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1 Asia Pacific Journal of Clinical Nutrition
       Volume 16, 3

         (September 2007)


Abstracts & Full papers

Contents

Abstract Papers

Original Articles

Nutritional Pathophysiology

Improved alpha amylase and Helicobacter pylorii inhibition by fenugreek extracts derived via solid-state bioconversion using Rhizopus oligosporus REENA RANDHIR, KALIDAS SHETTY

Asia Pac J Clin Nutr. 2007;16(3):382-392.

 

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Recycled palm oil is better than soy oil in maintaining bone properties in a menopausal syndrome model of ovariectomized rat

AHMAD NAZRUN SHUID, LOH HONG CHUAN, NORAZLINA MOHAMED, KAMSIAH JAARIN, YEW SU FONG , IMA NIRWANA SOELAIMAN

Asia Pac J Clin Nutr. 2007;16(3):393-402.

 

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High prevalence of goiter in an iodine replete area: do thyroid auto-antibodies play a role?

MAHIN HASHEMIPOUR, MASOUD AMINI, ASHRAF AMINORROAYA, HASSAN REZVANIAN, ALI KACHOEI, MANSOUR SIAVASH, MOHAMMAD HASSAN MOADDAB, MOHAMMAD MOHAMMADI, ROYA KELISHADI, JALE AMINI, SASSAN HAGHIGHI

Asia Pac J Clin Nutr. 2007;16(3):403-410.

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Macro- Micro- and Phyto-nutrients

Four week supplementation with mixed fruit and vegetable juice concentrates increased protective serum antioxidants and folate and decreased plasma homocysteine in Japanese subjects AKIRA KAWASHIMA, TAKEO MADARAME, HIROTO KOIKE, YASUHIRO KOMATSU, JOHN A WISE

Asia Pac J Clin Nutr. 2007;16(3):411-421.

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Effects of gamma-tocopherol supplementation on thrombotic risk factors INDU SINGH, ALAN H TURNER, ANDREW J SINCLAIR, DUO LI, JOHN A HAWLEY

Asia Pac J Clin Nutr. 2007;16(3):422-428.

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The effect of n3 PUFA/γ-Cyclodextrin Complex on serum lipids in healthy volunteers: a randomized, placebo-controlled, double-blind trial KOJI KOBAYASHI, KEI HAMAZAKI, SHUNTARO FUJIOKA, KEIJI TERAO, JUNJI YAMAMOTO, SATORU KOBAYASHI

Asia Pac J Clin Nutr. 2007;16(3):429-434.

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The effect of early nutritional supplementation with a mixture of probiotic, prebiotic, fiber and micronutrients in infants with acute diarrhea in Indonesia RINA AGUSTINA, WIDJAJA LUKITO, AGUS FIRMANSYAH, HARTATI NINGSIH SUHARDJO, DEWI MURNIATI, JACQUES BINDELS

Asia Pac J Clin Nutr. 2007;16(3):435-442.

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Nutritional Status, Dietary Intake, and Body Composition

The validity of the World Health Organisation’s obesity body mass index criteria in a Turkish population: a hospital-based study EMRE BOZKIRLI, MELEK EDA ERTORER, OKAN BAKINER, NESLIHAN BASCIL TUTUNCU, NILGUN GUVENER DEMIRAG

Asia Pac J Clin Nutr. 2007;16(3):443-447.

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Food security, selection, and healthy eating in a Pacific Community in Auckland New Zealand ELAINE RUSH, NAITA PUNIANI, NEIL SNOWLING, JANIS PATERSON

Asia Pac J Clin Nutr. 2007;16(3):448-454.

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Effect of purple sweet potato leaf consumption on the modulation of the antioxidative status in basketball players during training WEN-HSIN CHANG, CHIAO-MING CHEN, SHENE-PIN HU, NAI-WEN KAN, CHUN-CHIEH CHIU, JEN-FANG LIU

Asia Pac J Clin Nutr. 2007;16(3):455-461.

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Rising trends in BMI of Saudi adolescents: evidence from three national cross sectional studies HAZZAA M AL-HAZZAA

Asia Pac J Clin Nutr. 2007;16(3):462-466.

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Nutritionally-Related Disorders and Disease and Their Risk factors

Milk consumption is a risk factor for prostate cancer in Western countries: evidence from cohort studies LI-QIANG QIN, JIA-YING XU, PEI-YU WANG, JIAN TONG, KAZUHIKO HOSHI

Asia Pac J Clin Nutr. 2007;16(3):467-476.

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Intake of vitamin A-rich foods and lung cancer risk in Taiwan: with special reference to garland chrysanthemum and sweet potato leaf consumption YI-RU JIN, MEEI-SHYUAN LEE, JANG-HWA LEE, HON-KI HSU, JAU-YEONG LU, SHIN-SHIN CHAO, KOW-TONG CHEN, SAOU-HSING LIOU, LUO-PING GER

Asia Pac J Clin Nutr. 2007;16(3):477-488.

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Short-term effectiveness of an individual counseling program for impaired fasting glucose and mild type 2 diabetes in Japan: a multi-center randomized control trial MAKOTO WATANABE, AKIRA OKAYAMA, KAZUAKI SHIMAMOTO, HIROTSUGU UESHIMA

Asia Pac J Clin Nutr. 2007;16(3):489-497.

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Tocotrienol levels in adipose tissue of benign and malignant breast lumps in patients in Malaysia KALANITHI NESARETNAM, PATRICIA ALISON GOMEZ, KANGA RANI SELVADURAY, GAZALI.ABDUL RAZAK

Asia Pac J Clin Nutr. 2007;16(3):498-504.

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Growth and Child Nutrition

Multiple micronutrient fortification of salt and its effect on cognition in Chennai school children MALAVIKA VINODKUMAR, SRINIVASA RAJAGOPALAN

Asia Pac J Clin Nutr. 2007;16(3):505-511.

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Determinants of child malnutrition during the 1999 economic crisis in selected poor areas of Indonesia SAPTAWATI BARDOSONO, SOEMILAH SASTROAMIDJOJO, WIDJAJA LUKITO

Asia Pac J Clin Nutr. 2007;16(3):512-526.

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Anemia in pregnancy in Malaysia: a cross-sectional survey JAMAIYAHV HANIFF, ANITA DAS, LIM TECK ONN, CHEN WON SUN, NORAIHAN MOHD NORDIN, SANJAY RAMPAL, SAFIAH BAHRIN, MURALITHARAN GANESLINGAM, KUMAR ISWARAN K. KULARATNAM, ZAKI MORAD MOHAMAD ZAHER, MALAYSIAN ANEMIA STUDY GROUP

Asia Pac J Clin Nutr. 2007;16(3):527-536.

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Influences on maternal and child nutrition in the highlands of the northern Lao PDR WENDY HOLMES, DAMIAN HOY, ANNE LOCKLEY, KHAMPHO THAMMAVONGXAY, SOMPHAO BOUNNAPHOL, ANONH XEUATVONGSA, MICHAEL TOOLE

Asia Pac J Clin Nutr. 2007;16(3):537-545.

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Aging and Elder’s Nutrition

Determinants of blood pressure among Indonesian elderly individuals who are of normal and over-weight: a cross sectional study in an urban population SUDIJANTO KAMSO, JOHANNA SP RUMAWAS, WIDJAJA LUKITO, PURWANTYASTUTI

Asia Pac J Clin Nutr. 2007;16(3):546-553.

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Effect of continuous enteral L-arginine in a rat model of the short bowel syndrome XIAOHUA JIANG, WEIMING ZHU, NING LI, LI TAN, JIESHOU LI

Asia Pac J Clin Nutr. 2007;16(3):554-560.

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Nutritional Epidemiology and Public Health

A national study of the prevalence of obesity among 16,127 Malaysians GR LEKHRAJ RAMPAL, SANJAY RAMPAL MBBS, GEOK LIN KHOR, AZHAR MD ZAIN, M PSYCH, SHAFIE B OOYUB, RAMLEE B RAHMAT, SIRAJOON NOOR GHANI, JAYANTHI KRISHNAN

Asia Pac J Clin Nutr. 2007;16(3):561-566.

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Comparisons of attitudes and practices between obese and normal weight women in Taiwan SHENE-PIN HU, TZU-YIN CHIANG, SUNG-LING YEH, YI-WEN CHIEN

Asia Pac J Clin Nutr. 2007;16(3):567-571.

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Prevalence of overweight and obesity and its associated factors in aboriginal Taiwanese: findings from the 2001 National Health Interview Survey in Taiwan CHING-SUNG HO, ALAN C TSAI

Asia Pac J Clin Nutr. 2007;16(3):572-579.

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Anti-obesity drug use before professional treatment in Taiwan TSAN-HON LIOU, CHIH-HSING WU, HSU-CHEN CHIEN, WEN-YUAN LIN, WEI-JEI LEE, PESUS CHOU

Asia Pac J Clin Nutr. 2007;16(3):580-586.

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Improved α-amylase and Helicobacter pylori inhibition by fenugreek extracts derived via solid-state bioconversion using Rhizopus oligosporus

Reena Randhir and Kalidas Shetty The present research investigated the enrichment of fenugreek (Trigonella foenum graceum) seed substrate with phenolic antioxidants and L-DOPA via fungal-based solid-state bioconversion (SSB) system.  This approach using food grade fungus Rhizopus oligosporus, was chosen because it has been demonstrated to be effective in other seed and food substrates for improving health-relevant functionality and has long history of use for food processing in Asia. The protein content and b-glucosidase activity of the substrate which reflects fungal growth, increased with incubation time in conjunction with enhanced phenolic content and also suggested its possible involvement in phenolic mobilization. The antioxidant activity assayed by b-carotene bleaching and DPPH free radical scavenging methods both indicated high activity during early growth stage (days 4-6) followed by reduced activity during later growth stage (days 8-20). A direct association between higher phenolic contents during early growth stage (days 4-6) and antioxidant activity suggested a link to mobilization of polymeric and hydrophobic phenolic forms. The L-DOPA content of the fenugreek extract fluctuated during the course of bioconversion with higher levels during days 6-10 (1.5-1.7 mg/g DW). The SSB process substantially improved the in vitro porcine a-amylase inhibition activity by 75 % on day 4 which correlated to higher levels of total phenolics and related antioxidant activity of the extracts. The high a-amylase inhibitory activity also coincided with high L-DOPA content on day 6. These results have implications for diet-based diabetes management. The same bioconversion stage had Helicobacter pylori inhibitory activity, which has implications for ulcer management. Key Words: fenugreek, a-amylase inhibition, type 2 diabetes, solid-state bioconversion (SSB), Rhizopus oligosporus, b-glucosidase, phenolics, antioxidant activity, L-DOPA (levo-dihydroxy phenylalanine), superoxide dismutase, antioxidant protection factor, Helicobacter pylori inhibition

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葫蘆巴籽萃取物經過Rhizopus oligosporus的固態形式生物轉換改善α-澱粉酶及幽門螺旋桿菌抑制作用

本研究透過以真菌為基礎的固態形式生物轉換(SSB)系統,使葫蘆巴籽(Trigonella foenum graceum)基質酚類抗氧化劑與L-DOPA強化。這個方法採用食物等級的黴菌Rhizopus oligosporus,選擇的原因為它已經被指出對其他種籽及食物基質具改善健康相關功能之效益。在亞洲地區被運用在食品加工已經有長久歷史。基質中蛋白質含量及β-葡萄糖苷活性反應真菌生長情形,他們的量隨著培養時間增加及增加的酚類的量增加而增加。同時也指出他們可能參與酚的流動。抗氧化活性是採用β-胡蘿蔔漂白及DPPH自由基去除方法分析,兩者都顯示在早期生長期(4-6)有高活性,後期生長期(8-20)活性則下降。早期生長期(4-6)較高的酚類含量與抗氧化活性直接的相關,指出其與聚合過程及疏水性酚類形式的關聯性。葫蘆巴籽萃取物的L-DOPA含量在生物轉換過程中起伏,在第6-10天量較高(1.5-1.7 mg/g DW)SSB過程顯著促進了豬隻α-澱粉酶體外試驗抑制活性,在第4天時達75%,此與萃取物高量的總酚類及相關抗氧化物活性有關。α-澱粉酶抑制活性的高峰也伴隨著高的L-DOPA含量。這些結果對糖尿病飲食管理有其意義;相同的生物轉換階段的幽門螺旋桿菌抑制活性對潰瘍管理也有意義。 關鍵字:葫蘆巴籽、α-澱粉酶抑制作用、第二型糖尿病、固態形式生物轉換(SSB)Rhizopus oligosporusβ-葡萄糖苷、抗氧化物活性、L-DOPA(levo-羥基苯丙酮胺酸)、超氧化歧化酶、抗氧化物保護因子、幽門螺旋桿菌。

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Recycled palm oil is better than soy oil in maintaining bone properties in a menopausal syndrome model of ovariectomized rat

AHMAD NAZRUN SHUID, LOH HONG CHUAN, NORAZLINA MOHAMED, KAMSIAH JAARIN, YEW SU FONG , IMA NIRWANA SOELAIMAN Palm oil is shown to have antioxidant, anticancer and cholesterol lowering effects.  It is resistant to oxidation when heated compared to other frying oils such as soy oil. When a frying oil is heated repeatedly, it forms toxic degradation products, such as aldehydes which when consumed, may be absorbed into the systemic circulation. We have studied the effects of taking soy or palm oil that were mixed with rat chow on the bone histomorphometric parameters of ovariectomised rats. Female Sprague-Dawley rats were divided into eight groups: (1) normal control group; (2) ovariectomised-control group; (3) ovariectomised and fresh soy oil; (4)  ovariectomised and soy oil heated once; (5) ovariectomised and soy oil heated five times; (6) ovariectomised and fresh palm oil; (7) ovariectomised and palm oil heated once; (8) ovariectomised and palm oil heated five times. These oils were mixed with rat chow at weight ratio of 15:100 and were given to the rats daily for six months. Ovariectomy had caused negative effects on the bone histomorphometric parameters. Ingestion of both fresh and once-heated oils, were able to offer protections against the negative effects of ovariectomy, but these protections were lost when the oils were heated five times. Soy oil that was heated five times actually worsens the histomorphometric parameters of ovariectomised rats. Therefore, it may be better for postmenopausal who are at risk of osteoporosis to use palm oil as frying oil especially if they practice recycling of frying oils. Key Words: palm oil, vitamin E, heated frying oils, ovariectomy, bone histomorphometry

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回鍋棕櫚油在維持有更年期症狀卵巢切除的大鼠之骨質狀況較黃豆油佳

棕櫚油具抗氧化作用、抗癌及降低膽固醇之效力。它比起其他如黃豆油等炸油,在加熱時抗氧化作用。當炸油重複地加熱,會生成毒性降解產物像是醛類,在被攝取後可能被吸收進入系統循環中。我們研究卵巢切除的大鼠攝取混合黃豆油或是棕櫚油的大鼠飼料,對骨質組織型態學參數之影響。將母的Sprague-Dawley大鼠分成八組:(1)正常控制組;(2)卵巢切除控制組;(3)卵巢切除及新鮮黃豆油;(4)卵巢切除及加熱一次黃豆油;(5)卵巢切除及加熱五次黃豆油;(6)卵巢切除及新鮮棕櫚油;(7)卵巢切除及加熱一次棕櫚油;(8)卵巢切除及加熱五次棕櫚油。這些油脂與大鼠飼料以大鼠體重比為15100的比例混合,每天給予此食物共六個月。卵巢切除對骨質組織型態學參數有負面影響。攝取新鮮及加熱一次的油可以提供保護作用,對抗卵巢切除術的負面影響,但是這些保護作用在加熱五次的油則消失。大豆油加熱五次確實使卵巢切除大鼠的組織型態學參數變得較差。因此,對於有骨質疏鬆危險性的已停經者而言,最好使用棕櫚油當做炸油,尤其是習慣使用回鍋油者。

關鍵字:棕櫚油、維生素E、加熱炸油、卵巢切除、骨質組織型態學。

 

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High prevalence of goiter in an iodine replete area: do thyroid auto-antibodies play a role? MAHIN HASHEMIPOUR, MASOUD AMINI, ASHRAF AMINORROAYA, HASSAN REZVANIAN, ALI KACHOEI, MANSOUR SIAVASH, MOHAMMAD HASSAN MOADDAB, MOHAMMAD MOHAMMADI, ROYA KELISHADI, JALE AMINI, SASSAN HAGHIGHI Introduction: Despite long standing iodine supplementation in Iran the prevalence of goiter remains high in some areas. This may suggest that causes other than iodine deficiency, such as autoimmune thyroid diseases, should also be considered. We therefore assessed the prevalence of anti-thyroid antibodies in children living in an inland area in Iran and correlated these findings with prevalence of goiter within this region. Methods: In a cross-sectional study, 1948 students were selected by multistage random cluster sampling from the 108 primary schools (age, 7-13 year-old) of the urban and rural areas of Semirom. After obtaining written consent from their parents, the children were examined by endocrinologists for goiter grading. Grade 2 goitrous children (108 cases) were compared with non-goitrous children (111 children as control group) for anti-thyroid antibodies.

Results: Overall, 36.7% of 1948 students had goiter. The mean urinary iodine excretion level was 1.490.7 mol/L. This was within normal limits. Of 219 children studied, 4.3% presented with subclinical hypothyroidism, and 7.3% had positive anti-thyroid antibodies. There was non-significant difference of positive thyroperoxidase antibody (anti-TPO) (Odds Ratio= 3.2, p= 0.13) but significant difference of anti Tg between goitrous and non goitrous children (Odds Ratio: 5.6, 95% CI: 1.18-26.0, p: 0.015). 

Conclusion: This study suggests that autoimmunity may be one of the mechanisms responsible for goiter persistence after iodine replenishment in this iodine deficient region, but the role of other factors should also be considered.

Key Words: goiter, antithyroid antibody, throidperoxidase, antibody, autoimmune thyroid disease top

 

碘充足的地區的高甲狀腺腫盛行率:甲狀腺自體抗體是否扮演一個角色? 前言:儘管伊朗長期補充碘,但在某些地區的甲狀腺腫盛行率仍然相當高。這個現象指出除了碘缺乏以外的原因,像是自體免疫疾病也應該被考慮。我們因此評估居住在伊朗內陸地區的孩童抗甲狀腺抗體的盛行率,並將其與這個區域甲狀腺腫盛行率作相關。 方法:一個橫斷性研究,從Semiron108所城市及鄉村的小學(年齡為7-13)以多階段隨機集束抽樣選取1948名學生。取得父母所簽署的同意書之後,由內分泌醫師評估孩童的甲狀腺腫等級。比較第二級甲狀腺腫孩童(108名案例)及非甲狀腺腫孩童(111名孩童為控制組)的抗甲狀腺腫抗體。 結果:整體來說,1948名學生有36.7%有甲狀腺腫。平均的尿碘量為1.490.7 mol/L。這個值在正常的範圍之內。219名進一步評估的孩童中,4.3%呈現亞臨床低甲狀腺血症,7.3%的抗甲狀腺抗體為陽性。甲狀腺腫與非甲狀腺腫孩童在甲狀腺過氧化酶抗體(anti-TPO)沒有顯著差異(Odds Ratio= 3.2, p= 0.13),而抗Tg則有顯著差異(Odds Ratio: 5.6, 95% CI: 1.18-26.0, p: 0.015)

結論:本研究指出在這個碘缺乏的區域進行碘的補充之後,自體免疫可能是甲狀腺腫仍然持續存在的機制之一,但是其他因子的角色也應該被考慮。

關鍵字:甲狀腺腫、抗甲狀腺抗體、甲狀腺素過氧化酶抗體、甲狀腺球蛋白抗體、自體免疫甲狀腺疾病。

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Four week supplementation with mixed fruit and vegetable juice concentrates increased protective serum antioxidants and folate and decreased plasma homocysteine in Japanese subjects AKIRA KAWASHIMA, TAKEO MADARAME, HIROTO KOIKE, YASUHIRO KOMATSU, JOHN A WISE Fruit and vegetable consumption has been inversely associated with the risk of chronic diseases including cancer and cardiovascular disease, with the beneficial effects attributed to a variety of protective antioxidants, carotenoids and phytonutrients. The objective of the present study was to determine the effect of supplementation with dehydrated concentrates from mixed fruit and vegetable juices (Juice Plus+) on serum antioxidant and folate status, plasma homocysteine levels and markers for oxidative stress and DNA damage. Japanese subjects (n=60; age 27.8 yrs; BMI 22.1) were recruited to participate in a double-blind placebo controlled study and were randomized into 2 groups of 30, matched for sex, age, BMI and smoking status  (39 males, 22 smokers; 21 females, 13 smokers). Subjects were given encapsulated supplements containing mixed fruit and vegetable juice concentrates or a matching placebo for 28 days, with blood and urine samples collected at baseline, day 14 and day 28 for analytical testing. Compared with the placebo, 28 day supplementation significantly increased the concentration of serum beta-carotene 528% (p<0.0001), lycopene 80.2% (p<0.0005), and alpha tocopherol 39.5% (p<0.0001). Serum folate increased 174.3% (p<0.0001) and correlated with a decrease in plasma homocysteine of -19.9% (p<0.03). Compared with baseline, measures of oxidative stress decreased with serum lipid peroxides declining -10.5% (p<0.02) and urine 8OHdG decreasing -21.1% (p<0.02).  Evaluation of data from smokers only (n=17) after 28 days of active supplementation showed comparable changes.  Conclusion:  In the absence of dietary modification, supplementation with the fruit and vegetable juice concentrate capsules proved to be a highly bioavailable source of phytonutrients. Important antioxidants were elevated to desirable levels associated with decreased risk of disease while markers of oxidative stress were reduced, and folate status improved with a concomitant decrease in homocysteine, and these benefits occurred to a similar extent in smokers when compared to non-smokers. Key Words: fruits, vegetables, antioxidants, folate, homocysteine, carotenoids, smokers

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補充四週濃縮綜合蔬果汁,可增加日本受試者血清中保護性血清抗氧化物及葉酸,降低其血漿同半胱胺酸

攝取水果及蔬菜與癌症及心血管疾病等慢性疾病的危險性具有負相關,其益處可歸因於各種保護性抗氧化劑、胡蘿蔔素及植物營養素。本研究目的為評估補充脫水濃縮綜合蔬果汁的(Juice Plus+)對血清抗氧化劑及葉酸狀況、血漿同半胱胺酸濃度及氧化壓力標記及DNA傷害之影響。招募日本受試者(n=60;年齡27.8歲;BMI 22.1)參與本雙盲安慰劑控制研究,並隨機分成兩組各30名,配對性別、年齡、BMI及抽菸狀況(39名男性,22名抽菸者;21名女性,13名抽菸者)。給予受試者含有綜合蔬果汁濃縮物或是配對安慰劑的膠囊28天。在研究開始、第14天及第28均收集血液及尿液樣本進行分析測試。與安慰劑組比較,28天補充顯著升高血清beta-胡蘿蔔素528% (p<0.0001)、蕃茄紅素80.2% (p<0.0005)alpha生育醇39.5% (p<0.0001)。血清葉酸增加174.3% (p<0.0001),而與其相關的血漿同半胱胺酸降低19.9% (p<0.03)。與研究開始相比,氧化壓力的指標血清脂質過氧化物降低-10.5% (p<0.02)及尿中8OHdG減少21.1% (p<0.02) 。評估抽菸者(n=17)28天補充的結果顯示有類似的變化。結論:在不改變飲食的情況下,蔬果汁濃縮膠囊補充劑證明為植物營養素的高生物活性來源。重要的抗氧化劑提高至理想的濃度,因氧化壓力標記下降,伴隨疾病危險性也降低;葉酸狀況的改善伴隨著同半胱胺酸的降低。與非抽菸者比較,這些益處在抽菸者身上顯示類似的結果。

關鍵字:水果、蔬菜、抗氧化物、葉酸、同半胱胺酸、胡蘿蔔素、抽菸者。

  

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Effects of gamma-tocopherol supplementation on thrombotic risk factors INDU SINGH, ALAN H TURNER, ANDREW J SINCLAIR, DUO LI, JOHN A HAWLEY Objective: The antioxidant activity of vitamin E is derived primarily from alpha-tocopherol (α-T) and gamma-tocopherol (γ-T). Results of epidemiological studies have demonstrated an inverse relationship between vitamin E intake and coronary disease. However, the results of clinical trials using α-T are equivocal. We determined the effect of 5 weeks of 100 mg/d or 200 mg/d γ-T supplementation on thrombotic markers such as platelet reactivity, lipid profile and the inflammation marker C-reactive protein (CRP). Methods and results: Fourteen healthy subjects consumed 100 mg/day while 13 consumed 200 mg/d of γ-T and 12 received placebo (soybean capsules with less than 5 mg/d γ-T) in a double-blinded parallel study design. Fasting pre and post dose blood samples were analysed. Blood γ-T concentrations increased significantly (p<0.05) relative to dose during the intervention period. Both groups receiving active ingredients showed significantly lower platelet activation after supplementation (p<0.05). Subjects consuming 100 mg/d γ-T had significantly decreased LDL cholesterol, platelet aggregation and mean platelet volume (MPV) (p<0.05). Little effect of γ-T was observed on other parameters. Conclusions: These data suggest that γ-T supplementation may have a permissive role in decreasing the risk of thrombotic events by improving lipid profile and reducing platelet activity. Key Words: gamma tocopherol, platelets, lipids, CRP, thrombotic risk factors

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Gamma-生育醇的補充對血栓危險因子的影響 目的:維生素E的抗氧化活性主要衍生自alpha-生育醇(α-T) gamma-生育醇 (γ-T)。流行病學研究的結果指出維生素E的攝取與冠狀疾病為負相關。然而,採用α-T的臨床試驗結果是可議的。我們評估每天補充100毫克或200毫克的γ-T5週對血栓標記,例如:血小板活性、血脂及發炎標記C反應蛋白(CRP)的影響,

方法及結果:採用雙盲平行研究設計,14名健康受試每天攝取100毫克的γ-T13名攝取200毫克的γ-T12名接受安慰劑(大豆膠囊加每天低於5毫克的γ-T)。分析禁食前後血液樣本的劑量。血中γ-T上升濃度與介入期的劑量呈現顯著相關(p<0.05)。接受有效成分的兩組,顯示補充之後血小板活性顯著較低(p<0.05)。每天攝取100毫克γ-T的受試者,LDL膽固醇、血小板凝集及平均血小板容積(MPV)顯著降低(p<0.05)γ-T對其它的參數影響較小。

結論:這些數據指出補充γ-T可能透過改善血脂及降低血小板活性,達到降低血栓事件。

關鍵字:gamma-生育醇、血小板、脂質、CRP、血小板危險因子。

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The effect of n3 PUFA/γ-Cyclodextrin Complex on serum lipids in healthy volunteers: a randomized, placebo-controlled, double-blind trial KOJI KOBAYASHI, KEI HAMAZAKI, SHUNTARO FUJIOKA, KEIJI TERAO, JUNJI YAMAMOTO, SATORU KOBAYASHI Objectives: This study was carried out to examine whether serum triglyceride concentrations were decreased by administration of n3 polyunsaturated fatty acid (PUFA)/γ-cyclodextrin (γ-CD) complex-containing capsules as reported previously with n3 PUFA without γ-CD. Study Design: A placebo-controlled double-blind study with healthy subjects (n=35) and hypertriglyceridemic subjects (n=7) of 35-66 years of age was performed. The subjects were randomized to a group (n3 group) supplemented with n3 PUFA/γ-CD-containing capsules (660 mg EPA + 280 mg DHA/day) or a control group supplemented with capsules containing essentially no n–3 PUFA for 8 weeks with stratification by sex, age, and serum triglyceride levels in a double blind manner. Fasting blood samples were obtained at the start of administration and 4 and 8 weeks afterward. Results: EPA concentrations in the total phospholipid fraction of red blood cells increased significantly in all subjects in the n3 group, whereas no changes were seen in the control group. Triglyceride levels were significantly decreased (–17%) in the n–3 group compared with the control group at week 8. The following serum lipids did not significantly change over time: total-cholesterol, low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol. Only two subjects in the n–3 group guessed at the end of the study that their capsules were active. Conclusion: n3 PUFA/γ-CD complex lowered triglyceride levels in normal and slightly hypertriglyceridemic subjects. There was a possibility that γ-CD might at least partly cover the smell and aftertaste of fish oil. Key Words: EPA, n3 polyunsaturated fatty acids, γ-cyclodextrin, fatty acid composition, triglycerides

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n–3 PUFA/γ-Cyclodextrin複合物對健康自願者血脂影響之隨機安慰劑控制雙盲試驗 目的:本研究測試是否給予n3 多不飽和脂肪酸(PUFA)/ γ環糊精 (γ-CD)複合膠囊,會如同先前只有n3 PUFA而沒有γ-CD 的報告一樣,能降低血清三酸甘油酯濃度。

研究設計:一項安慰劑控制雙盲研究,以35位健康及7位高三酸甘油酯35-66歲受試為對象。以性別、年齡及血清三酸甘油酯分層後,受試者被隨機分配到n3 PUFA/γ-CD 複合膠囊(660 mg EPA + 280 mg DHA/day)組或是未含n3 PUFA膠囊的控制組,進行8週的雙盲試驗。分別在開始、第4週及第8週取空腹血液樣本。 結果:n3組 受試者中的紅血球總磷脂質EPA 濃度均顯著增加,但在對照組中則未見變化。在第8週時,n3組的甘油三酸酯比對照組顯著減少 (17%)。以下血脂衛未時間顯著改變: 總膽固醇、低密度脂蛋白膽固醇 和高密度脂蛋白膽固醇。只有2n3 組受試在研究終了猜測他們的膠囊含有效成分。 結論:n3 PUFA / γ-CD 複合物降低正常及輕微高三酸甘油酯症受試者的三酸甘油酯。一個可能性是γ-CD 至少部分掩蓋魚油的氣味和餘味。

關鍵字:EPAN3多元不飽和脂肪酸、γ糊精、 脂肪酸組成、三酸甘油酯。

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The effect of early nutritional supplementation with a mixture of probiotic, prebiotic, fiber and micronutrients in infants with acute diarrhea in Indonesia RINA AGUSTINA, WIDJAJA LUKITO, AGUS FIRMANSYAH, HARTATI NINGSIH SUHARDJO, DEWI MURNIATI, JACQUES BINDELS A randomized double blind clinical trial was conducted  to assess the efficacy of a special infant formula containing Lactobacillus rhamnosus LMG P-22799 (probiotic: 5 x 108 CFU/100mL), inulin (prebiotic: 0.15 g/100mL), dietary fiber (soy polysaccharides: 0.2 g/100mL) and increased amounts of zinc+iron (+0.4 and +0.6 mg/100mL, respectively) as active ingredients for the early dietary management of 58 Indonesian well-nourished male infants aged 3-12 months suffering from acute diarrhea with moderate dehydration. After adequate oral rehydration, the patients were randomly assigned to receive either a  low lactose infant formula supplemented with added precooked rice (1.5 g/100mL) with the above active ingredients (study group) or a low lactose infant formula with added precooked rice without the above active ingredient supplement (control group). No antibiotic, anti-secretory drug or antiemetic was given at all. Both study and control groups showed similar outcomes for weight gain and stool weight. The duration of diarrhea was significantly shorter in the study group than in the control group (1.63 versus 2.45 days; p<0.05; for the study and control group, respectively). No treatment failure or other side effects were observed during the course of the study. The present study supports the evidence for the efficacy of a special anti-diarrhea infant formula containing probiotic, prebiotic, fiber and iron+zinc after oral rehydration by shortening the duration of infantile diarrhea in developing countries. However, from the results of our study we cannot discern the individual contribution of the active ingredients and also not whether they may act independent from each other or in a synergistic way. Key Words: acute diarrhea, dietary fiber, Lactobacillus rhamnosus, micronutrients, probiotic, prebiotic, Jakarta

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印尼急性腹瀉嬰兒早期補充益生菌、益菌素、纖維及微量營養素混合物之效果

採用隨機雙盲臨床試驗,評估含Lactobacillus rhamnosus LMG P-22799 (益生菌:5 x 108 CFU/100mL)、菊糖 (益菌素:0.15 g/100mL)、膳食纖維 (大豆多醣:0.2 g/100mL)並增加鋅+鐵的量(分別加+0.4+0.6 mg/100mL)當作有效成份,以早期膳食管理印尼583-12個月大營養狀況良好,但有急性腹瀉並中度脫水的男性嬰兒。在由口充分補充水之後,病人隨機分派接受低乳糖嬰兒配方補充含上述活性成分(研究組)的米飯(1.5g/100mL),或是低乳糖嬰兒配方補充米飯,但沒有上述活性成分(控制組)全部都未給予抗生素、抗分泌藥物或是止嘔劑。研究組與對照組在體重增加及糞便重量都顯示相似的結果。研究組腹瀉時間顯著較控制組短(研究組與控制組分別為1.63 vs. 2.45天;p<0.05)觀察研究期間,並未發現治療失敗或是其他副作用。本研究證據支持在開發中國家,在由口補充水份之後,補充含有益生菌、益菌素、纖維、鋅+鐵的特殊抗腹瀉嬰兒配方,有縮短嬰兒腹瀉的效用。然而,由我們的研究我們無法辨別有效成分的個別貢獻,也無法得知他們是否可能獨立作用或是有協作用。 關鍵字:急性腹瀉、膳食纖維、Lactobacillus rhamnosus、微量營養素、益生菌、益菌素、雅加達

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The validity of the World Health Organisation’s obesity body mass index criteria in a Turkish population: a hospital-based study EMRE BOZKIRLI, MELEK EDA ERTORER, OKAN BAKINER, NESLIHAN BASCIL TUTUNCU, NILGUN GUVENER DEMIRAG Our aim was to determine the relationship between body fat percentage (BF%) and body mass index (BMI) and to evaluate the validity of World Health Organisation’s BMI cut-off values for obesity. Adult out-patients (n=909, 249 men, 660 women), mean age; 40.5 14.1 years were included. According to WHO’s BMI criteria, 440 subjects were obese (79 men, 361 women). The BF% of participants were measured using a bioelectrical impedance analysis (BIA) system (TANITA). Randomly selected 30 patients were also subjected to the dual-energy X-ray absorptiometry (DEXA) procedure for evaluation of the validity of TANITA measurements. The BF% results obtained by DEXA and TANITA revealed good correlation (r =0.952, p= 0.382). There was a positive correlation between BF% and BMI (p<0.001) for both methods. Cut-off values for BMI were calculated as 28.0 kg/m2 for women, 28.2 kg/m2 for men, if obesity was defined as BF ≥ 25% in men, ≥ 35% in women according to WHO’s criteria. Using the new cut-off values, the frequency of obesity increased up to 33.9% in our group. The increase was more pronounced in men (67.1% vs 26.6%).The WHO cut-off values underestimated the frequency of obesity in this population. Further studies are warranted for different ethnic groups. Key Words: obesity, body mass index, body fat percent, bioelectrical impedance analysis, dual energy X-ray absorptiometry, Turkey

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世界衛生組織的肥胖身體質量指數標準在一個土耳其族群的效度:一個醫院的研究

我們的目的評估體脂肪百分比(BF%)及身體質量指數(BMI)之間的相關性,以評量世界衛生組織(WHO)針對肥胖所訂定的BMI切點之效度。門診成人病患(n=909249名男性、660名女性),平均年齡40.5 14.1歲參與研究。依據WHOBMI標準,440研究對象為肥胖(79名男性、361名女性)。採用生物電阻分析(BIA)系統(TANITA)評估參與者的BF%。隨機選取30名病人,同時採用雙能量X光吸收儀(DEXA)以評估TANITA測量的效度。DEXATANITA所得的BF%結果顯示好的相關(r=0.952, p=0.382)。兩種方法測得的BF%BMI之間均為正相關(p<0.001)。若依據WHO的肥胖標準,男性為BF≥25%,女性為≥35%,則計算出來的女性BMI切點為28.0 kg/m2、男性為28.2 kg/m2。採用新的切點,我們的族群肥胖率增至33.9%。男性的增加較明顯(67.1% vs. 26.6%)WHO切點對會低估該族群的肥胖率。對不同的種族,進一步的研究是必要的。

關鍵字:肥胖、身體質量指數、體脂肪百分比、生物阻抗分析、雙能量X光吸收、土耳其。

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Food security, selection, and healthy eating in a Pacific Community in Auckland New Zealand ELAINE RUSH, NAITA PUNIANI, NEIL SNOWLING, JANIS PATERSON When an infant is brought home to the family, it is often a time of emotional, economic and physical stress due to the extra demands placed on parents. Household food security means “access at all times to enough and nutritionally appropriate food to provide the energy and nutrients needed to maintain an active and healthy life”.  Questions about food security were asked of 1376 Pacific Island mothers (as part of the Pacific Island Family Study) approximately six weeks after the birth of their baby.  Due to lack of money food sometimes ran out in 39.8% of households and in a further 3.8% food often ran out.  Variety of foods was limited by lack of money in 39.3%. Foods that were still bought when money was limited included bread (97%), milk (95%), meat and chicken (91%), vegetables and fruit (83%), rice or pasta (82%), breakfast cereals (69%), fish or shellfish (50%) and biscuits or chips (44%). Alcohol (1%), soft drinks (11%), ice cream (12%) and fruit juice (21%) were the least often bought. Energy density (MJ/kg) and nutrient-density of typical foods limited by lack of money were analysed. Rice, bread and fatty meats provided the most calories per dollar and fruit and vegetables the least.  The best protein-value for money was from minced beef, chicken and tinned tuna and the most fibre-rich foods included baked beans and mixed vegetables. Food security is a major problem for Pacific families.  The environment of food availability, choice and cost requires attention to help close the health gap. Key Words: food security, obesity, Pacific, energy density, diet, costs

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紐西蘭奧克蘭的太平洋社區之糧食安全、選擇及健康飲食

當一個嬰兒進到一個家庭時,由於額外需求加諸父母,它通常為情緒的、經濟的及生理的壓力的一刻。家戶糧食安全係指在任何時間都有足夠及營養均衡的食物可提供熱量及營養素,以維持一個活躍及健康的生活所需1376名太平洋島嶼(為太平洋島嶼家庭研究的一部份)其小孩出生約六週的母親,被問到有關於糧食安全的問題。39.8%家戶會因缺錢,導致有時糧食耗盡,3.8%為經常耗盡。39.3%其糧食的多樣性受限於金錢的缺乏。缺錢時仍然會購買的糧食包含:麵包(97%)、牛奶(95%)、肉類及雞肉(91%)、蔬菜及水果(83%)、米或是麵(82%)、早餐穀類(69%)、魚或是貝類(50%)及餅乾或是洋芋片(44%)。酒精(1%)、軟性飲料(11%)、冰淇淋(12%)及果汁(21%)為較少購買者。進一步分析因缺錢而受限的傳統食物的熱量密度(MJ/kg)及營養素密度。每一塊錢的米、麵包及油脂高的肉類所提供了大部分的熱量,蔬果則最少。每一塊錢的最佳蛋白質-價值來自於絞牛肉、雞肉及罐頭鮪魚以及大部分富含纖維的食物,包含白扁豆燒醃肉及混合蔬菜。糧食安全是太平洋家庭的重要問題。環境中的食物的可獲性、選擇及成本需要被注意,以協助縮短止健康的差距。 關鍵字:糧食安全、肥胖、太平洋、熱量密度、飲食、成本。

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Effect of purple sweet potato leaf consumption on the modulation of the antioxidative status in basketball players during training WEN-HSIN CHANG, CHIAO-MING CHEN, SHENE-PIN HU, NAI-WEN KAN, CHUN-CHIEH CHIU, JEN-FANG LIU

The aim of this study was to evaluate the effect of purple sweet potato leaves (PSPLs) consumption on antioxidative status and its modulation of that status in basketball players during training period. Fifteen elite basketball players were enrolled in this study. The seven-week study consisted of a run-in (week 1), PSPLs diet (daily consumption of 200 g PSPLs) (weeks 2, 3), washout (weeks 4, 5), and control diet (low polyphenol, with the amount of carotenoids adjusted to the same level as that of PSPLs) (weeks 6, 7). Blood and urine samples were taken for biochemical analysis. Compared with the control group, the results showed that PSPLs consumption led to a significant increase of plasma polyphenol concentration and vitamin E and C levels. Low density lipoprotein (LDL) lag time was significantly longer in the PSPLs group. A significant decrease of urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) was noted; however, there was no significant change in plasma glutathione (GSH), total antioxidant status (TAS) and malondialdehyde + 4-hydroxy-2(E)-nonenal level after consuming the PSPLs diet. In conclusion, consumption of PSPLs diet for 2 weeks may reduce lipid and DNA oxidation that can modulate the antioxidative status of basketball players during training period.

Key Words: purple sweet potato leaves, polyphenols, basketball, training, antioxidative status

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籃球員在訓練期間紅甘薯葉的攝取對其抗氧化力調節之影響

本研究的目的是探討籃球員在訓練期間攝取紅甘薯葉(PSPLs),對其體內抗氧化狀態之調節效應。15位籃球校隊的男女隊員納入本研究。7週的研究包括調整(第一週)、PSPLs飲食(每日攝取200gPSPLs)(第2-3週)、排空(第4-5週)及控制飲食(低多酚類且調整其類胡蘿蔔素含量與PSPLs一致)(第6-7週)。採集受試者空腹血液及24小時尿液以進行評估分析。研究結果顯示,與控制組相比,攝取PSPLs二週後,受試者血漿中多酚類濃度與維生素CE量皆顯著增加。低密度膽固醇(LDL)延遲時間有顯著較長;並且尿液中DNA氧化傷害指標--8-氫氧2'-去氧鳥糞核糖(8-OHdG)的含量也顯著下降。然而,血漿中麩胱甘肽(GSH)、總抗氧化物力(TAS)及丙二酫+4-hydroxy-2(E)-nonenal含量都沒有顯著改變。綜合上述,籃球員於訓練期間攝取PSPLs飲食2週後,可以降低脂質及DNA的氧化作用,進而調節體內的抗氧化狀態。

關鍵字:紅甘薯葉、多酚類、籃球、訓練、抗氧化狀態。

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Rising trends in BMI of Saudi adolescents: evidence from three national cross sectional studies HAZZAA M AL-HAZZAA Objective: To examine the trends in body mass index (BMI) of Saudi male adolescents between 1988 and 1996. Methods: The data set came from three major population-based cross sectional studies. They all involve nationally representative samples and were conducted between 1988 and 1996. BMI was calculated from body height and mass and plotted at the 50th and 90th percentiles. Results: BMI of Saudi adolescents progressively increased at both 50th and 90th percentiles between 1988 and 1996. The increases in BMI during the eight-year period ranged from 9.6 to 10.8% at the 50th percentiles and from 10.9 to 13.9% at the 90th percentiles. At ages 15-18 years, the yearly increase in median BMI from 1988 to 1996 averaged 0.246 kg/m2.

Conclusion: The rising trends in BMI between 1988 and 1996 are indication of increasing obesity among Saudi male adolescents. More attention to the promotion of healthy nutrition and physical activity throughout childhood and adolescence is required.

Key Words: body mass index, obesity, overweight, childhood, adolescence, Saudi Arabia

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沙烏地青少年BMI升高的趨勢:三個全國橫斷性研究的證據 目的:評估19881996年的沙烏地青少年的身體質量指數(BMI)之趨勢。

方法:數據來源為三個大型族群性橫斷性研究。它們均為全國代表性樣本,在19881996年間進行。BMI由身高及體重計算而來,以第5090百分位繪圖。 結果:19881996年間,沙烏地青少年的BMI5090百分位逐漸上升。第50百分位在這8年期間,BMI增加的範圍為9.610.8%,第90百分位為10.913.9%。年齡為15-18歲,BMI中位數從19881996年,每年平均增加0.246 kg/m2 結論:19881996年間BMI增加的趨勢,是沙烏地青少年肥胖增加的證明。需要多關注整個兒童到青少年期間的健康的營養及體能活動之促進。

關鍵字:身體質量指數、肥胖、過重、兒童、青少年、沙烏地阿拉伯。

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Milk consumption is a risk factor for prostate cancer in Western countries: evidence from cohort studies LI-QIANG QIN, JIA-YING XU, PEI-YU WANG, JIAN TONG, KAZUHIKO HOSHI We have previously found a positive association between milk consumption and prostate cancer risk using meta-analysis to analyze published case-control studies. In the present study, further meta-analysis was conducted to estimate the summary relative risk (RR) between the consumption of milk and dairy products and prostate cancer from cohort studies published between 1966- 2006. We found 18 relevant articles and 13 independent studies were available for our analysis. The summary RR was 1.13 (95% confidence interval = 1.02-1.24) when comparing the highest with the lowest quantile of consumption. The summary RRs by study stratification showed a positive association. A dose-response relationship was identified when combining the studies that partitioned the consumption by quintiles. We also evaluated the effects of some limitations, such as dairy classification, prostate cancer stages and publication bias, in the present study. These findings, together with the previous study, suggest that the consumption of milk and dairy products increases the risk of prostate cancer. This is biologically plausible since milk contains considerable amounts of fat, hormones, and calcium that are associated with prostate cancer risk. Key Words: milk, dairy products, prostate cancer, meta-analysis, cohort study, oriental populations

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牛奶消费与前列腺癌:西方国家列队研究的meta分析 我们曾经利用meta分析研究了病例-对照研究,发现牛奶消费和前列腺癌发生存在正相关。本研究中,我们收集了1966年到2006年发表的队列研究,用meta分析的方法进一步研究牛奶及奶制品消费和前列腺癌之间的总相对危险度(RR)。我们共搜索到18篇相关文章,其中含有的13个独立研究被用于本次分析。比较最高和最低消费组后得到总RR1.13(95%可信区间 = 1.02-1.24)。经分层分析后仍存在正相关。单独分析研究对象被分成5个剂量组的队列研究则发现RR值随消费量的上升而增强。我们还评价了诸如奶制品分类、癌症分级和出版偏倚对meta分析的影响。本研究提示牛奶和奶制品消费增加了患前列腺癌的危险性。其机制可能与牛奶和奶制品中的脂肪、激素以及钙有关。

关健字:牛奶、奶制品、前列腺癌、meta分析、队列研究。

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Intake of vitamin A-rich foods and lung cancer risk in Taiwan: with special reference to garland chrysanthemum and sweet potato leaf consumption YI-RU JIN, MEEI-SHYUAN LEE, JANG-HWA LEE, HON-KI HSU, JAU-YEONG LU, SHIN-SHIN CHAO, KOW-TONG CHEN, SAOU-HSING LIOU, LUO-PING GER

A case-control study was conducted to investigate the association between the consumption of local common foods that are rich in vitamin A and the risk of lung cancer in Taiwan. A total of 301 incident lung cancer cases, 602 hospital controls, and 602 neighborhood controls were recruited. The consumption of 13 food items and vitamin supplements was estimated by use of a food frequency questionnaire. The conditional logistic regression models were used to estimate the adjusted odds ratios (AOR) and 95% confidence intervals (CI) for lung cancer risk with each control group as reference by adjustment of covariates. A reduced risk for lung cancer was found to be associated with increased intakes of vitamin A, a-carotene, and b-carotene from 13 food items. More servings of vegetables (AOR for the highest versus the lowest quartile = 0.67-0.70, 95% CI = 0.42-1.08, plinear trend = 0.04), garland chrysanthemum (AOR for the highest versus the lowest tertile = 0.58-0.74, 95% CI = 0.37-1.14, plinear trend 0.04) and sweet potato leaves (AOR for the highest versus the lowest tertile = 0.43-0.65, 95% CI = 0.28-0.96, plinear trend 0.03) were associated with the reduced risk for lung cancer. In conclusion, higher consumption of vitamin A-rich vegetables, especially garland chrysanthemum and sweet potato leaves might provide potential protection from lung cancer.

Key Words: lung cancer, case-control study, vitamin A, garland chrysanthemum, and sweet potato leaves

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台灣地區富含維生素A食物的攝取與罹患肺癌的風險:尤指茼蒿及地瓜葉的食用研究 我們利用病例對照研究法,探討攝食台灣盛產且富含維生素A的食物與罹患肺癌危險性之關係。共收案301位原發肺癌新病人、602位醫院對照病人和602位鄰居對照受試者,使用食物頻率問卷估量其13種食物和維他命補充劑之攝取量後,以條件式羅吉斯迴歸模式估算肺癌病人與每組對照組於共變數調整後勝算比(adjusted odds ratio: AOR)與其95%信賴區間(95% CI)。結果發現從13種食物中攝食維生素Aα胡蘿蔔素和β胡蘿蔔素愈高者,其罹患肺癌的危險性愈低。而攝食較多份數的蔬菜(病例組與對照組之高vs.低四分位之調整後勝算比為0.67-0.7095% CI0.42-1.08,趨勢p值為0.04)、茼蒿(高vs.低三分位調整後勝算比分別為0.58- 0.7495% CI0.37-1.14,趨勢p 0.04)或地瓜葉(高vs.低三分位調整後勝算比分別為0.43-0.6595% CI0.28-0.96,趨勢p 0.03)者,其罹患肺癌的危險性則較低。結論:攝食較多富含維生素A的蔬菜,特別是茼蒿和地瓜葉,提供了對肺癌保護的可能性。

關鍵字:肺癌、病例對照研究法、維生素A、茼蒿、地瓜葉。

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Short-term effectiveness of an individual counseling program for impaired fasting glucose and mild type 2 diabetes in Japan: a multi-center randomized control trial MAKOTO WATANABE, AKIRA OKAYAMA, KAZUAKI SHIMAMOTO, HIROTSUGU UESHIMA The aim of this study is to evaluate the short-term effectiveness of our individual-based counseling program and tools among individuals in ordinary Japanese communities with impaired fasting glucose (IFG) and mild type 2 diabetes. A total of 233 eligible participants (age 30-69 years) in 14 local study centers were randomly assigned to an intervention group (INT, N=119) and a control group (CONT, N=114). During the 4-month intervention, the INT received 4 individual counseling sessions and one reminder on life style modification. The CONT received only an explanation of blood test results and general information on diabetes. Baseline characteristics did not differ significantly between groups. Percentages of participants with desirable changes in glycemic level and weight were significantly higher in INT than CONT: fasting plasma glucose reduction of more than 10 mg/dL (39% in INT vs. 26% in CONT, p=0.045), hemoglobinA1c reduction greater than 0.3% (14% vs. 4%, p=0.01), and weight reduction of more than 4 kg (13% vs. 4%, p=0.025). Decreases in total energy intake and percentage of heavy alcohol drinkers (more than 46 g/day) were significantly greater in INT than CONT. The increase in percentages of participants who engaged in leisure time physical activity more than 12 times per month was significantly greater in INT than CONT. Our program resulted in life style modification and glycemic level improvement in the short-term among individuals with IFG and mild type 2 diabetes. Results indicated that the program was sufficiently effective and feasible for implementation in ordinary communities. Key Words: randomized controlled trial, health education, program evaluation, hyperglycemia, public health

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個人諮詢課程對日本空腹葡萄糖不良及輕微第2型糖尿病患者之短期效果:一個多中心隨機控制試驗 本研究目的為評估我們的個人化諮詢課程及工具,對有空腹葡萄糖不良(IFG)及輕微第2型糖尿病的一般日本社區個人之短期效果。 在14個研究中心中共有233名合格的參與者(年齡在30-69歲),隨機分派為介入組(INTN=119)及控制組(CONTN=114)。四個月的介入期間,INT接受四次個人諮詢課程及一次的生活型態改變提示。CONT僅接受一次血糖測試結果的解釋及糖尿病的基本資訊。兩組研究初始的特性沒有顯著差異。參與者血糖值及體重改變符合期望的百分比,INT顯著的較CONT高:空腹血漿葡萄糖降低超過10 mg/dL(INT 39% vs. CONT 26%p=0.045)、糖化血色素降低高於0.3%(14% vs. 4%p=0.01)、體重降低超過4公斤(13% vs. 4%p=0.025)。總熱量攝取量及重度酒精攝取(一天超過46公克)百分比的降低,INT顯著的高於CONT。參與者每個月從事休閒活動超過12次增加的百分比,INT顯著高於CONT。我們的課程可導致IFG及第2型糖尿病之個人的短期生活型態改變及血糖值改善。結果指出這個課程在一般社區具有可行性,且有足夠效果。 關鍵字:隨機控制試驗、衛生教育、課程評估、高血糖、公共衛生。

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Tocotrienol levels in adipose tissue of benign and malignant breast lumps in patients in Malaysia KALANITHI NESARETNAM, PATRICIA ALISON GOMEZ, KANGA RANI SELVADURAY, GAZALI.ABDUL RAZAK Data on dietary exposure to vitamin E by plasma or adipose tissue concentrations of α-tocopherol (α-T) in observational studies have failed to provide consistent support for the idea that α-T provides women with any protection from breast cancer. In contrast, studies indicate that α, γ, and δ-tocotrienols but not α-T have potent anti-proliferative effects in human breast cancer cells. Our aim was to investigate whether there was a difference in tocopherol and tocotrienol concentrations in malignant and benign adipose tissue, in a Malaysian population consuming predominantly a palm oil diet. The study was undertaken using fatty acid levels in breast adipose tissue as a biomarker of qualitative dietary intake of fatty acids. The major fatty acids in breast adipose tissue of patients (benign and malignant) were oleic acid (45-46%), palmitic (28-29%) and linoleic (11-12%). No differences were evident in the fatty acid composition of the two groups. There was a significant difference (p=0.006) in the total tocotrienol levels between malignant (13.7 6.0 g/g) and benign (206.0 g/g) adipose tissue samples. However, no significant differences were seen in the total tocopherol levels (p=0.42) in the two groups. The study reveals that dietary intake influences adipose tissue fatty acid levels and that adipose tissue is a dynamic reservoir of fat soluble nutrients. The higher adipose tissue concentrations of tocotrienols in benign patients provide support for the idea that tocotrienols may provide protection against breast cancer. Key Words: tocotrienols, tocopherols, adipose tissue, fatty acid composition, malignant and benign lumps

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馬來西亞良性及惡性乳房腫塊病人脂肪組織三烯生育醇濃度

觀察性研究中對受飲食維生素E暴露影響的血漿或是脂肪組織的α-生育醇(α-T)濃度,是否提供婦女任何乳癌保護作用,無法提供一致的支持。反之,研究指出α γ δ-三烯生育醇而非α-T對人類乳癌細胞有潛在抗增生效應。我們的目的為研究在攝取大量棕櫚油飲食的馬來西亞族群中,惡性及良性脂肪組織的生育醇及三烯生育醇濃度是否有差異。本研究採用乳房脂肪組織的脂肪酸量當作飲食攝取的脂肪酸之定性生物標記。在病人(良性及惡性)乳房脂肪組織中主要的脂肪酸為油酸(45-46%)、棕櫚油酸(28-29%)及亞麻油酸(11-12%)。兩組的脂肪酸組成沒有差異。在惡性(13.7 6.0 g/g)及良性(206.0 g/g)脂肪組織樣本,總三烯生育醇量有顯著差異(p=0.006)。然而,兩組的總生育醇並未見顯著差異(p=0.420)。本研究顯示飲食攝取會影響脂肪組織的脂肪酸量,而脂肪組織是脂溶性維生素的動態儲存槽。良性病患的脂肪組織較高的三烯生育醇濃度,支持三烯生育醇可能對乳癌具有保護作用的想法。

關鍵字:三烯生育醇、生育醇、脂肪組織、脂肪酸攝取、惡性及良性腫塊。

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Multiple micronutrient fortification of salt and its effect on cognition in Chennai school children MALAVIKA VINODKUMAR, SRINIVASA RAJAGOPALAN Aim: To test the efficacy of a multiple micronutrient fortified salt in improving the micronutrient status and health of school children and its effect on cognition. Methods: A salt fortified with multiple micronutrients was developed containing chelated ferrous sulphate, microencapsulated vitamin A, B1, B2, B6, B12, folic acid, niacin, calcium pantothenate and iodine. The efficacy of the fortified salt was assessed in 7-11 year old school children in Chennai, India. In the experimental group (N=63), the food in the school kitchen was cooked with the fortified salt for a period of one year. The control group (N=66) consisted of day scholars who did not eat at the school. Hemoglobin, red blood cell count, hematocrit, serum vitamin A, urinary iodine and prevalence of angular stomatitis were measured at baseline and at the end of the study after one year. A battery of 7 memory tests (The personal information test, the Mann-Suiter Visual memory screen for objects, The digit span forward test, The digit span backward test, The delayed response test, The Benton Visual Retention Test and The Cattells retentivity test), one test for attention and concentration (Letter cancellation test) and one test for intelligence (Raven’s coloured progressive matrices) were administered to all the children at baseline and endline. Results:  There was a significant (p<0.05) improvement in the experimental group in hemoglobin, red cell count, urinary iodine and serum vitamin A whereas in the control group there was a statistically significant decline (p<0.05)  in hemoglobin, hematocrit, red cell count and urinary iodine. Angular stomatitis was eliminated from baseline 30.4% in the experimental group whereas it increased from 3.25% to 25.5% in the control group. In 4 tests out of the 7 memory tests and in the letter cancellation test for attention, the mean increment in scores in the experimental group is significantly more (p<0.05) than the control group. There was no significant improvement in overall intelligence as seen in the Ravens progressive matrices between the experimental and control groups. Conclusion: The study shows that the multiple micronutrient fortified salt is effective in improving multiple micronutrient status and cognition in children. Key Words: child nutrition, India, multiple micronutrients, salt fortification, iron, vitamin A, B complex vitamins, cognition

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食鹽添加多種微量營養素對Chennai學童認知的影響

目的:測試添加多種微量營養素的食鹽對改善學童微量營養素狀況及健康的效力,與其對認知的影響。

方法:食鹽添加多種微量營養素,包含有螯合硫化鐵、微囊化維生素AB1B2B6B12、葉酸、菸鹼酸、泛酸鈣及碘。以印度Chennai 7-11歲學童評估該強化添加食鹽的效力。實驗組(N=63),學校廚房採用強化食鹽烹調食物為期一年。控制組(N=66),為沒有在學校飲食者。研究開始及一年研究結束後,測量血紅素、紅血球計數、血比容、血清維生素A、尿碘及口角炎盛行率。所有兒童在研究開始及結束時均實施一套7項記憶力測驗(個人常識測驗、Mann-Suiter 視覺物體記憶力篩選、數字順背記憶測驗、 數字倒背記憶測驗、延遲反應測驗、班頓視覺保留測驗以及Cattells記憶力持久測驗)、一項專注力測驗(刪字測驗) 及一項針對智力的測驗(瑞文氏智力測驗)。 結果:實驗組在血紅素、紅血球、尿碘及血清維生素A有顯著的改善(p<0.05),反之控制組在血紅素,血比容,紅血球及尿碘則有統計上顯著下降(p<0.05)。實驗組口角炎較研究開始降低30.4%,反之控制組由3.25%增加至25.5%。在7項記憶力測試中有4項以及專注力的刪字測驗,實驗組平均增加的分數顯著的較控制組高(p<0.05)。以瑞文氏智力測驗評估整體智力的改善,實驗組與對照組沒有顯著差異。 結論:本研究顯示添加多種微量營養素的食鹽,可以有效改善兒童的多種微量營養素狀況及認知。 關鍵字:兒童營養、印度、多種微量營養素、食鹽強化、鐵、維生素A、維生素B群、認知。

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Determinants of child malnutrition during the 1999 economic crisis in selected poor areas of Indonesia SAPTAWATI BARDOSONO, SOEMILAH SASTROAMIDJOJO, WIDJAJA LUKITO

There is empirical evidence at the national level that suggests the 1999 Indonesian economic crisis impact was very heterogeneous both between urban and rural areas and across regions. A cross sectional study of  the nutritional status of children and its determinants was performed in urban poor areas of Jakarta, and rural areas of Banggai in Central Sulawesi, and Alor-Rote in East Nusa Tenggara. Two-stage cluster sampling was used to obtain 1078 households with under-five children in the urban poor area of Jakarta, and 262 and 631 households with under-five children each for the rural areas of Banggai and Alor-Rote, respectively. Data collection for both studies was performed from January 1999 to June 2001. The study shows that wasting affected more children in the urban poor areas of Jakarta than in the other study areas. On the other hand, stunting and anemia were significantly more severe among children 6-59 months of age in the rural area of Alor-Rote compared to the other study areas. The high prevalence of infectious diseases was significantly related to the higher prevalence of wasting in the study areas of Jakarta and Banggai, and also significantly related to the higher prevalence of stunting and anemia in the study area of Alor-Rote. To avert this kind of health impact of a economic downturn, there is a need to improve the nutritional and health status of under-five children and their mothers through the existing health care system, provide basic health services and improve the capacity of health staff across Indonesia as part of the decentralization process.

Key Words: crisis, poverty, economy, recent-onset malnutrition (wasting), chronic malnutrition (stunting and anaemia), determinants, under-five children, Jakarta, Banggai, Alor-Rote

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1999年經濟危機期間印尼貧窮地區兒童營養不良之決定因素

國家層級的實徵證據指出,1999年印尼經濟危機對城鄉地區及橫跨的區域的衝擊迥異。一個橫斷性營養狀況研究在雅加達貧窮的城市地區,及蘇拉維西中部的Banggai East Nusa Tenggara的鄉村地區進行。以兩階段集束抽樣,分別抽出雅加達貧窮地區1078個,Banggai 262個及Alor-Rote 631個有五歲以下孩童的家戶。數據收集從19991月起到20016月止。此研究顯示在雅加達貧窮的地區,耗損的影響的兒童較其他地區多。另一方面,在Alor-Rote的鄉村地區6-59個月大孩童發育遲緩及貧血的情形較其他地區嚴重。傳染性疾病的高盛行率與雅加達及Banggai研究地區較高的耗損盛行率具有顯著的相關,也與Alor-Rote研究地區較高的發育遲緩及貧血盛行率具有顯著相關。為避免此種因經濟下滑而健康受到衝擊,需要透過既存之健康照護系統,以改善五歲以下孩童及其母親的營養及健康狀況。不論地區,提供基本的健康服務及增進衛生人員的能力,是地方分權過程的一部份。

關鍵字:危機、貧窮、經濟、新開始的營養不良(耗損)、慢性營養不良(發育遲緩及貧血)、決定因素、五歲以下孩童、雅加達、BanggaiAlor-Rote

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Anemia in pregnancy in Malaysia: a cross-sectional survey JAMAIYAHV HANIFF, ANITA DAS, LIM TECK ONN, CHEN WON SUN, NORAIHAN MOHD NORDIN, SANJAY RAMPAL, SAFIAH BAHRIN, MURALITHARAN GANESLINGAM, KUMAR ISWARAN K. KULARATNAM, ZAKI MORAD MOHAMAD ZAHER, MALAYSIAN ANEMIA STUDY GROUP Anemia is the most prevalent nutritional deficiency during pregnancy.  Except for a study conducted 10 years ago in Kelantan, Malaysia’s available statistics are based on isolated small urban maternity hospital studies from the 1980s.  There was therefore, a need for a large study at national level to estimate the magnitude of the problem in the country as well as to understand its epidemiology.  This multi-center, cross-sectional study was conducted from February to March 2005, to assess the prevalence of anemia. Multistage stratified random sampling technique was used and 59 Ministry of Health (MOH) primary health care clinics were selected. Our final dataset consisted of 1,072 antenatal mothers from 56 clinics.  The overall prevalence of anemia in this population was 35 % (SE 0.02) if the cut off level is 11 g/dL and 11 % (SE 0.03) if the cut-off level is 10 g/dL. The majority was of the mild type. The prevalence was higher in the teenage group, Indians followed by Malays and Chinese being the least, grandmultiparas, the third trimester and from urban residence. After multiple linear regression analysis, only gestational age remained significant. These findings are useful for our Maternal Health program planners and implementers to target and evaluate interventions.  Work is in progress for outcomes and cost-effectiveness studies to best tackle this problem.  In conclusion, the prevalence of anemia is 35% and mostly of the mild type and more prevalent in the Indian and Malays. Key Words: anemia, pregnancy, prevalence, haemoglobin, grandmultiparity

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馬來西亞婦女懷孕時期貧血之橫斷性研究 貧血是懷孕期間最常見的營養缺乏症。除了10年前在Kelantan進行的研究之外,馬來西亞現有的統計根據是80年代幾個小型的城市中的產科醫院的研究。因此,需要一項全國性大型研究來評估問題的大小並瞭解它的流行病學。為估計貧血症的盛行率,從2005 2月到3月於多中心進行橫斷性研究。以多步驟分層隨機抽樣法,選取了59個衛生部(MOH)基層健康照護診所。我們最後的資料包含56個診所的1,072 個產前孕婦。這個族群整體的貧血盛行率若以11 g/dL為切點是35 % (SE 0.02);若以10 g/dL為切點則為11 % (SE 0.03)。多數為輕微型。盛行率較高的是青少年組;印度人隨後為馬來人,華人最低;多胎次,懷孕第三期和居住於都市者。以線性複迴歸分析之後,只剩懷孕年齡依然顯著。這些發現有助於我們的孕產婦健康計畫的計劃者及執行者來訂定介入目標及評估。為了最好應付這個問題,結果及成本效益的研究工作正在進展中。總而言之,貧血症的盛行率為35%,多數為輕微型,印度人和馬來人盛行率較高。

關鍵字:貧血、懷孕、盛行率、血紅素、多胎次。

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Influences on maternal and child nutrition in the highlands of the northern Lao PDR WENDY HOLMES, DAMIAN HOY, ANNE LOCKLEY, KHAMPHO THAMMAVONGXAY, SOMPHAO BOUNNAPHOL, ANONH XEUATVONGSA, MICHAEL TOOLE In two remote northern provinces of the Lao People’s Democratic Republic, provincial and district teams were trained and subsequently conducted a qualitative study using a participatory approach to investigate people’s knowledge, attitudes, beliefs and practices in relation to women’s and children’s nutrition.   Using focus group discussions, key informant interviews, and structured observation, the teams found that certain nutrition behaviours, including food taboos, may contribute to the high prevalence of child malnutrition and micronutrient deficiencies in these northern provinces.  Ethnic groups gave details of nutrition-related beliefs and practices; the teams found that many of these are likely to be amenable to change through relatively low-cost nutrition promotion informed by these findings.  In particular, barriers to exclusive breastfeeding, food taboos and hygiene behaviour could be addressed.  The study also demonstrated that with appropriate training, supervision and support, local teams are able to plan and conduct a large-scale qualitative study. Key Words: nutrition, Lao PDR, Laos, mother, child, qualitative study

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寮國人民民主共和國北部高原地區影響母親與小孩營養狀況的因素

在寮國人民民主共和國兩個偏遠北部省份,省級及區級團隊接受訓練後,接著進行一個質性研究,使用參與法,在探討他們的認知、態度、信念及實踐與母親及小孩營養的相關性。使用焦點團體討論,重點資訊訪談及結構性觀察,團隊發現某些營養的行為,包括食物禁忌,可能與那些北部省份小孩營養不良及微量營養素缺乏的高盛行率有關。氏族團體給予詳細的營養相關信念及實踐;團隊發現很多這些行為可能可以透過相對低的成本的營養素促進資訊而改變。尤其是完全母乳哺餵的阻礙、食物禁忌及衛生行為應該被提出。本研究也示範了,經過適當的訓練、管理及支持,區域的團隊有能力計畫及從事大規模的質性研究。

關鍵字:營養、寮國人民民主共和國、母親、小孩、質性研究。

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Determinants of blood pressure among Indonesian elderly individuals who are of normal and over-weight: a cross sectional study in an urban population SUDIJANTO KAMSO, JOHANNA SP RUMAWAS, WIDJAJA LUKITO, PURWANTYASTUTI Cardiovascular disease has become the first cause of death in Indonesia. The highest morbidity is found in the aged, and among cardiovascular disorders or diseases, the prevalence of hypertension is the highest. Many studies of the relationship between nutritional factors and hypertension have been conducted, especially with reference to the metabolic syndrome, but studies to understand determinants of blood pressure in Indonesia are lacking. There is an urgent need to gather information about various blood pressure risk factors in Indonesian elderly, which will allow policy makers to provide appropriate intervention programs. The primary purpose of this study was to investigate various determinants of blood pressure in Indonesian elderly who differed in body composition. A cross sectional study was undertaken in Jakarta on 556 elderly using multistage random sampling. Data were collected through interview using structured questionnaires, anthropometric measurements, biochemical blood analysis, and blood pressure measurements. Daily nutrient intake was analyzed using the World Food 2 Dietary Assessment Program. General Linear Model and Multiple linear regression analysis were performed to determine determinants of systolic and diastolic blood pressure. Monounsaturated fatty acid, saturated fatty acid, and sodium intake, plasma total cholesterol level, the ratio of total cholesterol to HDL-cholesterol and a sport Index were determinants of blood pressure in the normal weight elderly individuals, while potassium intake, calcium intake and BMI were determinants of blood pressure in the overweight elderly individuals. Key Words: Obesity, fat intake, sodium, potassium, calcium, physical activity, blood pressure, Jakarta

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印尼體重正常及過重老人血壓決定因子:一個城市族群的橫斷性研究

心血管疾病已經成為印尼第一死因。老年人的罹病率較高,而心血管失調或疾病者,其高血壓盛行率是最高的。很多研究已探討營養因子與高血壓之間的相關性,特別涉及代謝症候群這一部分。然而,在印尼瞭解血壓決定因子的研究闕如。有迫切需要去收集有關於印尼老年人的各種血壓危險因子之資訊,讓政策制訂者提供適當的介入計畫。本研究主要目的為研究不同體位的印尼老年人之血壓決定因子。採用多步驟隨機抽樣,共有556名在雅加達的老年人完成此橫斷性研究。數據是以結構性問卷面訪取得,收集體位、血液生化分析及血壓。每日營養素攝取是以World Food 2飲食評估系統分析。以一般線性模式及複迴歸分析評估收縮壓與舒張壓決定因子。單元不飽和脂肪酸、飽和脂肪酸及鈉的攝取、血漿總膽固醇量、總膽固醇與HDL-膽固醇比值及運動指數是正常體位的老年人血壓的決定因子;鉀及鈣的攝取及BMI則是體重過重的老年人之血壓決定因子。

關鍵字:肥胖、脂肪攝取、鈉、鉀、鈣、體能活動、血壓、雅加達。

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Effect of continuous enteral L-arginine in a rat model of the short bowel syndrome XIAOHUA JIANG, WEIMING ZHU, NING LI, LI TAN, JIESHOU LI The objective of this study was to evaluate whether continuous enteral supplementation of L-arginine can stimulate intestinal adaptation in a rat model of short bowel syndrome (SBS). Male Sprague-Dawley rats were randomly divided into three groups of 10 each: Sham rats underwent bowel transaction and received continuous enteral nutrition (Control group, Con group), SBS rats underwent 75% small bowel resection and received continuous enteral nutrition (SB group), and SBS rats underwent 75% bowel resection and received continuous enteral nutrition supplemented with L-arginine (300mg/Kg/d) (SB-Arg group). Fat absorbability, plasma free fatty acids, parameters of intestinal adaptation, enterocyte proliferation and apoptosis were determined on day 15 after operation. After massive small bowel resection, rats had significant bowel adaptation. Compared with SB untreated rats, SB rats supplemented with L-arginine demonstrated a significant increase in fat absorbability, plasma level of free fatty acids, ileal mucosal weight and DNA content, jejunal and ileal mucosal protein content, jejunal and ileal villus length, crypt depth and mucosal thickness. L-arginine supplementation increased enterocyte proliferation, while decreasing enterocyte apoptosis. We suggest that after massive small bowel resection, continuous enteral supplementation of L-arginine can stimulate intestinal adaptation. L-arginine may be a trophic factor to stimulate intestinal adaptation in rats of SBS.

Key Words: short bowel syndrome, adaptation, intestine, L-arginine, enteral nutrition

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持续肠内给予L-精氨酸对短肠综合征大鼠肠道代偿的影响 本研究目的在于探讨持续肠内给予L-精氨酸对短肠综合征大鼠肠道代偿的影响。雄性Sprague-Dawley大鼠随机分为三组,每组10只。假手术对照组(Con组)行空肠横断吻合,短肠对照组(SB组)和短肠精氨酸组(SB-Arg组)均行75%中段小肠切除。各组大鼠均给予等量的肠内营养支持,其中SB-Arg组肠内营养中添加L-精氨酸300mg/Kg/d。术后第15天检测脂肪吸收率、血浆游离脂肪酸水平、肠道代偿指标、肠粘膜细胞增殖和凋亡。结果显示,大鼠广泛肠切除术后出现明显的肠道代偿。SB-Arg组大鼠脂肪吸收率、血浆游离脂肪酸水平、回肠粘膜重量和DNA含量、空肠及回肠蛋白含量、空肠及回肠绒毛高度、隐窝深度及粘膜厚度均显著高于SB组;添加L-精氨酸能促进短肠大鼠肠粘膜细胞增殖并抑制肠粘膜细胞凋亡。本研究的结果表明,持续肠内给予L-精氨酸能促进短肠综合征大鼠肠道的代偿,精氨酸可能可作为短肠综合征大鼠肠道代偿的一种营养因子。 關鍵字:短腸綜合症、代償、腸道、L-精氨酸、腸道營養。

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A national study of the prevalence of obesity among 16,127 Malaysians GR LEKHRAJ RAMPAL, SANJAY RAMPAL MBBS, GEOK LIN KHOR, AZHAR MD ZAIN, M PSYCH, SHAFIE B OOYUB, RAMLEE B RAHMAT, SIRAJOON NOOR GHANI, JAYANTHI KRISHNAN A population-based cross-sectional study was conducted in all states of Malaysia with the aim to determine the prevalence of obesity among Malaysians aged fifteen years and above and factors associated. A stratified two-stage cluster sampling design with proportional allocation was used. Trained interviewers using a standardized protocol obtained the weight and height measurements and other relevant information.  Subjects with a body mass index ≥ 30 kg/m2 were labelled as obese. The results show that the overall national prevalence of obesity among Malaysians aged 15 years old and above was 11.7% (95% CI = 11.1 - 12.4%).  The prevalence of obesity was significantly higher in females (13.8%) as compared to 9.6% in males (p< 0.0001).  Prevalence of obesity was highest amongst the Malays (13.6%) and Indians (13.5%) followed by the indigenous group of “Sarawak Bumiputra” (10.8%) and the Chinese (8.5%). The indigenous group of “Sabah Bumiputra” had the lowest prevalence of 7.3%.  These differences are statistically significant (p< 0.0001). Logistic regression analysis results show that there was a significant association between obesity and age, gender, ethnicity urban/rural status and smoking status. The prevalence of obesity amongst those aged ≥ 18 years old has markedly increased by 280% since the last National Health and Morbidity Survey in 1996. Conclusion: The overall prevalence of obesity in Malaysia is very high as compared to 1996.  There is an urgent need for a comprehensive integrated population-based intervention program to ameliorate the growing problem of obesity in Malaysians. Key Words: prevalence, obesity, ethnicity, Malaysia

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一個16,127名馬來西亞人的全國性肥胖盛行率研究 一個基於人口的橫斷性研究在馬來西亞各州進行,目的為測定15歲以上馬來西亞人的肥胖盛行率及相關因子。採用等比例分配兩段分層集束抽樣。訓練過的訪員以標準程序取得體重、身高及其他相關資訊。身體質量指數≥ 30 kg/m2定義為肥胖。結果顯示15歲以上的馬來西亞人之全國肥胖盛行率為11.7%(95% CI =11.1-12.4%)。女性(13.8%)的肥胖盛行率顯著高於男性(9.6%)(p<0.0001)。肥胖盛行率由高為低依序為馬來人 (13.6%)、印度人 (13.5%)、原住民中的Sarawak Bumiputra (10.8%)及華人 (8.5%)。盛行率最低的則為原住民中的Sabah Bumiputra(7.3%)。這些差異皆達統計顯著意義(p<0.0001)。羅吉斯迴歸分析的結果顯示肥胖與年齡、性別、氏族城鄉狀態及抽菸狀態有顯著關連。自1996年上一次全國健康與死亡率調查以來,18歲以上的肥胖盛行率以280%顯著增加。結論:與1996年相比,馬來西亞總體肥胖盛行率非常高。急迫需要一個基於人口全面整合的介入計畫來改善馬來西亞人日益增加的肥胖問題。 關鍵字:盛行率、肥胖、氏族、馬來西亞。

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Comparisons of attitudes and practices between obese and normal weight women in Taiwan SHENE-PIN HU, TZU-YIN CHIANG, SUNG-LING YEH, YI-WEN CHIEN This study was designed to obtain baseline data regarding self-reported body image, attitudes toward overweight people, and dietary behaviors of normal-weight and obese women in Taiwan. Fifty obese women (BMI ≧ 27) and age-matched normal-weight women participated in this study. Written questionnaires were used for data collection. Simple frequency and t-test were used to analyze data. In general, the majority of normal-weight women perceived themselves as being heavier than their actual body weight. The normal-weight group had more high inaccurate images of their bodies than that of the obese group (72% vs. 24%). Obese and normal-weight women had similar attitudes to overweight people, but some of their attitudes showed significant differences. Obese women would prefer to consume more fried foods and drink sugar-containing foods than would normal-weight women (p < 0.05). Education about accurate perceptions of what is normal weight for women and adopting energy-diluted foods for obese women is needed in the future. Key Words: weight-related attitudes, food and beverage practices, normal-weight, obese people, women Chinese

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比較臺灣肥胖與體重正常女性的態度與行為 本實驗從自我報告取得臺灣體重過重者之身體形像、態度及飲食行為等數據,比較體重正常和肥胖者的差異。50位肥胖與年齡相配的50名體重正常者參與本研究,書寫式問卷使用於實驗數據的收集,數據分析以簡單頻率與t檢驗之方法。結果發現大部分體重正常者覺得自己的體重比實際的重,體重正常組與肥胖組比較,體重認知錯誤的比率較高(72%與24%),不論正常體重或肥胖者對於過重的態度類似,但是部分態度的項目是有顯著差異,肥胖者較體重正常者喜歡吃油炸食物和喝甜的飲料。未來在營養教育上應該針對何為正常的體重與肥胖者的飲食原則的議題來進行更進一步的研究。 關鍵字:體重相關的態度、飲食習慣, 體重正常、肥胖者、華人女性。

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Prevalence of overweight and obesity and its associated factors in aboriginal Taiwanese: findings from the 2001 National Health Interview Survey in Taiwan CHING-SUNG HO, ALAN C TSAI The study was undertaken to assess the prevalence of obesity in Taiwanese aborigines and to identify the associated factors. Data for this study were from the “2001 National Health Interview Survey (NHIS)” that conducted in-home, face-to-face, interviews on 6,592 households (26,658 persons) of a national probability sample in Taiwan. Aborigine-dense mountainous areas are over-sampled. BMI values were used to indicate obesity status. Logistic regression analyses were used to determine the significance of the association of the variables with the obesity status. Results showed that approximately 10.5% of aboriginal men and 14.5% of women compared to 4.1% and 3.5% of their non-aboriginal counterparts were obese (BMI > 30). An additional 45.1% of aboriginal men and 33.3% of women compared to 27.6% and 17.7% of their non-aboriginal counterparts were overweight (BMI 25-30). Regression analyses revealed few associations with increased risk of obesity in the aborigines. However, the aborigines and non-aborigines were distinctly different from each other in socio-economic status, lifestyle, environmental factors and attitude toward obesity. Results indicate that obesity is more prevalent among the aborigines but the causal reasons are not apparent. The public health authorities should develop more culturally appropriate community-based intervention strategies to promote the health of the aborigines. Key Words: aborigines, obesity, anthropometrics, lifestyle, Taiwan

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臺灣原住民肥胖盛行率及相關因素探討:以2001年臺灣國民健康訪問調查資料進行分析

本研究是要分析臺灣地區原住民肥胖的盛行率及相關因素,研究資料是來自民國90年國民健康局所做的國民健康訪問調查,本調查是全國性的抽樣調查資料,其中少數族群以擴大抽樣的方式來進行抽樣,針對6592戶(26,658人)進行在家,面對面的調查。有關肥胖狀態是以BMI值來表示,並以邏輯斯迴歸來探討與肥胖有關的因素。結果發現,原住民中有將近10.5%的男性及14.5%女性屬於肥胖(BMI>30),而非原住民中,男女性肥胖的比率則分別為4.1%3.5%,此外,原住民中有將近45.1%的男性及33.3%女性屬於過重(BMI 25-30),而非原住民中,男女性過重的比率則分別為27.6%17.7%

迴歸分析發現,影響原住民肥胖並沒有許多顯著的危險因子,然而,原住民和非原住民在許多社會經濟狀態、生活型態、環境因素及對於肥胖的態度有明顯的差異。研究結果發現原住民有較高的肥胖盛行率,但相關因子並不明顯,衛生主管機關應發展適合當地文化,以社區為基礎的介入策略來提升原住民的健康。 關鍵字:原住民、肥胖、人體測量、生活型態、臺灣。

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Anti-obesity drug use before professional treatment in Taiwan TSAN-HON LIOU, CHIH-HSING WU, HSU-CHEN CHIEN, WEN-YUAN LIN, WEI-JEI LEE, PESUS CHOU Between July 2004 and June 2005, a cross-sectional study was performed to determine the prevalence and patterns of anti-obesity medicine use among subjects seeking obesity treatment in Taiwan. Eighteen obesity outpatient clinics were selected via a random stratified sampling method and 1,060 first-visit clients (791 females and 269 males) aged above 18 years were enrolled and then completed a self-administered questionnaire. The prevalence of anti-obesity medicine use was 50.8%; more females than male used anti-obesity medicines (53.6% vs. 42.4%). Of the 1,060 subjects, 17.1% had used orlistat, 21.1% had taken sibutramine, and 18.3% had utilized unproven drugs such as cocktail therapy and other anti-obesity drugs. Furthermore, 23.6% and 22.4% of subjects indicated that they concurrently used Chinese herbal preparations and dietary supplements, respectively. Logistic regression analyses demonstrated that the odds ratio (OR) for anti-obesity medicine use was substantially higher in females (OR, 1.9; 95% CI, 1.3-2.6), those aged 18-24 years (OR, 1.6; 95% CI, 1.0-2.6), those with a body mass index (BMI) >35 kg/m2 (OR, 3.4; 95% CI, 2.1-5.7) and respondents concurrently using Chinese herbal preparations (OR, 1.7; 95% CI, 1.2-2.4) and dietary supplements  (OR, 2.2; 95% CI, 1.6-3.1). In conclusion, the prevalence of anti-obesity drugs use is high among Taiwanese adults before they seek obesity treatment. Young, obese females, and those who had taken Chinese herbal preparations/dietary supplements had a high likelihood to report using anti-obesity medicines. Use of unproven weight-loss drugs is common and warrants further investigation. Key Words: Orlistat, sibutramine, dietary supplement, off-label drugs, drug utilization

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臺灣民眾尋求專業減肥前使用減肥藥物情況之調查 本研究於西元20047月到20056月進行一項橫斷式調查,希望瞭解臺灣民眾在尋求專業減肥之前使用減肥藥物的情形,經由隨機分層抽樣的方法,選取十八家專業減肥醫院或診所,並由這些門診挑選18歲以上的受訪者共1,060位,其中女性791位、男性269位,每位受訪者皆填寫完成一份問卷。統計發現這些受訪者使用減肥藥物的盛行率是50.8%,其中女性高於男性(53.6%42.4%)。1,060位受訪者中,17.1% 曾經使用過orlistat21.1%使用過sibutramine18.3%使用過雞尾酒減肥療法或未經證實的減肥藥,此外23.6%受訪者指出在減肥期間合併使用中藥減肥、22.4%合併補充減肥健康食品。邏輯式迴歸分析發現,女性、年齡介於18-24歲、身體質量指數(BMI)大於35、同時合併使用減肥中藥/健康食品的受訪者使用減肥藥物的機會較高。總而言之,臺灣成年民眾在尋求專業減肥之前,使用減肥藥物的情形相當普遍,尤其是女性、超重和那些同時合併使用中藥及健康食品減肥的民眾;此外,相關單位對於未經證實的減肥藥物使用情形必須進一步了解。 關鍵字:Orlistat sibutramine健康食品、禁藥、 藥物使用。

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Last Updated: September 2007