Effect of Animal Protein Intake on Meeting Recommendations for Nutrient Intake among US Adults, What We Eat in America, NHANES 2015-2018.

Background: Replacing some animal sources of protein with plant foods is encouraged. Nutrient intake may reflect changes in the protein source. The adequacy of habitual nutrient intake among US adults has not been evaluated by the level of animal protein (AP) intake. Objectives: The objective of this study was to compare food consumption and nutrient intake and adequacy among quintiles of percent AP intake. Methods: Dietary intake data of adults 19+ y (N = 9706) from What We Eat in America, National Health and Nutrition Examination Survey 2015-2018 were used. Proportions of protein from animal and plant sources were estimated from ingredients in the Food and Nutrient Database for Dietary Studies 2015-2018, and then applied to dietary intakes. Intakes were classified by Q of percent AP. Food intake was described using the United States Department of Agriculture Food Patterns components. Usual nutrient intakes were estimated using the National Cancer Institute Method and compared with age and gender-specific Dietary Reference Intakes (DRIs). Comparisons between quintiles were made using t-tests. Results were considered significant at P < 0.01. Results: Total protein intake was higher as the Q of AP intake increased. Among the higher quintiles of percent AP, <1% did not meet their DRIs for protein than 17% in Q1 and 5% in Q2 (P < 0.01). In quintiles with lower compared with higher percent AP, there were significantly higher percentages not meeting DRIs for vitamins A, B12, choline, zinc, and calcium but meeting recommendations for folate, vitamin C, saturated fat, cholesterol, and fiber (P < 0.01). Among all quintiles, over one-third did not meet DRIs for fiber, vitamins A, C, D, E, K, choline, calcium, and potassium. Conclusions: Replacing protein from animal sources with plant foods may result in lower intakes of protein and some nutrients but a better intake of dietary components associated with reducing chronic disease risk. The current intake of US adults indicates dietary improvements are needed, regardless of protein source.

Diet Quality and Food Intakes samong US Adults by Level of Animal Protein Intake, What We Eat in America, NHANES 2015-2018.

Background: Dietary recommendations encourage consuming protein from a variety of plant and animal sources. Evaluating the diet of US adults by level of animal protein (AP) intake can inform dietary assessment and nutrition education. Objectives: The objective of this cross-sectional study was to estimate percentage of total protein intake from animal sources by US adults to compare diet quality, and intake from USDA Food Patterns (FP) groups by quintiles of AP. Methods: One day dietary intake data from adults 20+ y (N = 9566) in What We Eat in America (WWEIA), NHANES 2015-2018 were used. Proportions of total protein intake from animal and plant sources and the USDA FP groups were estimated from the ingredients in the Food and Nutrient Database for Dietary Studies 2015-2018, then applied to the dietary intakes. The 2015 Healthy Eating Index (HEI) was used as an indicator of diet quality. The USDA FP groups were used to describe the contribution of animal and plant foods to total protein intake. Data were analyzed by quintile (Q) of AP protein intake; comparisons were made using pairwise t-tests with adjustments for covariates using survey sample weights. Results were considered significant at P <0.001. Results: Total mean protein intakes ranged from 62 (Q1) to 104 g (Q5) (all comparisons P <0.001). Total HEI score (possible 100) of Q1 was slightly higher (54.2) (P <0.001) compared with Q1-Q4 (range: 48.0-50.3), which did not differ significantly from each other. Contributions of plant FP components to total protein intake of Q1 to Q5, respectively, were 15% to 1% from nuts/seeds, legumes, and soy products combined; 35 to 10% from grains. The contribution of animal FP components were 19-66% from meat/poultry/seafood, 14-19% dairy, and 3-5% eggs. Conclusions: The intake of foods considered to be good sources of plant protein was low. The overall diet quality of all adults was suboptimal regardless of plant protein intake.

Diet Quality of Frequent Fast-Food Consumers on a Non-Fast Food Intake Day Is Similar to a Day with Fast Food, What We Eat in America, NHANES 2013-2016.

BACKGROUND: Frequent fast food (FF) consumers may make more healthful food choices at eating occasions without FF. However, it is not clear if poor diet quality of frequent FF consumers is a function of FF consumption or less healthful food choices overall. OBJECTIVE: The objective of this study was to compare diet quality, energy, and nutrient intakes of infrequent FF consumers (INFREQ) with that of frequent FF consumers on an intake day with FF (FREQ-FF) or without FF (FREQ_NO FF). DESIGN: This study is a cross-sectional analysis of 1 day dietary intake data from What We Eat in America, National Health and Nutrition Examination Survey 2013-2016, the dietary intake component of National Health and Nutrition Examination Survey. PARTICIPANTS/SETTING: Participants included adults aged 20 years and older (N = 4,012), who, during the previous 7 days, reported no consumption of FF or pizza (n = 2,142 INFREQ) or reported FF or pizza three or more times and either had FF/pizza (n = 1,455 FREQ_FF) or did not have FF/pizza (n = 415 FREQ_NO FF) on the intake day. MAIN OUTCOME MEASURES: Main outcomes were energy, nutrient density (nutrient intake per 1,000 kcal), and diet quality evaluated using Healthy Eating Index (HEI) 2015. STATISTICAL ANALYSES PERFORMED: Group comparisons were made using t tests. Differences were considered significant at P < 0.001. RESULTS: Compared with INFREQ consumers, FREQ_FF consumers had higher intakes of energy and fat per 1,000 kcal, lower scores for total HEI and most components, and lower nutrient densities of most micronutrients (P < 0.001). HEI component scores of INFREQ consumers for vegetables, fruit, whole grains, and added sugars were higher than FREQ_FF consumers (P < 0.001). Energy intake, most nutrient densities, and total HEI and component scores of FREQ_NO FF consumers were not significantly different from FREQ_FF consumers with the exception of fruit but were different from INFREQ consumers for some nutrients and HEI components. CONCLUSIONS: Results suggest diet quality and nutrient intake of frequent FF consumers on a non-FF intake day is not markedly different from a day with FF.

Food Insecurity and Pediatric Malnutrition Related to Under- and Overweight in the United States: An Evidence Analysis Center Systematic Review.

Both food insecurity and malnutrition are associated with adverse health outcomes in the pediatric population. However, the research on the relationship between these factors has been inconsistent, leading to uncertainty regarding whether or how evaluation of food insecurity should be incorporated into nutrition screening or the nutrition care process. The objective of this systematic review was to determine the association between food insecurity and malnutrition related to undernutrition or overnutrition (defined by anthropometrics) in the pediatric population in the United States. A literature search was conducted using Medline, Embase, and CINAHL databases for studies published from January 2002 through November 2017. A total of 23 studies (19 cross-sectional and 4 prospective cohort studies) met inclusion criteria and were included in qualitative analysis. In 6 studies, there was no overall relationship between food insecurity and underweight. All included studies examined the relationship between food insecurity status and overweight/obesity and results were mixed, with large cross-sectional studies demonstrating a positive relationship between food insecurity and overweight/obesity. There were no clear patterns according to subpopulation. Evidence quality was graded as fair due to heterogeneity in how food insecurity was measured and populations included as well as inconsistency in results. Use of a 2-item food insecurity screening tool may allow for efficient, effective screening of food insecurity in order to identify potential contributors overweight and obesity.

Fruit and Vegetable Consumption of US Adults by Level of Variety, What We Eat in America, NHANES 2013-2016.

BACKGROUND: Dietary guidance encourages consuming a variety of fruit and vegetables (FVs), which has been associated with higher FV intake and nutrient adequacy. Dietary intake of adults in the United States has not been described in the context of variety. OBJECTIVES: The objective of this study was to describe FV consumption of adults in the United States by level of FV variety. METHODS: One day of dietary intake data of adults aged ≥20 y (n = 10,064) in What We Eat in America, NHANES 2013-2016 were used. FV variety was the count of foods consumed that contributed to total FV intake. Each FV was counted only once; a mixed dish counted as 1. Variety levels were high (≥5 items, n = 2316); moderate (3-4 items, n = 3423); or low (1-2 items, n = 3746). Differences between each level of variety were compared by t test. RESULTS: Among the low, moderate, and high levels, total FV intakes were 1.4, 2.6, and 4.4 cup equivalents (CE), respectively. CE amounts of FVs consumed were 0.3, 0.6, and 1.4 of vegetables excluding potatoes; 0.2, 0.3, and 0.3 of potatoes; 0.3, 0.6, and 1.2 of fruit; and 0.4, 0.4, and 0.5 from mixed dishes, respectively; percentages of each level reporting intake were 34%, 64%, and 89% for vegetables excluding potatoes; 23%, 34%, and 32% for potatoes; 22%, 49%, and 75% for fruit; and 72%, 71%, and 72% for mixed dishes, respectively. CONCLUSIONS: Those with more variety of FV intake include whole FVs more frequently and in higher amounts. These results support suggestions for encouraging more FVs at snacks and as side dishes and salads at meals to increase total intake.

Validity and Reliability of Pediatric Nutrition Screening Tools for Hospital, Outpatient, and Community Settings: A 2018 Evidence Analysis Center Systematic Review.

BACKGROUND: Nutrition screening tools are used to identify risk of malnutrition or change in risk of malnutrition. However, it is unclear which tools have demonstrated high validity, reliability, and agreement. OBJECTIVE: Our aim was to conduct a systematic review of valid and reliable pediatric nutrition screening tools for identifying malnutrition risk (under- or overnutrition), and to determine whether there are differences in validity and reliability according to users of the tools. METHODS: A literature search using Medline, Embase, and CINAHL databases was conducted to identify relevant research published between 1995 and May 2017 examining validity and reliability of nutrition screening tools in the pediatric population. A multidisciplinary workgroup developed eligibility criteria, data were extracted and summarized, risk of bias was assessed, and evidence strength was graded, according to a standard process. RESULTS: Twenty-nine studies met inclusion criteria. Thirteen pediatric nutrition screening tools designed for various settings were included in the review (seven inpatient/hospital, three outpatient or specialty setting, and three community). The most frequently examined tools were the Screening Tool for the Assessment of Malnutrition in Pediatrics, Screening Tool for Risk on Nutritional Status and Growth (13 studies each), and Paediatric Yorkhill Malnutrition Score (nine studies). No tools demonstrated high validity. Reliability and agreement were reported infrequently. CONCLUSIONS: Nutrition screening tools with good/strong or fair evidence and moderate validity included the Screening Tool for the Assessment of Malnutrition in Pediatrics, Screening Tool for Risk on Nutritional Status and Growth, and Paediatric Yorkhill Malnutrition Score in the inpatient setting and Nutrition Risk Screening Tool for Children and Adolescents with Cystic Fibrosis in the specialty setting. No tools in the community setting met these criteria. While differences in validity and reliability measures among tool users were found, the significance of these findings is unclear. Limitations included few studies examining each tool, heterogeneity between studies examining a common tool, and lack of tools that included currently recommended indicators to identify pediatric malnutrition.

Consuming Vegetable-Based Salad Is Associated with Higher Nutrient Intakes and Diet Quality among US Adults, What We Eat in America, National Health and Nutrition Examination Survey 2011-2014.

BACKGROUND: Consuming salad is one strategy with the potential to harmonize diets more closely with national dietary guidance. However, it is not known whether nutrient intake and diet quality differ between people who consume vegetable-based salad and those who do not. OBJECTIVE: The objective of this study was to compare nutrient intake and diet quality between salad reporters and nonreporters. DESIGN: This study is a cross-sectional analysis of 1 day of dietary intake data collected via 24-hour recall. PARTICIPANTS/SETTING: Adults 20 years and older (n=9,678) in What We Eat in America, National Health and Nutrition Examination Survey 2011-2014 were included. Respondents who ate salad on the intake day were considered salad reporters. MAIN OUTCOME MEASURES: This study estimated nutrient intake from all foods and beverages (excluding supplements) and evaluated diet quality using the Healthy Eating Index (HEI) 2015. STATISTICAL ANALYSES: Nutrient intake and HEI scores were compared between salad reporters and nonreporters using paired t tests with regression adjustment for confounding variables. Results were considered significant at P<0.001. RESULTS: On the intake day, 23% of adults consumed salad. Energy, protein, and carbohydrate intakes did not differ between salad reporters and nonreporters. Salad reporters had higher intakes than nonreporters of dietary fiber, total fat, unsaturated fatty acids, vitamins A, B-6, C, E, K, folate, choline, magnesium, potassium, and sodium (P<0.001). Total HEI 2015 scores were significantly higher for reporters (56 of a possible 100 points) than nonreporters (50 points) P<0.001. Reporters also had significantly higher scores for eight of 13 HEI components: total vegetables, greens and beans, whole fruits, total protein foods, seafood and plant proteins, fatty acids, refined grains, and added sugars (P<0.001). CONCLUSIONS: Incorporating vegetable-based salad into one's diet may be one effective way to increase nutrient intake and improve overall diet quality. Regardless of salad reporting status, HEI scores show that diets of US adults need improvement.

Findings from What We Eat in America, National Health and Nutrition Examination Survey 2011-2014 support salad consumption as an effective strategy for improving adherence to dietary recommendations.

OBJECTIVE: To verify the previously untested assumption that eating more salad enhances vegetable intake and determine if salad consumption is in fact associated with higher vegetable intake and greater adherence to the Dietary Guidelines for Americans (DGA) recommendations. DESIGN: Individuals were classified as salad reporters or non-reporters based upon whether they consumed a salad composed primarily of raw vegetables on the intake day. Regression analyses were applied to calculate adjusted estimates of food group intakes and assess the likelihood of meeting Healthy US-Style Food Pattern recommendations by salad reporting status. SETTING: Cross-sectional analysis of data collected in 2011-2014 in What We Eat in America, the dietary intake component of the National Health and Nutrition Examination Survey.ParticipantsUS adults (n 9678) aged ≥20 years (excluding pregnant and lactating women). RESULTS: On the intake day, 23 % of adults ate salad. The proportion of individuals reporting salad varied by sex, age, race, income, education and smoking status (P<0·001). Compared with non-reporters, salad reporters consumed significantly larger quantities of vegetables (total, dark green, red/orange and other), which translated into a two- to threefold greater likelihood of meeting recommendations for these food groups. More modest associations were observed between salad consumption and differences in intake and likelihood of meeting recommendations for protein foods (total and seafood), oils and refined grains. CONCLUSIONS: Study results confirm the DGA message that incorporating more salads in the diet is one effective strategy (among others, such as eating more cooked vegetables) to augment vegetable consumption and adherence to dietary recommendations concerning vegetables.

2015 Evidence Analysis Library Evidence-Based Nutrition Practice Guideline for the Management of Hypertension in Adults.

Hypertension (HTN) or high blood pressure (BP) is among the most prevalent forms of cardiovascular disease and occurs in approximately one of every three adults in the United States. The purpose of this Evidence Analysis Library (EAL) guideline is to provide an evidence-based summary of nutrition therapy for the management of HTN in adults aged 18 years or older. Implementation of this guideline aims to promote evidence-based practice decisions by registered dietitian nutritionists (RDNs), and other collaborating health professionals to decrease or manage HTN in adults while enhancing patient quality of life and taking into account individual preferences. The systematic review and guideline development methodology of the Academy of Nutrition and Dietetics were applied. A total of 70 research studies were included, analyzed, and rated for quality by trained evidence analysts (literature review dates ranged between 2004 and 2015). Evaluation and synthesis of related evidence resulted in the development of nine recommendations. To reduce BP in adults with HTN, there is strong evidence to recommend provision of medical nutrition therapy by an RDN, adoption of the Dietary Approaches to Stop Hypertension dietary pattern, calcium supplementation, physical activity as a component of a healthy lifestyle, reduction in dietary sodium intake, and reduction of alcohol consumption in heavy drinkers. Increased intake of dietary potassium and calcium as well as supplementation with potassium and magnesium for lowering BP are also recommended (fair evidence). Finally, recommendations related to lowering BP were formulated on vitamin D, magnesium, and the putative role of alcohol consumption in moderate drinkers (weak evidence). In conclusion, the present evidence-based nutrition practice guideline describes the most current recommendations on the dietary management of HTN in adults intended to support the practice of RDNs and other health professionals.

Dispersal of Amblyseius swirskii (Acari: Phytoseiidae) on High-Tunnel Bell Peppers in Presence or Absence of Polyphagotarsonemus latus (Acari: Tarsonemidae).

Amblyseius swirskiiAthias-Henriot (Acari: Phytoseiidae) is a predatory mite used to control thrips (Thysanoptera), whiteflies (Bemisia tabaci Genn., Hemiptera: Aleyrodidae), and broad mites (BMs) (Polyphagotarsonemus latus Banks, Acari: Tarsonemidae). Dispersal of A. swirskii, using the ornamental pepper "Explosive Ember" as a banker plant was evaluated for control of BMs in high-tunnel peppers. Open-canopy plants (5 weeks old) versus closed-canopy plants (10-weeks old) were used to evaluate the effect of plant connectedness in A. swirskii dispersal, in the presence (two females per plant) and absence of BMs. Plots consisted of a single central banker plant and four bell peppers extending linearly north and south. Sets of all treatments were destructively sampled 1, 4, and 7 days after releasing A. swirskii Within 24 h, A. swirskii dispersed four plants away from the banker plants (1 m), regardless of the state of the canopy. Canopy connectedness did increase the presence of A. swirskii on the crop plants. Predatory mite numbers on closed-canopy treatments doubled within the 7-day sampling period, whereas no significant increase was observed on open-canopy treatments. The presence of BMs had no significant effect on the movement of A. swirskii The results suggest further experiments with A. swirskii and banker plants for control of BMs is warranted.

Fruit and vegetable intake of US adults estimated by two methods: What We Eat In America, National Health and Nutrition Examination Survey 2009-2012.

OBJECTIVE: Estimates of fruit and vegetable (FV) consumption vary depending on intake definition, which may be determined by research purpose. Researchers have used two methods to evaluate intake: epidemiological and behavioural. The present study describes FV intake by adults using epidemiological v. behavioural approaches. DESIGN: One-day dietary intake data from What We Eat In America, National Health and Nutrition Examination Survey 2009-2012 were used. Sample weights were used to produce nationally representative estimates. FV intake (in cup-equivalents (CE)) was estimated using the Food Patterns Equivalents Database. The epidemiological method considered all FV after disaggregating foods and beverages. The behavioural method included foods that provided at least 0·2 CE FV per 100 g, and excluded sources high in fat, added sugar and Na. SETTING: Nationally representative survey of the US population. SUBJECTS: Adults (n 10 563) aged ≥20 years. RESULTS: For epidemiological v. behavioural, fruit intake was 1·1 v. 1·0 CE for males and 1·0 v. 0·9 CE for females. Vegetable intake was 1·8 v. 1·1 CE for males and 1·5 v. 1·0 CE for females. CONCLUSIONS: The definition of FV intake affects estimates of consumption by the population and is an important consideration when planning and comparing research studies. The method used should align with research goals to assure accurate interpretation and validity of results.

Acute Toxicity and Sublethal Effects of Fenpyroximate to Amblyseius swirskii (Acari: Phytoseiidae).

Knowledge about the effects of pesticides on biological control agents is required in order to successfully implement integrated pest management programs. The predatory mite Amblyseius swirskii Athias-Henriot has been used to control thrips, whiteflies, and broad mites in vegetable production; however, effects of fenpyroximate, an acaricide and insecticide used in vegetable crops, on A. swirskii have not been evaluated. The effect of four residual concentrations of fenpyroximate on A. swirskii females was measured under laboratory conditions including its effect on their fecundity and larval survival. Fresh residues of fenpyroximate were significantly toxic to adult females and larvae. Mortality increased and fecundity decreased as the concentration (0.026-0.208 ml/50 ml of water) and time after treatment (24-120 h) increased. Fifty percent of the larvae survived on the two lower concentrations (0.026 and 0.052 ml/50 ml of water) after 120 h.

Feasibility of NIR interactance hyperspectral imaging for on-line measurement of crude composition in vacuum packed dry-cured ham slices.

There is a growing market for packaged slices of dry-cured ham. The heterogeneity of the composition of slices between packages is an important drawback when aiming to offer consumers a product with a known and constant composition which fits individual consumer expectations. The aim of this work was to test the feasibility of NIR interactance imaging for on-line analysis of water, fat and salt and their spatial distribution in dry-cured ham slices. PLSR models for predicting water, fat and salt contents with NIR spectra were developed with a calibration set of samples (n=82). The models were validated with an external validation set (n=42). The predictive models were accurate enough for screening purposes. The errors of prediction were 1.34%, 1.36% and 0.71% for water, fat and salt, respectively. The spatial distribution of these components within the slice was also obtained.

Effects of post-processing treatments on sensory quality and Shiga toxigenic Escherichia coli reductions in dry-fermented sausages.

The effects of post-processing treatments on sensory quality and reduction of Shiga toxigenic Escherichia coli (STEC) in three formulations of two types of dry-fermented sausage (DFS; salami and morr) were evaluated. Tested interventions provided only marginal changes in sensory preference and characteristics. Total STEC reductions in heat treated DFS (32°C, 6days or 43°C, 24h) were from 3.5 to >5.5 log from production start. Storing of sausages (20°C, 1month) gave >1 log additional STEC reduction. Freezing and thawing of sausages in combination with storage (4°C, 1month) gave an additional 0.7 to 3.0 log reduction in STEC. Overall >5.5 log STEC reductions were obtained after storage and freezing/thawing of DFS with increased levels of glucose and salt. This study suggests that combined formulation optimisation and post-process strategies should be applicable for implementation in DFS production to obtain DFS with enhanced microbial safety and high sensory acceptance and quality.

A molecular phylogenetic analysis of the vampire moths and their fruit-piercing relatives (Lepidoptera: Erebidae: Calpinae).

Within butterflies and moths, adult hematophagy is limited to species within the vampire moth genus Calyptra. These moths are placed within the subfamily Calpinae, whose other members are known to exhibit a broad range of feeding behaviors including those that can be considered 'piercers' of fruits or other hosts and 'tear feeders'. Here, we reconstruct a phylogenetic hypothesis of Calpinae using molecular data to test whether hematophagy in Calyptra arose from plant or animal-related behaviors. We use a Bayesian method of ancestral state reconstruction to determine the most likely feeding behaviors for the subtribes and genera within this lineage.

Changes in protein abundance between tender and tough meat from bovine longissimus thoracis muscle assessed by isobaric Tag for Relative and Absolute Quantitation (iTRAQ) and 2-dimensional gel electrophoresis analysis.

The aim of this study was to find potential biomarkers for meat tenderness in bovine Longissimus thoracis muscle and to compare results from isobaric Tag for Relative and Absolute Quantitation (iTRAQ) and 2-dimensional gel electrophoresis (2-DE) analysis. The experiment included 4 tender and 4 tough samples, based on shear force measurements at 7 d postmortem, from young Norwegian red (NRF) bulls, taken at 1 h postmortem. A number of the proteins which have previously been related to tenderness were found to change in abundance between tender and tough samples, both in iTRAQ (P < 0.1) and 2-DE analysis (P < 0.05). Furthermore, 3 proteins that have not previously been related to tenderness were found to change significantly in abundance between tender and tough meat samples in the present study. These include proteins related to control of flux through the tricarboxylate cycle [2-oxoglutarate dehydrogenase complex component E2 (OGDC-E2)], apoptosis (galectin-1) and regulatory role in the release of Ca(2+) from intracellular stores (annexin A6). Even though the overlap in significantly changing proteins was relatively low between iTRAQ and 2-DE analysis, certain proteins predicted to have the same function were found in both analyses and showed similar changes between the groups, such as structural proteins and proteins related to apoptosis and energy metabolism.

On-line determination and control of fat content in batches of beef trimmings by NIR imaging spectroscopy.

An NIR imaging scanner was calibrated for on-line determination of the fat content of beef trimmings. A good calibration model was obtained for fat in intact beef (R=0.98, RMSECV=3.0%). The developed model could be used on single pixels to get an image of the fat distribution, or on the average spectrum from each trimming/portion of trimmings passing under the scanner. The fat model gave a rather high prediction error (RMSEP=8.7%) and a correlation of 0.84 when applied to 45 single trimmings with average fat content ranging from 1.6 to 49.3% fat. Test measurements on streams of trimmings making up batches varying from 10 to 24 kg gave a much lower prediction error (RMSEP=1.33%). Simulations based on true measurements indicate that the RMSEP decreases with increasing batch size and, for the present case, reached about 0.6% for 100 kg batches. The NIR scanner was tested on six batches of intact trimmings varying from 145 to 210 kg and gave similar fat estimates as an established microwave system obtained on the ground batches. The proven concept should be applicable to on-line estimation of fat in trimmings in order to determine the batch fat content and also to control the production of batches to different target fat levels. A possible requirement for the concept to work properly is that the trimming or layer of trimmings on the belt is not too thick. In this study maximum thickness was about 8 cm. Thicker trimmings might be measured, but careful hardware adjustments are then required.

Reduction of verotoxigenic Escherichia coli by process and recipe optimisation in dry-fermented sausages.

Outbreaks of verotoxigenic Escherichia coli (VTEC) linked to dry-fermented sausages (DFSs) have emphasized the need for DFS manufacturers to introduce measures to obtain enhanced safety and still maintain the sensory qualities of their products. To our knowledge no data have yet been reported on non-O157:H7 VTEC survival in DFS. Here, the importance of recipe and process variables on VTEC (O157:H7 and O103:H25) reductions in two types of DFS, morr and salami, was determined through three statistically designed experiments. Linear regression and ANOVA analyses showed that no single variable had a dominant effect on VTEC reductions. High levels of NaCl, NaNO(2), glucose (low pH) and fermentation temperature gave enhanced VTEC reduction, while high fat and large casing diameter (a(w)) gave the opposite effect. Interaction effects were small. The process and recipe variables showed similar effects in morr and salami. In general, recipes combining high batter levels of salt (NaCl and NaNO(2)) and glucose along with high fermentation temperature that gave DFS with low final pH and a(w), provided approximately 3 log(10) reductions compared to approximately 1.5 log(10) reductions obtained for standard recipe DFS. Storage at 4°C for 2months provided log(10) 0.33-0.95 additional VTEC reductions and were only marginally affected by recipe type. Sensory tests revealed only small differences between the various recipes of morr and salami. By optimisation of recipe and process parameters, it is possible to obtain increased microbial safety of DFS while maintaining the sensory qualities of the sausages.

Reduction of verotoxigenic Escherichia coli by process and recipe optimisation in dry-fermented sausages.

Outbreaks of verotoxigenic Escherichia coli (VTEC) linked to dry-fermented sausages (DFSs) have emphasized the need for DFS manufacturers to introduce measures to obtain enhanced safety and still maintain the sensory qualities of their products. To our knowledge no data have yet been reported on non-O157:H7 VTEC survival in DFS. Here, the importance of recipe and process variables on VTEC (O157:H7 and O103:H25) reductions in two types of DFS, morr and salami, was determined through three statistically designed experiments. Linear regression and ANOVA analyses showed that no single variable had a dominant effect on VTEC reductions. High levels of NaCl, NaNO(2), glucose (low pH) and fermentation temperature gave enhanced VTEC reduction, while high fat and large casing diameter (a(w)) gave the opposite effect. Interaction effects were small. The process and recipe variables showed similar effects in morr and salami. In general, recipes combining high batter levels of salt (NaCl and NaNO(2)) and glucose along with high fermentation temperature that gave DFS with low final pH and a(w), provided approximately 3 log(10) reductions compared to approximately 1.5 log(10) reductions obtained for standard recipe DFS. Storage at 4 degrees C for 2 months provided log(10) 0.33-0.95 additional VTEC reductions and were only marginally affected by recipe type. Sensory tests revealed only small differences between the various recipes of morr and salami. By optimisation of recipe and process parameters, it is possible to obtain increased microbial safety of DFS while maintaining the sensory qualities of the sausages.

Evidence-based care for breast cancer survivors: communicating the Institute of Medicine Guidelines in medical practice.

OBJECTIVE: To investigate patient reports of physician communication about the 2006 Institute of Medicine (IOM) Guidelines for Survivorship Care, and patient follow-up care behaviors in a sample of African American and Caucasian breast cancer survivors. METHODS: Fifteen-minute telephone interviews were conducted in a cross-sectional study with a sample of African American (n=30) and Caucasian (n=69) breast cancer patients, who were within 5 years of their diagnosis and primary treatment for breast cancer at two Baltimore, Maryland medical centers, during the summer of 2006. Multiple items assessed patient reports of physician discussions about IOM Guidelines, their recurrence concerns, and their follow-up treatment, screening, diet and exercise practices. RESULTS: Patients with higher incomes, more education, female physicians, and of younger ages reported more complete physician discussions of the IOM Guidelines. No significant differences were noted between African American and Caucasian patients. CONCLUSION: Patients at greatest risk for breast cancer recurrence - those with less education, income, and resources - report limited guidance from their physicians about evidence-based, follow-up care guidelines, designed to minimize their risk. PRACTICE IMPLICATIONS: Physicians need strategies for effectively delivering the IOM Guidelines for Survivorship Care to disadvantaged breast cancer patients, to promote enhanced quality of life and reduced risk of recurrence.