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Food Safety: Packed Lunch

Food Safety and Packed LunchThe featured abstract, from the respected journal, Pediatrics, explores the condition of packed lunches at a pre-school.  There is no reason to think that other school environments are any different.  Despite a parent’s best efforts at keeping a child’s lunch from spoiling and causing food-related illnesses, such incidents still occur because of inattentive food handling at school.  Malevolence is not usually a factor.

The University of Texas initiated a study into the conditions at schools that can lead to food-borne pathogenic illnesses, and found that temperature control is the prime concern.  Ninety percent of kids’ packed lunches reach unsafe zones. Even with multiple ice packs, “…the majority of lunch items…were at unsafe temperatures.”  As is the case with all health-related measures, “Education of parents and the public must be focused on methods of packing lunches that allow the food to remain in the safe temperature zone to prevent foodborne illnesses.”
(Almansour. 2011)

The “danger zone” for foods lies between 40° F. and 140° F.  Therefore, foods kept outside the “zone” are subject to the growth of pathogenic micro-organisms, whether at school, on a picnic, in the backyard, or in the kitchen.  A mantra that has been embraced long ago is that food should not be kept out of refrigeration longer than two hours.  Luncheon meats, smoked meats, and other cured comestibles are not an exception.  If the ambient temperature is higher than 90° F., the limit is one hour.  Unless the classroom has a refrigerator, this is practically impossible to do at school.  Note that the insulated bags we use to pack our kids’ lunches can rebound inside a refrigerator and prevent the cold from getting to the food.

Of course, Mom or Dad has to start with clean ingredients prepared on a clean surface, using clean hands and clean implements.  The CDC holds that only 3% of food contamination can be attributed to the farm.  The other 97% occurs between there and the kitchen.  (Alliance for Food and Farmng.  2010)  Including an ice source is imperative if you know the lunch will be kept at room temperature, such as within a middle-school locker, where teachers have found last month’s French fries after the mephitis rendered the neighboring crowd semi-conscious.  If the timing can be figured out, it’s O.K. to freeze those items that can be frozen without compromising their sensory quality.  Dressings like mayonnaise, and delicate items like tomatoes, are not in this group.  Peanut butter and jelly, and whole fruits and vegetables need not be cold.

If salad ingredients are part of the repast, especially lettuce, it’s vital that they be kept below 39° F. or so, lest they start to show a significant decline in visual quality as well as in safety.  However, even if it looks good, lettuce can harbor and encourage proliferation of E. coli, a dastardly micro-organism with a reputation worse than Blackbeard’s. By the way, this bacterium can thrive even on the pre-washed, ready-to-eat greens you bring directly home from the supermarket.  (Luo. 2010)  Wash them anyway. Plain water works, but a 50-50 mix with hydrogen peroxide can set the mind at ease. Peroxide reverts to plain water after exposure to light and air. That’s why it comes in an opaque brown bottle.

Smaller amounts of food in shallow containers are easiest to handle. You really don’t want to be sorting leftovers after they’ve been on the bus ride home.  Getting the containers back is another story.

References

Pediatrics 2011; 128; peds.2010-2885
Published online August 8, 2011 (doi: 10.1542/peds.2010-2885)
Temperature of Foods Sent by Parents of Preschool-aged Children
Fawaz D. Almansour, MS, Sara J. Sweitzer, PhD, RD, LD, Allison A. Magness, BS, Eric E. Calloway, BS, Michael R. McAllaster, BS, Cynthia R. Roberts-Gray, PhD, Deanna M. Hoelscher, PhD, RD, LD, CNS, Margaret E. Briley, PhD, RD, LD

J Food Sci. 2010 Sep;75(7):M390-7.
Effect of storage temperature and duration on the behavior of Escherichia coli O157:H7 on packaged fresh-cut salad containing romaine and iceberg lettuce.
Luo Y, He Q, McEvoy JL.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Sweet And Large

sweetnersA corned beef special with extra Russian dressing, a side of cole slaw, and a hunk of New York cheese cake for dessert, chased with a Diet Coke. This was pretty common lunchtime fare for a raft of patrons at a local eatery. Were they looking to cut calories? Or was diet soda merely the rage? If these folks were trying to fight the Battle of the Bulge, they chose the losing faction. If marketing diet soft drinks, they joined the pack.

Not too long ago scientists re-examined the effects of artificial sweeteners on human physiology, prompted, it seems, by the obesity epidemic that is sweeping the country and a considerable part of the Western World. It is presumed that eliminating the cause will also eliminate the effect. The cause in this case has multiple personalities, starting with saccharin, the oldest fake sugar, discovered at Johns Hopkins in the late 1870’s…from coal tar. Sounds yummy, right? Yep, a little waterproofing/shampoo in your coffee gets the day off to a running start, and it’ll even treat dandruff and kill lice. In its infancy, saccharin was featured on drug store shelves as a sugar replacement for people with diabetes. It was put into soda in the 1940’s for those who wanted to limit sugar intake, which was ironic because sugar was limited during World War II anyway. Saccharin is 300 times sweeter than table sugar and has a bitter aftertaste. Cyclamate came out in the 30’s, and was blended with saccharin to improve the flavor. Both were GRAS—generally recognized as safe—at first, in the late 50’s. In the late 60’s, however, cyclamate was abandoned by the U.S. as a carcinogen, and saccharin was viewed with suspicion. Other countries allow cyclamates to this day. Saccharin had received a warning label, but that was removed in 2000 by the Sweetness Act. How adorable! In 2010, the EPA took saccharin off its hazardous chemical list. Did you know this stuff is made from toluene, which has limited carcinogenic potential but still is paint thinner?

Aspartame was stumbled upon when Big Pharma was looking to make a new ulcer drug in the mid 1960’s. A combination of the amino acids phenylalanine and aspartic acid linked to a methanol backbone, aspartame is supposed to be avoided by those with phenylketonuria, a rare inherited metabolic disorder that fails to process phenylalanine, leading to mental retardation and other serious problems. Popular reports cite aspartame as causative of seizures and mood changes, an allegation that is still hotly debated (Magnuson, 2007) (Pediatrics, 1997). Its sweetness parallels that of saccharin.

Neotame, a product of Monsanto’s NutraSweet, is 7,000 times sweeter than sugar. That was approved in 2002. It’s the sweetest child on the block. Acesulfame potassium (K) hit the streets in dry foods in the 80’s and as a general sweetener in ’03. But the hot one these days is sucralose–Splenda®. It’s the most popular artificial sweetener, used mostly in soft drinks, but also in some baby foods (Why?).

What’s this got to do with obesity? For starters, the brain doesn’t appreciate being fooled. As soon as it gets the message that something sweet is eaten it initiates the secretion of insulin by the pancreas to start metabolizing glucose. When there is no nutritive entity to provide glucose, the brain makes you hungry enough to get some. You then eat.

Dr. Yanina Pepino and her team of researchers at Washington University School of Medicine found that sucralose is not an inert ingredient, but one that has a definite effect on blood sugar peaks. When subjects drank a sucralose beverage prior to drinking a glucose beverage, their sugar levels rose 20 percent higher than when they drank plain water before the glucose drink. The analysts related this to enhanced insulin and glucose responses caused by the artificial sweetener (Pepino, 2013), possibly leading to insulin resistance. True sweet taste cues serve to regulate energy balance, while non-nutritive sweeteners may promote increased food intake and consequent weight gain (Swithers, 2010).

Sucralose has chlorine groups replacing hydroxide groups in a glucose molecule, making it an organochloride that is related to some pesticides and plastics. It has the capability of lowering intestinal pH, making it acidic and hostile to beneficent colonic bacteria. Even after stopping sucralose, the changed pH may persist (Abou-Donia, 2008). Isn’t chlorine used in swimming pool and bathroom cleaners to kill bacteria?

Before sucralose hit the market, similar investigations focused on then-current artificial sweeteners, aspartame paramount among them. Where a 1986 project found ambiguity concerning appetite signals (Blundell, 1986), later study found that aspartame-sweetened carbonated water increased appetite in the short term (Black, 1993), implying a subsequent intake of excess energy. While the cheesecake crowd was enjoying its low-cal sodas, scientists were already looking at weight management in a highly homogeneous group of middle-aged women, learning that heavier gals were more likely to use non-nutritive sweeteners than their normal weight counterparts, but that, in the long term, artificial sweeteners were not able to prevent weight gain or help weight loss (Stellman, 1986). As with much of what we ingest, dose makes the difference. Those imbibing up to three artificially-sweetened drinks a day appear more likely to risk overweight and obesity than those who consume none (Fowler, 2008). For those who exercise, the difference is insignificant.

So, now, what’s the worry, insulin resistance or weight gain? Being a little overweight doesn’t automatically translate to type 2 diabetes, but it is one of the risk factors. Daily consumption of diet soda was associated with a 36% greater relative risk of metabolic syndrome and a 67% greater risk of incident type 2 diabetes, compared to non-consumption, in a 2009 report from the U of TX (Nettleton, 2009). Whatever the concern might be, fake sugars stir the soup and promote insulin release (Malaisse, 1998). One of the mechanisms involves faking out the brain, not only with renegade appetite signals, but also with altered reward processing of the sweet sensation that rightfully belongs outside the sphere of artificial sweeteners (Green, 2012). As with all heath topics, the debate goes on because some people remain completely unaffected. And we thought that only Superman was bulletproof. The bottom line is that artificial sweeteners do not activate the food reward pathways in the same fashion as natural ones (Smeets, 2005).

References

[No authors listed]
“Inactive” ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs.
Pediatrics. 1997 Feb;99(2):268-78.

Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, McLendon RE, Schiffman SS.
Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats.
J Toxicol Environ Health A. 2008;71(21):1415-29.

Stephen D. Anton, Corby K. Martin, Hongmei Han, Sandra Coulon, William T. Cefalu, Paula Geiselman, Donald A. Williamson
Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels
Appetite 55(1); Aug 2010: 37-43

Black RM, Leiter LA, Anderson GH.
Consuming aspartame with and without taste: differential effects on appetite and food intake of young adult males.
Physiol Behav. 1993 Mar;53(3):459-66.

Blundell JE, Hill AJ.
Paradoxical effects of an intense sweetener (aspartame) on appetite.
Lancet. 1986 May 10;1(8489):1092-3.

Brown RJ, de Banate MA, Rother KI.
Artificial sweeteners: a systematic review of metabolic effects in youth.
Int J Pediatr Obes. 2010 Aug;5(4):305-12.

Brusick D, Borzelleca JF, Gallo M, Williams G, Kille J, Wallace Hayes A, Xavier Pi-Sunyer F, Williams C, Burks W.
Expert panel report on a study of Splenda in male rats.
Regul Toxicol Pharmacol. 2009 Oct;55(1):6-12.

Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP.
Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain.
Obesity (Silver Spring). 2008 Aug;16(8):1894-900.

Green E, Murphy C.
Altered processing of sweet taste in the brain of diet soda drinkers.
Physiol Behav. 2012 Nov 5;107(4):560-7.

Magnuson BA, Burdock GA, Doull J, Kroes RM, Marsh GM, Pariza MW, Spencer PS, Waddell WJ, Walker R, Williams GM.
Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies.
Crit Rev Toxicol. 2007;37(8):629-727.

Malaisse WJ, Vanonderbergen A, Louchami K, Jijakli H, Malaisse-Lagae F.
Effects of artificial sweeteners on insulin release and cationic fluxes in rat pancreatic islets.
Cell Signal. 1998 Nov;10(10):727-33.

Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR Jr.
Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA).
Diabetes Care. 2009 Apr;32(4):688-94

Pepino MY, Tiemann CD, Patterson BW, Wice BM, Klein S.
Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load.
Diabetes Care. 2013 Apr 30.

Rogers PJ, Carlyle JA, Hill AJ, Blundell JE.
Uncoupling sweet taste and calories: comparison of the effects of glucose and three intense sweeteners on hunger and food intake.
Physiol Behav. 1988;43(5):547-52.

Rudenga KJ, Small DM.
Amygdala response to sucrose consumption is inversely related to artificial sweetener use.
Appetite. 2012 Apr;58(2):504-7.

Smeets PA, de Graaf C, Stafleu A, van Osch MJ, van der Grond J.
Functional magnetic resonance imaging of human hypothalamic responses to sweet taste and calories.
Am J Clin Nutr. 2005 Nov;82(5):1011-6.

Stellman SD, Garfinkel L.
Artificial sweetener use and one-year weight change among women.
Prev Med. 1986 Mar;15(2):195-202.

Swithers SE, Martin AA, Davidson TL.
High-intensity sweeteners and energy balance.
Physiol Behav. 2010 Apr 26;100(1):55-62. Epub 2010 Jan 6.

Qing Yang
Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings:Neuroscience 2010
Yale J Biol Med. 2010 June; 83(2): 101–108.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Childhood Success At School

boy-eating-breakfastThe electronic babysitter holds a place of great esteem in modern society, although there are plenty of families who relegate it to the limbo of indifference. That being said, we’ll mention a caution issued by the University of Montreal that admonishes against more than two hours of TV a day for toddlers because of its cumulative negative effects, notably on school readiness. Motor skills and psycho-social skills fall at the hands of PBS and the cable. Physical activity and reading skills falter, and social difficulties, include being bullied, float to the surface. The ability to follow instructions doesn’t improve, either. All this influences performance in kindergarten, which predicts success in later grades (Pagani, 2013). But TV viewing is only one of the variables in a child’s lifestyle that can be controlled. Here is a factor that can’t be blamed on genes and heredity, but can be placed at the feet of nonadaptive parents or guardians.

Two other life experience variables that matter in eventual, and even immediate, school performance are eating and sleeping. In fact, they influence adult life too because wellness behaviors don’t stop at either end of the longevity spectrum. For starters, the brain can’t function the right way with too little fuel…or with the wrong blend. Your everyday sedan might be able to get away with 89-octane. But don’t even think about using that puny formula in a high-performance car that demands 100-octane. The brain is a high-performance, original-equipment-only body part, interchangeable with nothing.

Even though breakfast has been touted as the most important meal of the day, there’s not a whole lot of data to back that up. But what’s lacking in quantity is more than accommodated in quality. Regardless of a chintzy toaster-pastry high-carb breakfast, kids who eat breakfast at all fare better academically than those who skip it. Yeah, the octane is really low, but sputtering and pinging trump sitting in the driveway. Breakfast eaters generally consume more daily calories, yet are less likely to be overweight. Not every breakfast skipper packs on the pounds, though (Rampersaud, 2005). Add a little fiber and some protein to that meal and sit back and watch the action.

In children whose nutritional status is compromised, the effects of breakfast consumption are more dramatic than in those who are nutritionally secure (Hoyland, 2009). This is part of the reason why school breakfast programs were initiated decades ago. It’s not a matter of bleeding heart liberalism, either, because breakfast reduces the amount of vagrant behavior a teacher has to put up with, and increases the volume of measureable education for which the teacher is responsible. In a practical sense, breakfast also improves school attendance, and that can have fiduciary ramifications in many areas.

There’s not much room to address all the vitamins and minerals the body needs to be its best, but consider iron as an ingredient in the recipe for scholastic luster. It’s been accepted that iron deficits high enough to cause anemia put kids at an academic disadvantage, and that iron therapy improves cognitive performance (Taras, 2005). An additional benefit of dietary iron, one that has psycho-social merit, is the improvement in hyperactive, inattentive behavior (Konofal, 2004) (Cortese, 2012). Enriched breakfast cereals, spinach omelets, nuts and seeds, and potatoes are sources of iron. A study at Tufts University found that kids who ate cooked oatmeal (which supplies almost 20% of the iron we need), in contrast to ready-to-eat cereal, displayed enhanced cognitive functioning, especially where visual processing was required. Spatial memory and short-term memory showed remarkable improvements. The compositional variations in cereal proteins, the fiber content and the glycemic scores indicate that what kids eat before school is important (Mahoney, 2005). What’s more, oatmeal provides a slower and more sustained source of energy. Non-heme iron needs vitamin C for assimilation, so that glass of OJ can make a difference. Supplemental vitamin C counts.

Studies on diet and success at school are trans-oceanic. You can find undernourished, stunted, hungry poor performers in other countries, sharing characteristics that can be modified by eating breakfast (Grantham-McGregor, 2005) (Ni, 2010). The only drawback to some school programs is that a handful of people see themselves excused from their obligations. See this story: http://www.washingtonpost.com/wp-dyn/content/article/2009/01/06/AR2009010601195.html?hpid=moreheadlines. Among the obligations is getting the kids to bed at a reasonable hour.

Kids grow when they are horizontal. The major secretion episodes of growth hormones occur soon after the onset of sleep. Disruption in the sleep-wake cycle upsets hypothalamus timing and causes observable neuro-cognitive consequences that affect learning, memory capacity and academic performance (Curcio, 2006). Sleep quality and quantity are closely tied to what happens in school because the prefrontal cortex, the “CEO” of the brain that orchestrates thoughts and actions toward specific goals, is vulnerable to sleep loss.

It’s not uncommon for high-school kids to fall asleep early in the school day. For many teens, school starts too early. Seven hours sleep won’t satisfy the need, and by the third or fourth class of the day, about twenty-five percent of kids are ready to go back to bed. If your teenager snores or grinds his teeth regularly, you might consider a visit to the doctor (Ng, 2009). Sleep deprivation will make kids moody. If they’re old enough to drive, it will increase the risk for an accident, as well. It’s one thing to fall asleep at school; another at the wheel (Carskadon, 2004).

No matter the part of the globe, children sleep more during the off season than during the school year. Still, there are things that affect sleep quantity—parent influence on bedtime, homework and extra-curricular activities, recreation and TV time. The problem is that sleep-wake patterns shift during the second decade of life and most kids get stuck at a certain point (Crowley, 2007) (Wyatt, 2004). Good habits have to start early and remain consistent. That’s where dad and mom enter the scene…maintaining consistency. Of course, a common-sense-but-not-likely-ever-to-happen solution is to start school at a different time. Even exposure to bright light early in the A.M. does little to improve academic performance (Hansen, 2005), but starting school as little as thirty minutes later has been associated with improved motivation, reduction of depressed mood, and measurable increases in academic success (Owens, 2010). Arising early in autumn means the kids have to go to bed early, too (Carskadon, 1998). Kindergarten foreshadows high school (Pagani, 2013). Start ‘em young.

References

Carskadon MA, Wolfson AR, Acebo C, Tzischinsky O, Seifer R.
Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days.
Sleep. 1998 Dec 15;21(8):871-81.

Carskadon MA, Acebo C, Jenni OG.
Regulation of adolescent sleep: implications for behavior.
Ann N Y Acad Sci. 2004 Jun;1021:276-91.

Cortese S, Angriman M, Lecendreux M, Konofal E
Iron and attention deficit/hyperactivity disorder: What is the empirical evidence so far? A systematic review of the literature.
Expert Rev Neurother. 2012 Oct;12(10):1227-40.

Crepinsek MK, Singh A, Bernstein LS, McLaughlin JE.
Dietary effects of universal-free school breakfast: findings from the evaluation of the school breakfast program pilot project.
J Am Diet Assoc. 2006 Nov;106(11):1796-803.

Crowley SJ, Acebo C, Carskadon MA.
Sleep, circadian rhythms, and delayed phase in adolescence.
Sleep Med. 2007 Sep;8(6):602-12.

Curcio G, Ferrara M, De Gennaro L.
Sleep loss, learning capacity and academic performance.
Sleep Med Rev. 2006 Oct;10(5):323-37.

Dubois L, Girard M, Potvin Kent M, Farmer A, Tatone-Tokuda F.
Breakfast skipping is associated with differences in meal patterns, macronutrient intakes and overweight among pre-school children.
Public Health Nutr. 2009 Jan;12(1):19-28

Eliasson A, Eliasson A, King J, Gould B, Eliasson A.
Association of sleep and academic performance.
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Gleason PM, Dodd AH.
School breakfast program but not school lunch program participation is associated with lower body mass index.
J Am Diet Assoc. 2009 Feb;109(2 Suppl):S118-28.

Grantham-McGregor S.
Can the provision of breakfast benefit school performance?
Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S144-58.

Hansen M, Janssen I, Schiff A, Zee PC, Dubocovich ML.
The impact of school daily schedule on adolescent sleep.
Pediatrics. 2005 Jun;115(6):1555-61.

Hoyland A, Dye L, Lawton CL
A systematic review of the effect of breakfast on the cognitive performance of children and adolescents.
Nutr Res Rev. 2009 Dec;22(2):220-43.

Konofal E, Lecendreux M, Arnulf I, Mouren MC
Iron deficiency in children with attention-deficit/hyperactivity disorder.
Arch Pediatr Adolesc Med. 2004 Dec;158(12):1113-5.

Caroline R. Mahoney, Holly A. Taylor, Robin B. Kanarek, Priscilla Samuel
Effect of breakfast composition on cognitive processes in elementary school children
Physiology and behavior. 2005; 85: 635-645

Ng EP, Ng DK, Chan CH.
Sleep duration, wake/sleep symptoms, and academic performance in Hong Kong Secondary School Children.
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Ni Mhurchu C, Turley M, Gorton D, Jiang Y, Michie J, Maddison R, Hattie J.
Effects of a free school breakfast programme on school attendance, achievement, psychosocial function, and nutrition: a stepped wedge cluster randomised trial.
BMC Public Health. 2010 Nov 29;10:738.

Owens JA, Belon K, Moss P.
Impact of delaying school start time on adolescent sleep, mood, and behavior.
Arch Pediatr Adolesc Med. 2010 Jul;164(7):608-14.

Pagani LS, Fitzpatrick C.
Children’s School Readiness: Implications for Eliminating Future Disparities in Health and Education.
Health Educ Behav. 2013 Feb 27.

Pagani LS, Fitzpatrick C, Barnett TA.
Early childhood television viewing and kindergarten entry readiness.
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Rampersaud GC, Pereira MA, Girard BL, Adams J, Metzl JD.
Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents.
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Shenghui Li, Lester Arguelles, Fan Jiang, Wenjuan Chen, Xingming Jin, Chonghuai Yan, Ying Tian, Xiumei Hong, Ceng Qian, Jun Zhang, Xiaobin Wang, and Xiaoming Shen
Sleep, School Performance, and a School-Based Intervention among School-Aged Children: A Sleep Series Study in China
PLoS One. 2013; 8(7): e67928.

Taras H.
Nutrition and student performance at school.
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Van Cauter E, Plat L, Copinschi G.
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Vanelli M, Iovane B, Bernardini A, Chiari G, Errico MK, Gelmetti C, Corchia M, Ruggerini A, Volta E, Rossetti S; Students of the Post-Graduate School of Paediatrics, University of Parma.
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Acta Biomed. 2005 Sep;76(2):79-85.

Wyatt JK.
Delayed sleep phase syndrome: pathophysiology and treatment options.
Sleep. 2004 Sep 15;27(6):1195-203.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.