Asia Pacific Journal of Clinical Nutrition

Volume 12, issue 3 (September 2003)

Includes: IUNS Symposium "North & West African Foods and Health" February, 2003, Marrakech, Morocco

Contents	Abstract	Full text
Dietary intake and anthropometry of Korean elderly people: a literature review. YOUNG-HEE PARK, LISETTE CPGM DE GROOT AND WIJA A VAN STAVEREN Asia Pac J Clin Nutr. 2003;12(3):234-242.	html	pdf
Development of a food frequency questionnaire in Koreans. JEONGSEON KIM, YOUNGJU KIM, YOON-OK AHN, HEE- YOUNG PAIK, YOUNJHIN AHN, YUKO TOKUDOME, NOBUYUKI HAMAJIMA, MANAMI INOUE AND KAZUO TAJIMA Asia Pac J Clin Nutr. 2003;12(3):243-250.	html	pdf
Calibration of a food frequency questionnaire in Koreans. JEONGSEON KIM , YOON-OK AHN, HEE-YOUNG PAIK, NOBUYUKI HAMAJIMA, MANAMI INOUE AND KAZUO TAJIMA Asia Pac J Clin Nutr. 2003;12(3):251-256.	html	pdf
Comparison of a malnutrition screening tool with subjective global assessment in hospitalised patients with cancer - sensitivity and specificity. JUDITH BAUER AND SANDRA CAPRA Asia Pac J Clin Nutr. 2003;12(3):257-260.	html	pdf
Singaporean Chinese adolescents have more subcutaneous adipose tissue than Dutch Caucasians of the same age and body mass index. PAUL DEURENBERG , KALPANA BHASKARAN AND PETRINA LIM KIM LIAN Asia Pac J Clin Nutr. 2003;12(3):261-265.	html	pdf
Secular trend in size at birth of Vietnamese newborns during the last 2 decades (1980-2000). LE T HOP Asia Pac J Clin Nutr. 2003;12(3):266-270.	html	pdf
Prevalence of metabolic syndrome among Filipino adults aged 20 years and over. CELESTE C TANCHOCO, ARSENIA J CRUZ, CHARMAINE A DUANTE AND AUGUSTO D LITONJUA Asia Pac J Clin Nutr. 2003;12(3):271-276.	html	pdf
Changes in glycosylated proteins in diabetic and non-diabetic patients with and without cardiovascular complications. ANJUMAN GUL AND M ATAUR RAHMAN Asia Pac J Clin Nutr. 2003;12(3):277-281.	html	pdf
Effects of phytosterol ester-enriched vegetable oil on plasma lipoproteins in healthy men. SHINJI SEKI, ICHIRO HIDAKA, KEIICHI KOJIMA, HISAKO YOSHINO, TOSHIAKI AOYAMA, MITSUKO OKAZAKI AND KAZUO KONDO Asia Pac J Clin Nutr. 2003;12(3):282-291.	html	pdf
Determination of total antioxidant activity in three types of local vegetables shoots and the cytotoxic effect of their ethanolic extracts against different cancer cell lines. ASMAH RAHMAT, VIJAY KUMAR, LOO MEI FONG, SUSI ENDRINI AND HUZAIMAH ABDULLAH SANI Asia Pac J Clin Nutr. 2003;12(3):292-295.	html	pdf
The factors associated with the belief that vegetarian diets provide health benefits. EMMA LEA AND ANTHONY WORSLEY Asia Pac J Clin Nutr. 2003;12(3):296-303.	html	pdf
IUNS Symposium "North & West African Foods and Health" February, 2003, Marrakech, Morocco
Regional food diversity and human health. MARK L WAHLQVIST Asia Pac J Clin Nutr. 2003;12(3):304-308.	html	pdf
The food of Near East, North West and Western African regions. BARBARA BURLINGAME Asia Pac J Clin Nutr. 2003;12(3):309-312.	html	pdf
Diet and long-term health: an African Diaspora perspective. NOEL W SOLOMONS Asia Pac J Clin Nutr. 2003;12(3):313-330.	html	pdf
Contemporary African food habits and their nutritional and health implications. RUTH ONIANG'O, JOSEPH MUTUKU, S J MALABA Asia Pac J Clin Nutr. 2003;12(3):331-336.	html	pdf
Nutrition-related health patterns in the Middle East. OSMAN GALAL Asia Pac J Clin Nutr. 2003;12(3):337-343.	html	pdf
Northwest African and Middle Eastern food and dietary change of indigenous peoples. HARRIET V KUHNLEIN, TIMOTHY JOHNS AND THE IUNS TASK FORCE ON INDIGENOUS PEOPLES' FOOD SYSTEMS AND NUTRITION Asia Pac J Clin Nutr. 2003;12(3):344-349.	html	pdf
Palm fruit in traditional African food culture. TOLA ATINMO AND AISHAT TAIWO BAKRE Asia Pac J Clin Nutr. 2003;12(3):350-354.	html	pdf
Palm fruit chemistry and nutrition. KALYANA SUNDRAM, RAVIGADEVI SAMBANTHAMURTHI, AND YEW-AI TAN Asia Pac J Clin Nutr. 2003;12(3):355-362.	html	pdf
Phytonutrient deficiency: the place of palm fruit. NAIYANA WATTANAPENPAIBOON Asia Pac J Clin Nutr. 2003;12(3):363-368.	html	pdf
A place for palm fruit oil to eliminate vitamin A deficiency. A J SPINNLER BENADÉ Asia Pac J Clin Nutr. 2003;12(3):369-372.	html	pdf
Alleviation of vitamin A deficiency with palm fruit and its products. NOEL W SOLOMONS AND MÓNICA OROZCO Asia Pac J Clin Nutr. 2003;12(3):373-384.	html	pdf
Report of the IX Asian Congress of Nutrition Asia Pac J Clin Nutr. 2003;12(3):385.		pdf

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Dietary intake and anthropometry of Korean elderly people: a literature review. YOUNG-HEE PARK, LISETTE CPGM DE GROOT AND WIJA A VAN STAVEREN
The health status of elderly people is an important issue in Korea due to the expansion of the elderly population. However, data on their nutritional status are limited. This review aims to give an overview of the dietary intake and anthropometry of Korean elderly people based on studies published, mainly in local journals in Korea. In total 18 studies were reviewed. Mean calcium and vitamin A intakes were inadequate, namely less than 67% of the Korean recommended daily allowances, in all groups of Korean elderly people. The intake of both nutrients was lower in urban elderly with a low income and in rural elderly (200-496 g/day of calcium and 117-281 retinol equivalents/day). In particular, "low income" urban elderly people had a low energy intake (less than 5300 kJ/day) with an inadequate intake of iron, thiamin, riboflavin and niacin in addition to calcium and vitamin A. In urban areas underweight (body mass index < 20 kg/m2) occurred in 7-31% of "all income" groups, whereas it occurred in 15-42% of "low income" groups. Rural elderly people showed a higher proportion of underweight (37% for men and 38% for women) as well as the lowest body mass index (21.0 kg/m2 for men and 21.3 kg/m2 for women). In conclusion, an inadequate intake of several micronutrients in old age, mostly calcium and vitamin A, is a matter of concern in Korea. This was observed most frequently in elderly people with a low income. In this group an inadequate intake of micronutrients is likely to be caused by a low energy intake.
Key words: elderly, Korean, review, nutritional status, dietary intake, anthropometry
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Development of a food frequency questionnaire in Koreans. JEONGSEON KIM, YOUNGJU KIM, YOON-OK AHN, HEE- YOUNG PAIK, YOUNJHIN AHN, YUKO TOKUDOME, NOBUYUKI HAMAJIMA, MANAMI INOUE AND KAZUO TAJIMA
We describe the development of a data-based food frequency questionnaire (FFQ) to determine the relationship between dietary intakes and diseases among Koreans. A total of 224 individuals were recruited to participate in a three-day dietary record survey. In all, 596 food items were consumed. The intakes of 20 nutrients including energy, protein, fat, carbohydrate, vitamins, minerals, and crude fibre were calculated for each food item by multiplying the weight of food consumed by its nutrient content. Some foods, consumed less than five times in a total of three days, were deleted from the preliminary food item list. The number of foods accounting for up to 90 cumulative percentage contribution to nutrient intake was 314. One hundred and seventy seven foods that accounted for up to 0.90 cumulative multiple regression coefficients and 90 cumulative percentage contribution were then selected. By grouping foods, 94 food items were finally included in the questionnaire: Grains and their products (15 food items), potatoes and starch (4), seeds (1), soybean, soybean products and other beans (4), vegetables (22), mushrooms (2), fruits (13), meats (7), eggs (1), fish (7), shellfish (4), other fish (2), seaweed (2), milk and dairy products (4), and beverages (6). Intake frequencies were classified into eight categories. Portion size was determined from food consumption reports in the three-day records. The mean percentage coverage of the 20 nutrient intakes by the developed FFQ was 82.4%. This questionnaire may be useful for ranking diet-related risk factors in Koreans.
Key Words: food frequency questionnaire, FFQ, dietary intake methodology, dietary assessment, dietary records, Koreans
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Calibration of a food frequency questionnaire in Koreans.
JEONGSEON KIM , YOON-OK AHN, HEE-YOUNG PAIK, NOBUYUKI HAMAJIMA, MANAMI INOUE AND KAZUO TAJIMA
The current trend of changes in nutrient intakes may have some relationship with the increase in the occurrence of degenerative diseases in the Korean population. To date, a calibrated food frequency questionnaire (FFQ) has not been developed that can be further used for large-scale epidemiological research in Koreans aged 40 and older. This study was undertaken to develop and calibrate an FFQ in Koreans. A total of 144 Koreans aged 40 years and above participated in the first phase, which was conducted using the three-day dietary record method. One hundred and thirty-eight of those who completed the first phase were then interviewed to test FFQ against dietary records as a reference. The mean absolute nutrient intakes estimated by the dietary records were statistically compared with those estimated by the FFQ using paired t-tests. The mean values from the FFQ differed at most by 14% from those of the dietary records for all nutrients with the exception of vitamin A. Spearman rank-order correlation coefficients and cross-classification were also calculated. The energy-adjusted and corrected correlations for attenuation varied from 0.36 to 0.82. The degree of good agreement by cross-classification between the dietary records and the FFQ ranged from 67% to 90%. The newly developed FFQ can be used as a dietary assessment tool to measure usual nutritional status of Koreans aged 40 years and older. Furthermore, this study demonstrates that the FFQ also provides a more labour-efficient tool that is easier to use than any of the commonly used methods for large-scale epidemiological studies of the relationships between nutrition and diseases in Koreans.
Key Words:: food frequency questionnaire, FFQ, calibration, dietary intake methodology, dietary assessment, dietary records, Koreans
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Comparison of a malnutrition screening tool with subjective global assessment in hospitalised patients with cancer - sensitivity and specificity.
JUDITH BAUER AND SANDRA CAPRA
Malnutrition is common in hospitals and it is important to implement an appropriate nutrition screening tool to identify patients at risk. The aim of the study was to assess the sensitivity and specificity of the malnutrition screening tool developed by the Malnutrition Advisory Group of the British Association of Parenteral and Enteral Nutrition against subjective global assessment in hospitalised patients with cancer. A cross-sectional study assessing the risk of malnutrition and nutritional status of sixty-five hospitalised patients with cancer, aged 56 ± 15 years. According to subjective global assessment, 25 % of patients were well nourished and 75% were malnourished (63% were moderately or suspected of being malnourished and 12% severely malnourished). The malnutrition screening tool had a low sensitivity of 59% and a specificity of 75%. The positive predictive value was 88% and the negative predictive value 38%. There were significant linear trends between subjective global assessment classification and percentage weight loss in the previous six months (P < 0.001) and body mass index (P = 0.007). The malnutrition screening tool developed by the Malnutrition Advisory Group of the British Association of Parenteral and Enteral Nutrition is not a suitable screening tool for detecting risk of malnutrition in hospitalised patients with cancer.
Key Words: nutrition screening, subjective global assessment, nutrition assessment
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Singaporean Chinese adolescents have more subcutaneous adipose tissue than Dutch Caucasians of the same age and body mass index.
PAUL DEURENBERG , KALPANA BHASKARAN AND PETRINA LIM KIM LIAN
Data on weight, height and skinfold thickness (biceps, triceps, subscapular and suprailiac) of 101 Singaporean Chinese adolescents (49 girls and 52 boys), aged 16-18 years, were compared with data of Dutch Caucasians (52 girls, 37 boys) of the same age. Age did not differ between the sexes in each ethnic group or between the ethnic groups within each sex group. The Chinese females were shorter, lighter and had a lower BMI, but the sum (mean ± SD) of four skinfolds was much higher (69.1 ± 15.4 mm) than in Caucasian girls (52.4 ± 17.8 mm). Also, the Chinese boys were shorter and lighter, but their body mass index was not lower compared to Caucasian boys. Their skinfold thickness was, as in girls, much higher compared to Caucasians (48.8 ± 17.0 mm versus 31.1 ± 10.2 mm). After correcting for (non significant) differences in age and skinfold thickness the Chinese adolescent girls had a 3.3 ± 0.4 kg/m2 (mean ± SE) lower body mass index than their Caucasian counterparts. Singapore Chinese boys had a 2.7 ± 0.4 kg/m2 lower body mass index (mean ± SE) than their Caucasian counterparts. Similarly, predicted body fat percent was 5.8 ± 0.6 percent points higher (mean ± SE) in Singapore Chinese girls compared to their Caucasian counterparts of the same age and body mass index. Singapore Chinese boys had 6.0 ± 0.6 percent more body fat percent (mean ± SE) than Caucasians of the same age and body mass index. The data confirm the high body fat percent/low body mass index relationship in Singaporean Chinese as is reported earlier in the literature for adults and children.
Key Words: body composition, subcutaneous body fat, skinfolds, Caucasian, Asian, body mass index, obesity, adolescents, Singaporeans, Dutch
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Secular trend in size at birth of Vietnamese newborns during the last 2 decades (1980-2000). LE T HOP
The aim of the study was to investigate the secular changes in size at birth of Vietnamese newborns, and to determine the relationship between size at birth of the infants and nutritional status of their parents. Length, weight, mid upper arm circumference and head circumference of 586 newborns from the two maternity houses Hoan Kiem and Hai Ba Trung in Hanoi, Vietnam were measured. Information on socioeconomic conditions, health status, weight, and height of the parents were also obtained. There was a significant increase of birth weight (190 g, P=0.008; T-test) and length (1.3 cm, P=0.001; T-test) of Vietnamese newborns compared to those of newborns of the 1980's (1980-1984). There was a positive secular trend in parent's height and weight after a period of one and a half decades (height and weight increase of mothers: 2.6 kg and 1.9 cm, respectively; height and weight increase of fathers: 4.5 kg and 1.6 cm, respectively). The data showed that the birth weight of infants in the Capital of Vietnam have caught up with those of infants from richer societies in the Northern hemisphere.
Key Words: secular trends, newborns, birth weight, birth length, head circumference, Hanoi, Vietnam

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Prevalence of metabolic syndrome among Filipino adults aged 20 years and over. CELESTE C TANCHOCO, ARSENIA J CRUZ, CHARMAINE A DUANTE AND AUGUSTO D LITONJUA
This study sought to determine the prevalence of metabolic syndrome, using data collected from 4,541 adults aged 20 years and over covered in the Fifth National Nutrition Survey conducted in 1998. The metabolic variables ana-lyzed were: total cholesterol, LDL-c, HDL-c, triglycerides and fasting blood glucose. In addition, measurements of obesity such as body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC) as well as blood pressure were taken. Comparing the mean metabolic characteristics of the non-obese, total obese and the android obese, results showed significant differences in almost all the variables except for the HDL-c. By gender, non-significant differences were observed between males and females in the non-obese group in terms of the BMI and glucose levels and in the android group, in terms of total cholesterol. In all three groups, the biggest difference was observed in the mean triglycerides, where males had significantly higher mean than the females. Comparing adults with >125 mg/dl fasting blood sugar (FBS) there were higher rates of hypertension, high waist-to-hip ratio (WHR), high cholesterol, high triglycerides, high LDL-c, low HDL-c, among the overweight and obese than among those with normal BMI. In general, the proportion of subjects with co-morbid factors increased with higher levels of FBS, except for high cholesterol wherein no pattern was established. The highest prevalence of high FBS was found in both males (35.8%) and females (14.5%) with the following combined characteristics: high BMI, high WHR and high WC. Males with co-existing high BMI, high WHR, and high WC were observed to have the highest prevalence rate of hypertension (66.5%). Among females, the highest prevalence rate of hypertension (37.9%) was seen among those with high fasting blood sugar. The proportion of subjects with hypertension generally increased with age irrespective of the BMI status. One of the significant correlates of high FBS is waist-hip ratio. Males with WHR of equal or greater than 1 have almost six times the risk of having high FBS, while females with WHR of equal or greater than 0.85 have five times the risk of having high FBS compared to those with normal WHR. Among females with triglyceride levels of equal or greater than 200 mg/dL, the risk of having high FBS is five times compared to those with triglyceride levels below 200 mg/dL. Univariate analysis to see the effect of the type of obesity to dyslipidaemia and hypertension revealed that females with high waist circumference generally provided greater risk compared to those who were overweight and obese as well as those with android obesity. For males, high waist circumference had greater risk of developing high triglyceride and high LDL-c. Android obese males had greater risk to high FBS. The results showed that the prevalence rate of metabolic syndrome is 0.28%, based on the number of individuals with the following characteristics: high FBS, hypertensive, android obese, with body mass index (BMI) of > 25.0 and high WC. Females had a higher rate than males - almost twice. Considering that metabolic syndrome, with its co-morbidity factors is prevalent among some Filipino adults aged 20 years and over, it is recommended that health programs geared towards minimizing the morbid risk factors be properly developed, promoted and fully implemented.
Key Words: obesity, abdominal fat, blood pressure, blood glucose, blood lipids, hyperlipidaemia, physical activity, Philippines, National Nutrition Survey, metabolic syndrome.

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Changes in glycosylated proteins in diabetic and non-diabetic patients with and without cardiovascular complications. ANJUMAN GUL AND M ATAUR RAHMAN
The objective of this study was to find the changes in glycoprotein composition in both diabetic and non-diabetic patients with and without cardiovascular complications. The study was carried out in Ziauddin Medical University Karachi, Pakistan. Eighty-three patients and control subjects were selected. Among them twenty-one were diabetic patients without any clinical evidence of chronic diabetic complications, twenty-one were diabetic patients with cardiovascular complications, twenty were non-diabetic patients with cardiovascular complications and twenty-one apparently normal, age, sex and weight matched control subjects were investigated. All these patients were selected on clinical grounds from National Institute of Cardiovascular Disease, Karachi. Fasting plasma glucose was increased in all diabetic patients and correlated significantly with and without cardiovascular complications. Fasting plasma glucose, glycosylated haemoglobin, glycosylated plasma proteins, serum fructo-samine, sialic acid, hexosamine and total serum protein and its fractions were increased in diabetic patients with and without cardiovascular complications. Fasting plasma glucose, glycosylated haemoglobin, glycosylated plasma proteins, serum fructosamine, sialic acid and hexosamine were not different in diabetic patients with cardiovascular complications and diabetic patients without chronic complications as compared with control subjects. In conclusion, fasting plasma glucose, glycosylated haemoglobin, glycosylated plasma proteins, serum fructosamine, sialic acid, hexosamine and total serum proteins and its fractions were increased in diabetic patients with and without complications, but these parameters remained within normal limits in non-diabetic patients with cardiovascular complications.
Key Words: fasting plasma glucose, glycosylated haemoglobin, glycosylated plasma proteins, serum fructosamine, sialic acid, hexosamine, total serum protein, non-diabetic patients with cardiovascular complications, diabetic patients with cardiovascular complications, Karachi, Pakistan.
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Effects of phytosterol ester-enriched vegetable oil on plasma lipoproteins in healthy men. SHINJI SEKI, ICHIRO HIDAKA, KEIICHI KOJIMA, HISAKO YOSHINO, TOSHIAKI AOYAMA, MITSUKO OKAZAKI AND KAZUO KONDO
It has been reported that phytosterol esters reduce cholesterol absorption and lower serum cholesterol concentration. There have been very few studies published on the effect of dose of phytosterol esters less than 1.0 g/day on plasma cholesterol levels in healthy subjects using commonly consumed foods. In this study, we evaluated the effect of 0.45 g/day (as free sterol) phytosterol ester-enriched dissolved in vegetable oil on plasma lipoproteins in sixty healthy males with slightly elevated total cholesterol concentration. This study was conducted in a randomized, double-blind, placebo-controlled, and arm parallel study. A total of 14 g /day of phytosterol ester-enriched vegetable oil containing 0.45g phytosterol (as the major free sterol) was compared with a control vegetable oil containing 0.04 g phytosterol (as the major free sterol). All subjects did not change their usual dietary habit and consumed foods that included about 360 mg/day cholesterol for 12 weeks. In subjects with higher total cholesterol concentrations (>200mg/dL), the phytosterol enriched-vegetable oil significantly reduced total cholesterol (10.3%, P<0.05), very low density (VLDL) lipoprotein cholesterol (22.5%, P<0.05), and remnant-like lipoprotein (RLP) cholesterol (24.7%, P<0.01) compared with the control vegetable oil. A reduction in low density lipoprotein (LDL) cholesterol concentration was also observed. In particular, the improvement in serum lipoprotein was more pronounced in subjects with higher total cholesterol concentrations. Triglycerides and high density lipoprotein (HDL) cholesterol did not change significantly. Plasma concentration of fat-soluble vitamins (tocopherol and retinol) and ß-carotene were not statistically significantly affected by phytosterol ester-enriched vegetable oil. These findings indicate that a daily consumption of phytosterol ester as low as 0.45 g/day (as free sterol) is effective in lowering blood total cholesterol concentration and RLP cholesterol concentration. Lower total cholesterol, VLDL cholesterol and RLP cholesterol due to consumption of the phytosterol ester-enriched vegetable oil may be helpful in reducing the risk of CHD in the population.
Key Words:phytosterols, phytosterol ester, plant sterols, sterols, vegetable oil, cholesterol, lipoprotein, apolipoprotein.
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Determination of total antioxidant activity in three types of local vegetables shoots and the cytotoxic effect of their ethanolic extracts against different cancer cell lines. ASMAH RAHMAT, VIJAY KUMAR, LOO MEI FONG, SUSI ENDRINI AND HUZAIMAH ABDULLAH SANI
Antioxidants play an important role in inhibiting and scavenging radicals, thus providing protection to humans against infections and degenerative diseases. Literature shows that the antioxidant activity is high on herbal and vegetable plants. Realizing the fact, this research was carried out to determine total antioxidant activity and the potential anticancer properties in three types of selected local vegetable shoots such as Diplazium esculentum (paku shoot), Manihot utillissima (tapioca shoot) and Sauropous androgynus (cekur manis). The research was also done to determine the effect of boiling, on total antioxidant activity whereby samples of fresh shoots are compared with samples of boiled shoots. In every case, antioxidant activity is compared to alpha-tocopherol and two methods of extraction used are the organic and the aqueous methods. Besides that, two research methods used were the ferric thiocyanate (FTC) and thiobarbituric acid (TBA) with absorbance of 500nm and 532nm respectively. Oneway ANOVA test at P < 0.05 determines significant differences between various samples. In the cytotoxic study, the ethanolic extract and several cell lines i.e. breast cancer (MDA-MB-231 and MCF-7), colon cancer (Caco-2), liver cancer (HepG2) and normal liver (Chang liver) were used. The IC50-value was determined by using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay. The antioxidant study found that all the samples in both aqueous and organic extraction were significantly different. The total antioxidant activity values of aqueous extract in descending order are as follows : M. utilissima (fresh) > D. esculentum (fresh) > S.androgynus (fresh) > M.utilissima (boiled) > D. esculentum (boiled) > S.androgynus (boiled). It also was found that S.androgynus shoots ethanolic extract was able to inhibit the viability of the breast cancer cell lines, MDA-MB-231 with the IC50 value of 53.33 mg/ml. However, S.androgynus shoots and D. esculentum shoots ethanolic extracts did not inhibit the viability of MDA-MB-231 cell line. While, the tapioca shoot ethanolic extract was able to inhibit the viability of MCF-7 cell line with the IC50 value of 52.49 mg/ml. S.androgynus shoots and D.esculentum shoots ethanolic extracts did not give an IC50 value against the MCF-7 cell line. S.androgynus, tapioca and D.esculentum shoots ethanolic extracts did not show cytotoxic effect against the Caco-2 and HepG2. There was no IC50-value from any sample against Chang Liver cell line. In conclusion, the antioxidant activity of both fresh and boiled samples were higher than alpha-tocopherol, although fresh vegetable shoots were found to be higher in antioxidant activity compared to boiled shoots. This study also suggested that S.androgynus shoots and tapioca shoots have potential as an anticancer agent against certain breast tumours.
Key words: antioxidant vegetables, shoots, paku shoot Diplazium esculentum, tapioca Manihot utillissima, cekur manis Sauropous androgynus, cytotoxic, cancer, breast, colon, liver, Malaysia, tropics

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The factors associated with the belief that vegetarian diets provide health benefits. EMMA LEA AND ANTHONY WORSLEY
The aim of this paper is to examine the factors associated with the belief that vegetarian diets provide health benefits. A random population mail survey about food choice was conducted among a sample of 1000 South Australians. An additional (non-random) survey of 106 vegetarians and semi-vegetarians was also conducted, giving a total of 707 participants from both samples. The main predictors of the belief that vegetarian diets provide health benefits for all respondents were found to be the belief that meat is neither healthy nor necessary and frequent searching for information on healthy eating. However, there were differences between vegetarians, non-vegetarians and semi-vegetarians. In particular, health issues were relatively more important for semi-vegetarians and vegetarians, while knowledge and convenience issues were most important for non-vegetarians. The results have important implications for public health. Many South Australians perceive that health benefits are associated with eating a vegetarian diet, which may also apply to plant-based diets in general. However, if non-vegetarians are to obtain some of the health benefits associated with the consumption of a plant-based diet, they require information on the preparation of quick and easy plant- based meals.
Key Words: beliefs, vegetarian, plant-based diets, meat, health, survey, Australia
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Regional food diversity and human health. MARK L WAHLQVIST
Regions are significant for the way we understand and strategize food for health and economic development. They generally represent various food cultures and opportunities for food exchange based on proximity, historical linkages and complementarities. The example of North and West Africa represents an intersection of some of the most original of human eating experiences out of Africa and the enrichment of these by Arab traders, through the exchange of products, ideas, observations, beliefs and technologies. All of these will have encouraged diversity in food intake. However food diversity and, with it, biodiversity may not always have been recognized as important, and, therefore, secured and protected. Ultimately, food diversity cannot be sustained unless the food chain and the technologies to support it are environmentally appropriate. Cooking, without renewable energy sources, is a critical example. Additionally, human settlement has always required an adequate, a dependable and a safe water supply, although this same settlement tends to compromise these water characteristics. Water is a major factor in food diversity, whether as a source of aquatic food, or the basis of food production and preparation. The extent to which food diversity for human health is required will depend on the food component (essential nutrient and phytochemical) density of the foods represented. For example, fish, fresh lean meat, eggs and seed foods (grains, pulses, nuts) will reduce the requirement. Regional food diversity can support food diversity at the community level - where otherwise it might be fragile - by shared learning experiences, and by trade. Diversity can also be captured and enshrined in recipes with composite ingredients and by traditional emblematic foods - like soups and pies; and it provides the basis for food culture and cuisine. The evidence for food diversity (or variety) as a major factor in health has grown substantially over the last few years - as integrative indices of health like "maternal nutrition" and "successful pregnancy" (for example, through the inclusion of a variety of food sources of folate, increasing the bioavailability of iron, and the sustainable intakes of quality food protein and essential fatty acids); "adult mortality rates"; other "specific disease incidences" (like cancer, cardiovascular disease, diabetes and bone health) for "risk factors for disease" (like hypertension and abdominal fatness); and for "wellbeing" (palatable, enjoying and neurologically relevant food stuffs). Thus, there is an ongoing need to promote and maintain food diversity at the regional level and between communities.
Key Words: food diversity, biodiversity, regions, nutrition, health, water, community, Africa, literacy, women
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The food of Near East, North West and Western African regions.
BARBARA BURLINGAME
Among the countries that can be classified as Near East Africa, North West Africa, and Western Africa, there is a great diversity of foods and dietary patterns. Prevalence of undernourishment as defined by FAO using dietary energy supply data, varies dramatically among these countries, with Tunisia in the lowest prevalence category (<2.5%), and Sierra Leone in the highest prevalence category (>35%). Throughout the 1960's, the dietary energy supply of North West African and Western African countries was similar. However, since the 1970s a great and consistent improvement has been seen in North and North West African countries. Both the proportion and number of undernourished in North Africa is now very similar to that of North America. Oil use, energy from fat, and protein from plant versus animal sources account for a large part of the food pattern differences between countries in these regions. Using Tunisia and Sierra Leone as examples again, dietary diversity as measured by the percentage of energy from foods other than starchy staples, is about 50% in the former, while in the latter, it is only 36%. Fatty fruits such as olives, cocoa and palm fruit have a special role in both the diet and the economies of the region.
Key Words: food, fatty fruit, palm fruit, food supply, energy intake, diet, Africa
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Diet and long-term health: an African Diaspora perspective.
NOEL W SOLOMONS
The life-stage approach, which views the behaviours and exposures of an individual from the preconceptual situation of the parent through pregnancy, infancy, childhood and adolescence, and into the advancing years through adulthood, is the basis of analysis of strategies to improve long-term health. Among the behaviours of note is the dietary selection pattern, conditioning our exposure to nutrients and dietary constituents that influences growth, nutriture, cognitive and physical performance, and disease resistance and susceptibility. The African Diaspora created a population displaced from Africa to the Western Hemisphere as part of the African slave trade from the 16th to 18th centuries. It continues to manifest distinct dietary and lifestyle practices in the context of a health experience that is different both from the population in their African countries of origin and from the other ethnicities in their countries of displacement and current residence. Afro-Americans are more susceptible to a series of diseases and conditions including low birth weight, violence, and HIV/AIDS, as well as the non-communicable diseases: obesity, diabetes mellitus, cardiovascular disease, hypertension, stroke, renal failure, breast cancer, prostate cancer and lead poisoning. The differential nature of dietary practices are conditioned at times by the poverty and marginalisation of the populace, resulting in either disadvantageous or beneficial outcomes relative to others' eating habits. Serious consideration must be given to the possibility that ethnic difference give rise to different requirements and tolerances for essential nutrients and distinct protective or adverse responses to foods and dietary substances. The major challenges to health improvement for the African Diaspora is coming to grips with the policy and programmatic nuances of differential treatment and the effecting the behavioural changes that would be needed in a population skeptical of the motives of media and of the power elites of their societies.
Key Words: Africa, Caribbean, Africa-American, diet, long-term health, chronic diseases, discrimination, energy metabolism
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Contemporary African food habits and their nutritional and health implications. RUTH ONIANG'O, JOSEPH MUTUKU, S J MALABA
Food is fundamental to human survival, in more than just one way. First, food is basic for averting hunger and maintaining health for every human being. Secondly, food satisfies our palate and makes us happy and emotion-ally and socially content. Third, food constitutes a form of cultural expression. The food we eat should be safe, palatable, affordable, and of the quality that can maintain mental, emotional, physiologic and physical health. Even with globalization that has seen food movements to and from different parts of the world, for most populations in Africa, food is still very locale-specific, especially in the rural farming areas where it is produced. Many locally produced foods have both nutritional and intrinsic value. The types of foods produced in Western Africa are very different from those produced in Eastern Africa. The staple foods, vegetables and the drinks that go with these foods are different. The way food is prepared is also very different in the two parts of Africa. Cultural specificity appears to be more pronounced in Western Africa, involving more secondary processing in the home and more spicing. Data linking food to health, as something that is understood by traditional communities is not easily available. This paper will collate information that discusses people's perceptions in both Western and Eastern Africa, and try to draw comparisons between the two. The paper presents a community picture of food, nutrition and health.
Key Words: food habits, familiar food, dietary energy supply, meal frequency, traditional diets, dietary practices, culture, staples, Africa.
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Nutrition-related health patterns in the Middle East. OSMAN GALAL
Nutritionally-related health patterns in the Middle East have changed significantly during the last two decades. The main forces that have contributed to these changes are the rapid changes in the demographic characteristics of the region, speedy urbanization, and social development in the absence of steady and significant economic growth. Within these changes, the Middle East has the highest dietary energy surplus of the developing countries. The population in the region has a low poverty prevalence, at 4%. The region's child malnutrition rate is 19%, suggesting that nutrition insecurity remains a problem due mainly to poor health care and not due to inadequate dietary energy supply or poverty. The one extreme country, Afghanistan, has an extremely high dietary energy deficit of 490 kilocalories and a 40% malnutrition rate. Iran and Egypt have relatively high child malnutrition rates of 39 and 16% respectively, but belong to the dietary energy surplus group. Morocco and the United Emirates have the lowest child malnutrition rates of 6 and 8% respectively. In the Middle East, as in other parts of the world, large shifts have occurred in dietary and physical activity patterns. These changes are reflected in nutritional and health outcomes. Rising obesity rates and high levels of chronic and degenerative diseases are observed. These pressing factors that include the nature and changes in the food consumption pattern, globalization of food supply, and the inequity in health care will be discussed.
Key Words: Middle East, food security, nutrition transition, health, Middle East, Egypt
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Northwest African and Middle Eastern food and dietary change of indigenous peoples. HARRIET V KUHNLEIN, TIMOTHY JOHNS AND THE IUNS TASK FORCE ON INDIGENOUS PEOPLES' FOOD SYSTEMS AND NUTRITION
This paper describes cultural and ecological characteristics of Northwest African and Middle Eastern food patterns and discusses the forces contributing to rapid dietary change. Focus is given to indigenous/ tribal/ ethnic/ minorities in these areas with contributions to definitions of these groups, the extent of their diversity, and the importance of their traditional knowledge of local food resources. Urbanization, particularly for those facing extreme poverty in the urban environment, is recognized as a significant force to dietary change and consequent poor nutrition, especially for children. Examples of food systems are given for the coastal zone of West Africa and the semi-arid and desert zones of North Africa and the Middle East, also including the food system of Pharaonic times. Trends in dietary change are presented as data derived from FAO Food Balance Sheets.Key Words: food habits, familiar food, dietary energy supply, meal frequency, traditional diets, dietary practices, culture, staples, Africa.
Key Words: indigenous peoples, tribal peoples, ethnic minorities, indigenous food, Northwest Africa, Middle East, dietary change, traditional food systems
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Palm fruit in traditional African food culture. TOLA ATINMO AND AISHAT TAIWO BAKRE
The centre of origin of the oil palm is the tropical rain forest region of West Africa. It is considered to be the 200-300 kilometre wide coastal belt between Liberia and Mayumbe. The oil palm tree has remained the 'tree of life' of Yoruba land as well as of other parts of southern West Africa to which it is indigenous. The Yoruba are adept at spinning philosophical and poetical proverbs around such ordinary things as hills, rivers, birds, animals and domestic tools. Hundreds of the traditional proverbs are still with us, and through them one can see the picture of the environment that contributed to the moulding of the thoughts of the people. Yoruba riddles or puzzles were also couched in terms of the environment and the solutions to them were also environmental items. They have a popular saying: A je eran je eran a kan egungun, a je egungun je egungun a tun kan eran: 'A piece of meat has an outer layer of flesh, an intermediate layer of bone and an inner layer of flesh. What is it? A palm fruit: it has an outer edible layer, the mesocarp; then a layer of shell, inedible, and the kernel inside, edible. The solution to this puzzle summarises the botanical and cultural characteristics of the palm fruit.
Key Words: palm fruit, oil palm, palm kernel, vitamin A, traditional food culture
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Palm fruit chemistry and nutrition. KALYANA SUNDRAM, RAVIGADEVI SAMBANTHAMURTHI
AND YEW-AI TAN
The palm fruit (Elaies guineensis) yields palm oil, a palmitic-oleic rich semi solid fat and the fat-soluble minor components, vitamin E (tocopherols, tocotrienols), carotenoids and phytosterols. A recent innovation has led to the recovery and concentration of water-soluble antioxidants from palm oil milling waste, characterized by its high content of phenolic acids and flavonoids. These natural ingredients pose both challenges and oppor-tunities for the food and nutraceutical industries. Palm oil's rich content of saturated and monounsaturated fatty acids has actually been turned into an asset in view of current dietary recommendations aimed at zero trans content in solid fats such as margarine, shortenings and frying fats. Using palm oil in combination with other oils and fats facilitates the development of a new generation of fat products that can be tailored to meet most current dietary recommendations. The wide range of natural palm oil fractions, differing in their physico-chemical characteristics, the most notable of which is the carotenoid-rich red palm oil further assists this. Palm vitamin E (30% tocopherols, 70% tocotrienols) has been extensively researched for its nutritional and health properties, including antioxidant activities, cholesterol lowering, anti-cancer effects and protection against atherosclerosis. These are attributed largely to its tocotrienol content. A relatively new output from the oil palm fruit is the water-soluble phenolic-flavonoid-rich antioxidant complex. This has potent antioxidant properties coupled with beneficial effects against skin, breast and other cancers. Enabled by its water solubility, this is currently being tested for use as nutraceuticals and in cosmetics with potential benefits against skin aging. A further challenge would be to package all these palm ingredients into a single functional food for better nutrition and health.
Key Words: palm oil, fatty acids, cardiovascular disease, cancer, vitamin E, carotenoids, flavonoids
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Phytonutrient deficiency: the place of palm fruit. NAIYANA WATTANAPENPAIBOON
The oil palm (Elaeis guineensis) is native to many West African countries, where local populations have used its oil for culinary and other purposes. Large-scale plantations, established principally in tropical regions (Asia, Africa and Latin America), are mostly aimed at the production of oil, which is extracted from the fleshy mesocarp of the palm fruit, and endosperm or kernel oil. Palm oil is different from other plant and animal oils in that it contains 50% saturated fatty acids, 40% unsaturated fatty acids, and 10% polyunsaturated fatty acids. The fruit also contains components that can endow the oil with nutritional and health beneficial properties. These phytonutrients include carotenoids (a-, b- and g-carotenes), vitamin E (tocopherols and tocotrienols), sterols (sitosterol, stigmasterol and campesterol), phospholipids, glycolipids and squalene. In addition, it is recently reported that certain water-soluble powerful antioxidants, phenolic acids and flavonoids, can be recovered from palm oil mill effluent. Owing to its high content of phytonutrients with antioxidant properties, the possibility exists that palm fruit offers some health advantages by reducing lipid oxidation, oxidative stress and free radical damage. Accordingly, use of palm fruit or its phytonutrient-rich fractions, particularly water-soluble antioxidants, may confer some protection against a number of disorders or diseases including cardiovascular disease, cancers, cataracts and macular degeneration, cognitive impairment and Alzheimer's disease. However, whilst prevention of disease through use of these phytonutrients as in either food ingredients or nutraceuticals may be a worthwhile objective, dose response data are required to evaluate their pharmacologic and toxicologic effects. In addition, one area of concern about use of antioxidant phytonutrients is how much suppression of oxidation may be compatible with good health, as toxic free radicals are required for defence mechanisms. These food-health concepts would probably spur the large-scale oil palm (and monoculture) plantations, which are already seen to be a major cause of deforestation and replacement of diverse ecosystems in many countries. However, the environ-mental advantages of palm phytonutrients are that they are prepared from the readily available raw material from palm oil milling processes. Palm fruit, one of only a few fatty fruits, is likely to have an increasingly substantiated place in human health, not only through the provision of acceptable dietary fats, but also its characteristic protective phytonutrients.
Key Words: palm fruit, phytonutrient, antioxidant, polyphenol, flavonoid, cardiovascular disease, cancer, diabetes, cataracts, age-related macular degeneration, phytochemicals
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A place for palm fruit oil to eliminate vitamin A deficiency. A J SPINNLER BENADÉ
There is general consensus that food-based approaches are viable and sustainable options for addressing vitamin A deficiency in populations. One such example is the fortification of food which, if properly monitored, could make a significant contribution towards improving the vitamin A status of populations throughout the world. Red palm fruit oil (RPO) with its high content of natural carotenoids, lends itself exceptionally well to this purpose at both household and commercial level. Results are now available from several feeding trials incorporating RPO into diets at household level or into commercially manufactured products. RPO in the maternal diet was shown to improve the vitamin A status of lactating mothers and their infants. Consumption of RPO incorporated in a sweet snack or biscuits significantly improved plasma retinol concentrations in children with subclinical vitamin A deficiency. There is evidence that if only 35-50% of the recommended daily intake for vitamin A were to be provided by RPO, it may be sufficient to prevent vitamin A deficiency (hypovitaminosis A). Red palm oil has a highly bioconvertible form of alpha- and beta-carotene, a long shelf life, and a higher cost/benefit ratio when compared to other approaches such as high-dose-vitamin A supplements and fortification of foods with retinyl ester fortificants. Consumption of RPO is safe and cannot produce hypervitaminosis A. Considering all the current information about RPO, the initiation of food-based interventions involving its use in developing countries with an endemic vitamin A deficiency problem, appears to be a logical choice.
Key Words: red palm oil, vitamin A deficiency, fortification, developing countries, food-based approaches
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Alleviation of vitamin A deficiency with palm fruit and its products.
NOEL W SOLOMONS AND MÓNICA OROZCO
The decreased dietary diversity wrought from the adoption of the settled, agrarian system to replace the hunter-gather and pastoralist lifestyles assured a stable supply of protein and calories from grains and tubers while creating a vulnerability for humans to suffer micronutrient deficiencies. The vitamin A from animal tissue is more bioavailable to humans than the provitamin A in the matrix of green plants. Provitamin A carotenes achieve a dietary vitamin A efficacy nearly equivalent to that of the preformed vitamin only in the context of an oily matrix. The homeostatic regulation of carotene bioconversion by the intestine, moreover, prevents any excess toxic accumulation of vitamin A from provitamin A sources. The efficacy and safety of the palm fruit (genus Elaeis) as a source of vitamin A, in addition to its cultural recognition as a food, are more consistent with the gentler concept of "alleviation" of the public health problem of hypovitaminosis A, then the more aggressive, medical model of "eradication" with its greater potential for risk and collateral damage. The palm fruit and its derivatives achieve new opportunities for creative contribution and sustained use in formats of supplementation (prophylactic in children and women, for lactation), food-to-food fortification (in bakery goods and snacks, as condiments), and even in food diversification strategies. Experience in India, South Africa, and Guatemala begins to define and delineate the opportunities and limitations for the palm fruit to contribute to the alleviation of endemic vitamin A deficiency.
Key Words: vitamin A, provitamin A, fatty fruits, palm fruit, red palm oil, hypovitaminosis A, hypervitaminosis A, food-to-food fortification, food safety, evolution, North Africa, Guatemala

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Last Updated: September 2004