 140 148 164

Vitamins and Minerals

Barry Biletch, John deRivera, and Aniket Lachyankar

Food Supplements
Patrick Aoude, Julia Knowles, and Derek Wegener

Diet and Diabetes

Nora Murphy and Jay McCowan

Diet and Heart Disease

Arjun Tanguturi and Rebecca Stolarczyk

Vegetarian and Vegan Diets

Dhroova Aiylam and Cameron Root

Childhood Obesity
Emma Hewett, Sierra Harris, Angelica Heeney, and Divya Satishchandra

Global Food System

Ryan Thibodeau., Thomas Devlin, and Abigail Yu

Green Revolution
Michael Andrews, Alexander Lee, and Sahit Mandala

Food Preservation
Adam Carrier, Tony Trakadas, and Katherine McDonough

GMO Crops
Rachel Maillet, Anish Athalye, George Han, and Osi Van Dessel

Sustainability and Food

Dennis Giaya, Eric Williams, and Rohit Satishchandra

Agriculture, Irrigation, Fertilization, and Pesticides

Ryan Fletcher and Aaron Hammond

Food Additives
Naveena Shanmugam, Jacob Grotton, Daniel Huang, and Jeeva Jacob

Cooking in Developing Countries

John Dymek, Deidre DiLiddo, and Mark Guertin

Chapter 1 Diet and Nutrition

Ingrid Marko, Ann Ming Samborski, and Amanda Stevens Diet Societal values intimidate individuals to obtain the ideal physique. Often in order to achieve this, a healthy lifestyle must be implemented. Unfortunately, such a simple solution is often taken to the extreme. In fact, there are numerous diet plans on the market that may become a detriment to the lives of many. Moreover, a sustainable way of life is without a doubt beneficial, but it is important to keep matters in perspective. The ever-changing rules of what defines a good diet confuse people to the point that they are uncertain of what foods to consume. There are so many different meal plans in existence that it is almost impossible to decide on which one to follow. Yet, with the technology and knowledge of today, it should be relatively easy for nutritionists to plan out a healthy meal. For instance, Dr. Oz (2011) writes that in order to be healthy, people must abstain from diet soda and low fat foods because the present processed sugars are the main contributors to an overweight population. Ultimately, the individual is the greatest influence because each body works differently due to the dissimilarity among DNA. In fact, protein, carbohydrates, and lipids satisfy the body enough that it may not require the remaining components to sustain a healthy state (Liao, 2012). When it comes to nutrients, the body regulates a certain amount that it needs each day. Skipping any of these will result in over-consumption of another, which then leads to an unhealthy diet (Liao, 2012). Important substances to consume daily are eggs, nuts, lipids, and similar foods. Even drinking whole milk and wine are a necessity according to Dr. Oz. It is overindulgence that leads to obesity. Fats have unfortunately obtained a social stigma; however, in the correct amount, lipids are actually beneficial to an individuals health. Monounsaturated fats, such as canola and olive oil, and polyunsaturated fats, such as omega-3, have great health benefits. They can reduce the risk of developing atherosclerosis, heart disease, and inflammation. However, trans fat does in fact cause complications if consumed too frequently. In moderation, sodium is a vital part of a good diet. The human heart cannot function without it, and yet, too much will increase blood pressure (Oz, 2011). An increasing problem with salty foods is that the sodium (Na) binds to certain elements found in processed food and causes a reaction that leads to a stimulated appetite, meaning individuals consume more than what is necessary. Ingesting antioxidants can help increase human health because it can result in rejuvenated skin and lower dementia and resistance to Parkinsons disease and T ype 2 diabetes (Oz, 2011). Good sources of food to induce this prevention are dark chocolate, wine, and coffee. Nutrigenomics have been linked to how the individual processes food. Certain aspects of the DNA and the genes present in some people change how food is digested and how it affects the body. Another important factor to staying healthy is exercise. Dr. Oz claims that there should be a balance between diet and exercise; in fact, calories consumed must equal calories burned to maintain a perfectly healthy body. If that scale is tipped so that there is an unequal balance, then the result will either be weight loss or weight gain. Because the human brain is always looking for nutrients, not calories, eating a moderate amount from every food group is essential. It is vital to eat in moderation, to ingest a certain amount of fruits and vegetables, and to exercise (Oz, 2011).


The most current food pyramid gives a detailed account of what foods should be consumed. The body uses nutrients for growth, maintenance, and energy (Wilson, 2007). Carbohydrates yield the energy that the body requires. Sucrose and glucose are simple carbohydrates, while fiber and starches are complex ones. Foods such as whole wheat bread, pasta, and rice contain primarily carbohydrates. Unfortunately, it is easy to overindulge in these foods, but an effective way to avoid this unhealthy habit is to eat until satisfied, not full. Another key nutrient is protein because it stimulates growth, repairs cells, and maintains tissue. These are extremely important for athletes who often induce stress on the bones and muscles. The proteins are broken down into amino acids and peptides. Because they are so important for the function of the body, protein levels can become dangerously low if there is an inadequate intake of carbohydrates or fats. The body often uses protein as a substitute for missing nutrients to produce energy, but a low level of any nutrient will lead to weakness and disease (Wilson, 2007). Lipids, another source of energy, help maintain body temperature and are required for tissue growth and hormone production. Too much of this group will lead to weight gain, as with any other nutrient. In moderation, everything allows the body to function properly. Vitamins help the immune system fight infection and regulate bodily functions. Minerals are similar to vitamins because they aid the daily functions of the body. Water dissolves and carries nutrients; it is not enough to consume nutrients alone because water is needed for transportation to every part of the body. When all nutrients are present, their functions weave together in a seamless harmony.

Economic Uncertainty It is simply not enough to have a beneficial meal plan if one does not have the means to purchase the food. Of course those with money have a clear advantage over the lower classes. In general, people can afford what is required. Food availability and resulting levels of consumption have increased throughout the years. The food supply showed that the average American was consuming 3,800 calories per day in 2000; the highest rate so far (USDA, 2001). The increase in calories directly means that there was a weight gain among the people. Over 62 percent of the population was considered to be overweight; an increase of 46 percent since 1980. These shocking statistics are a result of supply and demand, the availability of food. Other than the calorie intake, another cause of weight gain is lack of exercise

Increase in calories and food intake between 1983 and 2000. Food expenditures have risen in 2001 to $844.1 billion, a 3.8% increase then the 2001 counterpart (USDA, 2001). This rise was a result of a 5.5% income expansion from 2000. The cost of processing, transporting, and distribution from American farms rose to $121 billion. This only represents 20% of the total food expenses (USDA, 2001).

What a dollar spent for food in 2000.

Even given the strict diets followed by many consumers, America is on the path to having the most obese population. The access Americans have to a sustainable food supply should result in a healthy population. Yet, the opposite is true. Other countries in the world have people that struggle to survive on what little food they can get. Diseases and malnutrition have spread around the globe due to a lacking food supply in other countries. The main problem with access is the need to spend immense amounts of money. Currently here is national debt, and promoting a healthy diet is often ignored. The FDA is in charge of doing everything food and drug oriented. Dr. McClellan, a business man and doctor of economics, introduced the idea of efficient risk management where the FDA would only do things that have the most impact on society, because it cannot complete every single task available (Business: Food, drugs and economics; face value 2003). Challenges include how to inspect imports and medicine. These have to be completed, but everything has a cost. The amount of money the FDA can spend is limited. After the most important task has been accounted for, the nutritional problem can be assessed. Focusing on one aspect at a time will yield better results. Disease-Preventing Diets Nutrition is a vital component of a healthy lifestyle, and many people forget how important it actually is. An unhealthy diet can lower a persons life expectancy by decades, while a healthy diet can extend a persons life above the average life expectancy. This in mind, it is crucial that people recognize the nutrients that they are consuming and maintain a diet that will benefit their bodies.

Low-Carbohydrate Diets People who have a low intake of carbohydrates are usually slimmer and have less fat. Some foods containing this nutrient that are usually avoided and maintain body weight are white potatoes, rice, pasta, and bread. Foods that are high in carbohydrates compel blood sugar levels to rise and, in result, insulin levels as well. Eating foods that are composed of mainly carbohydrates leads to increased hunger levels, and the best low-carb diets comprise a variety of whole foods. Although, crushed or refined fruits, beans, vegetables, or whole grains are healthier than most foods, they have higher Glycemic Load (GL) levels. Whole foods, such as All-Bran and Cornflakes have low GLs. A low-carb diet should also include foods with healthy fats and protein (University of Maryland Medical Center, 2007) Besides reducing fat in the body, a diet low in carbohydrates can improve sleep disorders and the function of blood vessels. People who suffer from sleep apnea can benefit from this type of diet. Sleep apnea is a disorder that is a result of abnormal pauses in breathing or swallowing while sleeping, and it is a leading cause in daytime fatigue This disorder is more common in people who are overweight and several researchers, from the Karolinska Institute, ran experiments which proved that low-carb diets have a positive effect on sleep apnea (Diet and sleep apnea, 2011.). In a similar way, a diet that is low in carbohydrates improves blood vessel function by reducing fat, according to a study completed by Johns Hopkins researchers. Loss of stomach fat allowed arteries to expand and helped the blood flow more freely. Several overweight participants helped the researchers refine their idea that low-carb diets that helped burn fat improved the overall health of the patients vascular systems (Improve blood ve ssel function,2012). Heart-Healthy Diets Not only are fish tasty, but they are also important in lowering cholesterol levels. Oily fish such as salmon, sardines, tuna, mackerel, and trout have omega-3 fatty acids that are very beneficial, unlike saturated fats. Because of remarkable evidence from several studies on the subject, The Food and Drug

Administration announced that Omega-3 fatty acids lower triglycerides and slow down plaque growth in the bloodstream, as well as reduce inflammation. Although fish are relatively high in calories, eating reasonable amounts will benefit the health. A four-ounce serving of salmon provides 83% of the omega-3 acids a person needs a day (Griffin, 2005a). A diet with oatmeal and oat bran also benefits the heart. These two foods contain soluble fiber, which brings down low-density lipoprotein (LDL) cholesterol levels without reducing high-density lipoprotein (HDL). The fiber helps absorb cholesterol in the intestines and releases it as waste instead placing it into the arteries. Research published in 2005 the American Journal of Clinical Nutrition suggests that a diet with oatmeal lowered cholesterol levels almost as much as cholesterol drugs. Approximately five to ten grams of soluble fiber added to a persons diet can increase the strength of his or her heart (Griffin, 2005b) Diets containing soy and tofu also assist the heart by lowering blood pressure levels. An important compound that lowers blood pressure, isoflavone, is present in soymilk, tofu, green tea, and peanuts. Isoflavones increase the production of enzymes, nitric oxide (NO) that dilates the blood vessels. The increased amount of NO reduces pressure from blood against the vessel walls. A medical student at Columbia University, Safiya Richardson, completed research that suggests systolic blood pressure levels in people with pre-hypertension could decrease as much as 10 mmHg with a diet of soy protein and other healthy foods. This type of diet could reduce their chances of advancing to hyper tension (Soy reduces blood pressure, 2012).

Components of a diet that strengthen the heart.

Fruits and Vegetables Although it is important to keep a balanced diet containing each component of nutrition, eating fruits and vegetables seems to provide the most superior benefits. Consuming an adequate amount of these foods can prevent certain diseases, according to the United States Department of Health and Human Services Healthy People 2010 objectives. Fruits and vegetables fill important die tary needs and provide protection against chronic diseases such as hypertension, certain cancers, and Type Two Diabetes (Eat your fruits and vegetables, 2011). Research completed by Paolo Boffetta and his colleagues suggests that

eating proper amounts of these foods can slightly reduce the overall risk of cancer. Boffetta showed that there was a small inverse between eating many fruits and vegetables and reduced cancer risk, and several other studies supported this discovery. While vegetables and fruits may have some ability to prevent cancer, other unhealthy lifestyle choices, such as smoking, can nullify the benefits that a healthy diet provides (Cancer protective effects, 2010).

Unhealthy Diets Certain diets can improve health, while other diets cause negative effects. Some factors that cause disease are out of a persons control, such as genetics, but eating well can provide your body with the proper nutrients to prevent diseases. A diet low in nutrients is not able to protect the body against viruses that lead to chronic diseases such as the common cold or the influenza. An unhealthy diet is a large factor in obesity, disease, and decreased life expectancy (McLaughlin, 2011).

Negative Effects of Red Meat A diet composed of red meat can have lasting negative effects. According to Nicholas Bakalar in the New York Times, there is a link between red meat and mortality. Research conducted on 121,342 men and women yielded interesting results; 5,910 people in the group died of cardiovascular disease and 9,464 people died from cancer. Accounting for the people who lived sedentary or dangerous lifestyle, the researchers still found that a daily increase of three ounces of red meat was connected to a 12 percent greater risk of dying, a 16 percent increased risk of cardiovascular death, and a 10 percent greater risk of cancer-related death. Scientists deduced that if the patients had lowered their red meat consumption by a half, mortality rates would have decreased 9.3 percent in men and 7.6 percent in women. These results strongly suggest that consuming red meat is not only unhealthy, but can be deadly (Bakalar, 2012). Another peril of having a diet with too much red meat is that it can increase chances of contracting gout, a severely painful type of arthritis that causes joint inflammation. Frank Bruni, who is a meat-lover and a frequent diner, once had a diet that included a surplus of red meat and alcohol. After being diagnosed with gout, he had to quit eating most red meat and organ meat to avoid the excruciating burning and stabbing feelings caused by the disease (Bruni, 2012).

White Rice Research at the Harvard School of Public Health was conducted to determine the connection between intakes of white rice and Type Two Diabetes. White rice is consumed worldwide and has a high glycemic index (GI). Increased GI diets are known to heighten chances of becoming diabetic. The participants of the study were taken from Asian countries, whose population consumes up to 4 servings of white rice per day, and Western countries whose population eats much smaller amounts of white rice. None of the participants were diabetic at the beginning of each study. With each additional serving of rice, the study conducted separately on Asian and Western countries revealed that there is a 10 percent higher risk of developing Type Two Diabetes. This research suggests that people in certain Asian countries who eat a large amount of rice will have a higher risk of this type of diabetes (Diabetes and white rice, 2012).

An example of nutritional information printed on a box containing white rice.

Soft Drinks Certain beverages also have the ability to affect a persons health in a detrimental way. Research on soft drinks suggests that drinking too much can lead to vascular diseases or gout. Hannah Gardener and her colleagues discovered that diet soft drinks were less healthy than regular ones. Her group studied 2,564 participants by inquiring how many soft drinks, diet and regular, that the people consumed and the number of vascular problems that they had over a ten year time period. The study yielded surprising information: people who drank diet soft drinks every day were 43 percent more likely to have a vascular problem than people who drank none or people who chose regular soft drinks (Soft drinks and vascular disease, 2012). Research on regular soft drinks that are high in fructose suggests that frequent consumption leads to an increased risk of gout in men. A study published in the British Medical Journal investigates men 40 years or older with no previous history of gout. They were assessed on the amount of regular soft drinks, diet soft drinks, and other fruit drinks high in fructose that they consumed over 12 years. Other health factors were analyzed and after the 12 year period the researchers found that, in the group of men, 755 cases of gout arose. Among the men, there was an 85 percent increased risk of gout in men who consumed five to six servings of soda per week. Both of these studies display the effects of consuming any type of soft drink or drink high in fructose; the results are not desirable (Sugary soft drinks and gout, 2008).

Soft drinks are a hazard to good health.

Effect of Diet on Epigenetic Expression In addition to affecting a persons own health, certain nutrition habits have the ability to influence future generations. Environmental factors, such as diet, are able to alter DNA through epigenetic markings. These marks reform the ways in which genes are expressed without changing the DNA sequence permanently by adding or subtracting methyl groups. S-Adenosyl methionine, folic acid, and B vitamins are well-known nutrients that enter metabolic pathways, and when these nutrients are regularly consumed, gene expression can easily be altered. The foods that people include in their diets have the capability to affect their epigenetic expressions either negatively or positively, and in response, these altered genes are passed on to the offspring (Nutrition and the epigenome, 1969). Chemicals and additives also have the ability to affect epigenetic marks. Bisphenol A (BPA), which is a compound in the polycarbonate plastic used in water bottles, causes negative health effects in offspring. Epigenetic research showed that when pregnant yellow mice were given BPA, some of the mice gave birth to yellow, unhealthy mice. When the yellow mice that were fed BPA were given a diet rich in methyl foods, the majority of their offspring were healthy and brown; they seemed to counter the detrimental effects of the BPA exposure (Nutrition and the epigenome, 1969). A womans nutrition during pregnancy has a large impact on her children, but a man can also influence his offsprings health. Research by a preventive-health specialist, Dr. Bygren, aimed to discover how the switch in the amount of food available affected the offspring of that particular generation in both men and women. This research yielded intriguing information. The results revealed that boys who switched from famine to feasting in a single season later fathered children and grandchildren whose life spans were decreased from those who had not overeaten. Further research suggested that changing nutrition also affected womens offspring in the same way (Cloud, 2012). Knowledge of epigenetics has given scientists many new ideas on how to prevent and treat diseases and genetic disorders. A study published in the journal Clinical Epigenetics suggests that vegetables are made up of compounds that might have the ability to prevent and protect people from diseases such as cancer. The scientists leading the investigation say that this so-called epigenetic diet includes cauliflower, broccoli, cabbage, soybeans, kale, green tea, fava beans, thenspice turmeric, and grapes. When mothers tell children to eat their vegetables, theyre protecting them from fatal diseases. The compounds in the vegetables that make up an epigenetic diet suppress gene abnormalities that cause horrible diseases such as cancer and Alzheimers (Blanchard, 2012).


Malnutrition and Disease A growing problem with natural disasters and tyrannical rulers has led to a renewed interest in malnutrition. By its roots, the condition implies a state of poor nourishment (Jackson, 2008). According to John Saunders and his colleagues, the term malnutrition is used to describe a deficiency, excess, or imbalance of a wide range of nutrients, resulting in measurable adverse effects on body composition, function, and clinical outcome (Saunders, Smith, & Stroud, 2011). Several recent polls have shown that approximately one in three people is suffering from malnutrition. In fact, half of the adolescent deaths in underdeveloped countries are attributed to insufficient nourishment (Jackson, 2008). Malnutrition impacts the lives of approximately 3.5 million mothers and children, the elderly population, and those with chronic diseases. It is a common assumption that malnutrition acts as a harbinger of oncoming death; however, it can also cause life-long effects such as growth stunting. This phenomenon actually affects roughly 178 million children worldwide (Saunders, Smith, & Stroud, 2011). The condition is mainly caused by an inadequate diet, difficulty or inability to absorb consumed nutrients, or particular medical conditions. This is actually a secondary effect of a primary cause, namely civil circumstance, natural disaster, impoverished conditions (NY Times4, 2011), alcoholism, or addiction (Saunders et al., 2011). Other groups that are likely to develop a state of malnutrition are young children, pregnant women, those with diseases such as cystic fibrosis and liver disease, those taking appetite reducing medicine, and those living in low-income housing (Malnutrition, 2011). Additionally, the rise of malnutrition because of any circumstance is a risk factor for other diseases (Cathleen Samborski, personal communication, April 7, 2012). In fact, the prime contributor for this condition, in relation to disease, is neglecting to consume enough calories and nutrients (Saunders et al. 2011).

Malnutrition results from multiple health problems. As the body begins to deteriorate because of malnutrition, fat, muscle, and organ mass also depart. This visible change, technically referred to as cachexia, is often not observed in obese patients because they appear to be healthy rather than malnourished. Nevertheless, if the correct amount of nutrients is not being consumed, the body will suffer in numerous ways (Saunders et al. 2011). Common symptoms of malnutrition include irritability, stunt in growth, rapid loss of weight, pain in

muscles and joints, abnormally colored hair and skin, broken nails, and loss of hair (Malnutrition, 2011). From an internal view, the muscle function will often deteriorate at a faster rate than the actual muscle mass. Also, when calcium, magnesium, and vitamin D intake levels decrease, the bones become fragile and are difficult to strengthen. Without a proper diet, the digestive tract has difficulty performing its normal functions. Organs such as the pancreas and intestines suffer, and often processes such as the pancreatic exocrine function or the intestinal permeability begin to break down. Enzymes used to digest consumed food are less abundant, and this can even result in secondary lactose intolerance on certain occasions. In addition, diarrhea is a leading cause in loss of water and electrolytes, which can result in death in severe cases. The immune response becomes less effective early in a state of malnutrition. This causes the individual to be highly susceptible to infection especially respiratory tract viruses and bacteria and/or parasites. Oftentimes, the common symptoms of these pathogens (such as fever) do not occur because of the suppressed immune system. Also, wounds, particularly those caused by surgery, can take longer to heal than a normally functioning defense system.

Effects of malnutrition affect every part of the body; even psychological effects can occur. The endocrine complex fights to help the body preserve and use what nutrients it has. This leads to reduced levels of hormones because the materials needed to manufacture them are no longer present. Hormones begin to disappear from the body, and sometimes, when production of insulin becomes severely stunted, a form of diabetes can occur. When the body is forced into pure starvation, with absolutely no sustenance, the membranes that transport sodium and potassium (which are dependent on energy metabolized by the body) stop functioning. In a circumstance where nourishment is occasionally ingested, this process takes more time to occur; however, in the meantime, other bodily functions and processes cease to operate in an attempt to allow the body to remain alive. It is important to note that after an individual has been without proper nutrients for an extended period of time or the condition has become severe in a short time span, providing the afflicted with a balanced diet is complicated. The new amount of food must be introduced in a meticulous manner because too much can have a negative effect on the overall patients health, even if it is what he or she technically requires (Saunders et al. 2011).

Malnutrition Globally Although a great deal of the world is modern, there still remain large portions that are developing. In addition, some populations are affected by malnutrition because they must flee their native countries. For example, poor nutrition has been widely noted in the incoming population of refugee children. It is a great relief that within 4 to 6 months of arriving in the U.S.A., the children have usually reached normal weight and growth rate. However, an adverse affect to the dramatic change in culture often results in obesity. Populations that arrive from low socioeconomic backgrounds tend to experience obesity within a few months of arriving in the U.S. This is most prevalent in families from Latin America, Central Eastern Europe, the Caribbean, the Middle East, Northern Africa, Sub-Saharan Africa, and the once-lively Soviet Union. The condition is common in both adults and children. This new phenomenon is mainly attributed to the length of stay in the country, different cultures, original cultural beliefs, and low quality of housing. This new population is now at risk for both malnutrition that affects overall growth and for obesity that can cause further health problems such as diabetes. Deficiency in vitamin B12, folate, and vitamin A may also contribute to iron deficiency (Center for Disease Control and Prevention, 2011). Also, certain situations involving malnutrition occur because of political circumstance. For instance, a sole leader has ruled North Korea for decades. This form of government has not resulted favorably for majority of the population; one in three children in North Korea suffers from malnutrition. Food is hard to obtain because the state stores are not properly stocked, and the remainder of goods is sold in private markets. In addition, the price of food is drastically inflated so many cannot afford what they can find (NY Times1, 2012). Similarly, Haiti suffers from severe economical and political stress. In fact, riots occurred earlier in the year because of the inflated food and fuel prices (Klarreich, 2008). Another instance, Niger, an African country bordering the Sahara desert, is globally one of the poorest territories. Due to civil unrest, it is not uncommon to find malnourished children in rural areas as well as settled cities (NY Times3, 2010). In addition, overpopulation plays a large role in the high percentage of malnourished people. Not only are certain countries struggling to feed its entire people, but also, it is the sudden rise in population that causes the country distress. According to the latest Global Hunger Index, the levels of hunger in India have increased over the past two decades. Out of the entire population, 42% of Indian children (who are five and under) are underweight (NY Times2, 2012). Also, approximately 30% of Pakistani children are malnourished, and 40% have been stunted in their growth; this, in turn, affects their future ability to learn (Jilani, 2012). One of the most prominent problems currently is the overpopulation of refugee camps, particularly in Kenya. One of the most severe cases, Dabaad refugee complex contains four times as many occupants as it was originally intended to hold. Numerous children are malnourished, and since January, the numbers have risen from 20 malnourished children to more than 130. This affliction accounts for 30% of all children located in the outskirts of the camp. Children as old as ten are malnourished, which is incredibly rare. It is this phenomenon that truly displays the severity of the crisis in Kenya (Loewenberg & Dadaab, 2011). In short, many of these populations that suffer from malnutrition die because of diarrhea, pneumonia, or preventable diseases (NY Times4, 2011). This can easily be remedied by providing sufficient diet so that inability to absorb consumed nutrients may be avoided. However, civil circumstance, natural disasters, and poverty contribute to the worldwide condition of poverty that is prominent in every nation.


Diseases Caused as a Result of Malnutrition As malnutrition becomes widespread across an area, multiple diseases become prominent shortly after. Without the correct amount of nutrients, conditions develop because of a lack of vitamins, minerals, and/or amino acids. Malnutrition causes myriad physical detriments; however, the onslaught of disease results in further complications to the human body.

Vitamin Deficiencies Vitamin D deficiency is found in all areas of the world. This condition can lead to further damage such as rickets and osteoporosis. According to Saunders et al. (2011), the etiology of vitamin D deficiency is multifactorial and heavily dependent on non-dietary determinants such as limited sun exposure (protective or religious clothing, moving to temperate climates, and the tradition of keeping infants indoors), increased skin pigmentation, reduced in-utero exposure, and reduced capacity to synthesize vitamin D with increasing age. Those with dark skin, pregnant or nursing women, those living in mild climates, the elderly, and those with conditions such as celiac disease are particularly at risk (Saunders et al. 2011). Rickets is caused by poor diet and lack of fresh air and sunshine. The main cause is a deficiency in Vitamin D, calcium, or phosphorus. Without enough of these minerals in the blood, the body removes stored minerals from the bone. This, in turn, weakens bone structure. Common symptoms are skeletal deformities such as bowed legs, bent spin, pelvic deformities, fragile bones, stunted growth, bone pain, and muscle fatigue. Children usually stop growing, and adults develop osteoporosis. Rickets is still found in the US. In fact, it seems to be reappearing in many areas. In October 2008, American Academy of Pediatrics doubled the recommended amount of vitamin D for infants and children. It can be produced when in direct sunlight; however, it can also be obtained through fish, milk, fortified cereal, and eggs (Jackson, 2008). Vitamin A deficiency is not commonly seen in developed countries but is relatively common in refugee populations. It is the primary cause for blindness in children and approximately 500,000 lose their sight annually. Vitamin A deficiency creates a myriad of visual changes that can include loss of night vision, Bitot spots, which according to Saunders, Smith, and Stroud (2011), are areas of abnormal squamous cell proliferation and keratinization of the conjunctiva, xerophthalmia, keratomalacia, corneal perforation, and permanent blindness. It also retards bone growth as well as produces dry skin, fragile hair, and weakened humoral and cell-mediated immune response. Deficiency in Vitamin B12 occurs when animal products cease to be consumed in addition to inability to absorb the nutrient (i.e. intrinsic factor deficiency) and malabsorption (which may be called by the presence of Helicobacter pylori). Fatigue, unproductivity, memory loss, irritability, and depression are often symptoms that are not recognized as official but are associated with it. Essentially, this deficiency affects neurological functions. Other symptoms include weakness, numb extremities, inability to smell, imbalance, and in the most severe instances, degeneration of the spinal cord. Vitamin C or ascorbic acid deficiency occurs in individuals with malnutrition, alcoholism, or diets that exclude fruits and vegetables. The symptom is also known as scurvy and results in stunted collagen synthesis. Ecchymoses, petechiae, bleeding gums, hyperkeratosis, and difficulty in healing wounds may occur as well as fatigue, malaise, pain in the joints, edema, anxiety, and neuropathy. Thiamine (vitamin B1) assists in energy metabolism and assembling tissues. Deficiency occurs from lack of intake (such a excessive consumption of milled rice), sudden difference in metabolism (fever, pregnancy, liver disease, hyperthyroidism), severe diarrhea, or ingestion of food with anti14

thiamine compounds. Deficiency can result in beriberi (Saunders et al. 2011). The condition originated because a vitamin B1 was missing from processed rice, and therefore, whole populations were not receiving the proper dosages. Thiamine is located in the outer layer of rice, which is often removed for products such as white rice as opposed to brown rice. Also, foods such as tea and fish contain chemicals that render the thiamine useless to the body (Jackson, 2008). Symptoms include no appetite, constipation, tiredness, anger, amnesia, peripheral neuropathy, weakness, areflexia, foot drop, tachycardia, and heart failure. However, there are multiple types of this disease (Saunders et al., 2011). Wet beriberi is caused by the lack of thiamine in the body (Jackson, 2008) and often leads to cardiac failure (Saunders, Smith, & Stroud, 2011). Common symptoms of Wet beriberi are swelling of the lower leg, fast heart rate, congestive heart failure, engorged heart, and shortness of breath (Jackson, 2008). Dry beriberi affects the multifocal peripheral/nervous system and is caused by the inability of the body to absorb the nutrient (Saunders et al. 2011). Dry beriberi displays tingling of limbs, lack of feeling in hands and feet, vomiting, unnatural eye movement, disorientation, coma, and possibly death (Jackson, 2008). More severe cases occasionally become better diagnosed as Wernicke encephalopathy and Korsakoff syndrome (Saunders et al., 2011). Wernicke-Korasakoff is commonly seen in Europe; it is another form of beriberi and displays itself via irritability, confusion, and amnesia. The condition can be easily remedied if a person is given thiamine via injection or orally within a reasonable amount of time (Jackson, 2008). Pellagra is a deficiency in niacin or Vitamin B3. This was first observed in 1735 in Spain when a physician noticed symptoms in peasants eating a heavy corn diet. However, Latin America appears to have avoided this condition because the tortillas were allowed to soak in lime juice before they were cooked. The citrus released the niacin that is normally not accessible to the human digestive acids. Pellagra was discovered to result directly from the lack of niacin or vitamin B1 and even the amino acid tryptophan. If the body receives enough tryptophan, it can generate niacin. The chemical is used in the body to release energy from carbs, fats, and proteins. It is also used to make nucleic acids in RNA and DNA. Symptoms involve diarrhea, dermatitis, and dementia. In the West, this is rarely seen except for alcoholics because of their tendency to neglect nutrition. India suffers from this especially because sorghum is consumed as a staple crop. The product contains the amino acid leucine, which interferes with niacin absorption. This disease is rarely seen in most developed countries because grain is fortified. It does, however, occur in emergencies such as natural disasters or civil war. Niacin is hard to access by the body, but if the grain is soaked in alkali, then it is capable of being absorbed. Meat, poultry, yeast, fish, grain, flour, peanuts, lentils, milk, greens, and coffee/tea contain this vitamin (Jackson, 2008).

Mineral Deficiencies Iron deficiency is most prevalent in children. This mainly affects infants and toddlers, but women of childbearing age are also at risk. Iron deficiency anemia occurs from a lack of dietary iron. The lack of ingestion of meat or frequent ingestion of tannins or phytates causes internal problems that results in intestinal parasites, hemoglobinopathies, and chronic infections. Lack of iron can lead to stunted psychomotor abilities in infants and cognitive impairment in youth. Adults who are affected become fatigued, unproductive, and may lose the ability to reproduce. Severe anemia is categorized once the Hb level falls below 80.0 g/L. Iodine deficiency affects approximately 2 billion individuals. It is the greatest cause of thyroid disease and is found in soil and seafood. It regulates the metabolic process of the body. If Iodine is not ingested, physical and mental growth can stop. Hypothyroidism, goiter, and other conditions can also occur. By iodizing salt, this deficiency has drastically dropped, but extremely high amounts of iodine have been found in refugee populations. This can cause IIH (iodine-induced hyperthyroidism), which mainly occurs in females over the age of 40 after introduction to iodized salt. The body is so accustomed to lacking levels that the sudden surge causes further complications.

Zinc deficiency is most common in areas where plants are a staple to the diet. Zinc catalyzes more than 100 enzymes and helps fetus development during pregnancy and growth throughout adolescence. Stunted growth, lacking appetite, and weakened immune system are all symptoms of the condition. Hair loss, loose stools, stunted sexual maturation, infertility, hypogonadism, weight-loss, slowhealing wounds, skin and eye lesions, difficulty tasting, and fatigue are all more severe symptoms (Saunders, Smith, & Stroud, 2011).

Amino Acid Deficiencies Pellagra is a deficiency in niacin or tryptophan. It is usually accompanied by a lack of amino acids and micronutrients. The condition may occur because of severe diarrhea, cirrhosis, or alcoholism. High-leucine diets are normally seen in cases of Pellagra. Symptoms include photosensitive dermatitis (i.e. Casals necklace or face rash) in addition to diarrhea, stomatitis, and neurological abnormalities. In children, symptoms differ and may appear as anorexia, irritability, anxiousness, and apathy.

General Diseases Caused by Malnutrition Micronutrient deficiencies are also observed due to scarce resources. Rare deficiencies are commonly seen because of the rapid change in diet that these individuals go through during a stay in refugee camps, etc. (Saunders et al., 2011). PEM (protein-energy malnutrition) or protein-calorie nutrition is a deficiency in macronutrients, proteins, and carbohydrates. Another form of the deficiency, known as Kwashiorkor, refers to a lack of protein but a sufficient calorie intake. Marasmus is the lack of calories in addition to protein. The liver becomes enlarged, which makes the individual appear to be gaining weight. Symptoms include edema, swollen stomach, enlarged liver, peeling, white skin, and reddish pigmentation of the hair. These symptoms also result in fatigue, apathy, and irritability. This condition occasionally accompanies AIDS or other traumas. It is most seen in undeveloped countries that suffer from natural disaster or lack of resources. Majority of the cases are found in Asia, Africa, Latin America, and the Caribbean (Jackson, 2008). Bibliography American College of Cardiology (2012, March 26). Compound in soy products may help lower blood pressure. ScienceDaily. Retrieved March 29, 2012, from http://www.sciencedaily.comreleases/2012/03/ 120326113715.htm Bakalar, N. (2012). Risks: More red meat, more mortality. The New York Times. Retrieved March 22, 2012 from Blanchard, K. (2011). Vegetables in the diet have epigenetic effect to fight cancer. Digital Journal, Retrieved March 22, 2012 from BMJ-British Medical Journal (2011). Low-energy diet can improve sleep disorder.ScienceDaily. Retrieved March 22, 2012, from 110601204050.htm


BMJ-British Medical Journal (2012). White rice increases risk of Type 2 diabetes, study claims. ScienceDaily. Retrieved April 2, 2012, from BMJ-British Medical Journal (2008, January 31). Sugary Soft Drinks Linked To Increased Risk Of Gout In Men. ScienceDaily. Retrieved April 2, 2012, from Bruni, F. (2012). Red meat blues. The New York Times. Retrieved April 2, 2012, from Business: Food, drugs and economics; face value. (2003, Aug 23). The Economist, 368(8338). Retrieved from doc view/224014711?accountid=29120 Centers for Disease Control and Prevention. (2011). Guidelines for evaluation of the nutritional status and growth in refugee children during the domestic medical screening examination. Retrieved on March 22, 2012, from guidelines/domestic/nutrition-growth.html Cloud, J. (2010). Why your DNA isn't your destiny. Time Magazine, Retrieved April 3, 2012 from /article/0,9171,1952313-2,00.html Elsevier Health Sciences (2011). Eat your fruits and vegetables: Californians seem to be listening. ScienceDaily. Retrieved March 27, 2012, from Genetic Science Learning Center (1969) Nutrition and the Epigenome. Learn.Genetics. Retrieved March 22, 2012 from /epigenetics /nutrition/ Griffin, R. (2005a). Low cholesterol diet: fatty fish, healthy heart. Retrieved March 26, 2012 from Griffin, R. (2005b). The new low-cholesterol diet: Oatmeal and oat bran. Retrieved March 26, 2012 from Jackson, E. (2008). Diseases of malnutrition. Retrieved March 22, 2012, from Jilani, S. (2012, March 5). A Granddaughter Returns to Pakistan. The New York Times, Retrieved March 22, 2012 from Johns Hopkins Medicine (2012, March 13). Losing belly fat, whether from a low-carb or a low-fat diet, helps improve blood vessel function.ScienceDaily. Retrieved March 26, 2012, from Journal of the National Cancer Institute (2010, April 6). Cancer protective effect of fruits and vegetables may be modest at best.ScienceDaily. Retrieved March 28, 2012, from Klarreich, K. (2008, November 16). Schools Collapse, and Haitis Woes Continue. Time World Magazine. Liao, S. (2012) The ultimate balanced diet: what should really be on your plate? New research has some fascinating answers to an age-old question. Shape 31.5, 72.

Loewenberg, S. and Dadaab. (2011, July 19). Kenyas Latest Crisis: The Refugee Camp Around the Refugee Camp. Time World Magazine, Malnutrition. (2011). In CareNotes. Thomson Healthcare, Inc. Retrieved on March 22, 20120, from r&p=HRCA&sw=w McLaughlin, A. (2011) Illnesses caused by a poor diet. Retrieved March 23, 2012 from Oz, M. (2011) The oz diet. Time. Retrieved on April 2, 2012 from,9171,2091389,00.html. Saunders, J., Smith, T., and Stroud, M. (2011). Malnutrition and undernutrition [electronic version]. SciVerse ScienceDirect Journal of Medicine. 39 (1), 45-50. Springer Science+Business Media (2012, January 31). Are diet soft drinks bad for you?.ScienceDaily. Retrieved April 2, 2012, from The New York Times1. (2012, March 21). North Korea. The New York Times. The New York Times2. (2012, January 12). Indias Chronic Battle With Malnutrition. The New York Times. The New York Times3. (2010, April 26). Niger. The New York Times. The New York Times4. (2011, June 14). Malnutrition. The New York Times. University of Maryland Medical Center (2007) Feature stories. Low-carb diets: The right way to go? Retrieved March 26, 2012 from USDA (2001). Profiling food consumption in america. Agricultural Fact Book. Retrieved March 22, 2012, from: Wilson, M (2007). Overview of nutririon. Merck Manual. Retrieved on April 8, 2012 from http://www.merckmanuals.c om/professiona l/nut riti onal _disorders/nutrition n n_gen eral_c onside ratio ns/overview_of_nutrition. html?qt=6 %20nut rients&alt=sh Illustration Credits u=mlin_c_worpoly&it=r&p= HRCA&sw=w &u=mlin_c_worpoly&it=r&p=HRCA&sw=w http ://www. uploads/20 12/02/heart- healthy-diet-plan.gif c bb2c799464af190e07f.jpg


Chapter 2 Vitamins and Minerals

Barry Biletch, John deRivera, and Aniket Lachyankar

Introduction Organic molecules that are required in small amounts by organisms are called vitamins, and they can be divided into two groups: water soluble and fat soluble. Water soluble vitamins include the B vitamins and vitamin C. These vitamins are flushed out of the body through urine on a daily basis. As a result, there are no known cases of water soluble vitamin toxicity. Water soluble vitamins act largely as coenzymes in the body, allowing certain important enzymes to function properly. The fat soluble vitamins, A, D, E, and K, are stored in the body for longer durations of time, and the accumulation of these vitamins in the body can cause serious side effects. For example, Vitamin A is stored mainly in the liver. When arctic explorers ate the livers of seals and polar bears, acute toxicity occurred because of the massive amounts of vitamin A that they were ingesting (Vitamin A, 2007). Not all vitamins need to be ingested in their final form because the body can synthesize some vitamins from other molecules. Vitamin A is produced from beta-carotene and other carotenoids (Vitamin A, 2007), vitamin D is synthesized in the skin when in direct contact with UVB radiation (Vitamin D, 2007), and vitamin K is made by bacteria living in the intestines when insufficient doses are ingested orally (Vitamin K, 2007).

Vitamins to Combat Malaria Research being conducted at the University of Southampton might lead to the synthesis of malaria-combating drugs. Malaria is a disease spread by parasites that affects approximately 250 million people annually and causes the deaths of approximately 1 million people each year. Scientists hope to disrupt the production of vitamins in malaria-producing protists. They hope to learn more about the enzymes that are used to manufacture vitamins in these parasites. By targeting these particular vitaminmaking enzymes, the production of these essential vitamins can be stopped, leading to deficiencies and the death of the parasite. Drugs that target B9 production have been used very successfully in the past, but resistance to this particular drug in the parasites has increased, stimulating new research for a drug which is as effective. Scientists at the University of Southampton are currently researching the enzyme complex that produces vitamin B6- in malaria causing parasites. If successful, a new drug to treat malaria could be made and millions of lives saved (University of Southampton, 2012).

Malaria parasites have become resistant to several types of malaria combating drugs.


Vitamin Supplements In many cases, whether it is due to dietary habit or location, people can have vitamin deficiencies. Some vitamins, like vitamins C, B12, and D, are necessary for very important functions and can cause devastating effects for deficient individuals. To combat these effects, people usually choose to take vitamin supplements. There are many different forms of these supplements, the most popular being the pill. Another difference between different vitamin supplements is the purpose that each one serves. Today, companies have specifically targeted vitamin supplements to particular groups of people or deficiencies. For example, One-A-Day Products markets vitamins that are targeted at specific stages of life and genders ranging from vitamins for teenage girls to vitamins for men over the age of 50. Vitamin supplements ensure that the consumer lives their life to the fullest without any vitamin deficiencies. However, the process of accepting a supplement is very intricate and involves many organizations. One of the most involved parts of the supplement discovery and distribution process is the specification and regulation of the product itself. Organizations like the United States Pharmacopeial Convention (USP) and the U.S Food and Drug Administration are highly influential in setting the standard for vitamin supplements; industrial companies that look to manufacture supplements utilize this benchmark. The full list of standards can be found in the USP Dietary Supplements Compendium (DSC), an amalgamation of different monographs that specify identity, strength, quality, and purity of various dietary supplements. Again, manufacturers that hope to utilize these dietary supplements look to the DSC to make sure that their product conforms to the standards set by t he USPs compendium (Dietary Supplements Compendium, 2009). Vitamins supplements, as previously stated, come in many different forms. Some come for singular vitamins; supplements for simply vitamin C can be found on the shelf for those who do not think they consume enough of this essential vitamin. However, the most popular vitamin supplement has quickly become the multivitamin. This supplement variant is specifically designed to supply consumers with enough vitamins such that the consumer does not have any deficiencies. These vitamins cannot completely substitute for the vitamins in food because they are usually created for the purpose of accommodating a healthy diet. As noted above, companies like One-A-Day and Centrum are widely known for supplying multivitamins that serve very specific purposes. Some of the specialized formulae that do not apply to sex or age include vision, heart, energy, and prenatal support. Each multivitamin is specially formulated to ensure that the consumer is correctly treated (One-a-day Multivitamins, n.d.; (Centrum Multivitamins, n.d.).

Vitamin supplements can be beneficial, but their misuse can cause harm.


The Dangers of Multivitamins and Supplements It was long believed that vitamins were a cure-all supplement to healthy living, but recent studies have yielded results that contradict this. While it is known that extreme doses of vitamins can have serious effects on the body, it has only recently been suggested that doses even slightly higher than the recommended amount (in the form of artificial vitamins present in supplements and multivitamins) can pose health risks. It was found that men who took excess amounts of vitamin E had a 17% higher risk of developing prostate cancer than those who did not take the vitamin. The study did not originally conclude this result when it was ended in 2008, but follow up research revealed this striking result. A second study, in Iowa, on the effects of the use of multivitamins, folic acid, vitamin B6, magnesium, copper, zinc, and iron concluded that users of these supplements had an increased risk of death. Other studies since then have yielded similar results (Parker-Pope, 2011).

A New Way to Ingest Vitamins Vitamins can be harmed by stomach acids, so it is necessary to provide protection to the vitamins when designing vitamin supplements. Currently, pharmaceutical companies use materials such as cyclodextrin, which is a sugar molecule in the shape of a torus (see image). Scientists at Penn State did a series of experiments in which they developed cornstarch pouches which can hold oil soluble vitamins, such as A and C. The starch protects the vitamins from the acid in the stomach so that it can remain unharmed when they reach and is absorbed by the small intestine. The type of corn starch used forms coils with a hydrophilic outer surface and a hydrophobic inner surface. The fat-soluble vitamins are attracted to the inner surface of the starch coil where they are protected. This technique could lead to vitamin enriched starch foods, which would be a cheaper and more environmentally friendly way of manufacturing food supplements (Penn State, 2011).

This is the structure of cyclodextrin molecule.

New technology is emerging to make getting a daily dose of vitamins easier. David Edwards, a biomedical engineer at Harvard University, has invented a product he calls Le Whif. The liver and intestinal tract can damage vitamins and are also slow to absorb the vitamins into the bloodstream. To combat this, Le Whif grinds vitamins into aerosol particles that can be packaged into spray cans and then inhaled. Inhalation provides a more direct route to the bloodstream without the altering effects of the liver or intestines (Dyer, 2011).


Vitamin D and Eyesight A very recent study on the effects of vitamin D on mouse vision has yielded encouraging results. Mice that were given vitamin D supplements showed less aging in their eyes, and older mice who were given the supplement exhibited improved vision. This could lead to future drugs that slow the deterioration of the human eye and combat age-related macular degeneration. The retina of the human eyes builds up debris and inflames as it ages, which can lead to a 30% decline in photoreceptor cells. The study found that older mice which were given vitamin D supplements experienced an improvement in vision as well as a decrease in inflammation and the removal of some debris from the retina. It is believed that the vitamin D reduced the number of macrophages, which can cause damage and inflammation in the retina, and also changed some of the macrophages structure so that the cells actively decreased inflammation and debris buildup. A second benefit seen in the mice was a decrease in the amount of amyloid beta present in the eye. It is known that amyloid beta increases the risk of age-related macular degeneration (Biotechnology and Biological Sciences Research Council, 2012). The history of humans suggests why poor eyesight becomes a problem as we age and why it is more common now than in human ancestors. Vitamin D is ingested via certain foods, but the quantities found in most diets are insufficient for the body to function. Human bodies manufacture vitamin D in the skin when hit by UVB rays from the sun. This alternate form of production makes up the dietary gap in vitamin D consumption. Human ancestors lived in Africa, where they were exposed to direct sunlight daily, prompting adequate vitamin D production. Since then, humans have moved to less sunny areas of the globe and have clothed themselves in an attempt to block out the sun. The changes have occurred so quickly that the human body has not yet adapted to reduced sunlight exposure, explaining the degeneration of the retina due to a lack of vital vitamin D (Biotechnology and Biological Sciences Research Council, 2012). Vitamin D and Parkinsons Disease. Vitamin D is an essential component of life and its deficiency has very bad effects. Deficiencies have been linked to various conditions, including asthma, cancer, and multiple sclerosis; these various effects show that vitamin D affects numerous facets of human life. A study done by Paul Knekt at the National Institute for Health and Welfare in Finland attempted to connect the levels of vitamin D to Parkinsons disease. This study took a population of Finnish men and women over the age of 50 and checked the levels of vitamin D in these people over a 29-year period. In the group studied, 50 instances of Parkinsons disease occurred, and with these instances, the vitamin D levels of each subject that contracted Parkinsons were significantly lower than that of those without. The results suggest a peculiar relationship between the function of vitamin D in the nervous system and Parkinsons disease, which again strengthens the need for a healthy dosage of vitamin D in ones daily diet (Knekt et al., 2010).

Parkinson's disease can cause uncontrollable shaking, muscle stiffness, and movement issues among other things.


Vitamin A and Osteoporotic Hip Fractures. One of the functions that Vitamin A affects is bone metabolism. When taken in normal doses, the vitamin can promote healthy bone growth; however, excess amounts can cause adverse effects on bone structure. Research at the Harvard Medical School, conducted by Diane Feskanich and colleagues, attempted to connect diets with high vitamin A values to osteoporotic hip fractures in older women. The study consisted of over 30,000 postmenopausal females, some of which had sustained hip fractures with noticeable trauma. After screening the levels of vitamin A in all of the women, the quartile with the highest dosage of vitamin A in daily diet had a significantly higher risk of hip fracture than those women with a normal vitamin intake. With the transition to life after menopause, women will have to be careful to strike a keen balance between a healthy dosage of vitamin A and a excess (Feskanich et al., 2002).

Increased vitamin A intake has been linked to increased risk of hip fracture.

The Effects of Antioxidants on Pre-eclampsia A condition known as pre-eclampsia can develop in women who are pregnant for the first time, causing hypertension and other negative effects. This condition, which appears in approximately 5% of first-time pregnancies, is dangerous to both the mother and child. Luckily, research conducted at a Mexico City hospital has yielded a possible method for preventing pre-eclampsia, thought to be caused by a deficiency of L-arginine, an amino acid essential in blood circulation. The study consisted of three groups of pregnant women. The first group was given food bars containing L-arginine and antioxidant vitamins (Vitamin A, C, and E are all antioxidants). The second group was given bars containing just the vitamin supplements and the third group was given a placebo, which contained neither L-arginine nor vitamin supplements. Of first group of women, only 12.7% were diagnosed with preeclampsia compared with the 22.5% of the second group and the 30.2% of the third group. The results show that the best preventative procedure is to take both L-arginine and vitamins, although simply taking the vitamins can also have beneficial effects (British Medical Journal, 2011).


Antioxidants such as vitamin C and E neutralize harmful free radicals.

Vitamin B12 and Cancer A study of patients in Norway pointed to an interesting pattern that connected vitamin B12 and cancer proliferation. Previous studies that involved B12 and cancer had produced results towards the conclusion that B12 deficiencies were instrumental in cancer onset. However, during the study done in Norway, where the government does not necessitate folic acid and B12 supplements, there was a difference between the amounts of people who contracted cancer after treatment with the vitamins when compared to those who were not treated with the B12 vitamins and folic acid. There were 53 more B12 treated patients that were diagnosed with the cancer, a 21 percent increase from those who were not treated and still diagnosed with cancer. Of those diagnosed with the cancer, 36 more died of that same cancer, which was a 38 percent increase in risk. Of the forms of cancer that were diagnosed, scientists noted that lung cancer occurred most frequently in these subjects. This study suggests an interesting relationship between the levels of B12 and certain stages of cancer. It may be the case that low doses of vitamin B12 may cause early carcinoma onset, while on the other hand, higher doses of B12 later in life may cause cancer cells to proliferate.

Minerals in Type II Diabetes In an experiment done at the Shiraz University in Iran, scientists compared the levels of 4 minerals, zinc, copper, iron, and chromium, between normal children and children with Type II diabetes mellitus. One characteristic of all of these minerals is that they are mainly found in trace amounts in the human body and are therefore not widely recognized for importance in nutrition. Results showed that there was a significant decrease in 3 mineral levels for the diabetes patients: zinc, copper, and chromium. This shows that each of these three may play a role in the onset of childhood diabetes. Chromium is known to be a facilitator of insulin function in the human body. This points to a more direct relation between the functions of the mineral and the onset of diabetes. With more research, chromium may be used as a treatment for some forms of diabetes (Basaki et al., 2012).


Type II diabetes is caused by the inadequate production of insulin or the inability to use insulin. Magnesium Treatment for Migraines Magnesium is a commonly found ion and can be found in a supplemental form because it is an essential mineral for body functions. In a study done by the New York Headache Center, scientists observed that magnesium levels of patients with migraine symptoms were significantly higher than those of the controls. Magnesium plays a part in migraine pathogenesis. With this difference in magnesium levels, the scientists concluded that magnesium supplements could be used to treat migraine symptoms. This connections proves to make a much simpler and more available treatment than a manufactured medicine because it is so accessible and usable (Mauskop & Varughese, 2012).

Migraine headaches are caused when arteries in the brain enlarge, causing the adjacent nerves to release chemicals that trigger adverse effects.

The vast majority of calcium consumed by humans is distributed to the bones and teeth, but the 1% used by the rest of the body is very important to overall health. Although it is widely accessible,

many people do meet the minimum recommended amounts. This is partially due to lactose intolerance, because dairy is a good source of calcium. The main forms of calcium supplements are citrate and carbonate; however, the two forms are absorbed differently into the body. Research conducted at the University of Texas Southwestern Medical School indicates that calcium citrate is absorbed approximately 25% better than carbonate, despite carbonate having more raw calcium. Researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging have done research on the effects of nutrition on cancer rates. They found that the B vitamins, especially vitamin B9, reduce the risks of colorectal cancer in mice. However, this was not limited to the mice that ate the vitamins. It also affected the offspring of the females of these mice. Although increased consumption of these vitamins did not significantly reduce the frequency of cancer, it reduced the frequency of more severe forms by a factor of 300%. The researchers attributed this phenomenon to the protection of the Wnt signaling pathway, which is a set of genes that is commonly mutated in patients with cancer. At the moment, it is unclear whether or not the same conclusions.



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Riboflavin. (2011). In PubMed Health. Retrieved March 23, 2012, from PubMed Health Online: Thiamin. (2011). In PubMed Health. Retrieved March 23, 2012, from PubMed Health Online: University of Southampton (2012, January 27). Research on vitamins could lead to the design of novel drugs to combat malaria. ScienceDaily. Retrieved April 4, 2012, from Ursula V. Lay Ma, John D. Floros, Gregory R. Ziegler, Effect of starch fractions on spherulite formation and microstructure, Carbohydrate Polymers, Volume 83, Issue 4, 1 February 2011, Pages 1757-1765. USP dietary supplements compendium. (2009). Retrieved from supplements/dietary-supplements-compendium Vitamin. (2012). In Encyclopdia Britannica. Retrieved from EBchecked/topic/630930/vitamin Vitamins. (2011). In PubMed Health. Retrieved March 23, 2012, from PubMed Health Online: Vitamin A. (2007). In Merck Manual. Retrieved March 22, 2012, from Merck Manual Online: disorders/vitamin_deficiency_ dependency_and_toxicity/vitamin_a.html?qt=vitamin%20A&alt=sh Vitamin A. (2011). In PubMed Health. Retrieved March 23, 2012, from PubMed Health Online: Vitamin B6. (2007). In Merck Manual. Retrieved March 22, 2012, from Merck Manual Online: _disorders/vitamin_deficiency_dependency_and_toxicity/vitamin_b6.html Vitamin B6. (2011). In PubMed Health. Retrieved March 23, 2012, from PubMed Health Online: Vitamin B12. (2007). In Merck Manual. Retrieved March 22, 2012, from Merck Manual Online: _disorders/vitamin_deficiency_dependency_and_toxicity/vitamin_b12.html Vitamin C. (2007). In Merck Manual. Retrieved March 22, 2012, from Merck Manual Online: disorders/vitamin_deficiency_dependency_and_toxicity/vitamin_c.html Vitamin D. (2007). In Merck Manual. Retrieved March 22, 2012, from Merck Manual Online: _disorders/vitamin_deficiency_dependency_and_toxicity/vitamin_d.html Vitamin D. (2011). In PubMed Health. Retrieved March 26, 2012, from PubMed Health Online:

Vitamin E. (2007). In Merck Manual. Retrieved March 22, 2012, from Merck Manual Online: disorders/vitamin_deficiency_ dependency_and_toxicity/vitamin_e.html Vitamin E. (2011). In PubMed Health. Retrieved March 26, 2012, from PubMed Health Online: Vitamin K. (2007). In Merck Manual. Retrieved March 22, 2012, from Merck Manual Online: _disorders/vitamin_deficiency_ dependency_and_toxicity/vitamin_k.html Zeliadt, Nicholette. (2010, July, 10). Vitamin D deficiency linked to Parkinsons disease, cognitive decline[Electronic Version]. Scientific American.

Illustration Credits Hip Fractures


Chapter 3 Food Supplements

Patrick Aoude, Julia Knowles, and Derek Wegener Introduction The desire to be healthy is the cause of many developments in medical science, chemical engineering, and the nutritional industry. Both engineered and natural remedies have been labeled as cures for an unhealthy lifestyle. The most widespread of these remedies belong to a category known as Food Supplements. These products, also known as dietary supplements, are recognized as foodstuffs which supplement the normal diet and which are a concentrated source of nutrients or other substances with a nutritional or physiological effect. Food supplements exist in the form of capsules, pastilles, tablets, pills and other similar controlled dosages (Eberhardie, 2005). Although these supplements are similar in purpose and form to prescription drugs, the regulations surrounding them are very loose. In the United States, a doctors prescription is not necessary for the acquisition of these drugs and informational labels on their packaging are more similar to those found on food products. With these factors in consideration, it is necessary to question the safety of Food supplements as alternatives to a typical diet, and do these so-called supplements provide sufficient nutrition to support human lifestyle. The intended purpose of food supplements is, for numerous reasons, to replace the need to eat whole food for nutrition. One benefit of this concept is the provision of nutrients to regions of the world that have limited availability to specific nutrition. This characteristic benefits people living in extreme climates which cannot sustain crop production. A lack of fruit and vegetables may result in a deficiency of A and C vitamins for the population of these regions. In many cases, food supplements carry a lower cost burden than whole foods. This characteristic benefits impecunious or impoverished populations where a sufficient diet of whole food is not easily attainable (The Fight for Food Supplements, 2005). Also, food supplements provide concentrated amounts of nutrients and thereby limit the need to consume unneeded volumes of nutrients provided by entire foods. For example, a person may either consume one dietary fiber capsule, or a large bowl of fiber infused breakfast cereal that may contain amounts of carbohydrates, fat, and sugar as well. This characteristic of food supplements may benefit people who are affected by obesity. Many arguments can be made regarding the necessity of food supplements. The benefits of replacing food in the human diet cannot be ignored when considering the viability of food supplements.
Patients' reasons for taking food supplements and herbal medicines A lack of faith in the food production, transport and storage system, meaning that nutrients are lost because fruit is harvested too early or growth is forced. A belief that more is better, for example, a large intake of vitamin A in the diet and supplements will prevent blindness. With old age you do not metabolize vitamins and minerals and therefore you should take more. Food supplements delay ageing. Food supplements prevent cancer. Food supplements are safer and healthier than prescribed medication. Food supplements replace the deficiencies caused by a poor diet. Food supplements save you from having to eat vegetables and fruit. Food supplements are a good standby when waiting for a long time to be seen by a specialist doctor.

Reasons for using food supplements; the most common reasons that a patient may use to justify taking a food supplement on a routine basis (Eberhardie 2005).


The use of dietary supplements is a world-wide trend. In the U.S., dietary supplement use has steadily increased since the 1970s. However, the loose regulations surrounding these non-prescription products make it difficult to generate precise statistics. Analyses of a representative population were conducted between 2003 and 2006 for the purpose estimating dietary supplement use. Results were collected by means of a questionnaire and they indicated that 49% of the U.S. population (44% of males, 53% of females) employs dietary supplements. Multivitamin and multimineral use was the most frequently reported and between 28 and 30% of the surveyed population reported using dietary supplements containing vitamins B-6, B-12, C, A, and E; 1819% reported using iron, selenium, and chromium; and 2627% reported using zinc- and magnesium-containing supplements (Bailey et al., 2011). Although the safety of dietary supplements is in question, many people seem to be convinced of their effectiveness. The following image is a graphical representation of food supplement use in the U.S.

Food supplement use in the U.S. An estimated majority of the population consumes at least on food supplement on a routine basis. (Baily et al, 2011) Different age groups also produced varying results in this survey. Overall, botanical supplement use was more common in older than in younger age groups. About one-half of the U.S. population and 70% of adults 71 y use dietary supplements. Dietary supplement use in various age groups.
n Total 18,758 1781 1975 2233 2812 2283 All 1 13 48 913 1418 1930 49 0.9 39 1 43 2 29 2 a 26 2 a 39 1 33 0.9 26 2 32 2 20 1a 16 1a 27 1 14 0.6 2 0.4a 4 1a 3 1a 51 13 1 Age, y Any supplement, % MVMM Botanical


3112 2709 1853 Males 9490 892 963 1106 1455 1222 1594 1342 916 Females 9268 889 1012 1127 1357 1061 1518 1367 937

3150 5170 71

49 1 65 2 b 71 1 b

35 1 44 2b 46 2b

18 1b 20 1b 17 1b

All 1 13 48 913 1418 1930 3150 5170 71

44 1 39 2 46 3 29 2 a 23 1 a 36 2 44 1 58 2 66 2 b

31 1 27 2 35 2b 18 2a 14 1a 25 2 32 1 40 2b 43 2b

13 1 -2 4 1a 4 1a 51 14 1b 16 1b 18 1b 18 1b

All 1 13 48 913 1418 1930 3150 5170 71

53 1 38 2 40 3 29 3a 30 2a 43 2 55 2 72 2b 75 2b

36 1 25 2a 28 3 23 3a 19 2a 30 1 38 2 48 2b 48 2b

15 1 3 1a 3 1a 2 0.6a 61 13 1 21 2b 21 2b 16 1b

1 All values are percentages SE. Superscripts denote sets within age and
within gender and age groupings with prevalence estimates that are statistically indistinguishable from the lowest (a) or highest (b) population mean, as determined by Hsu's procedure with = 0.025. 2 Relative SE 40%; this estimate is not stable and is omitted.


Food supplements represent a multi-billion dollar industry, which indicates that people experience positive effects from these so-called food products. Although the form and function of supplements is similar to pharmaceutical drugs, they are distributed in the same manner as grocery store items. With public safety in consideration, is it necessary to be concerned with the nearly unregulated distribution of dietary supplements?

Production of Food Supplements The production of food supplements in the U.S. is a highly controversial area that faces opposition from many people. The main issue is lack of regulation in the production industry, which started in 1994 when the Dietary Supplement Health and Education Act (DSHEA) was passed. The DSHEA states that supplements will be regulated as food products rather than drugs. Furthermore, the safety and effectiveness of supplements are not monitored by the Food and Drug Administration (FDA) so the health of consumers is left at risk (Kinariwala, 2003). It is the sole responsibility of manufacturers to report health issues related to their supplements, and therefore, countless reports are never documented (Miller & Longtin, 2000). The FDA only interferes with supplement production once an unsafe supplement has already been marketed, and although the FDA can establish good manufacturing practices (GMPs), it has yet to do so effectively. Also, companies do not need to ensure their product is safe even under the recommended conditions (Abebe 2003). Regulations need to change in order to improve the safety and quality of supplements. Despite opposition, some organizations are working towards change, and coupled with support from the public and health-care companies, these organizations could persuade the FDA to change regulation laws for food supplements (Kinariwala, 2003). The European Union also faces similar difficulties with food supplement regulations. In the EU, supplements are also regulated as food without the enforcement of GMPs. Once again, the quality and safety of supplements are in the hands of the manufacturers (Pravst & mitek, 2011). However, the EU is working to make improvements, and in 2002, the EU produced directives regarding the regulation of food and dietary supplements. The EU 2004/24/EC directive recognizes the proven safety and efficiency of some herbal medicines. Those that had been in use for over 30 years and at least 15 years within the European Union were recorded on an approved list, and in general, supplements had to conform to a socalled positive list of safe supplements and active ingredients. However, companies could apply for clearance to sell supplements that did not appear on the positive list but were nevertheless approved as safe supplements. There is still concern among medical and nutritional circles regarding the regulation of food supplements, and all agree that new directives will result in increased consumer safety (Eberhardie, 2005).


An example of a chemically engineered dietary supplement The contents of a so-called natural dietary supplement

Labels from packaging of food supplements.

Contents The majority of natural health product consumers do not consider the possible risks associated with botanical supplements. Several recent studies have shown that high doses of the chemical compounds used in plant-based food supplements can cause liver cancer. Though these processing compounds are potentially harmful, the journal Food and Nutrition Sciences reported that the concentration in which these carcinogens appear is harmless (Some plant-based, 2011). Knowledge of supplements containing high levels of alkenylbenzenes has become essential in the push for stricter regulation and quality control. An interest in botanicals and botanical preparations in the European Union has resulted in an expanding market for herbal and dietary supplements. Researchers of Wageningen University have extensively monitored and analyzed the safety associated with plant-based

food supplements. Thirty potential carcinogens were studied, and it was found that the majority of the compounds shared something in common. They were part of the alkenylbenzenes group or the pyrrolizidine alkaloids group. Awareness of the possible risks associated with some botanicals has created a surge in improved quality control, so much that alkenylbenzenes estragole, methyleugenol and safrole (see figure below) being used as flavor additives have been prohibited in numerous EU member states (Some plant-based, 2011).

Chemical structures of alkenylbenzenes present in several plant-based food supplements.

Although dangerous carcinogens have been found in dietary supplements, they have not been banned. Even supplements that have basil, fennel, nutmeg, sassafras, cinnamon, or calamus as a main ingredients are high in alkenylbenzenes. Several recent studies revealing hazardous herbal supplements have created a surge in risk management actions being taken. Although researchers report the occurrence of liver cancer in animals after consumption of high concentrations of pure alkenylbenzenes, there are numerous supplements which contain negligible amounts of potential carcinogens in them. When testing the effects of alkenylbenzenes, the experimental animals were administered only the pure concentrations rather than the dietary supplements combined with regular feed. Even if the studies are not indicative of the level of risk present when consuming plant based supplements, it is appropriate to raise concern over the lack of regulation and quality control (Some plant-based, 2011).


Step 1 Step 2 Step 3

Herbs are checked for pesticides or hazardous chemicals. A microbiological analysis is conducted in order to test for contaminants such as fungi. A phytograph is done in order to ensure that the identity and quality of each herb are legitimate.

Step 4 Pills are made based on appropriate dosages. Step 5 The final product is quality tested.

The production process of herbal supplements (based on Barrett, 1999).

Permissible Claims Several recent studies have focused on the true benefits of certain herbal supplements such as gingko, Echinacea and Saint Johns Wort. These herbs have been reported to be cures for several illnesses while studies have shown that they are ineffective. Despite the negative results from studies done on herbal remedies, $14.8 billion was spent on herbal supplements in 2007. According to the Government Accountability Office (GAO), those who market supplements continue to inform consumers incorrectly, sometimes advising hazardous usage techniques. This was uncovered by incognito GAO employees who posed questions as if they were elderly clients. Furthermore, it was found that salesmen advised customers that herbal supplements were capable of preventing and curing Alzheimers disease and that prescription medication could be replaced with supplements. Gregory Kutz, managing director of Forensic Audits and Special Investigations at the GAO revealed during a testimony to the U.S. Senate Special Committee that the FDA and FTC had labeled the marketing approaches to be improper and likely in violation of statutes and regulations. Even though herbal supplements do not require pre -market testing because they are sold as food, the GAO tested 40 commonly purchased supplements and found that over 80% contained traces of lead, mercury, cadmium, and/or arsenic. The FDA and U.S. Environmental Protection Agency considered the results to be hazardous but stated that the levels of contaminants found were not high enough to put a consumer at risk. In general, the Americans who purchase herbal supplements are cautious in choosing a reliable brand, and are advised by the president of the Council for Responsible Nutrition that the GAO research should be of no concern to consumers. Consumers buy herbals supplements to improve their health and lifestyle but are at the mercy of marketers who fail to give valid information. The FDA regulates all dietary supplements but give the responsibility of determining their benefits and dosages to the manufacturing company. Also, the marketers are not required to present the means in which they determined the effectiveness and safety of products to the FDA. The FDA checks to see that all manufacturing processes are valid, but no tests are done on the claims made by manufacturers. If a faulty claim is revealed, the FDA must show that consumers are at risk before actions can be made to remove the product from stores. Though it is illegal to claim that a supplement can cure or prevent illnesses, the manufacturers are allowed to make general claims about improving everyday bodily functions. A disclaimer is required which says that the claims

have not been evaluated by the FDA, but the majority of consumers are still mislead. Although administrations like the FDA and the FTC are responsible for preventing false advertisements, there is not enough attention given to inappropriate marketing techniques (Harmon, 2010). Professor Edzard Ernst at the Department of Complementary Medicine at the University of Exeter advises that herbal remedies should be sold by pharmacists. He has written before that herbs such as ginkgo, St. Johns wort, saw palmetto and horsechestnut seed extracts are viable for use as natural remedies, but at the moment, they lack quality control because they are sold as food supplements rather than drugs. Interested consumers are constantly referring to Professor Ernst to answer questions concerning the efficacy and side effects of food supplements. Information supplied to these consumers is limited though due to legal restrictions. Despite the regulatory process being inadequate, there is a growing interest in herbal supplements. Salesmen should be allowed to provide appropriate advice if a consumer is questioning the accuracy of information present on a label (Freeman, 2000). Although herbal supplements cannot be claimed to treat disease, recent studies have shown that there are potential benefits involved in the use of plant-based dietary supplements. The majority of clinicians consider the use of herbal supplements to be disadvantageous, but people who use herbal supplements do not need to consult their physician first. It has been tested to see how beneficial herbal supplements are to the gastrointestinal health of a person. These studies have shown that herbal supplements do not aid in the treatment of liver disease, but can help in the alleviation of gastrointestinal symptoms (Lipman, n.d.). Herbal supplements can benefit a persons entire diet but are commonly used for specific purposes. For example, ginseng has been known to improve the overall health of the body, while echinacea is used specifically to improve ones immune system. Other examples of herbal supplements that have been used for specific purposes are spirulina, bee pollen, royal jelly, psyllium seed husks, wheat germ, wheat grass, shiitake mushrooms, and reishi mushrooms (Dupler & Fundukian, 2011).

Side Effects of Food Supplements The side effects of many food supplements remain unevaluated. The long term side effects are particularly problematic, and although health reports may provide some insight into more immediate effects, no major studies have been conducted on the extensive side effects. This is because food supplements are regulated as food so broad studies are not required (Johnson, Haley, & Ward, 2007). However, research shows that the side effects of many supplements may be harmful and interfere with medical drugs. Many protein supplements are taken as forms of ergogenic aid despite their documented adverse effects. These supplements make up part of a multi-billion dollar industry that is based on a marketing strategy that involves using mostly unproved claims. Additionally, many of these protein supplements can have harmful side effects including decreased liver function, dehydration, and worsening of gout. A more extensive list of these side effects can be found in table 1, which includes popular protein supplements such as Creatine Fuel Chews, Muscle Milk, and Hydroxycut (Johnson et al., 2007).For example, studies conducted on creatine show an increase in body mass and lean body mass. In reality however, this increase is mainly a result of increased water retention in muscles, which does not actually benefit the users physical performance. Also, the protein supplements may not provide any additional benefits for athletes in need of protein because sufficient amounts of protein are already provided in a normal diet (Clarkson & Rawson, 1999). It is important to consider the costs and benefits of consuming protein supplements.



Active Ingredient(s)

Trade Names

Documented Adverse Effects

Electrolyte disturbances29-31 Renal Damage29,32 Transient elevation in transaminase31,33 Increased post-exercise compartment pressures34-35


Creatine Monohydrate

Creatine Fuel Chews (Twinlab Inc. NY, NY) Creatine Monohydrate 100% (Higher Power, Boise, ID) Cell Tech (MuscleTech, Mississauga, Canada) Micronized Creatine (AST Sports Science, Golden, CO) Hydroxycut (MuscleTech, Mississauga, Canada) Muscle Milk (CytoSport, Benicia, CA) Ripped Fuel (Twinlab Inc. NY, NY) ProBURN (Prolab, Chatsworth, Ca)

Amphetamine Derivatives

Ephedrine Pseudoephedrine Phenylpropanolamine Phenteramine Ma-Huang

Acute Myocardial Infarction36-37 Arrythmias36-39 Myocarditis36,37 Severe Hypertension36 Stroke40 Hyperthermia41 Rhbdomyolysis41

Documented adverse side effects of top selling dietary supplements in the U.S. based on (Johnsonet et al., 2007)

Recent studies indicate that food supplements may have negative side effects and interact negatively with other drugs. The lack of regulation presents safety problems for customers because selfmedication is associated with many potential dangers and can result in health problems. Even when supplements or herbal medicines are well manufactured and given at a safe dose, it is important to know the effects of consuming other medications in combination with these dietary supplements that do not require a doctors prescription (Eberhardie, 2005). Some evidence shows that herbal supplements in particular may interfere with good oral health. The information gathered through health reports on adverse reactions to herbal supplements indicates that many of these products can degrade oral health (Abebe, 2003).Studies involving garlic, ginseng, ginkgo, St. John's wort, and echinacea have shown that all of these substances can have a peri or post-operative effect, and garlic, ginseng, and ginkgo can all increase the risk of bleeding (Eberhardie, 2005).It is essential that the reactions of food supplements with medical drugs are evaluated in order to protect the safety of customers.


Interactions of herbal supplements with dental drugs based on (Abebe, 2003) Herbal supplements (common and scientific names)
Cayenne/chile pepper (Capsicum spp.)

Commonly reported uses

Interacting dental drugs

Effects of interactions

For painful/itchy skin conditions and circulatory healer


Increased risk of bleeding Herb protects gastric irritation caused by aspirin

Many drugs taken orally

Increase bioavailability and effects of drugs

Dong quai(Angelica sinesis)

For painful menstrual cramp; general tonic; antispasmodic; for cardiovascular health and liver support


Increased risk of bleeding

Echinacea (Echinacea angustifolia)

Immune stimulant; antimicrobial; for colds, flu, eczema and upper respiratory infections

Ketoconazole, acetaminophen

Increased hepatotoxicity

Ephedra (Ephedra sinica)

For asthma, weight loss, CNS stimulation and nasal congestion

Halothane Epinephrine

Cardiac arrythmias Cardiac arrythmias and other cardiovascular complications Decreased steroid effect


Garlic (Allium sativum)

Antihypertensive; antioxidant; antihypercholesterolemia; antimicrobial; for cancer prevention, colds, flu, and diabetes


Increased risk of bleeding Increased risk of bleeding (postoperatively)

General anesthetics

Ginkgo (Ginkgo biloba)

To improve memory and brain function; for claudication and general cardiovascular health; antioxidant

Aspirin Acetaminophen plus caffeine plus enfotamine

Increased risk of bleeding Brain hemorrhage

Ginseng (Panax spp.)

To enhance endurance, vitality, adaptation and immune system; for stress


Increased steroid activity/toxicity Increased drug effect


Kava (Piper methysticum)

For insomnia, anxiety, stress, muscle tension and mild pain

CNS depressants (eg., benzodiazepines, opioids, general anesthetics, barbiturates and sedatives)

Increased CNS depression


St. Johns wort (Hypericumperforatum)

For mild to moderate depression, and anxiety and fatigue-related depression, insomnia, and for wound healing, bruises and first-degree burns; anti-inflammatory


Increased photosensitivity Potentiation of sedative effect


Valerian (Valerianaofficinalis)

Sleep aid, spasmolytic; for anxiety, muscle spasm, and menstrual and intestinal cramps

CNS depressants (e.g.) benzodiazepines, opioids, general anesthetics, barbiturates and sedatives)

Increased CNS depression

Public Opinion The demand for food supplements is fueled entirely by consumers whom wish to alter their diet. In some cases, a different diet is not much of a choice, but rather a necessity. A newspaper article titled The Fight for Food Supplements from the Briarpatch newspaper describes efforts of the Ontario Coalition Against Poverty, (OCAP), which has been mobilizing poor and homeless people to fight for their rights since 1990. The goal of this organization was to provide up to $250 for people on social assistance who are told they need food supplements by a medical professional. Numerous professionals voiced their opinions on this matter, including Dr. Debbie Honickman of Queen West Community Health Centre. She commented, It is appalling that family doctors should have to decide who needs extra money for special diets when in principle every social assistance recipient deserves the maximum allowance. This absurd approach will cost the government more in paper and physicians' fees than it would likely cost to give everyone on social assistance an extra $250 a month. I object to being drawn into such an inhumane and wasteful system. An organized march to the Ministry of Community and Social Services was held in order to demand that the dietary supplement be supplied to everyone on assistance. This organized movement was extraordinarily successful, although developers of the welfare system never expected a demand for food supplements to arise (Fight for Food Supplements, 2005). This article depicts a situation in which food supplements are important to public health and economics. In contrast, food supplements have an undesirable reputation among some circles. The adverse side effects lead people to question the legality of non-prescribed food supplements. A newspaper article titled Tighter regulation needed for dietary supplements in USA, from The Lancet, argues that the Food and Drug Administration (FDA) needs to take initiative by enforcing stricter regulations on supplements. Several commonly used products, namely Ginkgo biloba, St. John's wort, and ephedrine are known to have serious adverse effects. Although side effects are normally associated with pharmaceutical drugs, the FDA does not regard these dietary supplements as such and therefore, they are not distributed under the same stringent standards which pharmaceutical drugs are subject to (FDA, 2011). Standards are much less robust for dietary supplements because, under the Dietary Supplement Health and Education Act (DSHEA) of 1994, supplements are subject to the same regulatory requirements as food. There are no provisions that require FDA approval for the safety or effectiveness of supplements which leaves consumers and manufacturers responsible for the risks associated with these products. Organizations such as Public Citizen and the American Medical Association are taking steps to amend the Dietary Supplement Health and Education Act (DSHEA) of 1994 in order to classify dietary supplements as prescription drugs. However, they face immense opposition from groups such as the National Nutritional Foods Association, the American Herbal Association, and the Council for Responsible Nutrition (Kinariwala, 2003). Health-care providers and the millions of Americans who

consume food supplements should be aware of the associated risks and make informed decisions regarding their health, possibly with the advice of a medical professional.

Bibliography Abebe, W. (2003). An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations. PubMed, 77(1), 37-46. Bailey, R., Gahche, J., Lentino, C., Dwyer, J., Engel, J., Thomas, P., Betz, J., Sempos, C., and 4 Picciano, M..(2011). Dietary Supplement Use in the United States, 20032006.American Society forNutrition.141 (2), 261-266. Barrett, S. (1999). Herbal supplements. NCRHI Newsletter,22(1), 3. Clarkson, P. M., & Rawson, E. S. (1999). Nutritional supplements to increase muscle mass. Critical Reviews in Food Science and Nutrition, 39(4), 317. Dupler, D., & Fundukian, L. (2011). Nutritional supplements.Health and Wellness Resource Center, 6, Eberhardie, C. (2005). Food Supplements and Herbal Medicines.Nursing Standards 20.3. FDA releases NDA draft guidance. (2011). Nutraceuticals World, 14(7), 14. Fight for food supplements: Ocap's fight for food supplements for people on assistance has been such a success they need help to handle it. (2005). Briarpatch,34(3), 6. Freeman, M. (2000). Herbal remedies are not food supplements. Chemist and Druggist, 8. Harmon, K. (2010, May 28). Herbal supplement sellers dispense dangerous advice, false claims. Scientific American. Retrieved from herbalsupplement-dangers Johnson A, Haley CA, Ward CA .(2007). Hazards of Dietary Supplement Use. Journal of Special Operations Medicine 7(1)(Winter): 30-38. Kinariwala, N. (2003). Tighter regulation needed for dietary supplements in USA. The Lancet, 361(9368), 1566-1566. doi:10.1016/S0140-6736(03)13207-2 Lipman, T. (n.d.). Herbal supplements. Current Gastroenterology Reports, 7(4), 302-307. Miller, H. I., &Longtin, D. (2000).Death by dietary supplement. Policy Review, (102), 15-25. Retrieved from


Pravst, I., &mitek, K. (2011). The coenzyme Q10 content of food supplements. Journal Fr Verbraucherschutz Und Lebensmittelsicherheit, 6(4), 457-463. doi:10.1007/s00003-011-0704-5 Wageningen University and Research Centre (2011, December 12). Some plant-based food supplements contain high levels of cancer. Retrieved from releases/2011/12/111212123652.htm

Illustration Credits FactsAug2011.jpg


Chapter 4 Diet and Diabetes

Nora Murphy and Jay McCowan

Introduction Diabetes is a disease in which a person either does not naturally produce enough insulin to lower the bodys blood sugar level or the cells are resistant to the insulin that is produced. Diabetes has been recognized as a serious disease for about 2,000 years, but has only become treatable in the last century. With technology advancing and research continuing, diabetes is rapidly becoming more and more manageable for the average human. The main afflictions that make up the whole of diabetes are type 1 and type 2, with type 2 comprising approximately 90% of all cases.

Diabetes Type 1 Type 1 diabetes is a disease that afflicts victims autoimmune system and destroys their beta cells. These cells are located in the pancreas and are involved in the bodys process of creating insulin. Without insulin, the human body is unable to control blood sugar levels and this can lead to severe complications such as kidney failure, heart attack, and stroke (Homann, 2011). The history of diabetes is a long one, and for nearly 2,000 years diabetes went untreated, which resulted in certain death for any afflicted persons. However, in the last century and a half, medical breakthroughs have led to the discovery of insulin and of an effective treatment of the disease. In 1921, a Canadian surgeon named Frederick Banting was able to keep a severely diabetic dog alive for 70 days through intravenous injection of an extracted pancreatic liquid. Banting soon refined this extract with the help of his colleagues and was able to use it to drop the blood sugar levels of a young boy with diabetes. Within one day, the boys blood sugar levels returned to normal, and news of Bantings early form of insulin was heard around the world (Sattley, 2008). Shortly after the discovery of insulin, various forms were marketed, including PZI, which was developed in 1936, NPH (1938), and Lente (1952). Each new form of insulin was longer lasting than its predecessors, which in turn meant that it would help maintain blood sugar levels of a diabetic for a longer period of time. However, until the 1960s, there was no easy way to measure blood sugar, which meant injecting an accurate amount of insulin was a tough thing to do. The invention of urine strips changed all this, and, along with the invention of the single use syringe by Becton-Dickinson, the treatment of diabetes was streamlined into something that just about anyone could handle. New developments in the field since then have only continued to make living with diabetes easier, such as the introduction of the portable glucose meter, an instrument that was originally developed in 1969. The original glucose meter weighed over 3 pounds and cost roughly $650. Nowadays, these instruments are smaller than a calculator and much better live up to their description of being portable.


In the late 1970s, the first insulin pump was developed, a device that would automatically inject insulin into the body over the course of the day. These pumps have become the standard for diabetes control and assist the body in mimicking the natural release of insulin as best as possible. Finally, in 1979, the hemoglobin A1c test was developed and became the new standard for testing blood sugar levels. The A1c test is much more accurate than previous tests and this helps keep blood sugar levels closer to normal levels (Sattley, 2008). As shown by the Diabetes Control and Complications Trial, by avoiding the spikes and dips in blood sugar that were so frequently experienced, a diabetic could avoid developing long term complications such as eye, kidney, and nerve disease (Crandall, 2010). All of these inventions, in conjunction with the various studies that have been done, have changed diabetes from a disease that would turn deadly within a year to a condition that can be treated for without severely limiting daily life.

Statistics and Trends Of the 25.8 million people living in the United States with diabetes, only approximately 5% of them have type 1. The highest ranking ethnicity in relation to the prevalence of diabetes was non-Hispanic blacks, accounting for 12.6% of the diagnosed diabetics. However, studies seem to point towards Caucasians as having the highest chance of developing type 1 specifically (National diabetes fact sheet, 2011). In general, the chances of developing type 1 diabetes by 70 years of age is 1%, although this number is roughly 10 times higher if an immediate relative has type 1 diabetes. This is true unless that relative is the mother, in which case the chances drop to 4% if the mother is 25 years or younger and 1% if she is older than 25 (roughly the same chance as the average American) (Genetics & diabetes: whats your risk?, n.d.). Despite all these statistics, scientists are still trying to determine just how genetics play a part in the development of type 1 diabetes, although there may be more to it than just hereditary factors. New studies suggest that environmental factors actually play a larger role in the development of type 1 than was previously thought (Frequently asked questions (faqs), n.d.). What Happens in the Body? When a person develops type 1 diabetes, the immune cells have begun to destroy the insulin-producing beta cells (Fact sheets: type 1 diabetes facts, n.d.). Symptoms of the development of type 1 diabetes include extreme thirst, frequent urination, blurry eyesight, and sudden weight loss. These indicators are all signs that beta cells are being destroyed. In some people, this induces a so-called honeymoon phase, in which the existing beta cells still function. It is during this period that the most promise has been shown for halting the progression of type 1 diabetes and because of this, many studies are being done that involve the honeymoon phase. After all of the beta cells have been destroyed, however, the person enters a complete dependence on an outside source of insulin in order to maintain proper blood glucose levels. On average, the bodys blood sugar levels should be within the 70 to 140 mg/dL range, with that number being near the lower end before meals and the higher end before bedtime. In order to maintain these levels, proper diet and blood sugar management are required (Cihakova, 2001).


The glucose and insulin blood levels throughout a normal day. Blood glucose levels rise and fall throughout the day, and are closely matched by the bodys insulin levels. These levels tend to peak during the mealtime hours and sink down during the nighttime. Generally blood glucose levels stay within 70-140 mg/dL at all times

Processes in the pancreas of a person with type 1 diabetes.


New Developments Researchers are constantly searching for a cure and attempting to make life easier for those who live with diabetes. One such case can be found at Bristol University, where scientists are studying the effects of an enterotoxin of E. coli and how it protects the islet cells in rats. The enterotoxin does this by inhibiting the immune system and not letting it attack the insulin producing cells. So far the experimental enterotoxin has prevented the progression of type 1 diabetes in test animals. The therapy is administered in the form of a nasal spray and will hopefully soon be used in human clinical trials. The scientists at Bristol hope that by catching type 1 diabetes early, the enterotoxin would then be able to be used to stop the immune system before it completely destroyed all the islet cells (Can diabetes type 1 be prevented? 2001).

Diabetes population density map. Diabetes Type 2 Insulin is a hormone released by the pancreas that controls the amount of sugar in the blood. Insulin allows sugar to move from the blood to the cells to be used as energy or converted into fat. In a normal body, blood glucose levels vary though out the day but stay in the range of approximately 70 to 110 milligrams per deciliter. Diabetes is the condition in which not enough insulin is produced to meet the bodys needs. In patients with type 2 diabetes, the pancreas still produces insulin but the body becomes resistance to its effects. Because of this patients have abnormally and often dangerously high blood glucose levels and low amounts of sugar in the cells. Diabetes has been recognized as condition for 2,000 years but there was no distinction between the different types until 1935. Shortly after the discovery of insulin in 1921, doctors began to notice that insulin injections were having less of an effect on some diabetes patients (Ramlo & Edelam, 2000). As of 2010, 25.8 million people or 8.3% of U.S. population had type 2

diabetes and 27% of Americans over age 65 had diabetes (National diabetes fact sheet, 2010). Type 2 diabetes patients gradually lose sensitivity to insulin in adulthood, and the condition is strongly linked with poor diet and obesity. An obese person develops an insulin resistance because he or she requires very high levels of insulin to maintain a normal blood glucose level. Due to the gradual onset of symptoms, the conditions often goes undiagnosed for years or even decades. The symptoms are very similar to type 1 diabetes, the only difference being the rapidity of commencement. Often the distinguishing symptoms of diabetes are large volumes of urine or excessive thirst. When the blood has high glucose levels, the kidneys excrete this excess sugar out of the body in urine. The deluge of urine is often sweet as well; the primitive test for diabetes was to taste the urine. Other symptoms of type 2 diabetes include blurred vision, drowsiness, nausea, and decreased endurance during exercise. People with type 2 diabetes may not have any symptoms for years or decades before diagnosis. The onset of symptoms is much more gradual compared to type 1, and therefore people may not notice the warning signs (Crandall, 2010). Paula Deen, a 64 year old TV chef who is famous for her southern comfort food, announced in January 2012 that she was diagnosed with type 2 diabetes three years earlier. Her deep fried lasagna and Twinkie pie had prompted some nutritionists to label her as the most dangerous person to America. The deep fried, butter drenched, and sickeningly sweet recipes she is known for has led to her type 2 diabetes; 8.3 percent of Americans currently share the same diagnoses, and the majority of cases are due to poor diet. There is an extreme amount of research being done for prevention and treatment of type 2 diabetes because it affects so many Americans and the numbers are only rising (Carbone, 2012).

Processes of glucose absorption (left) vs.processes of glucose maintenance (right).


Prevention and Treatment Pre-diabetes is a condition in which blood glucose levels are high but not high enough to be considered diabetes. The fasting glucose levels of pre-diabetes are between 100 mg/dL and 126 mg/dL. Identification in this stage is crucial from taking preventative measures (Crandall, 2010). It is estimated that 35% of American adults have pre-diabetes, and 50% of Americans 65 or older are pre-diabetic (National diabetes fact sheet, 2010). Patients with impaired glucose tolerance, or pre-diabetic, should participate in 30 minutes of exercise 5 days a week, lose weight, and limit dietary fat. Studies have shown that by following these guild line adults age 40-65 years old that are in risk of developing type 2 diabetes can reduce their chance of developing the disease by 56%. By exercising for 2.5 hours a week and loosing approximately 6% of body weight, adults can cut their risk of developing diabetes in half (Vijan, 2008). Screening by physicians is crucial in diagnosing type 2 diabetes. Early recognition of type 2 diabetes or pre-diabetes can significantly reduce the complications associated with the disease. Type 2 diabetes often goes undiagnosed for 4 to 7 years. It would not be cost effective to routine screen every person for plasma glucose level but for patients demonstrating risk factors it is fiscally beneficial to test for the disease. The table below displays the major risk factors that would justify a test for high blood glucose levels.

The risk factors for developing type 2 diabetes. Once the condition has been diagnosed a treatment method has to be implemented that will adequately control blood sugar levels. Type 2 diabetes can be managed by diet and exercise, unlike type 1. If a change is not sufficient in moderating blood glucose levels, then a patient can take oral medications or inject insulin for treatment. The method of treatment often is dependent upon the severity of the situation; 16% of patients use no medication to manage their conditions, 58% use only oral medication, 14% use a combination of oral pharmaceuticals and insulin, and 12% use only insulin (National diabetes fact sheet, 2010).


Diet and exercise can help manage glucose levels and can provide patients with other long term benefits. Studies have shown that exercise can increase insulin sensitivity and improves glycemic control. Diet and exercise are not effective in the long term but are good first line interventions. Before beginning a new diet or exercise regimen, patients should undergo a detailed medical evaluation, especially if they may have other physical ailments. Most patients can moderate their symptoms for a period of time with diet and exercise before beginning a pharmaceutical regiment but patients with serve hyperglycemia should begin pharmacologic therapy at the time of diagnosis (Vijan, 2008). Patients with type 2 diabetes should seek help from a nutritionist for a specific diet plan that will assist them in controlling their diabetes. Generally the diet should focus on moderation with a restricted calorie intake. The patient should avoid consumption of saturated fats and simple sugars. Individualized exercise plans should be implemented, but patients need to be wary because exercise lowers blood glucose levels. The level of exercise should be about 30 to 45 minutes of moderate aerobic exercise 3 to 5 days a week (Vijan, 2008). Oral antihyperglycemic drugs can often lower blood sugar levels adequately in people with type 2 diabetes. There are many different varieties; some increase the production of insulin while others increase the bodys response to it and other can delay the absorption of glucose into the intestine. These oral medications are often prescribed to people who fail to lower blood sugar levels adequately enough with diet or exercise alone. These pharmaceuticals can be taken once or multiply times a day depending upon the condition. Patients with type 2 diabetes who cannot control their disease with oral drugs may need to take insulin injects alone or combine them with the oral antihyperglycemic (Crandall, 2010). Insulin is often required as a final result for patients who cannot control their type 2 diabetes with diet and exercise or oral antihyperglycemic drugs. Patients with type 2 diabetes must take modified insulin in order for their body to respond to it. Currently insulin must be injected into a fat layer or new forms of insulin can be taken as a nasal spray. Some patients wear a pump which pumps insulin into the body through a needle left in the skin. The pumps adds insulin to the body either at pre-determined times or when needed. The pumps administer inulin to the body similarly to the way that the pancreas releases insulin (Crandall, 2010).

Common insulin injection used by diabetic patients every day.


There are three forms of insulin available, which are categorized by duration of effectiveness and speed of action. The three types are: rapid acting insulin, intermediate acting insulin, and long acting insulin. Choosing the correct type of insulin differs from person to person and often depends on their daily activities, their willingness to monitor blood sugar levels, and how stable their blood sugar levels are. The amount, times, and type of insulin injects are chosen to best control the blood glucose levels (Crandall, 2010). Many prevention methods focus on lowering blood glucose levels in order to avoid the onset of insulin resistance. Some suggest the most effective plan of prevention would be to increase insulin sensitivity through diet and exercise along with oral antidiabetic agents such as metformin, acarbose, troglitazone, orlistat. Patients treat with certain antihypertensives, particularly angiotensin-converting enzyme inhibitors mainly trandolapril and perindopril, and angiotensin receptor blockers such as candesartan valsartan have seen significant decrease in the onset of type two diabetes symptoms. Other antihypertensives can actually increase the risk of developing type 2 diabetes. More research is being done to clarify an exact set of medications that would delay and prevent the onset of diabetes (Mathews & Levy, 2009).

Complications Along with the difficulties associated with testing and monitoring blood sugar levels, type 2 diabetes can result in severe complications, high medical costs, and premature death. Type 2 diabetes negatively affects many different parts of the body. Statistically speaking, adults with type 2 diabetes have rates of heart disease and risks of strokes 2 to 4 times higher than adults without diabetes. Type 2 diabetes is the leading cause of new blindness in adults and 28.5% of people with diabetes experience retinopathy. The condition is the leading cause of kidney failure accounting for nearly 50% of all cases. Approximately 60-70% of people with diabetes have mild to serve nervous system damage which often leads to amputation. The table below displays long term complications from type 2 diabetes (National diabetes fact sheet, 2010). Due to the daily treatment and monitoring required, as well as the many complications, diabetes cost American 174 billion dollars a year in direct and indirect costs. The average diabetic has medical costs 2.3 times higher than a person without type 2 diabetes. 116 billion dollars in direct costs are for things such as treatment and medical expenses and the 58 billion dollars in indirect cost are for disability, work loss, and premature mortality. Type 2 diabetes played a role in 160,022 deaths in 2010 and was the leading cause of 71,382 American deaths. The risk of death for people with diabetes is twice the risk of death for people the same age without diabetes (National diabetes fact sheet, 2010).


Long-Term Complications of Diabetes Tissue or Affected Blood vessels Organ Effects Fatty material (atherosclerotic plaque) builds up and blocks large or medium-sized arteries in the heart, brain, legs, and penis. The walls of small blood vessels are damaged so that the vessels do not transfer oxygen to tissues normally, and the vessels may leak. Complications Poor circulation causes wounds to heal poorly and can lead to heart disorders, strokes, gangrene of the feet and hands, erectile dysfunction (impotence), and infections.

Eyes Kidneys

The small blood vessels of the retina are Decreased vision and, ultimately, blindness occur. damaged. Blood vessels in the kidneys thicken. Protein leaks into urine. Blood is not filtered normally. The kidneys malfunction, and ultimately, kidney failure occurs.


Nerves are damaged because glucose is not Legs suddenly or gradually weaken. metabolized normally and because the blood People have reduced sensation, tingling, and pain supply is inadequate. in their hands and feet. nervous The nerves that control blood pressure and Swings in blood pressure occur. digestive processes are damaged. Swallowing becomes difficult. Digestive function is altered, and sometimes bouts of diarrhea occur. Erectile dysfunction develops. Blood flow to the skin is reduced, and sensation Sores and deep infections (diabetic ulcers) is decreased, resulting in repeated injury. develop. Healing is poor. White blood cell function is impaired. People become more susceptible to infections, especially of the urinary tract and skin. and Dupuytren's

Autonomic system


Blood Connective tissue

Glucose is not metabolized normally, causing Carpal tunnel syndrome tissues to thicken or contract. contracture develop.

The table above describes complications with diabetes (Crandall, 2010). Literature Cited Can diabetes type 1 be prevented?. (2001, March 1). British Journal of Ophthalmology (00071161), 85. Retrieved from Carbone, N. (2012, January 17). Butter connoisseur Paula Deen admits type 2 diabetes battle. Time Magazine, Retrieved from Centers For Disease Control, (2011). National diabetes fact sheet. Retrieved from website: Cihakova, D. (2001, September 10). Type 1 diabetes mellitus. Retrieved from


Crandall, J. P. (2010, April). Diabetes mellitus (dm). Retrieved from Eckman, A. (2011). Hypoglycemia. Retrieved from health/PMH0001423/ Fact sheets: type 1 diabetes facts, (n.d.). Retrieved from Ferry, R. F. (2011). Emedicine health. Retrieved from blood_sugar_hypoglycemia/article_em.htm Fowler, M. (2008, October). Hypoglycemia. American Diabetes Association. Retrieved on March 22nd, 2012, from http:// Frequently asked questions (faqs), (n.d.). Retrieved from Genetics & diabetes: whats your risk?, (n.d.). Retrieved from Homann, Dirk, (2011). Type 1 diabetes. Retrieved from Hypoglycemia. (n.d.). Retrieved from Hypoglycemia coma. (2012). Reactive hypoglycemia. Retrieved from http://www.reactive Hypoglycemia diet. (2012). Reactive hypoglycemia. Retrieved from http://www.reactivehypogl Hypoglycemia effects. (2012). Reactive hypoglycemia. Retrieved from http://www.reactive Hypoglycemia foods. (2012). Reactive hypoglycemia. Retrieved from http://www.reactivehypo Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational-age preterm infants. (1999). National Institute of Health. Retrieved from Low blood sugar. (2012). Reactive hypoglycemia. Retrieved from http://www.reactivehypogly Mathews, D. R., & Levy, J. C. (2009). Impending type 2 diabetes. The Lancet, 373(9682), 2178 2179. Mayo Clinic. (2010, January 12). Hypoglycemia Treatment. Retrieved from National diabetes fact sheet, (2011). Centers for Disease Control. Retrieved from

Ramlo, B., & Edelam, S. (2000). The natural history of type 2 diabetes: practical points to consider in developing prevention and treatment strategies. American Diabetes Association, 18(2), 80-85. Retrieved from v18n22000/pg80.htm Sattley, Melissa, (2008, December 17). The history of diabetes. Retrieved from Symptoms of hypoglycemia. (2012). Reactive hypoglycemia. Retrieved from http://www. Treatment of hypoglycemia. (2012). Reactive hypoglycemia. Retrieved from http://www.reactive Vijan, S. (2008). Diabetes mellitus type 2. Philadelphia, PA: PIER. Retrieved from Illustration Credits


Chapter 5 Diet and Heart Disease

Rebecca Stolarczyk and Arjun Tanguturi

Introduction A diet, which is the sum of the food eaten, is not only necessary to a human being, but also potentially beneficial. By keeping a healthy diet, an average human being sustains his body and keeps diseases at bay. Recent studies have shown that healthy dieting can prevent heart disease. Heart disease is the leading cause of death in the United States of America. Here are some essential facts:

Every year about 785,000 Americans have a first coronary attack. Another 470,000 who have already had one or more coronary attacks have another attack (Yetley & Park, 1995). An estimated 7.2 million people die every year because of heart disease (Sherman, 2009). In 2010, coronary heart disease alone was projected to cost the United States $108.9 billion (Yetley, & Park, 1995). For people with heart disease, studies have shown that lowering cholesterol and blood pressure levels can reduce the risk of dying from heart disease, having a nonfatal heart attack, or needing heart bypass surgery or angioplasty.

In developing regions including India, Russia, and the majority of southern Asia, the disability adjusted life years (DALY) lost is close to 30 years per 1000. Not only is this extremely high, but it also reflects upon the diet and exercise that people in these regions obtain.

Death rates from heart disease in the USA


Arrhythmia In a healthy human heart, all of the signals coordinate in a way that maintains the synchronous beating of muscle cells. However, occasionally problems develop with the electrical activity in the heart as the result of certain diseases or genetics. Personal lifestyle choices such as diet and exercise also play a critical role in the development of cardiac issues (Berry et al., 2012). Over 600,000 people are hospitalized every year for cardiac dysrhythmias, also known as arrhythmias or irregular heartbeat. A person with an arrhythmia has abnormal electrical activity in the heart, and therefore an unnatural heart rhythm. There are two main types of arrhythmias: bradycardia, in which the heart has less than 60 beats per minute; and tachycardia, in which the heart has more than 100 beats per minute. The first step in diagnosing an arrhythmia is determining where in the heart it originates. Once this is determined, specific treatment can be given to that region of the heart, if possible. There are several treatment options available to patients with arrhythmias including medicine, implantation of a pacemaker, anticoagulants (to reduce the risk of blood clots), cardiac defibrillation, and cardiac ablation (Your heart's electrical system, 2008).

The sinoatrial and atrioventricular nodes control pacing and beating of the heart.

Cardiomyopathy The term cardiomyopathy refers to disease of the heart muscle, which results in damage to muscle tone and reduction in ability to pump blood. This disease is not only the leading cause of heart failure in the US but also the most common reason for heart failure. Of the 500,000 Americans living with cardiomyopathy, a large number are not aware that they have this condition. For this reason, cardiomyopathy is particularly dangerous because it often goes unrecognized and untreated. In contrast to other types of heart conditions, cardiomyopathy often affects younger people. There are four distinct types of cardiomyopathy: dilated, hypertrophic, restrictive, and ischemic. Dilated cardiomyopathy, also called congestive cardiomyopathy, the most common form of this disease. It is characterized by weakening of the chamber walls of the heart. Dilated cardiomyopathy is usually idiopathic because in most cases, doctors are not able to identify the cause.


Dilated cardiomyopathy condition is characterized by weakening of the chamber walls of the heart. Hypertrophic cardiomyopathy, the second most common form of the disease, is described as the thickening of the hearts walls. This form is primarily genetic, but in some cases the cause is not clear.

A heart with hypertrophic cardiomyopathy has thickened chamber walls. The third type, restrictive cardiomyopathy, is rare in the United States. This condition does not allow for proper stretching of the heart, thus limiting the amount of blood that is able to fill the chambers. The fourth and final form of cardiomyopathy is ischemic. This occurs as a direct result of cardiac ischemia, which in turn usually results from coronary artery disease or heart attacks. In this case, ischemia refers to the narrowing or blocking of an artery so that oxygen-rich blood is unable to reach the heart. This often leads to angina pectoris, or heart pain. Ischemia cardiomyopathy directly describes the weakening of the heart muscle tissue as a result of cardiac ischemia.


Myocardial Infarction Myocardial infarction, also known simply as a heart attack, is the necrosis of heart muscle as a result of prolonged and untreated ischemia. This most often results from the lack of oxygen-rich blood flow to the heart caused by the development of thrombus in a coronary vessel. In some of the most fatal instances, myocardial infarction goes unnoticed and therefore untreated because the patient does not recognize the symptoms. This condition is part of a larger spectrum called acute coronary syndrome (ACS). This continuum includes unstable angina (chest pain), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). The ST-segment refers to changes identified on an electrocardiogram (ECG) which reflect active and continuous myocardial injury.

Myocardial infarction results from the blockage or rupture of a vessel of the heart.

Atherosclerosis Atherosclerosis is a term that refers to the condition in which plaque builds up within arteries. It has recently been discovered that inflammation plays a key role in the severity of this disease. Although inflammationthe reaction that causes redness, swelling, and painis actually one of the bodys defense mechanisms, it proves instead to be harmful in the development of atherosclerosis. This view suggests that incidents occurring from atherosclerosis such as stroke and heart attack arise from the blockage of arteries by blood clots rather than plaque. These blood clots develop from the rupture of obtrusive plaques located within the arteries. These new ideas answer many longstanding medical mysteries, for example, why some heart attacks occur without any initial symptoms. This new view of atherosclerosis also explains why some therapies aimed to prevent heart attacks are often unsuccessful (Libby, 2012). This inflammatory response does more harm than good in this case. Rather than returning to their original state, artery walls become altered. Some of the original characteristics of the vessels are no longer present, and a larger, more complex plaque is developed (Libby, 2012).

The buildup of plaque within the arteries restricts blood flow to and from the heart.

Periodontal Disease Periodontitis is a destructive dental disease that is primarily caused by microorganisms. It generally results in deterioration of periodontal ligament and alveolar bone in concurrence with gingival recession. Recent research has shown that localized infections characteristic of periodontitis can have a prodigious effect on the overall health of both animals and humans (Saini, R., Saini, S., & Saini, S.R., 2010). Statistical analysis of the research has helped conclude that elevated levels of a number of inflammatory molecules may be accurate indicators of cardiovascular disease. It is estimated that more than 500 distinct bacterial species are capable of colonizing in the mouth. Poor dental hygiene and oral infections are the main roots of bacteria, even in the absence of dental procedures. In patients with complex advanced diseases, lesions in the oral cavity can severely impact their quality of life. Generally bacteria collect in patients mouths after dental procedures. However, there is a wide variation in reported frequencies of transient bacteria in patients resulting from dental procedures (Saini, R., Saini, S., & Saini, S.R., 2010).

Tooth deterioration resulting from periodontitis.


The mouth is a reflection of a patients overall health, adverse habits, and nutritional status. It acts as an entry point for microbial infections that affect general health. Many theories have been presented explaining the link between periodontal disease and heart disease. For instance, some scientists infer that oral bacteria can affect the heart when it enters the bloodstream by attaching to plaques in the arterial region. Streptococcus viridian is the main infective agent that is able to enter the bloodstream from areas with great wounds or bleeding such as the oral cavity and it can lodge on the muscles of the heart and cause ulcerations (Saini, R., Saini, S., & Saini, S.R., 2010). Other scientists believe that inflammation caused by periodontal disease increases plaque buildup, which might be the cause of swelling of the arteries, which in turn leads to atherosclerosis and other possible heart complications.

Possible Solutions and Treatment Dietary changes must be made in order to ensure prevention of heart disease. The low-fat Dean Ornish diet and the low-carb Atkins diet both lead to weight loss; moreover, they also help decrease cardiovascular ailments, and help to improve lipid profiles (Sherman, 2009). Recent research in the field of nutritional science has confirmed that long term adherence to such diets may help prevent future cardiovascular misgivings. Alternate studies have also shown that patients consuming a Mediterranean diet, one that comprises low saturated fat, high monounsaturated fat and high dietary fiber, have generally shown far lower rates of cardiovascular disease than people with different diets (Heart disease and diet pills, 2000). Exercise is also a must; a diet without exercise, or vice versa, could lead to various consequences including heightened risk of cardiovascular disease (Sherman, 2009). High-intensity interval training has been shown to increase weight loss, and has also been shown, in concurrence with a regular 2000 kcal diet, to help prevent cardiovascular disease (Van Horn, 2008). In order to maintain a healthy body, diet and exercise must be balanced because they are interdependent components of a healthy lifestyle. Conclusion Heart disease has a huge impact on the mortality rate every year. However, with a moderate of diet and exercise, it can be prevented. A healthy diet is critical to maintain a healthy body and can help prevent life threatening conditions such as cardiomyopathy, atherosclerosis, and myocardial infarction. Unhealthy diets can also lead to oral issues such as periodontal disease, which in turn can lead to heart disease, and thereby cause long term harm. A healthy diet is an essential component towards battle against heart disease.


Berry, J., Dyer, Alan., Harris, M., et al. (2012). Lifetime Risks of Cardiovascular Disease. New England Journal of Medicine, 336, p321-329. Retrieved March 23, 2012 from the New England Journal of Medicine: Cardiomyopathy. (2011). Retrieved March 29, 2012 from Texas Heart Institute: Coronary heart disease. (2012, January). In Encyclopedia Brittanica. Retrieved March 22, 2012, from Encyclopedia Brittanica Online: topic/138261/coronaryheart-disease

Heart disease death rates, total population. (2010, December 20) Retrieved April 7, 2012, from Isenberg, B. , Williams, C. , and Tranquillo, R. (2006). Small-Diameter Artificial Arteries Engineered In Vitro. Circulation Research 98, 25-35. Retrieved October 6, 2011, from Highwire Press Kritchevsky, D. (1994, July). Diet and Heart Disease. South African Medical Journal. 26 Libby, P. (2008). Atherosclerosis: The New View. Retrieved March 23, 2012 from Scientific American: More on heart disease and diet pills. (2000, July). Harvard Heart Letter, 10(11), 5. Saini, R., Saini, S., and Saini, S.R. (2010). Periodontal disease: A risk factor to cardiac disease. Annals of Cardiac Anesthesia, 13(2), 159-161. Sherman, L. (2009, October). Diet and Heart Disease. The Journal of Chinese Medicine, 91, 81. Van Horn, L. (2008). Diet and Heart Disease. Journal of the American Dietetic Association. 108(2), 203. Your hearts electrical system. (2008). Yardley, PA: The StayWell Company Zafari, A. (2012). Myocardial Infarction. Retrieved March 29, 2012 from Medscape:

Illustration Credits media/medical/hw/h9999145_001.jpg


Chapter 6 Vegetarian and Vegan Diets

Dhroova Aiylam and Cameron Root Vegetarianism is broadly defined as the practice of eating foods entirely based on plants or the practice of a diet containing no meat. Multiple studies in recent years show an increase in the number and proportion of vegetarians relative to total population; for example, a study by the United States Department of Agriculture found that the number of self-classified vegetarians had increased fivefold after a span of fifteen years. Studies also show a growth in the number of vegetarians under the age of 18; one also states that those with meat in their diets are also shifting towards a greater vegetarian orientation, consciously consuming less meat and more plant-based foods. Because of these changes, some large producers of food products and retailers have diversified their vegetarian alternatives to meat or meatbased foods (Janda & Trocchia, 2001). There are four subgroups of vegetarians categorized by the additional foods they restrict (apart from meat). Lacto-ovo-vegetarians apply no further restriction and simply avoid meat products. Lactovegetarians refrain from eating eggs or any food containing eggs; ovo-vegetarians eat eggs but avoid dairy. Lastly, vegans avoid all animal products including, in most cases, honey and animal-based material (Rubin, 2002). Four motives behind individuals' becoming vegetarian are easily identifiable, although many other reasons for adopting the practice exist. These four, which can be reasonably asserted as the principal motives behind vegetarianism, are ethics, health, sensory effects, and influence; there is substantial overlap between them. Less prevalent reasons for vegetarianism include ecology, economy, concern for world hunger, and religion (Janda &Trocchia, 2001; Rubin, 2002). Ethics are the most common reason behind a vegetarian diet. Most vegetarians have two types of ethical concerns: care for the welfare of animals and a guilty conscience related to killing animals. As for the first, many vegetarians empathize with animals and cite numerous reasons why they oppose standard practices of treating animals raised for food; among these are the location and manner in which the animals are treated, the use of substances such as hormones to cause unnatural effects on animals' bodies, and the objectification of animals. Other ethical vegetarians may have chosen their diet because they had owned pets earlier in life, particularly in childhood. However, the larger concern of many ethical vegetarians is the inability to condone the killing of another living creature. This is reflected in multiple religious beliefs, such as Buddhism, which holds as a principle the aversion of unnecessary harm wrought on anything alive. Even those without religious considerations, however, typically believe that animals cannot be senselessly destroyed or eaten with a clean conscience. Yet many vegetarians consume milk, honey, or eggs without guilt, because the production of these foods does not require the death of an animal (Janda & Trocchia, 2001). The next-greatest motivation is the factor of health and the commonly held belief that a vegetarian diet is healthier than an omnivorous one. Studies indicate that vegetarian diets contain little saturated fat, animal protein, and cholesterol, if any, and they typically contain elevated levels of phytochemicals, carotenoids, folates, and antioxidants. As a result, vegetarian diets are associated with lowered risks of many major diseases. The number of health-motivated vegetarians has risen in the past century from nearly zero to a large population, especially in the United States. As an effect, many foods labeled as organic and natural have increased in tandem. Other sources for health-motivated vegetarianism include the negative health effects of eating meat, especially those concerning hormones and chemicals administered to animals, which are subsequently consumed by humans (Janda & Trocchia, 2001).

Sensory vegetarians avoid meat because they have a conscious dislike for its taste, smell, texture, or sight. This may originate from an imagination of the animal when it was alive or upon reflection on the death of the animal. Many ethical or health-based vegetarians perceive some or all of these sensory perceptions as negative. There is an entire range of ways in which vegetarians display an aversion to the sensory impact of meat. Some may view public displays of meat (e.g. in a butcher's shop) or even the sight of vegetarian foods made to imitate meat as repulsive. Others may dislike the sight of blood in meat or meat-based foods. However, a substantial number of sensory vegetarians consciously see others eating meat and regard it as cannibalistic and therefore a source of negative reinforcement. The last major motivation for vegetarianism in general is a vegetarian influence on a previously non-vegetarian person, which then causes latter to feel a need to emulate this influential other. This person can be a parent, a friend, or anyone else with a substantial amount of influence on the person. Of course, one may become a vegetarian for solely societal reasons: vegetarians are typically viewed as more health-conscious and self-disciplined than non-vegetarians. This is an important factor in a cultural phenomenon that has been occurring in recent decades, in which the state of being a vegetarian becomes viewed as trendy and special. This results in many meat-eaters' experiencing a societal aspiration to be classified as vegetarian; because the definition of vegetarian is subjective, some meat-eaters, especially those who consumed only fish, poultry, and plant products, then fulfill their social need and call themselves vegetarians, either by actually giving up all meat or by giving up only red meat. Any people of this type generally have little motivation to remain vegetarian, and they are the most likely to give up and return to an omnivorous diet. Those who truly do not consume any animal products may react with indignation to these individuals and become defensive of their own status as vegetarians (Janda & Trocchia, 2001).

History of Vegetarianism and Veganism The first recorded individual to live with a diet of no meat was Pythagoras of Samos. Shortly thereafter, other Greek philosophers such as Plutarch, Epicurus, and Plato took on this lifestyle choice as well. This practice continued through the centuries with relatively small followings, and in the midnineteenth century, the Vegetarian Society in England was popularizing the term vegetarian. Gradually, the global number of vegetarians increased. It was in the year 1944 when Donald Watson invented a new and stricter lifestyle, that of total abstinence from animal products. This would become veganism, the first offshoot of vegetarianism. Watson proposed that his newsletter on the subject would be called the Vegan News, and defined veganism as a diet of solely fruits, vegetables, nuts, grains, and other beneficial nonanimal products. Vegans thus became a discrete group, living more rigorously than vegetarians, who typically allow the consumption of dairy, eggs, or honey, and the use of leather, wool, and other such material. Indeed, if a vegetarian were to eschew all animal products, he or she would be generally considered a vegan (Safire, 2005). Other side branches exist in the world of vegetarianism: pescetarian or pesco-vegetarian is used for persons who eat seafood, but no meat or fowl; rawism describes a person who consumes only raw fruits and vegetables; a flexitarianist is anyone who eats like a vegetarian at home but consumes meat when dining out. All of these evolved from vegetarianism after veganism was established (Safire, 2005).

Protein in Vegetarian Diets Constructing a nutritionally complete vegetarian or vegan diet is a challenge of its own. Because they restrict if not abandon several of the food groups, vegetarian and vegan diets are predisposed towards nutritional imbalance. Specifically, fruits and vegetables are consumed in excess, yet there is a deficiency

of those nutrients that are generally obtained from animal meat or by-products. However, it is possible to tailor what one eats to address this discrepancy. Protein, vitamin B12, zinc, and selenium, the nutrients most lacking in a vegetarian or vegan diet, can be obtained from vegetarian and vegan sources. To do this is, of course, no small feat; it is difficult to consume them in adequate amounts unless one makes an explicit attempt to include rich sources in his or her diet. Most people believe protein is the primary concern of vegans and vegetarians. Though it may be, that concern is in fact misguided. Many people, especially athletes, consume far too much protein. In reality, only 1 of every 10 calories consumed should be protein. Athletes actually do not need more protein than non-athletes (Campbell & Venderly, 2006), and store-bought protein supplements are unnecessary and potentially harmful. Unlikely as it may seem, the average person gets more protein than he or she should be getting. It is especially important for the vegan, who does not eat animal flesh or by-products, to consume a healthy amount of protein. The recommended daily allowance is 0.8 g of protein for every kilogram of body mass. Interestingly, the average vegan consumes 10 12 percent of their calories as protein, as opposed to the 14 18 percent of non-vegetarians. While it is clear that vegan diets are considerably lower in protein, it is also clear that vegans are, in fact, consuming as much protein as they should (Vegan Nutrition, n.d.). In fact, excess protein can increase risk of osteoporosis and even result in kidney failure. For those who feel they are not consuming an adequate amount of protein, the following is a list of suggestions of foods they can add to their diet to remedy this (Protein in Vegetarian Diets, n.d.) Breakfast Foods: Oatmeal, soymilk, whole grain cereals Snacks: Peanut butter, nuts, soy yogurt Main Course: Brown rice, soybeans, lentils, beans, peas, tofu (Tempeh and seitan are also very high in protein, but are less popular) For those vegetarians who are comfortable consuming eggs and dairy products, foods like milk, eggs, cheese, and butter are additional sources of protein that are easy to incorporate into the diet. Proteins are required for healthy function because of what the body does with the amino acids of which they are made. The human body uses the standard 22 amino acids either as a means to build proteins and other bio-molecules or as a source of energy. Of these 22 amino acids, 9 are essential because the body cannot synthesize them on its own, and the rest are nonessential. Four of these thirteen are considered semi-essential amino acids because the bodys production of these amino acids is not fully established (Ornish, 1995). The nine essential amino acids (isoleucine, leucine, lysine, methionine, phenylalanine, serine, threonine, tryptophan, and valine) are very easy to find in natural vegetarian sources. They can be found in most vegetarian protein options, including nuts, seeds, beans, whole soy, whole grains, and vegetables (Vegetarian Diet, n.d. ).


This table documents the relative levels of amino acids in popular vegetarian foods:

Vitamin B12 While they may not always be comparable to omnivorous diets in terms of protein, vegetarian diets usually have no problem supplying adequate amounts of vitamins and minerals for good health. One important exception to this trend, however, is Vitamin B12. Ovo- and lacto-vegetarians (who consume some kind of animal by-product), while predisposed to a B12 deficiency, can find ways to make up for it. For vegans, however, it is almost impossible to include a source of Vitamin B12 in their diets, so this vitamin must come from a source other than food (Weil, 2004). The amount of B12 the body needs is very small between 1 and 6 micrograms a day (Vitamin B12, retrieved March 22nd, 2012). However, not getting this small but required dosage can cause serious problems. Also, the act of simply ingesting it is not enough it must be absorbed in order to have nutritional value. Again, the consequences can be serious. Vitamin B12 stimulates the bodys use of proteins, fats, and carbohydrates; it also boosts energy. It is necessary for cell division and critical for the well-being of the heart and nervous system. The major risk associated with a B12 deficiency is pernicious anemia. This dangerous disease affects many of the bodys organ systems, particularly the vascular and the nervous. Sufferers not only contract regular anemia, but they also lose coordination, sensation in their appendages, and immune system strength. Memory loss, dizziness, and depression are other common symptoms. Worst of all, it is very difficult to recover after the disease has been contracted (Vitamin B12, n.d.). How, then, can vegetarians and vegans avoid this undesirable fate? Of these two, the former are at a lesser risk they can usually obtain B12 from eggs, dairy, or other animal by-products. Vegans, on the other hand, are forced to obtain the vitamin from less natural sources. Fortified foods, like cereals and soy milk, are usually the most accessible and reliable way to ingest a healthy amount ( Vitamin B12, retrieved March 22nd, 2012). As a last resort, most multivitamins contain the RDA of vitamin B12. It should be noted that B12 is a cofactor, because it is not directly consumed. Rather, it is reused by the body. Eventually though, it runs out, and because it is of paramount importance, it must be reingested (Ornish, 1990). For people who are in particular need of vitamin B12, alternatives include


supplements and, in more serious cases, shots. Generally, however, it is possible and better to obtain B12 from a natural or semi-natural source. The following table shows vitamin B12 content as a percentage of the RDA (only the bottom few foods are vegetarian):

Trace Minerals in Vegetarian Diets

Aside from proteins and vitamins, trace metals, such as nickel, copper, and manganese, are also an essential part of a complete diet. The nature of the vegetarian diet makes it easier to obtain certain metals than others; for example, the adult vegetarian diet generally lacks zinc and selenium, whereas it has a higher concentration of copper and manganese. In most diets, cereals are the primary source of copper, manganese, and selenium (Gibson, 1994). However, the cereal also takes on the job of providing zinc in a vegetarian diet, which is often inadequate by itself. While multivitamins generally contain adequate amounts of the metals, there are many natural vegetarian sources for this missing zinc and selenium that can be incorporated into the diet. In most omnivorous diets, the principal sources of zinc are oysters, shellfish, liver, and muscle meats (Weil, 2004). Selenium is generally found in fish, liver, kidney, and Brazil nuts. None of these are vegetarian sources, with the exception of the Brazil nuts, and most of the food items that vegetarians replace these with, fruits and vegetables, have high water contents (Gibson, 1994). Although traditional meat substitutes like soy and tofu make up for the protein deficiency in the vegetarian diet, they do not carry with them the minerals that animal protein sources do. Nonetheless, meat substitutes like eggs and legumes are generally the secondary sources of zinc in the vegetarian diet, followed by milk and dairy products. Selenium is quite different. It is rather difficult to obtain selenium in a vegetarian diet from a source other than the Brazil nut because its other primary source is seafood. Luckily, Brazil nuts are extremely rich in selenium and thus offer a suitable substitute for their flesh food counterparts.


However, vegetarian diets do receive an advantage in some trace metals. Copper and manganese are present in abundance because they are found in large quantities in cereals, legumes, nuts, and leafy green vegetables (Gibson, 1994). The second and third of these, being meat substitutes, are much more likely to be consumed as part of a vegetarian diet. Diets that include unrefined cereals, like brown rice, are still better sources of these two trace metals. The table below provides a general evaluation of the vitamin and mineral content of fruits and vegetables:

Effects of Vegetarianism A commonly held belief is that a vegetarian diet results in a multitude of positive health benefits, a result that has been substantiated by several studies. Vegetarians have typically displayed a lower bodymass index and risk of certain chronic diseases. However, vegetarians also take certain risks by omitting meat from their diet; vegetarians must be careful and vigilant in order for their diets to be nutritionally adequate. Some types of vegetarian diets, despite their avoiding meat products, remain high in saturated


fat and cholesterol, and sparse diets such as those poor in grain or protein products are insufficient for the body's required amount of vitamins and minerals (Rubin, 2002). All vegetarians, especially vegans, risk becoming deficient in their protein, zinc, calcium, iron, vitamin B12, and vitamin D. Riboflavin (vitamin B2) and linoleic acid may also be missing from an unstructured vegetarian diet. Child vegetarians must also obtain a sufficient amount of energy from a diet largely composed of fiber, which fills the stomach but provides few calories. Additionally, most plantbased foods lack some portion of essential nutrients found mostly in meat. However, over the course of a day, a balanced vegetarian diet will complement itself and complete the necessary vitamin and mineral intake; this will even make it unnecessary to ingest vitamin supplements (Rubin, 2002). One study suggested that vegetarian diets are one of the most important factors in mortality rates, second only to smoking. It compared vegetarians with non-vegetarians of similar lifestyles, and its intention was to test the hypothesis that vegetarians have reduced rates of mortality from several types of cancer and ischemic heart disease. The primary subjects analyzed were those for whom full information was known on dietary and smoking habits (Key et al., 1999). Although the proportion of smokers was found to differ between studies, all results showed that a group of vegetarians contained fewer smokers and alcohol consumers than an equal group of nonvegetarians. In addition, the former group was also shown to have a lower body-mass index and higher frequency of exercise than non-vegetarians. After being adjusted for age, smoking status, and gender, death rates for long-term vegetarians (t > 5 yr.) from the causes above were found to be significantly lower than those for short-term vegetarians (0 yr. < t < 5 yr.) (Key et al., 1999).

Bibiography Campbell, Wayne W., and Angela M. Venderley. "Vegetarian diets: nutritional considerations for athletes." Sports Medicine 36.4 (2006): 293+. Academic OneFile. Web. 22 Mar. 2012. Gibson, R. (1994). Content and bioavailability of trace elements in vegetarian diets. American Journal of Clinical Nutrition. 1223S 32S . Helman, A. and Darnton-Hill, I. (1987.) Vitamin and iron status in new vegetarians. The American Journal of Clinical Nutrition, 45, pp. 785-789. Key, T., Fraser, G., Thorogood, M., Appleby, P., Beral, V., Reeves, G., Burr, M., Chang-Claude, J., Frentzel-Beyme, R., Kuzma, J., Mann, J., and McPherson, K. (1996.) Mortality in vegetarians and nonvegetarians. The American Journal of Clinical Medicine, 70, pp. 516-524. Ornish, D. (1990). Dr. Dean Ornish's Program for Reversing Heart Disease. New York: Random House. Ornish, D. (1995). Everyday Cooking with Dr. Dean Ornish. New York: Harper Collins. Phillips, F. (2005.) Vegetarian nutrition. Nutrition Bulletin, 30, pp.132-167 Protein in Vegetarian Diets. Retrieved March 23rd, 2012 from Rubin, K. (2002.) Vegetarian diets. Foodservice Director, 15 (5), pp. 66 Safire, W. Vegan. (2005, Jan 30.) The New York Times Magazine. 24.

Turner-McGrievy, G. (2010.) Nutrient adequacy of vegetarian diets. Journal of the American Dietetic Association, 110 Vegan Nutrition. Retrieved March 22nd, 2012 from "Vegetarian diet." CareNotes. Thomson Healthcare, Inc., 2011. Health Reference Center Academic. Web. 22 Mar. 2012. Vegetarian Diet: How to Get the Best Nutrition. Retrieved March 22nd, 2012 from Vitamin B12. Retrieved March 23rd, 2012 from Weil, A. (2004). Natural health, Natural Medicine. New York: Houghton Mifflin Company.

Illustration Credits


Chapter 7 Childhood Obesity

Emma Hewett, Sierra Harris, Angelica Heeney, and Divya Satishchandra Introduction Childhood obesity, which has tripled in the last thirty years, has become one of the most threatening health crises in the last decade. In fact, more than one third of children and adolescents were overweight or obese in 2008. Obesity has several immediate health effects. For example, obese youth are at greater risk of developing contributors to cardiovascular disease such as high cholesterol and hypertension. In addition, children are more likely to acquire pre diabetes, joint problems, and sleep apnea. Other psychological concerns are stigmatization and poor self-esteem. Perhaps more harmful are the long term effects of adolescent obesity, known as co morbidities, which comprise the risks of developing type 2 diabetes, stroke, and osteoarthritis. Furthermore, obese infants are at greater risk of becoming obese adults. Childhood obesity also increases the probability of acquiring cancer of various forms such as the breast, colon, endometrium, esophagus, kidney, pancreas, gall bladder, thyroid, ovary, cervix, and prostrate (Childhood Obesity Facts, 2011).

The best method of preventing childhood obesity and its many harmful effects is to maintain healthy eating habits and to engage in sufficient physical activity. Along with this, establishing safe and healthy domestic and school environments is crucial in preventing adolescent obesity. Overweight vs. Obesity Medical professionals use the BMI, or body mass index, to determine whether a child is overweight or obese. Doctors consider the height, weight, and specific gender and sex percentiles in order to calculate the BMI. A person is overweight when he has a BMI above the 85th percentile and below the 95th percentile of children with the same gender and sex, which essentially translates into having an excess body weight for a particular height arising from fat, muscle, bone, water, or a combination of these factors. Obesity is defined as having a BMI above the 95th percentile of children with the same gender and sex, which corresponds to having dangerously excessive amounts of body fat. However, both are result of a caloric imbalance: when the calories consumed is greater than the calories burned. The final stage of obesity is morbid obesity, in which a person is 50-100%, or 100 lbs. above their normal body weight (Basics about Childhood Obesity, 2011).

Environmental Influences on Childhood Obesity Physical Activity Researchers agree that environment plays a critical role in the likelihood of developing obesity. The built environment comprises the buildings, institutions, infrastructure and social norms that affect a persons environment. The two primary causes of adolescent obesity that arise from a childs environment are lack of physical activity and dietary habits.

Scientists are aware that physical activity vital to the caloric balance, and now they are trying to determine its relationship to the environment and how the lack of exercise contributes to obesity. Many findings suggest that adolescents with more access to recreational facilities are more fit than children who do not have access to such locations. Also, other studies have reported that spending time outdoors has a strong correlation to physical fitness in pre-schoolers. Accessibility to recreational facilities is another matter entirely. Other studies have shown that low income neighborhoods have fewer areas designated for physical activity, which puts kids living in these regions at a disadvantage. While these studies indicate a definite relationship between obesity and physical activity in the built environment, the research is not entirely accurate because the data was based on information provided by the parents, as opposed to direct observation. Nutrition Nutrition and dietary patterns are also a major component of the obesity equation; however, less research has been conducted to determine its connection to the built environment. Nonetheless, a few sources have demonstrated that the availability of nutritious foods such as fruits and vegetables in schools is related to childrens overall consumption of fruits and vegetables. Such findings suggest that the dietary practices at home are in need of improvement. One growing trend is the routine occurrence of dining out as a result of time or financial constraints. Restaurant food is higher in calories and lower in nutritional value, and habitual consumption could potentially lead to overweight and obesity. Many studies have also been performed with the goal of determining trends with the availability of healthful food options in neighborhoods that vary by income. Researchers were able to conclude that people living in low income neighborhoods have limited access to nutritious food options, and the resources that do exist are available at a much higher cost than those obtainable by families living in more affluent communities (Sallis & Glanz, 2006). Influence of Obese Parents Scientists have also studied the effects of having overweight or obese parents on the development of adolescent obesity. Research demonstrated that having an overweight parent increased the probability of developing unhealthy practices and subsequent weight gain. More specifically, having two obese parents increased the risk of adolescent obesity when compared to the risk associated with having two parents of normal weights. Having two severely obese parents further amplified these risks. Scientists also discovered that an obese maternal figure has greater influence than an obese paternal figure (Whitaker, Jarvis, Beeken, Boniface & Wardle, 2006).

School Environment and Other Factors Public schools tend not to have time devoted to exercise either, and this lack of mandatory physical activity compounds the issue of children not exercising in their free time. Not only do public schools lack the recommended one hour of physical activity per day recommended by the center for disease control, they also tend to carry unhealthy alternatives to wholesome meals on their cafeteria menus. Alongside the turkey sandwiches and fruit salad, excessively large slices of pizza and bags of crisps, chips, and cookies are found in the cafeteria. As far as options for drinks are concerned, many schools make sugary sodas and pops easily available for purchase via vending machines, although most schools do carry both two percent and whole milk. The situation is worse in alternative childcare facilities, for which very many states do not carry legislature requiring the programs to provide nutritious meals.


A typical school lunch.

Other environmental factors have also been examined for their impact on the development of childhood obesity. These include social factors, birth weight, and family size. For example, although the subject has not been thoroughly investigated, experts have established a relationship between socio economic status and obesity. According to recent studies, people with low socio economic status early in life, were more common to develop obesity in late adolescents and adulthood. In addition, not to their surprise, researchers also discovered a relationship between higher birth weight and childhood obesity. However, the potential social causes of obesity have not been explored extensively, and more research is necessary to make generalizations about the other potential environmental triggers of obesity (Parsons, Power, Logan, & Summerbell, 1999). The Role of Genetics in Childhood Obesity Recent studies have shown that genetics may play a role in the development of childhood obesity. Researchers continue to add to the human gene map, and the number of locations associated with obesity is increasing. Currently, there are more than 430 regions which indicate a relation with obesity phenotypes; however, most specific genes are still unknown. In fact, genetic factors explain between 60 and 80% of the variance of body mass index and body weight (Burrage & McCandless, 2007). Scientists are becoming increasingly more certain that weight is in fact a heritable trait; however, the dramatic increase in instances of childhood obesity is more likely a result of environmental changes (Anderson & Butcher, 2006).

Monogenic Obesity and Hormonal Abnormalities The genetics of obesity fall into two separate categories: syndromic obesity and monogenic obesity. Syndromic obesity is characterized by the presence of other conditions such as hypotonia, mental retardation, short stature, and other abnormalities. Monogenic obesity, in contrast, is distinguished by extreme body weights. The first gene recognized as having a critical impact on human body weight control was leptin, an adipocyte hormone. Leptin is released by the pituitary gland, and incites neurons in the hypothalamus which produce proteins that stimulate physical activity. In addition, leptin controls the hypothalamic neurons that instigate feeding. As a result, a leptin deficiency causes hyperphagia and increased energy intake, subsequently increasing the sedimentation of fat (Anderson & Butcher, 2006). In

one study, research examined two children of Pakistani origin who were severely obese. Both had extremely low levels of leptin in their bloodstreams. In fact, both children had a homozygous mutation of the leptin and melanocortin receptor gene, which, scientists now know, is associated with cases of morbid obesity (Farooqi, 2005). In a later study, however, researchers ascertained that heterozygous combinations of the leptin gene and its receptors have shown had minimal impact on body weight control. In order to fight childhood obesity resulting from leptin deficiencies, scientists have attempted leptin therapy, in which the hormone is regularly injected into the bloodstream. Three children were administered leptin doses for 48 months, and all three showed significant reductions of body weight, of which 98% was body fat. Other hormonal abnormalities arising from genetic mutations associated with adolescent obesity include deficiencies in the melanocortin 4 receptor and prohormone convertase 1. Since the late 20th century, mutations, in the melanocortin 4 receptor have been linked to adolescent obesity. Experts suspect that receptor trait is dominant because some studies have shown that 100% of the subjects who posessed heterozygous mutations also demonstrated obese phenotypes. However, further investigation is necessary because other analysis has shown that homozygous carriers of the trait were reported to be more obese than carriers with heterozygous combinations. MC4R deficiencies causes hyperphagia and an increased amount of fat mass. In addition, scientists have noted an accumulation of lean mass and noteworthy heightened levels of bone mineral density (Farooqi, 2005).

Hormonal levels play a significant role in childhood obesity.

Other Hormonal Causes of Obesity In addition to leptin, and melanocortin, other hormones have been examined for their role in the development of childhood obesity. One such hormone is adiponectin, a protein hormone which controls many metabolic processes including, glucose regulation and fatty acid catabolism. Adiponectin is released from the adipose tissue, and its levels in the bloodstream are inversely proportional to the body fat percentage. The hormone promotes energy expenditure, and as a result has been analyzed in studies pertaining to obese children. In one report, researchers observed the levels of adiponectin in obese and non-obese children of Greek descent. The adiponectin levels in the obese subjects were significantly lower than the levels of the non-obese subjects. In addition, the adiponectin levels steadily decreased as the subjects went through puberty, which further exascerbated the obesity issue. Further, male adolescents had the lowest levels of adiponectin, and later studies revealed a relationship between the adiponectin

levels and increased levels of testosterone. Adiponectin also played a role in the resistance of another hormone: insulin. Insulin, a hormone produced by the pancreas, is the most important hormone in monitoring the sugar levels and fat expenditure in the body. The hormone causes liver, muscle, and fat tissue cells to absorb glucose from the blood and store it as glycogen for future use. In addition, insulin prevents body from using fat as an energy source by hindering the release of glucagon, another hormone. Insulin resistance occurs when the hormone is defective in regulating the amounts of blood sugars. When the glucose levels increase, other health complications, such as obesity, can arise. As previously mentioned, adiponectin deficiencies have been correlated with insulin resistance in boys and girls. According to this study, children with adiponectin deficiencies also demonstrated insulin resistance, and subsequent obesity. These results suggest that adiponectin levels are a reliable source for information regarding a childs likelihood of developing obesity because it inversely affects another critical condition, that is, insulin resistance (Panagopoulou, et al., 2008).

Biological Changes Associated with Obesity Gout is the most common form of inflammatory arthritis and results from uric acid crystal deposits throughout the body. Having a protein-rich diet and being obese are among the common causes of this joint condition. Back and knee pain are prevalent in overweight and obese populations and can lead to forms of arthritis. Osteoarthritis (OA) is common among individuals over the age of 55. Before age 55, obesity is a major cause of OA. The added weight increases the amount of wear on joints such as the hip, knee, ankle, and foot. Liver cirrhosis is a scarring of the liver tissue caused by liver disease. Liver disease relating to obesity is called nonalcoholic fatty liver disease (Erickson, 2008). Nonalcoholic fatty liver disease (NAFLD) is the inflammation of the liver not associated with alcohol consumption. NAFLD is dangerously common in the United States population. About 20% of all Americans, 75-92% of obese Americans, and 13-14% of pediatric Americans have the disease. A sedentary lifestyle, a saturated fat rich diet, obesity, type 2 diabetes, and genetic predisposition are among nonalcoholic fatty liver disease risk factors. Adipose tissue releases hormones as an endocrine organ. Some of these cytokines and chemokines also cause the progression of NAFLD (Erickson, 2008). Nonalcoholic fatty liver disease is associated with the amount of visceral fat. A chronic elevation of inflammatory mediators in the body is related to the amount of fat mass in the splanchnic region. In a healthy body, the liver is the largest location of these inflammatory mediators; however, in an obese body, the adipose tissue can produce inflammatory mediators (Tordjman, Guerre-Millo, & Clment, 2008). Adipose tissue is converted into pro-inflammatory molecules in the liver and lymphoid organs, leading to other disease and complications of the liver. Adipose tissue macrophages, which are a large source of inflammatory effects, are linked with obesity complications. For instance, accumulation of these adipose macrophages in the liver can cause an increase in free fatty acid and increase in pro-inflammatory factors. Together, these factors cause liver damage leading to disease (Tordjman, Guerre-Millo, & Clment, 2008). Metabolic Syndrome and Other Complications The metabolic syndrome is defined as the combination of conditions that cause a greater risk factor for cardiovascular disease and diabetes. Obesity is often considered the most prominent factor

contributing to the metabolic syndrome. A high fat diet especially in obese patients strains the endoplasmic reticulum and causes excess glucose production. This is a natural, healthy response to fasting; however, the reaction is harmful and falsely activated because of obesity. This overproduction of glucose can often cause insulin-resistance ("How obesity increases," 2009). Hypertriglyceridemia (high blood level of triglycerides) is generally considered an element of the metabolic syndrome, and the a major cause of the condition is obesity. When combined with other conditions, the risk of colon and rectal cancers, pancreatitis, cardiovascular disease, and diabetes increases dramatically. Hypertriglyceridemia may also be associated with atheroma and plaque build-up (Giovannucci & Michaud, 2007). Diabetes Adult-onset diabetes, or type 2 is greatly influenced by physical inactivity and obesity. Insulin production is depleted because of the loss of pancreatic beta cells, which store and release insulin to control the level of glucose in the blood. Although obesity originally is a strong risk factor for hyperglycemia (high blood sugar) and hyperinsulinemia (high blood level of insulin), the depletion of beta cells will eventually cause insulin levels to drop. The risk of pancreatic cancer for an obese individual ranges from 1.5 to 3.0 times the risk of a healthy weight individual (Giovannucci & Michaud, 2007). In addition to obesity, a major contributing factor of hyperinsulinemia is physical inactivity. Insulin sensitivity is increased by and circulating insulin is decreased by physical activity (Giovannucci & Michaud, 2007). Skin Defects Obesity has a strong effect on skin as well. The function of the skin as a barrier is impaired in an obese individual. These patients experience a greater water loss through the skin, and this data suggests that there is a fundamental change in the epidermis. Other problems include increased skin dryness and a significantly impaired skin repair. It has also been suggested that obesity has caused an increase in sweat gland activity. The surface of the skin in the skin folds of obese individuals has been shown to have a higher pH (Yosipovitch, DeVore, & Dawn, 2007). Because lymphatic flow is reduced by obesity, there is a build-up of protein-rich under the skin. This collection causes reduced tissue oxygenation and a dilatation of tissue channels. Lab tests with mice show that obesity decreases the ability to heal wounds. This depleted skin strength is caused by the lack of sufficient collagen to equal the increased surface area (Yosipovitch, DeVore, & Dawn, 2007). Hormonal Abnormalities As a Result of Obesity Adipose tissue has a strong effect on the hormone production and secretion in the endocrine system. Studies are now suggesting that adiponectin, one of the major hormones associated with obesity, can cause osteoporosis. In these studies, patients with higher levels of the hormone had weaker skeletons and more bone fractures on average. Higher adiponectin individuals also tended to have weaker muscles, making these patients more susceptible to bone damage ("Obesity hormone adiponectin," 2011). There is a change in the sex hormones in the body associated with obesity. These changes cause a risk of prostate cancer, as well as other changes. Obesity has been shown to reduce the production of testosterone and an increased level of estradiol. Leptin is a hormone that manipulates body weight by controlling the use of energy. The body of an obese patient has become resistant to leptin. These hormone

problems are not only associated with obesity, but any higher BMI (Giovannucci & Michaud, 2007). Childhood obesity has an effect on the pubertal development. Leptin and insulin levels are the proposed cause of this altered process as well. Obesity tends to cause earlier development in girls, while it causes a delay in boys (Giovannucci & Michaud, 2007). Successful pregnancy rates are depleted by obesity and are only partially restored after weight loss. There are several factors linking the two. High insulin levels are one because high insulin can cause will reduce the level of sex hormone-binding hemoglobin and raise the levels of growth-factor 1. High insulin levels in the body can also lead to hyperandrogenaemia, the excessive production of androgens. Unhealthy levels of leptin and antiponectin are also likely causes of reduced ovulation and conception rates (Norman, 2010). Whereas female reproductive success is invariably reduced by obesity, there is much less evidence to suggest a similar problem with males. High insulin levels in the female frequently cause poor quality oocytes and a poor quality endometrium. Because of these issues, many assisted fertility organizations will not give treatment to obese patients until they lose weight. In males, obesity can cause overall lower testosterone levels, there is not enough evidence to suggest that there is an effect on semen production (Norman, 2010). The troubles do not stop once pregnancy is achieved. Dangerous complications may arise for the mother, and the effect on the unborn child is negative. An obese mother leads to growth issues in the developing baby. The baby will have a disproportionally greater fat mass and will be overweight. Overweight babies are more likely to have metabolism disorders, to have vascular issues, and to grow up to be overweight adults (Norman, 2010).

A child with ROHHAD, a rare overgrowth syndrome. Co-morbidities Associated with Childhood Obesity Obesity is almost guaranteed to give way to medical complications. Some complications are common, some are infrequent, and others are more or less severe. But that so many of our children today suffer from obesity and will continue to suffer well into their adult life is concerning, to say the least. Some of the more effects that overweight youth can suffer from include heart disease, diabetes, and early death, but data on the very young is generally lacking.


In 2011, an Australian study concerning the co-morbidities of grade school children found that similarly to adults, the obese and overweight were more likely to suffer from musculoskeletal joint pain, especially in the knees. Also as in adults, the overweight children selected for the study suffered from high blood pressure, although only one suffered liver damage from their condition But joint pain and liver damage are not the only conditions that the overweight youth experience. In Alabama, nearly a third of all obese children between the ages of five and eleven suffer from pulmonary hypertension, a disease that leads to swelling of the heart and eventually death. A child might also suffer from high cholesterol, which greatly increases the likelihood of a heart attack.

A photomicrograph of nephron tissue that is clogged with cholesterol. In addition to the more obvious physical pressure that obese and overweight youth suffer from comes a psychological pressure from their peers. Children with high levels of adiposity are more likely to be bullied or taunted because of their weight, and this social stress leads to higher rates of depression among the obese. Despite no correlation being found between eyes, nose, and throat conditions in the Australian study, it is thought that asthma is a co-morbidity of obesity, or at least that obesity changes the expression of asthma in children. It is already known that excess adipose tissue may cause breathing to become more labored and more difficult, especially during sleep.

Treatments and Prevention As a growing problem, childhood obesity is the subject of research worldwide. In particular, researchers are striving to find better therapies as well as to improve the treatments already in place. This research has included diet studies, experimental surgeries, clinical trials, pharmaceutical trials, and long term patient follow-up. This section will cover diet studies, surgical treatments, and prevention measures. Diet indeed has an effect on obesity, but not nearly as much as hormonal activity and biological factors. Diet studies were originally centered on a low calorie intake with a high calorie output lifestyle. However, in recent years, doctors have found this approach to be rudimentary and ineffective. The focus has shifted to the type of foods involved in the patients diets. The two main types of diets being explored are a low-fat, calorie-restrained diet and a low-carbohydrate, unrestricted calorie diet.

The surgical treatment of childhood obesity has been under scrutiny and has undergone much development in the past years. Originally the only surgical option was the gastric bypass, which changes the digestive tract to bypass the stomach. However, research has presented two additional options which are biologically safer as they maintain the natural digestive process of the body. These options are gastric banding and the vertical sleeve procedures.

Diet Investigation into childhood obesity has shown that the correlation between diet and obesity is not as strong as once was believed. However, it is still an important aspect in the treatment and prevention of the disease. Two main focuses of this section are the low-fat, calorie restricted diet and the lowcarbohydrate, unrestricted calorie diet. The low-fat, calorie restricted diet does just as it sounds. It centers on eating low fat foods and restricting the calories consumed. The low-carbohydrate, unrestricted calorie diet limits the consumption of carbohydrates but does not restrict the amount of calories consumed. Low carbohydrate foods are meats, vegetables, and cheeses.

A low-carbohydrate meal A study involved participants separated into two groups, each on either the low fat diet or the low-carbohydrate diet. After six months, weight loss in the low-carbohydrate group was significantly lower than in the low-fat group. Triglyceride levels, or fats in the blood, were analyzed before and after the study and the low-carbohydrate group showed a substantial decrease in levels as compared to that of the low-fat group. Additionally, the low-carbohydrate group showed a greater decrease in glycemic index (a measure of the sugar in blood) and a greater increase in sensitivity to insulin. This shows a decrease in severity of diabetes and a step towards resolution of metabolic syndrome (Samaha et al., 2003). Both diets showed an improvement in biological systems and a weight loss. However, the low-carbohydrate group showed a significantly greater improvement in overall health and bodily function.

Surgery Surgical treatments of obesity have been involved in a typical plan of care for many decades. However, these treatments have not been applied to children or adolescents for fear of harming the child. Recent studies have extended these treatments to adolescents on an experimental basis and have proved effective. The two major surgical interventions are the gastric bypass and gastric banding. The Roux-en-Y gastric bypass reroutes the normal digestive tract. It detaches a section of the duodenum from the bottom of the stomach and reattaches it at the top of the stomach. Instead of letting

the food pass through the stomach, it goes directly to the small intestine. Because this is a small pathway for food, the patient feels full sooner and therefore cannot eat as much. Although effective in causing weight loss, it prevents proper absorption of nutrients and can cause dumping syndrome, where the patient cannot properly excrete (Han, 2010). The gastric banding procedure uses an inflatable ring and places it around the upper part of the stomach. This inflatable bladder contains saline, which is inserted and inflated to create a small pouch of stomach above the band. This pouch fills quickly and slowly drains into the main portion of the stomach, which creates the sensation of being full. The patient will stop eating at this point, allowing for smaller portions, proper digestion, and good eating habits (Han, 2010). Both of these procedures are effective in aiding the patient to lose weight. They have recently been applied to adolescents and have shown promising results. Dr. Robert Cywes (2011) conducted a trial and placed the gastric band in adolescents. He did a 48 week follow up and observed a substantial decrease in BMI across the time after the procedure. Coupled with a successful diet, these procedures can help begin and maintain a healthy lifestyle.

Diagram of the surgical lap band procedure

BMI decrease 48 week following placement of lap band (Cywes, 2011).


Prevention Perhaps one of the most important aspects in treatment of obesity is recognizing the cultural environment of the patient. Certain cultures have limitations and expectations such as diet, activity, and medical intervention. A patient may not have had any control over their diet due to the cultural requirement. This is also applicable to the activity level available. One other factor to consider is physical environment. If the patient is in an unsafe environment, physical activity is limited. If the patient is responsible for providing for members of the family (for instance, low-income families), they cannot be active and may need to eat whatever they can afford. As a conclusion, this all points to the need for a doctor to understand the cause of the patients obesity and that it may not have been preventable. Prevention of childhood obesity is multi-faceted, but crucial. First, it needs to be an effort of society. It needs to appear in every aspect of society and start early, because studies have shown that childhood obesity, if not treated, will continue into adulthood. Second, communication needs to be patient centered. Bringing the issue to the public isnt enough. Families need to understand childhoo d obesity from the childs perspective because without that, families cannot help to prevent it (Barlow, 2007). Along with familial and cultural changes, necessary diet precautions need to be taken. Refrain from high-carbohydrate foods, high-fat foods, and increase physical activity. Hormones should be monitored closely as incorrect levels can contribute to obesity. Prevention is possible and should become a societal effort. Bibliography

Anderson, P. M.. & Butcher, K. F. (2006). In Childhood Obesity: Trends and Potential Causes. Retrieved Mar. 22, 2012, from Barlow, S. E., MD, MPH, & Committee, T. E. (2007). Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics, 5164-5192. Burrage, L. M. & McCandless, S. E. (2007). In Obesity. (sect. The Genetics of Obesity). Retrieved March 29, 2012, from Center for Disease Control. (2011, Sept. 15). Basics About Childhood Obesity Atlanta, GA: Author. Retrieved Mar. 22, 2012, from Cywes, R., Bhoyrul, S., Billy, H., Ponce, J., Okerson, T., & Oefelein, M. G. (2011). Interim results at 48 weeks of LAP-BAND AP experience (APEX) study: prospective, multicenter, open-label longitudinal patient observational study. Surgery for Obesity and Related Diseases, 1-6. Erickson, S. K. (2008). Nonalcoholic fatty liver disease (NAFLD). Journal of Lipid Research, Retrieved from 10.1194/jlr.R800089-JLR200 Farooqi, S., (2005). Genetic and hereditary aspects of childhood obesity [electronic version]. Best Practice & Research Clinical Endocrinology & Metabolism , 13(13), 359-374. Retrieved Apr. 4, 2012, from

Giovannucci, E., & Michaud, D. (2007). The role of obesity and related metabolic disturbances in cancers of the colon, prostate, and pancreas. Gastroenterology, 132(6), 2208-2225. Han, J., Lawlor, D., & Kimm, S. (2010). Childhood obesity. The Lancet, 372(9727), 1737-1748. How obesity increases the risk for diabetes. (2009, June 21). ScienceDaily, Retrieved from Norman, J. E. (2010). The adverse effects of obesity on reproduction. Reproduction, 140, 343-345. doi: 10.1530/REP-10-0297 Obesity hormone adiponectin increases the risk of osteoporosis in the elderly, study finds. (2011, November 1). ScienceDaily, Retrieved from Panagopoulou, P., Galli-Tsinopoulou, A., Fleva, A., Pavlitou-Tsiontsi, E., Vavatsi-Christaki, N., et al. (2008). Adiponectin and insulin resistance in childhood obesity. [electronic version]. Journal of Pediatric Gastroenterology & Nutrition, 47(3), 356-362. Retrieved Apr. 4, 2012, from Parsons, T. J., Power, C., Logan, S., & Summerbell, C. D. (1999). Childhood predictors of adult obesity. [electronic version]. International Journal of Obesity and Related Metabolic Disorders. Journal of the International Association for the Study of Obesity, 23(8), Retrieved Mar. 22, 2012, from Sallis, J. F. & Glanz, K. (2006). The role of built environments in physical activity, eating, and obesity in childhood. [electronic version]. The Future of Children, 16(1), 89-108. Retrieved Apr. 1, 2012, from Samaha, F. F., Iqbar, N., & et al, (2003). A low-carbohydrate as compared with a low-fat diet in severe obesity. Retrieved from Tordjman, J., Guerre-Millo, M., & Clment, K. (2008). Adipose tissue inflammation and liver pathology in human obesity. Diabetes & Metabolism, 34(6), 658-663. Whitaker, K. L., Jarvis, M. J., Beeken, R. J., Boniface, D., & Wardle, J. (2010). Comparing maternal and paternal intergenerational transmission of obesity risk in a large population-based sample. The American Journal of Clinical Nutrition, 1560-1567. Yosipovitch, G., DeVore, A., & Dawn, A. (2007). Obesity and the skin: Skin physiology and skin manifestations of obesity. Journal of the American Academy of Dermatology, 56(6), 901-16. Illustration Credits

Chapter 8 Global Food Systems

Thomas Devlin, Ryan Thibodeau, and Abigail Yu

Introduction Food is one of the few universal constants; it is a resource that all humans need to survive. This continuous need for food causes many problems across the globe because of the issue of feeding everyone healthily. At the moment, malnutrition and starvation plague the planet; the growing population will only exacerbate both of these issues. These quandaries also stem from the discrepancies between developed and developing countries. Eight hundred million currently live without food security and every minute twelve preschool-aged children die from hunger/malnutrition (Pinstrup-Andersen, 2008). Organizations and scientists across the world are working on improving the situation for everyone; one of the methods for doing this involves creating a global food system.

A rural farmer waters his crops. Before delving into global food systems, it is best to understand food systems in a general sense. Food systems cover the following processes: growing, harvesting, processing, packaging, transporting, marketing, consuming, and disposing of food. It is no wonder this topic arises whenever nutrition and agriculture are being debated. The systems of food are strongly influenced by politics, economics, and nature. The overall goal is to provide food security, meaning all households have access to food, to as many people as possible ("A primer on community", 2002). This causes sustainability to be one of the main priorities of all organizations and companies that produce food. Food systems encompass all matters that involve food. Community food systems are the most popular method of dispersing crops and meat in both developing countries and the more rural areas of developed countries. The goals of a community food system are: optimized health, better diet, stable base of family farms, marketing channels, and increased participation in food and agriculture policies. The participants in this system are small scale, and retail farms that both have small amounts of land and sell them directly to a consumer or a farmers' market. The market types that primarily serve a community are roadside stands and farmers' markets ("Lesson three", 2002). Local food systems are often successful but are strongly influenced by weather, climate, and amount of arable land ("A primer on community", 2002). These three variables can make it difficult for people in certain areas, such as cities and deserts, to obtain food, which explains why the global food system infrastructure is being designed to solve this problem.

There is already a basic infrastructure for global food in place around the world. The United States is a prime example of this. The United States imports eighty percent of fish and shellfish, forty five percent of fruits, fifty percent of nuts, and twenty percent of vegetables ("Food safety goes global", 2011). These trends clearly show that the foods that last longer while refrigerated are the best to import and export. This brings up the issue of sustainable food and food preservation techniques. Without even examining these two problems, however, there are a number of other items that will soon present themselves to be major dilemmas in light of pending climate change. As time passes, it is becoming apparent that a complete, working global food system will be necessary to maintain life on earth. By the year 2050, the global population will exceed nine billion people, much of that growth springing from developing countries. Also by 2050, the demand for food and water irrigation is expected to double. Because of this demand and climate change, there will be stress on many staple crops including rice, wheat, corn, and soybeans (Dooley, 2011). In the time period from 2005 to 2008 alone, prices for food surged, which is sure to continue. The main problem is that there is enough food to feed the world, yet poverty prevents some from being able to access it (Pinstrup-Andersen, 2008). The world needs a global food system in order sustain human life on earth. One of the steps taken to further the progress of a global food system was to do a full assessment of the conditions of all the major ecosystems on earth. The last time this was done was by the United Nations in the year 2000. The ecosystems were broken down into: forests, freshwater systems, coastal/marine habitats, grasslands, and agricultural lands. This altogether created PAGE, or the pilot assessment of global ecosystems and it showed the true impact of environmental change. In sobering results, all five groups of ecosystems were and are worsening, primarily a byproduct of mankind. Some of the causes for this are overfishing the oceans and disturbing the carbon, nitrogen, and water cycles on earth (Linden, 2000). Using this information, humans need to take action to develop a global food system that feeds people and ensures that the universal ecosystems do not collapse. One organization that is working to reform the global food system so that it is more effective in helping all people is the Slow Food Movement. Slow Food, its name a wordplay on "fast food", is an antiindustrialist-agriculture movement. They claim that the agro-industry is failing and targets politics as a source of this failure. Slow Food is working towards creating better tasting food for more people peacefully (Walsh, 2008). However, it will take much more than one movement to make a major change; the UN reported that 50 million more people went hungry in 2007 when compared to 2006. In recent years, food studies have become a mainstream discipline in the science world. There are conflicting views on the best kind of food system, yet the majority consensus is that an international level of food control is necessary to be having the most effective method of feeding people. The primary reason for this is the governance over the food system would be fairer if controlled by a non-partisan global organization as opposed to a series of self-interested companies. The global food debate also deals much with methods of producing food. Strategies which were once considered taboo are being used regularly, including using genetically modified organisms (Nicholson, 2011). As the situation progressively worsens, it is likely that people will be more open to new ideas in order to provide food for the global population. The rest of this chapter will cover a variety of topics dealing with global food. First, there will be an in-depth look at developing and developed countries. The later sections will deal with the problems the world is facing in creating a global food system. Following that will be some of the solutions both proposed and currently in place to solve some of these problems. Mankind is entering a tumultuous time in which sustainability of people and nature will be of major importance. Food is a universal constant, and we must do all in our power to ensure it is there for everyone.


Developed and Developing Countries The problems facing global food systems can be as difficult as they are important to understand; an key distinction, then, must first be made between developing and developed countries. The two terms are both colloquial expressions which are used with an increasing frequency to identify different statistical extremes of countries classified by the United Nations Human Development Index (HDI). According to the UN: The designations developed and developing are intended for statistical convenience and do not necessarily express a judgment about the stage reached by a particular country or area in the development process, (Standard Country or Area Codes, 2010). The HDI was developed to provide a more accurate representation of the quality of life in a given country than what could be provided by considering only the gross domestic product of a nation. To do this, the index accounts for a number of indicators present in a country, such as average years of schooling for adults over 25, percent of total land area that is forested, the female to male ratio of members in a nations parliament, and the age expectancy of citizens at birth (HDI Indicator Selector, 2011). Countries with a low HDI are considered to have a lower standard of living than those with a higher HDI and because of this are frequently known as developing countries, their counterpart then being developed countries. The UN Human Development Report 2011 makes the following distinctions between classified nations: very high human development, high human development, medium human development, and low human development. The highest rated nation in each category was Norway, Uruguay, Jordan, and the Solomon Islands, respectively (United Nations Development Programme, 2011).

Field workers in Ghana, ranked number 135 out of 187 countries by the UN human development index in 2011. Although each country is largely unique and has its own mix of political, social, and economic problems that must be dealt with on a per country basis, agriculture is such a globally connected enterprise that several common issues persist in many developing nations. Many of these problems originate in the process of food production. Although it may be tempting to respond to the problem of feeding more people simply by growing more food, this solution would be irresponsible at best, and it could be a logistical catastrophe if poorly executed. As the number of people in the world increases, so too does the amount of food needed to feed them all; if coming generations are to be fed as well as present ones, then sustainability must be a focus of whatever food production methods employed. It is important to avoid soil exhaustion, which places

restrictions on how much can be grown on any particular plot of land. Using land more efficiently by growing more nutrient rich foods and increasing harvesting yields is an important technique used to keep soil from being depleted. Water sources must also be monitored and maintained in an effort to preserve the resources of the local communities that require water for both agriculture and general civilian use, such as hygiene. Maintaining ecological diversity is also essential to preserving the health of farmed land, and so it must also be considered.

Genetically modified soybean crops being tested by Monsanto. On a global scale, changes in societal values with regards to such topics as genetic modification, cloning, and synthetic biology will be necessary because those techniques are only some of the methods that may have to be employed if maintaining a stable global food supply is to be achieved. Political priorities may need to change to become more focused on feeding people than maximizing profits (Foresight. The Future of Food and Farming, 2011). In addition to attempting to achieve ecological sustainability, it is vital that the people dwelling on a land must be capable of maintaining whatever agricultural techniques that may be brought to their land. While external organizations that focus on providing aid to countries that need it may provide a temporary boost in the quality of life for those they help, a permanent system must be implemented if a region is to succeed in improving itself (Mintzberg, 2006). In March 2010, the International Technical Conference on Agricultural Biotechnologies in Developing Countries met in Mexico to discuss the topic reflected its title: Agricultural biotechnologies in developing countries: options and opportunities in crops, forestry, livestock, fisheries and agro-industry to face the challenges of food insecurity and climate change. After four days of di scussions and debates about topics focused on the use of a scientifically-based agriculture that heavily promoted the usage of genetically modified crops, the conference was adjourned. One of the central themes of the various meetings of the conference was incorporating indigenous peoples into the agricultural systems employed by governments of developing countries. It was suggested that making the local people of a particular country informed and active members of the national agricultural community would encourage them to aid in the food production system, a suggestion that has found support from multiple researchers. An initial boost in assistance may be particularly useful in regions already struck by poor food reserves, however, as research has shown that another difficulty plaguing developing nations in their attempts to develop is the considerable role that under-nutrition plays in hindering education in populations (Walton & Allen, 2011).


Global Food Systems In an effort to promote a successful continuation of reliable food production, many countries have instituted programs to track, foresee, and manage national and international agriculture. As mentioned above, the United Nations tracks the calculated HDI of various countries, which includes information on how those nations manage their food. Despite this, attempts at addressing the looming challenge of adjusting global agricultural systems have long been undermined by the lack of comprehensive scientific research and statistics to support the conclusions reached. In 2011, an international team of researchers conducted a thorough examination of available statistics and research data, which provided potential solutions to the problem of feeding the global community that were all supported by corroborating data. Their examinations of farm data and satellite images suggested, perhaps predictably, that using less land, eating less meat, and wasting less food can significantly increase the chances of successfully feeding the increasing global population over the next four decades. More specifically, their work suggested that the state of international agriculture could be improved drastically if land clearing for agricultural purposes were halted, food production yields in developing countries were raised to 60%, agrochemicals were used more strategically in farming, global diets shifted towards being primarily plant based, fewer crops were used for animal feed and biofuel, and the waste of food production were decreased. Such changes would result in the ability to feed successive generations without the need to destroy a large amount of all remaining tropical forests and topsoil, although practical integration of the suggestions could prove challenging. If it is to work, the changes must be adopted in the manner discussed in the second paragraph of the prior section, namely, through increased collaboration between governments and their people (Coren, 2011). Globalization, the current method commonly employed to improve worldwide food conditions, has both solved and raised problems. By linking developing and developed countries to one another through agricultural based interactions, the challenges facing one region can affect many external areas. Even the farming practices of one nation can have an impact on others. Different standards of food production can be blamed for some of these problems: historically, the United States has imported foods that do not meet its standards of quality, but are approved for export by a foreign power (Unsanitary Practices, 2011). While many of these foods are prevented from entering into sale in markets, it is unreasonable for the regulatory boards in charge of filtering under-qualified foods off consumers plates to do so with complete success. Increased quality of food, however, has been shown to come from increased globalization of consumables, encouraged both by health benefits and consumer demand. Through importations, it is possible for developing countries to acquire nutrient giving foods that would have been unrealistic or impossible to grow locally. Foreign grown genetically modified crops, although at times controversial, have had some documented benefits for the developing nations that import them (Rosado, Casss, Solano, & Duarte-Vzquez, 2005). Developed nations, on the other hand, can experience a growth in demand for more particular foods once they become more globally available through trade, which has the potential to benefit the economies of both the buyer and the seller (Food Value Chains, 2011).


A fisherman prepares to sift through a recent shrimp harvest

Problems in the Global Food System Throughout the recent century, the global food system has been relatively stable. Populations were lower than they are today, there was more food that could be given to the needy, and the world was not in an economic crisis. Now problems with the system arise unexpectedly, and more and more people are dying from these problems. These problems include health concerns such as: malnutrition, starvation, an uneven distribution of food, and climate change. Due to the growing problem of malnutrition and starvation, governments around the world are paying increasing attention to nutrition. The focus of food aid organizations is shifting from providing more and more calories and food for the malnourished to providing macro-nutrients like iron and vitamins. Statistics show that one billion people in the world do not have enough calories, while another billion are deprived of micro-nutrients. Over time more effects of malnutrition are becoming evident: bloated bellies, wasted limbs (Sao & Rome, 2012).

A circle graph displaying the causes of death from malnutrition in children in the year 2008.


As shown in the graph, malnutrition kills at least 8.8 million children per year. Additional problems caused by malnutrition include: anemia, weak immune systems, and mental impairments. According to research published in The Lancet, malnourished children are less likely to: go to school, stay in school, excel academically, earn high income jobs, marry rich spouses, or die a late death. In the womb, the child develops a certain metabolism that does not change throughout a persons life. However, when that person starts to eat more processed foods this can lead to obesity. In countries like India and Egypt, the average income per head has doubled, yet the number of children dying from malnutrition has only dropped by a quarter (Sao & Rome, 2012). Another problem is the uneven distribution of food to developing countries. Two weeks after the earthquake that struck Haiti, food distribution in the country remained unstable and limited. One food distributor tells of a distribution center where rice and bottles of oil were distributed, and how the line of people stretched at least half a mile. Eventually, after a long wait, the people got restless and forcefully broke into the center, despite the attempts of the police to hold them back. According to the author, even well-established aid groups struggle to distribute food evenly. A picture in the article depicts the World Food Program putting boxes of food back into a truck after the people refuse to sign forms for the food. Another example shows the United Nations peacekeepers helplessly standing by as crowds of starving Haitians fight for food. The peacekeepers had to resort to tear gas to calm the crowd. Brazilian army Colonel Fernando Soares says that Theyre not violent, just desperate. They just want to eat. The problem is, there is not enough food for everyone, (Robert & Fisher, 2010). The problem of uneven food distribution can be seen in the aftermath of almost every disaster, whether they are man-made or natural. Agriculture is the greatest global consumer of water. A shortage of water has a major effect on food production. Water is required to maintain functioning ecosystems and environmental flow. However, the future water supply of the world will be strongly influenced by climate change, especially since evaporation occurs more quickly in a warmer climate than in a colder one. Another factor to come into play is higher precipitation in some regions of the world because when this happens, the excess water causes flooding and run-offs. The rapid use of groundwater has also been a recent topic of discussion. The world has been using its ground water at a rate far higher than the replenishment rate, which could lead to droughts in many parts of the world. Water dynamics is more difficult to manipulate than carbon dioxide dynamics because each region of the world has a different water system. Until the second half of the century, water supply was more affected by competition from other regions than climate change. As populations grow and urbanization increases, more land is needed to build cities. Additionally, materials such as wood and fiber are more in demand. As forest lands keep on disappearing, any more encroachment of agriculture would result in a major threat to biodiversity. Limiting deforestation is a key in reducing greenhouse gas emissions. Though Europe and Asia have no room for more agriculture, sub-Africa and South America certainly have plenty of grounds for agriculture. This, however, comes at a cost. The deforestation of rainforests and such for the use of farm land greatly changes the environment and the culture of that region. More global climate change issues include: high extreme temperatures, rises in sea levels, tropical storms, and greenhouse gases (Godfray et al., 2010).

Solutions to the Problems with the Global Food System There has been much controversy lately between countries on how to fix the global food system. Many solutions have been proposed. Some of these solutions include: Slow Food; the Blue Food revolution; organizations (such as World Food Program); and genetically modified organisms, or GMOs.


Slow Food is an international organization that focuses on giving luxury foods such as cheddar cheese and sun dried tomatoes to the underprivileged. However, recently the company has been facing recent controversy. Slow Food has been accused of focusing more on its food aspect than the actual problem of public-health issues. The company has responded by trying to put politics back as its center of focus, and calls for a reform of the global industry. Slow Food and its critics both agree that the current global food system is faulty and needs to be amended. According to the U.N. Food and Agriculture Organization (FAO), in 2007, 50 million more people were hungry than in 2006. Slow Food works to attempt to rid the U.S. of the inconvenient fast food system we currently have and work towards a country containing good, clean, fair food, hence the name Slow Food. Although this type of food is certainly better-tasting, agribusiness has long stated that industrial farming is the only way to feed a growing nation of 7 billion (and growing). Organic farming is less convenient than industrial farming and often yields fewer crops. This would lead to forestation of many acres of land to be turned into farm land. The FAO director-general claims that food production needs to double by 2050, and that the organic way of farming is dangerously irresponsible. Towards the end of the article, the author claims that so -called Slow Foodies are not advocating eating pure organic food, but, instead, that people should realize what is on their plate and how it got there. In the end, the author says that Slow Food is out to give better food to people, not just condemning the chemical fertilizers of industrial farming (Walsh, 2008). As meat consumption keeps on rising, there becomes less and less land to farm livestock. Aquaculture could be the solution to this problem. Fish farming already makes up half of the global seafood production. Additionally, many scientists fear that in the coming century, with the constantly growing world population, more cities will grow. This will lead to less room for farmers to raise livestock. However, as the earth is three-fourths water, there is plenty of room to farm fish, so to speak. A major problem, nonetheless, is that with so much fish farming occurring, there is a fear that the fish population will die out, lead to no food source for humans. Therefore, fishermen and scientists have developed a way in which to grow feed in pens, and then slaughter them when they are big enough to eat. Though aquaculture will certainly be a part of the future, many people wonder whether this program would actually be sustainable, or even cost-effective (Simpson, 2011).

Food being distributed by the World Food Program in Uganda. Extreme hunger is quite common in this Uganda. However, the World Food Program has claimed to have been reaching more people in the world than any other organization. According to this United Nations food-aid agency, they had planned to feed approximately 90 million people in 73 countries in 2008, most of which are on the brink of starvation. WFP, which has been ongoing for 45 years, has handled war, famine, and other disasters, man-made or natural. In 2007, $2.9 billion from rich-world governments was set aside for the year 2008. However, due to the constantly rising price of food, that amount because $755 million short. With new demands and rising food prices, the WFP is struggling to meet the needs of people around the world. Uganda is the country that is given the most food by WFP. Even though the land is lush and fertile, and the government is stable, most of Uganda is facing extreme

poverty. With factors such as a long-running guerrilla war and HIV/AIDS also plaguing the country, Uganda needs the WFP more than ever. With rising food prices, rations from the organization are becoming more and more difficult to attain (Blue, 2008). There is much controversy on whether organizations should distribute food to developing countries. On one hand, no one wants to see people starve and many nations are in desperate need of the help. On the other hand, long-term food aid encourages the people to stay on a land that can no longer sustain them. While the WFP is not designed to fight the deep roots of hunger, but it can help. On average, WFP feeds approximately 20 million schoolchildren each year and encourages the children to go to school. As of now, the organization is working towards a system where the world no longer needs to rely on food aid. However, the author predicts that, with the rising food prices, she predicts that programs like these will be the first to be cut from budgets (Blue, 2008). Genetically Modified Organism (GMOs) is a delicate topic in society nowadays. On one hand, GMOs increase yields, reduce pesticides, save costs and help the environment (Kalaitzandonakes, 2006). However, on the other hand, GMOs are so cost inefficient that they restrain society from advancing (Fedoroff 2011). There is more on the topic of GMOs in a later chapter. Conclusion Humans have survived on earth because of their ability to work together for a common goal. The new goal that man must aim for is a food system, and he must work for it on a truly global scale. The current terrain of climate change, population growth, and the difference between developing and developed countries provide an array of obstacles that need to be overcome. Solutions have been proposed as seen in the previous sections, but there is not a conclusive method of solving world hunger. Despite this, humans continue to make bounds. One example of people dealing with issues is the outbreak of melamine in dairy products. Melamine is an organic base that can cause health issues. In 2008 there was an outbreak of melamine which contaminated dairy products in China. To eliminate the melamine, the whole system of dealing with milk and milk products had to be restructured (Food safety goes global, 2011). This alone is a microcosm of how drastic change can cause large differences. If this can be extended, major change will happen.

A cartogram using 2003 data that represents the distribution of food consumption


It is a sad fact that the food system currently in place across the globe is a failure. People across the globe, especially in developing countries, simply do not have the food security they need. This itself is enough for someone in a developed country to feel guilty for their indulgence. Many kids in America have heard their parents utter the phrase, There are starving kids who would be happy to get this much food. But, in reality, this is no laughing matter. Man has come so far in developing agriculture and working to feed themselves and others. Now is the time to make the final push to spread this to all peoples. A policy of self-reliance has worked in some areas, but it does not cover the entire planet. The need of food is a global problem so thus it needs a global solution, and that solution is a well-organized international food system. Bibiography A primer on community food systems: Linking food, nutrition and agriculture. (2002). Department of Horticulture, Cornell University, Ithaca, NY. Retrieved from Blue, L. (June, 18, 2008). World food program: on the front lines of hunger [Electronic Version] TIME Magazine. Retrieved on March 22, 2012, from Coren, M. (2011, October 19). A global plan for sustainable agriculture. Scientific American. sustainableagric-2011-10 Dooley, D. (2011). Sustainable food systems: The global picture. California Agriculture, 25(01), 2. Retrieved from|A253952907&v=2.1&u=m lin_c_worpoly&itr&p=AONE&sw=w Fedoroff, N. (August 18, 2011) Engineering food for all [Electronic Version] New York Times. Retrieved April 3, 2012 from Food safety goes global. (2011). Dairy Industries International, 76(2), 21-22. Retrieved from Foresight. The Future of Food and Farming. (2011). Retrieved March 22, 2012, from Globalization Exposes Food Supply to Unsanitary Practices, Scientists Say. (2011). Retrieved April 8, 2012, from 110523121316.htm Godfray, H. C. J. (et. al) (2010). The future of the global food system. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 365(1554), 27692777. doi:10.1098/rstb.2010.0180 HDI Indicator Selector. (2011). Retrieved April 8, 2012, from indicators/default.html Kalaitzandonakes, N. (2006) Cartagena protocol: a new trade barrier, Regulation Magazine (Electronic Version). Retrieved on April 3, 2012 at


Lesson three: Think globally, eat locally. (2002). Department of Agriculture, Cornell University, Ithaca, NY. Retrieved from Linden, E. (2000, April 26). Condition critical. Time Magazine, Retrieved from,9171,996743,00.html Mintzberg, H. (2006). Developing Leaders? Developing Countries? Development in Practice, 16, 4-14. Nicholson, S. (2011). Understanding and governing the global food system. Book Review Essay, 120. Retrieved from 10.1162/GLEP _a_00058 Pinstrup-Andersen, P. (2008). Business as usual not an option for rescuing world food system, says Cornell's Pinstrup-Andersen. Chronicle Online, Retrieved from Sao, P. & Rome, P. (February 18, 2012) Poverty and food: the nutrition puzzle [Electronic Version], The Economist. Retrieved April 2, 2012 from http://www.economist. com/node/21547771 Research Principles for Developing Country Food Value Chains [electronic version]. (2011). Science, 332 (6034), 1154-1155. Robert, M. & Fisher, R. (January 27, 2010) Problems with food distribution [Electronic Version], The New York Times. Retrieved April 2, 2012 from http://thelede.blogs. /?scp=3&sq= uneven%20distribution%20of%20food%20in%20the%20world&st=cse Rosado, J., Casss, L., Solano, L., Duarte-Vzquez, M. (2005). Nutrient addition to corn masa flour: Effect on corn flour stability, nutrient loss, and acceptability of fortified corn tortillas. Food and Nutrition Bulletin, 26 (3).

Simpson, S (February 2011) The blue food revolution [Electronic Version], Scientific American. Retrieved April 3, 2012 from Standard Country or Area Codes for Statistical Use. (2010). Retrieved April 8, 2012, from Tsioumani, E. (2010). Agricultural Biotechnologies in Developing Countries [electronic version]. Environmental Policy and Law 40 (4), 158-159. United Nations Development Programme (2011). Human Development Report 2011. Palgrave Macmillan. Walsh, B. (September 4, 2008). Can Slow Food feed the world? [Electronic Version]. TIME Magazine. Retrieved on March 22, 2012, from Walton, E., Allen, S. (2011). Malnutrition in developing countries [electronic version]. Paediatrics and Child Health, 21 (9), 418-424.


Illustration Credits pictures/2008/09/24/malawi460.jpg -as-spill-I,29307,1814302_1723554,00.html


Chapter 9 Green Revolution

Michael Andrews, Alexander Lee, and Sahit Mandala

Introduction The Green Revolution is mostly credited to the works of plant scientist Norman E. Borlaug. His innovations in the production of food helped to eradicate hunger from many developing countries around the world. His early life as a farm boy was conducive to his works as a plant scientist. Borlaugs grandfather was essential to his success, pushing him to leave the family farm and continue in his education. A humble and modest man, Borlaug diligently pursued the issue and thanks to his work, countries such as India and Mexico were able to become self -sufficient with abundant cereal stores (Gillis, 2009) Borlaugs career in plant science began shortly after the Second World War in an odd fashion after he declined a lucrative job offer at DuPont chemicals in favor of an opportunity to assist Mexican farmers with food production in Mexico. The project began in the States with the support of the Rockefeller foundation as well as some political help from Washington D.C. Borlaug himself began designing and testing innovative solutions in the soils of Mexico. Depleted nutrient levels, disease, and low crop yield were a constant adversity, but Borlaug persisted in every aspect of helping the Mexican people until a solution was eventually devised and crop yields became healthy again. His plant varieties came to heated debate when negative effects on the environment were observed in areas that utilized his techniques and methods of farming. It was claimed that his work brought about more issues than it did solutions to world hunger. Norman, confident in his work, responded with his own views that an increase in world population due to increased food production had brought unforeseen issues into play (Norman Borlaug, 1970).

Norman Borlaug with a HYV wheat variety; note the thick, stout stems and engorged wheat heads.


One of Borlaugs most important contributions was a dwarf wheat breed that prevented a crop destroying effect of fertilizer use. The swelling of the wheat grain head as a result of responsible fertilization caused the stalk to bend and fall, killing the plant and severely mitigating the effects of a crop producing chemical. The dwarf strain prevented this from happening with strong and compact bodies, yet full sized heads to continue the increased crop yield. He then incorporated these strains into other wheat varieties, creating an entirely new species of this essential grain that could be grown in a large variety of areas around the world (Miller, 2012).

The Green Revolution in India India, perhaps the most notable of Borlaugs successes, suffered from a lack of grain an d cereal production in the 1960s and 70s. Two year long consecutive droughts destroyed crop production in the mid 1960s, and left India in a severe shortage of food stores and exports. The situation was improved in 1980 under the Rajiv Ghandi administration and a liberalization of the government, but India continued to suffer from a lack of food stores. Because the agriculture of India relies almost entirely on the monsoon season, the slightest discrepancy from year to year was extremely detrimental to crop yield (University of Michigan, n.d.).

A graph of the population and net cereal production and trade in India from of 1951 2005. A graph the to population

High yield variety crops virtually eliminated the uncertainty of grain production for India. Wheat, a previously non-important food crop, began to grow as a staple in much of the country. It continued to surpass even cereal grain in net production well into and beyond the 1970s when the semi dwarf hybrid wheat plants along with chemical fertilizers and irrigation were introduced to the northern provinces of India (Everson, 2003). These new hybrid wheat plants were able to produce almost 50% more crop than the previous traditional crops, yet required a significantly larger amount of water to grow (Zwerdling, 2009). This led to an influx of new irrigation methods and technology. Punjab profited greatly from the Green Revolution technology, boosting its economy and the general health of people as the shortage of food dwindled at an increasing rate throughout the next few decades. Due to the focus on the wheat crop; however, rural poor areas continued to suffer from lack of money and growth in the agricultural sector. The 1980s were a turning point in the development of the more rural areas in India. The availability of tube wells became more widespread throughout the country, allowing small farmers to access much needed water in order to irrigate their fields. Prior to these years, it is speculated that the cost

of drilling and operating a tube well was well beyond the grasp of a small private farmer, putting them at a severe disadvantage in the agrarian society. With the implementation of these wells, the eastern sectors of India exploded into the market for high yield varieties of wheat and fertilizers. Because of the implementation of the new revolutionary farming techniques, rural India was able to mitigate many of the effects of starvation with an increased production of staple crops (Fujita, n.d.).

A diagram of a simple tube well similar to those used to irrigate fields in India.

Methods of the Green Revolution Pesticides Possibly the most controversial point of the green revolution were the new pesticides used on crops. Pesticides have been used for millennia; before the green revolution they were largely used in developed areas. Improved pesticides significantly decreased the amount of lost crop due to insects and small animals, saving large quantities of food. Pesticides were often distributed to the crops through methods similar to the water distribution system in a farm. Improved Farming Methods Farming techniques have been fine tuned for centuries by millions of farmers. Methods for irrigation have improved over the centuries, hitting high points with river based empires and modern infrastructures. Modern industry often uses circular water distribution systems, allowing for the efficient distribution of water to crops. Other than water distribution, efficient layouts for farms have been important along with fertilizer and tilled soil.

An aerial photograph of crop fields in Kansas with rotating water systems.


Different crops use different resources in the soil. Growing one crop on a single plot of land over years will result in soil decay and the eventual decline in farm productivity. In order to rejuvenate the soil in a field, farmers will rotate crops by switching what crop grows in which field every season. This keeps the soil well-kept and more able to sustain the crop load. This practice was well spread throughout developed and undeveloped areas at the start of the green revolution. The green revolution encouraged subsistence farmers to use fertilizers instead of this traditional rotation method, allowing for greater yields in crop assuming sufficient fertilization (Tilma, 1998). This method is still used in modern times with industrial farms. High Yield Crops The scientists of the Green Revolution were focused on creating the optimal conditions for low resource farming. Concerns included water, fertilizer, seed, and sunlight availability along with maintenance and weeding necessities. Studies were made as to the optimal crop to grow- factoring in each of the said limitations. High Yielding Crops are efficient plants to farm, having a high output to input ratio. Combined with genetic engineering, High Yielding Crops significantly improved the amount of grain produced on each acre of land (Evenson & Gollin, 2003). Wheat and rice varieties were found to be very efficient for farming, allowing for large gains when supplied with a sufficient amount of fertilizer, water, and sunlight. Though wheat and rice are efficient, different crops were engineered for different regions where the environment was unfit for their production. Genetic Engineering An important point of the Green Revolution was the modification and spread of high yielding crops such as wheat and rice. Genetic modification, specifically the process of selective breeding, allowed farmers to engineer crops with more desirable traits such as more nutritious fruit or thicker stems. Spearheaded by scientists such as Norma Borlaug, the modification and customization of crops combined with developed agricultural techniques lead to a significant increase in the productivity of farmland, allowing for a higher population density in both developed and developing areas (Khush, 1999). Similar to how Mendel engineered peas through breeding to express different traits and qualities, engineers of the Green Revolution used pollination and selective breeding to bring forth desirable traits. For corn, dwarfism, thicker stems, and energy expensive grains were breed into plants to allow for maximum crop production. Thicker stems kept corn stalks from failing structurally, short height allowed for less energy consumption, and focusing more energy on pods gave more energy for human consumption (Robbins, 2007). For other plants, such as rice, similar methods were employed. Samples with the desired qualities were bred together to produce more profitable crops. These high yield crops were a significant part of the improved food availability during the 1960s; they optimized energy consumption for the farm as a whole.

Environmental Impacts Pesticides Pesticides are chemicals that are used to kill or control pests. A fundamental contributor to farm efficiency in the Green Revolution, pesticides killed any plants, insects, animals, or fungi that reduced the yield of a certain crop (Rodriguez, 2010).


An example of pest invasion.

Although intended to improve food quality and quantity, pesticides have had a variety of environmental impacts. Although not by design, 95% of all pesticides move to unintended destinations, killing species unrelated to farming (Sustaining the earth, 2004). Pesticides reduce biodiversity by killing a large number of soil-borne organisms as well as miscellaneous plants and animals. During the Green Revolution, pesticides were spread throughout developing countries. This widespread use of poisonous chemicals severely impacted the local environment around farms, affecting plant and animal life and bringing multiple species closer to extinction.

Fertilizer Production and Soil Depletion A fertilizer is a substance that is added to soil to provide nutrients for crops. These nutrients were often used to replace nutrients used up by previous crops, often due to the over farming of farmland. A main part of fertilizer is fixed nitrogen (usually in the form of ammonia.) In the natural nitrogen cycle, bacteria fix the nitrogen that is used by plants.. The industrial fertilization process fixes unnatural amounts of nitrogen from the atmosphere into soil, allowing for more crops to be grown using rich soil. Fixing large quantities of nitrogen from the atmosphere has had a number of less predictable environmental effects, including low oxygen levels in water, heavy metal and radioactive element accumulation, and an increase in the quantity of greenhouse gasses in the atmosphere (Bodelier, 2000). Fertilizers also can cause chemical burns on nearby animals and plants.

Chemical symbol for urea, a less potentially harmful form of ammonia produced by animals

Political Involvement The Green Revolution was riddled with political and socioeconomic strife due to various unforeseen effects of the new agricultural production. The most brought up and extremely detrimental effect was the destruction of much of the supplemental diet of poor peasants and farmers. The promoted use of pesticides destroyed weedy vegetables present throughout the fields, in turn destroying the main

source of Vitamin A for the poor population. In rice paddies in the more tropical areas of Asia, small fish that lived in the marshy waters were killed by the chemical pesticides, creating a protein deficiency in local farmers diets. These disadvantages to the technologically advanced farming techniques caused dissent in some areas of the world because of impact they created. The Green Revolution was also very much a play by the United States to gain favor and power in areas of the world they had lost footholds in. The government of the US was challenged by the communist regime in China, and placed under even more pressure following their failure to secure a decisive military victory in the Korean War. They decided to attempt to counteract this growing loss of control by helping India feed its population, which was growing rapidly despite a severe shortage of food. The entirety of the US goal was to set in motion an effort that would place them in an alliance with one of the fastest growing and potentially influential nations in the world by helping them to eradicate a persistent problem (Reiff, 2011). The main ideology behind the United States push into the developing world was the phrase where hunger goes, communism follows. The administrations of Truman, Kennedy, Eisenhower, and Johnson all became heavily invested in the fight against poverty in the southeast regions of Asia. Widespread use of new pesticides, fertilizers, and high yield crops became the standard response, and funds from philanthropist sources as well as government tasked teams were thrown at this ever growing problem. Indias problems were nearly resolved only a few decades after the onset of this program, indicating a major success by the United States in accomplishing their goal (Reiff, 2011).

Food Quantities The underlying product of the Green Revolution was the increase in crop yields worldwide. With heightened efficiency and productivity, farms were able to better meet the demand of locals, curtailing previous deficits which plagued the respective regions. Mexico, India, Malaysia, and other developing countries increased their output through the Green Revolution in crop such as maize and wheat, and world production increased overall. Even in the post-Revolution decades, the techniques and innovations of the Green Revolution were spread naturally throughout Asia and South America, resulting in increasing global output well into the 21st century.

Wheat yields in developing countries from 1950 to 2004. Yield values are given in kilograms per hectare of land. Data for the plot was compiled from FAO database.


Statistically, throughout the Green Revolution from 1950 to 1992, the amount of grain grown per billions of acres rose by more than 150%, reflecting the heightened efficiency of modernized farms. Overall, global yields increased from 682 million tons of grain per 1.70 billion acres to 1.9 billion tons of grain per 1.73 billion acres. Considering India as a case study, rust disease, sparse crops, and irregular methods of harvest in India led to low grain yields, at around 800 pounds per acre, in 1963. However, within 5 years, more robust crops allowed for wheat which densely grew and resisted rust, increasing yields to 6000 pounds per acre. In Latin America, there were 16 million peasant production units as of late 1980s, occupying close to 60.5 million hectares. Two thirds of the Latin American rural population was the 75 million peasants. Each farm had an average of 1.8 hectares of cultivated space. From these small units came 55 percent of the maize, 77 percent of the beans, and 61 percent of the potatoes.

Population One of the ultimate goals for the Green Revolution was to meet the demand of a growing population. Developing nations lacked the resources to maintain the local populace, commonly resulting in famine and hunger. Also, without a consistent economic system, many people remained in poverty. In theory, developing agriculture in the regions would provide a source of food and bolster the wavering economy. The result was a self-sustaining solution to famine and poverty, which was beneficial to individual living conditions.

Plot of global population growth from 1950 to 2010. Data reflects the consistent growth which population sustained over and beyond the Green Revolution. Compiled from US Census International Database.


Plot of world grain production per capita. Data is plotted by kilograms of wheat per person. The crop yields were able to better meet increasing global demands. In fact, in the late and post Revolution period, grain production exceeded general population demands (Hughes, 2000). From the above figures, population growth is seen to have increased from the early 1950s to early 1960s, when the Green Revolution was beginning to take hold. Food production per capita increased by approximately 75 kg per person by late Revolution, which highlighted the surprising differential between population growth and crop yields. After the Green Revolution, growth waned due to an increasing population, and it remained at around 325 kg per person by the 1990s. The nutritional value of the Green Revolution was also important. The increase in grain production grew into the global diet, and contributed to 50 percent of all calories consumed by the late 20st century (The Quiet Revolution of the Sixties, 2006). Although the initial goal for the Green Revolution was to sustain the population, there were many detrimental effects on population dynamics. Overpopulation, for example, remained a underlying issue. In the post-Revolution years, with agricultural growth slowing down, per capita production began to decrease as population growth continued consistently, as seen in the graph above. The growth of the global population has only within the last decade begun to taper off. Some considered the need for a second Green Revolution to meet the demands of a population which grew by 85 million people per year by early 21st century (The Quiet Revolution of the Sixties, 2006). Many consider the modern situation to be the result of unsustainable growth and dependence on increasing crop yields.

Development Issues Although the Green Revolution did have a relatively positive effect on the general population, specific aspects of the movement are shown to have been more detrimental. Economically, although many farmers benefited from the modernization which was fueled through US funds and innovation, the long

term costs of these modern techniques resulted in mainly rich farmers benefiting. The costs of patented plant varieties and dependence of fertilizer would hurt the poor and put many into debt (Miller, 2012). Pesticides and fertilizers were expensive investments for farmers. Also, farmers who followed fertilizeroriented techniques drained the soil of natural fertility, resulting in the increasing amounts of fertilizer used over time. A similar trend was seen with pesticides, which resulted in resistant pests which required other pesticides in order to be eradicated. Over time, the costs would build up for these products. Further, rich farmers could afford tractors and other technologies which allowed them to greatly increase productivity on their larger plots of land, resulting in a more industrialized system of farming. (The Quiet Revolution of the Sixties, 2006) Also, despite the efforts to bring crops to famine-stricken areas of poverty, many people still suffered from hunger. As a movement, the Green Revolution was not a charitable solution as much as a profitable investment. The fact remained that those who could not afford the new crops, even despite some cost reductions, starved. Also, the costs commonly increased over time due to the expensive nature of maintaining pesticide and fertilizer techniques. Also, poor peasants who depended on special weeds as a primary source of vitamin A suffered when these weeds were extinguished (Reiff, 2011). As a result, even though the grain production yields surpassed population counts, the actual food consumption among lower class families was relatively low. For example, analysis of hunger shows that from 1970 to 1990, excluding China from the calculations, there was a 11 percent increase in poverty. (The Quiet Revolution of the Sixties, 2006) The Green Revolution also led to the degradation of society and living conditions. The introduction of new technologies and chemicals ultimately led to heavy pollution, such as pesticides found in the water supply or the fumes of tractors and other machinery. The development of irrigation systems contributed to the spread of malaria due to an increasing number of stagnant water sources as mosquito breeding grounds. Also, the modernized techniques depleted groundwater sources and degraded the land, resulting in looming problerms for many villages (The Quiet Revolution of the Sixties, 2006). In meeting the demand of crops, new irrigation systems were continuously being built. Approximately 70 percent of fresh water was used for irrigation purposes. However, growing fears arise due to the kinds of water sources which were tapped. In south Asia, for example, many of the ground water sources used have tested positive for arsenic concentrations (University of Michigan, n.d.). These water sources are still used as irrigation sources as well as drinking water wells.

Pesticides and Health Pesticides provided a powerful solution to pests which devastated crops in Asia. Pesticides, alongside fertilizers, have far reaching implications on ecological destruction. However, as a potent chemical, usage of pesticides has had a negative effect on humans as well. Due to their streamlined, common usage, diseases due to pesticides have been a major health hazard of the Green Revolution, and their effects have been documented over the years. A large portion of exposure comes from the application of the chemicals onto the land. Farmers who must apply the chemical and further cultivate the chemical-ridden fields receive long term exposure. Also, many farming areas are subject to poor regulation and safety. Protective equipment is rarely available, let alone used, by farmers. In India, for example, people have used the containers which would hold pesticides as kitchen storage tools. Overuse due to misunderstanding of guidelines also has caused considerable poisoning of water supplies (Pepper, 2008).


Recent studies also highlight the health effects of pesticides. In one study, in a group of 210 Indian farmer who used pesticides, 70 had signs of DNA damage. DNA damage is a key culprit in diseases such as cancer. Also, the National Institute of Environmental Health Sciences has also attributed neurological problems such as headaches and tremors in farmers to pesticide (Pepper, 2008). One major study by the WWF-UK describes the effects of pesticides as endocrine disruptors. As endocrine disrupting chemicals (EDCs), pesticides can act as artificial hormones in the human body, altering the cellular development within the body. The effects of the pesticide vary from type to type, but the effects are greater if exposure occurs in children and in babies in the womb, as the pesticide interferes with development. Also of concern, persistent pesticides have tendency to remain in an organism over time due to their lipophilic properties and resistance to metabolism. As a result, some pesticides have the ability to build up a the higher end of the food chain, and make their way into environmental and human diets. The danger of these persistent pesticides demanded regulation in 2001 by the UN environmental program (Lyons, 1999). As EDC, pesticides can have a variety of effects. Some pesticides emulate the effects of estrogen and testosterone in the human body, and while also disrupting the synthesis and decomposition of these natural hormones in the body. Sex hormone disruptors can cause the reproductive system to be deformed or cause irregularity in reproductive processes. Amitrole and dithiocarbamates pesticides have been linked to thyroid disruption, which affects the intelligence and growth. Organophosphates and carbamate insecticides can interrupt enzymes activity, which is tied to the blockage of nerve impulses. Further, pesticides can alter natural hormone synthesis, causing many other hormone related problems to occur (Lyons, 1999). Understanding of pesticide related diseases has arisen in the past few years. Mental diseases in children such as ADHD and autism have been tied to pesticide exposure. Exposed children may develop brain disorders should exposure occur prior to key development stages for the brain. Also, a special type of cancer, known as acute lymphoblastic leukemia, was tied to pesticide exposure beyond the farms. (Jackson-Michel, 2010) Bibliography Bodelier, P. L. E. (2000, January 27). Stimulation by ammonium-based fertilizers of methane oxidation in soild around rice roots. Retrieved from Everson, R. E. (2003). Assessing the impact of the Green Revolution, 1960 to 2000. Science, 300, 758-762. Fujita, K. (n.d.). Green Revolution in India and Its Significance in Economic Development: Implications for Sub-Saharan Africa. Retrieved April 10, 2012, from Gillis, J. (2009). Norman Borlaug, plant scientist who fought famine, dies at 95. Retrieved from pagewanted=all Khush, G. S. (1999). Green revolution: preparing for the 21st century. Genome, 42(4), 646-655. Retrieved from


The Green Revolution: Penn States Hazleton Students Investigate the Quiet Revolution of the Sixties. (2006) Retrieved from: greenrevolution_sp2006.htm Jackson-Michel, S. (2010). The effects of herbicides and pesticides on humans. Retrieved from Lyons, G. (1999). Endocrine disrupting pesticides. Retrieved from http://www.pan- Miller, H. (2012). The father of the green revolution. Retrieved from defining-ideas/article/108641 Norman Borlaug: Biography. (1970). Retrieved April 10, 2012, from prizes/peace/laureates/1970/borlaug-bio.html# Pepper, D. (2008). The Toxic Consequences of the Green Revolution. Retrieved from greenrevolution Reiff, D. (2011). Where the hunger goes: on the green revolution. Retrieved from Robbins, Paul (2007). "Green Revolution" in Encyclopedia of environment and society (1-4129-2761-7, 978-1-4129-2761-1). Rodriguez, G. (2010, September 21). Fao corporate document repository. Retrieved from Sustaining the earth. (2004) 6 ed., pp. 211-216. Pacific Grove, California: Thompson Learning. Tilman, D. (1998). The greening of the green revolution. Nature, 396(6708), 211-212 University of Michigan. n.d.. The Effects of the Green Revolution. Retrieved from Zwerdling, D. (2009). Green Revolution trapping Indias farmers in debt. Retrieved April 10, from Illustration Credits norman_borlaug.jpg


Chapter 10 Food Preservation

Adam Carrier, Katherine McDonough, and Tony Trakadas

Introduction Preservation can be defined as, the act of maintaining something in its original or existing state (Preserve, 2012). According to this definition, preservation is not limited to food, but rather any material that is degradable. Books, artifacts, environments, relationships, and even human bodies can be preserved in some way. In particular, the methods of food preservation have progressed even more in the past decade as to allow humans to store foodstuffs more easily and for longer periods of time. Genetic modifications of the most resilient and fruitful plants have made modern plants more suitable for long distance travel so the entire world can enjoy the produce. The history of preservation has no definitive starting point, but human embalming, or preservation, can date back to the early Egyptians. History Spices have been used in preservation in the past for the embalming of humans. Egyptians used a variety of organic materials ranging from beeswax to exotic resins that preserved the dead so that their body would be suitable for the afterlife (Graham, 2001). The ancient Egyptians were experts in the art of human embalming especially in around 1000 B.C. One popular spice used by the Egyptians was cinnamon. Recent discoveries in the field of spice have revealed that cinnamon can be used as more than just a food flavoring. The additive form of cinnamon has shown to affect blood sugar in a positive way and in turn could be used to combat diabetes and even obesity. Janelle Glick, a Lancaster General Hospital registered dietitian, says that cinnamon may not work for all people who desire to lose weight, but it does help to maintain a reasonable blood sugar level (Jurgelski, 2010). There are many different methods of preserving food, but perhaps the most well-known method is canning. The origins of canning foods date back to France in the 18th century when Napoleon Bonaparte offered the challenge for a man to develop a method of food preservation so his armies would not starve on long journeys. The work of Nicholas Appert culminated fifteen years of work into the invention of the canning process. Food would be placed into a can, would be heated to a certain temperature, and then would be sealed without any air within the can. This would allow food to be stored for long periods of time, while still being easily transportable.

The process of embalming used many exotic spices and preserved the bodies of the dead for hundreds of years.


Causes of Spoilage For millennia, humans have been attempting to protect food from spoilage, or deterioration. The goal of food preservation is to slow down the process of spoilage, allowing food to remain edible for longer periods of time. Up until the modern age, how the food became spoiled was unknown, and the ways of preventing it were discovered by chance. Now the factors that cause the degradation of food have been identified, which has allowed the development of modern food preservation techniques. Foods can be spoiled by a myriad of factors including, harmful organisms, enzyme activities, and other chemical reactions. Bacteria are the simplest of organisms comprising a single cell and a few organelles. Despite their simplicity, bacteria can be incredibly detrimental to food. Under optimal conditions bacteria reproduce at astounding rates, a single cell can produce billions with an hour. Bacteria growth is regulated by several key factors including temperature, ph levels, nutrient availability, moisture, and oxygen levels (Food Preservation, 2012). Typically, if food is left unpreserved, then it has all the right qualities to promote bacterial growth. Bacteria are not the only organisms that are harmful to food. Certain fungi, such as molds, and plants thrive under similar conditions to bacteria, and break down food to obtain energy. Animals such as insects and rodents often feed on unprotected food and nonfood items such as adhesives and packaging. Along with consuming foodstuffs, insects can cause contamination as vectors for microbes (Tucker, 2008).

Strawberries with mold (fungi) growing on them; fungi and bacteria are the most common causes of spoiling. These microorganisms feed on the food, breaking down key components such as proteins into waste products. In fact, there are two ways an organism might cause the deterioration of a substance: chemically and physically. In chemical deterioration, an organism consumes the food as a source of energy or its waste products can damage the food, and in physical deterioration, an organism can affect the growth or activity of the food product. Both of these are factors in spoilage because they render food unsafe for consumption. (Tucker, 2008) Organisms are not the only spoiling agents; certain enzymes can cause chemical reactions resulting in spoilage. In plants and animals, enzyme activity is moderated, but this balance is disturbed upon the death of the organism. Many enzymes remain active and, while unregulated, start breaking down the cells of the foodstuff. For example, in fruits the enzymes continue the processes of ripening and cellular respiration after harvest. However, eventually these processes lead to rotting. This uncontrolled enzyme activity is not just found in fruits; many meats contain pepsin that post-slaughter break down tissue. Enzymes can cause various problems, which are shown in the table below. In addition, these processes can have other side effects; enzyme activity can increase the odds of infection from bacteria. (Food Preservation, 2012).

Common spoiling enzymes and their effect on various foods [based on Food Preservation, 2012]. Enzyme
Ascorbic Acid Oxidase Lipase Lipoxygenase Peroxidase Thiaminase

Vegetables Cereal Vegetables Fruits Meats

Spoilage Action
Destroys Vitamin C Discolors Destroys Vitamin A Browns Destroys Thiamine

There are also several non-enzymatic chemical reactions that cause the deterioration of foods, such as oxygen and light-induced reactions. Most food contains unsaturated fatty acids that will react when exposed to oxygen (Dalton, 2002). This reaction will start a chain of events leading to the spoilage of a food product. The effects of oxidation include the production of rancid flavors, discoloration, and the destruction of vitamins. Exposure to light can also cause spoilage in foods, discoloration in vegetables and meats, and the destruction of riboflavin in dairy products (Food Preservation, 2012).

Preservation Methods Through the understanding of spoilage causing factors, deterioration of food can be prevented more effectively. Food vary, but all food items will be spoiled when exposed to one or more of the same factors. In order to ensure the longest shelf life possible, several of the factors that cause deterioration must be properly addressed. The most destructive processes are caused by bacteria and other organisms and often by preventing their growth, food can become sufficiently preserved. Still enzymatic and chemical reactions must be accounted for, in order to preserve the quality of the foodstuff. For example, if a particle food item is photosensitive, it must be kept away from direct sunlight. Although all food will eventually break down, the process can be slowed. The key to preservation is controlling the environment surrounding the food; this can be done by regulating moisture content, atmospheric makeup, oxygen and light exposure, and microbial growth (Blum, 2012). Preservatives are most often used in foods to prevent spoilage, as well as to exterminate bacteria. While preservatives are typically less effective than processes such as freezing, pickling, and canning, they can effectively slow microbial growth, thus extending shelf life. There are three different ways preservatives can fight off spoilage: by inhibiting microbial growth, by slowing oxidation and other harmful reactions, and by blocking natural enzymatic processes. A wide range of preservatives, both natural and artificial, are used to achieve one or more of these prevention techniques. While most only target one cause of spoilage, some, such as sulfites, target all three (Dalton, 2002).


Food preservatives can be broken down into three basic categories: antimicrobials, antioxidants, and enzymes inhibitors. Sulphites, one type that can be placed into any of the three categories, interrupt normal functions of cells as a way to kill the organism. Propionates (antimicrobial compounds that occur naturally in certain fruits) and benzoates fight fungi. Common meat preservatives that block deadly bacteria are nitrates and nitrites. Chemical breakdown of food is often stopped with antioxidants. Preservatives in natural products are a major current search for food scientists (The Future, 2002). Because bacteria are one of the largest contributors to spoilage, food is typically fortified against them. Bacteria need specific conditions to flourish, and changing the environment around them can inhibit their growth. By changing the temperature, moisture, pH levels, or oxygen, levels of a bacteri as environment spoilage can be stopped. For example, in the process of drying, water is removed from a foodstuff, and without any water, bacteria on the surface of the food quickly die out. This does not ensure that food will never spoil, however. All bacteria require different conditions to thrive, and just because some cannot survive below freezing temperature does not mean all bacteria dont. Some bacteria also can survive unfavorable circumstances, essentially hibernating until the conditions improved to levels, which allow them to thrive. If a bacteria colony is frozen, then when they are thawed the cells may enter stasis and start growing again (Food Preservation n.d.). An ancient method of preservation, referred to as coning or curing, involves the use of salt and sugar to prevent microbial spoilage. These compounds can prevent or inhibit the growth of food-borne pathogens and protect against some microbial spoilage. The most common way they fight bacteria is through dehydration. Sugar and salt induce osmosis by affecting the equilibrium in and outside of cells. Because the outside of the cell has a lower concentration of water than within, water osmoses out of the cell to compensate. This loss of water leaves the moisture content of the cell diminished. This lack of water inhibits the growth of bacteria and fungi, which rely on an excess of cellular water to thrive (Parish, 2006). Preservatives do not just limit bacterial growth. Antioxidants are used to stop oxygen related spoilage; it can cause foods to break down by reacting with lipids and fats. Other preservatives prevent spoilage by targeting enzymes. Citric acids are commonly used to change the pH levels of fruit, inhibiting rotting (Dalton, 2002). The use of preservatives is not the only way foods are protected from bacteria. Microbial growth can be stopped, or slowed down, by removing the water from a given food item. This process is known as drying and has been used to preserve foods for tens of thousands of years. While salting is one way to cause dehydration, the very earliest drying technique used the heat from sun to evaporate the water in a given food item. This simple technique worked well for preserving plants, but did not work for meats. Because of this, other drying methods were developed, and by about 8,000 BC, smoking and salting were first used to preserve meats. These methods are still used along with more advanced techniques such as freeze drying (Zeuthen and Bogh-Sorensen, 2003).

Drying is one of the most effect preservation techniques; however, the food loses valuable nutrients through the process.


Freezing, along with drying, is used to slow down bacterial growth, as well as enzymatic processes. Not only if food able to remain fresh, but also maintains the texture and taste is the most popular method for long time food preservation and storage. Microbial growth is prohibited and internal chemical reactions are slowed during the freezing process. The lower temperature decreases the rate at which the reactions occur. Lowering the temperature also decreases the water levels necessary for microbiological deterioration. The rate at which heat should be removed from food is dependent on the composition and nature of the specific food material and the temperature and surface heat transfer of the cooling device. The success of the process is dependent on proper freezing. However, as the food is frozen and preserved, so are the microorganisms already in the food. The microbial deterioration will resume when the food is thawed (Tucker, 2008). The process of chilling, much like freezing, consist of storing foods at below room temperature. As opposed to freezing, chilling does not bring the temperature below freezing, and as a result, it does not deteriorate the quality of the food. Chilling decreases multiple processes that would spoil the food by decreasing the rate of motion of the molecules in the food. Decreasing the rate of motion decreases the both physical and physiological processes, chemical and enzymatic reactions, and microorganism growth. Bacteria and mesophilic microorganisms, however, are capable of growing at chilled temperatures. The rate at which the foods are chilled is important. Increased rates can have both negative and positive effects on the food based on the food being chilled. The amount of fluids in pre-packaged meat can be decreased with a faster cooling rate. Peaches, however, can gain a rough texture if chilled too quickly. As the temperature is chilled, the evaporation rate decreases; this allows for more profitable food when the food is sold by weight because of the extra water weight. Fruit also are able to remain hydrated longer, which prevents wilting from occurring early. The respiration and ripening rate of fruit is also decreasing with temperature, and the life cycle of the fruit is therefore being extended (Tucker, 2008).

The refrigerator is most common device in homes used to chill and freeze foods. Canning is another well developed and established technique of preserving foods, and most people encounter foods that have undergone this process on a regular basis. This method, known as thermal processing, can be performed in one of two different ways. Separate sterilization sterilizes the food and can separately and places the food in the can in an aseptic zone. In-container sterilization heats the unit of food placed in container until both are sterilized. To sterilize the food, time and temperature conditions must be maintained because it is under these conditions that bacteria are killed. The cooling process is equally important in order to prevent large amounts of spoilage after processing. These steps have been improved throughout the last century when the underlying principles of food preservation were understood (Tucker, 2008).


Organic Food Debate While the various types of preservatives used in foods can enhance the shelf life and flavor of many types of foods, there has been a resurgence of organic foods. Foods without preservatives or additive chemicals are known as organic, or natural, foods. The controversies surrounding the uses of chemical preservative in food have led 23% of the population of the United States to consistently purchase organically grown food. The spending on natural foods and nutritional supplements by consumers across the U.S.A increased from $55.1 billion in 2001 to $68 billion in 2004 (Organic Consumers Association, 2005). Organic foods use preservation techniques that humans have been using for centuries, such as salting, smoking, and drying. Organic food enthusiast argue that the chemical preservatives are harmful to the human body, but non-organic food enthusiasts say that the chemicals have no negative effects on the human body. Those who favor organic foods argue that chemical preservatives are bad with their proof being that human bodies are taking longer and longer to decompose due to excess preservatives from food. People who accept the use of chemical preservatives in everyday foods reason that the chemicals are necessary for long distance shipping. Most of the produce consumed in industrialized countries is indigenous to other areas. Produce is shipped over hundreds of miles without preservatives would be vulnerable to premature spoilage and would be unacceptable for the consumer. The availability of seasonal produce in the everyday lives of Americans introduces a dependency on foreign produce. Organic foods enthusiasts say that eating organic foods decreases foreign control over the American food supply. This organic food resurgence brings up a moral question. Is it better to eliminate the availability of exotic produce to the majority of the population, or just have the minority group suffer and adapt or accept and reform (Donaldson-Briggs, 2001)?

Natural Preservative Alternatives With the organic food market on the rise, more and more people desire less synthetic chemical preservatives in food. One example of a natural preservative that may or may not be considered a spice is garlic. Researchers at Washington University recently published a paper outlining how garlic can be used as a safe and natural preservative. According to the American Society for Microbiology (2011), past studies have found proof that thiosulfates, a group of unstable and volatile sulfur-containing compounds, have antimicrobial behavior, but this new study demonstrated that organ sulfur compounds derived from garlic also possess similar antimicrobial behaviors.

Limitations on Calcium Disodium EDTA on various foods.

Food Cabbage, pickled Canned carbonated soft drinks Canned white potatoes Clams (cooked canned) Crabmeat (cooked canned) Cucumbers (pickled) Distilled alcoholic beverages Limitation (parts per million) 220 33 110 340 275 220 25 Use Promote color, flavor, and texture retention. Promote flavor retention. Promote color retention. Promote color retention. Retard struvite formation; promote color retention. Promote color, flavor, and texture retention. Promote stability of color, flavor, and/or product clarity.


With these new developments in preservatives, people that choose organic foods over foods with artificial preservatives will be able to use this natural chemical to enhance the shelf life of organic food rather than using manmade chemicals. The amount of a given preservative that can be added to a product is limited by part 172 of the Code of Federal Regulations. Some examples of food preservatives with restrictions include Anoxomer, BHA, BHT, dehydroacetic acid, and calcium didsodium EDTA.

Spices in Preservation Preservatives are characterized as food additives because they are added to food and act to resist spoilage. Under the category of additives, preservatives can be divided into two major categories. Antioxidants prevent fruit from spoiling and prevent oils and fats from turning rancid, and antimicrobial agents impede the development of bacteria and mold (Food additives, 2011). Spices can be both antioxidants and antimicrobial agents because they can act to prevent the spread of bacteria and also prevent, or prolong, the spoilage of fruits and fats. Spices can come from shrubs, vines, lichens, seeds, flowers, roots, vines, and the fruits of herbaceous plants. The spices derive from compounds known as phytochemicals and cause the aroma and flavor of spice. In nature, the spices know evolved as defenses of plants against predatory animals and insects. A recent study on spices entitled Darwinian Gastronomy attempted to quantify the amount of spice in region of the world. In one test, they concluded that India had the most spices used in a meatbased dish out of a sample size of 36 countries. While the amount of spices per recipe was informative, the other research enacted in this study proved to reveal the preservative qualities of spices. Of the 30 tested spices, all of the spices were able to kill 25% of the bacteria for which they had been tested. Not only did each spice have antimicrobial behavior, 50% of the 30 spices tested were able to prevent 75% of bacterial growth. The most efficient spices were garlic, onion, allspice, and oregano. The regions of the world nearest to the equator of Earth have a higher spice usage seemingly because food spoilage rates are higher in areas of a higher climate. When a spice is cooked, the phytochemicals are not affected and retain the aroma and flavor. Spices are not the only factor in antimicrobial behavior because there are other chemicals called synergist: lemon juice, peppers, and other similar citric acids act as disruptors to the membranes of bacterial cells. The low pH attributed to synergists allows spices to more actively kill and prevent bacterial growth and bacteria.

A spice shop where people are able to purchase multiple preservatives.


Future of Food Preservation Although techniques for food preservation have been established, scientists are still searching for more efficient methods. Many different techniques have been invented and tested in the recent years. Different technologies focus on improving different problems that are current in common techniques. The main focuses include environment, cost, efficiency, and quality. New procedures include combining previous techniques, manipulating internal processes, using ultraviolet waves, and inventing original processes. Hurdle technology is a broad approach to food preservation. Many different forms of emerging technology in food preservation are based on hurdle technology, which is a combination of techniques. Each preservative factor is referred to as a hurdle, and they can be both natural hurdles and applied hurdles. Even though the most important hurdles can be included into six different categories, water activity, temperature, acidity, redox potential, preservatives and microorganisms, the entire list of hurdles is quite extensive. The effect on food, which can be either positive or negative, differs based on the hurdle and the food, but all hurdles should be kept in their specific optimal range. Each food is unique and differs in intensity and quality of hurdles (Leistner, 2000). The deliberate combination of hurdles can yield many diverse yet desirable effects, including microbial stability and sensory quality of food. Some hurdles in combinations of hurdles are used to counteract the negative effects other hurdles may have on the foods. The desired effect is based on the need of different cultural settings. Industrialized countries focus on minimally processed foods, minimally packaged foods, and future food lines when developing hurdle technology. However developing countries focus differently, storage without refrigeration and high-moisture foods are their main focuses (Leistner, 2000). All of different types of hurdle technology manipulate organisms physiological reactions to inhibit growth, shorten survival, or kill organisms. A basic approach is to use preservative factors to disturb the homeostasis of the organisms, and as a result the disturbance would prevent the organism from further development or kill it. By straining all of an organisms repair mechanisms, metabolic exhaustion is used to achieve a process known as auto sterilization, and the increasing the number of hurdles is able to increase the rate of exhaustion. Metabolic exhaustion can also be achieved by manipulating the stress shock protein synthesis. Subjecting an organism to multiple and diverse stresses will cause the organism to attempt to produce multiple proteins, which will exhaust the organism. Multi-target preservation would disturb homeostasis by targeting different parts of an organism at the same time. The process would require careful selection and combination of hurdles to create a proper synergistic effect (Leistner, 2000). Ultraviolet radiation is currently being developed and tested as a food preservation technology. The latest results have shown high dosages cannot achieve sterilized foods before the quality of food is diminished. However, low doses have been shown to increase the shelf life. Ultraviolet fraction of sunlight is used to kill the bacteria living in water. Other types of radiation are being used to defend against fungi and bacteria in other parts of the food as well. Opaque materials and rough surfaces do not gain a great benefit from the new technology (Prokopov & Tanchev, 2007). Ultrasonification, the use of sending ultrasound waves through food, is also being tested as a food preservation technique, but high resistance has been found in bacteria and spores. Even though bacteria have been found to have a high resistivity, the ultrasounds have been found effective in freeing bacteria attached to surfaces. Salmonellae have been found less frequently in food treated by ultrasonification. Damage can be caused to strains of the staph infection-causing agent when using ultrasound (Prokopov & Tanchev, 2007).


An area of future research is bacteriocins, toxins produced by bacteria, for food preservation. Even though those formed by pathogenic bacteria are not suitable for processes dealing with foods, bacteriocins produced from lactic acid bacteria have been deemed safe. Scientists have already identified 30 different bacteriocins, and these may provide a food preservation process, which would be a natural method (Prokopov & Tanchev, 2007). Although preservation by heating technologies is well developed, other preservation technologies are still being developed and tested. One example is high pressure processing (HPP), but the aim of this method is not to replace heat techniques but advance a possible alternative. High hydrostatic pressure is an emerging technology that has the potential of improving the quality of processed foods and preserving modern food products. Meat and seafood are more frequently subjected to HPP, but plants have undergone HPP. The effects on shelf life and safety of specific food still need to be examined more closely (Heinz, 2010). The original discovery of successful HPP occurred over a century ago, but the process has been made more accessible and popular in the most recent decades. Three variables, temperature, pressure, and time exposed to pressure, alter the exact process of HPP. This differs from the more common two variable processes, and it allows for a more varied outcome using the same technique. After the food is subjected to pressure over 350 megapascals for a time period ranging from seconds to minutes, the microorganisms, viruses, and spores in the food are inactive. However, the vitamins, flavors, and color are virtually unaffected (Heinz, 2010).

High pressure processing, a possible technology used to complete high pressure processing. Growing food, which is less susceptible to spoilage than other foods, is another focus of food scientists. Techniques for growing foods using LED lights in urban settings have recently shown to be successful. These plants have been shown to have a higher sustainability than other foods grown using traditional methods (Wogan, 2011).



American Society for Microbiology (2011, August 15). Garlic doesn't just repel vampires. ScienceDaily. Retrieved March 29, 2012, from 08/110815172343.htm Billings, Jennifer and Sherman, P. W (1999.). Darwinian gastronomy: why we use spices. BioScience, 49 (6), 453-463. Blum, D. (2012). 5. Food that lasts forever. Time.179 (10), 70-74. Retrieved from,9171,2108051,00.html Dalton, l. (2002). Food Preservatives. Science & Engineering News, 80 (45), 40. Retrieved from Donaldson-Briggs, Amanda (2001.). Viewpoint: preserving our food. British Food Journal, 103, 505507. Food additives. (2011.). The Columbia Encyclopedia, 6th ed.. Retrieved March 23, 2012 from Food preservation. (2012). In Encyclopdia Britannica. Retrieved March 23, 2012 from The future of food preservation. (2002, November 21). Retrieved on March 26, 2012, from Gould, G. W. and Russell, N. J. (eds. ). (2003). Food preservatives. ?hl=en&lr=&id=HMaJcmeEFgUC&oi=fnd&pg=PA1&dq=food+preservatives&ots=kWNPb_B7j z&sig=pP8DLDM7rD_BSk_w1RkOSmJgUcc#v=onepage&q=food%20preservatives&f=false Graham, S. (2001). Scientists uncover the chemical complexities of mummification. Scientific American, Retrieved April 2, 2012 from Heinz, V. (2010, February 1) Food preservation by high pressure. Journal of Consumer Protection and Food Safety, 5 (1), 73. History of food canning. (2012). FoodReference. Retrieved 4/4/12 from html/artcanninghistory.html Jurgelski, S. (2010). Spice of life. Sunday News (1055-2715), p. G.1. Retrieved April 2, 2012 from LexisNexis Academic. Leistner, L. (2000). Basic aspects of food preservation by hurdle technology. International Journal of Food Microbiology, 55, 181186. Organic Consumers Association. (2005). Retrieved April 5, 2012 from http://www.or


Parish. M. (2006). How do salt and sugar prevent microbial spoilage? Scientific American. Retrieved March 22, 2012, from http://www. scientificamerican .com Preserve. (2012). Retrieved April 5, 2012 from definition/preserve Prokopov, T. and Tanchev, S. (2007). Methods of food preservation. In A. McElhatton and R. J. Marsha (ed.) Food safety: a practical and case study approach. New York: Springer+Buisness Media. Spice. (2012). Retrieved April 5, 2012 from definition/spice Tucker, G. (2008). Food biodeterioration and preservation. Retrieved from US army food... just add urine. (2004, July 22). BBC News. Retrieved March 22, 2012, from Wogan, D. (2011, August 3). More on food sourcing and food sustainability. Scientific American. Retrieved March 22, 2012, from http://www. scientificamerican .com Zeuthen, P. and Bogh-Sorensen, L. (2003). Food preservation techniques. Retrieved from

Illustration Credits 2fd89a433f5a41b73e5436c22e7bf081&rgn= div5&view=text&node=21:


Chapter 11 GMO Crops

Rachel Maillet, Anish Athalye, George Han, and Osi Van Dessel History The first genetically modified food granted a license for human consumption was a tomato known as Flavr Savr. A Californian company known as Calgene produced the transgenic crop and submitted it to the U.S. Food and Drug Administration for approval in 1992. The FDA concluded that Flavr Savr was safe for human consumption and posed no more risks than a genetically unmodified tomato. In 1994, the company began selling the modified tomato, but production stopped in 1997 because it was unprofitable. This financial setback resulted in its sale to Monsanto Company. Through genetic engineering, Calgene hoped to slow the ripening process of a tomato while still retaining the natural taste and color. The plant was made more resistant to rotting through the addition of an antisense gene (APH(3)II), which interfered with the production of an enzyme that contributes to the breakdown of cell walls. However, the tomato disappointed researchers because the inserted gene did not increase the firmness of the fruit. Therefore, the modified tomato still had to be harvested the old fashioned way like any unmodified vine-ripe tomato. As a result, the project was considered a failure because the costs did not exceed the profits, eventually ceasing the production of Flavr Savr (Redenbaugh, 1992).

The Science of Genetic Modification Knowledge of genetics has become essential in genetically modifying organisms. Genetic modification is defined as manipulating the development of the organism through the insertion of special DNA sequences. However, genetic modification differs from plant breeding because of the precision of gene transfer. In conventional breeding, desired genes in two parents are bred over generations to produce offspring that have the desired trait. However, in transgenic organisms, genes can be inserted from a completely different organism without the issue of fertility (Halford, 2000). In both plants and animals, desirable traits are introduced into the organism using rDNA technology (Genetically Engineered Animals, 2012). At Monsanto, the company that produces 90% of all transgenic crops, scientists follow a special procedure to produce genetically modified plants. Scientists first select the trait they want a plant to have and where they can obtain this trait. Next, scientists acquire the desired gene from an organism by using genome-mapping technology. After they have the genes, they must insert it into the plant, which can be accomplished through several techniques. One procedure uses a gene gun that literally shoots pieces of DNA into plant tissue. Another method uses a bacterium, Agrobacterium tumefaciens, to insert genes into plant seedlings. This organism specializes in invading plant DNA, so scientists at Monsanto have used this bacterium to insert new proteins in plant chromosomes. After many years of testing in growth chambers that monitor disease resistance, drought tolerance, and other factors, the company will finally narrow down the seedlings to the one that is best genetically modified. This seed will be reproduced and sold to farmers around the world (Boyle, 2011).


Applications Recently, scientists have expressed interests in the applications of GMOs. In food technology, plants and livestock are modified with desired traits. Often times, production costs are lowered as well, resulting in cost savings passed on to the consumer. Although there are many benefits from GMOs, the application of the technology is dependent on the profitability, costs of transition, certainty of outcome, and consumer preference (Bremmers, 2004). There are many applications and current uses of modified plants. Over the last decade, transgenic crops have been planted on more than a billion acres in the world. In the coming years, scientists predict that 10.3 million farmers will plant biotech corn, canola, cotton, soybeans, and other genetically modified crops (Chassy, 2007). The use of transgenic plants is growing as well. In 2010 alone, the amount of land planted with transgenic crops grew by 10% to 366m acres (Genetically modified crops, 2011).

Genetically modified crops. This bar chart shows the increase of genetically modified crops in certain countries from 2009 to 2010 in hectares (Genetically modified crops, 2011).

This occurs because farmers are willing to pay more for modified seeds that will result in higher yields, greater pest resistance, and lower labor demand. This is not surprising given that the quantitative impacts of genetically modified crops have been truly remarkable. They have brought farmers $27 billion in additional profits, reduced pesticide use by 224 million kg, and cut greenhouse gases by amount equivalent to removing 4 million cars off the road (Chassy, 2007). Currently, genetically modified crops are extremely successful and have been adopted faster than any type of technology in agriculture in the United States. The most accepted modified crop is the soybean. In the United States, 94% of all soybeans are modified with a gene that makes the plant resistant to herbicides. Corn has also been modified, with 72% of all corn herbicide resistant, insect resistant, and vitamin enriched. Many of the genes for insect resistance were required from the bacterium Bacillus thuringiensis. Lastly, 73% of all cotton has been modified so that it is pest resistant (Adoption Crops, n.d.).


Adoption of genetically engineered crops. This graph shows the growth rate of adopted modified crops in the US. HT represents herbicide resistant and Bt represents insect resistant (Adoption of Genetically Engineered Crops in the US, n.d.). Scientists are constantly modifying and altering crops in new ways. In Britain, scientists are now testing modified wheat that contains a peppermint gene that not only frightens aphids, but also attracts predators that eat them. The wheat is designed to release a pheromone when under attack from aphids, which creates panic and causes the insect to flee. Scents are also released to attract parasitoid wasps as a second layer of defense, which preys on aphids. This has become an alternative to chemical insecticides that are used to control crop pest. Although tests are still being conducted, this new approach could eventually help protect crops and flowers from aphids without the use of toxins (Genetically terrify aphids, 2012). In livestock, genetic modifications have been applied to three main categories: animal production, human nutrition, and healthcare. In the livestock chain, applications of transgenic technology are possible in animal breeding, growing (genetically modified food, vaccinations, and supplements), and processing. An example of transgenic animal breeding is the genetic modification of pigs. A main issue that researchers have aimed to fix is the excess fat on pigs. In Japan, through implanting a spinach gene, scientists have created pigs that produce less fat and healthier meat. Others have modified the IGF-1 gene in pigs because studies have shown that the transgene can help reduce carcass fat by up to 20% and increase lean body mass. Another application has increased the milk production in baby pigs, leading to an increase in the growth of transgenic pigs. This in turn has resulted in lower food costs, lower use of antibiotics, and less pollution. Lastly, there has been a growing problem with pollution from the phosphorous contained in the manure of monogastic animals. This has led Canadian scientists to alter pigs that have 75% less phosphorous in their manure, resulting in a healthier environment. Although it is still being developed, there are many applications of genetically modified feed, feed additives, hormones, and vaccines for livestock as well. A large number of crops used to feed animals are already modified for greater benefits. New crops have improved feeding value through the addition of phytase, which is beneficial for the welfare of the animal and the environment. Currently, there are studies done on genetically adding edible vaccines, antibodies, enzymes, and hormones in animal feed as well. This is expected to reduce costs, increase growth rates, and increase animal health. Lastly, genetically added feed additives, such as nutrients and supplements, play a large role in enhancing


livestock nutrition as well. Through these feed additives, animals will be able to digest more efficiently, resulting in healthier and more productive animals (Bremmers, 2004). The types of genetic modifications are endless. To this day, there are thousands of different modifications, ranging from birds that cannot transmit avian flu to humans, corn that is pest repellant, and dogs with sharper hearing abilities. As we progress into the future, new ideas for modifications will spawn, and new transgenic organisms will be born.

Controversy and Possible Risks The risks that result in the greatest controversy are the harmful effects on human health and the environment. There are many other risks that pose as a threat to the continuance of GM crops. The engineering of herbicides for weed control results in the harm to wildlife. These plants, that have various toxicities, can enter into a water supply and remain in a particular environment for a very long time. The possibility that certain genes from genetically engineered crops will come in contact with other plants produces the risk of large weed populations that are difficult to control with plants or insects. Certain types of crops harm specific organisms. The mortality of the monarch caterpillar increases with each feeding on milkweed covered with the pollen from Bt corn, which produces a dangerous toxin. If this species was affected, several other species farther down the food chain may also be affected. In 1985, scientists transferred the certain genes into a tobacco plant that resulted in the production of a crystalline material toxic to butterflies, moths, and other insect pests. Bt corn and cotton have been designed to diminish the pest population, but experiments have shown that fields with Bt corn have an increased amount of insects and other pests than those fields with insecticides; however, insecticides are harmful to non-target insects while the toxin produced from Bt products is harmless to non-target insects, animals, and humans. If insecticides are commonly used and kill thousands of innocent insects, than Bt crops are useful, but if insecticides are rarely used, than Bt crops are simply useless (Biello, 2007). Also, if the weed population increases by genetically engineering these organisms, diverse bird populations may become scarce (Marvier, 2002). Issues have risen, and sides have been chosen about whether or not genetically engineered organisms should exist. The only genetically modified crop grown in Europe is a type of corn. Because of the withdrawal of the potato as a GM crop, approximately 140 jobs were cut from the company which developed the Amflora potato for the paper industry. Although the company is looking for authorizations for certain food products in the future, it does not plan to market other GMOs, including the diseaseresistant potato product and the disease-resistant wheat product. Environmentalists were enthused about this destruction of another genetically modified food product in Europe (Kanter, 2012).

These genetically modified Amflora potatoes are no longer produced in Europe.


The most controversial risk is whether the by-products that accumulate over time from GM crops are extremely harmful to the environment and the health of humans. These risks are not definitive, as they vary in different environments and conditions. However, it is important that these issues be soon resolved because the public will further support transgenic crops. For those that are against the genetic modification of crops, it is unjust to jump to any negative conclusions. The worldwide use of GM crops has the potential to harm people and the environment, but there are serious problems with food and nutrition that cannot afford to reject the use of these crops. Society, as a large scale, must come to an agreement with the use of GM crops (Nap, Metz, Escaler, & Conner, 2003).

Benefits Genetically engineered crops are being used to improve the management of pest insects, devise new policies regarding effective land and water, and produce new crops from the thousands of possibilities of gene and genome combinations. In 2009 it was reported that thirty different genetically engineered crops were being grown on approximately three hundred million acres in twenty-five different countries. Fifteen of those twenty-five countries were known as developing countries. Genetically engineered crops have been growing in fields for over fourteen years. Throughout those years, not one extreme health or environmental effect has been the result. It isnt completely inaccurate to think of some harmful effects of GM crops on the environments as being no different than other unintended problems that affected human health and the environment as well. Each new plant variety produced contains the risk of different unintended problems; however, three government agencies thoroughly examine these GM crops while other crops are never expected by any type of agencies. These conventional crops that are never assessed have been recorded to cause harmful effects on humans or animals (Ronald, 2011). New crops are essentially being made to improve the nutrition of humans, to diminish the use of various harmful pesticides, and to improve the soil. A certain type of rice has been produced with an increased amount of iron that reduces the chances of blindness and anemia worldwide. The increase in GM crops would also increase the reduction of harmful pesticides. Such chemical pesticides cause great harm to insects and worms that feed on pest insects and aid in decomposition and gaining nutrients. Between 1997 and 1998, harmful pesticides were reduced by one percent because of the genetic engineering of corn, cotton, and soybeans. The development of engineered crops that bear herbicides can actually improve the soil. This would cut down on processes that reduce the amount of soil (Marvier, 2002). Insect resistant crops are among those that are genetically engineered. These crops were grown to reduce the use of harmful pesticides that control various insects that feed on the plants. There are approximately three hundred thousand deaths related to pesticides globally. Modified populations of corn and cotton were produced that contain certain proteins, Bt toxins from Bacillus thuringiensis, which kill the pests that feed on the plants. Even better, these toxins do not cause harm to most insects, wildlife, and people who prove to be beneficial. Bt crops are actually the second most popular type of engineered crop. Since the planting and growing of Bt crops, the number of pounds of chemical insecticides have been reduced. With the reduction of harmful insecticide comes the reduction of injuries in Chinese and Indian farmers. There has also been an increase in biological diversity. Despite all of the advantages of using this crop, certain insects may actually become accustomed to the toxins and will evolve to become resistant to the Bt crops. Since there is much controversy about whether or not genetically


modified/engineered crops are beneficial or not, farmers have been reluctant to try producing and growing these types of crops. There are new methods that are being designed to produce more accurate and precise improvements than those being used that utilize a random process of mutagenesis or the mating of two closely related organisms. Foods that are being developed through biotechnology raise speculation about the legitimacy of the labeling of the products. Although fruits, vegetables, cereals, flour, oils, milk, fish, and shellfish do not need to be approved by the FDA, the Federal Food, Drug, and Cosmetic Act states that these foods must be safe for consumers. The food products of biotechnology are regulated under the same, strict conditions that regulate conventional foods (Maryanski, 1999). The most rapidly adopted technology in the history of agriculture and farming, genetically modifying crops increases the amount of crops yielded and makes our foods healthier. For those opposed to genetically modifying crops, every crop is actually the result of repeated experimentation and adjustment by humans over time. In producing a new crop, scientists and plant breeders try to alter a minute part of the genome of the crop rather than drastically changing large parts of the plant. This method, unlike wide-cross hybridization and mutation breeding, produces predictable results that do not bring about dangerous new species. A device called the gene gun is used to produce adequate results. Not only does this device yield the healthy crops needed, but it also reduces the chances of bacterial contamination and an inconsistency in results. Even with this fairly simple method of genetically modifying organisms, plant breeders do not just transfer the genes to the genomes by themselves, but they also include an antibiotic-resistant marker to ensure that no other cells than the modified ones are grown into a full plant. The United States, Argentina, and Canada are currently the countries to be growing the largest population of genetically modified crops. Specific organisms like soybeans, corn, cotton, and canola have been modified to be more resistant to pest insects, herbicides, and diseases. Engineered crops that are able to tolerate herbicides help conserve that soil on large areas of land as the management no longing needs to till the soil. GMOs affect the soil because they have the ability to decrease the plant decomposition rates and the levels of carbon and nitrogen (Phifer & Wolfenbarger, 2000). Aside from improving the conditions of the soil, genetically modifying crops produces a healthier supply of food to feed thousands of people. Deficiencies in vitamins and minerals can result in anemia, intellectual development impairment, blindness, and even death. A rice product that is being engineered contain an enriched amount of provitamin A and digestible iron. Approximately three billion people globally consume an inadequate amount of vitamins and minerals. Genetically engineered rice has the ability to make people healthier and to save the lives of many people. Vaccine proteins are also being included in some crops to eliminate diseases in developing countries. Trees are being modified with different genes that enable them to decontaminate certain heavy metals found in the soil in result to pollution. Researchers say that by the year 2025, there will be approximately eight billion people worldwide. The future may likely include the increase in genetically modified crops to provide a key food source. However, there are many concerns that come to people about genetically modifying organisms, especially crops. Crops that are resistant to herbicides actually kill all weeds without harming beneficial crops. The toxic chemical that is found in Bt pollen is belittled by the sunlight and natural weather conditions, such as rain, over time. The so called supercrops that have the potential to invade other existing plants are found to be growing in their own environments without any traces of invasion. Scientists perform careful studies to ensure that no genetically engineered crops secrete proteins that cause allergic reactions. There are many risks and concerns that are proved to be illegitimate. With this in mind, the American Medical Association believes that genetically modified crops have the potential to prevent and even cure diseases. GM crops have the ability to help developing countries overcome a scarcity of food.

These crops are just as healthy, nutritious, and safe as the other foods regularly sold in grocery stores (Prakash, 2005). International Policy In recent years biotechnology has evolved into a controversial subject with debates about the evolution, expenditure, and expansion of genetically modified organisms (GMOs). There has been a volatile reception of GMOs in developed countries, and clear differences in regulation dictate the response from the different international organizations. For some countries the acceptance of biotechnology comes with relative ease, such as the quick FDA approval, while in other institutions the technology undergoes intense scrutiny, such as the regulatory body of the European Union (EU). The difference of opinion between the EU and the US was analyzed in a study during 1996-1997, which studied the public opinion of the application of biotechnology. The study showed various level of support for the use of GMOs in different applications and in the figure below a graphical representation of public concern can be seen (Bailey & Lappe, 2002). The survey concluded that there were three factors responsible for the greater European resistance to biotechnology

Applications for GMOs and their support. This bar graph shows the results for a survey conducted between 1996-1997 asking about applications for GMOs.

The first factor responsible for the hostile public reaction against GMOs in the EU could be attributed to the influence of the press and mass media. It is generally accepted that the media plays a crucial role in defining public perception and there are currently two understanding of how the system actually influences society. One view supports that the content of the press is the determining factor in public understanding while another view believes that the total presence in the media is the deciding factor (Bamford, 2007). In Europe the latter seems to be the greater influence. As the news of biotechnology increases, there is a steady increase in public concern for the technology. The second factor that may have contributed to the negative public opinion in the EU could be the trust in regulatory procedures. Europe and the United States have rather different histories of biotechnology regulation. The US held short public debates in the 1980s to settle most issues concerning new regulations for biotechnology. These debates were resolved with relative ease because U.S. regulators did not see biotechnology as posing special risks, and most of the regulation was already contained within existing laws addressing known physical risks of new products. In Europe, by contrast, debate took a much longer period as the union had to agree on a viable transnational consensus. With

added regulatory process, the EU naturally had to take longer in approving biotechnology, but this extended period of time was detrimental through the extended time that GMOs circulated the media (Buhler, Stephen, Eddie, & Mann, 2002).

Press coverage of GMOs. This graph is representative of the number of articles relating to biotechnology between the years 1984 and 1996. It represents how GMOs were in the European media more than in the USA.

The third factor that is responsible for the negative understanding of GMOs is the role of knowledge in public perceptions. There is a common belief that with scientific understanding, the public will become more approving of a technology. The study however showed that the correlation with public understanding in biotechnology and public concern was reversed, the more the public understood the subject, the less approving they were about the technology. The European public understood the technical aspects of biotechnology better than the American public, but chooses to eliminate any use of GMOs in the market. The approval of the American public is representative of either the naivety to new technology or the general acceptance of GMOs benefits (Conner, Glare, & Nap, 2002).

GMOs within the European Union The use of GMOs within the European Union has prompted intense controversy and debate. Although the USA was able to obtain authorization for the commercial use of GMs quickly, the EU has posed long regulatory delays on the technology upon the requests for more scientific information. Through growing public distrust of GMOs regulators that approved the use of biotechnology are reconsidering questions previously dismissed and officially resolved. Coupled with government reconsideration and public pressure, retailers have also begun reviewing their procedures and methods. The EU as well as other government agencies have grown more cautious to GMOs and have begun integrating as well as employing an assortment of protective measures. The major precautionary method installed by governments is the necessary evidence required to demonstrate the safety of GMOs. Through legislation, governments have broadened the practical definition of the adverse effects which must be prevented and have also devised a market stage precaution for such effects. The risks of genetically modified (GM) crops have sparked controversy within the European Union as companies test for the commercial stage of GMs in Europe. One such legislation established by the EU is known as the EC Deliberate Release Directive 90/220. The legislation sets a procedure to not only harmonize the integration of GMOs into the market but also increase regulation for safe use. The major issue for this

legislation as well as the regulatory procedure of the EU is that the multinational system has defined risk in a multitude of ways, thus imposing conflicting views.

International Risk Analysis Risk is defined differently for every country. Risk debates focuses on the conflicting ideologies of how technology should be used within society. It also deals with contending visions of how society should be organized. Certain protesters warn that the environment is at risk from a specific technological practice or development such as GMs, this warning may actually express a more specific agenda by the opposing organization. For example, a warning that a technology is out of control may be used to imply that expert managers are needed to bring it under control and thus to protect the environment. Risk debates generate conflicts of accountability about how potential harm can be reduced, and as a consequence of the debate risk conflicts highlight disagreements among experts. Given the volatile nature of risk debates, a small and self-critical society revolves around the disagreements. Experts are constantly discussing the advantages and disadvantages until the final outcome is that more research is required. This response may be used as a political strategy to delay contentious decisions, to accommodate disagreements, or to gain resources to gather more scientific information. In practice, additional research often leads to further controversy over how to interpret the experimental results, partly because the research is grounded within a particular model of the relevant uncertainty. Although funded in order to guide policy, the scientific research itself is often driven by policy directives and their epistemic criteria for risk (Andow, Hilbeckk, & Van Taut, 2008). Although GM crops shows promise in the future, there is a multitude of concerns about the impact of GM crops on the environment. Key issues of GM crops are putative invasiveness, vertical or horizontal gene flow, other ecological impacts, effects on biodiversity and the impact of presence of GM material in other products. These are interdisciplinary and complex issues that are the major scientific reason for the restriction in international policy. An important step in making an informed decision about GMs is by defining the appropriate baseline for comparison of the risks and rewards of such technology. The best and most appropriately defined reference point for GMs is the impact of plants developed by traditional breeding. The latter is an integral and accepted part of agriculture. In many instances, the putative impacts identified for GM crops are very similar to the impacts of new cultivars derived from traditional breeding. When assessing GM crops relative to existing cultivars, the increased knowledge base underpinning the development of GM crops will provide greater confidence in the assurances plant science can give on the risks of releasing such crops (Mariani, 2007). Throughout the history of plant breeding, new technologies have regularly been utilized to develop new gene combinations for improving crop cultivars. These included: the artificial manipulation of chromosome number; the development of addition and substitution lines for specific chromosomes; chemical and radiation treatments to induce mutations and chromosome rearrangements; as well as cell and tissue culture approaches such as embryo rescue, in vitro fertilization and protoplast fusion to allow the recovery of interspecific and intergeneric hybrids. The genetic gains from the integration of these technologies into mainstream plant breeding have substantially improved the performance of the resulting cultivars. They continue to make a major contribution to genetic improvements in yield, environmental adaptation, resistance to specific diseases and pests, and specific quality attributes that are constantly demanded by farmers, the food industry and consumers. Although beneficial to some, it is regarded that with reintroduction into the natural ecosystem, an uncontrollable interaction will occur, resulting in the upset of the natural evolutionary process (Young et al. 2008).


Future of GMO Crops A booming global population is putting pressure on food producers. Over half of the global population suffers from diseases caused by lack of food and dietary deficiency. Out of these people, in developing countries, over 800 million are chronically undernourished. Two primary reasons are that food is scare in developing countries, and whatever food is available in developing countries (maize, wheat, and rice) is deficient in essential vitamins, amino acids, and minerals. Already, food demand is extremely high; by 2050, that demand will double. To solve that problem, scientists are trying to start an Evergreen Revolution, similar to the Green Revolution of the late 1960s (Despain, 2010). They propose to leverage genetically modified organisms to improve global agricultural productivity. Proponents of the movement claim that GM crops will significantly improve agricultural productivity and combat agricultural challenges (such as climate change). However, critics continue to argue against GM crops, citing problems such as biodiversity displacement, native plant devastation, and wildlife damage (Nap, Metz & Escaler, 2003). There are many challenges associated with adoption of transgenic crops. Recently, scientists, policymakers, farmers, economists, and biotechnology representatives have been discussing the necessity of ecological monitoring (Marvier, 2002). The details of monitoring have still not been decided; however, it is important that the issues are worked out soon. A sound monitoring program will be essential for public acceptance of genetically modified crops (Goyal & Gurtoo, 2011).

Research and Technology Much research in genetically modified plants focuses on designing hardier and more efficient crops. Scientists are developing several strategies to attempt to design better crops. One such strategy allows plants to use solar energy more efficiently. There are three types of photosynthesis: C3, C4, and CAM. Most plants including wheat, rice, and soy employ the C3 process, in which three carbon compounds are fixed in a photosynthetic cycle. Some plants, such as corn and sugarcane, have evolved into the more efficient C4 variety, which are able to store carbon dioxide for photosynthesis and thus survive in harsher conditions and are produce more biomass efficiently. Genetically engineered C3 crops using the C4 strategy would have the same abilities. Another method involves designing crops to fix nitrogen, which would cause plants to require less supplemental nitrogen. Nitrogen is plentiful in the atmosphere (in fact, it constitutes about 80% of the air on Earth), but nitrogen-containing fertilizer is expensive and contaminates the environment. Certain crops such as soy and some legumes have developed the ability to fix nitrogen gas from the air; giving this trait to other crops will decrease pollution and increase yields. A third method is to bioengineer grains to produce seeds without fertilization through apomixis. This cloning type of reproduction would eliminate the need for annual interbreeding, greatly reducing costs. Adapting crops to withstand heat, drought, and salinity is another option. These factors account for the majority of crop losses. Engineering crops to better survive a wide variety of climate conditions would allow farmers to use land not normally suitable for agriculture and reduce the impact of climate shift caused by global warming on crop production. Another strategy is bioengineering plants with greater resistance to pests and diseases. Scientists are currently experimenting with ribonucleic acid interference (RNAi) genes to find new methods of killing insects and viruses (Qaim & Zilberman, 2003). Increasing the light-gathering capability of plants is another plan. Plants could be more efficient at gathering light from the sun; most collect only 1-3% of light, while human-designed solar panels

collect 10-15% of light. But some plants are more efficient at capturing light than others; scientists are looking into inserting these genes into the less efficient plants (Despain, 2012). Research on genetically modified plants focuses not only on making more efficient crops, but also on designing better crops. In current research, scientists are cloning a set of genes for the biosynthesis of vitamins, essential amino acids, and minerals and using a novel method to introduce multiple genes into cereal crops (Zhu et al., 2007). Adoption Biotech crops are the fastest adopted crop technology with over 160 million acres planted today, a 94-fold increase from the 1.7 million hectares planted in 1996 (ISAAA Brief, 2011). They are not a silver bullet solution to world hunger problems, but an outright rejection of genetically modified crops is illogical and potentially harmful to the environment and poorer people in the world (Lynas, 2010). Indeed, out of the 29 countries planting GM crops today, 19 are developing countries, growing approximately 50% of global biotech crops. The top 10 planters each grew more than 1 million hectares.

Over 160 million acres of GMO crops are grown worldwide.


Biotech crops are benefitting people in both developed and developing countries. In the United States, 69 million hectares of GM crops are being planted. In developing countries, GM crops are benefitting resource-poor farmers. For example, in China, 7 million farmers (growing approximately 0.5 hectares each) grew 3.9 million hectares of GM cotton. Biotech crops in Africa are making steady progress: three countries (South Africa, Burkina Faso, and Egypt) have commercialized biotech crops, altogether planting 2.5 million hectares; several other countries are conducting field trials focusing on staple crops including maize, cassava, banana, and sweet potato.

There is contrast between developed and developing countries in the cultivation of GMO crops. With the rising world population, it is imperative that genetically modified crops succeed. The world needs at least 70% more food by 2050, and demand is only going to increase after that. In developing countries where 2.5 billion subsistence farmers survive, food production needs to be doubled by 2050. With such a great rise in demand, biotech crops are essential not only for developing countries Bibliography Adoption of Genetically Engineered Crops in the US. (n.d.). Retrieved April 8, 2012, from Andow, D., Hilbeckk, A., and Van Taut, N. (2008) Environmental Risk Assessment of Genetically Modified Organisms. Cambridge: CAB International


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Levidow, L., Carr, S., and Wield D. (2011) Genetically modified crops in the European Union: regulatory conflicts as precautionary opportunities. Journal of Risk Research, 3:3, 189-208 Lynas, M. (2010, November 4). What the Green Movement Got Wrong: A turncoat explains. The Telegraph. Retrieved March 23, 2012, from Mariani, M. T. (2007) The Intersection Of International Law, Agricultural, Biotechnology, and Infectious Disease. The Netherlands: Koninklijke Brill Marvier, M. (2002). Genetically engineered crops. AccessScience. Retrieved March 22, 2012, from the AccessScience database. Maryanski, J. (1999). Food biotechnology. AccessScience. Retrieved March 22, 2012, from the Access Science database. Nap, J. P., Metz, P. L. J., Escaler, M. and Conner, A. J. (2003). The release of genetically modified crops into the environment. The Plant Journal, 33, 118. Pecahn, P. (2005) Genes on the Menu: Facts for Knowledge-Based Decisions. New York: Springer Phifer, P. and Wolfenbarger, L. (2000, December). The ecological risks and benefits of genetically engineered plants. Science, 290, 2088-2093. Prakash, C. (2005). Genetically modified crops. AccessScience. Retrieved March 22, 2012, from the AccessScience database. Qaim, M. and Zilberman, D. (2003). Yield Effects of Genetically Modified Crops in Developing Countries, 299, 900-902. Redenbaugh, K. (1992). Safety Assessment of Genetically Engineered Fruits and Vegetables. Boca Ratom: CRC Press, Inc. Ronald, P. (2011). Genetically engineered crops - what, how, why. Retrieved March 22, 2012, from Young, R. O., Chambers, W. B., Kim, J. A., and Have, C. T. (2008) Institutional Interplay: Biosafety and Trade. New York: United Nations University. Zhu et al. (2007). Vitamin, Protein and Essential Mineral Enhancement of Cereal Crops for Food Security. Molecular Plant Breeding, 5 (2), 125-127.

Illustration Credits


Chapter 12 Sustainability and Food

Dennis Giaya, Eric Williams, and Rohit Satishchandra

Introduction The high population density of many countries raises questions about there are enough resources to support the growing population. With a growing amount of people to feed and a finite amount of exploitable food sources, the agriculture industry is striving towards more efficient and ultimately more sustainable methods of food production. Sustainability as a concept is rooted in a social context, and as a term is loosely defined. There is no mathematical equation to give the sustainability of any particular system because sustainability is dependent on multiple factors, many of which are rather subjective. There are two main categories discussed under the title of sustainability: critical limits and competing objectives. There exists a scientific procedure to determine the critical limit of earth to sustain human life. However, considering competing objectives is a multifaceted problem. This involves balancing the resources available in a manner best suited to serve the human population for an amount of time deemed acceptable. For this method to work, items must be prioritized so that fair compromises can be made to ensure maximum desired output (Fricker, 2000). The sustainable agriculture movement embraces methods that are designed to maximize the food production in a given area while minimizing the environmental impact. Practices such as rotating crops, using less harmful chemicals, and recycling are all embraced under the sustainable movement. Another critical focus is the processing and transportation of goods. Processing consumes energy, and current transportation methods are fueled by depleting natural resources that also release harmful pollutants into the atmosphere. For example, milk production is an energy intensive process from raising the cows to transporting the milk. It is important to get as much milk per cow as possible in order to maximize profit and reduce environmental impact. Focusing on retrieving more milk per cow leads to better treatment of the cows and a more effective production process that is less wasteful. Dairy farmers are beginning to reuse water from the milk cooling process, harvest rainwater, and install boreholes in an effort to minimize water consumption. By increasing efficiency by 27%, dairy processors have prevented as much as 270,000 tons of carbon dioxide from entering the atmosphere annually. This is a joint effort between the processors and the retailers to use less energy and reduce emissions in the production and distribution process (Tasker, 2011). Unfortunately, helping the environment comes at a cost. Adhering to sustainable agriculture practices is difficult for many farmers who are struggling economically. Although sustainable practices are better in the long run, the operating costs can be impractical for some smaller farms. Additionally, the cost of decreased output from using fewer chemicals is ultimately passed on to the consumer. Growing crops in a sustainable manner is better for the environment, but in some cases it may mean a decrease in volume. It all goes back to balancing the factors that contribute to sustainability. A decrease in output would mean increased competition that leads to increased prices for the consumer. However, these initial challenges are insignificant when compared to the result once devastating irreversible environmental damage has occurred.


This bar graph illustrates the amount of carbon dioxide released in the atmosphere to produce a half-pound of each of the foods. With the recent hype of climate change, the term carbon footprint has become increasingly popular. A carbon footprint is a measure of the ecological impact of a specific individual, location, or organization. Specifically, the carbon footprint accounts for the carbon dioxide emissions produced; it is measured in tons of carbon dioxide ETAP (2007). Many factors can affect the carbon footprint of the agriculture industry. Different types of crops can have different carbon footprints depending on the method used to grow them. Also, it is generally true that eating lower on the food chain reduces the carbon footprint of the end result. For example, eating beef will have a large carbon footprint because that cow had to be fed and taken care of. Energy was required to grow the crops to feed the cow and also to transport them to the cow. By eating the crops themselves rather than the cow, all of the excess intermediate energy can be omitted from the process. Carbon footprint is important to consider when discussing sustainable agriculture because a high carbon footprint has a severe environmental impact. Polluting the atmosphere is harmful on two separate levels. First there is the climate change and water pollution that results from high carbon dioxide emissions. Then it must be considered that climate change could render some crops obsolete and would make obtaining water more difficult than it already is for some areas that are struggling to obtain usable farmland. History There has been a shift in U.S. agriculture. A census released by the USDA (United States Department of Agriculture) shows a dramatic increase in the number of farms and farmers from 2002 to 2007. An increased awareness of how health, food, and the environment are all interrelated and impact sustainability has been the catalyst for most of the change. Some problems Americans are currently faced with include environmental degradation, water scarcity, and rising gasoline prices. These all affect the ability to grow and transport quality food. The agrofuel boom, a recent movement to use agricultural products such as corn and other grains to create fuel, has diverted a large portion of grain supplies and is contributing to the global food crisis (Hundal, 2010).

Major crops grown in the United States include corn, soybeans, hay, wheat, cotton, rain, and rice. The U.S. is the worlds largest producer of corn. Corn is a versatile crop that is mostly used to feed livestock. It is also consumed by people or used to create environmentally friendly ethanol fuels for use in cars and trucks with a lower carbon footprint. Hay and grain are mainly used for animal consumption (EPA, 2009). On a global scale, food production is not being distributed evenly to meet the needs of a growing population. Economically stable nations suffer from food over consumption that leads to obesity while developing countries are plagued with starvation and a dwindling food supply. Increased production is limited by three major factors: land, water, and energy. An increasing global population means a decrease in the amount of land area per person available for growing food (Leaver, 2011). The availability of water is essential to growing food as irrigated crops account for 50% of the global food (Boutraa, 2010). A large amount of nonrenewable energy is used to make fertilizer for agriculture as well as to transport crops from the producer to the consumer. The main effect of globalization is that it is the driving force behind the sustainable agriculture movement. By considering the needs of people as a whole and the resources available to them, some kind of plan can be made to utilize the resources to their full potential and ensure maximum output for as long as possible.

Rotating crops seasonally is a good way to avoid overfarming a plot of land to the point that it becomes unusable.

Environmental Impact of Current Agriculture The environmental impacts of agriculture can be divided into two groups: those caused by expansion and those caused by amplification. Expansion refers to the scenario in which croplands and pastures extend into new areas and replace natural ecosystems, and amplification denotes the process by which existing crops are managed for higher production through the use of irrigation, fertilizers, and mechanization. The availability of land area to produce food has not increased substantially over the past 50 years. Meanwhile, the rising global population has decreased the agricultural land area available per person to grow food from 1.30 to 0.72 hectares in the last 40 years. These trends will most likely stay the same in future years because land will be used for other uses such as urbanization, biofuel production, desertification, and salination. Global agriculture has cleared 70% of the grassland, 50% of the savanna, 45% of the temperate deciduous forest, and 27% of the tropical forest biome. Croplands and pastures currently represent almost 40% of the non-ice land on Earth, and much of the expansion has been isolated

to the tropics, where an estimated 80% of new croplands will replace forests. This clearing of the biomes eliminates biodiversity and key ecosystem services, and also contributes a major source of greenhouse gas emissions (approximately 12% of total anthropogenic CO2 emissions). In addition, almost 70% of global freshwater usage is used for irrigation. Rainwater farming currently consumes the most of the global water supply (Foley et al., 2011). Thus there is increasing pressure to slow the expansion of agricultural land because of its associated GHG emissions and contribution to the loss of biodiversity. Agriculture has also become dependent on non-renewable energy sources to maintain its operation; 4% of global fossil fuel energy is used by farming, and about 50% of this amount is required for production of nitrogen fertilizer (Leaver, 2011). Food Transport and Climate Public concern regarding climate change has significantly increased in recent years; one particular aspect that has garnered increased attention has been food production and the impact it has on greenhouse gas (GHG) emission. Few studies, however, have analyzed the GHG emissions linked to food production in comparison to the transportation and distribution of food products. The findings of one recent study suggest that despite the vast amount of distance food travels in general, the great majority of food-related GHG emissions can be linked to the production phase. In fact, 83% of the average U.S. household footprint for food consumption is from production, and only 11% of life-cycle GHG emissions can be attributed to transportation as a whole. Further, the results indicated that the most plausible course of action in the attempt to lower food-related GHG may involve a shift in dietary standards, rather than an emphasis on localized retail. Food, combined with home energy and transportation, comprises a large share of most consumers personal impact on the climate. Unlike home and transportation, however, the purchase of food allows consumers to reduce more easily their personal impact because of the substantial amount of personal choice involved and relative lack of long-term restricting effects.

The total t-km of freight by mode per year per household, transport-related GHG emissions by mode, total GHG emissions by supply chain tier associated with household food consumption in the United States, and comparative climate impacts of different food groups.


There has been a steady increase in both organic and locally grown food in the U.S., which shows the increasing awareness in American consumers of their impact on the environment. Red meat and cereal (and other grain products) contribute the vast majority of transport and supply-chain affiliated GHG emissions. Trucking contributes the vast majority of food transportation for all major food groups. Dairy products are responsible for the most emission of methane. It was determined that relatively small shifts in the average household diet could yield GHG reductions similar to that of localized production. For example, a 21-24% reduction in red meat consumption, shifted to chicken, fish or an average vegetarian diet lacking meat consumption would achieve the same reduction as total localization (Weber& Matthews, 2008) Solutions for Sustainable Agriculture Clearly, these problems present environmentalists, and the human population in general, with an alarming dilemma. Just as world population and consumption continue to rise, so also does the need to grow food sustainably and reduce the agricultural footprint. Environmentalists insist that halting, or at the very least delaying, agricultural expansion is the first step in ensuring secure and sustainable food supply for the coming years. They claim that crops situated in tropical locations, where much of the deforestation occurs, produce low yields, and are not a significant source of protein. The next step is closing the disparities in yield among various landscapes worldwide so that underperforming landscapes can become equal with the areas of highest yield, thereby increasing food supply while keeping expansion at a minimum. Finally, maximizing the efficiency of irrigation and eating less meat and dairy products are essential in sustainable agriculture (Foley et al., 2011) Though conventional agricultural systems are largely specialized, the growth of one crop year after year is not a prevalent practice. Crop rotation, or the planting of different crops on a particular plot of land over time, has been observed for over 2,000 years. Through the years, different regions of the world have adopted various combinations of crops; this independent evolution can be attributed to the adaptability of particular crops to certain environments. The widespread use of synthetic fertilizers, herbicides, and fungicides led agriculturalists to believe that the need for crop rotation would slowly diminish because farmers could regulate yield-limiting elements such as fertility and erosion. Removing crop rotation without conceding production has been more of a challenge than originally anticipated however. Though the true benefits of switching crops is not fully understood, farmers have continued the practice because of noticeable benefits, such as increased nitrogen-use efficiency and a decline in weed resistance due to the diversity of herbicides associated with particular crops. Careful design of rotations can also be useful in controlling pest populations or the spread of pests across a landscape. Attention is now being drawn to system redesign, which could be as simple as introducing an off-season cover crop or as extensive as radically altering the crops grown and expanding number of crops, thus increasing the length of the rotation. Similarly, a push toward reduced tilling and greater focus on crop diversity could prove extremely beneficial in the long run. These systems could provide greater farming system resilience and enhanced income stability (Francis & Porter, 2011). Maintaining soil fertility through more efficient use of fertilizer is a goal driven by high energy prices and environmental regulation. The use of green manures as cover crops, animal manure and compost, and grain legumes is an alternative in organic systems that distinguish them from large-scale conventional systems. Research has shown that although starter fertilizer often provides a noticeable effect on crop appearance in the early stages of development, it has little influence on crop yields. Substituting compost and manure, along with non-traditional soil amendments are viable strategies for sustainable nutrient management (Francis & Porter, 2011).


The search for sustainable agricultural methods that can secure a stable food supply for future generations inherently places greater demand on food crop production, animal feed, fiber, and fuels. In recent years, improved genetics have led to crops receiving private research in the hope of dramatically increasing yields. In nearly all cases, plant genes are moved within or across species, which creates new combinations based on mutations. The most obvious instance of this has been in U.S. corn production, which has increased 500% in the last 70 years. Today scientists are able to use market-assisted breeding and biotechnology to better measure and increase the precision of DNA alterations. Seed development has the potential to reduce water requirements and fertilizer needed for corn and cotton crops (Agriculture 's Sustainable Future, 2009). Future Plans Increasing global awareness of environmental effects of excess carbon has led to plans to reduce carbon outputs. Five proposed solutions are the end of using tropical land for farming, increasing productivity of initially low-yield farms, improve water usage and waste, reduce fertilizer use, and reduce meat consumption. Doing such can reduce economic costs and environmental costs simultaneously. There are core issues that can be addressed which will have a significant effect on sustainability (Jonathan, 2011). Three major issues that can be addressed are land use, meat consumption, and food waste. All three of these can be reduced in order to improve the sustainability of food production. By the year 2050, the world population is expected to reach nine billion. These people will need to be fed, which will cause an increase in food consumption and therefore an increase in food production. An extrapolation of current statistics regarding food production indicates an impending dilemma. Farming is the leading cause of deforestation, and to some extent, soil erosion. Previous solutions were made without sufficient data of the situation. Each idea only focused on one problem. The overarching problem is caused by the combination of the individual factors. Recent research has allowed for informed ideas. The proposed plan includes slowing and stopping clear-cutting land, increasing food production in developing countries, and using fertilizers strategically. It was also suggested that individuals start consuming more vegetables and fruits as opposed to meats. In addition, crops used for animal feed uses a significant amount of the food produced globally. Reducing this would provide more food for the growing population. (Coren, 2011). Currently, 38% of global land area (excluding Antarctica and Greenland because of the cold climates of these regions) is used for farming. Although this is not the majority of the available land, it is the best portion of land. Naturally, the most arable sections of land were chosen first. The remaining land comprises deserts, mountains, and tropical rainforests. Although expanding into the rainforests is possible, and has already occurred, it is not an expedient choice because the rainforests are large consumers of atmospheric carbon dioxide. Clearing the rain forests would harm the planet greatly (Jonathan, 2011). Ideally, food production per unit area should be increased; however, it is not nearly enough to provide sufficient food for the growing population. Global production has been increased by approximately 20%. This increase is far less than what is needed and is less than what is reported. In addition, a portion of the produced food is not being consumed by people. Alternate uses reduce the food supply by 40%. Also, meat production has a net food loss. The conversion of plant mass to animal mass is about 30 to one (Jonathan, 2011).


Mean carbon footprint versus total nitrogen applied. As more nitrogen fertilizers are added, emissions increase dramatically (from Huthaa, Thorburnb, Radford, & Thornton, 2010).

The number of miles food travels is another aspect that can be reduced to improve sustainability. On average, food travels 1500 miles before it reaches the consumer (Lindsey, 2011). This can be reduced to by producing food locally. This way, the emissions by the truck or ships used to transport the food is avoided. The solution must come from a multitude of actions. First, agriculture must not be allowed to spread into tropical forests. Although this might restrain expansion for land, the environmental effects of expansion would have more drastic, negative effects in the long-term. This has been done by offering socalled carbon credits to countries that do not cause deforestation. Other countries can buy these carbon credits, causing incentives to the counties to continue to avoid clearing forests. In addition, food can be certified to be shown that it was not grown on deforested land. Such a method would require individual initiative to choose foods not grown on deforested lands (Jonathan, 2011). The next problem to be addressed is the production per land area. Improvements can either be made to the highest producing farms, such as through genetic engineering, or to the lowest producing farms, which are generally in areas where food shortages are common. Research has shown that increasing food production of low yield farms would have the greatest impact. These farms are primarily located in Africa, Central America and Eastern Europe. Yields can be improved with better seeds, efficient fertilizer use, and improved irrigation, all readily available, as opposed to genetic engineering, which is a greater investment. Such tactics would have little environmental effect, the worst being fertilizer use if done improperly, and could result in gains of up to 60%. Still, caution must be taken to avoid overuse of chemicals irrigation (Jonathan, 2011). Resources must be used more efficiently. The resources are water, fertilizers and energy. One calorie of food requires, on average, one liter of irrigation water to grow. However, this optimal amount is often exceeded because of poor technique. Better tactics would reduce water usage. For example, applying water directly to the roots of crops as opposed to spraying the water into the air would minimize

water lost to evaporation. It is also possible to reduce evaporation in irrigation systems by covering said systems with organic matter. Fertilizers are difficult to use efficiently. Fertilizers are commonly overused or underused, the first of which is wasteful and harmful to the environment and the second of which will reduce crops production. Incentives can be made to prevent watershed contamination, an effect of overused chemicals (Jonathan, 2011). In standard use of fertilizers, 1% of the nitrous oxide directly enters the atmosphere (Huth, Thorburn, Radford, & Thornton, 2010). Fertilizers can account for 75% of the emission of crop production, so care must be taken not to overuse them (Hillier, Hawes, Squire, Hilton, Wale, & Smith, 2009).

Drip irrigation system; water is applied directly to the roots of plants to conserve water.

Food can be made more readily available if individuals choose to eat less meat. As mentioned before, meat consumption loses a large portion of the calories used as animal feed. In fact, completely ending all meat consumption would allow cause a 50% increase of available calories. This situation is unlikely, as many people might oppose giving up meat because of personal preference. Still, minor changes can be made. Switching grain-fed beef to other types of meat would have a significant effect (Jonathan, 2011). Another major solution is to reduce food waste. After the effort and resources have been spent to produce the food, it makes sense not to waste it. However, up to 30% of the food produced is lost. In richer countries such as the US, a great deal of food is thrown out. This happens frequently at restaurants; causes include oversize portions, in which servings are too large, and extras are discarded. Reducing portions would be beneficial in terms of reducing food wasted and would also help a country deal with growing obesity. Less developed countries suffer most of the losses at the production stages. Food is lost to failed crops and pests because of lower quality refrigeration and storage. Some food is never delivered because of lack of infrastructure to handle the food. Improving the infrastructure and communication would help reduce waste (Jonathan, 2011).


Conclusions Overall, the greatest gains can be made possible by a combination of the available strategies, methods, and personal choices. The five proposed strategies, although each helpful on its own, require the other four to be significant. These also need person initiative to be implemented. An example of what has happened and what can happen if proper decisions are made is the case of the orangutans that inhabit Borneo. The orangutans have been threatened because of the deforestation of their habitats. The orangutans live in a 415000-hectare wildlife preserve; however, the reserve is immediately surrounded by oil-palm plantations. Because of this, their population is in decline. The values of these industries makes the end them quite unlikely. This means that continuance of current practices can mean extinction of the specie. However, activists have worked to prevent such an end (Finitude, 2009). A plan has been made to pay foresters to not cut down trees. This benefits both the country and the environment. One example is Indonesia. Being the third greatest producer of carbon, it had agreed to one of these contracts. It has plans to cut pollution by 26%, and this deal could increase that figure to 41%. However, despite the potency of the idea, implementing it might not be as easy as thought. The land not being used is highly sought out for because of the potential productivity. Still, activists are trying their best. This halt of the industrial invasion would allow for the release of captive orangutans back into their natural habitats, without the fear of being run out by business (The Finitude of Forests, 2009). The plan also includes the re-planting of multiple trees. Such would bolster affected communities and improve lives. These new trees would also contribute towards removing carbon from the atmosphere. It has been estimated to be a quantity of 75 million tons spanned over the next 30 years (Finitude, 2009). These figures will not come to pass if the plan is not implemented. The plan has to receive certain certifications before can be applied. For example, it has to be proven that the land was in sufficient danger of being cleared in order for carbon credits to be awarded. There are also political qualms halting progress. The companies have greater sway in the debate, making it difficult to get the plan approved. These trees provide a source of income for multiple companies, and protecting the trees would reduce their profits (The Finitude of Forests, 2009). This example shows how food production can be made sustainable as long as the proper actions are taken

Bibliography Boutraa, T. (2010). Improvement of water use efficiency in irrigated agriculture: a review. Journal of Agronomy 9: 18. Coren, M. (2011, October 19) A Global Plan For Sustainable Agriculture. [electronic version] Scientific American. EPA (2009). Major crops grown in the United States. Retrieved from United States Weber, C., & Matthews, H. S. (2008). Food-miles and the relative climate impacts of food choices in the united states. Environmental Science and Technology, 42(10), 3508. ETAP (2007). The carbon trust helps U.K. businesses reduce their environmental impact. Retrieved March 22, 2012, pdfs/jan07_carbon_trust_initiative.pdf Foley, J. (2011). Solutions for A cultivated planet. Nature, (478), 337.

Francis, C. A., & Porter, P. (2011). Ecology in sustainable agriculture practices and systems. Critical Reviews in Plant Sciences , 30 (1-2), 64-73. Fricker, A. (2000). Sustainable agriculture. Futures,32 (9-10), 941-942. Hamilton R. (2009) Agriculture's Sustainable Future: Breeding Better Crops. [electronic version] Scientific American. Hillier, J., Hawes, C., Squire, G., Hilton, A., Wale, S., and Smith, P. (2009) The Carbon Footprints of Food Crop Production. International Journal of Agricultural Sustainability, 7, 79-147. Hundal, L. (2012). The conversion to sustainable agriculture. Journal of Environmental Quality , 41 (2), 616-616. Huth, N. I., Thorburn, P. J., Radford, B. J., and Thornton, C. M. (2010 March, 15) Impacts of fertilisers and legumes on N2O and CO2 emissions from soils in subtropical agricultural systems: A simulation study. [online version] Agriculture, Ecosystems & Environment, 136, 34, 351357. Jonathan A. F. (2011, November) Can We Feed the World & Sustain the Planet?. Scientific American, 305, 60-65. Kissinger, M., (15 February 2012) International trade related food miles The case of Canada, Food Policy, 37, 2, 171178. Leaver, J. D. (2011). Global food supply: a challenge for sustainable agriculture. Nutrition Bulletin, 36 (4), 416-421. Lindsey B. (2011 March-April) By the Numbers: Food miles. Academic on File, Retrieved March 22, 2012. Tasker, J. (2011). Carbon footprint under scrutiny. Farmer's Weekly , 155 (20). The Finitude of Forests; Bayan. (2011, April 16). The Economist, 50.

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Chapter 13 The History of Agriculture

Ryan Fletcher and Aaron Hammond Introduction For the past ten thousand years, the history of human civilization has run parallel to the development of agriculture. First honed in the Fertile Crescent, Egypt, and India, plant and animal domestication allowed local Neolithic peoples to grow a surplus of food and thus support non-agrarian specialists. Between craftsman, warriors, and kings, this increasing social complexity led naturally to more stratified and capable societies and soon gave rise to the cultural and infrastructural institutions which define civilization. Nonetheless, some societies remained steadfast in their hunting and gathering ways. These groups were almost universally eclipsed, however, by their better nourished and more populous neighbors who had made the switch. Agriculture was therefore crucial in shaping the ancient world and consequently key in the emergence of advanced civilization. The first undisputed archaeological evidence for plant domestication comes from the Levant, a region on the eastern coast of the Mediterranean which includes present-day Syria, Lebanon, Israel, Jordan, and Palestine. At numerous sites throughout this area, evidence of the cultivation of emmer wheat, einkorn wheat, peas, flax, chick peas, bitter vetch, and barely has been discovered (Diamond, 1991). These plants are often referred to by anthropologists as the founder crops because of their immense importance to these agricultural pioneers.

This map identifies locations associated with early Neolithic agriculture. These sites are spread throughout Southwest Asia, particularly in the Levant. Neolithic trading and migration soon spread these crops to both Egypt (8000 BC) and Mesopotamia (7000 BC). Particularly fertile soil, due to regular silt deposits by the Nile in the former and the Tigris and Euphrates in the latter, allowed for large-scale agricultural operations which would lead the civilizations local to these regions to flourish, building cities and leaving an indelible mark on early art

and science. In a similar way, knowledge of plant cultivation exploded across Europe around this time, and evidence suggests the presence of farming as far west as Ireland by the mid-sixth millennium BC (Diamond, 1991). Because the Eurasian landmass exists primarily on an east-west axis with relatively consistent latitude and climate, early plant domesticates required little modification to spread throughout the two continents (Diamond, 1999). Consequently, within a few millennia, nearly all of Europe and western Asia had succumbed to the agricultural revolution. Plant domestication also appears to have independently originated in China. By 7500 BC, the rich loess of the Yangtze and Huang He Rivers had provided the requisite material to cultivate millet, rice, and soy and mung beans. Surrounded by tall mountains and inhospitable deserts, the Neolithic Chinese were entirely geographically isolated from the rest of Eurasia, leading to this difference in agricultural fare. Furthermore, the East Asian land proved fertile enough to allow early Chinese to overcome this isolation and consequently develop civilization of a complexity on par with their European relatives (Mazoyer & Rudart, 2006). Agriculture likewise developed independently in several other locales around the world. By 5000 BC, the Sahel zone in Africa boasted domesticated rice and sorghum, and the peoples of the New Guinea had been farming sugar cane and bananas in gardens for two thousand years. The Amerindians, too, began to domesticate a number of plants within a few millennia. In Mesoamerica, the familiar trio of maize, beans, and squash took hold in the mid-third millennium. At the same time, early Andeans had domesticated manioc, quinoa, and the potato, and groups in the Eastern United States had begun growing sunflower and goosefoot. The Americas, unlike Eurasia, are situated on a north-south axis; there is great latitudinal and climatic variation on the landmass (Diamond, 1999). Species of plants suited for one area thus could not be grown in others. The spread of agriculture was therefore much slower for aboriginal Americans than for their European counterparts. In many cases, however, distribution was altogether impossible, meaning that many Native American groups remained hunters and gatherers.

This map identifies the major continental axes for Eurasia, the Americas, and Africa. The north-south orientation of both the Americas and Africa seriously hindered propagation of crops throughout the landmasses.


In many areas, the domestication of animals directly followed the domestication of plants. Whether they served as beasts of burden, means of transportation or warfare, or dietary and material supplements, early animal domesticates complemented the increased productivity offered by agriculture. Southwest Asia was home to many potential candidates for domestication; by the sixth millennium BC, dogs, sheep, goats, pigs, and cows had all been bred in captivity by Neolithic farmers (Diamond, 1999). Archaeological evidence suggests that dogs were primarily used for hunting, whereas goats, pigs, and cows provided some variety to the otherwise bland agrarian diet through meat and milk (Mazoyer & Rudart, 2006). Better than offering foodstuffs alone, bulls were used to supplement human muscle and sheep were sheared for their wool. The horse, arguably the most important animal domesticate, emerged from southern Russia as early as the fifth millennium BC, consequently revolutionizing warfare and communication. Around the same time, the water buffalo was first domesticated in China, essentially filling the same role as the cow in Southwest Asia (Diamond, 1999). Eurasia thus offered a veritable menagerie for Neolithic farmers, and the material culture benefitted accordingly. The peoples of the Americas, in contrast, did not benefit much from domestication of animals. Because of widespread extinctions of many of the large mammals of North and South America possibly precipitated by the migration thereto, few possible animal domesticates persisted until the development of agriculture. Only the llama and alpaca proved sufficiently docile; these animals, however, could not accept a human rider or plow. The Amerindians thus primarily used these two for their wool and to carry light loads. As a consequence of this absence of large mammals, Native Americans were largely unexposed to the suite of diseases that accompany these animals, leading to a lack of acquired immunities (Diamond, 1999). When such viruses were introduced to the natives during European colonization, the results were therefore catastrophic. In retrospect, the benefits of agriculture seem abundantly clear. Farming and husbandry offer much more food per acre than hunting and gathering, which obviously must improve the quality of life for those cultivating the acre. This is not the case, however. On average, those in modern hunting and gathering societies spend only fifteen hours a week on the acquisition of food. Comparatively, those in primitive farming societies spend upwards of sixty hours a week tilling, plowing, watering, and harvesting (Diamond, 1991). Furthermore, animal and wild plant populations tend to be more stable sources of food than farming; there is never a bad season of deer, whereas a bad growing season can lead to famine for primitive farmers. The increased population density that generally accompanies farming also tends to be miserable. Cities, on the whole, tend to be much dirtier, disease-ridden places than rural hamlets (Mazoyer & Rudart, 2006). In addition, the surplus of food provided by agriculture allows for a social stratification and, consequently, inequality (Harris, 2001). The question thus arises as to why then nearly all successful civilizations have been those based upon an agrarian model. Although agriculture can lead to an unfortunate situation for the populace, it is a sustainable and scalable economic model for the state. In times of war, quantity often beats quality. Consider that, in a battle of two opposing tribes, the one who presents ten warriors is likely to beat the one who presents one. Whereas hunting and gathering produces better-fed and happier people, the sheer abundance of food offered by agriculture leads populations to grow accordingly (Diamond, 1991). Therefore, in most confrontations between farming and non-farming peoples, the green thumbs generally win. The history of agriculture has been inextricable from the past ten thousand years of human history. This trend shows no sign of abating. The population of Earth is perpetually increasing; so too must food production increase to meet this growing demand. Although modern methods of farming and animal husbandry would be foreign to Neolithic farmers, modern man can learn from his primitive forebears. Moreover, he should appreciate the sacrifices in quality of life that made agriculture possible and likewise shaped the world in an overwhelmingly positive way.

Sustainable and Alternative Agricultural Methods For the last ten thousand years agriculture has served as the keystone to human civilization. From humble origins in manual labor, agricultural methods rapidly advanced towards large scale animal husbandry and mechanized crop farming during the nineteenth and twentieth centuries (Mazoyer & Roudart, 2006). These agricultural advances have vastly increased worldwide food production; however, these same methods pose serious problems in terms of their sustainability and have significant detrimental environmental impacts. Agriculture of today must be able to sustain itself for many centuries to come if humanity is to continue its swift technological advancements and maintain its large global population. The world populace is projected to increase by billions of individuals over the next several decades, and is anticipated to reach a maximum size of between ten billion and eleven billion individuals. In order to avoid potential food shortages in the future, food production and thus agricultural yields must increase with the global population. Unfortunately, the human race has already manipulated 70% of the worlds farmable landmass. As the amount of available land for farming dwindles, future food demands must be met by farmers either increasing the productivity of their current farmlands or exploiting alternative sources of arable space, such as the worlds oceans. New, space conserving methods of agriculture will be needed in order to avoid potential catastrophe and starvation in the future (Raman, 2006). Starvation has been avoided, for the most part, due to increases in productivity of current farmlands. This increased productivity has been created by farmers applying chemicals to and exploiting technology usage in agricultural spaces. Because technology and chemicals are only as abundant as their raw materials, which are a finite resource, further increases in the productivity of current agricultural methods will eventually decline (Raman, 2006). The application of these chemicals by farmers has serious detrimental health effects. Because fertilizers and pesticides play important roles in the productivity of current agriculture, twenty million tons of fertilizer and five-hundred thousand tons of pesticides are applied in the United States alone. Researchers have found many of these chemicals to cause health issues in humans; for instance, the commonly used herbicide Atrazine has been linked to numerous forms of cancer. The pilots of cropdusting aircraft have significantly higher instances of stomach cancer than individuals in the normal population. Unfortunately, farmers eschew alternatives to this massive chemical usage because of its financial benefits (Uri, 2006). Both chemical products and soil degradation have serious detrimental effects on the environment. On average, just over five tons of soil per acre is eroded annually with an estimated societal cost of approximately twenty-nine billion dollars. This eroded soil, and the chemicals applied to it by farmers, often find their way into bodies of water. As precipitation falls on agricultural lands, it absorbs these chemical and forms a mixture with soil. This mixture then flows into streams, rivers, and lakes. Eventually this concoction appears in the oceans of the world, polluting waterways and ruining entire ecosystems in the process (Uri, 2006). Soil degradation and the usage of chemicals can be entirely avoided using the practice of aquaculture, or the farming of aquatic organisms such as fish, mollusks, crustaceans, and aquatic plants. Aquaculture can meet future food demands because it can utilize the free space of the oceans; approximately three quarters of the planet is covered by water while only a quarter of the planet is dry land. Aquaculture can also reduce pressures on natural fisheries, which are currently either at their maximum productivity or are in decline due to overharvesting. Lastly, aquaculture is an excellent alternative to animal husbandry for the production of necessary proteins that are not found in plants (Parker, 2002).

Aquaculture is composed of four distinct stages. The process begins with hatchery, which is the production of seeds, eggs, and young fish that are used to stock growing facilities. Seeds are used for the cultivation of aquatic plants, and eggs are used for the breeding of fish, crustaceans, or mollusks. Both seeds and eggs are either captured from their natural environment or produced from broodstock, which are adult specimens kept alive for the purpose of reproduction (Parker, 2002). The young organisms produced in hatchery are then transported to the previously mentioned growing facilities, where they are allowed to fully mature into adult specimens in a process known as grow-out. This process can either be an intensive program, in which a very dense, highly maintained, population is maintained in a small space, or an extensive program, in which a lower population density is maintained with less micro-management. Intensive programs often take place in cages, tanks or ponds, and extensive programs often take place in lakes or unrestricted areas of the ocean (Parker 2002).

The Aquaculture Processes of Cobia Production





Farming of cobia begins with the collection and hatchery of eggs. After the eggs have grown into young fish, they are transported to a growing facility in which they mature into adults. Once the maturation process has finished, the fish are harvested and then marketed worldwide.


After the farmed organisms have matured during the grow-out stage, they are meticulously harvested and marketed. Mollusks often require manual harvesting, whereas both fish and aquatic plants can be mechanically or even automatically harvested. Most of these yields are sold for human consumption, but a small percentage of these yields are marketed for other purposes such as animal feed, sport and bait fish, and pets (Parker, 2002). A visual representation of the aquaculture processes involved in the production of cobia, a popular fish used in sushi dishes in Asian nations, can be seen in the figure above. Farmers use numerous technologies in aquaculture, especially for hosting the organism being farmed. They often use large floating cages or nets for containing schools of fish and groups of crustaceans. These containment devices usually employ robots to automatically clean their inner surfaces. Cages are nearly always composed of corrosion-resistant metals and nets are composed of incredibly durable rope. Farmers alsoraise mollusks on ropes suspended from a floating platform (Parker, 2002). Examples of these technologies can be seen in the figure below.

Technologies Used in Aquaculture

Fish Cage

Fish Net

Technologies Used in Aquaculture. An example of a fish cage can be seen at the top left. An example of a fish net can be seen at the top right, and an example of a mollusk platform can be seen at the bottom center (based on U.S. Patent No. 178,626, 1988; U.S. Patent No. 917,853, 1992; & U.S. Patent No. 568,856, 2006). Mollusk Platform


Similar to aquaculture, hydroponics can ensure the sustainability of agriculture while simultaneously reducing the detrimental effects of current agricultural methods on the environment. By definition, hydroponics is a class of techniques used for growing plants in a soilless medium. All hydroponic methods involve a water and nutrient solution being directly sprayed or applied to the root system of plants. This allows farmers to precisely control the environment in which plants are grown, specifically its water, chemical, and light requirements. Because of this, hydroponics uses significantly less water and fewer chemicals than traditional crop farming. Due to the nature of hydroponics, the roots of plants do not need to actively search for nutrients and hence do not grow to be as large as those in soil agriculture. This allows for more plants to be grown in a smaller area. The entire range of benefits that hydroponic method offers can be seen in the table below (Winterborne, 2005). A simple hydroponics method referred to as deep water culture is often used by novice farmers. This apparatus used in this method consists of a bucket and lid, a large net pot, a large air pump, some length of airline, a large air stone, and clay pebbles. The air stone is placed at the bottom of the bucket and the airline is placed under the air stone. The bucket is then filled to between two-thirds and threequarters full with the nutrient and water solution. Lastly, the lid is placed on top of the bucket, which holds the net pot that contains the clay pebble growth medium. The air pump and airline system produces bubbles under the air stone, which in turn both both mixes the nutrient solution and and generates spray, which wets the net pot and thus the root system of the plant. Most of the root system of the plant lives in the aerated nutrient solution; therefore, the air pumping system must be working constantly. Otherwise, the roots will experience oxygen deprivation and quickly die. As the roots of the plant grow, they begin to extend downward towards to bottom of the bucket, so the water level must be lowered accordingly. Unfortunately, this method of hydroponics demands a high level of maintenance; because the size of a bucket is often between five and ten liters, and plants often consume up to five liters of water per day, the plants may literally dry out if left unattended for any significant period of time (Winterborne, 2005).

Hydroponic Systems

A deep water culture system can be seen at the left, and an ebb and flow system can be seen at the right (Winterborne, 2005).


Farmers seeking for a hydroponics method involving less maintenance often choose ebb and flow systems. These apparatuses are composed of a slightly slanted growth box with clay pebbles in the bottom, a collection reservoir, and a water pump. The growth both is slanted towards the reservoir, and the water pump floods the growth box to a pre-determined level. The water then slowly drains back down towards the reservoir until a minimum water level is reached. The pump re-floods the reservoir and the process is continually repeated (Winterborne, 2005). A visual representation of both an ebb and flow system and a deep water culture system can be seen below. Benefits of Hydroponics Factor
Water Chemicals Diseases Weeds Quality Maturation Sanitation Transplanting

Advantage over soil agriculture

10% that of soil irrigation No herbicides or pesticides, significantly less fertilizer No soil bacteria or viruses Virtually none Healthier and higher than that of soil agricultural yields Non-seasonal dependent, faster than that of soil agriculture Easy, safe Not possible with soil agriculture


Diamond, J. (1999). Guns, germs, and steel: The fates of human societies. New York: Norton. Diamond, J. (1991). The third chimpanzee. New York: Hutchinson Radius. Harris, M. (2001). Cultural materialism. (Updated ed.). Altamira Press. Kvietelnitis, P. (2006). U.S. Patent No. 568,856. Washington D.C.: U.S. Patent and Trademark Office. Mazoyer, M. and Roudart L. (2006). A history of world agriculture from the Neolithic age to the current crisis. London: Earthscan. Mukadam, H. and Morgan, J. (1992). U.S. Patent No. 917,853. Washington D.C.: U.S. Patent and Trademark Office. Nakamune, H. and Hirose, H. (1988). U.S. Patent No. 178,626. Washington D.C.: U.S. Patent and Trademark Office. Parker, R. (2002). Aquaculture science, second edition. Albany: Delmar.


Raman, S.(2006). Agricultural sustainability: Principles, processes, and prospects. Binghamton: Food Products Press. Uri, N. (2006). Agriculture and the environment. New York: Nova Science Publishers. Winterborne, J. (2005). Hydroponics: Indoor horticulture. Surrey: Pukka Press.

Illustration Credits


Chapter 14 Food Additives

Naveena Shanmugam, Jacob Grotton, Daniel Huang, and Jeeva Jacob Introduction In recent years, processed food has become more and more commonplace in the market. However, processed food often contains synthetic compounds used to enhance the quality, taste, texture, or longevity of the food. These additives may include various vitamins, minerals, herbs, extracts, preservatives, and colorings.

An illustration depicting many of the food additives present in commonly consumed foods.

Food containing any kind of additive is also known as a functional food. Millions of Americans consume significant amounts of food additives every day, the most common examples being those found in general processed food, boxed food, and supplements. These compounds have been placed under extensive scrutiny through repeated experimental studies, and rising consumer concern has led to increased awareness on the nature of these additives. Experiments have provided strong evidence that a large number of food additives and preservatives produce harmful effects upon ingestion, especially among children. Additionally, there has also been considerable debate over whether or not these functional foods are beneficial or detrimental to our health. For instance, many critics attest that functional foods provide nothing more than a placebo effect to trick people into thinking that they are eating healthier. In fact, an incredible 95% of food additives have not been clinically tested or supported by raw data, a statistical figure that should be a warning sign to consumers everywhere (Schardt, 1999). Furthermore, it is extremely difficult to remove many of these compounds from the body, and the cumulative effects of food additive consumption over time can lead to a troublesome buildup of compounds that cannot be broken down and degrade naturally. Over time, this toxic buildup and constant consumption can lead to chronic illnesses such as diabetes, obesity, and decreased lifespan (Chemical Cuisine, 2011).


Herbs and Spices Herbs and spices have been used for thousands of years for their rich flavor and plentiful health benefits. Their potential for curing chronic disease is alluring to researchers and the public alike, especially after the rise of the cost of health care. Researchers have recently discovered the countless health benefits of herbs and spices, ranging from a decrease in cancer risk to a modification of tumor behavior. Growing evidence leans towards anticancer characteristics in culinary herbs and spices which vary in diet according to ethnicity. They are capable of influencing carcinogen bioactivation and are likely anticancer contributors. These spices have traveled along the Silk Road since the second century and have been used to flavor food since 50,000 B.C. (Kaefer & Milner, 2007). Herbs and spices are used to season and preserve food and can also affect eating habits. A large majority of American households are also trying to reduce their risk of heart disease and cancer, health conditions for which herbs and spices can provide a solution. However, overall food consumption patterns and food preparation techniques are equally important to attain full benefits. Due to the shift in consumption of different ethnic foods the overall consumption of spices has doubled from 1970 to 2005 (Kaefer & Milner, 2007).

The medical properties of various herbs and spices. Spice Medical Properties/Indications Spice
Ajowan Allspice Aniseed Asafetida Bergamot Camphor Capsicum peppers Caraway Cardamom Chive Cilantro Cinnamon, Cassia Clove Coriander Cubeb Cumin Curry leaves Fennel Fenugreek expectorant, anti-flatulent anti-emetic, purgative anti-spasmodic, expectorant, sedative anti-helminthic, anti-tussive antiseptic, anti-spasmodic, sedative antiseptic, cardiostmulant, anti-spasmodic analgesic, counter-irritant, expectorant diuretic, anti-spasmodic, galactogogue antiseptic antispetic, diuretic antibacterial, anti-inflammatory antiseptic, anti-diarrhea topical anesthetic, anti-dyspeptic anti-spasmodic, diuretic, anti-inflammatory antiseptic, diuretic, anti-asthma anti-microbial, vermifuge, diuretic anti-emetic anti-spasmodic, diuretic anti-diabetes, anti-hypercholesterolemia Galangal Garlic Ginger Horseradish Lemon Grass Licorice Mustards Nigella Nutmeg, Mace Onion, Shallot Paprika Peppercorns Saffron Sesame seed Star anise Turmeric Vanilla Wasabi Zedoary

Medical Properties/Indications
expectorant, anti-bacterial anti-microbial, anti-hypercholesterolemia, anti-cancer, antihypertensive for colds, anti-emetic, anti-rheumatic anti-microbial, expectorant, purgative fever, insect bites anti-spasmodic, anti-tussive, peptic ulcer counter-irritant, emetic, purgative diuretic, anti-helminthic, purgative astringent, hallucinogen for colds, expectorant, anti-cancer, asthma colorant, source of ascorbic acid expectorant, anti-microbial anti-rheumatic, for neuralgia diuretic, galactogogue, demulcent antiseptic, anti-rheumatic anti-arthritic, anti-oxidant, anti-cancer anti-spasmodic, febrifuge expectorant, for sinusitis expectorant, diuretic


Different regions in the world have distinct ethnic food, but there is overlap in the types of spices used in the 36 different countries that were studied. The difficulty in measuring their benefits arises from their small amounts of daily intake. The concentration of these spices also depends on personal preference (Kaefer & Milner, 2007). Herbs known as sages belong to the genus Salvia which includes more than 900 different species. The commonly used sage is a culinary herb that contains many health benefits. There is evidence supporting that is was used as a tonic for treatment in the sixteenth century. To support this finding, many poets have even referred to this herb as medicine in their poetry. The monoterpenoids are responsible for the aromatic scent and are the essential oils that provide the beneficial factors. Sage also possesses medical properties and produces chemicals that are used in the perfumery industry. Some species of Salvia are used as a hallucinogens, and for this reason these species have been deemed illegal in some parts of the world. The hallucinogenic effect of this herb is obtained from dried leaves that are chewed to produce this effect for up to an hour. This short-lasting effect is the reason for why sage is used in many religious rituals (Hanson, 2010).

Various spices and herbs.

There are many different species of sage which are used in different products such as perfumes and cosmetics. The most commonly used kind is garden sage which is grown in warm, sunny areas. Sage is usually harvested before its flowering because of the quality of essential oil is at its highest then. This oil is then used for its antioxidant properties in cheeses, pickles, processed foods, and bitters. The variety of antioxidants ranges from volatile oils to phenolic acids and contains anti-inflammatory agents which can fight against rheumatoid arthritis, bronchial asthma, and atherosclerosis. Sage is highly known for its aromatic fragrant and bitter taste. This herb also proves to be an effective cure for symptoms of menopause, night sweats, and hot flashes and could possibly prove to be a cure for people with diabetes (Kirby, 2008).


Nutmeg can create hallucinogenic effects with over dosage, an effect that has been recorded since the Middle Ages. Over dosage interacts with different parts of the nervous system and has side effects such as dry mouth, flushed skin, and faster heartbeat. The side effects are too great to measure and have even lead to catastrophic events such as miscarriages. In many tests, some of the compounds have stimulated the central nervous system while others have caused sedative effects (OMathna, 2010). Both herbs and spices offer potential cures for many diseases, including Alzheimers disease. The herbs that proved to be therapeutic are Melissa officinalis, Salvia officinalis, Yi-Gan San, and BDW (Ba Wei Di Huang Wan). They are also useful for agitation and have sedative effects (Luiz, Alice, MederiosSouza, & Almeida, 2006). The table below lists commonly used spices and their medical benefits, which can be taken as self-medication in small dosages.

Probiotics Probiotic bacteria provide health benefits, mainly vitamin production. The disturbance of proper balance of intestinal microbiota results in inflammatory bowel diseases, metabolic diseases, cancer, and autoimmune diseases. Intestinal bacteria, probiotics have been proven to be therapeutic against these types of infections and diseases. Probiotics are live microbes which, when administered in adequate amounts, confer a health benefit. Probiotic bacteria can be added to food or taken as pharmaceutical products and can reduce pathogenic bacteria and metabolites in the normalization of gastrointestinal functions (Rossi & Amaretti, 2011).

This is a depiction of probiotic bacterial cells on the left. On the right is an example of yogurt that uses probiotics.

The use of lactic acid bacteria (LAB) has increased in the past few decades due to the capabilities of the probiotics that they contain. These probiotics are known to feed beneficially off the host and improves the intestinal microbial balance. It was during the 20th century when Metchnikoff explored the idea of ingesting bacteria that could have a positive influence on the host. He started to promote lactobacilli in yogurt because it was important for human health and longevity. Some microbial possess beneficial properties that are useful in food production, storage, and fermented foods. Lactic acid bacteria decrease the risk of food-borne pathogens and thus reduce the use of chemical preservatives. LAB has been defined as a function food that affects beneficially to the body and reduces the risk of disease. It is known for its significant growth in the global market as well (Sheetal, et al., 2012).

However, probiotic lactobacilli face different environments once ingested by the host because the lactobacilli need to outlast the harsh conditions of the stomach. After entering the system, probiotic lactobacilli provide a number of health benefits, such as improvement in lactose metabolism, antimutagenic properties, anti-carcinogenic properties, reduction in serum cholesterol. They also produce organic acids which provide benefits of their own (Sheetal, et al., 2012). The function of antimicrobials in food is to preserve food by preventing the growth of microorganisms. Antimicrobial spices and their essential oils are underutilized for many reasons, including limited data about their effects in food, strong odor, and high cost. Customers demand quality in their organic food, and as a result anti-microbial effects of probiotics have wide reception. Some of the benefits include controlled microbial contamination in food, extended shelf-life, decreased development of antibiotic resistance, and a reduced need for antibiotics. Natural anti-microbials are found in animals and plants and shows potential in fresh fruits and vegetables. Along with flavoring many herbs and spices also enforce anti-microbial effects on humans (Tajkaimi, Ibrahmin,& Cliver, 2010).

Artificial Sweeteners Artificial sweeteners are synthetic sugar substitutes or alternatives that serve to sweeten food. The most common high-intensity sweeteners are cyclamates, aspartame, saccharin, and acesulfame K. The sensation of sweetness is transmitted through certain receptors located on specialized taste cells. Sweeteners function by binding to these receptors and triggering them. The increased sweetness caused by these artificial sweeteners is postulated to be caused by either a tighter or longer binding of these compounds to the receptors. Most artificial sweeteners are employed in low calorie products such as baked goods, dairy products, desserts, sodas, and candy. They are also often used as a carbohydrate replacement for diabetics or those who wish to diet, and thus consume less sugar. Numerous studies have been attempted to determine the potential side effects and toxicity of these sweeteners, with mixed results. High concentrations of these synthetic sweeteners in rats have been shown to induce the development of tumors and liver failure. Thus, cyclamates have been banned in several countries and the potential side effects of saccharin, aspartame, and acesulfame potassium have been a center of controversy for quite some time. However, as of today the FDA has ruled that most of these artificial sweeteners on the market are relatively harmless, and have not taken extra precautions to reconsider the potential dangers of them (Chaudhary, 2010).

Some of the most commonly used artificial sweeteners.


Aspartame Aspartame (known under its brand names of Equal and NutraSweet) is a chemical composed of two amino acids and methanol. Discovered accidentally in 1965 when a scientist noted its particularly sweet taste, it is 200 times sweeter than sugar. Its chemical formula is C14H18N2O5. It is typically found in diet foods, soft drinks, gelatinous products, and low-calorie sugar packets. Although aspartame was originally hailed as the perfect artificial sweetener, studies have suggested that the sweetener might cause cancer, in addition to causing other problems such as dizziness and hallucinations. A 1970s study suggested that aspartame induced brain tumors in rats. However, the Food and Drug Administration was able to persuade the review panel to reverse its conclusion that aspartame was unsafe. Since then, many studies have been conducted in an attempt to demonstrate the carcinogenic dangers of aspartame, but in most cases these results have been ignored and labeled as flawed and/or controversial. The results of these studies claim that aspartame is linked to premature birth in pregnancies, cancer, and decreased lifespan. However, by now health-conscious individuals are quite familiar with this sweetener and tend to avoid it (Winter, 2004).

Acesulfame Potassium Acesulfame potassium is an artificial sweetener that is widely used in the market today, despite having come under fire for its potentially harmful side effects in the 1980s. It is approximately 200 times sweeter than sucralose, and its appearance can be likened to that of crystal sugar. Acesulfame potassium is a relatively new calorie-free artificial sweetener. A dipeptide of aspartic acid and a methyl ester of phenylalanine, the chemical formula for it is C4H4KNO4S. Most studies done on the compound are deeply controversial and antiquated. The compound was initially petitioned for in September 1982, and the FDA approved it in 1988 (Acesulfame K, 2011). However, the Center for Science in the Public Interest conducted studies that suggesting that it caused tumors and increased levels of cholesterol in mice, just as aspartame had a few years before. Initially, acesulfame potassium was permitted only in such foods as sugar-free baked goods, chewing gum, and gelatin desserts. In July 1998, however, the FDA allowed the chemical to be used in soft drinks, thereby greatly increasing consumer exposure. (Chemical Cuisine, 2011). Methylene chloride is used in the manufacturing of acesulfame potassium, which through multiple independent studies has itself been demonstrated to be carcinogenic and toxic. Like many other artificial sweeteners, overconsumption of it over prolonged periods of time will increase appetite and cause a craving for the chemical. This can be attributed to the theory that it may potentially cause low blood sugar, interfere with behavior, and induce hyperactivity (Winter, 2004). Saccharin One of the most popular artificial sweeteners, saccharin (benzoic sulfilimine) is otherwise known as Sweet N Low. It is 350 times sweeter than sugar but has a bitter or metallic aftertaste, especially when used at high concentrations. First discovered in 1878 in a lab at Johns Hopkins University, the compound is most often used to sweeten products such as drinks, candies, cookies, medicines, and toothpaste. Its chemical formula is C7H5NO3S. Initially, although saccharin was commercialized and used in the food market shortly after its discovery, it did not become popular until World War I, when sugar was scarce. It gained more popularity in the 1960s and 1970s among dieters attempting to try sugar alternatives and substitutes. Even today, it remains one of the most widely used artificial sweeteners. However, just as with the most other artificial sweeteners, previous studies conducted on the substance have strongly suggested that it is carcinogenic

and potentially harmful. In 1977 the FDA proposed the substance be banned, but Congress intervened and decided against it, as long as a warning label was placed on foods containing saccharin. However, in 2000 U.S. Department of Health and Human Services removed saccharin from their list of cancer causing substances and Congress subsequently removed the law enforcing the warning label (Winter, 2004).

Cyclamates Cyclamate, otherwise known as sodium cyclamate, is an artificial sweetener that is the calcium salt of cyclamic acid (cyclohexanesulfamic acid). First discovered in the University of Illinois in 1937, the discovery was purely accidental, much like the discovery of aspartame was. It is approximately 30 to 50 times sweeter than table sugar, and the chemical formula for it is C6H12NNaO3S. Originally intended to be used as a compound to mask the bad taste of certain medicines, its potential as an artificial sweetener was realized and it became marketed towards diabetics to be used as a sugar alternative. However, studies conducted in the late 1960s proved that, when cyclamate was used in conjunction with saccharin, it proved to be potentially fatal and carcinogenic in rats, among a multitude of other side effects. Thus, in 1969 the artificial sweetener was banned by the FDA and it is currently illegal in the United States (Chemical Cuisine, 2011). Acids An acid is defined as any substance that has a pH less than seven. Acids are typically used in most food products for a couple of reasons. These include: altering the taste of the food, preserving the food, and controlling the pH of the food. Usually organic or naturally occurring acids are added into the foods for these purposes. However, some companies have been using synthetic acids in their products to exercise more control over all aspects of these foods. Also, synthetics are easier to make and cost less; making them highly desirable by companies that sell food products (Feed, 2012). One common food additive is citric acid. Despite its popularity, it is an organic acid. Citric acid is an acid that is usually found in most fruits. It has been used to create most of the candies that you and I know of today. Citric acid is known for its sweet taste and is used to create many sweets like ice-cream and or fruit juice. If citric acid is present in its original organic state, it can stop browning in fruits or vegetables. Citric acid has also been known to be used as an enzyme inhibitor. It is most commonly found in most fruits such as oranges, apples, and grapefruits. It is also commonly found in some cheeses and in many jams. Like citric acid, sorbic acid is used for is used to inhibit enzymes. Sorbic acid is most commonly found in yeast, molds, and bacteria (Davidson & Singh, 2012). Another commonly used organic acid is called tartaric acid, which is known for being extremely sour or having a rough and hard taste. Ironically, it is used in the creation of wine, ice-cream, and juice because of the property of tartaric acid making it bind into a metal state so that rigidity is maintained (Belitz, Growsch, & Schienberle, 2009). Synthetic Acids One of the most commonly used food additives that is currently employed in the marketplace is ascorbic acid. This acid can be organically found, but it is much easier to be produced. The acid usually is produced from a glucose molecule and through a process which is called the Richstein process converts into ascorbic acid. Most companies pass it off as a source of vitamin C and advertise that it is the pure vitamin as well. However, this synthesized acid is not just a source of vitamin C, as it also has the potential to lead to cancer in some people.


Acetic acid, which is most commonly found in vinegar, is another acid that can be produced organically but is easier to produce industrially. Most of the acetic acid used is created by the fermentation of bacteria; this is mostly done in the United States and in Europe because those places use the most acetic acid. An average about half of the total production is in America with the rest coming from Japan and other places in Europe (Piper, 2011).

Common food acids. Chemical agent

ascorbic acid butylated hydroxyanisole (BHA) butylated hydroxytoluene (BHT) citric acid sulfites tertiary butylhydroquinone (TBHQ) tocopherols acetic acid benzoic acid natamycin nisin nitrates, nitrites propionic acid sorbic acid

Mechanism of action
oxygen scavenger free radical scavenger free radical scavenger enzyme inhibitor/metal chelator enzyme inhibitor/oxygen scavenger free radical scavenger free radical scavenger disrupts cell membrane function (bacteria, yeasts, some molds) disrupts cell membrane function/inhibits enzymes (molds, yeasts, some bacteria) binds sterol groups in fungal cell membrane (molds, yeasts) disrupts cell membrane function (gram-positive bacteria, lactic acid-producing bacteria) inhibits enzymes/disrupts cell membrane function (bacteria, primarily Clostridium botulinum) disrupts cell membrane function (molds, some bacteria) disrupts cell membrane function/inhibits enzymes/inhibits bacterial spore germination (yeasts, molds, some bacteria) inhibits enzymes/forms addition compounds (bacteria, yeasts, molds)

sulfites and sulfur dioxide

Food Colorings A food coloring is any food additive that is used to color a food or drink. Food colorings usually come in the form of pastes, powders, gels, and liquids. They can be any color, and come in many different classes. Most are harmless, and most Americans, unlike most other people from foreign countries, are uneducated about most food colorings. One can be dounf with consumer knowledge over the food coloring cochineal in the US. Cochineal is a food dye that was used in America but was banned because people started to worry about what they were eating. Cochineal is still used in most South American countries both as a food coloring and also as a paint pigment. It is an insect that used to be put in all sorts of foods, with the general public unaware. Anthocyanins are one class of food colorings that includes colors from red to blue including all the purples in between. These colors usually come from fruits such as strawberries and grapes. And are used mostly in beverages but have also been used in some fruit products (Cheesman, 2012).


Recent discoveries have led to the need for recent research in the effects of different food colorings. Colorings like Blue #1 and Blue #2 have been known to cause some sort of kidney malfunction in most rodents (Melnick, 2011).

A table of synthetic food colorings.

Common name
allura red AC brilliant blue FCF erythrosine fast green FCF indigo carmine sunset yellow FCF tartrazine

U.S. designation Products

FD&C red no. 40 FD&C blue no. 1 FD&C red no. 3 FD&C green no. 3 FD&C blue no. 2 FD&C yellow no. 6 FD&C yellow no. 5 gelatin, puddings, dairy products, confections, beverages beverages, confections, icings, syrups, dairy products maraschino cherries beverages, puddings, ice cream, sherbet, confections confections, ice cream, bakery products bakery products, ice cream, sauces, cereals, beverages beverages, cereals, bakery products, ice cream, sauces

Food Additives and Children A large number of studies have been conducted on the effects of food additives on children; in particular, many studies have claimed to have established a link between a high consumption of food additives and hyperactivity in children. It is a well-known fact that certain foods cause specific reactions in certain individuals, including food allergies and in this case, increased hyperactivity. A study conducted on the potential effects of food colorings and additives on children subjected children who were already hyperactive to a mixture of various food colorings and additives, with the dosage amount being equivalent to average daily intake over the course of a week. The study showed statistically significant differences in hyperactivity between the children that were given the food colorings and additives and the control group. Furthermore, the discrepancy between individual children and their individual responses to the additives was noted to be significant as well. This is a prime example of just one of many studies that have helped to establish the link between food additives and hyperactivity in children (Eigenmann, 2007). Artificial food colorings, preservatives, and other additives may play a role in increasing hyperactive behavior among young children. Amount and type of food can influence mental health that can result in wide range of behavior variation, including attention, conduct disorder and mood. The role of food additives, specifically artificial food colors, in elevating hyperactive behavior in children has been long debated. There has been evidence that removal of food colors from the diet can make improvement in the behavior of some children with ADHD. Studies done by research group at Southampton extend this discovery indicating that some children from the general population without ADHD also get similar benefits.


There has been a link postulated between food additives and hyperactivity in children. Hyperactivity can be described as a physical state in which a person is abnormally active impulsive and inattentive. There can be marked variations across the range of severity in a general population of children. Some children show little hyperactivity while others exhibit a considerable amount, meeting the diagnostic criteria for Attention-Deficit Hyperactivity Disorder (ADHD). A number of nutrition and diet have been suggested to treat ADHD. One of the most extensively investigated is fatty acid intake as there is evidence that a balance between omega-3 and omega-6 fatty acids are contributing factors to behavioral and cognitive development in children. However the findings are somewhat contradictory. It would appear then that there is some evidence that omega-3 supplementation may improve the behavior of some children but perhaps only those who show specific learning disabilities and there is as yet no evidence of a beneficial effect in the general child population. The first study done on sample children with hyperkinetic syndrome and other neurological problems indicates a link between hyperactivity and food intolerance (Stevenson, 2010). Putting the children on a few food diets produced improved behavior in a substantial proportion of the children. The potential value of elimination diets in the treatment of children with ADHD has been recognized. However these studies were done in children with complex behavioral difficulties and the effect in a broader range of children is still an open question. The research suggests that the removal of colors (and perhaps other food stuffs) may have a beneficial effect on hyperactivity symptoms in children diagnosed with ADHD. However studies to know the impact of food additives on behavior in children in general have been examined less extensively. Another study done using parents behavior ratings and known as Isle of Wight study indicate that, the levels of hyperactivity were significantly higher on a mix of food containing four specific colors than on fruit juices alone. As per the National Institute for Health and Clinical Excellence, the elimination of artificial coloring and additives from the diet is not recommended as a generally applicable treatment for children and young people with ADHD. They are cautious about making strong recommendations about the use of an AFC free diet in the clinical management of children with extreme hyperactivity or ADHD. It is therefore becoming accepted that one of the approaches to the treatment of ADHD that should be considered is diet modification, but only on the basis of detailed clinical appraisal of individual cases.


Phosphates and Kidney Disease A team of Dutch scientists have postulated that there may be a potential link between hypophosphatemia (elevated phosphate concentration) and advanced chronic kidney disease. While natural phosphates (organic esters) that are normally present in foods pose no danger to the human body because these phosphates are not completely absorbed, artificially added inorganic phosphates are almost completely absorbed, thus contributing to an individuals phosphate concentration. Unfortunately, inorganic phosphates are commonly found in processed and fast food normally consumed by those in the lower end of the socioeconomic status. Although no conclusive studies have been published to validate this link, further studies should be conducted (Eberhard et al., 2012).

Food Additive Influence on Consumers Although the direct side effects of food additive consumption have been scrutinized and researched extensively, very few studies have directed their attention to the psychological aspects of consumer concern over food additives. However, one recent study has attempted just that, providing crucial information representing how the average consumer deals with purchases involving food additives. Two types of experiments were conducted. The first was hypothetical, where consumers were educated about the dangers of phosphate additives and asked to play out a situation involving the purchasing of ham in a supermarket. In this study, consumers were found to be willing to pay more for phosphate-free ham and tended to decide their purchases based on how healthy the brand of ham was. Likewise, the second set of experiments was modeled after an actual situation where consumers were educated about the dangers of phosphate additives and asked to play out a situation involving the purchasing of ham. However, in the real situation, consumers were found to be willing to pay less for phosphate-free ham and tended to decide their purchases based on information on the flavor quality of the brand of ham. The study concluded that the presence of food additives, both hypothetical and real, greatly influence the purchasing decisions of many consumers (Keiko et al., 2010).

Some of the food additives that pose health concerns. Additive

tartrazine Ponceau 4R Sunset yellow Camoisine Quinoline yellow Allura red Sodium benzoate

Used in
Sweets, biscuits, mushy peas Sweets, biscuits, drinks Sweets, ice cream, drinks Biscuits, jelly, sweets, ready meals Sweets, smoked haddock, pickles Soft drinks, cocktails, sausages Soft drinks, baked goods

Hyperactivity, asthma rashes Allergy, intolerance Gastric upset, allergy Allergy, intolerance Hyperactivity, asthma, rashes Some evidence of hypersensitivity Hyperactivity, asthma


The food additive known as pink slime, which is now commonly found in beef products.

Consumer Reaction to Information on Food Additives Consumers are becoming increasingly concerned that the food they eat could be harmful to health. There have been issues and outrage lately over the beef product known as "pink slime." Officially called Lean Finely Textured Beef (LFTB), these are beef additives made from processed trimmings of beef leftover from other cuts. Pink slime is a lower fat meat that is added to ground beef or beef products as inexpensive filler. Similarly the presence or absence of food additives and accurate information of the additive are considered to be very important factors in an individuals purchase decisions. There is always positive and negative information on food additives available to consumers; therefore, consumer s food choice is believed to be greatly influenced by how they judge this available information. To examine the issue of information effect on choice behavior, the researchers simultaneously provided both negative and positive information about sodium nitrite, a food additive contained in ham sandwiches, to the subjects and tested whether information provision affects the subjects choice. The results showed that when given both positive and negative information, the negative information was dominated. This therefore, shows the general public concern in the detrimental effects of a food additive. The results also showed that the subjects prefer a low-priced ham sandwich and do not prefer a ham sandwich containing sodium nitrite. Information about flavor had the greatest effect on the choice of a ham sandwich with sodium nitrite, which shows that people eat these food additives to enhance the taste, regardless of the negative effects that may be attributed to them. Sodium nitrite eliminates the smell of pork, which is the raw material for ham and sausages. Therefore, it plays a significant role in the creation of the distinctive flavor of meat products, which is called curing flavor. (Keiko, Junyi, & Tatsuyoshi, 2010). Nitrates and nitrites are not cance r-causing agents (carcinogenic), but nitrates can be converted to nitrites in the gut and saliva. Nitrites are considered to be more toxic because they can combine readily with natural amines in some foods to form highly carcinogenic chemicals called nitrosamines. A study published earlier this year by researchers at Rhode Island Hospital in the US reported a link between increased levels of nitrates and increased deaths from certain diseases including Alzheimer's, diabetes mellitus and Parkinson's, possibly through the damaging effect of nitrosamines on DNA (Dengate, 2009). However, the residual volume of sodium nitrite in the food products sold in the current market is very small, only 1/5 to 1/14 of 70 ppm as prescribed by the Food Sanitation Law.


It is not yet confirmed that using such a small amount of sodium nitrite would create the risk mentioned above. On the other hand it is also mentioned that, Since Carcinogenic N-nitrosamines are formed by the combination of sodium nitrite and low amine, which is abundant in fish, it is desirable to limit the use of food additives as much as possible. (Keiko, Junyi, & Tatsuyoshi, 2010). In patients with renal disease, a high serum phosphate concentration is a major risk factor for elevated cardiovascular and overall mortality hypophosphatemia, a state of abnormally elevated levels of phosphate in the blood that has been identified in the past decade as a strong predictor of mortality in advanced chronic kidney disease (CKD). For example, a study of patients in stage CKD 5 (with an annual mortality of about 20%) revealed that 12% of all deaths in this group were attributable to an elevated serum phosphate concentration. Recently, a high-normal serum phosphate concentration has also been found to be an independent predictor of cardiovascular events and mortality in the general population. Phosphate occurs naturally in the form of organic esters in many kinds of food, including meat, potatoes, bread, and other farinaceous products; the consumption of such foods cannot be restricted without incurring the risk of lowering protein intake as this natural phosphate is not fully absorbed. On the other hand, inorganic phosphate in food additives in processed and fast food is effectively absorbed and can measurably e levate the serum phosphate concentration. Therefore, phosphate additives in food are a matter of concern, and their potential impact on health may well have been underappreciated. Furthermore, calls for labeling the content of added phosphate in food are appropriate.

Bibliography Beil, L. (2011). The color of controversy.Science News, 180(5), 22. Belitz, H.D., Grosch, W., Schieberle, P. (2009) Food additives. In Food chemistry. (8). 429 - 466. Berlin: Springer-Verlag. Chaudhary, N. (2010). Food Additives [electronic version].Bibechana, 6, (3), 22-26. Cheeseman, M. (2012).Artificial Food Color Additives and Child Behavior [electronic version].Environmental Health Perspectives, 120, (1), a15-a16. Chemical Cuisine: Learn about Food Additives (2012). Retrieved September 29, 2011, from Davidson, P., Singh, R. (2012). Food additive. Encyclopdia Britannica Online Academic Edition, Dengate, S. (2009).nitrates, nitrites and nitrosamine. http://www.fedupwithfood additives .info /factsheets/PDFconversions/Factnitrate.pdf Eberhard R., Kai H., Markus K., Martin K., and Mann, J. (2012).Phosphate Additives in Food-a Health Risk [electronic version].DtschArztebl International, 109, (4), 4955. Eigenmann, Philippe A (2007). "Food colourings, preservatives, andhyperactivity". Lancet (0140-6736), 370 (9598), p. 1524.


Feed. (2012). In Encyclopedia Britannica.Retrieved from 203664/feed. Food Ingredients and Colors.International Food Information Council (IFIC) and U.S. Food and Drug Administration. (2004) /Food/FoodIngredients Packaging/ ucm094249.pdf Hanson, J. (2010). Natural products from the hallucinogenic. Science Progress, 93 (2), 171-180. Kaefer, C. M., Milner, J.A. (2007). The role of herbs and spices in cancer prevention.The Journal of Nutritional Biochemistry. 19 (6), 347-361. Keiko A., Junyi S., and Tatsuyoshi S. (2010). Consumer reaction to information on food additives: Evidence from an eating experiment and a field survey [electronic version]. Journal of Economic Behavior & Organization, 73, (3), 433-438. Kirby, S. (2008) Sage. In AccessScience. Retrieved from searchStr= herbs+and+spices&id=598100. Luiz, L., Alice, M., Mederios-Souza, P., Almeida, G., (2006). The use of herbal medicine in Alzheimers Disease a systematical review. Hindawi. 3(4), 441-445. Melnick, M. (2011) Does food dye fake kids hyper. In Time magazine. OMathna, D. (2010). Does it work? Can nutmeg cause hallucinations?.HEALTH, 96. Piper, P.W. (2011) Resistance of yeasts to weak organic acid food preservatives.In Advances in Applied Microbiology. 98 110. Rossi, M., Amaretti A., Raimondi S. (2011). FolateProdction by Probiotic Bacteria. Retrieved March 29, 2012, from Schardt, D. (1999). Functional foods.Nutrition Action Health Letter, 26, (3), 1. Sheetal P., Padma A., Jayantilal D., and Bharat R. (2012).Potential of Probiotic Lactobacillus Strains as Food Additives [electronic version].Retrieved March 23, 2012, from Google Scholar. Stevenson, J. (2010) Recent research on food additives: implications for CAMH. In Child and Adolescence Mental Health.15(3). 130 133. Tajkarimi, M., Ibrahim, S., Cliver, D., (2010) Antimicrobial herb and spice compounds in food. Food Control, 21(9), 1199-1218. Winter, R (2004).The Consumers Dictionary of Food Additives. New York: Three Rivers Press


Illustration Credits d_additives_2008/2008/body/28_FoodAdd.ashx?w=709&h=380&as=1 TqYnd5Pm2sY/s1600/herb_chart.jpg preview.jpg


Chapter 15 Cooking in Developing Countries

John Dymek, Deidre DiLiddo, and Mark Guertin Introduction According the World Health Organization, indoor air pollution is the fourth greatest health risk to the citizens of developing countries. The toxic smoke produced by inefficient stoves does not only cause death and disease in these developing countries, they are a major contributor to global warming, second only to then use of fossil fuels. Both private organizations and governments have ignored this problem for years. Foraging for fuel poses dangers of its own. Conflict-torn regions are a hazardous environment for women and children, the primary gatherers. These children are kept out of what little education they are offered to forage (Foell, Pachauri, Spreng, & Zerriffi, 2011).

A mother in a developing country holds her child near a potentially harmful cooking fire. Developing countries is actually defined by the UN conventions as Least Developed Countries. These countries represent the poorest and weakest segment of the international populations. They comprise more than 880 million people in several different areas of the globe. Weak economic and social infrastructure is based on a mainly agricultural lifestyle. These countries are the victim of both internal and external conflict. Political instability has kept the citizens from modern developments in social and technological ways ("Least developed countries:," 2012). Agricultural areas of developing countries are not the only societies at risk. Overcrowded cities and poor living conditions only add to the cumulative hardships of life in urban areas. New threats arise with the use of outdates cooking methods. Inexpensive and poorly constructed living quarters pose an extreme fire hazard that often leads to structural collapse.


Fuel Types and Biomass

Environmental Attributes of Different Fuel Types

1E+05 1E+04 1E+03 1E+02 1E+01 1E+00 1E-01 1E-02 1E-03 1E-04 1E-05 1E-06 1E-07 Charcoal Biogas LPG

This table is based on data from Afrane and Ntiamoah (2011). Information is given for 1kg of charcoal, biogas, and LPG (Liquified Petroleum Gas). SO2 is sulfur dioxide, DCB is 1.4 dichlorobenzene, CO2 is carbon dioxide, and C2H4 is ethylene. EV is energy value, CE is cookstove efficiency, AP is acidification potential, EP is eutrophication potential, FAETP is freshwater aquatic ecotoxicity potential, GWP is global warming potential, HTP is human toxicity potential, POCP is photochemical ozone creation potential, TETP is terrestrial ecotoxicibal warming potential, HTP is human toxicity potential, POCP is photochemical ozone creation potential, and TETP is terrestrial ecotoxicity potential. Equiv compares to an equivalent amount of the material. The information is given on a logarithmic scale of base 10. Wood, charcoal, and similar wood-based products, as well as other biomass products including animal dung, are heavily used in developing countries for cooking and other such uses. Charcoal is the result of carbonization of wood. It can be generated from waste wood after logging and sawmill operation so as not to cause as much deforestation (Afrane & Ntiamoah, 2011). Charcoal has advantages over firewood, as it is more efficient, but pollutes more than LPG, and is extremely inefficient to produce (Akpalu, Dasmani, & Aglobitse, 2011). In Ghana, two types of charcoal stoves are commonly used: the traditional type and an improved type, both of which are made locally from scrap metal. The improved model has additional insulation (Afrane & Ntiamoah, 2011). Overuse of such biomass energy sources as charcoal and firewood for cooking in developing countries has contributed to high levels of deforestation and indoor pollution, which has in turn negatively affected the health of many. Estimates show that 15 million hectares of tropical forest land are cleared each year to make room for small-scale farming or for use as fuel for heating or cooking. There is a


consensus that the rate of biomass consumption in developing nations is a threat to long-term sustainability of forests (Akpalu, Dasmani, & Aglobitse, 2011). Fuel consumption patterns in developing countries are dynamic, as they depend on prices and accessibility of each fuel type. Local users of biomass generally do not respond to external forest loss. Cooking fuel in Ghana, for example, is demanded based on prices; a household will be ambivalent about using two different fuels if prices are equivalent, regardless of combustion efficiency. In these countries, biomass remains dominant as fuel for both heating and cooking. It is estimated that biomass is heavily relied upon by 70% of Ghana, and the average Ghanian uses approximately 640 kg of wood yearly, where forest growth in the nation is under half of the wood fuel demand (Akpalu et al., 2011). Indoor air pollution is a health issue worth noting. Literature indicates that exposure levels are severely high. Solid fuel use on open flames or traditional stoves may result in exposure to dangerous toxins; in addition, incomplete combustion allows small particles to be released into the household. Use of charcoal is expanding and taking away from use of other solid biomass, as it is cleaner; however, it poses other types of health risks and ecological detriments. Studies reveal that indoor air pollution causes a common illness known as acute lower respiratory infection (ALRI) in children and obstructive lung diseases in adults. Estimates show 2.44 million deaths due to indoor biomass pollution in developing countries; these may be due to improper ventilation and incomplete combustion of biomass (Akpalu et al., 2011). According to a study by Palmer and Mann (2011), fine particles (PM10) have been estimated to cause 9.1% of all deaths in Christchurch, New Zealand, and 48% of those are from wood fires in homes, while an estimated 80% of PM10 is actually from said wood fires. However, this is in a more industrial setting, so it must be considered that this toxicity rating is compared to traffic- and industry-related PM10; wood burning does, in fact, release toxic particles into the air and cause deaths, according to this study. In rural India, cooking dominates aggregate energy consumption. According to the Nation Sample Survey report, 88.4% of this energy demand is met by unprocessed biomass fuels: fuel wood, crop residues, feces, et cetera. Usage has both direct and indirect disadvantages. Direct effects include detrimental health impacts from indoor air pollution and environmental impacts of soil erosion and deforestation, resulting in decreasing agricultural productivity. Biomass fuels have been estimated to cause 5-6% of diseases in India.97% of households in Jharkand, Bihar, Chhattisgarh, and Uttar Pradesh use biomass fuels. Use of firewood and chips has increased from 75% in 2004-5 to 78% in 2007-8 despite petroleum fuels. Dung cakes, coal, and other burnable fuels have declined steadily; however, this says nothing about what these fuels have been replaced with (Pandey & Chaubal, 2011).

Fossil Fuels Liquid Petroleum Gas (LPG) is a mix of propane and butane. It has a human toxicity potential orders of magnitude higher than charcoal and biogas, and also has higher potential for terrestrial ecotoxicity, eutrophication, and freshwater aquatic ecotoxicity (Afrane & Ntiamoah, 2011). Fossil fuels such as LPG, propane, and kerosene are used sparingly in developing countries. As stated before, fuel consumption patterns in developing countries are dynamic, as, again, they depend on prices and accessibility of each fuel type. In developing countries including Ghana, households use kerosene and LPG as cooking fuels, which have higher efficiency and lower environmental impacts than charcoal, alongside wood derivatives (Akpalu et al.2011).


Kerosene and LPG are commonly used modern fuels, as they have high energy density, high heat-transfer efficiency, and high combustion efficiency. Kerosene is used varyingly but extensively in urban centers for cooking. The use of LPG varies between urban centers, partially due to limited availability. It is non-toxic, emits few pollutants, and the required stove is easy to use. Biomass and petroleum derivatives all have negative impacts on the environment due to particle emission. If the use of cooking fuel is not properly managed, especially wood derivatives, then it can harm both humans and the environment in numerous ways. Extraction, processing, and transportation of cooking fuels each have detrimental effects at all levels (Akpalu et al., 2011). Especially in rural areas, some houses generally favor biomass over petroleum products, even with high availability of the latter. Only rarely can biomass be completely substituted. A town in Sierra Leone has 2/3 of its families refusing to switch to modern fuel due to ease of wood stoves. In Ghana, governmental policies aim to promote use of LPG to reduce environmental impact, and have been successful, increasing the use of clean cooking fuels, albeit slowly (4% in 1998 to 9.5% in 2006). In rural India, use of LPG has increased steadily over the years, albeit marginally 8.6% in 2004-5 to 9.1% in 2007-8. Dung cakes, coal, and other burnable fuels have declined steadily; however, this says nothing about what these fuels have been replaced with. Kerosene is easily obtained as the only fuel available from the open market, but is not used very often, being used by 0.72% of houses in 2007-2008 (Pandey & Chaubal, 2011).

Biogas Biogas is a mix of carbon dioxide and methane produced by anaerobic digestion of organic waste such as cow feces. It isnt used as often as other types of fuels, but, according to the above table, is much better for the environment. The waste left after gas generation, or the digestate, can be used as fertilizer for farms with little negative impact. Methane can be lost from the biogas system due to leakage, technological deficiencies, or excess production; however, methane losses of 1% have been reported when used for generation of heat (Afrane & Ntiamoah, 2011).

Indoor Air Pollution and Health Complications Cooking is an unavoidable activity that is necessary to survive. In most developing countries, the main method of cooking is indoor open fires or primitive indoor stoves. Although these methods work sufficiently for these people, it is not done in the most sanitary and healthy conditions. Biomass fuels and coal are generally the main source of fuel for cooking. Biomass fuels and coal are burned, which releases harmful pollutants into the surrounding air and atmosphere. Because the smoke does not have a means of escape, many people are affected by the unclean air. Most fires and cookstoves are inside of homes, and there is generally a lack of ventilation in these homes. A single window or an opening to enter and exit through may be the only opening that allows smoke to exit the home. This is an issue because of the particulate matter that is released into the air. Without proper ventilation the soot and matter build up and pollute the air inside the home.


An open fire is used by many to cook within the home. A lack of windows causes the smoke and soot to build up inside the home. Exposure to the combustion of these materials can cause acute respiratory infections, chronic obstructive pulmonary disease (COPD), lung cancer, asthma, nasopharyngeal and laryngeal cancers, and tuberculosis, as well as many other diseases (Indoor air pollution and health in developing countries, 2005). The effects of diseases are most commonly found when cooking is done indoors or when the stove is poorly ventilated. More than half of the pneumonia deaths that occur in children that are five years or younger are a direct result of exposure to the particulate matter that is a result of burning biomass. The levels of this matter that are released into the air are generally 100 times higher than the acceptable health standard. Although a disease may not develop as a result of exposure, people are still affected. The smoke causes inflamed airways and lungs, lowers the oxygen-carrying capacity of the blood, and impairs the immune response, which can bring on other sicknesses (WHO, 2011). Another health issue that is common to people in developing countries exists among pregnant women. Generally, the women are in the kitchen and cooking with these stoves and fuels. When the women are pregnant, exposure to the indoor air pollution causes birth defects such as low birth weight. This can be fatal considering that in these underdeveloped countries, women give birth at home, without the luxury of a hospital, where other complications could arise. Low birth weight can have a domino effect on other health issues that will come as the child begins to grow and develop. The global effects of the methods of cooking in developing countries are being studied to raise awareness of the problem that is at hand. The lack of clean fuels is ignored by governments and private aid organizations. The indoor air pollution is the fourth greatest health risk factor found in developing countries. This health risk is fourth to unclean water and sanitation, unsafe sex, and undernourishment. This has recently been focused on and hopefully there will be an effort to replace these stoves that emit harmful gases and soot (Developing nations to get clean-burning cookstoves, 2010). To minimize the exposure to cooking related emissions, cooking devices need to be improved or an alternate source of energy needs to be implemented. However, fires and stoves that are built are easy and essentially free. If newer and cleaner methods were implemented, for most people, government aid would be required.


The map displays the amount of deaths that can be attributed to indoor air pollution. Countries in Africa tend to have more deaths because the majority of the country cooks with open stoves and indoor fires. Not only do these cook stoves cause indoor air pollution, but they can also catch fire, which risks the lives of those that are using them. In addition to premature deaths, there is a lot of time wasted when the focus of everyday life is on finding and gathering fuels that can be anything from crop waste to cow dung. Time and energy that could be better used are spent on such a rigorous and repetitive activity that cannot currently be avoided (Silent and deadly, 2010).

Alternative Cooking Methods Solar cooking, a simple and efficient alternative to fuel, is a concept that has been applied for hundreds of years. It is always readily available and essentially it is free. There are numerous advantages in the use of solar cooking. The lack of complicated procedure makes it easy to use and solar cooking is also safer and more sanitary than traditional fuels. On top of health concerns, many are suffering because they cannot afford the fuels that are necessary for cooking. Developing countries have the potential to gain many benefits from the use of solar cookers. For example, these countries tend to have a strong concentration of the energy from the sun, as well as a need for an alternative cooking method that is at little or no cost to them. Solar cookers would not only be more cost-efficient, but would also increase the nutritious value of the food that the people consume. In some of the more sunny regions, where the concentration of the rays are the most intense, solar energy can be captured and used to cook food. Although burning wood is a sufficient source of energy, it is not always readily available because deforestation is occurring in many locations. Deforestation refers to the removal of a forest in which the land is then used for industrial related activities that leave the animals native to the area stranded without food or shelter. A related problem that most families encounter is that they do not have enough money to afford fuels to cook their food.


Solar cookers are environmentally friendly because they reduce the amount of fuels that must be used or wood that needs to be burned to cook. These fuels tend to be expensive, unsanitary, or inaccessible in certain areas. Fortunately solar energy is usually readily available, unless it is at night. Solar cooking also allows for the women, who tend to be responsible for household activities, to be able to accomplish many tasks while the food is cooking because solar cooking generally takes a long time to sufficiently cook food (A review of the thermal performance parameters of box type solar cookers and identification of their correlations, 2010). If solar energy is implemented in a way so that families can afford a device that would cook their food using a resource that is guaranteed to be available to them, the families would lead healthier and less stressful lives. There are multiple designs of solar cookers, and they are all designed to function in a similar way. However, some solar cookers are more efficient than others. Equations can be applied to each design of a solar cooker to determine the efficiency, heat loss, heating power, and other variables that would be presented in choosing the most fitting solar cooker. Solar cookers have advantages over other cooking methods because they cost nothing to power and they have a high nutritional value for foods. Although there are numerous advantages to solar cookers, some of the disadvantages could include limited amount of sunshine, time of cooking, and high cost to initially purchase the device (Design optimization of solar cooker, 2007).

A simple box type solar cooker can easily be built with basic materials such as wood, aluminum, mirrors, and glass.

The diagram above illustrates a simple design that shows the basic necessities of a solar cooker. Although it lacks complexity, the food will be sufficiently cooked over a long period of time. One of the main issues that comes with solar cookers is that people that live in rural areas of developing countries are generally accustomed to tradition. These people perform every part of their daily lives out of routine tradition. Cooking with fires and cookstoves is the method of cooking that has been used for generations. Although solar cooking is more efficient and affordable, researchers fear that the people in developing countries will not accept this method because it is not a traditional method of cooking.


Global Politics on Cooking in Developing Countries U.S. Involvement The primary form of cooking in developing countries is through the use of primitive indoor stoves. Smoke inhalation and heart disease from these stoves kills 1.9 million men, women, and children every year. These stoves are also a major part of Global Climate change. They produce huge amounts of soot and reduce forest cover. The United States has taken an active role in supplying developing nations with renewable energy and modern cookware. Secretary of State Hillary Clinton has pledged the USs support to the Global Alliance for Clean Cookstoves that provides clean-burning stoves to villages in Africa, Asia, and South America. Secretary Clinton has used her political influence and public fame to push the agenda to an important position in the US. Recruiting well-known chefs and public-figures, she has made the problem known to the public (Broder, 2010).

US Secretary of State Hillary Rodham Clinton meets with Chef Jose Andres, Culinary Ambassador for the Global Alliance for Clean Cookstoves. The US is also providing $50 million in seed money to these developing countries. Several other partners including foreign governments are to contribute another $10 million. There has been little attention for this subject from scientific institutes. Until recently, many ignored the inefficient biofuel based stoves. Currently stoves on the market run as little as $20 US dollars and are 50% more efficient than there third-world counterparts. The higher end models, running around $100, capture 95% of harmful emissions and burn fuel more efficiently. Global Alliance for Clean Cookstoves Nearly half the worlds population is using dirty and inefficient cooking methods for their daily meals. Women and young children are often affected by the population produced from these stoves. Chronic illnesses often appear in areas where clean, efficient cooking methods are not available. Natural resources are strained by these inefficient methods and. The Global Alliance for Clean Cookstoves is a new public-private partnership that has enlisted the helped of several global businesses and governments. The alliance has been formed to provide developing countries with clean and efficient household cooking solutions ("Global alliance," 2012).

Number of people gaining clean cooking facilities and additional cumulative investment needs. One major issue in the transition of primitive fuel users to more current methods is the conversion itself. Close to 800,000 poverty-stricken people would need to gain access to improved cooking methods a day to meet the international organizations goal. The approach of introduced by global charity is the promoting of more efficient and sustainable fuels and encouraging the self-transition to more modern fuels and technologies. Cultural and habitual customs take a major role in the introduction of new technology in developing areas. Some biomass fuels may be more accessible in one area of the globe (Akpalu et al., 2011). Cookstove programs are often implemented by non-governmental organizations of varying size, capacity, funding sources and focus. Some are primarily concerned with solving energy poverty problems while others see the introduction of new cooking technologies to be of high priority. All too often though, many choose to ignore the needs of the developing areas. Among the supporters are the Shell Foundation, the Morgan Stanley Foundation, the World Health Organization, the United Nations Environment Program, the United Nations High Commissioner for Refugees and the governments of Germany, Norway and the Netherlands.

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Lahkar, P. J., Samdarshi, S. K. (2010, August). A review of the thermal performance parameters of box type solar cookers and identification of their correlations. Science Direct, 14, 1615-1621. Mirdha, U. S., Dhariwal, S. R. (2007). Design optimization of solar cooker. Science Direct, 33, 530-544. National Institutes of Health, National Institute of Environmental Health Sciences. (2012). Global alliance of clean cookstoves. Retrieved from website: programs/cookstoves/index.cfm Palmer, P., & Mann, J. (2011, March 4). How toxic are fine particles emitted from home fires in Christchurch, New Zealand? The New Zealand Medical Journal, 124(1330), 30-33. Retrieved from Pandey, V. L., & Chaubal, A. (2011). Comprehending household cooking energy choice in rural India. Biomass and Bioenergy , 35(11), 4724-4731. doi:10.1016/j.biombioe.2011.09.020 Silent and deadly; indoor pollution. (September, 2010). The Economist, 396, 72. Wentzel, M., Pouris, A. (2007, March).The development impact of solar cookers. Science Direct, 35, 1909-1919. World Health Organization. (2011, September). Indoor air pollution and health. Retrieved from United Nations, Office of the High Representative for the Least Developed Countries. (2012). Least developed countries: About ldc's. Retrieved from website:

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