Categories
Useful Facts on Miscellaneous Substances
Addictive Drugs
Use of addictive drugs, such as cocaine, marijuana and nicotine, affects food and liquid intake, behavior, taste preference, and body weight.
Changes in specific nutrient status and metabolism can also develop; heroin addiction can cause hyperkalemia and morphine use can result in calcium inhibition. Nutrition-related physiological aspects, such as impaired gastrin release, hypercholesterolemia, and hypothermia are also seen with morphine use.
Nutrition-related conditions can affect sensitivity and dependence on drugs and their effects. Diabetes decreases sensitivity and dependence on morphine, protein deprivation produces preferential fat utilization with low cocaine use, and vitamin D deficiency decelerates morphine dependency. During use and/or withdrawal from nicotine, heroin, marijuana, and cocaine, major changes in food selection occur, which results in weight gain or loss.
Changes in food selection and consumption caused by cocaine, nicotine, heroin, and marijuana, particularly during drug withdrawal, should be treated by diet modification. The use of specific nutrients (e.g.., Calcium and vitamin D) to modify the withdrawal process or to stimulate health recovery in the addict is unstudied to date, but is a logical direction for the future.
To the extent that alcohol, cocaine or the other drugs of abuse modify nutritional status or food intake, dietary changes cannot be expected to compensate for those changes. Adopting a balanced eating pattern may help renourish an individual and prevent the negative effects of inadequate intake.
Tests of specialized supplements with high levels of several vitamins and minerals have shown benefits in increasing compliance and in reducing hunger for drugs during drug cessation treatment.
Nutritional changes have been used during the withdrawal or
detoxification stage of drug cessation treatment and for renutrition to
enhance withdrawal from alcohol and cocaine. Dietary supplementation
(particularly of tyrosine and tryptophan) helped restore brain
chemicals modified by cocaine or alcohol.
[Journal of the American Dietetic Association 90:1261- 1267, 1990.]
Marijuana
Marijuana has been found to increase food intake in human beings. A single dose of marijuana produced increased appetite in clinical human studies.
Increased weight and total caloric intake have been reported in persons who smoked marijuana for 3 to 7 weeks. [Greenberg,
I., Kuehnle, J., Mendelson, J.H., and Bernstein, L.G.: Effects of
marijuana use on body weight & caloric intake in humans.
Physcopharmacology (Berlin) 4:79, 1976.] Foltin et al. [Foltin,
R.W., Brady, J.V., and Fischman, M.W.: Behavioral analysis of marijuana
effects on food intake in humans. Pharmacol Biochemical Behavior
25:577, 1986.] found that men who were given two or three
marijuana cigarettes during periods between meals significantly
increased their daily caloric intake, the total number of eating
occasions,
and between-meal snacks.
A number of symptoms of nutritional deficiency occurred significantly more often in alcohol and marijuana abusers than in nonusers. These included muscle weakness, bleeding gums, fatigue, dyspnea on exertion, indigestion, appetite loss, sore tongue, and low plasma zinc. All subjects had diets that were adequate in nutrients, but abusers ate less fruit, vegetables, and milk and more snack foods than nonusers.
Thus, although marijuana use increases appetite and food intake in human beings, the decrease in dietary quality seen in users is accompanied by several signs of nutritional deficiency.
Heroin
In a few reported cases, heroin overdose in human beings was
accompanied by severe rhabdomyolysis, destruction of skeletal muscle
accompanied by myoglobinemia, which can lead to acute kidney failure.
The condition resulted in severe hyperkalemia, probably caused by a
rapid efflux of potassium from damaged muscle cells. The associated
acute renal failure may exacerbate
the hyperkalemia. [Pearce, C.Y., And Cox, J.C.: Heroin & Hyperkalemia, Lancet 2:923, 1980.]
Heroin addicts have shown flat glucose tolerance curves, with an exaggerated and delayed insulin response following oral glucose loading. Heroin addicts have a markedly reduced acute insulin response to glucose administered intravenously and have low potassium values. It is clear that heroin alters glucose tolerance and subsequent metabolism, and the severe adverse effects of the drug on skeletal muscle, kidney function, and glucose metabolism are of concern for human users.
The effects of morphine on lipid profiles could have important implications. Its ability to raise levels of insulin and to induce hypoglycemia and hyperglycemia could have important consequences, especially for persons with diabetes. Because coronary heart disease is a leading cause of incapacitating illness and death, the hypercholesterolemic effect of morphine, threefold increase in the atherogenic index and high aortic cholesterol deposition, is of critical interest. Its antagonistic interaction with calcium and vitamin D is also of interest.
Cocaine
Cocaine abuse can lead to food deprivation or nutrient imbalance in human beings. Castro et al. [Castro,
F.G., Newcomb, M.D. and Cadish, K: Lifestyle differences between young
adult cocaine users and their nonuser peers. Journal Drug Education
17:89, 1987] found that young adult cocaine users ate
significantly fewer complete/balanced meals per day,
and drank more alcohol and coffee, than non users. Within the cocaine
group moderate users perceived themselves as less healthy than did
light users.
Data regarding specific nutritional effects of cocaine use is sparse. However, the well documented medical effects of cocaine, such as increased heart rate, body temperature and metabolic rate, along with feelings of euphoria and increased energy would increase caloric requirements beyond normal. Cocaine also causes decreased appetite and anorexia by inactivation of the feeding center located on the lateral hypothalamus.
The anorexigenic effects of cocaine as well as its metabolism cause
deficiencies of most water soluble vitamins. Studies have demonstrated
vitamin B6, thiamin and C deficiencies to be common among cocaine users. [Addison. Kim, Cocaine: Effects on nutrient levels. Supplement Journ Am Dietetic Association. 90:A65, 1990]
If the results of food deprivation in monkeys can be extrapolated to human beings, a vicious circle of food deprivation and cocaine abuse can theoretically occur. It is also interesting to note that there was an elevated prevalence rate for anorexia nervosa and bulimia among 259 cocaine abusers compared with nonaddicts.
Nicotine
The role of nicotine, the ingredient of tobacco that causes dependence, has emerged as a focal point of smoking research. In 1988, nicotine was designated an addictive drug by the US Surgeon General.
Within the past decade, a series of objective studies has increased understanding of the relationships between smoking and nicotine with respect to body weight and food intake. Nicotine changes food selection, based on taste, and appears to alter body weight. In addition, nicotine affects the intrauterine growth of fetuses and decreases birth weight of infants born to smoking mothers.
Smokers have higher fat intakes, but not higher total energy
intakes, than nonsmokers, according to one study. Grunberg and Morse [Grunberg, N.E., & Morse, D.E.: Cigarette smoking and food consumption in the USA. J Appl Soc Phsycol 14:310, 1984]
found a significant inverse relationship between cigarette smoking and
sugar consumption in an epidemiological
study of the US population, which covered a 14 year period. Smokers who
were given a choice of bland, salty and sweet foods expressed the least
preference for sweets and ate significantly fewer sweets than did non
smokers.
Body weight in human beings tends to increase after they quit smoking. This is probably due to the increased consumption of sweet foods (particularly chocolate) after quitting.
Alcohol (Ethanol)
Alcohol is of importance to nutrition because it provides energy (7 kcal per gram) and because it can affect the requirements for and the intake, digestion, absorption, transport, storage, metabolism, and excretion of many other nutrients.
Once absorbed, alcohol diffuses rapidly across capillary and other cell membranes and is distributed uniformly throughout all extracellular and intracellular body water. It is first metabolized by the liver to acetaldehyde, then to acetate, and finally to carbon dioxide and water. More than 95 percent is oxidized and the remainder is excreted in the urine, feces, perspiration and expired air.
Three types of malnutrition may be observed in alcoholics, primary
malnutrition due to a decreased intake of nutrients, secondary
malnutrition caused by an impairment in the digestion and absorption of
nutrients, and tertiary malnutrition due to an alteration in the
ability to convert nutrients to their active coenzyme forms, resulting
in nutritional complications that
potentiate the direct effects of alcohol. [The Surgeon General's Report on Nutrition and Health, Prepublication copy, 1988. 17:629-649]
Excessive drinking depletes the body of nutrients leading to kidney damage and cirrhosis of the liver, and ultimately to death.
An often fatal complication of alcohol abuse is profoundly low blood sugar. It has been proposed that alcohol blocks gluconeogenesis by metabolic shifts that result in reduced conversions of gluconeogenic precursors into glucose and glycogen. In the absence of glycogen stores, profound hypoglycemia occurs.
Hypertension may also be attributable to alcohol consumption. Three to four drinks per day causes a measurable increase in both the systolic and diastolic blood pressures.
Impairments in the metabolism of vitamin A have been reported in alcoholics. Even moderate alcoholic disease is associated with severely decreased vitamin A concentrations.
Riboflavin, niacin, vitamin D and vitamin E deficiency, as well as lower serum levels of ascorbic acid have been documented in alcoholics.
Alcohol also inhibits the absorption of vitamin B6 and its release from the liver. Folate deficiency is probably the most common vitamin deficiency among alcoholics. Alcohol directly inhibits enzymes involved in folate metabolism and increases urinary excretion of folate.
Thiamine deficiency is observed frequently among alcoholics in whom
decreased consumption and absorption and an increased requirement all
appear to play a role in the development of a deficiency. [Leevy, C.M. and H. Baker, 1968. Vitamins and alcoholism. Am. J. Clin. Nutr. 21:1325-1328]
Ascorbic acid has been shown to be potentially useful in alcohol
detoxification. Studies of healthy men indicated that supplementation
with 1 gram or 5
grams ascorbic acid daily for 2 weeks before alcohol dosing
significantly enhanced the clearance of alcohol from the blood. [Chen,
M.F., Boyce, H.W., and Hsu, J.M: Effect of ascorbic acid on blood
alcohol clearance. Journal American College of Nutrition. 9:185, 1990]
Caffeine
Caffeine is a derivative of xanthine. It is a pharmacologically active substance, and acts as a stimulant to the heart and central nervous system. It increases gastric acid secretion and is known to cause vasodilation.
Large intakes of caffeine can induce a variety of toxic effects ranging from tremor to migraine, although as little as 200 mg can cause unpleasant effects such as sweating and palpitations. Effects are most likely when excessive quantities are taken or in highly sensitive individuals.
Caffeine has an adverse effect on certain nutrients, it wastes the B vitamins and inositol. People with high blood pressure should abstain from caffeine.
Scandinavian-style boiled coffee (ground coffee beans boiled in water)
was found to contain more lipid material than drip-filter coffee. Volunteers
consumed a lipid-enriched fraction from boiled coffee for 6 weeks. Serum
cholesterol rose in every subject. The increase was due mainly to low-density-lipoprotein
cholesterol. After supplementation had ended, lipid levels returned tobaseline.
Thus, boiled coffee contains a lipid that powerfully raises serum cholesterol.
[Zock, P.L., Katan, M.B., Merkus, M.P., van Dusseldorp, M., Harryvan,
J.L.: Effect of a lipid-rich fraction from boiled coffee on serum cholesterol.
Lancet 335:1285, 1990.]
Table 1.3 Principal food sources of caffeine
FOOD |
CAFFEINE CONTENT |
Ground coffee (cup) |
97 - 125 mg |
Fiber
Dietary fiber is a term used to describe a heterogeneous group of plant food components that are resistant to human digestive enzymes. It is as a non-starch polysaccharide, a type of carbohydrate. Fiber is found exclusively in plant foods. There is no RDA but we should eat at least 25 grams per day.
There are two basic categories of dietary fiber:- water insoluble and water soluble. These include - cellulose, hemicellulose, gums, pectin, psyllium and lignin.
Insoluble fibers are found in the skin, peel, and husks of fruit, vegetables and whole grain products. The inclusion of this fiber in a low-fat diet may reduce the risk for colon cancer. Insoluble fibers also aid in the treatment of constipation and diverticulosis.
Psyllium, oat products, barley and beans are good sources of gum, a type of soluble fiber. Gums and pectin influence absorption in the stomach and small intestine. By binding with bile acids, they decrease fat absorption and lower cholesterol levels. They coat the stomach lining, and by doing so they slow sugar absorption, regulating blood sugar levels, which is useful to diabetics since it reduces the amount of insulin needed at any one time.
Lignin also binds with bile acids, assists in lowering cholesterol levels and helps speed up food through the digestive tract.
Dietary patterns emphasizing foods high in complex carbohydrates and fiber are associated with lower rates of diverticulosis, reduced risk of coronary heart disease and diabetes mellitus, lower blood glucose and blood lipid levels, and some types of cancer.
Epidemiologic evidence suggests that frequent consumption of vegetables
and fruits, particularly dark green and cruciferous vegetables (such as
cabbage and broccoli), may lower the risk for cancers of the lung, bladder
and alimentary tract. [The Surgeon General's Report on Nutrition and
Health, Prepublication copy, 1988. 17:629-649]
Whole-grain cereals, whole-grain bread, other grain bakery products and pasta, legumes - kidney beans, lima beans, navy beans, and split peas, fruits, especially the skin and edible seeds are the best source of fiber.
If you think that the perilous conditions of our diet is worldwide in
scope, just look at the 'underprivileged' areas of rural Africa. In the
year 1975, the southern areas of rural Africa avoided the major scourges
of the modern world. British doctors found in their research on rural African
villages that cancer of the colon and the rectum is extremely rare, and
that there is no appendicitis, hemorrhoids, obesity, heart attacks, varicose
veins, phlebitis, or diverticulosis of the colon. As if this evidence were
not enough proof that something is wrong with our diet, it has been shown
that Africans develop the same diseases we have as soon as they adopt a
Western diet-that is, as soon as they cut their intake of roughage. [David
Reuben, 1975. The Save Your Life Diet.]
Gelatin
The most notable characteristic of gelatin is that it is soluble in hot water but forms a solid jelly when it cools. The Latin word gelatus means frozen, and is recalled in the Italian word for ice cream, gelati.
Gelatin is a protein, and is formed from collagen, which is the primary protein in connective tissue. Animal bones, skin and gristly meat are a major source of gelatin. By itself gelatin has a low biological value. Commercial jellies with their sugar and flavour make an attractive desert, but with their 2% of an inferior protein, it is unrealistic to suppose that because they are solid they add significantly to the nourishment of a convalescent.
Agar is a vegetable gelling agent, and since, unlike gelatin it is not
derived from an animal source it is used as an alternative to gelatin,
by vegetarians and people following a kosher diet, in many of the same
foods. [Yudkin, J., The Penguin Encylopedia of Nutrition. 1985]
Gluten
Gluten is a mixture of two proteins, gliadin and glutenin. It is the presence of gluten in wheat and rye that makes these cerealssuitable for the production of bread. When mixed with water and kneaded, the gluten in wheat or rye flour becomes elastic and traps small bubbles of carbon dioxide from yeast fermentation. The flour of other cereals such as oats or maize, with little or no gluten, can be used only for flat cakes such as tortillas.
Children with coeliac disease, and some adults with a similar disease known as sprue, have a sensitivity to gluten which causes damage to the intestinal villi so that they are unable to properly digest and absorb some of the food components, especially fat. It has been suggested that several other unrelated diseases, including schizophrenia and multiple sclerosis, in some patients may be caused by a sensitivity to gluten. The evidence for these claims is not conclusive and has not been substantiated.
Nevertheless, it does seem as if some babies without obvious coeliac
disease are sensitive to gluten although they lose this sensitivity gradually
through their first few months or years. For this reason many manufacturers
of baby foods avoid using gluten-containing items in their products. [Yudkin,
J., The Penguin Encylopedia of Nutrition. 1985 ]
Lecithin
Lecithin is a phosphatide or phospholipid, a fatty substance found in animal and plant tissues. It is composed of choline, phosphoric acid, two fatty acids and glycerol.
Lecithin is produced by the liver and passes into the intestine, to be absorbed into the blood. As an emulsifying agent it allows fats and cholesterol to flow easily in the blood stream and through arterial walls.
It is essential in maintaining the surface tension of cell membranes, and in controlling cellular intake and secretion. It also helps in conducting impulses to and from nerve cells.
It has also been shown to control heart disease and atherosclerosis. If enough lecithin is present the disease does not occur.
The best natural sources of lecithin are eggs, wheat, soya oil and nuts. It is also readily available in supplement form.
Monosodium Glutamate (MSG)
MSG, usually manufactured from wheat gluten, is used not because of its own flavor but because it enhances the favor of stews, soups, savory sauces and cooked vegetables. MSG is the sodium salt of glutamic acid, an amino acid found in most proteins and thus present in the gravies of cooked meats and protein derivatives such as hydrolyzed vegetable protein.
MSG is found in many Chinese foods, partly because it is present in
soya sauce and because the pure substance is often used. It is also found
in dried soups and many other prepared foods. Some individuals react to
MSG by what is called the Chinese Restaurant Syndrome. This is characterized
by pain in the neck, headache and perhaps palpitations. This condition
is only transitory and individuals sensitive to MSG soon learn to avoid
eating foods containing it. [Yudkin, J., The Penguin Encyclopedia of
Nutrition. 1985]
Oxalic Acid (Oxalate)
In the small amounts normally present in food, the only importance of oxalic acid is that it combines with calcium in the diet and so reduces the amount of this mineral element that can be absorbed. Large quantities may cause poisoning by damaging the lining of the mouth and stomach, and interfering with the action of the nerves and muscles.
A few foods, notably unripe tomatoes and some varieties of strawberries, may have small amounts. However, beetroot has about 100 milligrams per 100 grams, parsley about 150 milligrams, and rhubarb and spinach between 300 and 600 milligrams.
As well as deriving oxalate from the diet, the body can synthesize it
from citric acid. Some urinary stones contain calcium oxalate, as well
as other calcium salts, but it is not known to what extent this is derived
from dietary oxalic acid or from excessive synthesis. Nevertheless, if
a person is known to excrete an excessive amount of oxalate in the urine,
or to have had kidney stones containing oxalate, it is reasonable to restrict
the consumption of spinach and rhubarb, as well as chocolate and cocoa.
[Yudkin, J., The Penguin Encyclopedia of Nutrition. 1985]
Phytic acid (Phytate)
Phytic acid is a compound of inositol and phosphoric acid. It occurs partly as an acid and partly as salts such as calcium phytate in plant foods, especially in the bran of cereals, and in pulses and nuts.
It readily combines with minerals including calcium, iron and zinc, and if these are present in only marginally adequate amounts in the diet, phytic acid may reduce their availability sufficiently to cause deficiency. There are, however, a few ways in which this hazard is reduced.
Germination, soaking fermentation and cooking all reduce the effect
of phytate in legumes. Flour has calcium carbonate added to it in amounts
more than enough for all the phytic acid present to be converted to the
insoluble calcium phytate. The yeast used for providing dough contains
an enzyme, phytase, that breaks down much of the phytic acid. The body
gradually adapts to much of the phytic acid in the diet, perhaps by an increase
in the amount phytase in the intestine, so that after time its effect in
reducing the availability of calcium and other elements diminishes. [Yudkin,
J., The Penguin Encyclopedia of Nutrition. 1985]
Psyllium (Plantago ovata)
Psyllium is obtained from the seed husks of a plant grown in India and the Mediterranean region. It contains eight times the soluble fiber of oat bran. When included as a part of a low-fat, low-cholesterol, high-fiber diet, psyllium has been found to be effective in lowering blood cholesterol levels, especially LDL-cholesterol.
Since 1930, the primary use of psyllium has been a bulk forming laxative.
Approximately four million people in the United States use a commercial
pharmaceutical form of psyllium. The acute toxicity of psyllium is very
low. In 1981, a committee of the National Research Council concluded that
"There is no evidence in the available information on psyllium husk
gum that demonstrates or suggests reasonable grounds to suspect a hazard
to the public when it is used at levels that are now current or that might
reasonably be expected in the future." [Get A Taste For The Healthy
Life - theme for Project Nutrition, Kellogg Company, 1990.]
Steroids
Steroids are a group of organic compounds including sterols, of which the best known is cholesterol. It has received attention in connection with circulatory ailments, especially hardening of the arteries. If excess cholesterol is present in the body, it tends to precipitate from solution in the gall bladder as gallstones, and in the blood vessels where the constriction thus formed reduces blood flow, causing high blood pressure.
Other sterols produced in the ovaries and testes, that control the physiology of the reproductive process and the secondary sex characteristics, are known as sex hormones. Although primarily involved with reproductive mechanisms, sex hormones are also significant as growth substances of general importance to body health and well-being.
The female sex hormones, the estrogen's are essential for the changes of the menstrual cycle, and progesterone which prepares the uterus for fertilization and is required for normal pregnancy. Progesterone, now produced synthetically, is used clinically to prevent abortion in certain difficult pregnancies.
The male sex hormones, androgens, regulate the development of reproductive organs and secondary sex characteristics such as beards, deep voices, etc.
Some steroids that are synthesized commercially are used for muscle
and bone growth in athletes and body builders. The abuse of anabolic-androgenic
steroids has been well documented in bodybuilders, and the potential for
harmful side effects clearly exposed. [ Position stand on the use of
anabolic-androgenic steroids in sports. Indianapolis: American College
of Sports Medicine, 1984.]
Adverse reactions may include increased risks of the following: liver diseases, including liver cancer, heart disease and stroke, decreased immune function, acquired immune deficiency syndrome (AIDS), kidney stones and diseases, gall stones, hypertension, prostate enlargement, testicular atrophy, sterility, impotence, stunted growth in adolescents, psychological changes, irreversible virilization in women, and fetal damage.
The well documented negative effects far outweigh the short term benefits of steroid usage. There is no long term advantage of using steroids as ultimately they are going to cause harm to your system.
Tannins
Tannins are one of the phenolic compounds (phenolic acid, coumarins, flavonoids) that are widely distributed in plants, conferring increased resistance to pests. Tannin effects in human beings range from pharmacologic, therapeutic, and aesthetic benefits to anti-nutritional and other undesirable results. Plant tannins can complex with and precipitate proteins. Sorghum tannin can bind up to 12 times its weight in protein.
Condensed tannins, the major phenols in commonly consumed foods and beverages such as fruit, vegetables, tea, red wine, cocoa, legumes, certain grains (sorghum, millet), and pulses, are more nutritionally hazardous. Concern for potential nutritional hazards, therefore, is for populations that rely on sorghum, millet, or certain legumes as their dietary staple.
Decreases in growth rate, feeding efficiency, and protein digestibility are some of the effects caused by complexing of phenols with protein, starch, digestive enzymes, vitamins and minerals. Additionally, malnutrition enhances tannin toxicity. Attempts to inactivate or remove tannins from foods and feeds have had limited results.
Tartrazine
Tartrazine (FD&C Yellow No. 5) is used in foods, beverages, drugs
and cosmetics. It has been estimated that about 100 000 persons in the
United States are sensitive to this substance. Symptoms of allergy include
generalized urticaria, swelling, often of the face and lips, runny nose,
and on occasion even life threatening asthma. Since tartrazine is found
in a large number of products,tartrazine-sensitive individuals are advised
to read labels and avoid food containing "FD&C Yellow No. 5".
[Sense and Nonsense in Nutrition. Jack Yetiv. 1988]
Water
Although water is often excluded from lists of nutrients, it is an essential dietary component, in that it must be acquired from the diet in amounts well in excess of that produced by metabolism in the body.
Water is the most abundant constituent of the human body, accounting for about four-fifths of body weight.
Waste products need to be excreted from the body. This process of excretion is done by the kidneys, where the nitrogen-containing products of protein metabolism, sulfates, phosphates and other electrolytes are dissolved in water and excreted as urine. To compensate for this loss, a thirst sensation is created. If this thirst sensation is not met with an adequate consumption of water, dehydration will occur.
Toxicity results from the ingestion of water at a rate beyond the capacity of the kidneys to excrete it. The manifestations usually include a gradual mental dulling, confusion, convulsion, coma and death.