JAMA Internal Medicine: Nutrition Topic Collection

Availability of Potassium on the Nutrition Facts Panel of US Packaged Foods

Curtis CJ, Niederman SA, Kansagra SM. — Mon, 13 May 2013 00:00:00 GMT

Studies have indicated that diets low in potassium and high in sodium are associated with increased risk for cardiovascular disease, the leading cause of death in the United States, whereas higher potassium intake is associated with reduced risk for both all-cause and cardiovascular disease–related mortality. Yet, the majority of US adults consume considerably less than the 4700 mg/d of potassium that is recommended by the 2010 Dietary Guidelines for Americans.

Rapid Assessment of Cardiovascular Risk Among Users of Smoking Cessation Drugs Within the US Food and Drug Administration's Mini-Sentinel Program

Toh S, Baker MA, Brown JS, et al. — Mon, 13 May 2013 00:00:00 GMT

In June 2011, the US Food and Drug Administration (FDA) issued a Drug Safety Communication indicating that varenicline tartrate, a drug prescribed for smoking cessation, may increase the risk of certain cardiovascular events in individuals with cardiovascular disease. The finding was based on the FDA's review of a randomized placebo-controlled trial of 714 smokers. In July 2011, the FDA requested that the Mini-Sentinel program perform a rapid safety assessment of the drug.

Changes in Sodium Levels in Processed and Restaurant Foods, 2005 to 2011 Changes in Sodium Levels in Foods, 2005 to 2011

Jacobson MF, Havas S, McCarter R. — Mon, 13 May 2013 00:00:00 GMT

Importance

Excess consumption of sodium is an important cause of hypertension, a major risk factor for heart disease and stroke. The higher the level of consumption, the greater is a person's likelihood of developing hypertension. Numerous organizations have recommended reductions in sodium intake in the United States. Roughly 80% of the sodium consumed by Americans has been added by food manufacturers and restaurants.

Objective

To compare the mean (SD) levels of sodium for identical products ascertained in 2005, 2008, and 2011.

Design and Setting

Comparison study in an academic research setting.

Participants and Exposures

Center for Science in the Public Interest staff have monitored sodium levels in selected processed foods and fast-food restaurant foods for many years.

Main Outcomes and Measures

The sodium content in identical foods, as measured in 2005, 2008, and 2011.

Results

Between 2005 and 2011, the sodium content in 402 processed foods declined by approximately 3.5%, while the sodium content in 78 fast-food restaurant products increased by 2.6%. Although some products showed decreases of at least 30%, a greater number of products showed increases of at least 30%. The predominant finding is the absence of any appreciable or statistically significant changes in sodium content during 6 years.

Conclusions and Relevance

Based on our sample, reductions in sodium levels in processed and restaurant foods are inconsistent and slow. These findings are in accord with other data indicating the slow pace of voluntary reductions in sodium levels in processed and restaurant foods. Stronger action (eg, phased-in limits on sodium levels set by the federal government) is needed to lower sodium levels and reduce the prevalence of hypertension and cardiovascular diseases.

Restaurant Meals: Almost a Full Day's Worth of Calories, Fats, and Sodium

Scourboutakos MJ, Semnani-Azad Z, L’Abbe MR. — Mon, 13 May 2013 00:00:00 GMT

Because of the prevalence of eating out, the connection between fast food consumption and disease risk has garnered widespread attention. However, less attention has been given to the disease-promoting potential of meals from sit-down restaurants (referred to as “SDRs” and defined by the presence of table service), which account for a larger share of total away-from-home food spending and whose share is expected to rise over the next decade.

The Energy Content of Restaurant Foods Without Stated Calorie Information Energy Content of Restaurant Foods

Urban LE, Lichtenstein AH, Gary CE, et al. — Mon, 13 May 2013 00:00:00 GMT

Importance

National recommendations for the prevention and treatment of obesity emphasize reducing energy intake through self-monitoring food consumption. However, little information is available on the energy content of foods offered by nonchain restaurants, which account for approximately 50% of restaurant locations in the United States.

Objective

To measure the energy content of foods from independent and small-chain restaurants that do not provide stated information on energy content.

Design

We used bomb calorimetry to determine the dietary energy content of the 42 most frequently purchased meals from the 9 most common restaurant categories. Independent and small-chain restaurants were randomly selected, and 157 individual meals were analyzed.

Setting

Area within 15 miles of downtown Boston.

Participants

A random sample of independent and small-chain restaurants.

Main Outcome and Measures

Dietary energy.

Results

All meal categories provided excessive dietary energy. The mean energy content of individual meals was 1327 (95% CI, 1248-1406) kcal, equivalent to 66% of typical daily energy requirements. We found a significant effect of food category on meal energy (P ≤ .05), and 7.6% of meals provided more than 100% of typical daily energy requirements. Within-meal variability was large (average SD, 271 kcal), and we found no significant effect of restaurant establishment or size. In addition, meal energy content averaged 49% greater than those of popular meals from the largest national chain restaurants (P < .001) and in subset analyses contained 19% more energy than national food database information for directly equivalent items (P < .001).

Conclusions and Relevance

National chain restaurants have been criticized for offering meals with excess dietary energy. This study finds that independent and small-chain restaurants, which provide no nutrition information, also provide excessive dietary energy in amounts apparently greater than popular meals from chain restaurants or information in national food databases. A national requirement for accurate calorie labeling in all restaurants may discourage menus offering unhealthy portions and would allow consumers to make informed choices about ordering meals that promote weight gain and obesity.

Adulterated Sexual Enhancement Supplements More Than Mojo Adulterated Sexual Enhancement Supplements

Cohen PA, Venhuis BJ. — Mon, 13 May 2013 00:00:00 GMT

Over the last 5 years the US Food and Drug Administration (FDA) has identified more than 330 dietary supplements adulterated with active pharmaceuticals. Although the FDA has recalled some of these products, recent research suggests that, even after the recalls, products remain available over the Internet and on store shelves. One of the largest categories of tainted supplements are those sold to enhance sexual performance. A combination of manufacturer scrupulousness and consumer demand has created a huge market for dangerous sexual enhancement supplements. One recent example, Rock Hard for Men (manufacturer unknown), sold as a “natural” supplement, actually contains 2 potent prescription drugs—a phosphodiesterase-5 (PDE-5) inhibitor, tadalafil, and a sulfonylurea, glyburide. This combination of medications is of particular concern because a very similar combination discovered in other sex supplements has already led to more than a dozen deaths. If physicians, legislators, and regulators do not act decisively soon, more deaths may follow.