More women die from heart disease than from any other cause. In fact, one in four women in the United States dies from heart disease, according to the National Heart, Lung and Blood Institute (NHLBI).

“The risk of heart disease increases for everyone as they age,” says cardiologist Shari Targum, M.D., a medical officer at the Food and Drug Administration (FDA). “For women, the risk goes up after menopause, but younger women can also develop heart disease.”

FDA offers many resources to help educate women of all ages about the safe use of FDA-approved drugs and devices for the treatment and prevention of heart disease. FDA has fact sheets, videos, and other web-based tools on heart disease and conditions like diabetes and high blood pressure that may increase a woman’s risk for heart disease.

FDA created the “Heart Health for Women” site to connect women to FDA resources to support heart-healthy living. Visit the website at: www.fda.gov/womenshearthealth

“I encourage women of all ages to look to FDA for resources to help them reduce their risk for heart disease and make informed decisions about their health,” says Marsha Henderson, director of the Office of Women’s Health at FDA.

Heart Health for Women

When you think about heart disease, you probably imagine heart attacks and chest pain. But women need to know that heart health is about more than just heart attacks. Women need to take steps to reduce their risk for heart disease:

• Manage conditions like diabetes, high blood pressure, and high cholesterol that can increase your risk for heart disease.
• Learn to recognize the symptoms of a heart attack in women, including nausea, anxiety, an ache or feeling of tightness in the chest, and pain in the upper body.
• Use the Nutrition Label to make heart-healthy food choices.
• Daily use of aspirin is not right for everyone. Talk with a health care professional before you use aspirin as a way to prevent heart attacks.
• If you smoke, try to quit. See our booklet to learn more about medicines to help you quit.
• Talk to a health professional about whether you can participate in a clinical trial for a heart medication or procedure. Visit the FDA Patient Network to learn more about clinical trials.

Menopause and Heart Health

“Menopause does not cause heart disease,” says Targum. “But the decline in estrogen after menopause may be one of several factors in the increase in heart disease risk.” Other risks, such as weight gain, may also increase around the time of menopause.

Hormone therapy is used to treat some of the problems women have during menopause. “However, the American Heart Association recommends against using post-menopausal estrogen hormone replacement therapy to prevent heart disease,” says Targum.

Make a Plan, Take Action

Work with your health care team to make a plan for your heart health. Whatever your regimen, make sure to keep a list of your medicines and bring it with you to all of your appointments.

The 100 calorie packs available in most major food markets can be a handy way to maintain snack portion control between meals for kids and adults.

The challenge… read the nutrition label and see what the salt, fat, and carbohydrate intake is in this low calorie snack. It may be 100 calories, but it is not necessarily a healthy snack.

The site, fruits & veggies, more matters, at www.fruitsandveggiesmorematters.org/healthy-weight-management,  issued a 100 calorie list of foods that make for healthy and low calorie snacking. Here are their suggestions:

 100 Calorie Snacks

Tortilla Chips  – 3/4 c

Strawberries –  2 cups

Sliced Peppers –  2 cups

Pretzels –  1 ounce

Muffin  – 1 ounce (1 mini)

Lettuce, shredded -20 cups

Ice Cream (not premium) 3/8 cup

Fresh Blueberries  – 1 1/4 cup

Donut 3/8 –  whole

Cucumbers, sliced  – 7 cups

Chocolate Chip Cookies – 2-2inch cookies

Cherry Tomatoes –  4 cups

Cheese P-Nut Butter Snack Cracker  – 3

Cantaloupe Cubes – 2 cups

Canned Peaches (in juice) – 1 1/2 cup

Bagel –  1/4 of 5 oz. bagel

Baby Carrots – 2 cups

Apple Slices –  2 cups

American Cheese (thin slices) -2 slices

100% Vegetable Juice -2 cups (16 fluid ounces)

100% Orange Juice – 7 fluid oz.

Happy Snacking on 100 Calories!

Given all the concerns about drinking sugary beverages, let’s take a look at who is consuming diet drinks across the U. S.

The following information, posted by the Centers for Disease Control , comes from the National Health and Nutrition Examination Survey, 2009-2010 describes the consumption of diet beverages among the U.S. population during 2009-2010 by sex, age, race and ethnicity, and income, and details trends in diet drink consumption from 1999-2000 through 2009-2010.

About 20% of the U.S. population aged 2 years and over consumed diet drinks on a given day during 2009-2010. The percentage consuming diet drinks was similar for females and males at all ages except among adolescents aged 12-19. The percentage consuming diet drinks increased with age for both males and females. On a given day, about 3% consumed some but no more than 8 fluid ounces (fl oz) of diet drinks, and 11% consumed 16 fluid ounces or more.

Although 15.3% of non-Hispanic white children and adolescents consumed diet drinks, only 6.8% of non-Hispanic black and 7.5% of Hispanic children and adolescents consumed any diet drink on a given day during 2009-2010. Similarly, 27.9% of non-Hispanic white adults consumed any diet drink on a given day compared with 10.1% of non-Hispanic black and 14.1% of Hispanic adults.

The percentage of higher-income persons who consumed diet drinks on a given day was greater than that of lower-income persons. A total of 18.3% of children and adolescents living in households with income at or above 350% of the poverty line consumed diet drinks, compared with 11.5% of those living between 130% and 350% of the poverty line, and 8.0% of those living below 130% of the poverty line. A similar pattern was observed for adults: Although 32.6% of adults living at or above 350% of the poverty line consumed diet drinks, only 20.1% of those living between 130% and 350% of the poverty line, and 12.2% of those living below 130% of the poverty line, consumed diet drinks.

Summary:

Overall, the percentage consuming diet drinks was higher among females compared with males. Diet drink consumption differed by age, race and ethnicity, and income. For example, the percentage of non-Hispanic white children and adults who consumed diet drinks was higher than those for non-Hispanic black and Hispanic children and adults, and the percentage of higher-income persons who consumed diet drinks was higher than that for lower-income persons.

The percentage of females and males who consumed diet drinks increased between 1999 and 2010 and was mirrored by a decrease in consumption of added sugar calories in regular soda over a similar time period. These results suggest that sugar drinks may have been replaced with diet drinks during that time.

Although substituting sugar drinks with diet drinks may promote weight loss in the short term it is unclear if long-term consumption leads to weight loss, weight maintenance, or even weight gain.

Many of us use sugar substitutes on a regular basis. Which ones are the safest?  The following is a Food and Drug Administration (FDA) release on the status of sugar substitutes.

Release…May 19, 2014

Whether it’s to cut down on the number of calories they consume or any of a variety of other reasons, some people use sugar substitutes – also called high-intensity sweeteners – to sweeten and add flavor to their foods. They can be used alone to sweeten foods and beverages such as iced tea or coffee, or as an ingredient in other products. There are a number of sugar substitutes on the market from which to choose.

“Sugar substitutes are called ‘high-intensity’ because small amounts pack a large punch when it comes to sweetness,” says Captain Andrew Zajac, U.S. Public Health Service (USPHS), director of the Division of Petition Review at the Food and Drug Administration (FDA). According to Zajac, unlike sweeteners such as sugar, honey, or molasses, high-intensity sweeteners add few or no calories to the foods they flavor. Also, high-intensity sweeteners generally do not raise blood sugar levels.

The FDA has approved a new high-intensity sweetener called advantame.

Advantame—which does not yet have a brand name (such as Sweet’N Low, a brand name for saccharin, or Equal, a brand name for aspartame)—has been approved as a new food additive for use as a sweetener and flavor enhancer in foods, except meat and poultry.

Examples of uses for which advantame has been approved include baked goods, non-alcoholic beverages (including soft drinks), chewing gum, confections and frostings, frozen desserts, gelatins and puddings, jams and jellies, processed fruits and fruit juices, toppings, and syrups.

How Do You Know it’s  Safe?

FDA is required by law to review all new food additives for safety before they can go on the market. The process begins when a company submits a food additive petition to FDA seeking approval. One exception is for substances “generally recognized as safe,” or GRAS, because those substances are generally recognized by qualified experts as safe under the conditions of intended use and are exempt from the food additive approval process.

Zajac explains that the agency’s scientists thoroughly review all the scientific evidence submitted by a company to ensure the product is safe for the intended use.

“In determining the safety of advantame, FDA reviewed data from 37 animal and human studies designed to identify possible toxic (harmful) effects, including effects on the immune, reproductive and developmental, and nervous systems,” Zajac says.

Advantame is chemically related to aspartame, and certain individuals should avoid or restrict the use of aspartame. To that end, FDA evaluated whether the same individuals should avoid or restrict advantame, as well.

People who have phenylketonuria (PKU), a rare genetic disorder, have a difficult time metabolizing phenylalanine, a component of both aspartame and advantame. Newborns are tested for PKU using a common “heel-prick” test before they leave the hospital.

Foods containing aspartame must bear an information statement for people with PKU alerting them about the presence of phenylalanine. But advantame is much sweeter than aspartame, so only a very small amount needs to be used to reach the same level of sweetness. As a result, foods containing advantame do not need to bear that statement.

Five Sugar Substitutes Already on the Market:

The last high-intensity sweetener approved by FDA was Neotame (brand name Newtame) in 2002. The other four on the market, and are:

• Saccharin, was first discovered and used in 1879, before the current food additive approval process came into effect in 1958. Brand names include Sweet‘N Low

• Aspartame, first approved for use in 1981. Brand names include Equal

• Acesulfame potassium (Ace-K), first approved for use in 1988. Brand names include Sweet One

• Sucralose, first approved for use in 1998. Brand name is Splenda

In addition to the six sugar substitutes ( high-intensity sweeteners) that are FDA-approved as food additives, the agency has received and has not questioned GRAS notices for two types of plant/fruit based high-intensity sweeteners: certain steviol glycosides obtained from the leaves of the stevia plant (Stevia rebaudiana (Bertoni) Bertoni) and extracts obtained from Siraitia grosvenorii Swingle fruit, also known as Luo Han Guo or monk fruit.

While these sugar substitutes (high-intensity sweeteners) are considered safe for their intended uses, certain individuals may have a particular sensitivity or adverse reaction to any food substance. Consumers should share with their health care provider any concerns they have about a negative food reaction.

In addition, FDA encourages consumers to report any adverse events through MedWatch: FDA’s safety information and adverse event reporting program.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

Congress passed the Hunger-Free Kids Act in 2010 with bipartisan support to help ensure every American child had access to the nutrition they need to grow into healthy adults. One goal of the law was to help reduce America’s childhood obesity epidemic and reduce health risks for America’s children by helping schools across the country produce balanced meals so children had access to healthy foods during the school day. USDA based the new school meal standards on independent, expert recommendations from the Institute of Medicine to ensure kids are being fed healthy food while they are at school.

Results of the Healthy-Hunger Free Kids Act school meals provision to date include:

• Kids are eating more fruits and vegetables as a result of updated standards. A recent Harvard study has concluded that, under the updated standards, kids are now eating 16 percent more vegetables and 23 percent more fruit at lunch.
• Over 90 percent of schools report that they are successfully meeting the updated nutrition standards. Students across the country are experiencing a healthier school environment with more nutritious options. The new meals are providing children more whole grains, fruits and vegetables, lean protein and low-fat dairy, as well as less sugar, fat, and sodium.
• School lunch revenue is up. Despite concerns raised about the impact of new standards on participation and costs, a USDA analysis suggests that in the first year of implementing updated meal patterns, schools saw a net nationwide increase in revenue from school lunches of approximately $200 million. This includes the annual reimbursement rate adjustments, as well as increased revenue from paid meals and the additional 6 cents per meal for schools meeting the new meal standards.
• Healthy food standards have not increased food waste. While reducing plate waste at schools, homes and workplaces continues to be a priority for USDA, a recent study by the Harvard School of Public Health showed that new school meal standards did not result in increased food waste.
• Participation is increasing substantially in many areas of the country. USDA has received reports from many schools indicating a positive response to healthier offerings and increased participation. Examples include Los Angeles, Dallas, and some of Florida’s largest school districts. In fact, Los Angeles Unified-one of the nation’s largest school districts-has seen a 14% increase in participation under the new meal standards. As more kids and schools continue to successfully make the transition to the new standards, USDA expects participation to keep climbing.
• HHFKA has led to participation increases within many schools. The Community Eligibility Provision (CEP) under the HHFKA has been successfully implemented in almost 4,000 schools in early adopting States. More than 600 school districts across 11 States have at least one school participating in CEP. The evaluation results demonstrate that participating schools were able to increase participation in their meals programs, and as well as experience revenue gains and decreased administrative costs.
• Virtually all schools continue to participate. Data from states indicated very few schools (only 0.15% of schools nationwide) reported dropping out of the programs due to struggles over providing kids healthy food. State agencies reported that the schools no longer participating in the NSLP were mainly residential child care institutions and smaller schools with very low percentages of children eligible for free and reduced price meals.
• USDA has and will continue to listen to stakeholders and provide guidance and flexibilities, as appropriate, to help schools and students adapt to the updated requirements. Early in the implementation process for school meals, when schools asked for flexibility to serve larger servings of grains and proteins within the overall calorie caps, USDA responded. In January of this year, that flexibility was made permanent. USDA is also phasing other requirements in over the next several years. And hearing schools concerns on the lack of availability of whole grain pasta, USDA is allowing schools that have demonstrated difficulty in obtaining adequate whole grain pasta to use traditional pastas for an additional two years while industry works to create better whole grain pasta products.

• USDA is helping schools encourage kids to choose new healthier options. Most recently, the Department announced $5.5 million in new grants to support Smarter Lunchrooms, a broad toolkit of easy-to-implement, low-cost, evidence-based strategies that increase consumption of healthier foods and decrease plate waste.

• USDA is supporting numerous training sessions in conjunction with our partners to help schools implement the updated meal standards and prepare for Smart Snacks. USDA has completed seven sessions with various audiences since the rule was published, and additional training is planned for the rest of the year. The Department has made in-person trainings at 16 school professional organization meetings and have tree more scheduled this spring and summer.

• USDA is supporting implementation of the updated school meals standards and new Smart Snacks standards through a variety of additional methods.