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1 Asia Pacific Journal of Clinical Nutrition
Volume 16, issue
2
(June 2007)


Abstracts

Contents

Abstract Papers

Review Article

Anthocyanins and anthocyanin-rich extracts: role in diabetes and eye function DILIP GHOSH AND TETSUYA KONISHI

Asia Pac J Clin Nutr. 2007;16(2):200-208.

 

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Original Articles

Nutritional Pathophysiology

Fructose malabsorption in Thai adults
NARUMON DENSUPSOONTORN, PIPOP JIRAPINYO, NUCHNOI THAMONSIRI AND RENU WONGARN

Asia Pac J Clin Nutr. 2007;16(2):209-212.

 

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Hypoalbuminemia is a predictor of delayed postoperative bowel function and poor surgical outcomes in right-sided colon cancer patients

VARUT LOHSIRIWAT, VITOON CHINSWANGWATANAKUL, SUPATRA LOHSIRIWAT, THAWATCHAI AKARAVIPUTH, WIROON BOONNUCH, ASADA METHASADE AND DARIN LOHSIRIWAT

Asia Pac J Clin Nutr. 2007;16(2):213-217.

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Cytokines related to nutritional status in patients with untreated pulmonary tuberculosis in Indonesia

ELVINA KARYADI,  WIL MV DOLMANS, CLIVE E WEST, REINOUT VAN CREVEL, RONALD HH NELWAN,  ZULKIFLI AMIN, RAINER GROSS, JOHANNA VAN DER VEN-JONGEKRIJG AND JOS WM VAN DER MEER

Asia Pac J Clin Nutr. 2007;16(2):218-226.

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Macro- Micro- and Phyto-nutrientsExtent of error in estimating nutrient intakes from food tables versus laboratory estimates of cooked foods

SHASHI AJIT CHIPLONKAR AND VAISHALI VILAS AGTE

Asia Pac J Clin Nutr. 2007;16(2):227-239.

 

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Nutritional Status, Dietary Intake, and Body CompositionThe association between amount of cigarettes smoked and overweight, central obesity among Chinese adults in Nanjing, China

FEI XU, XIAO-MEI YIN AND YOUFA WANG 

Asia Pac J Clin Nutr. 2007;16(2):240-247.

 

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Correlation of dyslipidemia with waist to height ratio, waist circumference, and body mass index in Iranian adults

ALI CHEHREI, SAEID SADRNIA, AMMAR HASSANZADEH KESHTELI, MOHAMMAD ALI DANESHMAND AND JALAL REZAEI

Asia Pac J Clin Nutr. 2007;16(2):248-253.

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Insulin, lipid profiles and measures of fatness in Taiwanese women in relation to duration of residence in Australia

WAN-PING LEE, JENNIFER LINGARD AND MARGARET BERMINGHAM Asia Pac J Clin Nutr. 2007;16(2):254-261.  

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Nutritionally-Related Disorders and Disease and Their Risk factors

Association between serum CRP concentrations with dietary intake in healthy and dyslipidaemic patients MAJID GHAYOUR-MOBARHAN, HANYEH YAGHOOTKAR, SUZAN A LANHAM-NEW, DAVID J LAMB, AND GORDON A FERNS

Asia Pac J Clin Nutr. 2007;16(2):262-268.

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Red cell folate and predicted neural tube defect rate in three Asian cities TIMOTHY J GREEN, C MURRAY SKEAFF, BERNARD J VENN, JENNIFER EP ROCKELL, JOANNE M TODD, GEOK L KHOR, SU PENG LOH, G DURAISAMY, SITI MUSLIMATUN, RINA AGUSTINA, XU LING AND XIAOPING XING

Asia Pac J Clin Nutr. 2007;16(2):269-273.

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Growth and Child Nutrition

Reduction in childhood malnutrition in Vietnam from 1990 to 2004 NGUYEN CONG KHAN, LE DANH TUYEN, TRAN XUAN NGOC, PHAN HOAI DUONG, HA HUY KHOI

Asia Pac J Clin Nutr. 2007;16(2):274-278.

 

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Nutritional status, body composition and health conditions of the Karen hill tribe children aged 1-6 years in Northern Thailand

PRASONG TIENBOON AND PRASIT WANGPAKAPATTANAWONG

Asia Pac J Clin Nutr. 2007;16(2):279-285.

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Diet supplemented with MCT oil in the management of childhood diarrhea

CELESTE C TANCHOCO, ARSENIA J CRUZ, JOSSIE M ROGACCION, ROSEMARIE S CASEM, MARIETTA P RODRIGUEZ, CONSUELO L ORENSE AND LILIBETH C HERMOSURA

Asia Pac J Clin Nutr. 2007;16(2):286-292.

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Psychosocial care and nutritional status of children aged 6-36 months among patrilineal (Karo) and matrilineal (Minangkabau) households in Jakarta JUDHIASTUTY FEBRUHARTANTY, AVITA A USFAR, ERMITA DIANAWATI, DUMA O FRANSISCA, AIRIN ROSHITA AND UMI FAHMIDA

Asia Pac J Clin Nutr. 2007;16(2):293-300.

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Zinc-iron, but not zinc-alone supplementation, increased linear growth of stunted infants with low haemoglobin

UMI FAHMIDA, JOHANNA SP RUMAWAS, BUDI UTOMO, SOEMIARTI PATMONODEWO AND WERNER SCHULTINK

Asia Pac J Clin Nutr. 2007;16(2):301-309.

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Maternal and Women’s Nutrition

Anaemia in pregnant, post partum and non pregnant women in Lak District, Daklak Province of Vietnam LIEU THI THUY TRINH AND MICHAEL DIBLEY

Asia Pac J Clin Nutr. 2007;16(2):310-315.

 

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Determinants of exclusive breastfeeding duration in Xinjiang, PR China FENGLIAN XU, COLIN BINNS, SU ZHENG, YAN WANG, YUN ZHAO AND ANDY LEE

Asia Pac J Clin Nutr. 2007;16(2):316-321.

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Aging and Elder’s Nutrition

Fatty acid intakes and food sources in a population of older Australians VICTORIA M FLOOD, KAREN L WEBB, ELENA ROCHTCHINA, BRIDGET KELLY AND PAUL MITCHELL

Asia Pac J Clin Nutr. 2007;16(2):322-330.

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Long-term adoption of a Mediterranean diet is associated with a better health status in elderly people; a cross-sectional survey in Cyprus

DEMOSTHENES B PANAGIOTAKOS, ANNA POLYSTIPIOTI, NATASSA PAPAIRAKLEOUS AND EVANGELOS POLYCHRONOPOULOS

Asia Pac J Clin Nutr. 2007;16(2):331-337.

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Interview to study the determinants of hypertension in older adults in Taiwan: a population based cross-sectional survey

ALAN CHUNG-HONG TSAI, JENN-CHANG LIOU AND MING-CHENG CHANG

Asia Pac J Clin Nutr. 2007;16(2):338-345.

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A multidimensional assessment of nutritional and health status of rural elderly Malays  SUZANA SHAHAR, ZURIATI IBRAHIM, AFAF RUHI ABDUL FATAH, SURIAH ABDUL RAHMAN, NOOR AINI MOHD YUSOFF, FATIMAH ARSHAD, ZAITUN YASSIN AND SITI NUR ‘ASYURA ADZNAM  

Asia Pac J Clin Nutr. 2007;16(2):346-353.

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Nutritional Epidemiology and Public HealthPhysical activity among adolescents in Taiwan LI-JUNG CHEN , ANNE M HAASE AND KENNETH R FOX

Asia Pac J Clin Nutr. 2007;16(2):354-361.

 

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Metabolic syndrome: recent prevalence in East and Southeast Asian populations

PAUL NESTEL, RAMON LYU, LIP PING LOW, WAYNE HUEY-HERNIG SHEU, WANNEE NITIYANANT, IKUO SAITO AND CHEE ENG TAN

Asia Pac J Clin Nutr. 2007;16(2):362-367.

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Household food security status measured by the US-Household Food Security/Hunger Survey Module (US-FSSM) is in line with coping strategy indicators found in urban and rural Indonesia

AVITA A USFAR, UMI FAHMIDA AND JUDHIASTUTY FEBRUHARTANTY 

Asia Pac J Clin Nutr. 2007;16(2):368-374.

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Attitudes of agricultural scientists in Indonesia towards genetically modified foods

JUDHIASTUTY FEBRUHARTANTY, TRI NISA WIDYASTUTI AND DWI NASTITI ISWARAWANTI

Asia Pac J Clin Nutr. 2007;16(2):375-380.

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Future Events

Asia Pac J Clin Nutr. 2007;16(2):381.

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Anthocyanins and anthocyanin-rich extracts: role in diabetes and eye function

DILIP GHOSH AND TETSUYA KONISHI
Anthocyanins are the largest group of water-soluble pigments in the plant kingdom, known collectively as flavonoids. More than 8000 flavonoids, and 500 anthocyanin structures had been reported by the year 2000 and more are continually being isolated. Anthocyanins are believed to display an array of beneficial actions on human health and well-being. Due to our increasing understanding and awareness of the potential beneficial human health effects, research on anthocyanins has recently intensified. During the past two decades an increasing number of studies have investigated the diverse protective effects elicited by polyphenolics present in various fruits and vegetables. These effects include antioxidant, anti-allergic, anti-inflammatory, anti-viral, antiproliferative, anti-mutagenic, anti-microbial, anti-carcinogenic, protection from cardiovascular damage and allergy, microcirculation improvement, peripheral capillary fragility prevention, diabetes prevention, and vision improvement. Other physiological effects are continually being investigated. The aim of the present article is to summarise the known anti-diabetic and eye function properties of anthocyanins to help in our understanding of their functional mechanism.
Key Words: anthocyanins, anthocyanin-rich extracts, disease prevention, diabetes, eye function

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花青素及富含花青素萃取物在糖尿病及眼睛功能的角色

花青素是一种水溶性的植物色素。从广义上看,属酚类化合物中的类黄酮类。目前已经有8000 多种酚类化合物被分离出来, 其中有500 多种是花青素。近年来对花青素可能对健康带来的好处的研究越来越多。将来花青素的这种特性在功能食品和保健食品中有可能得到日益广范的应用。在过去的二十年间越来越多的研究结果表明水果和蔬菜中的种酚类化合物多种多样的保护作用。其中包括抗氧性, 抗过敏, 抗炎症, 抗病毒, 抗细胞扩散, 抗突变因素, 抗微生物, 抗癌, 保护免受心血管损伤和过敏, 改善微循环, 预防周边微血管脆弱, 预防糖尿病, 和改善视觉等作用。为了帮助我们理解花青素的作用机制, 本文总结了多年来花青素对于预防糖尿病和改善视觉方面的研究成果。
關鍵字:花青素、富含花青素萃取物、疾病預防、糖尿病、眼睛功能。

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Fructose malabsorption in Thai adults

NARUMON DENSUPSOONTORN, PIPOP JIRAPINYO, NUCHNOI THAMONSIRI AND RENU WONGARN Fructose malabsorption has not been well-defined in Thai populations but there has been increasing consumption of fructose-fortified drinks. Objectives: To assess the incidence of fructose malabsorption and intolerance in Thai normal subjects as well as the facilitating effect of glucose on fructose absorption. Methods: Twenty-five gram of fructose was ingested by 77 subjects (37 men, 40 women; mean age 26 and 31 y, range 20-50 y and 21-50 y for men and women, respectively). Measurement of breath-H2 levels after fructose ingestion in each subject up to 2 h was performed. Those who showed fructose malabsorption were later given 25 g of each glucose and fructose and second tests of breath-H2 tests were done. Results: Fructose malabsorption was found in eleven females with a significant rise in average breath-H2 level at 30, 60, 90, and 120 min (p < 0.001), whereas none of the males had an abnormal breath-H2 test. Only 1 of the 11 females with increased breath H2 had gastrointestinal symptoms. In all the fructose malabsorbers, excess breath-H2 reverted to normal when the fructose solution was mixed and administered with 25 g glucose (p < 0.001).  Conclusion: The incidence rate of fructose malabsorption was 11 of 77 subjects but these were female. One of the 11 had gastrointestinal symptoms. It was found that an equal amount of glucose would abolish fructose malabsorption.
Key Words: Breath-H2 test, Fructose malabsorption, Fructose intolerance

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泰國成年人之果糖吸收不良

在泰國,添加果糖的飲料消耗量日漸增加,而果糖吸收不良在泰國族群尚未被完整定義。目的:評估果糖吸收不良及耐受不良在泰國正常人的盛行率及葡萄糖對果糖吸收的影響。方法:77 名研究對象(37 名男性,40 名女性;男女平均年齡分別為26 歲及31歲,範圍在20-50 歲及21-50 歲)食用25 公克的果糖。每名研究對象在食用果糖兩個小時後測量呼出氫氣的含量。有果糖吸收不良的人,之後再給予葡萄糖及果糖各25 公克,並測量第二次呼氣中氫氣的含量。結果:11 名女性有果糖吸收不良現象,她們在30、60、90 及120 分鐘,呼氣中氫氣含量顯著上升(p<0.001),反之沒有任何一名男性其呼氣氫氣測量不正常。在11 名呼氣中氫氣含量上升的女性中只有1 名有腸胃道症狀。在所有果糖吸收不良者,當攝取果糖溶液混合25 公克的葡萄糖後,會使呼氣中過多的氫氣恢復正常(p<0.001)。結論:果糖吸收不良的發生率在77 名研究對象中有11 名,且均為女性。11名研究對象中有一名有腸胃道症狀。此研究結果發現等量的葡萄糖可以消除果糖吸收不良。
關鍵字:呼吸氫氣測試、果糖吸收不良、果糖不耐症。

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Hypoalbuminemia is a predictor of delayed postoperative bowel function and poor surgical outcomes in right-sided colon cancer patients

VARUT LOHSIRIWAT, VITOON CHINSWANGWATANAKUL, SUPATRA LOHSIRIWAT, THAWATCHAI AKARAVIPUTH, WIROON BOONNUCH, ASADA METHASADE AND DARIN LOHSIRIWAT Purpose: To determine the relationship between preoperative serum albumin and postoperative bowel function as well as surgical outcomes in right-sided colon cancer patients. Methods: This retrospective study in a university hospital included 84 patients who underwent elective right hemicolectomy for adenocarcinoma of the right-sided colon between January 2004 and December 2005. The patients had a preoperative serum albumin assessment. Serum albumin less than 3.5 g/dL was regarded as hypoalbuminemia. Postoperative outcomes were classified into mortality, morbidity (infectious and noninfectious complications), time to first bowel movement, time to resume normal diet, and hospital stay. Results: Forty males (48%) and forty-four females (52%) with a mean age of 64 (range, 27-89) years were included. Forty-eight patients (57%) had hypoalbuminemia. No 30-day postoperative mortality occurred. All 14 postoperative complications occurred in hypoalbuminemic cases. Therefore, 29% of the hypoalbuminemics had complications whereas none occurred in nonhypoalbuminemics (p=0.001). In univariate analysis, hypoalbuminemia and postoperative complications were the risk factors for delayed postoperative recovery of bowel function and prolonged length of hospital stay. In multivariate analysis, hypoalbuminemia was the significant risk factor for postoperative complications (p<0.001) and delayed time to first bowel movement (p=0.018) whereas postoperative complications were the significant risk factor for delayed time to resume normal diet (p<0.001) and prolonged hospital stay (p<0.001). Conclusion: Hypoalbuminemia is a potential predictor of delayed recovery of bowel function postoperatively and significantly associated with postoperative complications in right-sided colon cancer patients undergone right hemicolectomy.
Key Words: hypoalbuminemia, colectomy, postoperative complications, ileus, nutrition

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低血清白蛋白是右側結腸癌病人術後大腸功能延遲及不良手術結果之預測因子
目的:探討右側結腸癌病人術前血清白蛋白與術後大腸功能及手術結果之相關。
方法:這個回溯性研究是在大學醫院進行,共有84 名病人在2004 年1 月至2005 年12 月完成右側結腸腺癌的選擇性右側大腸切除。病人經過術前血清白蛋白評估,低於3.5g/dL 視為低白蛋白血症。術後結果分為死亡、疾病(感染與非感染併發症)、第一次排便時間、第一次恢復正常飲食時間及住院天數。結果:有40 名男性(48%)及44 名女性(52%)參與研究,平均年齡為64 歲(範圍27-89 歲)。48 名病人(57%)有低白蛋白血症。沒有30 天術後死亡的情形發生。14 名有術後併發症者均為低白蛋白血症的病例。因此,有29%的低白蛋白血症者有併發症,反之非低白蛋白血症者則未發生(p<0.001)。單變項分析發現,低白蛋白血症與術後併發症為延遲術後大腸功能恢復及延長住院天數的危險因子。多變項分析中,低白蛋白為術後併發症(p<0.001)及延後第一次排便時間(p=0.018)的顯著危險因子,而術後併發症為延後恢復正常飲食時間(p<0.001)及延長住院天數(p<0.001)的危險因子。結論:低白蛋白血症是右側結腸病人完成右側大腸切除後,延後術後大腸功能恢復的潛在預測因子,並與術後併發症有顯著相關。
關鍵字:低白蛋白血症、結腸切除術、術後併發症、腸阻塞、營養。

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Cytokines related to nutritional status in patients with untreated pulmonary tuberculosis in Indonesia

ELVINA KARYADI,  WIL MV DOLMANS, CLIVE E WEST, REINOUT VAN CREVEL, RONALD HH NELWAN,  ZULKIFLI AMIN, RAINER GROSS, JOHANNA VAN DER VEN-JONGEKRIJG AND JOS WM VAN DER MEER Although several studies have dealt with the patterns of cytokine production in tuberculosis, little is known about the association between nutrient deficiencies and cytokines in tuberculosis. The objective of this study was to assess the concentration of cytokines related to nutritional status during tuberculosis. In 41 untreated tuberculosis patients and matched healthy controls in an urban hospital in Indonesia, we measured: height and weight, parameters of iron, vitamin A and zinc; and cytokines concentrations in the circulation and production in whole blood cultures. Plasma interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1ra) were significantly higher in patients than in controls. Patients with cavities (n=26) had higher concentrations of IL-6 than patients without cavities (n=15). Body mass index <18.5 kg/m2 was associated with high concentrations of tumor necrosis factor-α (TNF-α) and IL-6. Anaemia was associated with high concentrations of IL-6 and IL-1ra. Zinc deficiency was associated with high LPS-stimulated production of TNF-α and IL-1ra. Marginal plasma retinol concentrations were associated with high concentrations of IL-6 after LPS stimulation. In conclusion, low concentrations of micronutrients in tuberculosis were associated with increased cytokine production. An intervention study would allow causality to be examined.
Key Words: interleukin-6, tumor necrosis factor-α, interleukin-1 receptor antagonist, body mass index, micronutrient

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印尼未治療肺結核病人細胞激素與營養狀況有關
雖然幾個研究已經探討過結核的細胞激素產生型態,但是結核病人的營養素缺乏與細胞激素間的關係所知有限。本研究目的為評估在結核病期間,細胞激素的濃度與營養狀況的相關。在印尼城市的醫院,41 名未治療的結核病人與其配對的健康對照組,我們測量其身高與體重、鐵、維生素A 及鋅;以及在循環中和全血培養產生的細胞激素濃度。病人的血漿中介白質-6(IL-6)及介白質-1接受體拮抗物(IL-1ra)顯著的較對照組高。有肺部空洞的病人(n=26)比起沒有空洞的病人(n=15)有較高的IL-6 濃度。身體質量指數小於18.5kg/m2 與較高濃度的腫瘤壞死因子-α(TNF-α)及IL-6 有關。貧血者有較高的IL-6 及IL-1ra。鋅缺乏與高的LPS-刺激產生TNF-α 及IL-1ra 有關。血漿視網醇濃度臨界缺乏與經LPS 刺激後高濃度的IL-6 相關。綜合以上,肺結核病人低微量營養素濃度與
細胞激素產生增加有關。介入性研究將可評估其因果關係。
關鍵字:介白質-6、腫瘤壞死因子-α、介白質-1 接受體拮抗物、身體質量指數、微量營養素。

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Extent of error in estimating nutrient intakes from food tables versus laboratory estimates of cooked foods

SHASHI AJIT CHIPLONKAR AND VAISHALI VILAS AGTE Individual cooked foods (104) and composite meals (92) were examined for agreement between nutritive value estimated by indirect analysis (E) (Indian National database of nutrient composition of raw foods, adjusted for observed moisture contents of cooked recipes), and by chemical analysis in our laboratory (M). The extent of error incurred in using food table values with moisture correction for estimating macro as well as micronutrients at food level and daily intake level was quantified. Food samples were analyzed for contents of iron, zinc, copper,
β-carotene, riboflavin, thiamine, ascorbic acid, folic acid and also for macronutrients, phytate and dietary fiber. Mean percent difference in energy content between E and M was 3.070.6%, that for protein was 5.32.0%, for
fat was 2.61.8% and for carbohydrates was 5.10.9%. Mean percent difference in vitamin contents between E and M ranged from 32 (vitamin C) to 45.5% (β-carotene content); and that for minerals between 5.6 (copper) to 19.8% (zinc). Percent E/M were computed for daily nutrient intakes of 264 apparently healthy adults. These were observed to be 108, 112, 127 and 97 for energy, protein, fat and carbohydrates respectively. Percent E/M for their intakes of copper (102) and β-carotene (114) were closer to 100 but these were very high in the case of zinc
(186), iron (202), and vitamins C (170), thiamine (190), riboflavin (181) and folic acid (165). Estimates based on food composition table values with moisture correction show macronutrients for cooked foods to be within 5% whereas at daily intake levels the error increased up to 27%. The lack of good agreement in the case of several micronutrients indicated that the use of Indian food tables for micronutrient intakes would be inappropriate.
Key Words: micronutrient, error estimate, food tables, cooked foods’ composition

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以食物成分表及實驗室分析熟食估計營養素攝取量之誤差程度
使用間接分析(E)(印度國家生鮮食物營養素成分資料庫,已校正烹調後水分含量)及我們實驗室做的化學分析(M)來評估煮熟食物單項(104)和混合餐食(92)的營養素值的一致性。我們將使用食物成分表,來評估每日攝取量之巨量及微量營養素會引起誤差的校正水分予以量化。我們分析食物樣本中的鐵、鋅、銅、β-胡蘿蔔素、核黃素、硫胺、抗壞血酸、葉酸及巨量營養素、植酸和膳食纖維。在E 和M 之間熱量平均相差3.070.6%、蛋白質5.32.0%、脂質2.61.8%及醣類5.10.9%。在E 和M 之間維生素平均差異從32(維生素C)到45.5%(β-胡蘿蔔素);而礦物質從5.6(銅)到19.8%(鋅)。計算264 名健康成人每日營養素攝取量E/M 百分比。熱量、蛋白質、脂質及醣類分別為108、112、127 及97。他們的銅(102)及β-胡蘿蔔素(114)攝取E/M 百分比接近一百,而鋅(186)、鐵(202)及維生素C(170)、硫胺(190)、核黃素(181)及葉酸(165)卻相當高。使用經校正水分的食物成分表後,顯示熟食的巨量營養素誤差在 5%,而每日攝取量誤差則增加至27%。多個微量營養素的評估一致性欠佳,顯示使用印度的食物成分表評估微量營養素攝取量並不恰當。
關鍵字:微量營養素、誤差估計、食物成分表、熟食食物組成。

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The association between amount of cigarettes smoked and overweight, central obesity among Chinese adults in Nanjing, China

FEI XU, XIAO-MEI YIN AND YOUFA WANG Objectives: To examine the association between overweight, central obesity and cigarette smoking (total amount of cigarettes smoked [TACS] and status).
Design: Population-based cross-sectional study.Setting: Administrative villages and neighborhoods (n=45) randomly selected from three urban districts and two rural counties in Nanjing City, China.Subjects and methods: A representative sample (n=13,463) of permanent local male residents aged 35 years or older; 66.5% were urban residents. The response rate was 90.1%. Overweight (BMI>=24) and central obesity (waist circumference>=85 in men) were defined according to the new Chinese standard. The association between smoking (amount and status) and obesity was examined using logistic and linear regression analysis. Results: The overall prevalence of overweight was 36.1% (29.7% with 24<=BMI<28 and 6.4% with BMI>=28). After adjusted for age, residence, education, occupation, family income, alcohol drinking, dietary intake, occupational and leisure-time physical activity, the prevalence was significantly lower among current smokers (33.0%) than in non-smokers (39.9%) and ex-smokers (39.2%), respectively (p<0.05). The amount of cigarette smoked was reversely associated with BMI (compared to non-smokers, ORs and 95%CIs for smokers with low-, medium- and high-TACS were 0.88 [0.79, 0.98], 0.77 [0.69, 0.86], and 0.77 [0.69, 0.86], respectively). The prevalence of central obesity was 35.9%. Compared to nonsmokers, only male ex-smokers were at increased risk of central obesity (OR=1.38, 95%CI=1.10, 1.74), while there was no significant association with current-smokers (OR=1.02 [0.92, 1.12]). The amount of cigarette smoked was not significantly associated with central obesity. Conclusions: Cigarette smoking was negatively associated with body weight indicated by BMI but not with central obesity indexed by waist circumference in Chinese men. Cessation of smoking may increase the risk of gaining overall body weight and developing central obesity. Cigarette smoking prevention and cessation should be a public health priority in China.
Key Words: overweight, body mass index, waist circumference, cigarette smoking, prevention, cessation, China, Nanjing

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中國南京成人抽菸量與過重、中央型肥胖間的關係
目的:評估過重、中央型肥胖與抽菸的相關(抽菸的總量[TACS]及狀態)。
設計:族群基礎橫斷性研究。地點:隨機選取自中國南京市三個城市轄區及兩個鄉村地區的行政村(n=45)。研究對象與方法:當地年齡在35 歲或以上的男性永久居民的代表性樣本(n=13,463);66.5%為城市住民。回應率為90.1%。過重(BMI>=24)及中央型肥胖(男性腰圍>=85)的定義是依據新中國標準。抽菸(量與狀態)與肥胖相關性的評估是採用羅吉斯與線性迴歸分析。結果:整體過重盛行率為36.1%(29.7%為24<=BMI<28 和6.4%為BMI>=28)。在校正年齡、居住地、教育程度、職業、家庭收入、飲酒、飲食攝取、職業及休閒體能活動後,目前仍有抽菸者(33.0%)盛行率顯著較非抽菸者(39.9%)及已戒菸者(39.2%)低(p<0.05)。抽菸量與BMI 呈現負相關(與非抽菸者相比,抽菸者低、中、高的TACS 的ORs 及95%CI 分別為0.88 [0.79, 0.98]、0.77 [0.69, 0.86]和0.77 [0.69, 0.86])。中央型肥胖的盛行率為35.9%。與非抽菸者相比,只有已戒菸者中央型肥胖的危險性增加(OR=1.38,95%CI=1.10, 1.74),與目前仍有抽菸者則沒有顯著相關(OR=1.02 [0.92, 1.12])。抽菸量與中央型肥胖並未有顯著的相關。結論:在中國男性中抽菸與以BMI 當體重指標有負相關,但是以腰圍當中央性肥胖的指標則無相關性。中斷抽菸可能會提高體重增加與中央型肥胖的危險性。抽菸的預防與中斷是目前中國公共衛生優先的課題。
關鍵字:過重、身體質量指數、腰圍、抽菸、預防、中斷、中國、南京。

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Correlation of dyslipidemia with waist to height ratio, waist circumference, and body mass index in Iranian adults

ALI CHEHREI, SAEID SADRNIA, AMMAR HASSANZADEH KESHTELI, MOHAMMAD ALI DANESHMAND AND JALAL REZAEI Overweight and obesity are increasing problems in many countries and are related to multiple cardiovascular risk factors. Although imaging techniques can determine total body fat and its distribution reliably, anthropometric measurements remain important in clinical practice. The purpose of this study was to determine the
association between some anthropometric measurements and dyslipidemia as an important cardiovascular risk factor in Iranian population. A total of 750 subjects (580 females and 170 males) were selected by multistage random sampling from residents of Arak (Iran) and related villages in 2005. None of them had any significant past medical history. Body mass index(BMI), waist circumference(WC), and waist to height ratio(W/Ht) of subjects were measured to identify their relationship with their lipid profile including total cholesterol(TC),triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), and the ratio of total cholesterol to high density lipoprotein cholesterol(TC/HDL-C). Fasting blood sugar (FBS) was also measured. WC and W/Ht showed greater correlation with TC, TG, LDL-C, TC/HDL-C level than did BMI. Among lipid profile, TG showed the closest correlation with W/Ht (r=0.309, p<0.001) and WC (r=0.308, p<0.001). HDL-C level did not show any statistical relationship with W/Ht, but it was weakly correlated with WC (r=-0.088, p<0.05). None of the indices showed any association with FBS level. It can be concluded that W/Ht and WC can best predict dyslipidemia in an Iranian adult population. We suggest using both W/Ht and WC as inexpensive and easy methods in clinical and epidemiological fields.
Key Words: obesity, dyslipidemia, waist to height ratio, waist circumference, body mass index

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伊朗成人血脂異常與腰圍身高比、腰圍及身體質量指
數的相關
過重與肥胖是很多國家日漸增加的問題,與多種心血管疾病危險因子有關。雖然影像技術可以可靠的評估總體脂肪量及其分布,體位測量在臨床的應用仍然相當重要。本研究目的為評估在伊朗族群的一些體位測量值,與以血脂異常當作重要的心血管危險因子之相關。750 名研究對象(580 名女性及170 名男性),以多步驟隨機抽樣選自2005 年伊朗Arak 及其相關村莊居民。他們沒有任何病史。測量研究對象的身體質量指數(BMI)、腰圍(WC)及腰圍身高比(W/Ht),以確認與他們的血脂的相關性,包括總膽固醇(TC)、三酸甘油酯(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)及總膽固醇與高密度脂蛋白膽固醇比值(TC/HDL-C)。同時測量空腹血糖值(FBS)。結果
顯示WC及W/Ht 與TC、TG、LDL-C、TC/HDL-C 的相關性較BMI 高。在血脂方面,TG 顯示與W/Ht(r=0.309, p<0.001)及WC(r=0.308, p<0.001)相關最高。 HDL-C 值與W/Ht 沒有任何統計相關,但與WC 為弱相關(r=-0.088, p<0.05)。沒有任何指標與FBS 值具有相關性。綜合上述,在伊朗的成人族群W/Ht 和WC 可以最佳預測血脂異常。我們建議在臨床及流行病學,同時使用W/Ht 和WC這兩個便宜又簡單的方法。
關鍵字:肥胖、血脂異常、腰圍身高比、腰圍、身體質量指數。

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Insulin, lipid profiles and measures of fatness in Taiwanese women in relation to duration of residence in Australia

WAN-PING LEE, JENNIFER LINGARD AND MARGARET BERMINGHAM This study investigated the relationships between measures of fatness and blood insulin and lipids in Taiwanese females living in Taiwan (n=97) or Australia (n=100), and examined the effect of length of residence in Australia on these relationships. Fasting glucose and lipids were determined by Reflotron and fasting insulin using Microparticle Enzyme Immunoassay; insulin resistance (IR) was identified by HOMA. There were no significant inter-country differences in crude plasma insulin or HOMA-IR between Taiwan and Australia (51.742.2 vs. 45.029.0 pmol/L and 1.431.21 vs. 1.291.00, respectively, all p> 0.05), but when insulin and HOMA-IR were adjusted for waist circumference, they were greater in Taiwan (45.71.6 vs. 38.01.6 pmol/L and 1.261.59 vs. 1.131.59, respectively, all p< 0.05). Subjects living in Australia greater than 5 years had higher insulin and HOMA-IR values than those with less than 5 years residence (50.032.3 vs. 32.410.5 pmol/L and 1.451.00 vs. 0.900.28, respectively, all p< 0.01), even after adjustment for all measures of fatness. Subjects in Australia > 5 years have 6 (CI, 1.3-27.9) times the risk of having insulin > 50 pmol/L; the increased risk being confined to generally and/or centrally obese women. Measures of central obesity and general obesity were positively associated with HOMA-IR in both countries (r = 0.23, p< 0.05 and 0.27 p< 0.01, Taiwan, 0.43 and 0.43, both p< 0.01, Australia). Taiwanese females living in Australia initially appear to have a more favorable state of IR than those in Taiwan, but insulin resistance is associated with length of residence in Australia, particularly among the obese.
Key Words: insulin resistance, diet, obesity, blood lipids, Taiwanese, Taiwanese immigrants in Australia

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澳洲的台灣女性胰島素、血脂質及肥胖測量與居留時間的相關性
研究計畫為探討居住在台灣(n=97)或是澳洲(n=100)的台灣女性肥胖測量、血中胰島素與脂質之間的相關性,並評估居留在澳洲時間長短對那些相關性的影響。採用Reflotron 測量空腹血糖與脂質,採用Microparticle 酵素免疫分析法測量禁食胰島素濃度;胰島素阻抗(IR)則用HOMA 確認。血漿胰島素或是HOMA-IR 在台灣或澳洲國家間均沒有顯著差異(( 分別為51.742.2 vs. 45.029.0 pmol/L 和1.431.21 vs. 1.291.00,所有 p > 0.05)),但當胰島素和HOMA-IR 經腰圍校正後,台灣則較高(分別為45.71.6 vs. 38.01.6 pmol/L 及1.261.59 vs. 1.131.59,所有p< 0.05)。甚至在校正所有肥胖測量值之後,居留在澳洲超過五年者比居留時間少於五年者有較高的胰島素與HOMA-IR 值(分別為50.032.3 vs. 32.410.5 pmol/L 和 1.451.00 vs. 0.900.28,所有 p<0.01)。居留在澳洲超過5 年者,其胰島素大於50pmol/L 的危險性增加六倍;這增加的危險性僅限於一般性或是中央型肥胖的女性。在兩個國家均顯示出,中央型肥胖與全身性肥胖的測量值與HOMA-IR 呈現正相關(r = 0.23, 台灣女性p < 0.05 和0.27 p < 0.01, 澳洲女性 0.43 和 0.43, 全部 p< 0.01)。台灣女性居住在澳洲開始時顯示比起居住在台灣者有較佳的IR,但是胰島素阻抗與居留在澳洲時間長短較具有相關性,尤其是肥胖者。
關鍵字:胰島素阻抗、飲食、肥胖、血脂質、台灣人、澳洲的台灣移民。

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Association between serum CRP concentrations with dietary intake in healthy and dyslipidaemic patients

MAJID GHAYOUR-MOBARHAN, HANYEH YAGHOOTKAR, SUZAN A LANHAM-NEW, DAVID J LAMB, AND GORDON A FERNS Serum CRP concentrations are elevated in subjects at risk of coronary events and in subjects with metabolic syndrome. Although dietary fat and antioxidants are known for their immune-modulating actions, their reported effects on CRP concentrations have been inconsistent. In the present study we have investigated whether dietary constituents are associated with serum CRP concentrations in healthy subjects and patients with dyslipidaemic. Dyslipidaemic subjects (n=238) were recruited from Hospital Outpatient Clinics in Guilford, UK. Apparently healthy subjects (n=188) were recruited from amongst adjacent University and Hospital employees. A validated food frequency questionnaire was used to estimate dietary intake.  Dyslipidaemic patients had higher serum CRP [1.25 (0.42-3.26) mg/L] than control subjects [0.50 (0.17-1.42) mg/L] (p<0.001). In the dyslipidaemic patients, approximately 4% of the variation in serum CRP could be explained by dietary cholesterol intake (p = 0.015, 2.8%), and weakly by dietary vitamin C intake (p = 0.06, 1.2%). No relationship between dietary constituents and serum CRP concentrations was found among the healthy subjects.  Hence the present study shows that serum CRP concentrations are increased in patients with classical coronary risk factors, and that they may be modulated by dietary cholesterol. Key Words: CRP, dyslipidaemia, dietary intake,  atherosclerosis, inflammation

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健康和血脂異常病人之血清CRP濃度與飲食攝取之相關

血清CRP濃度在有冠狀動脈疾病危險與有代謝症候群的人身上有升高之現象。雖然膳食脂肪及抗氧化劑已知具有免疫-調節功能,但對於CRP濃度的影響卻不一致。本研究我們研究健康者與血脂異常患者,其飲食成份是否與血清CRP濃度相關。血脂異常的研究對象(n=238)招募自英國Guilford醫院門診。明顯健康者(n=188)招募自相鄰的大學及醫院員工。採用經效度驗證的飲食頻率問卷評估研究對象的飲食攝取。血脂異常病人[1.25 (0.42-3.26) mg/L]比起對照組研究對象[0.50 (0.17-1.42) mg/L]有較高的CRP濃度(p<0.001)。血脂異常者其膽固醇攝取量可以解釋4%的血清CRP變異(p=0.015, 2.8%),飲食中維生素C攝取的解釋力則較弱(p=0.061.2%)。在健康者中,並未發現飲食成份與血清CRP濃度有相關。因此,本研究顯示具有傳統冠狀動脈危險因子的病人,其血清CRP濃度較高,或許可以試著以膳食膽固醇來調整。

關鍵字:CRP、血脂異常、飲食攝取、動脈硬化、發炎。

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Red cell folate and predicted neural tube defect rate in three Asian cities

TIMOTHY J GREEN, C MURRAY SKEAFF, BERNARD J VENN, JENNIFER EP ROCKELL, JOANNE M TODD, GEOK L KHOR, SU PENG LOH, G. DURAISAMY, SITI MUSLIMATUN, RINA AGUSTINA, XU LING AND XIAOPING XING Background: Periconceptional folic acid reduces neural tube defect (NTD) risk. Red blood cell folate concentration is inversely associated with NTD risk. In many countries there is a lack of information on NTD rates. Red cell folate status in women of childbearing age may be a surrogate for NTD rates and may be helpful in identifying countries or regions most likely to benefit from improved folate status. Objective: To predict NTD rates using red cell folate concentrations in women of childbearing age living in three Asian cities Design: Cross-sectional convenience samples of non-pregnant women living in Beijing (n=220), Kuala Lumpur (n=389), and Jakarta (n=129). Results: Red cell folate concentrations were highest (p<0.001) in women from Jakarta at 872 nmol/L (95% CI; 833, 910) followed by Kuala Lumpur at 674 nmol/L (95% CI: 644, 704) and lowest in Beijing at 563 nmol/L (95% CI: 524, 601). Accordingly, predicted NTD rates were highest in Beijing at 30/10000 (95% CI: 27, 33), followed by Kuala Lumpur at 24/10000 (95% CI: 22, 25), and lowest in Jakarta at 15/10000 (95% CI: 14,15). Conclusion: Our red blood cell folate data suggests that of the three cities improving the folate status of women in Beijing would have the greatest impact on NTD rates. Key Words: red cell folate, NTD, fortification, Asia, women

三大亚洲城市的红血球叶酸及神经管畸形的预测发生率 

背景:妊娠期间的叶酸摄取有效降低神经管畸形的风险。红血球的叶酸水平及神经管畸形的风险是互为相比的。现今的很多国家都缺乏神经管畸形发生率的相关资料。育龄妇女的红血球叶酸水平也许是可代替神经管畸形发生率的另一种指标,并且可用于确认那一些从提高叶酸水平计划当中最可能受惠的国家或区域。目的:使用三大亚洲城市的育龄妇女之红血球的叶酸水平以预测神经管畸形的发生。方法:采用断面式方法以录取居于北京(人数:220),吉隆坡(人数:389)及雅加达(人数:129)的未孕妇女参与此项调查。結果:雅加达的妇女拥有最高的(p<0.001)红血球叶酸水平,872 nmol/L (95% CI; 833, 910),其次是吉隆坡妇女,叶酸水平高达674 nmol/L (95% CI: 644, 704)。北京妇女的叶酸水平为之最低,只达563 nmol/L (95% CI: 524, 601)。有鉴于此,预测北京的神经管畸形的发生率将是最高,达至30/10000 (95% CI: 27, 33),接着是吉隆坡,24/10000 (95% CI: 22, 25),而雅加达的发生率将是最低,只是15/10000 (95% CI: 14,15) 結論:根据我们的红血球叶酸研究结果显示,在这三大城市中,北京将是在提高叶酸水平以降低神经管畸形的发生率的计划中最为受惠的城市,并拥有最显着的效果。

關鍵詞:红血球叶酸,神经管畸形,食品强化,亚洲,妇女。

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Reduction in childhood malnutrition in Vietnam from 1990 to 2004

NGUYEN CONG KHAN, LE DANH TUYEN, TRAN XUAN NGOC, PHAN HOAI DUONG, HA HUY KHOI Reduction in childhood malnutrition in Vietnam between 1990 and 2004 was assessed using data from 5 national surveys. The prevalence of malnutrition, including stunting, declined significantly for underweight from 45% in 1990 to 26.6% in 2004. While the average reduction was 1.3% per year in the period from 1990 to 2000, it was 1.8% per year in the period from 2000 to 2004. The prevalence of stunting declined from 56.5% in 1990 to 30.7% in 2004, with an average reduction of 2% per year in the period from 1990 to 2000 and 1.5% per year in the period from 2000 to 2004. There were clear differences in the decrease in malnutrition prevalence between urban, rural and mountainous areas, the reduction being highest in the urban regions and lowest in the mountainous areas. Regression analysis showed that the nutrition status of the child is positively related to better household living conditions and to the educational level of the father, but not the mother. Stunting is higher in children whose parents are farmers and higher in households with more children. Stunting prevalence is lower in households with safe water access and hygienic toilets.  In future , the dramatic reduction is childhood malnutrition as seen in the period 1990 to 2004 might not continue. More comprehensive apptoaches will be  needed to lower childhood malnutrition in Vietnam further. Key Words: malnutrition, Vietnam, stunting, poverty

top 越南19902004年兒童營養不良下降的情形

 採用五個全國性調查的資料評估越南在19902004年兒童營養不良情形是否下降。營養不良的盛行率,包含發育遲緩、體重過輕1990年的45%顯著降低到2004年的26.6%19902000年間每年平均降低1.3%2000年至2004年之間每年則下降1.8%。發育遲緩的盛行率自1990年的56.5%降低至2004年的30.7%,在19902000年之間每年平均降低2%2000年至2004年之間每年則下降1.5%。都會、鄉村及山區的營養不良盛行率下降情形有明顯的差異,降低最多的是都會地區,最低的則在山區。迴歸分析顯示兒童營養狀況與較佳的家戶居住狀況及父親的教育程度有關,與母親教育程度則無關。父母親為農民,並且其家庭的小孩數目較多者,發育遲緩率較高。發育遲緩盛行率在有安全飲用水的家戶及衛生的廁所較的家戶較低。像19902004年之間兒童營養不良的盛行率急遽的降低,在未來可能無法持續。需要採用更加全面的方法以降低越南兒童營養不良的情形。   關鍵字:營養不良、越南、發育遲緩、貧窮。

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Nutritional status, body composition and health conditions of the Karen hill tribe children aged 1-6 years in Northern Thailand

PRASONG TIENBOON AND PRASIT WANGPAKAPATTANAWONG Introduction: In Thailand, according to the national nutrition survey of the Thai population who live in the cities by the Ministry of Public Health, about 12% of preschool children aged 1-6 years were malnourished.  The rate of malnutrition is much higher among mountain minority (‘hill tribe’) children than city children.  This paper reports a study of malnutrition, body composition and health conditions of Karen hill tribe children aged 1-6 years in Thailand.Methods: All children aged 1-6 years (N = 158; 83 boys, 75 girls) from the three Karen villages (Mae Hae Tai, Mae Yot, Mae Raek) of Mae Chaem district in the north of Thailand were studied.  Anthropometric measurements of all children were obtained and body composition data were derived. All children were examined by a qualified medical doctor.  A stool sample and blood smear for malaria from all children were examined by a well qualified medical technologist.  Results: All families of the study boys and girls had incomes lower than the Thailand poverty line (US $ 1,000/year).  There were no significant differences in weight, height or body mass index of boys and girls from each of the three villages.  Malnutrition in children were found 85.5% by using weight-for-age, 73% by height-for-age (stunting) and 48.4% by weight-for-height (wasting).  Boys had more total body fat mass than girls.  However, all of them had low lean body mass and fat mass.  Nearly all children (98%) suffered from either upper respiratory tract infection, skin infection, scabies and/or diarrhoea.  Also, nearly all of them (97%) had scaly and dry skin over their chest walls and legs.  About 10% of children had either angular stomatitis (5%) or bleeding per gums (3%) or bow legs (1%) or frontal bossing (1%) with their implications for micronutrient deficiency. None of the children from the three villages were infested with the malarial parasite.  On average, 54% of children from Mae Hae Tai village and 85% of children from Mae Yot village but only 4% of the children from Mae Raek village were infested with parasites.  Ascaris lumbricoides was the most common infestation in all children from three villages.  Conclusion: The prevalence of malnutrition was high among the Karen hill tribe children aged 1-6 years, Thailand.   Most of the children suffered from upper respiratory tract infection, skin infection, scabiasis and/or diarrhrea.  Nearly all of them had scaly and dry skin over their chest walls and legs which indicated essential fatty acid deficiencies.  However, only 10% of them had vitamin deficiencies such as B2, C, and D. Key Words: nutritional status, body composition, PEM (Protein Energy Malnutrition), micronutrient deficiencies, health, illness, intestinal parasitosis, Karen, children, hill tribes, Thailand

泰國北部Karen 山區部落1-6 歲少數民族兒童營養狀況、體組成及健康情形
前言:在泰國,依據公共衛生部針對泰國城市族群所做的國民營養調查,約有12%1-6 歲的學齡前兒童為營養不良。在山區少數(“山區部落”)兒童營養不良率遠較
城市兒童高。此研究報告居住在泰國Karen 山區部落的1-6 歲兒童之營養不良、體
組成及健康狀況。方法:泰國北部湄蔣縣的三個Karen 村落(Mae Hae Tai、Mae Yot、Mae Raek)1-6 歲兒童(N=158;83 名男孩、75 名女孩) 全部納入研究。所有兒童均進行體位測量及並換算成體組成資料。所有的兒童均經過一位合格的醫生評估。所有兒童的糞便及血液塗片經過一位合格的醫事技術員檢查是否有瘧疾。結果:參與研究的男孩及女孩的家庭收入均低於泰國的貧窮線(1,000 美元/年)。來自於三個村落的男孩及女孩的體重、身高或是身體質量指數沒有顯著差異。採用年齡別體重評估營養不良的兒童為85.5%,年齡別身高(發育遲緩)為73%及身高體重別(耗損)為48.4%。男孩總體脂肪量雖較女孩高,但是男女的瘦體組織及脂肪重均是低的。幾乎所有的兒童(98%)患有上呼吸道感染、皮膚感染、疥瘡及/或腹瀉。同樣的,幾乎全部的兒童(97%)在他們的胸部及腿部呈現鱗狀及乾性皮膚。約有10%的兒童因為他們的微量營養素缺乏,而有口角炎、牙齦出血(3%)、O 型腿(1%)或是額骨突起之現象。三個村落的兒童均未感染瘧原蟲。平均54%Mae Hae Tai 兒童、85%Mae Yot 兒童,但是只有4%Mae Raek 兒童感染寄生蟲。蛔蟲是三個村落所有的兒童最常見的寄生蟲感染問題。結論:在泰國Karen 山區部落的1-6 歲兒童有高的營養不良盛行率。大部分的兒童患有上呼吸道感染、皮膚感染、疥瘡及/或腹瀉。幾乎所有的兒童胸部及腿部皮膚呈現鱗片狀及乾性,指出必需脂肪酸缺乏的問題。只有10%的兒童有維生素缺乏,如維生素B2、C 及D。
關鍵字:營養狀況、體組成、PEM(蛋白質熱量營養不良)、微量營養素缺乏、健康、生病、腸內寄生蟲病、Karen、兒童、山區部落、泰國。

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Diet supplemented with MCT oil in the management of childhood diarrhea

CELESTE C. TANCHOCO, ARSENIA J. CRUZ, JOSSIE M. ROGACCION, ROSEMARIE S. CASEM, MARIETTA P. RODRIGUEZ, CONSUELO L. ORENSE AND LILIBETH C. HERMOSURA This study was undertaken to determine the effect of medium-chain triglyceride (MCT) oil supplementation on the duration and episodes of diarrhea attacks, and specifically its effect on the clinical manifestations of patients.    Seventeen children aged 6 months to 47 months old with a mean age of 19.6 months, suffering from acute diarrhea at the Pediatric Ward of the Philippine General Hospital Medical Center and other neighboring health centers were studied.  A double-blind randomized design was employed.  Physical and clinical assessment was performed by a physician prior to enrolment in the study.  Dietary, anthropometric, and biochemical assessment were undertaken by clinical investigators before and after the supplementation. The subjects were randomly assigned to either the MCT oil- supplemented diet or the non-MCT oil diet.  Daily monitoring of food intake and the frequency or episodes of diarrhea attacks was done.  Subjects were closely monitored for any possible adverse reactions. The baseline characteristics of the subjects were not significantly different for any of age, height, weight, cholesterol or triglyceride concentrations between the two groups.  Nutrient intakes at baseline and during intervention were also not significantly different.  There were no differences in cholesterol and triglyceride between the two groups after supplementation.  Stool frequencies of the MCT group and the non-MCT group at baseline, after the 6th hr, and at 12th hour, were not different.  No subject developed fat malabsorption during the intervention, as assessed with Sudan Black stain.  There was nostatistically significant difference in the rate of weight gain among subjects in the MCT group compared to subjects  in  the non-MCT group , but a trend in this direction (0.22 + 0.22 kg/day vs -.048 + .26 kg/day), (p=.042).  MCT oil may promote weight gain (although what this constitutes in body compositional terms is uncertain) and shows a trend towards shorter duration of intervention among children with acute diarrhea. Limited sample size precludes conclusions on these possibilities.  MCT oil did not cause vomiting, dehydration, or fat intolerance.  MCT oil did not cause an elevation in cholesterol and triglyceride levels. More studies, with larger sample size, and longer duration will be worthwhile to assess the effect of MCT oil on childhood diarrhea. Key Words: medium-chain triglyceride oil (MCT oil), diarrhea, children, nutritional status

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飲食中補充MCT處理小孩腹瀉

 此研究評估在腹瀉期間補充中鏈脂肪酸(MCT)油脂的效應,特別對病人臨床表現的效應17名,於菲律賓醫院醫學中心小兒科病房及其鄰近的健康中心就診的急性腹瀉兒童,年齡647個月,平均年齡19.6個月採用雙盲隨機設計。在納入研究前,由一名醫生進行身體及臨床評估。在補充之前及之後,臨床研究者進行飲食、體位測量及生化評估。研究對象隨機分派進入MCT油脂補充飲食或非MCT油脂補充飲食。每日監測飲食攝取及腹瀉的頻率。任何可能會出現的副作用均接受嚴密的監控。兩組在研究開始之年齡、身高、體重、膽固醇或是三酸甘油酯濃度等基本特性均沒有顯著差異。研究開始及介入其間的營養素攝取也沒有顯著差異。在補充MCT油脂後,兩組的膽固醇及三酸甘油酯沒有不同。MCT組與非MCT組在研究開始、6小時及12小時候排便的次數沒有差異。採用蘇丹染色評估,沒有研究對象在介入期間脂質吸收不良的現象MCT組比起非MCT組的研究對象體重增加率沒有統計上顯著差異,但是有趨勢存在(0.22 + 0.22 kg/day  vs   -.048 + .26 kg/day), (p=.042)MCT油脂可能促進體重增加(雖然這個成分在體組成的名詞還不),且在急性腹瀉兒童短期介入呈現趨勢。因為受樣本數,使得無法下結論。MCT油脂不會引起嘔吐、脫水或脂質耐受不良。MCT油脂也不會造成膽固醇及三酸甘油酯的升高。較多較大樣本及較長的時間之研究,將值得用以評估MCT油脂在兒童腹瀉的效應

 關鍵字:中鏈三酸甘油酯(MCT油脂)、腹瀉、兒童、營養狀況。

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Psychosocial care and nutritional status of children aged 6-36 months among patrilineal (Karo) and matrilineal (Minangkabau) households in Jakarta

JUDHIASTUTY FEBRUHARTANTY, AVITA A. USFAR, ERMITA DIANAWATI, DUMA O. FRANSISCA, AIRIN ROSHITA AND UMI FAHMIDA A study on psychosocial care among Karo (patrilineal kinship) and Minangkabau (matrilineal kinship) households who lived in Jakarta, Indonesia was aimed at investigating psychosocial care practices of mothers and the relation of psychosocial care to the nutritional status of children aged 6-36 months as indicated by Weight-for-
Age (WFA), Weight-for-Height (WFH), and Height-for-Age (HFA) Z-scores. The study was a cross sectional study. The tool used to assess the psychosocial care was the Home Observation for Measurement of the Environment (HOME) inventory scale for infants and toddlers. Psychosocial care of 52 respondents from Karo and 87 from Minangkabau were generally good. Out of the total 45 items of the six sub-scales HOME inventory, 1 item in sub-scale I (Emotional and verbal responsiveness), 4 items in sub-scale II (Acceptance of child’s behavior), 1 item in sub-scale IV (Provision of play materials), 1 item in sub-scale V (Parental involvement with child), and 3 items in sub-scale VI (Opportunities for variety in daily stimulation) were statistically different between the two ethnic groups. More Minangkabau children were underweight and wasting compared to Karo children. Within the Karo group, well-nourished children in terms of WFA and WHA tended to have greater total HOME scores than their underweight and wasting counterparts. Among Minangkabau group, well-nourished children in terms of WFA, WHA, and HFA tended to have greater total HOME scores than their underweight, wasting, and stunting counterparts. The total HOME score of well-nourished Karo children in terms of WFA, WFH and HFA were greater than that of well-nourished Minangkabau children.
Key Words: Indonesia, Karo, Minangkabau, nutritional status, psychosocial care

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雅加達父系(Karo)及母系(Minangkabau)家庭中6-36 個月兒童 心理社會照護與營養狀況 研究印尼雅加達Karo(父系親系)Minangkabau(母系親系)家庭的心理社會照護,目的為探討母親的心理社會照護行為及心理社會照護與6-36 個月的兒童營養狀況之相關,以年齡別體重(WFA)、身高別體重(WFH)及年齡別身高(HFA)Z 分數作為指標。本研究是一個橫斷性研究。心理社會照護採用嬰幼兒家庭環境評估量表(HOME)為評估工具。52 Karo 87 Minangkabau 受試者受試者其心理社會照護普遍良好。在HOME 量表中共有45 題及6 個次量表,次量表I 1 (情感及言語應答)、次量表II 4 (小孩行為舉止的接受度)、次量表IV 1 (遊戲材料的提供)、次量表V 1 (父母親參與小孩)及次量表VI 3 (日常刺激變化的機會)在兩個氏族有統計上的差異。Minangkabau 兒童比起Karo 的兒童有較多體重過輕及耗損之現象。在Karo 組中,以WFA WHA而言,良好營養狀況的兒童比起體重過輕及耗損傾向的兒童有較高的總HOME 分數。在Minangkabau 組,以WFAWHA HFA 而言,良好營養狀況的兒童比起體重過輕、耗損及有發育遲緩傾向的兒童有較高的總HOME 分數。以WFAWFHHFA 而言,Karo 營養狀況良好的兒童,其總HOME 分數較營養狀況良好的Minangkabau 兒童高。
 
關鍵字:印尼、KaroMinangkabau、營養狀況、心理社會照護。

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Zinc-iron, but not zinc-alone supplementation, increased linear growth of stunted infants with low haemoglobin

UMI FAHMIDA, JOHANNA SP RUMAWAS, BUDI UTOMO, SOEMIARTI PATMONODEWO AND WERNER SCHULTINK Zinc supplementation has been shown to benefit linear growth. However the effect may depend on whether zinc is the most limiting nutrient. This study aims to investigate the effect of supplementation with zinc-given alone or with iron and vitamin-A in improving infants’ micronutrient status and linear growth.  The study was a double-blind-community-intervention study involving 800 infants aged 3-6months in rural East Lombok, West Nusa Tenggara. Syrup consisting of zinc-alone, Zn (10 mg/d), zinc+iron, Zn+Fe (10 mg/d of each), zinc+iron+vitamin-A, Zn+Fe+vit.A (10 mg/d of each zinc and iron plus 1,000 IU vitamin-A), or placebo were given daily for six months. Outcomes measured were length, weight, and micronutrient status (haemoglobin, serum zinc, ferritin and retinol). Zn+Fe and Zn+Fe+vit.A supplementations benefit zinc and iron status of the subjects, while Zn-alone supplementation disadvantaged haemoglobin and iron status. The highest increment in vitamin A and haemoglobin status was shown in Zn+Fe+vit.A group. An effect on linear growth was observed among initially-stunted subjects in Zn+Fe and Zn+Fe+vit.A groups who grew 1.1-1.5cm longer than placebo. On the other hand, in the Zn-alone group, mean height-for-age Z-score decreased to a greater extent than placebo. The between-group difference in HAZ among initially-stunted subjects was significant after four months supplementation. While the difference was not significant in follow-up after 6 months, the pattern remained the same where means height-for-age Z-score in Zn+Fe+vit.A and Zn+Fe groups were higher than placebo and Zn-alone groups. Given the low haemoglobin/iron status of the subjects, zinc supplementation would have positive effect on growth if the low haemoglobin/iron status is also addressed and corrected.

Key Words: optimal growth, infant, iron, micronutrient, zinc

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補充-,而非單獨補充鋅,可促進發育不良併有低血紅素的嬰兒線性生長

補充鋅指出有益於線性生長,然而其效應可能取決於鋅是否為最限制的營養素。本研究目的為調查單獨給予鋅或是和鐵及維生素A一起補充,對於改善嬰兒微量營養素狀況與線性生長的效應。本研究為雙盲社區介入研究,800名居住在東Lombok鄉村、西Nusa Tenggara3-6個月嬰兒參與研究。每天給予研究對象含鋅(10mg/d)、鋅+(鋅跟鐵各10mg/d)、鋅++維生素A(鋅跟鐵各10mg/d加上1,000IU的維生素A),或是安慰劑的糖漿為期六個月。結果變項為身長、體重及微量營養素狀況(血紅素、血清鋅、鐵蛋白與視網醇)。補充鋅+鐵與鋅++維生素A對於研究對象的鋅及鐵狀況有益,然而單獨給予鋅時則不利於血紅素及鐵的狀況。維生素A與血紅素增加最多的為鋅++維生素A組。原本為發育不良的研究對象,在補充鋅+鐵及鋅++維生素A後比給予安慰劑組成長了1.1-1.5公分。另一方面,在單獨補充鋅組,平均年齡身高別Z分數下降程度較安慰劑組大。原本為發育不良的研究對象在經過四個月的補充之後,HAZ在組別間有顯著的差異。然而在追蹤六個月後,儘管平均年齡身高別Z分數仍維持相同的模式,即鋅++維生素A及鋅+鐵的組較安慰劑組或單獨補充鋅組高,但其間的差異不再顯著。對血紅素/鐵狀況較差的研究對象而言,在低血紅素/鐵狀況已被改善的條件下,補充鋅將對生長狀況具有正面的影響。

關鍵字:理想生長、嬰兒、鐵、微量營養素、鋅。

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Anaemia in pregnant, post partum and non pregnant women in Lak District, Daklak Province of Vietnam

LIEU THI THUY TRINH AND MICHAEL DIBLEY Objectives: To determine anaemia prevalence and related factors in pregnant women (PW), post partum women (PPW) and non pregnant women (NPW) in a remote mountainous district. Methods: A cross-sectional survey was conducted in 2001. All PW, all PPW within 6 months of delivery and a random number of NPW equivalents to the number of PW in each commune were selected. Hemoglobin (Hb) was measured using Hemocue method. Mild anaemia was defined as Hb=7g/dL-11g/dL in PW, and 8g/dL-12g/dL in NPW and PPW. Severe anaemia was defined as Hb<7g/dL in PW, and<8g/dL in NPW and PPW. Pregnancy status was determined using urine pregnancy test and calculation of expected menstruum. Results: There were 901 women surveyed: 281 PW, 348 PPW and 272 NPW. More than half (58%) were anaemic: 54% mild and 4% severe. Mean Hb was 11.1g/dL. More PPW had anaemia (62%; OR=1.4; 95%CI=1.1-2.1 compared to NPW) than NPW (54%) and PW (53%). Other related factors were being BoY, Ede and Koho ethnics (OR=2.7; 95%CI=1.4-5.0 compared to Kinh ethnic), having primary education or lower (OR=1.5; 95%CI=1.1-2.1 compared to secondary education or higher). Among PW, being pregnant during the third trimester increased anaemia (OR=2.2; 95%CI=1.3-3.8 compared to being pregnant during the second trimester). Among PPW, women aged 30 or older were more anaemic (OR=1.7, 95%CI=1.1-2.9 compared to women aged 20-29). Conclusion: Anaemia prevalence was very high. Interventions should be focused on PPW, PW during the last trimester, minority ethnic women, low-educated and older women. Key Words: anaemia, women, pregnancy, postpartum, prevalence, factors associated, ethnicity, education, Vietnam, Lak district, Daklak province

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越南Daklak 省Lak 區懷孕、產後及未懷孕的女性之貧血狀況

目的:評估在偏遠山區懷孕婦女(PW)、產後婦女(PPW)及未懷孕婦女(NPW)的貧血盛行率與其相關因子。方法:一個橫斷性調查在2001 年進行。研究納入每個行政區中所有的PW、在六個月之內分娩的PPW,及隨機選取與PW 等量的NPW。採用Hemocue 法測量血紅素量(Hb)。輕微貧血的定義在PW Hb=7g-11g/dLNPW PPW 8g/dL-12g/dL;嚴重貧血的定義在PW Hb<7g/dLNPW PPW <8g/dL。懷孕狀態的評估是採用尿液驗孕並計算預產期。結果:總共有901 名女性接受調查:281 PW348 PPW 272 NPW。超過一半(58%)的人有貧血的現象:54%輕微及4%嚴重。平均血紅素為11.1g/dLPPW(62%OR=1.495% CI=1.1-2.1)的貧血盛行率高於NPW(54%)PW(53%)。其他相關因子為BoYEde Koho (Kinh 族相比OR=2.795% CI=1.4-5.0),教育程度為初等或更低(與中等教育或更高相比OR=1.595% CI=1.1-2.1)。在PW,懷孕第三期貧血機率也增加(與懷孕第二期相比OR=2.295% CI=1.3-3.8)。在PPW,年齡在30 歲或以上的女性貧血機率也較高(與年齡在20-29 歲的女性相比OR=1.795% CI=1.1-2.9)。結論:貧血盛行率非常高。介入的焦點應該放在PPW 及懷孕最後期的PW、少數民族的女性、低教育程度與較老的女性。
關鍵字:貧血、女性、懷孕、產後、盛行率、相關因子、氏族、教育程度、越南、Lak 區、Daklak 省。

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Determinants of exclusive breastfeeding duration in Xinjiang, PR China

FENGLIAN XU, COLIN BINNS, SU ZHENG, YAN WANG, YUN ZHAO AND ANDY LEE Objective: To document ‘exclusive breastfeeding’ duration and factors associated with duration in Xinjiang, PR China. Methods: A cohort of 1219 mothers in Xinjiang, PR China was recruited to study their infant feeding practices. The mothers who delivered babies during 2003 and 2004 were contacted in hospital and again at 0.5, 1.5, 2.5, 3.5, 4.5 and 6 months postpartum, or until they ceased to breastfeed. Interviews were conducted using a structured questionnaire.  Survival analysis was used to calculate the mean of ‘exclusive breastfeeding’ and explore factors affecting ‘exclusive breastfeeding’ duration. Results: The average ‘exclusive breastfeeding’ duration in Xinjiang was 1.8 months. Factors negatively associated with ‘exclusive breastfeeding’ duration were mother’s going to work and using pacifier. Factors positively associated with ‘exclusive breastfeeding’ duration were ‘whether the maternal mother breastfed her children’ and deciding ‘exclusive breastfeeding’ before delivery. Conclusions: ‘Exclusive breastfeeding’ duration in Xinjiang, PR China was short. The study identified some factors associated with ‘exclusive breastfeeding’ duration. The results suggested an education program aimed to correct traditional inappropriate breastfeeding perceptions and promote ‘exclusive breastfeeding’ in Xinjiang. Key Words: ‘exclusive breastfeeding’, breastfeeding duration, factors, Xinjiang, China

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中国新疆纯母乳喂养时间的影响因素 

目的: 调查中国新疆的纯母乳喂养时间及其影响因素。

方法: 队列研究。于20032004年,随机抽取在新疆乌鲁木齐市、石河子市、察布查尔县和裕民县分娩的1219名产妇。调查孩子出生时的喂养状况,并于产后0.5, 1.5, 2.5, 3.5, 4.5 6个月随访婴儿的喂养状况。6个月前断奶的孩子随访到断奶为止。调查工具为测试合格的问卷。统计方法为生存分析。结果:新疆纯母乳喂养时间为1.8个月。不利于维持纯母乳喂养时间的因素为母亲上班和给孩子含空奶嘴,有利因素为姥姥有母乳喂养经历、产前决定纯母乳喂养。结论:中国新疆的纯母乳喂养时间比较短。根据本次研究筛检出的影响纯母乳喂养的因素,建议开展有关的健康教育,更正传统上不合理的喂养观念,从而延长该区的纯母乳喂养时间。

关键词: 纯母乳喂养、母乳喂养时间、因素、新疆、中国。

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Fatty acid intakes and food sources in a population of older Australians

VICTORIA M FLOOD, KAREN L WEBB, ELENA ROCHTCHINA, BRIDGET KELLY AND PAUL MITCHELL Objective: To document dietary intakes and food sources of fatty acids among older Australians. Design: Population-based survivor cohort. Setting: Two postcode areas in the Blue Mountains, West of Sydney, Australia. Subjects: In 1997-9, 2334 people aged 55 years and over, participated in a 5-year follow-up of the cohort attending
the Blue Mountains Eye Study (BMES). Dietary data were collected using a semi-quantitative food frequency questionnaire by 2005 persons (86% of those examined). Types of fats were classified as saturated fatty acids (SFA), monounsaturated (MUFA), polyunsaturated (PUFA) and trans unsaturated fatty acids. Results: Mean total fat intake contributed 31.3% of daily energy intake (12.2% SFA, 11.2% MUFA, 5.0%
PUFA). Mean omega 3 (n-3) PUFA intake comprised 0.5% of energy intake (long chain n-3 PUFA provided mean intake of 260mg, consisting of eicosapentaenoic (EPA), docosapentaenoic (DPA) and docosahexaenoic (DHA) fatty acids) and the n-6: n-3 PUFA ratio was 9:1. The main fatty acids contributing to the diet were palmitic acid, oleic acid and linoleic acid. Meat products were the highest contributors to total fat and MUFA intakes; milk products were the highest contributor to SFA intakes; and fat spreads and oils, and breads and cereals were the main food groups contributing to PUFA intakes. Fish was the main source of long chain n-3 fatty acids. Conclusions: This population-based descriptive study documents fatty acid intakes in a population of older Australians. It will serve as a basis for investigations of associations between dietary fatty acid intakes and a number of eye diseases.
Key Words: fatty acid, Blue Mountains Eye Study, omega-3 fatty acids, dietary intake, fish

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澳洲老年族群的脂肪酸攝取及其食物來源

目的:紀錄澳洲老年人的膳食脂肪酸攝取及食物來源。設計:族群基礎存活世代。地點:澳洲雪梨西部藍山的兩個郵遞區號區域。研究對象:自1997 1999 年,2334 名年齡為55 歲或以上的老年人參與追蹤5 年的藍山眼睛研究(BMES)2005 名研究對象的飲食資料採用半定量膳食頻率問卷收集(86%被評估)。脂質依據型態分為飽和脂肪酸(SFA)、單元不飽和脂肪酸(MUFA)、多元不飽和脂肪酸(PUFA)及反式不飽和脂肪酸。結果:平均總脂肪攝取量佔每日熱量攝取量13.3% (12.2% SFA11.2%MUFA5.0% PUFA)。平均Omega 3 (n-3)PUFA 攝取佔0.5%的熱量攝取(長鏈n-3PUFA 平均攝取260mg,由20 5 烯酸(EPA)22 5 烯酸(DPA)22 6 烯酸(DHA)組成)n-6n-3 PUFA 比值為91。膳食主要脂肪酸來源為棕櫚酸、油酸及亞麻油酸。肉類製品可貢獻最高量的總脂肪及MUFA 攝取;奶類製品則貢獻最高量的SFA 攝取;塗抹人造奶油、麵包及穀類為提供PUFA 攝取的主要食物類別。魚類為長鏈n-3 脂肪酸的主要來源。結論:這個族群基礎的調查研究說明澳洲老年族群的脂肪酸攝取,可作為研究膳食脂肪攝取與數種眼睛疾病相關的基礎。
 
關鍵字:脂肪酸、藍山眼睛研究、omega-3 脂肪酸、膳食攝取、魚。

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Long-term adoption of a Mediterranean diet is associated with a better health status in elderly people; a cross-sectional survey in Cyprus

DEMOSTHENES B. PANAGIOTAKOS, ANNA POLYSTIPIOTI, NATASSA PAPAIRAKLEOUS AND EVANGELOS POLYCHRONOPOULOS Background: There is increasing evidence that there are protective health effects from diets which are high in fruits, vegetables, legumes, and whole grains, and which include fish, nuts, and low-fat dairy products. We sought to investigate the association of Mediterranean diet on clinical status of 150 elderly men and women. Methods: During 2004 - 2005, we studied 53 men and 97 women, aged 65 to 100 years, from various areas of Cyprus. A diet score that assesses the inherent characteristics of the Mediterranean diet was developed for each individual (range 0-55). Adoption of the Mediterranean diet was evaluated against the presence of cardiovascular risk factors like hypertension, diabetes, hypercholesterolemia and obesity. Results: 26% of men and 18% of women had diabetes, 60% of men and 58% of women had hypertension, 60% of men and 68% of women had hypercholesterolemia, and 34% of men and 52% of women were obese. More than 90% of the participants reported consistency in their dietary habits for at least the past 3-4 decades. A significant inverse correlation was observed between diet score and the number of the investigated risk factors (rho
= -0.26, p < 0.001). When we took into account age, sex, smoking habits, and physical activity status, we observed that a 10-unit increase in the diet score was associated with 21% lower odds of having one additional risk factor in women (p < 0.001) and with 14% lower odds in men (p = 0.05). Conclusion: Adherence to a Mediterranean diet is associated with reduced odds of having hypercholesterolemia,
hypertension, diabetes and obesity among elderly people.
Key Words: hypertension, hypercholesterolemia, diabetes, obesity, Mediterranean diet, elderly

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老年人長期採用地中海型飲食與較佳的健康狀況有 關:一個賽浦路斯橫斷性調查


 背景:越來越多的研究證實攝取含有高量的水果、蔬菜、豆類及全穀類,包含魚類、堅果類及低脂乳製品的飲食,對健康具有保護的效應。本研究計畫探討地中海型飲食對150 名男女性老人的臨床狀況之相關。方法:在2004-2005 年期間,我們研究來自賽浦路斯不同地區的53 名男性及97 名女性,年齡在65-100 歲。每個人回答一個評估地中海型飲食的固有特性的問卷,並計算飲食分數(範圍0-55)。評估採用地中海型飲食對抗心血管疾病 的危險因子的能力,如高血壓、糖尿病、高膽固醇血症及肥胖。結果:26%的男性與18%的女性有糖尿病,60%的男性與58%的女性有高血壓,60%的男性與68%的女性罹患高膽固醇血症,64%的男性與52%的女性為 肥胖者。超過90%的參與者自陳,至少過去三四十年間的飲食習慣是一致。飲食分數與研究的危險因子數呈現顯著負相關(rho=-0.26, p<0.001)。當我們考量年齡、性別、抽菸習慣及體能活動狀況,發現飲食分數每增加10 單位,可降低女性(p<0.001) 21%多一個額外危險因子的機率,男性則降低14%(p=0.05)。結論:採用地中海型飲食,與老年人降低罹患高膽固醇血症、高血壓、糖尿病和肥胖的機率有關。
 
關鍵字:高血壓、高膽固醇血症、糖尿病、肥胖、地中海型飲食、老人。

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Interview to study the determinants of hypertension in older adults in Taiwan: a population based cross-sectional survey

ALAN CHUNG-HONG TSAI, JENN-CHANG LIOU AND MING-CHENG CHANG

The aim of the study was to assess the association of socioeconomic, anthropometric and lifestyle factors with self-reported hypertension in older adults in Taiwan. The data were part of the “1999 Survey of Health and Living Status of the Elderly in Taiwan”. The survey was conducted in-home, face-to-face, by interviews of 4440 men and women, 53 years or older, in a population-based cross-sectional study. The prevalence of self-reported hypertension was 31.1% for men and 38.0% for women. A logistic regression model showed a higher probability of self-reported hypertension for female gender, older age, and greater BMI, and lower probability for increased consumption of leguminous foods. No association was observed with cigarette smoking, alcohol consumption or physical activity. Current cigarette smokers and alcohol-drinkers underreported their hypertension status. Compared to the medically measured hypertension of a sub-sample study of the same cohort, only about 60% of
medically-substantiated hypertensive patients self-reported their hypertensive status, indicating that the interview survey underestimated the prevalence of hypertension in this Taiwanese elderly population. The interview survey appears to identify associations of hypertension with age, gender, BMI and some food patterns, but does not recognize the likely associations with the candidate risk factors of physical inactivity, cigarette smoking, alcohol consumption and limited education, at least in this Taiwanese population. Thus caution must be applied where interview alone categorises individual older Taiwanese as hypertensive or not. A survey which has validation or cross-checking questions about the medical diagnosis of hypertension and the likelihood of its memory and appreciation by the patient (such as method, definition, communication with patient, recall and follow-up, lifestyle advice or pharmaco-therapy, presence of cognitive impairment) may clarify the significance of the discrepancy between self-reporting and medical record. In turn, this would allow a more robust evaluation of blood pressure determinants in such populations. Nevertheless, there is a role for community-based surveys that utilise selfreporting
in the identification, prioritization and surveillance of putative contributors to hypertension; this is the case where, as in the Taiwanese elderly, it assumes major importance in the burden of disease and premature mortality.
Key Words: hypertension, interview surveys, self-reporting, medical records, body mass index, elderly, foods, legumes, Taiwan, validation

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以訪談調查研究台灣老人高血壓之影響因子: 一族群代表性之橫斷研究
 

本研究的目的在探討以受訪者問卷自陳方式來瞭解台灣中老年人的高血壓症與社會、經濟、體位指標及生活習性等因素間的關聯性。本研究之原始資料來自「1999 年台灣地區中老年身心社會生活狀況長期追蹤調查」。該調查以橫斷方式對4440 53 歲以上的中老年人進行在家訪談。研究發現有31.1%的台灣中老年男性自答有高血壓,女性則有38%。資料經羅吉斯迴歸分析顯示女性、年齡大及肥胖者患高血壓的可能性較高;而多攝取豆類食品者患高血壓的機率則較低。是否有吸菸、飲酒或運動等行為則與高血壓無關。本研究也發現,吸菸者及常飲酒者有低報患有高血壓的情形。本研究亦分析經實際血壓測定的樣本子群的資料,以驗證自陳高血壓的準確性,發現只有60%有高血壓的患者自答有高血壓。此結果顯示,自陳式調查低估了台灣中老年人高血壓的盛行率。自陳式調查大致可以偵測出高血壓與年齡、性別、肥胖及一些飲食因素之關聯性,但不能偵測出高血壓與吸菸、飲酒、運動或教育程度之關聯性。因此引用自陳的方式判別有無高血壓的資料時,必需格外謹慎。要減少臨床檢查與自陳方法間估計高血壓罹患率之差異,或許可以採用一個能對臨床診斷結果及受訪者之記憶力加以驗證及對照的問卷來補強。儘管有這些缺點,自陳式調查在社區健康研究方面仍佔有重要的角色。此工具在判別、衡量及追蹤台灣中老年人高血壓的致病因子等方面具重要的任務。 關鍵字:高血壓、面談式調查、自答、病歷、身體質量指數、食物、豆類、台灣、效度。

 

top A multidimensional assessment of nutritional and health status of rural elderly Malays

SUZANA SHAHAR, ZURIATI IBRAHIM, AFAF RUHI ABDUL FATAH, SURIAH ABDUL RAHMAN, NOOR AINI MOHD. YUSOFF, FATIMAH ARSHAD, ZAITUN YASSIN AND SITI NUR ‘ASYURA ADZNAM A multidimensional assessment of nutritional and health status comprised of subjective global assessment (SGA), anthropometry function, biochemistry, dietary intake, social and health aspects was carried out on 820 older people (52.8% men and 47.2% women) from four rural areas of Peninsular Malaysia. A proportion of the subjects had been classified as either overweight (25.7%) or chronic energy deficient (20.3%). Although 49% of subjects had normal body weight, 68.4% have been classified as having mild to moderate malnutrition according to the SGA. Only 1.1% and 2.3% had low serum albumin and ferritin, respectively. Almost 80% of subjects, especially men, were at high risk of cardiovascular diseases on the basis of the assessment of total cholesterol and LDL-cholesterol. The majority of the subjects (87.2%) were fully independent in performing daily tasks, with men having a significantly higher score compared to women (p<0.001). However, men were less likely to be able to perform a flexibility test (50.7%) than were women (27.0%) (p<0.05). The mean energy intake for men (1412 461 kcal/d) and women (1201 392 kcal/d) were below the Recommended Nutrient Intake (RNI) for Malaysia, although this is a difficult assertion to make in an age-group which generally experiences declining energy expenditure. Moreover, 52.5% of men and 47.5% of women might have underreported their food intake. Dietary micronutrients most likely to be deficient were thiamin, riboflavin and calcium. It is concluded that a substantial proportion of rural elderly Malays had problems related to both undernutrition and overnutrition. An appropriate nutrition intervention program is needed to improve the nutritional status of rural elderly Malays.
Key Words: nutritional status, functional status, food intake, older people, anthropometry

top 馬來西亞鄉村老人營養與健康狀況之多面向評估
營養與健康狀況的多面向評估包含主觀整體評估(SGA)、體位功能、生化、飲食攝取、社會及健康等面向,總共有820 名(52.8%男性和47.2%女性)來自於馬來西亞半島四個鄉村區域的老人完成此評估。研究對象被歸為體重過重或是慢性熱量缺乏的比例為25.7%及20.3%。雖然49%的研究對象為正常體位,但有68.4%依據SGA 被歸為輕度到中度營養不良。分別只有1.1%和2.3%的人有低血清白蛋白及鐵蛋白。根據總膽固醇與LDL-膽固醇的評估,大約80%的研究對象其心血管疾病危險性高,尤其是男性。多數的研究對象的日常相關活動都可以完全獨立,男性的分數顯著性較女性高(p<0.001)。儘管如此,男性(50.7%)比起女性(27.0%)較少有能力去完成柔軟度測試(p<0.05)。男性(1412 461 大卡/天)及女性(1201 392 大卡/天) 的平均熱量攝取均低於馬來西亞的建議營養素攝取量(RNI),雖然如此,我們還是無法斷言這個年齡組的人是否普遍熱量消耗降低。此外,52.5%的男性及47.5%的女性低報食物攝取量。飲食中微量營養素最可能缺乏的為硫胺、核黃素及鈣質。總之,有相當數量的鄉村馬來老人有營養不良與營養過剩相關的問題。需要一個適當的營養介入系統,以改善馬來西亞鄉下老年人的營養狀況。
關鍵字:營養狀況、功能性狀態、食物攝取、老人、體位測量。

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Physical activity among adolescents in Taiwan

LI-JUNG CHEN , ANNE M HAASE AND KENNETH R FOX

Purpose: Most of the studies investigating prevalence and correlates of physical activity have been conducted in Western countries. To date, there are no internationally published data with nationally representative samples on physical activity prevalence among Taiwanese adolescents and little is known about the relevant factors associated with activity and inactivity. The objectives of this study were to assess the prevalence of physical activity in Taiwanese adolescents and to identify associated socio-demographic and behavioral variables. Methods: Data were extracted from the 2001 National Health Interview Survey in Taiwan. The sample was 2235 adolescents (1157 boys and 1078 girls) aged 12-18 years. Univariate and multivariate logistic regression analyses were conducted to examine associations of demographic and behavioral variables with physical activity. Results: Although 80% of adolescents reported engaging in some physical activity, only 28.4% of the sample met recommended guidelines. Boys and urban adolescents were more active than girls and rural adolescents; and the prevalence of physical activity declined with age. Mean sedentary time was 9.5 hours each day. Though the proportions of non-students, regular smokers or drinkers were small, around half of them were physically inactive.
Conclusions: The percentage of Taiwanese adolescents meeting recommended amounts of physical activity for health is low, particularly, girls in the 15-18-age range being the least active. Associated factors with physical activity include both demographic and health behavior variables (e.g. age, gender, smoking). These data provide a baseline for future comparisons and preliminary identification of groups at higher risk of low physical activity in Taiwan.
Key Words: adolescent, health, physical activity, Taiwan

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台灣青少年的體能活動
目的:調查體能活動盛行率及其相關因素的研究大多數在西方國家。迄今,在台灣仍未有以全國代表性樣本,探討青少年體能活動盛行率之文章在國際期刊刊登,跟體能活動與否的相關因子也所知不多。本研究目的為評估台灣青少年的體能活動盛行率,並找出與其相關的社會人口學及行為變項。方法:資料取自2001 年國民健康訪問調查。樣本為2235 名年齡在12-18 歲的青年人(1157 名男性及1078 名女性)。採用單變項及多變項羅吉斯迴歸分析評估人口學及行為變項與體能活動之相關性。結果:雖然80%的青少年自陳從事一些體能活動,但只有28.4%的樣本達到建議量。男孩與居住在城市的青少年比起女孩及居住在鄉村的青少年活動量較高;且體能活動盛行率隨著年齡遞減。平均每天靜坐的時間為9.5 小時。雖然非學生、規律抽菸者或飲酒者只佔人數的一小部分,但其中約有一半是不運動的。結論:台灣青少年中活動量能達到健康建議量的百分比很低,尤其15-18 歲的女孩活動量最低。與體能活動相關的因素包含人口學變項及健康行為變項(例如:年齡、性別、抽菸)兩者。這些資料提供未來比較及初步確認台灣有較低體能活動的高危險族群的基礎。
關鍵字:青少年、健康、體能活動、台灣。

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Metabolic syndrome: recent prevalence in East and Southeast Asian populations

PAUL NESTEL, RAMON LYU, LIP PING LOW, WAYNE HUEY-HERNIG SHEU, WANNEE NITIYANANT, IKUO SAITO AND CHEE ENG TAN Background: The prevalence of the metabolic syndrome among a number of Asian populations as defined by several current criteria has been increasing rapidly and appears to resemble that among Western populations. Methods: We review 25 surveys of the metabolic syndrome in Asian populations (PR China, Hong Kong, Taiwan, Japan, Philippines, Singapore) that report adequate information published during the last 5 years. Results: Using Asian-adapted definitions of obesity (BMI ≥ 25 kg/m2) and increased waist circumference (for male ≥ 90 cm; for female ≥ 80 cm) prevalence appears to be between 10 to 30%. Those with the syndrome are more likely to have a history of diabetes and cardiovascular disease. The risk of developing Type 2 diabetes is 10 times higher among middle-aged Japanese men with the metabolic syndrome compared to healthy subjects. In Chinese and Japanese populations, people who have the metabolic syndrome are 3 to 10 times more likely to develop cardiovascular disease. Variance in prevalence estimates of the metabolic syndrome even within the same country result from differences in sampling and possibly from definitions. Conclusions: The outstanding conclusion from recent surveys across the Asian-Pacific region is that of a consistent increase in the prevalence of the metabolic derangements associated with abdominal adiposity that lead to high risk of morbidity and mortality. Key Words: metabolic syndrome, epidemiology, East and Southeast Asia, cardiovascular disease

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代謝症候群:當前東亞及東南亞人口的盛行率
背景:以幾個目前代謝症候群的標準定義,顯示在亞洲人口的代謝症候群盛行率已經快速增加,且與西方族群相似。方法:我們查證25 個調查亞洲族群(中國大陸、香港、台灣、日本、菲律賓、新加坡)代謝症候群之研究,這些都是近五年的報告並有足夠的訊息。結果:使用適用於亞洲人的肥胖定義(BMI ≥ 25 kg/m2)及腰圍(男性 ≥ 90 cm;女性 ≥ 80 cm),盛行率呈現在10-30%之間。有症候群的人,大部份有糖尿病及心血管疾病史。有代謝症候群的日本中年男性罹患第二型糖尿病的危險性較健康的人高出十倍以上。在華人及日本人中,有代謝症候群者有3-10 倍的機會可能發展成心血管疾病。即使在同一個國家,估計代謝症候群盛行率的變異可能來自抽樣的差異及不同的定義。結論:從近期橫跨亞太地區的調查得到的重要結論為,各國的與腹部肥胖有關的代謝紊亂盛行率呈現一致上升的趨勢,將導致罹病率與致死率危險上升。
關鍵字:代謝症候群、流行病學、東亞及東南亞、心血管疾病。

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Household food security status measured by the US-Household Food Security/Hunger Survey Module (US-FSSM) is in line with coping strategy indicators found in urban and rural Indonesia

AVITA A USFAR., UMI FAHMIDA, AND JUDHIASTUTY FEBRUHARTANTY The food security assessment used by the United State’s Food Security/Hunger Survey Module (US- FSSM) was used in five studies: these were in two urban and four rural areas in Indonesia between February 2004-August 2005. The number of households assessed was 3,704 and consisted of 45% urban and 55% rural. All households had children below five years. This paper aims to assess the applicability of US-FSSM for measuring household food-insecurity in Indonesia. Common coping-strategies discussed are to borrow money from the family, get an additional job, to lessen portion size of food, and to sell small assets. Although households in urban and rural areas were similar in size/number of children and male headed; the urban households were more income-secure, educated, and had better access to electrical appliances. A majority of the households was food-insecure (77% and 84% in urban and rural consecutively). More food-insecure households without and with hunger were found in rural areas. The number of affirmative responses to 17 out of 18 questions in the USFSSM was more in the rural households, showing less fortunate cases of food-insecurity. For a given coping strategy, as food-security status becomes more severe, the higher the percentage of households employing it. For a given food-security status, percentage of households was higher among lower-degree and less among
higher-degree coping. Combining food-security and coping-strategy indicators may help to identify transientfood-secure households. Observing both indicators throughout different time of the year continuously may further identify adaptive mechanism by chronic-food-insecure households. Information on household food diversity could enrich findings on dietary intake modification, hence moving from food-security to nutrition-security.
Key Words: food security, Indonesia, coping strategies, urban and rural setting

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印尼城市及鄉村的家戶糧食安全狀況以美國家戶糧食安全/飢餓調查模數(US-FSSM)測量與因應策略指標的發現一致
2004 年2 月至2005 年8 月印尼的兩個城市及四個鄉村區域,有五個研究以美國糧食安全/飢餓調查模數(US-FSSM)評估糧食安全。被評估的家戶數目有3,704,由45%的城市及55%的鄉村所組成。所有的家戶均有五歲以下的兒童。本文的目的為評估採用US-FSSM 測量印尼家戶糧食不足的適用性。被討論到常見的因應策略有:從家庭借錢、多找一份工作、食物份量變小及販售小部分的資產。雖然在城市以及鄉村的家戶有類似的兒童及男性人數;但城市的家戶收入較有保障、教育程度較高及能使用到較多的家電用品。大部分的家戶有糧食不足(城市及鄉村分別為77%及84%)的情形。在鄉村地區,有較多的糧食不足家戶,不管有無飢餓狀況。在US-FSSM 的問題中18 題有17 題
的回答為肯定的,大部分是鄉村家戶,指出有糧食不足的不幸案例。當糧食安全狀況變得更嚴重時,有較高比例的家戶會使用已知的因應政策。在一定的糧食安全狀況下,較高百分比的家戶為低程度,高程度間因應比例較少。合併糧食安全及因應政策指標有助於確認短暫糧食安全家戶。連續觀察兩種指標在同一年的不同時間點的差異,可以進一步確認慢性糧食不足家戶的適應機制。家戶糧食多樣性的資訊可以加強飲食攝取的改變的發現,由糧食安全轉變為營養安全。
關鍵字:糧食安全、印尼、因應策略、城鄉區域。

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Attitudes of agricultural scientists in Indonesia towards genetically modified foods

JUDHIASTUTY FEBRUHARTANTY, TRI NISA WIDYASTUTI AND DWI NASTITI ISWARAWANTI Conflicting arguments and partial truths on genetically modified (GM) foods have left confusion. Although studies of consumer acceptance of GM foods are numerous, the study of scientists is limited. Therefore, the main objective of this study was to assess the attitudes of scientists towards GM foods. The study was a cross sectional study. A total of 400 scientists (involved in at least one of teaching, research and consultancy) in the Bogor Agricultural Institute, Indonesia were selected randomly from its faculties of agriculture, veterinary, fishery, animal husbandry, forestry, agricultural technology, mathematics and science, and the post graduate department. Data collection was done by face-to-face interview using a structured questionnaire and selfadministered
questionnaire. The result showed that the majority (72.8%) of the respondents were favorably disposed towards GM foods, 14.8% were neutral, and only 12.5% were against them. The majority (78.3%) stated that they would try GM food if offered. Most (71%) reported that they were aware of the term “GM foods”. Only half of the respondents felt that they had a basic understanding about GM foods. However, based
on a knowledge test, 69.8% had a good knowledge score. Nearly 50% indicated that they were more exposed to news which supported GM foods. Over 90% said that there should be some form of labeling to distinguish food containing GM ingredients from non-GM foods. Attitudes were significantly associated with willingness to try GM foods if offered, restrictions on GM foods, and exposure to media reports about the pros and cons of GM foods.
Key Words: attitude, genetically modified foods, intention, knowledge, scientists, Bogor, Indonesia

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印尼農業科學家對基因改造食品的態度
針對基因改造(GM)食品矛盾的論點及部分的真相已經逐漸釐清。雖然研究消費者對GM 食品的接受度研究很多,但針對科學家所做的研究仍然有限。因此,本研究主要的目的為評估科學家對於GM 食品的看法。本研究是一個橫斷性研究。隨機選取自印尼Bogor 農業研究所的農業、獸醫、水產、畜牧、森林、農業技術、數學及科學系所與博士後研究單位,共有400 名科學家(每個系所至少有一名教學、研究與顧問人員參與)參與研究。面對面訪談,以自填式的結構問卷收集資料。結果顯示大部分的受訪者(72.8%)傾向贊同GM 食品、14.8%持中立立場,只有12.5%反對。大部分受試者(78.3%)表示如果提供的話,他們願意嘗試GM 食品。大部分(71%)自陳他們知道GM 食品的意涵。只有一半的受訪者認為他們對GM 食品有基本的了解。然而,根據認知測驗,69.8%有良好的認知分數。將近50%指出他們接觸到較多支持GM 食品的新聞。超過90%的受訪者認為非GM 食品應該有一些標示,以區別是否為GM 食品。對GM 食品的態度與嘗試的意願、GM 食品的規定、接觸到傳播媒體對GM 食品正反面的報告有顯著的相關。
關鍵字:態度、基因改造食品、介入、認知、科學家、Bogor、印尼。

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Last Updated: June 2007