FOOD FACTS ASIA lssue 32, March 2008

EDITOR - JULIE HOWDENFOOD FACTS ASIA IS PUBLISHED BY FOOD & NUTRITION COMMUNICATIONS CO.,LTD. ON BEHALF OF THE ASIAN FOOD INFORMATION CENTRE

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Meeting When Where Contact

What's Going On?

3rd InternationalFunctional FoodSymposium -Health Benefits ofPlant Polyphenols

Global Agro-Industries Forum:ImprovingCompetitivenessand DevelopmentImpact

5th InternationalCrop ScienceCongress 2008

3rd Asia PacificNutrigenomicsConference 2008:Diet-GeneInteraction inHuman Health andDisease

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April 3-5,2008

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Hong Kong

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C U R R E N T T O P I C S I N F O O D S A F E T Y A N D N U T R I T I O NF O O D F A C T S A S I A I S S U E 3 2 , M a r c h 2 0 0 8

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IN THIS ISSUE

The Secrets to a Longer Life (1) Newsbites (3) Diet and Cancer - What's New? (4)

Obesity - Is HFCS to Blame (6) What's Going On? (8)

w w w . a f i c . o r g

It's a New Year - 2008 and the Chinese Year of the Rat - and many people's thoughts turn to the future. For most of us, that means wishing for a long, healthy and happy life. But what can we do to increase our chances?

In almost every country in the world, the fastest growing population group is the 60 years and over age group. This has been attributed to improved health care, better housing, increased incomes and more nutritious diets. The countries in the world with the greatest life expectances include Japan, Australia, Italy, Greece and Sweden. Japan tops the longevity stakes with a life expectancy of 86 years for women and 79 years for men. The number of people living to be 100 years or more in Japan has increased greatly. In 1963, there were only 153 recorded centenarians in the country while by 2006 the figure had increased to 28,395, of which 85% were women. While there is a genetic factor influencing life expectancy, scientist's estimate that it accounts for only about 30% of the observed differences in longevity rates. So it makes sense to look at diets and lifestyles and see what other factors play a role. The International Union of Nutritional Sciences (IUNS) Subcommittee on Nutrition and Aging and the World Health Organization (WHO) attempted to do just that in 1987. The "Food Habits in Later Life" study looked at 818 subjects aged 70 years and over, in Sweden, Greece, Japan and Australia (the study separated the Australian group into Anglo-Celts and Greeks living in Australia). The subjects were followed for seven years. Information was gathered on dietary habits, lifestyles and general health. The study found that those with a better memory and healthier diet (particularly a "Mediterranean" type diet with an emphasis on fruits and vegetables, fish, legumes, cereals and olive oil) tended to live longer than those who didn't follow a healthy lifestyle. Not surprisingly, smoking was found to significantly shorten the life span. Several other studies in European countries have shown

similar results - no smoking, moderate alcohol, and a healthy lifestyle including a Mediterranean-style diet and exercise - make for a longer and healthier life.

The Secrets to a Longer Life

NEW FROM AFIC Understanding Current Public Perception Trends with Media Research! Have you subscribed to AFICNews? AFICNews is a free monthly e-bulletin, giving the latest information on current food and health news trends across the Asia Pacific region. New version of AFICNews has been launched since January 2008. It features regional food and health related conferences and events, analysis of most frequently reported food safety and nutrition topics in daily press and newswires around the Asian region, and surveys of nutrition and food safety features in lifestyle press in specific Asian countries. If you are not already subscribed, just simply send a blank email to aficnews-subscribe@afic.org.AFIC will update you.

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Why Do We Age? The aging process is thought to be due to the accumulation of free radicals (substances formed as a result of normal body processes) which damage body tissues and DNA. In younger people, this damage is quickly and easily repaired. However, as we get older the damage accumulates resulting in chronic inflammation and irreversible DNA damage. This in turn increases the incidence of age-related conditions such as cancer and heart disease. But it appears that there are steps we can take to reduce the speed of this aging process and increase our chances of blowing out those 100 candles!Studies conducted on rats have shown that lowering energy (calorie) intake can extend the lifespan by 30 per cent. It is thought that fewer calories results in a decrease in the production of free radicals and hence an increase in longevity. Researchers have found lower blood sugar levels, reduced insulin levels and a reduction in the production of free radicals in rats fed low calorie diets. Low calorie diets have also been shown to increase the lifespan of worms, mice and flies and an ongoing experiment in monkeys is showing positive results too.Studies in genetics have also thrown some light on the effects of energy restriction and the aging process. A US study reported that a reduced calorie diet changed the activity of a small number of genes involved in stress response, protein repair and energy production. The activity of these genes usually decreases with age and researchers believe that a reduced calorie diet may delay this reaction and allow the genes to stay intact and active for longer. The evidence to date in humans is indirect and most of the trials have been short term. A US study in overweight people found that those who reduced their calorie intake by 25% for 6 months had reduced fasting insulin levels and a lower body core temperature, both of which are markers associated with longevity in humans. High levels of insulin are known to increase inflammation and oxidative stress, both linked with cell damage and the aging process. In addition, weight loss is known to reduce blood pressure, blood sugar levels, blood cholesterol, the amount of body fat, heart rates and weight, all factors which in turn are linked with a reduction in the risk of a whole host of lifestyle-related disorders linked with an early demise including certain cancers and heart disease. But what about people who are not overweight? Can they expect to live longer if they cut their energy intake? Although studies in this area are lacking, scientists have hypothesized that a lowering of insulin levels and body core temperature as well as effects on gene expression from reduced calorie diets are probably linked with an increased life span. However, caution must be exercised with consumption of a very low calorie diet. The varied risks associated with very low calorie diets include problems with nutrient inadequacy; possible loss of

FOOD FACTS ASIA lssue 32, March 2008 FOOD FACTS ASIA lssue 32, March 2008

Liquids versus SolidsBecause a significant percentage of the increase in HFCS in the US was in the form of sweetened beverages, studies have also looked at the effects of calories taken in liquid form versus those taken as solids on satiety. The evidence is conflicting, probably because satiety is quite a complex area. It depends on many factors including calorie content, energy density (the calories per gram or ml) and how the food or beverage is taken (as a snack or as part of a meal). Some studies have shown that calories taken as solids are more satisfying than those taken in liquid form but other studies have contradicted these findings. Looking specifically at the effect of HFCS on energy intake, a recent study has shown that beverages containing the same number of calories have similar effects on appetite levels. The study (Perrigue et al 2006) compared various beverages of equivalent caloric content and reported that there were no differences in energy intake levels or appetite-related hormone levels between beverages sweetened by HFCS, those sweetened by sucrose or milk when they were taken as part of a meal. The researchers concluded that; "Energy balance consequences of HFCS-sweetened soft drinks are not different from those of other iso-energetic drinks, e.g., a sucrose-drink or milk."

Summing It UpWhile more studies are needed, there is currently no scientific evidence to suggest that HFCS or other sugar sources have a unique effect (other than contributing calories) on obesity. Too many calories from any source can lead to weight gain. That doesn't mean that you should consume unlimited amounts of HFCS or sugar. Just as with most messages on healthy eating - you should enjoy them in moderationas part of a healthy diet.

muscle mass and bone density; and an increased risk of anaemia, memory loss or depression. Additionally, it's not always easy to follow a calorie restricted diet for long periods of time.

The Case of the Okinawans One of the most studied elderly populations is a group of people living on the Japanese island of Okinawa. It is believed that Okinawa has the world's largest number of centenarians (people living over 100 yrs) with 50 people per 100,000 aged over 100 yrs. In most developed countries including the USA, the rate is 10-20 per 100,000. So what do the Okinawans do that helps prolong their lives? They appear to have "better" genes for aging which is thought to account for about one third of their longer life spans. They have a reduced risk of inflammation and autoimmune disease, which is believed to be genetically pre-determined. Yet, when Okinawans moved away from home and migrated and adopted alternative lifestyles, they did not fare as well in the longevity stakes. More recently, lifestyle changes have eroded the average lifespan in Okinawa and this implies that there are probably other factors which contributed to their longevity. One of these is their low saturated fat diet which is high in seafood, seaweed, fruit and vegetables. The other striking factor is that their diet is low in calories, due to a cultural tradition called "hara hachi bu" meaning "eat until you are only 80% full", which is widely practiced in Okinawa. The Okinawans consume 20% fewer calories than the average Japanese diet which in turn is lower than that consumed in most other countries. In effect this means they consume about 500 cals less than the typical 2,000 plus calorie-diet consumed daily by an adult woman in a Western country. Alcohol too is consumed in moderation and regular exercise is an important part of their lives, even when they are very old. The Okinawans are also said to have a psycho-spiritual outlook on life and use meditation and other means to reduce stress. This lifestyle seems to be paying off. In addition to their long life spans, the Okinawans have an 80% lower incidence of cancers such as breast and prostrate cancer when compared to the USA. They also have very a low incidence of heart disease and stroke. The average body mass index (BMI) is just 18-22 and they have low levels of body fat.

Tips for a Longer Life Based on the Okinawan experience, it can be safely said that the aging process is influenced by a variety of genetic, environmental and lifestyle factors. While we can't control for all of these, there are a lot of things we can do to increase our chances of living longer.

Studies using very high doses of fructose have reported that fructose may raise blood triglyceride levels. However the levels used in the study far exceeded those found in the average diet and no studies have been conducted with HFCS. As HFCS has a similar composition to sucrose, it would be expected to have similar metabolic effects. Sucrose has not been shown to raise triglyvceride levels when taken in amounts found in atypical diet. No Direct Link between HFCS and Obesity The theory about the possible link between HFCS intakes and the rising incidence of obesity surfaced because over the past 25 years there has been a significant increase in the use of HFCS in foods in the US. And the ever increasing girths of the American population seemed to mirror this rise. Yet this association doesn't prove cause and effect. Many other factors have changed in the USA over the last 25 years - people are less active, serving sizes have increased and more people are eating out more frequently.Another important point to note in this debate is that the growth in the incidence of overweight and obesity is not confined to the US even though HFCS is not commonly used in other parts of the world. A report from the Center for Food, Nutrition and Agriculture Policy Workshop in 2005 stated, "there is currently no convincing evidence to support a link between HFCS consumption and overweight/obesity".There have been two recent reviews on HFCS and obesity. The findings of the first of these was released in April 2007 ("High Fructose Corn Syrup - Everything you wanted to know and were afraid to ask", Experimental Biology Annual Conference). A second review undertaken by the University of Maryland Center for Food, Nutrition and Agriculture Policy (CFNAP) was published in August 2007. The conclusion reached by both of the reviews is that HFCS and sucrose are chemically similar and that they are metabolized by the body in a similar manner.The reviews looked at the increase in HFCS use in the US food supply. As it was used to replace sucrose, the intake of sucrose fell at the same time. While the combined intake of sucrose and HFCS increased, so too did available energy from fats, oils and grain products. The overall contribution of calorie-contributing sweeteners (sucrose, fructose, honey etc) to total calorie intake in the US has not changed significantly over the last few decades. What has happened is that the total number of calories consumed in the USA has risen while the levels of physical activity have declined. This imbalance in energy intake versus energy expenditure is what is thought to have caused the obesity epidemic. And the excess calories have come from multiple sources - not just HFCS.

Reference: (1.) Hein GL, Storey ML, White JS, Lineback DR. (2005).Highs and lows of high fructose corn syrup: a report from the Center for Food and Nutrition Policy and its Ceres[R] Workshop. Nutrition Today 40 (6):253-256 (2.) Anderson GH. (2007) "Much ado about HFCS in Beverages: the meat of the matter" AJCN, 86(6); 1577-1578 (3.) Forshee et al. (2007). "A critical examination of the evidence relating high fructose corn syrup and weight gain". Critical Reviews in Food Science and Nutrition 47: 561-582. (4.) Perrigue M et al (2006). Hunger and satiety profiles and energy intakes following the ingestion of soft drinks sweetened with sucrose or high fructose corn syrup (HFCS). Proc. Exper. Biol. 2006. Abstract #LB433 (5.) Schorin MD (2006). High Fructose Corn Syrups Part 2: Health Effects. Nutr Today 41(2):70-77 (6.) Melanson et al. (2007). "Effects of high-fructose corn syrup and sucrose consumption on circulating glucose, insulin, leptin, and ghrelin and on appetite in normal-weight women". Nutrition 23: 103-12. (7.) Monsivais et al. (2007). "Sugars and satiety: does the type of sweetener make a difference?". American Journal of Clinical Nutrition 86: 116-123.

Life Expectancies in Selected Countries, 2005(Sourced from WHO World Health Statistics 2007)

Comparison of sugars in various sweeteners

Country Life Expectancy for Men

Life Expectancy for Women

Japan

Australia

Sweden

Italy

Greece

Selected Asian Countries (Alphabetical Order)China

India

Indonesia

Malaysia

Philippines

Republic of Korea

Singapore

Thailand

79

79

79

78

77

71

62

66

69

64

75

78

67

86

84

83

84

82

74

64

69

74

71

82

82

73

What is High Fructose Corn Syrup (HFCS)?HFCS was first introduced to the food supply in the 1970s. It's made from corn starch which is broken down and enzymatically-treated to produce fructose. The fructose is then blended with glucose to achieve the desired ratio of the two sugars. HFCS is composed of either 42 per cent or 55 percent fructose (depending on the type of HFCS and the degree of sweetness required).The name HFCS confuses a lot of people who think that HFCS is high in fructose. In fact, the amount of fructose in HFCS is similar to that in sucrose which is made up of 50 per cent fructose and 50 per cent glucose. (See table below). Both sucrose and HFCS supply 16 kilojoules (or 4 calories) per gram. Sucrose and HFCS differ in their bonding. Sucrose is a disaccharide in which glucose and fructose and joined by a chemical bond whereas the glucose and fructose in HFCS is not bound. Once digested, the two sweeteners appear to be metabolized similarly. HFCS was classif ied as GRAS (General ly Recognised As Safe), by the US Food and Drug Administration in 1983. The FDA reaffirmed this classification in 1996. The sweetener is used in many different foods and beverages in the USA because of its unique properties. While it sweetens foods (the sweetness level is similar to table sugar), it also reduces water activity to inhibit microbial spoilage and helps to extend the shelf life of a product. HFCS helps baked foods brown better and improves the texture of these products. A whole range of food products in the USA, from tomato ketchup to soft drink, from cookies to breads,

have HFCS added. It also helps keep the cost of food production down as it is cheaper than sucrose, the sugar it usually replaces in foods and beverages.

Pure Fructose and HFCS are not the sameA lot of the misunderstanding in this area appears to stem from the confusion between studies using pure fructose and those using HFCS. Fructose is found naturally in fruits, honey, some vegetables, sugar cane and beets. Fructose appears to affect appetite and fullness in a different way to other sugars and it was hypothesized that this effect may increase the risk of obesity.Studies using very high doses of pure fructose (not HFCS) show that fructose appears to lower the levels of the hormones insulin and leptin, (both of which are associated with satiety) and increase the level of ghrelin, a hormone that seems to affect our perception of hunger, when compared to glucose. This led to theories that HFCS could affect normal food intakes leading to increased deposition of fat. However studies on HFCS and sucrose show no differences in the effects of these sweeteners on insulin, leptin or ghrelin even when they are taken at doses much higher than the average intake.

Following are some factors that can help contribute to a longer life:Stay active - exercise not only helps keep body fat levels down, it also keeps the brain active. A US study of 6,000 women aged 65 yrs and above, found that those who were active tended to retain their cognitive function betterthan those who were sedentary. Increased cardiovascularfitness appears to be linked to better brain function.Watch those calories - while a severe reduction in calories is not advised if you are normal weight or underweight, try to concentrate on wholesome foods like fruit, vegetables and whole grains, and aim to keep off those kilos that come creeping up with age. Watch that serving sizes don't get too big and make sure you offset your calorie intake by being active. If you are overweight, it's a good idea to drop the excess kilos through a healthy diet and exercise plan.Load up on fruits and vegetables - the more brightly coloured the better. Fruits and vegetables are rich sources of bioflavenoids and other antioxidants which are known to help neutralise free radicals. They are also low in fatand provide dietary fibre. Aim for a minimum of five servings offruits and vegetables daily and make sure you get lots of variety.

Choose the good fats - studies in populations that live longer in both Europe and Japan, show that their diets tend to be low in saturated fats (the type that raise cholesterol). Instead choose moderate amounts of monounsaturated fats (olive oil, canola oil, fatty fish, nuts, seeds, flax). Choose fish two to three times a week. Get enough sleep - a lack of sleep increases the risk of obesity and it can affect metabolism and hormone production. Aim for 7-8 hours a night. Moderate alcohol - high alcohol intakes are linked to increased body weight and other health issues including certain cancers. If you drink alcohol, limit it to just one to two drinks daily and aim for 1-2 alcohol-free days a week. De-stress - whatever works for you. Meditation, yoga, religion, a simple cup of tea or a walk in a garden. Don't smoke - smoking is linked to an increased riskof cancers, heart disease and stroke.

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FOOD FACTS ASIA lssue 32, March 2008 FOOD FACTS ASIA lssue 32, March 2008

References: (1.) Heilbrann LK et al. JAMA, Apr 5 2006 (2.) Wilcox D et al caloric Restriction and human longevity: what can we learn from the Okinawans? Biogerontology 2006; 7:173-177 (3.) World Health Statistics 2007. World Health Organization. www.who.int (4.) Wahlqvist Ml et al. Does diet matter for survival in long-lived cultures? Asia Pacific J Clin Nutr 2005; 14(1):2-6 (5.) Knoops Kt et al Mediterranean diet, lifestyle factors and 10- year mortality in elderly European men and women: the HALE project. JAMA, 2004; 292(12):1433-9

Obesity - Is HFCS to Blame?

% Sucrose HFCS-42 HFCS-55 Honey

Fructose

Glucose

Others

Moisture

50

50

0

5

42

53

5

29

55

42

3

23

49

43

5

18

(From Hein et al 2005)

N E W S B I T E S

Guidelines for Infant Formula Preparation - the World Health Organization (WHO) in collaboration with the Food and Agriculture Organization (FAO) has produced a set of guidelines for the preparation of infant formula. "The safe preparation, storage and handling of powdered infant formula guidelines" provide advice on the different steps to follow in both a health care and at-home setting to reduce the risk of infants falling ill through inappropriate handling of infant formula. The guidelines are also available in Chinese and can be accessed at www.who.int/foodsafety/publications/micro/pif_guidelines.pdf

Chinese Pagoda Updated - the Chinese Ministry of Health re-launched their healthy eating tool, the Pagoda, on January 15 2008. The revised pagoda now includes recommendations on the importance of physical activity and getting enough fluids.

The startling rise in the levels of obesityaround the world has been blamed on

many factors- sedentary lifestyles,more eating out of home, bigger portion sizes. One hypothesis that surfaced

in the USA was that the rise in overweight was due to

an increase in the intake ofhigh fructose corn syrup (HFCS) a sweetener commonly added

to beverages and foods in the USA in place of sucrose (table sugar).

But the science doesn't support this theory.

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FOOD FACTS ASIA lssue 32, March 2008FOOD FACTS ASIA lssue 32, March 2008

Recommendation 3: Limit consumption of energy-dense foods. What it means: Energy-dense foods are foods that are high in calories. While any food will cause weight gain if we eat too much of it, these foods offer calories but little in the way of additional nutrients so they should be consumed in moderation. Energy-dense foods include cakes, biscuits, pastries, soft drinks, sweetened drinks, confectionary, fried and fast foods. Recommendation 4: Plant foods - fruits, vegetables and grain foodsWhat it means: Aim for 5 servings of fruits and vegetables every day. The more colourful the better - so aim to include a variety of fruits and vegetables - red, green, purple, yellow, orange. Choose high fibre cereals and pulses to increase fibre intakes. And avoid grains or nuts that are spoiled or have not been properly stored as they may be infected by toxins from fungus (aflotoxins) which can cause liver cancer.

Recommendation 5: Animal foodsWhat it means: The WCRF recommendation is to eat no more than 500g of cooked red meat (beef, lamb, pork or goat) a week and to make sure the meat is lean and trimmed of fat. This translates to about 750g of raw meat and is consistent with the Australian National Dietary Guidelines that recommend 3-4 servings of lean red meat a week. The Report recommends that processed meats (such as ham, bacon, salami, frankfurts) should be avoided or taken only occasionally in small amounts. Recommendation 6: Limit alcoholic drinksWhat it means: The recommendation is similar to that of most public health authorities - if alcohol is consumed, men should have no more than two standard drinks a day and women should take no more than one drink a day.Recommendation 7: Watch your salt intake What it means: Salt and foods that are preserved using salt (such as pickled vegetables) are thought to be a cause of stomach cancer so it's best to limit the intake of salt and salty foods. Of particular note for people living in China, the Panel warned against eating Cantonese style salted fish. This fish, which is often given to children, is thought to increase the risk of naso-pharyngeal cancer.

Recommendation 8: Aim to meet nutritional needs through diet aloneWhat it means: You don't need supplements if you are taking a healthy diet. While there are studies suggesting that some supplements may decrease the risk of certain cancers, the evidence is conflicting. A healthy well-rounded diet is the best remedy for cancer prevention.Recommendation 9: BreastfeedingWhat it means: Aim to breastfeed for up to six months.Recommendation 10: Cancer survivors What it means: People who have survived cancer are advised to follow the 9 recommendations given above if possible. The panel noted that there is no evidence to provide any separate recommendations for people who are living with cancer or who have recovered from the condition.

Summing It UpProfessor Jim Mann, Professor of Human Nutrition and Medicine at Otago University, New Zealand, is a member of the expert panel that compiled the WCRF/AICR report. Professor Mann believes that addressing the obesity problem is key to reducing the incidence of cancer. "Obesity and lack of physical activity increase the risk of a whole range of cancers, including some of the commonest cancers we know. Reducing the incidence and prevalence of obesity is an absolutely critical factor in cancer risk reduction," said Professor Mann. He advises that the best protection against cancer requires a balanced eating pattern, including a variety of fruit, vegetables and other foods high in fibre, combined with regular physical activity to promote a healthy body weight.

In December 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) announced an update of their 1997 recommendations for the prevention of cancer with a healthy diet and exercise. So what has changed since the previous recommendations and just what do theguidelines mean for people on a day-to-day basis? More Emphasis on Managing Body Weight Interestingly and perhaps not surprisingly, the recommendations are very similar to the previous set of diet and cancer guidelines (WCRF/AICR Report 1997) and consistent with what most health authorities are recommending for a healthy lifestyle and the prevention of diet-related diseases. The main change is that the revised guidelines have a much heavier emphasis on managing body weight. Compared to the 1997 recommendations, the changes found in the new guidelines include:

Putting It into Practice Here's what the recommendations actually mean for the average person trying to follow a healthy diet. Recommendation 1: Be as lean as possible within the normal range of body weightWhat it means: Children and adolescents should keep a healthy weight throughout childhood and adults should try to avoid that gradual creeping up of the scales that often goes hand-in-hand with increasing age. The BMI (weight in kg /height in metres squared) for a healthy weight is usually 20 - 25. The WCRF report recommends that people aim for a BMI at the lower end of the normal body weight range, say a BMI of 21-23.Recommendation 2: Be physically active as part of everyday lifeWhat it means: Try to be moderately active (this means brisk walking or something similar) for at least 30 minutes a day. Aim to gradually increase the time (up to 60 minutes) or the intensity of exercise and cut back on screen time (TV, computer, and gaming consoles).

- More focus on body weight. The panel found that there was stronger evidence for the link between being overweight or obesity and an increased risk of certain cancers. In fact the first three recommendations of the Report relate to keeping body weight under control and staying active.- More focus on physical activity. The previous report noted a link between colon cancer and physical activity. Further studies in this area have produced convincing evidence that physical activity itself is protective against several types of cancer in addition to playing a key role in the control of body weight.

- A recommendation to breastfeed for up to 6 months has been included in the 2007 guidelines. Breastfeeding helps control body weight in both mothers and infants and also appears to reduce the risk of breast cancer.- A recommendation for cancer survivors (people who are either living with, being treated for or having survived cancer) has been included for the first time. The guideline for this group is to simply follow the recommendations for cancer prevention.- A recommendation to get nutrients from a varied diet and not to rely on supplements.

Diet and Cancer - What's New?

References: (1.) World Cancer Research Fund and the American Institute for Cancer Research. "Food, Nutrition, Physical Activity and the Prevention of Cancer: a global perspective". Washington DC:AICR, 2007

The incidence of cancer in Asia has risen over the past few decades with deaths from cancers overtaking previous causes of mortality as we race to catch up with Western countries. Cancers of the bowel, breast and lung are now all too common. But there is some good news. Scientists now believe that most cancers are caused by external factors, many of which we can control. That means that, in theory at least, many cancers are preventable. So how do we reduce our risk of cancer?

Fruits &

Vegetables