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A.3 SPECIAL ISSUES IN HUMAN NUTRITION (ASSESSMENT STATEMENTS) A.3.1 Distinguish between the composition of human milk and artificial milk used for bottle-feeding babies. A.3.2 Discuss the benefits of breastfeeding. A.3.3 Outline the causes and symptoms of Type II Diabetes. A.3.4 Explain the dietary advice that should be given to a patient who has developed Type II Diabetes. A.3.5 Discuss the ethical issues concerning the eating of animal products, including honey, eggs, milk and meat. A.3.6 Evaluate the benefits of reducing dietary cholesterol in lowering the risk of coronary heart disease. A.3.7 Discuss the concept of food miles and the reasons for consumers choosing foods to minimize food miles. HUMAN BREAST MILK VS. POWDERED BABY FORMULA There are fundamental differences between breast milk and powdered formula. • Powdered formulas are usually made from cow’s milk. The baby formula market is big business. • Breast milk contains substances that formulas do not (the enzymes amylase/lipase), white blood cells such as macrophages, antibodies and hormones) - (see next slide). Human milk has about 50% more lactose than cow’s milk. Additionally, human milk has more cholesterol – for building new cell membranes and nerve cells. Some babies are naturally lactose intolerant (although very rare). Baby formulas that are lactose-free are available. Acquired lactose intolerance can develop (are before age 5 and unusual before age 10) while secondary lactose intolerance can result from some common intestinal disorder in babies (this condition is far less frequent in breastfed babies). The symptoms of lactose intolerance include vomiting, diarrhea, abdominal pain, and rashes. HUMAN BREAST MILK VS. POWDERED BABY FORMULA In terms of protein, human milk has lower levels of protein than cow’s milk. This is primarily because humans do not need to grow as fast as calves during the first year of life. Human milk contains higher levels of the amino acid taurine than in cow’s milk. Taurine has been linked to brain development. Milk protein comes in two varieties: (1) An easily digestible, liquid form called whey; and, (2) A more difficult to digest, solid form called curd (made of a protein called casein). Human milk contains 65% whey and 35% casein. Cow’s milk contains 18% whey and 82% casein. Animal milk is heat-treated before being marketed. This process denatures protein and may cause allergic reactions in infants. HUMAN BREAST MILK VS. POWDERED MILK (BABY FORMULA) Breast-Milk Colostrum Present. A thick, sticky and yellowish form of milk produced in late pregnancy and the first few days after birth. More info HERE. Colostrum has high concentrations of carbs, proteins, antibodies, macrophages, beneficial bacteria, growth modulators and a mild laxative to clear excess bilirubin and encourage the baby’s first stool (meconium). Baby Formula (usually made from cow’s milk) Not Present Antibodies Present in colostrum in high concentrations but low volume. Proteins Present in lower amounts than baby formula but is easily digested/absorbed. The enzymes amylase and lipase. Hormones are present. Taurine (amino acid) present in high amounts—linked to brain development. Higher concentrations but harder to digest/absorb. Derived from bovine (cow) sources. Carbohydrates Present. High in lactose. Linked to brain development. Lower in lactose. May come from glucose. Lipids, Cholesterol & Fatty Acids Present. Human fatty acids. Newborns need substantial quantities of lipids and lipid content in breast milk can vary depending on the baby’s needs. Lipids are required to build phospholipids for new cells and the help build nerve cells. Palm, corn, coconut, soy or safflower oils. Vitamins and Minerals In lower concentrations than baby formula but easier to absorb. Iron is present but in lower concentrations than baby formula. In higher concentrations, but harder to absorb. Not Present HOW TO BREASTFEED (CAUTION: SOME NUDITY) SCANDALS ARGUMENTS FOR BREASTFEEDING OVER FORMULA AREA EFFECT WHO BENEFITS Immunity Colostrum and early breast milk contain high concentrations of antibodies & macrophages, protecting the infant from infections until immunity develops. The Child Digestive Function Colostrum stimulates digestive tract function of baby and eases defecation. Easier to digest than formula milk. The Child Cost Breast milk is both free and readily available so long as both mother and child are healthy. The Child Nutrition More complete than baby formula. Composition of breast milk can change depending on the needs of the baby. The Child Mother and Child Bonding Aids in mother/child bonding and communication. The Mother & Child The Mother’s Health Aids in weight-loss, reduces breast cancer risk,/Type II Diabetes, and post-partum depression risks. The Mother Continued on Next Page ARGUMENTS FOR BREASTFEEDING OVER FORMULAS AREA EFFECT WHO BENEFITS Sleep Some of the proteins in breast milk help to induce sleep in infants. Not present in cow or soy milk. Mother & Child Contamination No need to prepare, wash or sterilize glass or plastic bottles and synthetic nipples, as in the case with infant formula. In the preparation of bottle milk, there is a risk of water being polluted /bottle contamination with bacteria. Child Allergies The risk of allergies is not present, whereas cow’s milk in particular carries multiple risks of inducing allergies. Child Specificity Human milk is species-specific. It is designed to meet a human baby’s nutritional needs at each developmental stage w/out upsetting the delicate digestive system. The high percentage of whey and lower levels of casein make human milk more digestible than cow’s milk. The overall lower protein level is better suited to humans. Child Menstruation Breastfeeding causes the uterus of the mother to return to ‘normal’ after delivery. It also inhibits the onset of menstrual cycles, acting as a natural contraceptive , encouraging space between babies. The Mother Nutrients The nutrients in human milk are more easily digestible into the child’s blood stream (particularly iron and vitamins. Child POST-PARTUM DEPRESSION ARGUMENTS AGAINST BREASTFEEDING Breastfeeding can be painful for the mother (sensitive or infected nipples). The pain can be while the baby feeds or it can be from engorgement (the breasts are full of milk). Women who carry certain pathogens are advised not to breastfeed because of the risk of passing them to the child. HIV can be passed from mother to child through breast milk. The benefits of breast milk would be outweighed by the dangers of the virus. EARLY TREATMENT IS SAID TO CLEAR H.I.V. in 2nd BABY. Some cultures do not accept breastfeeding in public. In exclusive breastfeeding, the father of the child may feel “left out” whereas in bottle feeding, he can share a certain bond with the child. Although some countries have laws which allow the mother to take breaks to breastfeed during her work day, many countries do not. TYPE II DIABETES Type II diabetes is the most common form of diabetes worldwide and develops as a result of the complex interplay between genetics and . (Also known as ‘adult-onset diabetes’ or diabetes mellitus type II or non-insulin dependent diabetes mellitus (NIDDM)). • Type II diabetes results from the body developing an insensitivity to insulin over a period of years. While it is most common in overweight or obese adults over age of 40, it is now being observed in overweight children. • Some groups have a higher incidence of Type II diabetes than others: (1) Native Australians (Aborigines); (2) Native Americans; and (3) Maoris. TYPE II DIABETES (ANIMATIONS) Reminder: Beta cells in the pancreas produce insulin while Alpha cells produce glucagon. STATISTICS AND SYMPTOMS (CAN BE MILD AND DEVELOP OVER A PERIOD OF YEARS) Symptoms: (1) being more thirsty than usual; (2) urinating more than usual; (3) feeling tired and fatigued all the time; (4) more infections than usual (skin infections in particular); (5) elevated blood glucose levels and glucose in the urine. DIETARY ADVICE FOR TYPE II DIABETICS (GAINING CONTROL OF BLOOD GLUCOSE LEVELS) 1. Decreasing body mass and maintaining a healthy BMI through exercise and a proper, well-balanced diet. 2. Eating foods rich in fiber and complex carbs, cutting down on saturated fat. Complex carbs release their energy slowly. Fiber allows nutrients to be absorbed slowly over time. 3. Eating small, regular meals throughout the day. 4. Eat lots of fresh fruits and vegetables. Low GI foods. 5. Exercise. THE BENEFITS OF REDUCING CHOLESTEROL (LDL) Cholesterol is an essential component (lipid) of the human body. It is considered a steroid and often is the basis for various hormones and cell membranes. • There are two main types of cholesterol (HDL vs. LDL). High LDL (lowdensity lipoproteins) levels are associated with increased risk coronary heart disease. Research has shown that a 10% rise in blood cholesterol plasma levels is associated with a 30% increase in the risk of death from CHD. It appears as though total blood cholesterol levels are less important the LDL levels. • Diets that are high in saturated are linked (positively correlated) with high LDL and total blood cholesterol levels, along with CHD. • Cholesterol levels do have a genetic component and high cholesterol levels tend to run in families. • High LDL levels promote inflammation and plaques. Reducing saturated fat consumption and high animal product consumption is a first step in lowering cholesterol. Diet and exercise are critical. Medications may be necessary. CHOLESTEROL THE IMPORTANCE OF FIBER Fiber is plant material, made up of the polysaccharide cellulose, that cannot be digested by the small intestine. Cellulose from plant cells walls is the main component of dietary fiber (although fungi and crustaceans have cell walls made up of the polysaccharide chitin. 1. Fiber helps to prevent constipation, by increasing the bulk of material in the large intestine. 2. Fiber might help to prevent obesity by increasing bulk in the stomach, reducing the desire to eat. 3. Fiber may reduce the risks of appendicitis, colon cancer, and hemorrhoids. 4. Fiber might slow the rate of sugar absorption, helping to prevent and treat diabetes. FOOD MILES The term ‘food miles’ was coined to express the distance from where food was produced to where it is consumed. The longer the distance food has to travel, the greater the environmental impact. FOOD MILES (THE CONTROVERSY) • Some consumers now refuse to buy foods with high food miles, preferring to buy food that is ‘local.’ Other consumers are not concerned about food miles and, instead, want continuity of supply throughout the year and maximum choice of world foods. Environmentalists point out that there are other energy costs in food production, including the use/abuse of cheap labor, pesticides and fertilizers, increased air pollution, traffic congestion, and release of greenhouse gases. ETHICAL ISSUES OF MEAT CONSUMPTION Many people choose what to eat, based on likes and dislikes, availability, choice and cost. Some people also have ethical reasons for not eating certain foods. Background: • Vegetarians do not eat the flesh of any animals: no red meat, no poultry, and no fish. • Some vegetarians (vegans) do not eat ANY animal products (eggs, milk, dairy, honey) or any product that contains animal products. • For some vegetarians and vegans, vegetarianism goes even further . . . They will not wear/use leather, fur, wool or silk. ETHICS OF EATING ANIMAL PRODUCTS Meat: Animals have to be killed to obtain meat, usually after rearing them on a farm or In a factory. • Is it right for one animal to take the life of another animal to obtain food? • Is the pain caused to animals during transport/slaughter justified? • Is the suffering of animals reared for meat in unnatural and crowded conditions justifiable. • What are the consequences of land deforestation, antibiotic/hormone use? Milk: Cows and other mammals produce milk after giving birth. This milk can be used for human consumption if the calf or young mammal is separated from its mother soon after birth. • Is the huge milk production of cows acceptable, given that it is associated with health problems and a short life expectancy? • Is the suffering of cows whose claves are taken away soon after birth justifiable? • Is it acceptable to make cows have calves in order to stimulate milk production, when these calves will only be killed? Eggs: Most eggs come from hens (female birds) that have been specially bread for prolific egg production. • Is it acceptable to breed and keep kens that produce far greater numbers of eggs than their wild relatives? • Is the suffering of egg-laying hens kept in unnatural conditions justifiable—small cages or large groups. • Is it acceptable to kill male chicks at 1-3 days old because they do not lay eggs. Honey: Bees are kept alive in hives and surplus honey is removed when available. • Is it justifiable to take honey from bees that have stored it for their own use within the bee colony? • Is it acceptable to keep bees in an area where the bees will compete with wild insects that forage on nectar from flowers? THE STATS & SHOCKING FACTS ETHICAL ISSUES AND MEAT CONSUMPTION Arguments for a Vegetarian Lifestyle: Killing sentient beings is wrong, especially if it is not necessary for survival. ‘Sentient’ means having a nervous system, implying the organisms can perceive sensations like pleasure or pain. Raising animals for the sole purpose of slaughtering them for human consumption is wrong. Intensive livestock production is a wasteful industry which misuses valuable resources and land. Mass –production/factory industrial farming uses practices that are unnecessarily cruel including penning up animals, restricting their movements, cutting/burning off beaks, exposing animals to artificial light only, transporting them in uncomfortable conditions over long distances. Arguments Against Vegetarianism: Farm animals such as cows, sheep, pigs and chickens would not exist if not raised for food. Without meat production and fishing industries, thousands of jobs would be lost. Meat and fish can be grown in decent conditions as in ‘free-range’, ‘free-fromcruelty’, and organic practices. FACTORY FARMING ANIMATION DOCUMENTARIES/LECTURES WARNING: SOME OF THESE VIDEOS ARE GRAPHIC/DISTURBING OPTION A: DOCUMENTARIES/LECTURES