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PubMed2006

Calcium and dairy intakes of adolescents are associated with their home environment, taste preferences, personal health beliefs, and meal patterns.

OBJECTIVE: To identify correlates of calcium, dairy, and milk intakes among male and female adolescents. DESIGN: Cross-sectional study design. Adolescents self-reported measures pertaining to correlates on the Project EAT (Eating Among Teens) survey and completed a food frequency questionnaire at school. SUBJECTS/SETTING: Subjects were a total of 4,079 middle and high school students from Minneapolis/St Paul, MN, public schools. STATISTICAL ANALYSES PERFORMED: Multiple linear regression models based on social cognitive theory were examined by sex. RESULTS: Male adolescents reported higher daily intakes of calcium (male: 1,217+/-663 mg; female: 1,035+/-588 mg; P<0.001), dairy servings (male: 2.9+/-1.9; female: 2.4+/-1.7; P<0.001), and milk servings (male: 2.0+/-1.5; female: 1.5+/-1.4; P<0.001) than female adolescents. Calcium intakes of male adolescents were significantly and positively related to availability of milk at meals, taste preference for milk, eating breakfast, higher socioeconomic status, and social support for healthful eating; intakes were significantly and inversely related to consumption of soft drinks and fast food. Among female adolescents, availability of milk at meals, taste preference for milk, eating breakfast, higher socioeconomic status, personal health/nutrition attitudes, and self-efficacy to make healthful food choices were significantly and positively related to intakes; intakes were significantly and inversely related to fast-food consumption. Models of calcium intake explained 71% of the variance in male adolescents and 72% of the variance in female adolescents. CONCLUSIONS: Multicomponent interventions with a focus on the family environment are likely to be most effective in increasing calcium intakes among adolescents.

Adolescent↗
PubMed2005

Palm oil and palm olein frying applications.

Several million tones of palm oil and palm olein are used annually in the world for frying. This paper will discuss their frying performances in three major applications - industrial production of potato chips/crisps, industrial production of pre-fried frozen French fries and in fast food outlets. In the first study, about four tones of potato chips were continuously fried 8 hours a day and five days a week. The palm olein used (with proper management) performed well and was still in excellent condition and usable at the end of the trial. This was reflected in its low free fatty acid (FFA) content of around 0.23%, peroxide value of 4 meq/kg, anisidine value of 16, low polar and polymer contents of 10% and 2%, respectively, induction period (OSI) of 21 hours and high content of tocopehrols and tocotrienols of 530 ppm even after >1900 hours. In the second study in which an average 12 tones pre-fried frozen French fries were continuously fried a day for 5 days a week, palm oil performed excellently as reflected by its low FFA of 0.34%, food oil sensor reading of 1.1, low polar and polymer contents of 17% and 2.8%, respectively, over the 12 days of trial. In the third study in which palm shortening, palm oil and palm olein were simultaneously used to intermittently fry chicken parts in the laboratory simulating the conditions in fast food outlets, the three frying oils also performed very satisfactorily as reflected by their reasonably low FFA of <1%, smoke points of >180 degrees C, and polar and polymer contents of <25% and <6%, respectively, after 5 days of consecutive frying. All the quality indicators did not exceed the maximum discard points for frying oils/fats in the three applications, while the fried food product was well accepted by the in-house train sensory panel using a-nine point hedonic score.

Consumer Behavior↗
PubMed2006

Monitoring and decreasing public smoking among youth.

This study examined the impact of tobacco possession laws on public smoking among youth. There were two intervention sites: a fast food restaurant and a shopping mall. Two control sites were also monitored for public smoking among youth. Preliminary findings suggest that when police issued tickets to minors for violating tobacco possession laws, the number of youth smoking in public declined in both towns, with a more dramatic decrease occurring at the fast food site. In contrast, public smoking among youth in the control sites was not affected. The significance of reducing number of youth smoking in public through tobacco possession laws is discussed.

Adolescent↗
PubMed2000

[Junk food revolution or the cola colonization].

In ancient times, the main problem was to get food. Nowadays the difficulty is to decide for or against some foodstuff. In industrialized countries, this abundance led to the fact that people eat differently from what they should. Traditional populations were subject to periods of feast and famine. Those with a metabolism which stored energy with high energetic efficiency had a survival advantage. This is called the 'thrifty' genotype hypothesis. With the secured supply of calories, coupled with a sedentary lifestyle, the thrifty genotype becomes disadvantageous, causing obesity. Industrialization or 'cola-colonization' also leads to a dramatic increase in obesity and non-insulin dependent diabetes mellitus in developing countries. The spread of fast food restaurants all over the world has changed modern nutrition fundamentally. Influence begins early in childhood. Advertising concentrates on the selling of image over substance. However, fast food contains high levels of fat, especially trans fatty acids. Higher consumption of trans fatty acids was associated with a higher incidence of and mortality from coronary heart disease.

Adult↗
PubMed2004

Prevalence and risk factors of asthma and wheeze in school-going children in Lucknow, North India.

OBJECTIVE: To assess the prevalence of asthma and wheeze and factors associated with it in children aged 6-7 and 13-14 years. METHOD: School based, prospective survey using self/parental reporting of occurrence of asthma or wheeze on pre-designed questionnaire. RESULTS: Out of 112 schools, 17 and 15 schools were randomly selected for recruitment of subjects in age group 6-7 and 13-14 years, respectively. Prevalence of asthma and wheeze reported were 2.3% and 6.2%, respectively, in age group 6-7 years and 3.3% and 7.8%, respectively, in age group 13-14 years. On the basis of adjusted odds ratio, risk factors for wheeze or asthma were tertiary education of mother, antibiotic use in the first year of life, eating pasta or fast-food or meat once or more per week and exercise once or more/week while the protective factors were intake of vegetables once or more and fruits thrice or more per week. In univariate analysis, breastfeeding was also found to be protective. CONCLUSION: Promotion of rational use of antibiotic in first year of life, avoidance of fast food and promotion of breastfeeding and intake of fruits and vegetables may reduce the risk of asthma/wheeze and should be encouraged.

Adolescent↗
PubMed1997

[Dietary habits and consumption patterns in a health district].

OBJECTIVE: To describe nutritional habits in a Health District by defining the patterns of food consumption. DESIGN: A descriptive, crossover study. SETTING: Health District of Molina de Segura, Murcia. METHOD: A community survey by interview of 1,071 people (95% confidence; accuracy to 3%), selected from the Municipal Roll by simple randomised sampling, was performed. The statistical methods were: Chi-squared and Student's tests, ANOVA, Pearson's linear correlation, factorial and discriminatory analysis. MEASUREMENTS AND MAIN RESULTS: 17.3%, especially men, never took milk products (p < 0.0005). 12.5%, mainly young people, consumed more than 3 eggs a week (p < 0.02). 85% ate fruit daily; 70%, green and root vegetables; and 78%, olive oil. 12.6% had pulses more than 3 days a week. Only 6.5% had potatoes or pasta daily. Among men and young people there was a "bar culture", along with a "fast food" pattern. CONCLUSIONS: The abandoned Mediterranean diet must be promoted. Measures should be taken to moderate young people's and men's alcohol consumption. "Fast food" and "bar culture" patterns are the most deeply rooted. The nutritional education of the chronically ill should also be emphasised.

Adult↗
PubMedDate not supplied

The incidence of Helicobacter pylori infection is not increased among obese young individuals in Greece.

GOALS: To identify possible risk factors affecting the acquisition of Helicobacter pylori (Hp) infection and to investigate whether the incidence of infection is higher among obese and overweight verus normal-weight young adults in Greece. STUDY: Serum was obtained from 224 young male Navy recruits (mean age, 22.84 years) during their induction into the Hellenic Navy. An enzyme-linked immunosorbent assay to detect Hp-specific IgG serum antibodies, as well as gastroscopy with biopsy, were used to identify the infected individuals. A structured questionnaire was filled out for each subject regarding environmental conditions, socioeconomic conditions, dietary habits, and data related to their personal and family health history. RESULTS: H. pylori positivity rate was 27.23%. Univariate analysis recognized that the number of siblings in the same bedroom was significantly higher among Hp-positive than Hp-negative individuals. Logistic regression analysis showed that sharing the same bedroom with more than one sibling during childhood and consumption of fast food are independent predictors of Hp acquisition. The presence of obesity (body mass index > or =25 kg/m2) remained unrelated to the Hp status of the individuals. CONCLUSIONS: These data suggest that the risk of Hp infection does not increase in overweight young persons. Sharing the same bedroom with more than one sibling during childhood is an important determinant in acquiring Hp infection. Increased fast food consumption could be an important source of the infection outside of the home.

Adult↗
PubMed2005

Out-of-home food outlets and area deprivation: case study in Glasgow, UK.

BACKGROUND: There is a popular belief that out-of-home eating outlets, which typically serve energy dense food, may be more commonly found in more deprived areas and that this may contribute to higher rates of obesity and related diseases in such areas. METHODS: We obtained a list of all 1301 out-of-home eating outlets in Glasgow, UK, in 2003 and mapped these at unit postcode level. We categorised them into quintiles of area deprivation using the 2004 Scottish Index of Multiple Deprivation and computed mean density of types of outlet (restaurants, fast food restaurants, cafes and takeaways), and all types combined, per 1000 population. We also estimated odds ratios for the presence of any outlets in small areas within the quintiles. RESULTS: The density of outlets, and the likelihood of having any outlets, was highest in the second most affluent quintile (Q2) and lowest in the second most deprived quintile (Q4). Mean outlets per 1,000 were 4.02 in Q2, 1.20 in Q4 and 2.03 in Q5. With Q2 as the reference, Odds Ratios for having any outlets were 0.52 (CI 0.32-0.84) in Q1, 0.50 (CI 0.31 - 0.80) in Q4 and 0.61 (CI 0.38 - 0.98) in Q5. Outlets were located in the City Centre, West End, and along arterial roads. CONCLUSION: In Glasgow those living in poorer areas are not more likely to be exposed to out-of-home eating outlets in their neighbourhoods. Health improvement policies need to be based on empirical evidence about the location of fast food outlets in specific national and local contexts, rather than on popular 'factoids'.

Journal Article↗
PubMed2000

"Happy Meals" in the Starship Enterprise: interpreting a moral geography of health care consumption.

This paper extends earlier explorations of the use of metaphor in the marketing of the Starship Children's Hospital in Auckland, New Zealand, by examining controversy surrounding the opening of an in-hospital McDonalds fast-food outlet. The golden arches have become a key element of many children's urban geographies and a potent symbol of the corporate colonisation of the New Zealand landscape. In 1997 a minor moral panic ensued when a proposal was unveiled to open a McDonald's restaurant within the Starship. Data collected from media coverage, advertising and interviews with hospital management are analysed to interpret competing discourses around the issue of fast food within a health care setting. We contend that the introduction of a McDonald's franchise has become the hospital's ultimate placial icon, adding ambivalence to the moral geography of health care consumption. We conclude that arguments concerning the unhealthy nature of McDonald's food obscure deeper discourses surrounding the unpalatable character of the health reforms, and a perceived 'Americanisation' of health care in New Zealand.

Adult↗
PubMed2006

Are the eating and exercise habits of successful weight losers changing?

OBJECTIVE: The purpose of this study was to examine whether the diet and exercise behaviors of successful weight losers entering the National Weight Control Registry (NWCR) have changed between 1995 and 2003. RESEARCH METHOD AND PROCEDURES: Participants (N = 2708) were members of the NWCR who enrolled in intermittent years since 1995. Participants had lost an average of 33.1 kg and maintained a 13.6-kg loss for 5.8 years before enrollment. Evaluations of diet and physical activity were conducted at entry into the NWCR and prospectively over 1 year. RESULTS: From 1995 to 2003, the daily percentage of calories from fat increased from 23.8% to 29.4%, saturated fat intake increased from 12.3 to 154.0 g/d, and calories from carbohydrate decreased from 56.0% to 49.3% (p < 0.0001). The proportion consuming <90 grams of carbohydrate (considered a low-carbohydrate diet) increased from 5.9% to 17.1% (p = 0.0001). Physical activity was elevated in 1995 (mean = 3316 kcal/wk) but comparable in all other years (mean = 2620 kcal/wk). Stepwise regression collapsing across cohorts indicated that weight regain over 1 year was related to higher levels of caloric intake, fast food consumption, and fat intake and lower levels of physical activity (p < 0.03). DISCUSSION: The macronutrient composition of the diet of NWCR members has shifted over the past decade. Still, only a minority consumes a low-carbohydrate diet. Despite changes in the diet over time, the variables associated with long-term maintenance of weight loss were the same: continued consumption of a low-calorie diet with moderate fat intake, limited fast food, and high levels of physical activity.

Adult↗
PubMed1998

Image Theory's Compatibility Test and Evaluations of the Status Quo.

The research on image theory's concept of progress decisions about either (1) the acceptability of the status quo vis a desired state or (2) the acceptability of movement toward a desired state has been limited to the laboratory. To demonstrate the feasibility of research on nonlaboratory, job-related progress decisions and to develop methods for doing it with minimal intrusion on participant work time, two experiments examined evaluations of the status quo vis a desired state in the context of three organizations: a controller's office, a pretrial services office, and a chain of fast food restaurants. Experiment 1 used fairly elaborate, time consuming methods in the controller's office and pretrial services office to measure the compatibility between participants' images of desirable supervision and their images of current supervision as well as their satisfaction with both supervision and with the organization. In both cases, as compatibility decreased, satisfaction decreased, but satisfaction with the organization appeared to derive from satisfaction with supervision rather than directly from compatibility. Experiment 2 measured the same concepts in the fast food chain using simple, single-item methods, obtaining roughly the same results as Experiment 1, except that it also demonstrated that hope for change can mitigate the effects of incompatibility on satisfaction. These results provide evidence for the role of compatibility in decision making and for the feasibility of using simple methods of measuring compatibility, acceptability, and hope in nonlaboratory research. Copyright 1998 Academic Press.

Journal Article↗
PubMed2002

Diet activity, and lifestyle associations with p53 mutations in colon tumors.

Inactivation of the p53 tumor suppressor gene is a common event in the development of colon cancer. We use data collected as part of a multicenter case-control study of colon cancer to evaluate associations between p53 mutations and diet and lifestyle factors. p53 mutational status was determined for 1458 incident cases of colon cancer using single-strand conformational polymorphism/sequencing of exons 5-8. We determined associations among those with and without mutations compared with population-based controls (N = 2410) and to cases with p53 mutations compared with cases without p53 mutations. Associations also were examined by location and function of specific types of p53 mutations. p53 mutations were identified in tumors in 47.1% of cases; 81.9% of people with mutations had a missense mutation. Cases with a p53 mutation were more likely to consume a Western-style diet, compared with controls [odds ratio (OR), 2.03; 95% confidence interval (CI), 1.53-2.69], than were cases who were p53 wild type (Wt), compared with controls (OR, 1.57;95% CI, 1.20-2.06). Specific components of the Western-style diet, including diets with a high glycemic load (mutation versus control: OR, 1.48; 95% CI, 1.11-1.98 and Wt versus control: OR, 0.98; 95% CI, 0.75-1.28) and diets high in red meat, fast food, and trans-fatty acid (mutation versus control: OR, 1.92; 95% CI, 1.47-2.50 and Wt versus control: OR, 1.39; 95% CI, 1.08-1.80) appeared to be most strongly associated with p53 mutations. Diets with a high glycemic load (relative to lowest intake) were significantly associated with missense mutations (OR, 1.69; 95% CI, 1.23-2.33 comparing p53+ to controls and OR, 1.72; 95% CI, 1.19-2.50 comparing cases p53+ to cases p53 Wt), as were diets high in red meat, fast food, and trans-fatty acids (OR, 1.92; 95% CI, 1.14-2.56 comparing p53+ to controls and OR, 1.40; 95% CI, 1.00-1.98 comparing cases p53+ to cases p53 Wt). Physical inactivity, large body mass index, cigarette smoking, using aspirin/nonsteroidal anti-inflammatory drugs, and other dietary factors appeared to be comparably associated with colon cancer in those with and without p53 mutations. These data suggest that components of a Western-style diet such as high consumption of red meat and foods that increase glycemic load are associated with a p53 disease pathway.

Adult↗
PubMed1994

A multistate outbreak of Escherichia coli O157:H7-associated bloody diarrhea and hemolytic uremic syndrome from hamburgers. The Washington experience.

OBJECTIVE: To determine the source of and describe a large outbreak of Escherichia coli O157:H7 infections in Washington State. DESIGN: Case-control study; environmental investigation; provider-based surveillance for E coli O157:H7 infections. SETTING: Chain of fast-food restaurants, hospitals, physician offices, local laboratories, and local health departments. PARTICIPANTS: Patients with diarrhea and neighborhood controls. A case was defined as diarrhea with culture-confirmed E coli O157:H7 infection or postdiarrheal hemolytic uremic syndrome (HUS) occurring from December 1, 1992, through February 28, 1993, in a Washington State resident. Controls were age- and neighborhood-matched friends of the first 16 case patients. INTERVENTIONS: Announcement to the public; recall of implicated hamburger lots. MAIN OUTCOME MEASURE: Abatement of outbreak due to E coli O157:H7. RESULTS: Infection was associated with eating at a fast-food chain (chain A) in the 10 days before symptoms began. Twelve (75%) of 16 case patients but no controls had eaten at chain A (matched odds ratio undefined; lower 95% confidence interval, 3.5; P < .001). In total, 501 cases were reported, including 151 hospitalizations (31%), 45 cases of HUS (9%), and three deaths. Forty-eight patients (10%) had secondary infections. Of the remaining 453 patients (90%), 398 (86%) reported eating at a Washington chain A restaurant; 92% of them reported eating a regular hamburger. The pulsed-field gel electrophoresis pattern of the E coli O157:H7 strains isolated from all regular hamburger lots of a single production date shipped to Washington was identical to that of the strains isolated from patients. Ten (63%) of 16 regular hamburgers cooked according to chain A policy had internal temperatures below 60 degrees C. Public health action removed more than 250,000 potentially contaminated hamburgers, preventing an estimated 800 cases. CONCLUSIONS: This E coli O157:H7 outbreak, the largest reported, resulted from errors in meat processing and cooking. Public health surveillance through state-mandated reporting of E coli O157:H7 infection as is carried out in Washington State was critical for prompt outbreak recognition and control. Measures should be developed to reduce meat contamination. Consumers and food service workers should be educated about cooking hamburger meat thoroughly.

Adolescent↗
PubMed2003

Emission of polycyclic aromatic hydrocarbons and their carcinogenic potencies from cooking sources to the urban atmosphere.

Traffic has long been recognized as the major contributor to polycyclic aromatic hydrocarbon (PAH) concentrations. However, this does not consider the contribution of cooking sources of PAHs. This study set out, first, to assess the characteristics of PAHs and their corresponding benzo[a]pyrene equivalent (B[a]Peq) emissions from cooking sources to the urban atmosphere. To illustrate the importance of cooking sources, PAH emissions from traffic sources were then calculated and compared. The entire study was conducted on a city located in southern Taiwan. PAH samples were collected from the exhaust stacks of four types of restaurant: Chinese, Western, fast food, and Japanese. For total PAHs, results show that the fractions of gaseous PAHs (range, 75.9-89.9%) were consistently higher than the fractions of particulate PAHs (range, 10.1-24.1%) in emissions from the four types of restaurant. But for total B[a]Peq, we found that the contributions of gaseous PAHs (range, 15.7-21.9%) were consistently lower than the contributions of particulate PAHs (range, 78.1-84.3%). For emission rates of both total PAHs and total B[a]Peq, a consistent trend was found for the four types of restaurant: Chinese (2,038 and 154 kg/year, respectively) > Western (258 and 20.4 kg/year, respectively) > fast food (31.4 and 0.104 kg/year, respectively) > Japanese (5.11 and 0.014 kg/year, respectively). By directly adapting the emission data obtained from Chinese restaurants, we found that emission rates on total PAHs and total B[a]Peq for home kitchen sources were 6,639 and 501 kg/year, respectively. By combining both restaurant sources and home kitchen sources, this study yielded emission rates of total PAHs and total B[a]Peq from cooking sources of the studied city of 8,973 and 675 kg/year, respectively. Compared with PAH emissions from traffic sources in the same city, we found that although the emission rates of total PAHs for cooking sources were significantly less than those for traffic sources (13,500 kg/year), the emission rates of total B[a]Peq for cooking sources were much higher than those for traffic sources (61.4 kg/year). The above results clearly indicate that although cooking sources are less important than traffic sources in contributing to total PAH emissions, PAH emissions from cooking sources might cause much more serious problems than traffic sources, from the perspective of carcinogenic potency.

Air Pollutants↗
PubMed2005

Development and characterization of a solvent extraction-gas chromatographic/mass spectrometric method for the analysis of perfluorooctanesulfonamide compounds in solid matrices.

A method utilizing solvent extraction and analysis by gas chromatography-positive chemical ionization mass spectrometry (SE-GC-PCIMS) was developed for the analysis of three neutral hydrophobic perfluorooctanesulfonamide compounds [perfluorooctanesulfonamide (PFOSA), N-ethyl perfluorooctanesulfonamide (N-EtPFOSA), and N,N-diethyl perfluorooctanesulfonamide (N,N-Et2PFOSA)]. These compounds are suspected metabolic precursors of perfluorooctane sulfonate. The SE-GC-PCI-MS method was used to analyze all three perfluorooctanesulfonamides in fast food, fish, and Arctic marine mammal liver samples. The SE-GC-PCI-MS method produced relatively higher recoveries of the analytes (averaging 83 +/- 6%, 84 +/- 9%, and 89 +/- 19% for N,N-Et2PFOSA, N-EtPFOSA, and PFOSA, respectively) with lower coefficients of variation, and less susceptibility to matrix effects, than ion pair extraction-liquid chromatography-tandem mass spectrometric methods. Method detection limits (MDLs) were 100, 120, and 250 pg/g for N,N-Et2PFOSA, N-EtPFOSA, and PFOSA, respectively. The three compounds were found at concentrations ranging from below the MDL to 22 ng/g wet weight in fast food, fish, and Arctic marine mammal liver samples.

Animals↗
PubMed2001

Severe anaphylaxis induced by latex as a contaminant of plastic balls in play pits.

BACKGROUND: Latex causes anaphylaxis in specific contexts among children. We present 2 cases that show that severe reactions may occur in everyday circumstances with latex as a contaminant. OBJECTIVE: Because 2 cases of severe reactions to latex suggested similar circumstances of exposure, we investigated the immediate environment in which episodes occurred. METHODS: A 5-year-old girl presented to our casualty department with anaphylaxis after playing in a ball pit filled with approximately 10-cm diameter plastic balls in an American-style fast-food outlet. Two months later, a 9-year-old boy had severe anaphylaxis followed by an asthma attack with loss of consciousness while playing in the playpen of a different outlet belonging to the same company. Latex sensitization was confirmed in both cases by means of skin prick testing, latex glove skin prick testing, and 1-glove finger testing. Immunoblotting of elutions from a ball, the natural rubber latex foam pit lining, and its polyvinyl chloride sheet were performed. RESULTS: In the girl's immunoblot high levels of IgE specific to Hev b 4, Hev b 7, and Hev b 2 were found. The boy's immunoblot showed positivity to Hev b 7. The polyvinyl chloride ball sample showed a high concentration of specific Hevea species allergen similar to that of the foam layer sample. CONCLUSION: Severe anaphylaxis can result from contact with latex proteins as a contaminant, rather than as a component, of play area ball pits and therefore outside the reported settings. Emergency health care workers should be aware of this kind of risk. A latex-reduced environment might prevent potentially severe reactions in young customers of fast-food outlets.

Anaphylaxis↗
PubMedDate not supplied

Burger King and Subway: key nutrients, glycemic index, and glycemic load of nutritionally promoted items.

PURPOSE: The purpose of this investigation was to estimate the glycemic load (GL) of nutritionally promoted fast-food menu items and to compare menu items nutritionally. METHODS: Published glycemic index (GI) values and nutritional information from the Web sites of Subway and Burger King were used to calculate the GL of nutritionally promoted items. Menu items were compared based on calories, macronutrients, saturated fat, GI, and GL as basic items and as often served. RESULTS: Subway offered 7 low-fat (total/saturated fat: 3-5/1-2 g), low-calorie (230-330) sandwich options that had an average GL of 29. If the customer accepts the soda and baked potato chips, the total calories exceed 600 and the total/saturated fat becomes 13/4 g, with a doubling of the GL. The Burger King low-fat options contained 4.5 g total fat and 1.5 g saturated fat, with GLs of 53 to 54, and low-calorie options (265-310 calories) had low GLs (0-18.3). Adding fries and a soda brings the GL up from a 53 for just the sandwich to 123 for the meal. The bunless low-carb Whopper has the same fat content (total/saturated fat: 42/13g) as the original Whopper, but the GI and GL are zero. CONCLUSIONS: The nutritional information for meal options available at Burger King and Subway can help the patient with diabetes make choices. Accepting the fries or chips and soda can dramatically increase the calories, carbohydrate, fat, and GL of the nutritionally promoted fast-food meal.

Diet, Diabetic↗
PubMed2005

Effects of dietary fats versus carbohydrates on coronary heart disease: a review of the evidence.

Recommendations arising from the traditional diet-coronary heart disease (CHD) paradigm, which focuses on effects of total and saturated fat on serum total and low-density lipoprotein cholesterol, may have failed to reduce CHD risk and inadvertently exacerbated dyslipidemia, insulin resistance, and weight gain, particularly among individuals who are older, female, sedentary, or obese. A suitable dietary paradigm must consider types and qualities of fats and carbohydrates consumed, their effects on a range of intermediary risk factors, and characteristics that may modify individual susceptibility. Based on current evidence, replacement of total, unsaturated, and even possibly saturated fats with refined, high-glycemic index carbohydrates is unlikely to reduce CHD risk and may increase risk in persons predisposed to insulin resistance. In contrast, a diet that is 1) rich in whole grains and other minimally processed carbohydrates; 2) includes moderate amounts of fats (approximately 30%-40% of total energy), particularly unsaturated fats and omega-3 polyunsaturated fats from seafood and plant sources; 3) is lower in refined grains and carbohydrates; and 4) eliminates packaged foods, baked goods, and fast foods containing trans fatty acids, will likely reduce the risk of CHD.

Coronary Disease↗