Cause Asthma runs in families, so that parents with asthma have a strong risk of having children with asthma, or with other atopic (see ATOPY) illnesses such as HAY FEVER or eczema (see DERMATITIS). There is therefore a great deal of interest in the genetic basis of the condition. Several GENES seem to be associated with the condition of atopy, in which subjects have a predisposition to form ANTIBODIES of the IgE class against allergens (see ALLERGEN) they encounter – especially inhaled allergens.
The allergic response in the lining of the airway leads to an in?ammatory reaction. Many cells are involved in this in?ammatory process, including lymphocytes, eosinophils, neutrophils and mast cells. The cells are attracted and controlled by a complex system of in?ammatory mediators. The in?amed airway-wall produced in this process is then sensitive to further allergic stimuli or to non-speci?c challenges such as dust, smoke or drying from the increased respiration during exercise. Recognition of this in?ammation has concentrated attention on anti-in?ammatory aspects of treatment.
Continued in?ammation with poor control of asthma can result in permanent damage to the airway-wall such that reversibility is reduced and airway-narrowing becomes permanent. Appropriate anti-in?ammatory therapy may help to prevent this damage.
Many allergens can be important triggers of asthma. House-dust mite, grass pollen and animal dander are the commonest problems. Occupational factors such as grain dusts, hard-metals fumes and chemicals in the plastic and paint industry are important in some adults. Viral infections are another common trigger, especially in young children.
The prevalence of asthma appears to be on the increase in most countries. Several factors have been linked to this increase; most important may be the vulnerability of the immature immune system (see IMMUNITY) in infants. High exposure to allergens such as house-dust mite early in life may prime the immune system, while reduced exposure to common viral infections may delay the maturation of the immune system. In addition, maternal smoking in pregnancy and infancy increases the risk.
Clinical course The major symptoms of asthma are breathlessness and cough. Occasionally cough may be the only symptom, especially in children, where night-time cough may be mistaken for recurrent infection and treated inappropriately with antibiotics.
The onset of asthma is usually in childhood, but it may begin at any age. In childhood, boys are affected more often than girls but by adulthood the sex incidence is equal. Children who have mild asthma are more likely to grow out of the condition as they go through their teenaged years, although symptoms may recur later.
The degree of airway-narrowing, and its change with time and treatment, can be monitored by measuring the peak expiratory ?ow with a simple monitor at home – a peak-?ow meter. The typical pattern shows the peak ?ow to be lowest in the early morning and this ‘morning dipping’ is often associated with disturbance of sleep.
Acute exacerbations of asthma may be provoked by infections or allergic stimuli. If they do not respond quickly and fully to medication, expert help should be sought urgently since oxygen and higher doses of drugs will be necessary to control the attack. In a severe attack the breathing rate and the pulse rate rise and the chest sounds wheezy. The peak-?ow rate of air into the lungs falls. Patients may be unable to talk in full sentences without catching their breath, and the reduced oxygen in the blood in very severe attacks may produce the blue colour of CYANOSIS in the lips and tongue. Such acute attacks can be very frightening for the patient and family.
Some cases of chronic asthma are included in the internationally agreed description CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) – a chronic, slowly progressive disorder characterised by obstruction of the air?ow persisting over several months.
Treatment The ?rst important consideration in the treatment of asthma is avoidance of precipitating factors. When this is a speci?c animal or occupational exposure, this may be possible; it is however more di?cult for house-dust mite or pollens. Exercise-induced asthma should be treated adequately rather than avoiding exercise.
Desensitisation injections using small quantities of speci?c allergens are used widely in some countries, but rarely in the UK as they are considered to have limited value since most asthma is precipitated by many stimuli and controlled adequately with simple treatment.
There are two groups of main drugs for the treatment of asthma. The ?rst are the bronchodilators which relax the smooth muscle in the wall of the airways, increase their diameter and relieve breathlessness. The most useful agents are the beta adrenergic agonists (see ADRENERGIC RECEPTORS) such as salbutamol and terbutaline. They are best given by inhalation into the airways since this reduces the general side-effects from oral use. These drugs are usually given to reverse airway-narrowing or to prevent its onset on exercise. However, longer-acting inhaled beta agonists such as salmeterol and formoterol or the theophyllines given in tablet form can be used regularly as prevention. The beta agonists can cause TREMOR and PALPITATION in some patients.
The second group of drugs are the antiin?ammatory agents that act to reduce in?ammation of the airway. The main agents in this group are the CORTICOSTEROIDS. They must be taken regularly, even when symptoms are absent. Given by inhalation they have few side-effects. In acute attacks, short courses of oral steroids are used; in very severe disease regular oral steroids may be needed. Other drugs have a role in suppressing in?ammation: sodium cromoglycate has been available for some years and is generally less e?ective than inhaled steroids. Newer agents directed at speci?c steps in the in?ammatory pathway, such as leukotriene receptor-antagonists, are alternative agents.
Treatment guidelines have been produced by various national and international bodies, such as the British Thoracic Society. Most have set out treatment in steps according to severity, with objectives for asthma control based on symptoms and peak ?ow. Patients should have a management plan that sets out their regular treatment and their appropriate response to changes in their condition.
Advice and support for research into asthma is provided by the National Asthma Campaign.
See www.brit-thoracic.org.uk
Prognosis Asthma is diagnosed in 15–20 per cent of all pre-school children in the developed world. Yet by the age of 15 it is estimated that fewer than 5 per cent still have symptoms. A study in 2003 reported on a follow-up of persons born in 1972–3 who developed asthma and still had problems at the age of nine. By the time these persons were aged 26, 27 per cent were still having problems; around half of that number had never been free from the illness and the other half had apparently lost it for a few years but it had returned.... asthma
Nutritional Profile Energy value (calories per serving): Moderate Protein: High Fat: Moderate Saturated fat: High Cholesterol: Moderate Carbohydrates: None Fiber: None Sodium: Low Major vitamin contribution: B vitamins Major mineral contribution: Iron, phosphorus, zinc
About the Nutrients in This Food Like fish, pork, poultry, milk, and eggs, beef has high-quality proteins, with sufficient amounts of all the essential amino acids. Beef fat is slightly more highly saturated than pork fat, but less saturated than lamb fat. All have about the same amount of cholesterol per serving. Beef is an excellent source of B vitamins, including niacin, vitamin B6, and vitamin B12, which is found only in animal foods. Lean beef pro- vides heme iron, the organic iron that is about five times more useful to the body than nonheme iron, the inorganic form of iron found in plant foods. Beef is also an excellent source of zinc. One four-ounce serving of lean broiled sirloin steak has nine grams fat (3.5 g saturated fat), 101 mg cholesterol, 34 g protein, and 3.81 mg iron (21 percent of the R DA for a woman, 46 percent of the R DA for a man). One four-ounce serving of lean roast beef has 16 g fat (6.6 g saturated fat), 92 mg cholesterol, and 2.96 mg iron (16 percent of the R DA for a woman, 37 percent of the R DA for a man).
The Most Nutritious Way to Serve This Food With a food rich in vitamin C. Ascorbic acid increases the absorption of iron from meat. * These values apply to lean cooked beef.
Diets That May Restrict or Exclude This Food Controlled-fat, low-cholesterol diet Low-protein diet (for some forms of kidney disease)
Buying This Food Look for: Fresh, red beef. The fat should be white, not yellow. Choose lean cuts of beef with as little internal marbling (streaks of fat) as possible. The leanest cuts are flank steak and round steak; rib steaks, brisket, and chuck have the most fat. USDA grading, which is determined by the maturity of the animal and marbling in meat, is also a guide to fat content. U.S. prime has more marbling than U.S. choice, which has more marbling than U.S. good. All are equally nutritious; the difference is how tender they are, which depends on how much fat is present. Choose the cut of meat that is right for your recipe. Generally, the cuts from the cen- ter of the animal’s back—the rib, the T-Bone, the porterhouse steaks—are the most tender. They can be cooked by dry heat—broiling, roasting, pan-frying. Cuts from around the legs, the underbelly, and the neck—the shank, the brisket, the round—contain muscles used for movement. They must be tenderized by stewing or boiling, the long, moist cooking methods that break down the connective tissue that makes meat tough.
Storing This Food Refrigerate raw beef immediately, carefully wrapped to prevent its drippings from contami- nating other foods. Refrigeration prolongs the freshness of beef by slowing the natural multi- plication of bacteria on the meat surface. Unchecked, these bacteria will convert proteins and other substances on the surface of the meat to a slimy film and change meat’s sulfur-contain- ing amino acids methionine and cystine into smelly chemicals called mercaptans. When the mercaptans combine with myoglobin, they produce the greenish pigment that gives spoiled meat its characteristic unpleasant appearance. Fresh ground beef, with many surfaces where bacteria can live, should be used within 24 to 48 hours. Other cuts of beef may stay fresh in the refrigerator for three to five days.
Preparing This Food Trim the beef carefully. By judiciously cutting away all visible fat you can significantly reduce the amount of fat and cholesterol in each serving. When you are done, clean all utensils thoroughly with soap and hot water. Wash your cutting board, wood or plastic, with hot water, soap, and a bleach-and-water solution. For ultimate safety in preventing the transfer of microorganisms from the raw meat to other foods, keep one cutting board exclusively for raw meats, fish, and poultry, and a second one for everything else. Finally, don’t forget to wash your hands.
What Happens When You Cook This Food Cooking changes the appearance and flavor of beef, alters nutritional value, makes it safer, and extends its shelf life. Browning meat after you cook it does not “seal in the juices,” but it does change the fla- vor by caramelizing sugars on the surface. Because beef’s only sugars are the small amounts of glycogen in the muscles, we add sugars in marinades or basting liquids that may also con- tain acids (vinegar, lemon juice, wine) to break down muscle fibers and tenderize the meat. (Browning has one minor nutritional drawback. It breaks amino acids on the surface of the meat into smaller compounds that are no longer useful proteins.) When beef is cooked, it loses water and shrinks. Its pigments, which combine with oxygen, are denatured (broken into fragments) by the heat and turn brown, the natural color of well-done meat. At the same time, the fats in the beef are oxidized. Oxidized fats, whether formed in cooking or when the cooked meat is stored in the refrigerator, give cooked meat a character- istic warmed-over flavor. Cooking and storing meat under a blanket of antioxidants—catsup or a gravy made of tomatoes, peppers, and other vitamin C-rich vegetables—reduces the oxidation of fats and the intensity of warmed-over flavor. Meat reheated in a microwave oven also has less warmed-over flavor. An obvious nutritional benefit of cooking is the fact that heat lowers the fat content of beef by liquif ying the fat so it can run off the meat. One concrete example of how well this works comes from a comparison of the fat content in regular and extra-lean ground beef. According to research at the University of Missouri in 1985, both kinds of beef lose mass when cooked, but the lean beef loses water and the regular beef loses fat and cholesterol. Thus, while regular raw ground beef has about three times as much fat (by weight) as raw ground extra-lean beef, their fat varies by only 5 percent after broiling. To reduce the amount of fat in ground beef, heat the beef in a pan until it browns. Then put the beef in a colander, and pour one cup of warm water over the beef. Repeat with a second cup of warm water to rinse away fat melted by heating the beef. Use the ground beef in sauce and other dishes that do not require it to hold together. Finally, cooking makes beef safer by killing Salmonella and other organisms in the meat. As a result, cooking also serves as a natural preservative. According to the USDA, large pieces of fresh beef can be refrigerated for two or three days, then cooked and held safely for another day or two because the heat of cooking has reduced the number of bacteria on the surface of the meat and temporarily interrupted the natural cycle of deterioration.
How Other Kinds of Processing Affect This Food Aging. Hanging fresh meat exposed to the air, in a refrigerated room, reduces the moisture content and shrinks the meat slightly. As the meat ages enzymes break down muscle pro- teins, “tenderizing” the beef. Canning. Canned beef does not develop a warmed-over flavor because the high tempera- tures in canning food and the long cooking process alter proteins in the meat so that they act as antioxidants. Once the can is open, however, the meat should be protected from oxygen that will change the flavor of the beef. Curing. Salt-curing preserves meat through osmosis, the physical reaction in which liquids flow across a membrane, such as the wall of a cell, from a less dense to a more dense solution. The salt or sugar used in curing dissolves in the liquid on the surface of the meat to make a solution that is more dense than the liquid inside the cells of the meat. Water flows out of the meat and out of the cells of any microorganisms living on the meat, killing the microor- ganisms and protecting the meat from bacterial damage. Salt-cured meat is much higher in sodium than fresh meat. Freezing. When you freeze beef, the water inside its cells freezes into sharp ice crystals that can puncture cell membranes. When the beef thaws, moisture (and some of the B vitamins) will leak out through these torn cell walls. The loss of moisture is irreversible, but some of the vitamins can be saved by using the drippings when the meat is cooked. Freezing may also cause freezer burn—dry spots left when moisture evaporates from the surface of the meat. Waxed freezer paper is designed specifically to hold the moisture in meat; plastic wrap and aluminum foil are less effective. NOTE : Commercially prepared beef, which is frozen very quickly at very low temperatures, is less likely to show changes in texture. Irradiation. Irradiation makes meat safer by exposing it to gamma rays, the kind of high- energy ionizing radiation that kills living cells, including bacteria. Irradiation does not change the way meat looks, feels or tastes, or make the food radioactive, but it does alter the structure of some naturally occurring chemicals in beef, breaking molecules apart to form new com- pounds called radiolytic products (R P). About 90 percent of R Ps are also found in nonirradiated foods. The rest, called unique radiolytic products (UR P), are found only in irradiated foods. There is currently no evidence to suggest that UR Ps are harmful; irradiation is an approved technique in more than 37 countries around the world, including the United States. Smoking. Hanging cured or salted meat over an open fire slowly dries the meat, kills micro- organisms on its surface, and gives the meat a rich, “smoky” flavor that varies with the wood used in the fire. Meats smoked over an open fire are exposed to carcinogenic chemicals in the smoke, including a-benzopyrene. Meats treated with “artificial smoke flavoring” are not, since the flavoring is commercially treated to remove tar and a-benzopyrene.
Medical Uses and/or Benefits Treating and/or preventing iron deficiency. Without meat in the diet, it is virtually impossible for an adult woman to meet her iron requirement without supplements. One cooked 3.5- ounce hamburger provides about 2.9 mg iron, 16 percent of the R DA for an adult woman of childbearing age. Possible anti-diabetes activity. CLA may also prevent type 2 diabetes, also called adult-onset diabetes, a non-insulin-dependent form of the disease. At Purdue University, rats bred to develop diabetes spontaneously between eight and 10 weeks of age stayed healthy when given CLA supplements.
Adverse Effects Associated with This Food Increased risk of heart disease. Like other foods from animals, beef contains cholesterol and saturated fats that increase the amount of cholesterol circulating in your blood, raising your risk of heart disease. To reduce the risk of heart disease, the National Cholesterol Education Project recommends following the Step I and Step II diets. The Step I diet provides no more than 30 percent of total daily calories from fat, no more than 10 percent of total daily calories from saturated fat, and no more than 300 mg of cholesterol per day. It is designed for healthy people whose cholesterol is in the range of 200 –239 mg/dL. The Step II diet provides 25– 35 percent of total calories from fat, less than 7 percent of total calories from saturated fat, up to 10 percent of total calories from polyunsaturated fat, up to 20 percent of total calories from monounsaturated fat, and less than 300 mg cho- lesterol per day. This stricter regimen is designed for people who have one or more of the following conditions: • Existing cardiovascular disease • High levels of low-density lipoproteins (LDLs, or “bad” cholesterol) or low levels of high-density lipoproteins (HDLs, or “good” cholesterol) • Obesity • Type 1 diabetes (insulin-dependent diabetes, or diabetes mellitus) • Metabolic syndrome, a.k.a. insulin resistance syndrome, a cluster of risk fac- tors that includes type 2 diabetes (non-insulin-dependent diabetes) Increased risk of some cancers. According the American Institute for Cancer Research, a diet high in red meat (beef, lamb, pork) increases the risk of developing colorectal cancer by 15 percent for every 1.5 ounces over 18 ounces consumed per week. In 2007, the National Can- cer Institute released data from a survey of 500,000 people, ages 50 to 71, who participated in an eight-year A AR P diet and health study identif ying a higher risk of developing cancer of the esophagus, liver, lung, and pancreas among people eating large amounts of red meats and processed meats. Food-borne illness. Improperly cooked meat contaminated with E. coli O157:H7 has been linked to a number of fatalities in several parts of the United States. In addition, meats con- taminated with other bacteria, viruses, or parasites pose special problems for people with a weakened immune system: the very young, the very old, cancer chemotherapy patients, and people with HIV. Cooking meat to an internal temperature of 140°F should destroy Salmo- nella and Campylobacter jejuni; 165°F, the E. coli organism; and 212°F, Listeria monocytogenes. Antibiotic sensitivity. Cattle in the United States are routinely given antibiotics to protect them from infection. By law, the antibiotic treatment must stop three days to several weeks before the animal is slaughtered. Theoretically, the beef should then be free of antibiotic residues, but some people who are sensitive to penicillin or tetracycline may have an allergic reaction to the meat, although this is rare. Antibiotic-resistant Salmonella and toxoplasmosis. Cattle treated with antibiotics may pro- duce meat contaminated with antibiotic-resistant strains of Salmonella, and all raw beef may harbor ordinary Salmonella as well as T. gondii, the parasite that causes toxoplasmosis. Toxoplasmosis is particularly hazardous for pregnant women. It can be passed on to the fetus and may trigger a series of birth defects including blindness and mental retardation. Both Salmonella and the T. gondii can be eliminated by cooking meat thoroughly and washing all utensils, cutting boards, and counters as well as your hands with hot soapy water before touching any other food. Decline in kidney function. Proteins are nitrogen compounds. When metabolized, they yield ammonia, which is excreted through the kidneys. In laborator y animals, a sustained high-protein diet increases the flow of blood through the kidneys, accelerating the natural age-related decline in kidney function. Some experts suggest that this may also occur in human beings.
Food/Drug Interactions Tetracycline antibiotics (demeclocycline [Declomycin], doxycycline [ Vibtamycin], methacycline [Rondomycin], minocycline [Minocin], oxytetracycline [Terramycin], tetracycline [Achromycin V, Panmycin, Sumycin]). Because meat contains iron, which binds tetracyclines into com- pounds the body cannot absorb, it is best to avoid meat for two hours before and after taking one of these antibiotics. Monoamine oxidase (MAO) inhibitors. Meat “tenderized” with papaya or a papain powder can interact with the class of antidepressant drugs known as monoamine oxidase inhibi- tors. Papain meat tenderizers work by breaking up the long chains of protein molecules. One by-product of this process is tyramine, a substance that constructs blood vessels and raises blood pressure. M AO inhibitors inactivate naturally occurring enzymes in your body that metabolize tyramine. If you eat a food such as papain-tenderized meat, which is high in tyramine, while you are taking a M AO inhibitor, you cannot effectively eliminate the tyramine from your body. The result may be a hypertensive crisis. Theophylline. Charcoal-broiled beef appears to reduce the effectiveness of theophylline because the aromatic chemicals produced by burning fat speed up the metabolism of the- ophylline in the liver.... beef
Habitat: Western temperate Himalayas from 2,500 to 4,000 m.
English: American cowslip, Marsh Marigold, Water Buttercup.Folk: Mamiri (Punjab).Family: Theaceae.Habitat: Cultivated in Assam, Darjeeling, Travancore, the Nilgiris, Malabar, Bengal, Dehra Dun and Kumaon.
English: Tea.Unani: Chaai, Shaahi, Shaayi.Siddha/Tamil: Thaeyilai.Action: Stimulant, diuretic, astringent. In China, used for diarrhoea and dysentery (causes gastrointestinal upsets and nervous irritability when consumed in excess). Green tea: anticancer effects have been observed in Chinese green tea, Camellia thea, extract; the extract of Japanese green tea showed antihepatotoxic effects.
Important constituents of leaf buds and very young leaves are: caffeine, with a much smaller amount of other xanthines (theophylline and theo- bromine); tannins (the main tannin in green tea is (-)-epigallocatechin); flavonoids, quercetin, kaempferol. The stimulant and diuretic are due to caffeine content, the astringency due to the tannins.Drinking tea lowers thiamine and thiamine diphosphate losses in urine and blood serum respectively but increases niacin losses. Hot water extract of black tea facilitates Ca absorption in the body experimentally. Tea may decrease zinc bioavailability.The tea, if added to the meal, significantly lower the availability of iron. Milk is as effective as ascorbic acid in countering the depressing effect of tea on iron availability (in vitro).The green tea catechin inhibited car- cinogenesis in small intestines when given during or after carcinogen treatment to experimental rats. (-)-epi- gallocatechin gallate and theaflavin di- gallate from green tea inhibited the in- fectivity of both influenza A and B virus (in vitro).Green tea, when added to a lard- cholesterol diet, decreased the cholesterol and triglyceride levels in fowls. Tea polyphenols exhibit hypocholes- terolaemic activity.Tea polyphenols—(-)-epicatechin gallate, (-)-epigallocatechine galate, theaflavin monogallate A or B, and or theaflavin digallate—are used for treating hyperglycaemia.Saponins from tea are used as an- tiulcer agents.Concurrent use of tea and beta- adrenergic agonists may increase the risk of cardiac arrhythmias. Caffeine, a component of tea, may increase insulin resistance. (Sharon M. Herr.)... camellia sinensisHabitat: Grown in Tamil Nadu, Karnataka and Kerala.
English: Arabian coffee.Unani: Kahvaa.Siddha/Tamil: Kaapi, Bannu.Action: Diuretic, antinarcotic, psychotropic agent, direct heart stimulant (raises blood pressure). Neutralizes therapeutic effects of many herbs; potentiates the action of aspirin and paracetamol; depletes the body of B-vitamins. Charcoal of the outer seed parts—astringent, absorbent.
Key application: Powdered coffee charcoal—in nonspecific, acute diarrhoea; local therapy of mild inflammation of oral and pharyngeal mucosa (average daily dose 9 g). (German Commission E.)According to WHO, coffee drinking is not responsible for breast cancer and may protect against cancer of colon and rectum. Caffeic and chlorogenic acids in coffee act as anticarcinogens.Bronchial asthma is less frequent among coffee drinkers due to caffeine and theophylline.The aroma components include several furfuryl methyl mercaptan derivatives. Coffee extracts yielded organic acids. Atractyloside, several sterols and acids, as well as alkaloids, have been reported. Caffeine is the major alkaloid of coffee. One cup of coffee contains approx. 60-120 mg caffeine; other active constituents include chlorogenic acid, caffeol and diterpenes.Chlorogenic acid in coffee might inhibit glucose-6-phosphatase, which might lower hepatic glucose production caffeine seems to stimulate pancreatic beta cells to secrete insulin. (Natural Medicines Comprehensive Database, 2007.)... coffea arabicaNutritional Profile Energy value (calories per serving): Low Protein: Trace Fat: Trace Saturated fat: None Cholesterol: None Carbohydrates: Trace Fiber: Trace Sodium: Low Major vitamin contribution: None Major mineral contribution: None
About the Nutrients in This Food Coffee beans are roasted seeds from the fruit of the evergreen coffee tree. Like other nuts and seeds, they are high in proteins (11 percent), sucrose and other sugars (8 percent), oils (10 to 15 percent), assorted organic acids (6 percent), B vitamins, iron, and the central nervous system stimulant caffeine (1 to 2 percent). With the exceptions of caffeine, none of these nutrients is found in coffee. Like spinach, rhubarb, and tea, coffee contains oxalic acid (which binds calcium ions into insoluble compounds your body cannot absorb), but this is of no nutritional consequence as long as your diet contains adequate amounts of calcium-rich foods. Coffee’s best known constituent is the methylxanthine central ner- vous system stimulant caffeine. How much caffeine you get in a cup of coffee depends on how the coffee was processed and brewed. Caffeine is Caffeine Content/Coffee Servings Brewed coffee 60 mg/five-ounce cup Brewed/decaffeinated 5 mg/five-ounce cup Espresso 64 mg/one-ounce serving Instant 47 mg/rounded teaspoon
The Most Nutritious Way to Serve This Food In moderation, with high-calcium foods. Like spinach, rhubarb, and tea, coffee has oxalic acid, which binds calcium into insoluble compounds. This will have no important effect as long as you keep your consumption moderate (two to four cups of coffee a day) and your calcium consumption high.
Diets That May Restrict or Exclude This Food Bland diet Gout diet Diet for people with heart disease (regular coffee)
Buying This Food Look for: Ground coffee and coffee beans in tightly sealed, air- and moisture-proof containers. Avoid: Bulk coffees or coffee beans stored in open bins. When coffee is exposed to air, the volatile molecules that give it its distinctive flavor and richness escape, leaving the coffee flavorless and/or bitter.
Storing This Food Store unopened vacuum-packed cans of ground coffee or coffee beans in a cool, dark cabinet—where they will stay fresh for six months to a year. They will lose some flavor in storage, though, because it is impossible to can coffee without trapping some flavor- destroying air inside the can. Once the can or paper sack has been opened, the coffee or beans should be sealed as tight as possible and stored in the refrigerator. Tightly wrapped, refrigerated ground coffee will hold its freshness and flavor for about a week, whole beans for about three weeks. For longer storage, freeze the coffee or beans in an air- and moistureproof container. ( You can brew coffee directly from frozen ground coffee and you can grind frozen beans without thawing them.)
Preparing This Food If you make your coffee with tap water, let the water run for a while to add oxygen. Soft water makes “cleaner”-tasting coffee than mineral-rich hard water. Coffee made with chlorinated water will taste better if you refrigerate the water overnight in a glass (not plastic) bottle so that the chlorine evaporates. Never make coffee with hot tap water or water that has been boiled. Both lack oxygen, which means that your coffee will taste flat. Always brew coffee in a scrupulously clean pot. Each time you make coffee, oils are left on the inside of the pot. If you don’t scrub them off, they will turn rancid and the next pot of coffee you brew will taste bitter. To clean a coffee pot, wash it with detergent, rinse it with water in which you have dissolved a few teaspoons of baking soda, then rinse one more time with boiling water.
What Happens When You Cook This Food In making coffee, your aim is to extract flavorful solids (including coffee oils and sucrose and other sugars) from the ground beans without pulling bitter, astringent tannins along with them. How long you brew the coffee determines how much solid material you extract and how the coffee tastes. The longer the brewing time, the greater the amount of solids extracted. If you brew the coffee long enough to extract more than 30 percent of its solids, you will get bitter compounds along with the flavorful ones. (These will also develop by let- ting coffee sit for a long time after brewing it.) Ordinarily, drip coffee tastes less bitter than percolator coffee because the water in a drip coffeemaker goes through the coffee only once, while the water in the percolator pot is circulated through the coffee several times. To make strong but not bitter coffee, increase the amount of coffee—not the brewing time.
How Other Kinds of Processing Affect This Food Drying. Soluble coffees (freeze-dried, instant) are made by dehydrating concentrated brewed coffee. These coffees are often lower in caffeine than regular ground coffees because caffeine, which dissolves in water, is lost when the coffee is dehydrated. Decaffeinating. Decaffeinated coffee is made with beans from which the caffeine has been extracted, either with an organic solvent (methylene chloride) or with water. How the coffee is decaffeinated has no effect on its taste, but many people prefer water-processed decaf- feinated coffee because it is not a chemically treated food. (Methylene chloride is an animal carcinogen, but the amounts that remain in coffees decaffeinated with methylene chloride are so small that the FDA does not consider them hazardous. The carcinogenic organic sol- vent trichloroethylene [TCE], a chemical that causes liver cancer in laboratory animals, is no longer used to decaffeinate coffee.)
Medical Uses and/or Benefits As a stimulant and mood elevator. Caffeine is a stimulant. It increases alertness and concentra- tion, intensifies muscle responses, quickens heartbeat, and elevates mood. Its effects derive from the fact that its molecular structure is similar to that of adenosine, a natural chemical by-product of normal cell activity. Adenosine is a regular chemical that keeps nerve cell activ- ity within safe limits. When caffeine molecules hook up to sites in the brain when adenosine molecules normally dock, nerve cells continue to fire indiscriminately, producing the jangly feeling sometimes associated with drinking coffee, tea, and other caffeine products. As a rule, it takes five to six hours to metabolize and excrete caffeine from the body. During that time, its effects may vary widely from person to person. Some find its stimu- lation pleasant, even relaxing; others experience restlessness, nervousness, hyperactivity, insomnia, flushing, and upset stomach after as little as one cup a day. It is possible to develop a tolerance for caffeine, so people who drink coffee every day are likely to find it less imme- diately stimulating than those who drink it only once in a while. Changes in blood vessels. Caffeine’s effects on blood vessels depend on site: It dilates coronary and gastrointestinal vessels but constricts blood vessels in your head and may relieve headache, such as migraine, which symptoms include swollen cranial blood vessels. It may also increase pain-free exercise time in patients with angina. However, because it speeds up heartbeat, doc- tors often advise patients with heart disease to avoid caffeinated beverages entirely. As a diuretic. Caffeine is a mild diuretic sometimes included in over-the-counter remedies for premenstrual tension or menstrual discomfort.
Adverse Effects Associated with This Food Stimulation of acid secretion in the stomach. Both regular and decaffeinated coffees increase the secretion of stomach acid, which suggests that the culprit is the oil in coffee, not its caffeine. Elevated blood levels of cholesterol and homocysteine. In the mid-1990s, several studies in the Netherlands and Norway suggested that drinking even moderate amounts of coffee (five cups a day or less) might raise blood levels of cholesterol and homocysteine (by-product of protein metabolism considered an independent risk factor for heart disease), thus increas- ing the risk of cardiovascular disease. Follow-up studies, however, showed the risk limited to drinking unfiltered coffees such as coffee made in a coffee press, or boiled coffees such as Greek, Turkish, or espresso coffee. The unfiltered coffees contain problematic amounts of cafestol and kahweol, two members of a chemical family called diterpenes, which are believed to affect cholesterol and homocysteine levels. Diterpenes are removed by filtering coffee, as in a drip-brew pot. Possible increased risk of miscarriage. Two studies released in 2008 arrived at different conclusions regarding a link between coffee consumption and an increased risk of miscar- riage. The first, at Kaiser Permanente (California), found a higher risk of miscarriage among women consuming even two eight-ounce cups of coffee a day. The second, at Mt. Sinai School of Medicine (New York), found no such link. However, although the authors of the Kaiser Permanente study described it as a “prospective study” (a study in which the research- ers report results that occur after the study begins), in fact nearly two-thirds of the women who suffered a miscarriage miscarried before the study began, thus confusing the results. Increased risk of heartburn /acid reflux. The natural oils in both regular and decaffeinated coffees loosen the lower esophageal sphincter (LES), a muscular valve between the esopha- gus and the stomach. When food is swallowed, the valve opens to let food into the stomach, then closes tightly to keep acidic stomach contents from refluxing (flowing backwards) into the esophagus. If the LES does not close efficiently, the stomach contents reflux and cause heartburn, a burning sensation. Repeated reflux is a risk factor for esophageal cancer. Masking of sleep disorders. Sleep deprivation is a serious problem associated not only with automobile accidents but also with health conditions such as depression and high blood pres- sure. People who rely on the caffeine in a morning cup of coffee to compensate for lack of sleep may put themselves at risk for these disorders. Withdrawal symptoms. Caffeine is a drug for which you develop a tolerance; the more often you use it, the more likely you are to require a larger dose to produce the same effects and the more likely you are to experience withdrawal symptoms (headache, irritation) if you stop using it. The symptoms of coffee-withdrawal can be relieved immediately by drinking a cup of coffee.
Food/Drug Interactions Drugs that make it harder to metabolize caffeine. Some medical drugs slow the body’s metabolism of caffeine, thus increasing its stimulating effect. The list of such drugs includes cimetidine (Tagamet), disulfiram (Antabuse), estrogens, fluoroquinolone antibiotics (e.g., ciprofloxacin, enoxacin, norfloxacin), fluconazole (Diflucan), fluvoxamine (Luvox), mexi- letine (Mexitil), riluzole (R ilutek), terbinafine (Lamisil), and verapamil (Calan). If you are taking one of these medicines, check with your doctor regarding your consumption of caf- feinated beverages. Drugs whose adverse effects increase due to consumption of large amounts of caffeine. This list includes such drugs as metaproterenol (Alupent), clozapine (Clozaril), ephedrine, epinephrine, monoamine oxidase inhibitors, phenylpropanolamine, and theophylline. In addition, suddenly decreasing your caffeine intake may increase blood levels of lithium, a drug used to control mood swings. If you are taking one of these medicines, check with your doctor regarding your consumption of caffeinated beverages. Allopurinol. Coffee and other beverages containing methylxanthine stimulants (caffeine, theophylline, and theobromine) reduce the effectiveness of the antigout drug allopurinol, which is designed to inhibit xanthines. Analgesics. Caffeine strengthens over-the-counter painkillers (acetaminophen, aspirin, and other nonsteroidal anti-inflammatories [NSAIDS] such as ibuprofen and naproxen). But it also makes it more likely that NSAIDS will irritate your stomach lining. Antibiotics. Coffee increases stomach acidity, which reduces the rate at which ampicillin, erythromycin, griseofulvin, penicillin, and tetracyclines are absorbed when they are taken by mouth. (There is no effect when the drugs are administered by injection.) Antiulcer medication. Coffee increases stomach acidity and reduces the effectiveness of nor- mal doses of cimetidine and other antiulcer medication. False-positive test for pheochromocytoma. Pheochromocytoma, a tumor of the adrenal glands, secretes adrenalin, which is converted to VM A (vanillylmandelic acid) by the body and excreted in the urine. Until recently, the test for this tumor measured the levels of VM A in the patient’s urine and coffee, which contains VM A, was eliminated from patients’ diets lest it elevate the level of VM A in the urine, producing a false-positive test result. Today, more finely drawn tests make this unnecessary. Iron supplements. Caffeine binds with iron to form insoluble compounds your body cannot absorb. Ideally, iron supplements and coffee should be taken at least two hours apart. Birth control pills. Using oral contraceptives appears to double the time it takes to eliminate caffeine from the body. Instead of five to six hours, the stimulation of one cup of coffee may last as long as 12 hours. Monoamine oxidase (MAO) inhibitors. Monoamine oxidase inhibitors are drugs used to treat depression. They inactivate naturally occurring enzymes in your body that metabolize tyra- mine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. Caffeine is a substance similar to tyramine. If you consume excessive amounts of a caffeinated beverage such as coffee while you are taking an M AO inhibitor, the result may be a hypertensive crisis. Nonprescription drugs containing caffeine. The caffeine in coffee may add to the stimulant effects of the caffeine in over-the-counter cold remedies, diuretics, pain relievers, stimulants, and weight-control products containing caffeine. Some cold pills contain 30 mg caffeine, some pain relievers 130 mg, and some weight-control products as much as 280 mg caffeine. There are 110 –150 mg caffeine in a five-ounce cup of drip-brewed coffee. Sedatives. The caffeine in coffee may counteract the drowsiness caused by sedative drugs; this may be a boon to people who get sleepy when they take antihistamines. Coffee will not, however, “sober up” people who are experiencing the inebriating effects of alcoholic beverages. Theophylline. Caffeine relaxes the smooth muscle of the bronchi and may intensif y the effects (and/or increase the risk of side effects) of this antiasthmatic drug.... coffee
Nutritional Profile Energy value (calories per serving): Low Protein: Low Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Moderate Sodium: Low Major vitamin contribution: Vitamin A, vitamin C Major mineral contribution: Potassium
About the Nutrients in This Food Grapefruit and ugli fruit (a cross between the grapefruit and the tangerine) have moderate amounts of dietary fiber and, like all citrus fruits, are most prized for their vitamin C. Pink or red grapefruits have moderate amounts of vitamin A. One-half medium (four-inch diameter) pink grapefruit has 1.4 g dietary fiber, 1,187 IU vitamin A (51 percent of the R DA for a woman, 40 percent of the R DA for a man), and 44 mg vitamin C (59 percent of the R DA for a woman, 49 percent of the R DA for a man). One half medium (3.75-inch diameter) white grapefruit has 1.3 g dietary fiber, 39 IU vitamin A (2 percent of the R DA for a woman, 1 percent of the R DA for a man), and 39 mg vitamin C (52 percent of the R DA for a woman, 43 percent of the R DA for a man). Pink and red grapefruits also contain lycopene, a red carotenoid (plant pigment), a strong antioxidant that appears to lower the risk of cancer of the prostate. The richest source of lycopene is cooked tom atoes.
The Most Nutritious Way to Serve This Food Fresh fruit or fresh-squeezed juice.
Buying This Food Look for: Firm fruit that is heavy for its size, which means that it will be juicy. The skin should be thin, smooth, and fine-grained. Most grapefruit have yellow skin that, depending on the variety, may be tinged with red or green. In fact, a slight greenish tint may mean that the grapefruit is high in sugar. Ugli fruit, which looks like misshapen, splotched grapefruit, is yellow with green patches and bumpy skin. Avoid: Grapefruit or ugli fruit with puff y skin or those that feel light for their size; the flesh inside is probably dry and juiceless.
Storing This Food Store grapefruit either at room temperature (for a few days) or in the refrigerator. Refrigerate grapefruit juice in a tightly closed glass bottle with very little air space at the top. As you use up the juice, transfer it to a smaller bottle, again with very little air space at the top. The aim is to prevent the juice from coming into contact with oxygen, which destroys vitamin C. (Most plastic juice bottles are oxygen-permeable.) Properly stored and protected from oxygen, fresh grapefruit juice can hold its vitamin C for several weeks.
Preparing This Food Grapefruit are most flavorful at room temperature, which liberates the aromatic molecules that give them their characteristic scent and taste. Before cutting into the grapefruit, rinse it under cool running water to flush debris off the peel. To section grapefruit, cut a slice from the top, then cut off the peel in strips—starting at the top and going down—or peel it in a spiral fashion. You can remove the bitter white membrane, but some of the vitamin C will go with it. Finally, slice the sections apart. Or you can simply cut the grapefruit in half and scoop out the sections with a curved, serrated grapefruit knife.
What Happens When You Cook This Food Broiling a half grapefruit or poaching grapefruit sections reduces the fruit’s supply of vitamin C, which is heat-sensitive.
How Other Kinds of Processing Affect This Food Commercially prepared juices. How well a commercially prepared juice retains its vitamin C depends on how it is prepared, stored, and packaged. Commercial flash-freezing preserves as much as 95 percent of the vitamin C in fresh grapefruit juices. Canned juice stored in the refrigerator may lose only 2 percent of its vitamin C in three months. Prepared, pasteurized “fresh” juices lose vitamin C because they are sold in plastic bottles or waxed-paper cartons that let oxygen in. Commercially prepared juices are pasteurized to stop the natural enzyme action that would otherwise turn sugars to alcohols. Pasteurization also protects juices from potentially harmful bacterial and mold contamination. Following several deaths attributed to unpas- teurized apple juices containing E. coli O157:H7, the FDA ruled that all fruit and vegetable juices must carry a warning label telling you whether the juice has been pasteurized. Around the year 2000, all juices must be processed to remove or inactivate harmful bacteria.
Medical Uses and/or Benefits Antiscorbutic. All citrus fruits are superb sources of vitamin C, the vitamin that prevents or cures scurvy, the vitamin C-deficiency disease. Increased absorption of supplemental or dietary iron. If you eat foods rich in vitamin C along with iron supplements or foods rich in iron, the vitamin C will enhance your body’s ability to absorb the iron. Wound healing. Your body needs vitamin C in order to convert the amino acid proline into hydroxyproline, an essential ingredient in collagen, the protein needed to form skin, ten- dons, and bones. As a result people with scurvy do not heal quickly, a condition that can be remedied with vitamin C, which cures the scurvy and speeds healing. Whether taking extra vitamin C speeds healing in healthy people remains to be proved. Possible inhibition of virus that causes chronic hepatitis C infection. In Januar y 2008, research- ers at Massachusetts General Hospital Center for Engineering in Medicine (Boston) published a report in the medical journal Hepatology detailing the effect of naringenin, a compound in grapefruit, on the behavior of hepatitis viruses in liver cells. In laborator y studies, naringenin appeared to inhibit the ability of the virus to multiply and/or pass out from the liver cells. To date, there are no studies detailing the effect of naringenin in human beings with hepatitis C.
Adverse Effects Associated with This Food Contact dermatitis. The essential oils in the peel of citrus fruits may cause skin irritation in sensitive people.
Food/Drug Interactions Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and others. Taking aspirin or NSAIDs with acidic foods such as grapefruit may intensif y the drug’s ability to irritate your stomach and cause gastric bleeding. Antihistamines, anticoagulants, benzodiazepines (tranquilizers or sleep medications), calcium channel blockers (blood pressure medication), cyclosporine (immunosuppressant drug used in organ transplants), theophylline (asthma drug). Drinking grapefruit juice with a wide variety of drugs ranging from antihistamines to blood pressure medication appears to reduce the amount of the drug your body metabolizes and eliminates. The “grapefruit effect” was first identified among people taking the antihypertensive drugs felodipine (Plendil) and nifedip- ine (Adalat, Procardia). It is not yet known for certain exactly what the active substance in the juice is. One possibility, however, is bergamottin, a naturally occurring chemical in grapefruit juice known to inactivate cytochrome P450 3A4, a digestive enzyme needed to convert many drugs to water-soluble substances you can flush out of your body. Without an effective supply of cytochrome P450 3A4, the amount of a drug circulating in your body may rise to dangerous levels. Reported side effects include lower blood pressure, increased heart rate, headache, flushing, and lightheadedness. Some Drugs Known to Interact with Grapefruit Juice* Drug Class Generic (Brand name) Antianxiety drug Diazepam ( Valium) Antiarrhythmics Amiodarone (Cordarone) Blood-pressure drugs Felodipine (Plendil), nicardipine (Cardene), nimodipine (Nimotop), nisoldipine (Sular), verapamil ( Verelan) Cholesterol-lowering drugs Atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor), simvastatin/ezetimibe ( Vytorin) Immune Suppressants Cyclosporine (Neoral), tacrolimus (Prograf ) Impotence Drug Sildenafil ( Viagra) Pain Medication Methadone (Dolophine, Methadose) * This list may grow as new research appears.... grapefruit
Habitat: Native to South America; cultivated in some Indian gardens. In northern India, grows in Lucknow.
English: Mate Tea, Yerba Mate. Paraguay Tea.Action: Stimulant to brain and nervous system, mild antispasmod- ic, eliminates uric acid. Used for physical exhaustion, rheumatism, gout and nervous headache. (A national drink of Paraguay and Brazil.) Causes purging and even vomiting in large doses.
Key application: In physical and mental fatigue. (German Commission E, WHO.) In fatigue, nervous depression, psychogenic headache especially from fatigue, rheumatic pains. (The British Herbal Pharmacopoeia.) German Commission E reported analeptic, positively inotropic, positively chronotropic, glycogenolytic, lipolytic and diuretic properties.The leaves contain xanthine derivatives, including caffeine (0.2-2%), theobromine (0.3-00.5%), theophylline (absent in some samples), polyphe- nolics, tannins and chlorogenic acid, vanillin, vitamin C, volatile oil. Used in the same way as tea, due to its caffeine and theobromine content.Mate is a world famous tea and is commonly consumed in several South American countries.The flavour constituents exhibited moderate to weak broad-spectrum antimicrobial activity against several Gram-positive bacteria. Some components are bactericidal, particularly against the most carcinogenic bacteria, Streptococcus mutans.... ilex paraguariensisHabitat: Warmer parts of India, from Central Himalayas to Assam, lower hills of West Bengal; Uttar Pradesh, Andhra Pradesh, Western
Ghats from Konkan southwards to Trivandrum. Often cultivated.English: Indian Long Pepper, Joborandi.Ayurvedic: Pippali, Maagadhi, Maagadha, Maagadhaa, Maagad- hikaa, Magadhodbhavaa, Vaidehi, Upkulyaa, Pippalikam, Chapalaa, Kanaa, Krishnaa. Uushnaa, Shaun- di, Kolaa, Tikshna-tandulaa.Unani: Filfil Daraaz, Daarfilfil.Siddha/Tamil: Thippili, Arisi thippili. Thippiliver (root).Action: Fruits—used for diseases of the respiratory tract (cough, bronchitis, asthma); as sedative (in insomnia and epilepsy); as chola- gogue (in obstruction of bile duct and bladder), as emmenagogue, as digestive, appetizer and carminative (in indigestion); as general tonic and haematinic (in anaemia, chronic fevers and for improving intellect). Applied locally on muscular pains and inflammations.
Several aristolactams and dioxoa- porphines have been isolated from Indian long pepper. It also contains the long chain isobutyl amide, longamide, besides guineensine and the lignans, pluviatilol, methyl pluviatilol (farge- sin), sesamin and asarinine.Piperine is the major alkaloid of peppers.Piperine is antipyretic, hypotensive, analeptic, CNS stimulant. It has been reported to exert significant protection against CCl4-induced hepatotoxicity in mice. It improves drug availability in experimental animals, and is used for enhancing the efficacy of co- administered medicaments.Piperine enhanced bioavailability of hexobarbital, phenytoin, propranolol and theophylline. (Sharon M. Herr.) (Piperine is also a component of Piper nigrum.)N - isobutyl - deca - trans - 2 - trans - 4 - dienamide, isolated from the fruit, exhibited antitubercular property.Milk extract of the fruit effectively reduced passive cutaneous anaphylaxis in rats. It protected guinea-pigs against antigen-induced bronchospasm.In China, Piper longum oil constituents were reported to inhibit the increase in serum total cholesterol induced by triton in mice.The root powder exhibited antifer- tility activity.A related species, P. peepuloides Roxb., is known as Saamvali Peepal. It is used specifically against obstinate skin diseases and as a sialagogue.Dosage: Fruit—1-3 mg (API, Vol. IV); root—1-3 g powder. (CCRAS.)... piper longum
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