Take medicine with water, to prevent unexpected drug-food interactions –FG
Bottling companies urged to insert advisory warnings on all products
By Azoma Chikwe
Sodium benzoate (produced from benzoic acid) is a food additive used as a preservative. It is used in a variety of processed food products and drinks. It is suspected that sodium benzoate, in addition to artificial food colour, may increase hyperactivity in some children. Sodium benzoate in soft drinks may also react with added vitamin C to make benzene, a cancer-causing substance.
Benzoic acid is a colourless crystalline solid and a single aromatic carboxylic acid. Salts of benzoic acid like sodium benzoate are used as food preservatives.
The 2007 Lancet study that linked additives with increased hyperactivity included the preservative sodium benzoate. In 2006 and 2007, the United States Food and Drug Administration (FDA) tested a sample of almost 200 beverages from stores in different states that contained sodium benzoate and vitamin C. Four of the beverages had benzene levels that were above federal safety standards. The drinks were then reformulated by manufacturers and later deemed safe by the FDA. The agency points out, however, that the tests were limited and that it’s still not known how much benzene consumers could be exposed to from beverages.
Last week, the Nigerian Bottling Company (NBC) allayed concerns over benzoic acid in soft drinks. In a statement, the management said, “Our attention has been drawn to media reports which contain misleading information on the safety of benzoic and ascorbic acids as ingredients in soft drinks, citing a Lagos High Court order.
“In the judgement delivered on February 15, 2017 in a suit involving Fijabi Adebo Holdings Limited & Dr. Emmanuel Fijabi Adebo v. Nigerian Bottling Company Limited (NBC) & National Agency for Food and Drug Administration and Control (NAFDAC), the Lagos High Court dismissed all claims against NBC and held that the company had not breached its duty of care to consumers and that there was no proven case of negligence against it.
“In the same judgement, the court directed NAFDAC to mandate NBC to include a warning on its bottles of Fanta and Sprite that its contents cannot be taken with Vitamin C as same become poisonous if taken with Vitamin C. This order was premised on the fact that the products contain the preservative, benzoic acid. NBC has since appealed this order.
“Whilst we do not wish to delve into the details of the case or the merits of the court order by this medium, we find it imperative in the interest of consumers and members of the public to make the following clarifications:
In the subject case which dates back to 2007, the UK authorities confiscated a consignment of our products shipped to that country by the plaintiff because their benzoic acid levels were not within the UK national level, although well within the levels approved by both the national regulators for Nigeria and the international levels set by Codex, the joint intergovernmental body responsible for harmonizing food standards globally.
“The UK standards limit benzoic acid in soft drinks to a maximum of 150 mg/kg. Both Fanta and Sprite have benzoic levels of 200 mg/kg which is lower than the Nigerian regulatory limit of 250 mg/kg when combined with ascorbic acid and 300 mg/kg without ascorbic acid and also lower than the 600 mg/kg international limit set by Codex.
“Both benzoic acid and ascorbic acid (Vitamin C) are ingredients approved by international food safety regulators and used in many food and beverage products around the world.
“These two ingredients are also used in combination in some of these products within levels which may differ from one country to another as approved by the respective national food and drug regulators and in line with the range prescribed by Codex.
“The permissible ingredient levels set by countries for their food and beverage products are influenced by a number of factors such as climate, an example being the UK, a temperate region, requiring lower preservative levels unlike tropical countries.
“Given the fact that the benzoic and ascorbic acid levels in Fanta as well as the benzoic acid level in Sprite produced and sold by NBC in Nigeria are in compliance with the levels approved by all relevant national regulators and the international level set by Codex, there is no truth in the report that these products would become poisonous if consumed alongside Vitamin C.
“The wrong perception emanating from the media reports that our Fanta and Sprite beverages which are fully compliant with all national and international food quality and safety standards are unsafe, simply because their levels of Benzoic acid were not within the UK standards, is not only unfounded but also undermines the entire food and beverage industry in Nigeria which is regulated by the same ingredient levels approved by NAFDAC and other regulatory bodies for the country.
“NBC hereby assures our consumers and members of the public of our unwavering commitment to product quality, safety and customer satisfaction.”
On what the Nutrition Society of Nigeria says about the safety levels of additives and preservatives in our foods, President of the body, Dr Bartholomew Brai, said,” First, Nutrition Society of Nigeria as a professional body is interested in the availability of nutritious and safe foods for all Nigerians to ensure the well-being and development of individuals and the nation.
“The chemical additives (colours, stabilizers, preservatives, etc.) in our foods and drinks must be within the limits approved by Standards Organization of Nigeria (SON). This is the only way to ensure the safety of foods and drinks consumed in this country. We do not accept any individual or company violating the set standards or approved guidelines for chemical additives in foods and drinks.
“I am sure that SON and NAFDAC who are saddled with the responsibility of regulating these products are doing their work and the manufacturers on their part are keeping to the stipulated standards.
On how safe Fanta and Sprite are, he said,”Any decision to declare a product unsafe for human consumption must be evidence-based. Right now there is nothing suggesting that Fanta and Sprite are not safe for consumption.
“The issue here is the preservative, benzoic acid, which is a chemical additive (preservative) used in the manufacture of soft drinks and juices. It is added to prevent microbial growth. It is also used in the production of toothpastes, shampoos, and cosmetics. Benzoic acid is safe at low concentrations and should therefore be used within the limits fixed by the regulatory bodies.
Asked at what level they become injurious, he said, “To answer this question, I would like to remind you that there are recommended limits for the use of benzoic acid in soft drinks. The Nigerian standard is between 250mg/kg and 300mg/kg while the global limit stipulated by Codex is 600mg/kg. It follows that any value above the set standards is unacceptable because it could be injurious to man.
On how safe it is to take drugs with soft drinks, Dr Brai said, “Do not forget that drugs are chemical compounds and your soft drinks also contain certain chemical compounds. We need to safeguard the possibility of nutrient – drug interactions when we take certain drugs with soft drinks. It is therefore advisable to take our drugs with potable water.”
Minister of health, Prof Isaac Adewole, explaining the difference between the standards of Fanta and Sprite in Nigeria and the United kingdom, said, “ With reference to the Codex standards, each country or region is permitted to adapt a standard/limit based on the country’s specific scientific evidence such as environmental, storage and distribution conditions.
“Benzoic acid as a preservative prevents the growth of microorganisms which thrive more at higher climatic temperatures like in Nigeria. Due to the different environmental conditions obtainable in the UK, the standard for benzoic acid was set at a lower limt of 150mg/kg while in Nigeria it was set at 250mg/kg even below that of Codex(as at time of production of that batch, Codex limit was 600mg/kg.)
“Food products being imported into a country must comply with the relevant standards of the destination country. NAFDAC has processes in place to ensure products imported into the country are evaluated to ascertain compliance with required Nigeria Industrial Standards.
“The claimant did not obtain NAFDAC certification before export, otherwise, he would have been advised on the required standard of the destination country. In view of the above, we would like to advise all Nigerians to takemedicine with potable water. This would helpto prevent unexpected drug-food interactions.
“ For the benefit of the health of all Nigerians, all bottling companies are encouraged to insert advisorywarnings on all products as necessary.”
It is important to kow how safe the ingredients in the foods and beverages the public consume are. If, like many Nigerians, someone stocks his refrigerator with processed foods and beverages, it is not uncommon to worry about how safe food additives really are.
Over the years, the safety of many food additives, from food dyes to trans fats, has come into question. A scare over a food additive may linger in our minds long after researchers find that there’s actually no cause for alarm. It can take years, or even decades, to find out the truth, and sometimes the case is never really closed.
To help consumers figure out what’s safe, a look was taken at the latest research on some of the most controversial food additives.
Sodium nitrite is an additive used for curing meat. Sodium nitrite is usually found in preserved meat products, like sausages and canned meats.There is a theory that eating a lot of sodium nitrite might cause gastric cancer.
There is evidence that sodium nitrite could be blamed for a lot of the gastric cancers that people had in the past. Until the early 30s, gastric cancer caused the most deaths of all cancers in the United States. After that, more Americans began to use modern refrigeration and ate less cured meat. Also, producers started to use much less sodium nitrite in the curing process around that time. As these changes took place, deaths from gastric cancer also dropped dramatically.This theory has been debated for decades, and it is still an open question.
Trans fats are created when manufacturers add hydrogen to vegetable oil. Trans fats are food additives in the sense that they’re mainly added to the food supply by manufacturing processes, although small amounts of trans fats are present naturally in animal fat.
These “partially hydrogenated oils” are used most often for deep-frying food, and in baked goods. Margarine and vegetable shortening may also be made with partially hydrogenated oil.Trans fats are believed to increase the risk of heart disease and type 2 diabetes.
Most scientists now agree that eating trans fats can be very harmful to health. Trans fats have been found to lower people’s HDL (good) cholesterol and raise LDL (bad) cholesterol. The American Heart Association recommends getting less than 1% of your daily calories from trans fats.
Product labels are now required to list the amount of trans fat in a serving. Partially hydrogenated oil may also be listed as an ingredient.
But many fried foods and baked goods that are laden with trans fats are served in restaurants, and they don’t come with nutrition labels. To avoid trans fats, it’s best to limit your overall daily fat intake.
“Usually, when you increase the total amount of fat you consume, you increase the amount of trans fat as well,” says a researcher.. “If you reduce your total fat intake from 13 per cent of your daily calories to less than 10 per cent(which is recommended), you probably won’t exceed the limit on trans fat.
There are so many controversial studies about ingredients that are a little more emotionally mediated by one study showing it harmful and another study showing it not harmful, and then people say, ‘What am I to do?’”
“You’re going to get more nutrient bang for your buck to eat less refined foods when you can,” says Dietetician .
Artificial food colors are chemical dyes used to color food and drinks. Many types of processed foods, beverages, and condiments have artificial coloring in them.
Artificial food color is suspected of causing increased hyperactivity in children. Also, the dye Yellow has been thought to worsen asthma symptoms. In the 70s, the Food and Drug Administration of America(FDA) famously banned Red Dye after some studies found that large doses could cause cancer in rats.
In 2007, a British study published in The Lancet concluded that consuming artificial coloring and preservatives in food can increase hyperactivity in kids. Scientists have been studying the link between food additives and hyperactivity in children for more than 30 years, with mixed results. But the results of the 2007 study compelled the European Food Standards Agency to urge companies to voluntarily remove artificial colouring from food products. The FDA, however, hasn’t changed its opinion on the use of FDA-approved artificial food colors, which it considers safe when used properly.
Reports suggesting that the food color Yellow might aggravate some people’s asthma, symptoms date back to the 50s. But in most controlled studies, Yellow has not been shown to have a significant impact on asthma, according to a review of all known studies, which is updated every year.
High fructose corn syrup
High fructose corn syrup is a sweetener made from corn. It’s sweeter and cheaper than sucrose, which is the form of sugar made from sugar cane.
High fructose corn syrup is a common additive in many kinds of processed foods, not just sweets. Most non-diet soft drinks are sweetened with high fructose corn syrup.
Some experts have proposed that people metabolise high fructose corn syrup in a way that raises the risk of obesity and type 2 diabetes more than sugar made from sugar cane. Much of the controversy stems from the observation that obesity and consumption of high fructose corn syrup increased at the same time.
The high fructose corn syrups commonly used to sweeten foods and drinks are 55-58 per cent fructose and 42-45 per cent glucose. Sucrose (cane sugar) is a double sugar made of fructose and glucose. Digestion quickly breaks down cane sugar and high fructose corn syrup into fructose and glucose.
The American Medical Association recently stated that there is scant evidence to support the idea that high fructose corn syrup is any worse than cane sugar and that consuming too much sugar of either kind is unhealthy.
Aspartame is an artificial sweetener known by various brand names, including Equal and Nutrasweet. Aspartame is a commonly used additive for sweetening diet and soft drinks.
Various health concerns have been raised about aspartame since it was introduced in 1981. Most recently, it has been suspected of causing cancer. There have been reports of aspartame causing seizures, headaches, mood disturbances, and reduced mental performance. A study published in 2005 suggested that aspartame could cause leukemia and lymphoma in rats. Another study, published in 1996, argued that an increase in the rate of brain tumours could be related to consumption of aspartame.
Dozens of studies in people and animals have tested for effects possibly related to aspartame. The majority of these studies show that things such as headaches, seizures, mental and emotional problems didn’t occur with aspartame more often than with placebo, even at doses many times higher than anyone would likely ever consume. Large epidemiological studies haven’t found a link between aspartame and cancer. A study of about 500,000 people, sponsored by the National Cancer Institute, compared those who drank beverages containing aspartame with those who didn’t. It found that people who drank increasing amounts of beverages containing aspartame did not have a greater risk for lymphomas, leukemias, or brain cancer. Another study looked at data from a large survey done by the National Institutes of Health. The survey included detailed information on 1,888 cases of leukemia or lymphomas and 315 cases of brain cancer. The researchers found no link between aspartame consumption and those cancers.
“For more than three decades, research has found aspartame to be safe, and today it is approved for use in more than 100 countries,” says a researcher. “In fact, the United States Food and Drug Administration has confirmed the safety of aspartame 26 times over a period of 23 years, with the most recent confirmation in April 2007.”
Monosodium glutamate (MSG)
MSG by itself looks like salt or sugar crystals. It is a form of the naturally occurring chemical glutamate. Glutamate doesn’t have a flavour of its own, but it enhances other flavours and imparts a savoury taste. Tomatoes, soybeans, and seaweed are examples of foods that have a lot of glutamate naturally. Some scientists say that glutamate, also known as “umami,” is the fifth essential flavour that the human palate can detect, in addition to sweet, salty, bitter, and sour. MSG is an additive used in many foods.
Many people claim to have bad reactions when they eat food seasoned with MSG. In the late 60s, people started talking about “Chinese restaurant syndrome,” alleging that food prepared with MSG at Chinese restaurants made them sick.
Many studies over the past four decades have tested the idea that some people may be sensitive to MSG. Most scientists today agree that if there is such a thing as a sensitivity or allergy to MSG, it’s extremely rare. Studies haven’t found any regular pattern of symptoms that could be typical of a reaction to MSG. Also, people are more likely to have symptoms if they’re given MSG crystals than if they eat the same amount of MSG mixed with food.
“It’s very hard for me to believe that there’s a problem with it,” a researcher says. Nevertheless, some still swear that they have bad reactions to MSG. “People who think they have problems with it should avoid it,” she says.
Some food labels come right out and say that a product contains added MSG. But there are other ingredients that may contain MSG such as “hydrolysed soy protein” and “autolysed yeast.”
TIPS ON HEALTHY LIVING : Myths and facts about Alzheimer’s disease
1. Dementia and Alzheimer’s disease are the same thing
Fact : Dementia is not a specific disease itself; rather, the term refers to a group of symptoms that can be caused by several different brain disorders. Dementia is characterised by impaired intellectual functioning such as memory loss, language difficulty, decreased perception, and impaired reasoning. Alzheimer’s disease is just one of many types of dementia though it does account for between 60 to 80 per cent of all cases of dementia.
Another difference between dementia and Alzheimer’s disease is that Alzhemier’s is degenerative and there is currently no cure. On the other hand, depending on the cause of the dementia, such as drug interactions or a vitamin deficiency, the symptoms of some types of dementia may be reversible.
2. The disease only happens to older people
Fact : While most people diagnosed with Alzheimer’s disease are age 65 and older, about 200,000 Americans under age 65 are diagnosed each year with early-onset (also called younger-onset) Alzheimer’s.
When people are in their 40s or 50s, doctors may not consider Alzheimer’s disease and it may take a long time to get an accurate diagnosis. Symptoms are of early-onset Alzheimer’s may be attributed to stress, menopause, or depression in younger people.
3. Its symptoms are just a normal part of aging
Fact : Some memory loss happens to most of us as we age, but memory loss associated with Alzheimer’s interferes with daily life and is a more serious problem. In the early stages, people with Alzheimer’s may forget information they recently learned, they may forget important dates or events, and they may ask the same questions over and over. As the disease progresses, people will eventually become disoriented, confused, and may be unable to carry out routine daily tasks. In the later stages, people with Alzheimer’s lose the ability to eat and talk, and they may become totally dependent on others for care.
4. Alzheimer’s isn’t deadly
Fact : Alzheimer’s is the sixth leading cause of death in the United States(U.S). One in three seniors dies with Alzheimer’s or another form of dementia. People diagnosed with Alzheimer’s live on average about eight years following their diagnosis, but survival ranges from four to 20 years.
In the latest stages of the disease, people with Alzheimer’s lose their ability to respond to their environment and often lose awareness of their surroundings.
They usually require full-time care, and gradually lose the ability to walk, sit, and eventually, swallow. They also become vulnerable to infections such as pneumonia.
5. There are lots of treatments for Alzheimer’s disease
Fact : Out of the top ten causes of death in the U.S., Alzheimer’s disease is the only one that cannot be prevented, cured, or slowed. There are two types of medications approved by the FDA to help manage Alzheimer’s symptoms, cholinesterase inhibitors (Aricept, Exelon, Razadyne), and memantine (Namenda) prescribed to help treat the cognitive symptoms (memory loss, confusion, and problems with thinking and reasoning) of Alzheimer’s disease.
Supplements such as vitamin E have been tested but have not been shown to be effective in treating Alzheimer’s symptoms.