Probabilistic Quantitative Assessment of Coronary Heart Disease Risk From Dietary Exposure to Industrially Produced Trans-Fatty Acids in Partially Hydrogenated Oils.

We conducted a probabilistic evaluation of changes in coronary heart disease (CHD) risk and public health burdens from industrially produced trans-fatty acids (IP-TFAs) exposure from the uses of partially hydrogenated oils in food. Our analyses used four quantitative methods based on human studies considering the uncertainty associated with risk parameters for CHD and IP-TFA daily dietary exposure of 0.05% of energy. Method 1 used experimental controlled feeding trial data for changes in low-density lipoprotein cholesterol; Method 2 used changes in both low-density lipoprotein cholesterol and high-density lipoprotein cholesterol; Method 3 used changes in a combination of three emerging CHD risk factor biomarkers; and method 4 used prospective observational studies of CHD cases associated with long-term dietary exposure of trans-fatty acids. We estimated mean percent changes in CHD risk and annual CHD cases in U.S. adults, with lower and upper 95% uncertainty intervals. Our results show that consuming 0.05% of energy from IP-TFA, instead of cis-monounsaturated fatty acids, can cause annual mean increases in CHD cases of 814 (510-1151, method 1), 1502 (990-2043, method 2), or 6877 (3611-10 694, method 4) in U.S. adults. Results for method 3 were intermediate between those for methods 2 and 4. Sensitivity analyses using alternate risk parameters or an alternate exposure scenario resulted in minor changes in public health burden estimates. The results demonstrate that IP-TFA exposure as low as 0.05% of energy from partially hydrogenated oil uses in food can cause substantial public health burdens in the United States from increased CHD risk.

Prevalence of self-reported food allergy in American adults and use of food labels.

BACKGROUND: Few population-based studies in the United States have determined the prevalence of food allergy in adults and the problems these individuals might have with reading food labels. OBJECTIVE: The objectives of this study are to report the prevalence of self-reported food allergy, to identify the characteristics of food allergy reactions, and to describe the use of labels among adults with food allergy. METHODS: Questions from the US Food and Drug Administration's 2001 Food Safety Survey were analyzed to determine the prevalence of food allergy and opinions about food labels in the management of food allergy. RESULTS: The prevalence of self-reported food allergy is 9.1% among all survey respondents, with 5.3% of all respondents reporting a doctor-diagnosed food allergy. The prevalence of food allergy to the 8 most common allergens (peanut, tree nuts, egg, milk, wheat, soybeans, fish, and crustacean shellfish) is self-reported as 2.7% among respondents with doctors' diagnoses. Several label issues, such as words on some ingredient lists being too technical or hard to understand and food labels not always alerting persons to new ingredients, were reported as serious or very serious obstacles for managing an allergy. CONCLUSION: The prevalence of self-reported doctor-diagnosed food allergy among US adults is 5.3%, and a large portion of adults with food allergy found certain label issues a serious problem for managing their food allergy. CLINICAL IMPLICATIONS: The findings provide a needed source of population-based prevalence data of food allergy among US adults. Label issues identified are useful in understanding the difficulties of managing a food allergy.

Population-based incidence of infection with selected bacterial enteric pathogens in children younger than five years of age, 1996-1998.

BACKGROUND: Previous studies of bacterial enteric infections have suggested a disproportionate disease burden for children younger than 5 years of age. OBJECTIVES: This study describes population-based incidence of culture-confirmed infections with 6 bacterial enteric pathogens in children younger than 5 years of age in the Foodborne Diseases Active Surveillance Network (FoodNet), 1996-1998. METHODS: Cases were ascertained through active laboratory-based surveillance in Minnesota, Oregon and selected counties in California, Connecticut, Georgia, Maryland and New York. RESULTS: Twenty-one percent (5218 of 24,358) of infections were in children younger than 5 years of age, but this age group made up only 7% of the total person-years of observation. Among those younger than 5 years of age, the incidence (cases per 100,000 person-years) for each pathogen was: Salmonella, 55.3; Campylobacter, 43.4; Shigella, 32.7; E. coli O157, 10.3; Yersinia enterocolitica, 7.1; Listeria monocytogenes, 0.7. Incidence varied widely among the 7 FoodNet sites. CONCLUSIONS: This study confirmed a disproportionate disease burden in young children. Investigation of risk factors specific to this age group and review and enhancement of current prevention and control strategies for children younger than 5 years of age may reduce illness.

Sulfites--a food and drug administration review of recalls and reported adverse events.

Sulfite-sensitive individuals can experience adverse reactions after consuming foods containing sulfiting agents (sulfites), and some of these reactions may be severe. In the 1980s and 1990s, the U.S. Food and Drug Administration (FDA) acted to reduce the likelihood that sulfite-sensitive individuals would unknowingly consume foods containing sulfites. The FDA prohibited the use of sulfites on fruits and vegetables (except potatoes) to be served or presented fresh to the public and required that the presence of detectable levels of sulfites be declared on food labels, even when these sulfites are used as a processing aid or are a component of another ingredient in the food. In the present study, data from FDA recall records and adverse event reports were used to examine the current status of problems of sensitivity to sulfites in foods. From 1996 through 1999, the FDA processed a total of 59 recalls of foods containing undeclared sulfites; these 59 recalls involved 93 different food products. Fifty (55%) of the recalled products were classified as class I, a designation indicating that a consumer reasonably could have ingested > or = 10 mg of undeclared sulfites on a single occasion, a level that could potentially cause a serious adverse reaction in a susceptible person. From 1996 through mid-1999, the FDA received a total of 34 reports of adverse reactions allegedly due to eating foods containing undeclared sulfites. The average of 10 reports per year, although derived from a passive surveillance system, was lower than the average of 111 reports per year that the FDA received from 1980 to 1987, a decrease that may have resulted in part from FDA regulatory action.

Serum homocysteine concentrations and their relation to serum folate and vitamin B12 concentrations and coronary artery disease prevalence in an urban, bi-ethnic community.

OBJECTIVE: To compare fasting serum total homocysteine (tHcy) concentrations in a randomly selected sample of elderly (> or = 65 years of age) Hispanic and non-Hispanic White (NHW) men and women, to examine associations of tHcy with folate and vitamin B12, and then to correlate these with the prevalence of coronary heart disease (CHD) in these 4 ethnic/ gender groups. DESIGN AND PARTICIPANTS: Equal numbers of Hispanic and NHW men and women were randomly selected from the Healthcare Financing Administration (Medicare) registrant list for Bernalillo County (Albuquerque), New Mexico, and asked to volunteer for a paid home interview, to be followed by a paid, comprehensive interview/examination covering health and health-related issues. INTERVENTIONS AND MAIN OUTCOME MEASURES: Serum concentrations of tHcy, folate, and vitamin B12 were determined and correlated with the prevalence of CHD, after adjusting for other CHD risk factors (age, diabetes, hypertension, smoking, dyslipidemia, adiposity). RESULTS: Men and Hispanics had higher serum tHcy concentrations compared to women and non-Hispanic Whites (NHWs), respectively. After adjusting for lower concentrations of serum folate and vitamin B12 in Hispanics, the differences between Hispanics and NHWs were no longer significant. There was a direct association between serum tHcy concentrations and the prevalence of CHD after adjusting for other known risk factors that was most significant in Hispanic women. CONCLUSIONS: The higher serum tHcy concentrations observed in Hispanics compared to NHWs can be explained by lower levels of serum folate and vitamin B12. A direct association between serum tHcy concentrations and prevalence of CHD was observed primarily in women, and was most significant in Hispanic women.