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1 Asia Pacific Journal of Clinical Nutrition
       Volume 17, 1

         (March 2008)


Abstracts

Contents

Abstract Papers

The Asia Pacific Clinical Nutrition Society Award for 2008: Citation for Widjaja Lukito

Mark L Wahlqvist

Asia Pac J Clin Nutr. 2008;17(1):1.

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Review Articles

Evidence-based nutrition (EBN) in the Asia Pacific region: clinical practice and policy-setting MARK L WAHLQVIST, MEEI-SHYUAN LEE, JOSEPH LAU, KEN N KUO, CHING-JIAN HUANG, WEN-HARN PAN, HSING-YI CHANG, ROSALIND CHEN AND YI-CHEN HUANG

Asia Pac J Clin Nutr. 2008;17(1):2-7.

 

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Cardiovascular pathogenesis in hyperhomocysteinemia TAO HUANG, GAOFENG YUAN, ZHIGUO ZHANG, ZUQUAN ZOU AND DUO LI

Asia Pac J Clin Nutr. 2008;17(1):8-16.

 

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Original Research Communications

Nutritional Pathophysiology

Effectiveness of a Taiwanese traditional diet for pain management in terminal cancer patients

TSUNG-HSIU WU, TAI-YUAN CHIU, JAW-SHIUN TSAI, CHING-YU CHEN, LIH-CHI CHEN AND LING-LING YANG

Asia Pac J Clin Nutr. 2008;17(1):17-22.

 

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Protection of myocardium in streptozotocin-induced diabetic rats by water extracts of Hsian-tsao (Mesona procumbens Hemsl.)

MIN YANG, ZHENGPING XU, RONGHUA ZHANG, PIANHONG ZHANG, YAN WENG, YUELIANG SHEN AND XIAOMING ZHANG

Asia Pac J Clin Nutr. 2008;17(1):23-29.

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Effect of a milk supplemented with Bifidobacterium lactics Bl on the recovery from acute diarrhea MENG MAO, TAO YU, YING XIONG,  ZHILING WANG, HANMIN LIU, MARTIN GOTTELAND AND OSCAR BRUNSER

Asia Pac J Clin Nutr. 2008;17(1):30-34.

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Glycemic index of common Malaysian fruits S DANIEL ROBERT, AZIZ AL-SAFI ISMAIL, THAN WINN AND THOMAS MS WOLEVER

Asia Pac J Clin Nutr. 2008;17(1):35-39.

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Macro- Micro- and Phyto-nutrients

Iron status among Australian adults: findings of a population based study in Queensland, Australia FARUK AHMED, TERRY COYNE, ANNETTE DOBSON AND CHRISTINE MCCLINTOCK

Asia Pac J Clin Nutr. 2008;17(1):40-47.

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Micronutrient deficiencies and anemia among preschool children in rural Vietnam NGUYEN VAN NHIEN, NGUYEN CONG KHAN, NGUYEN XUAN NINH, PHAN VAN HUAN, LE THI HOP, NGUYEN THI LAM, FUSAO OTA, TOMOKI YABUTANI, VU QUYNH HOA, JUNKO MOTONAKA, TAKESHI NISHIKAWA AND YUTAKA NAKAYA

Asia Pac J Clin Nutr. 2008;17(1):48-55.

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An assessment of progress toward universal salt iodization in Rajasthan, India, using iodine nutrition indications in school-ages children and pregnant women form the same households ERIC-ALAIN ATEGBO, RAJAN SANKAR, WERNER SCHULTINK, FRITS VAN DER HAAR AND CHANDRAKANT S PANDAV

Asia Pac J Clin Nutr. 2008;17(1):56-62.

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Suburban clustering of vitamin D deficiency in Melbourne, Australia BIRCAN ERBAS, PETER R EBELING, DIANNE COUCH AND JOHN D WARK

Asia Pac J Clin Nutr. 2008;17(1):63-67.

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Effects of vitamin D fortified milk on vitamin D status in Mongolian school age children DAVAASAMBUU GANMAA, UUSH TSERENDOLGOR, LINDSAY FRAZIER, ERIKA NAKAMOTO, NYAMJAV JARGALSAIKHAN AND JANET RICH-EDWARDS

Asia Pac J Clin Nutr. 2008;17(1):68-71.

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Co-existing micronutrient deficiencies among stunted Cambodian infants and toddlers VICTORIA P ANDERSON, SUSAN JACK, DIDIER MONCHY, NEANG HEM, PHEAROM HOK, KARL B BAILEY AND ROSALIND S GIBSON

Asia Pac J Clin Nutr. 2008;17(1):72-79.

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Fatty acid profiles of blood lipids in a population group in Tibet: correlations with diet and environmental conditions PATRIZIA RISÉ, FRANCA MARANGONI, ANTONELLA MARTIELLO, CLAUDIO COLOMBO, CRISTINA MANZONI, CLAUDIO MARCONI, FLAMINIO CATTABENI AND CLAUDIO GALLI

Asia Pac J Clin Nutr. 2008;17(1):80-85.

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Nutritional Status, Dietary Intake, and Body Composition

Fish consumption and health in French Polynesia ERIC DEWAILLY, LUDIVINE CHÂTEAU-DEGAT AND EDOUARD SUHAS

Asia Pac J Clin Nutr. 2008;17(1):86-93.

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Dietary patterns and food choices of a population sample of adults on Guam REBECCA S POBOCIK, ALISON TRAGER AND LORA MORRELL MONSON Asia Pac J Clin Nutr. 2008;17(1):94-100.

 

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Bone mineral density of vegetarian and non-vegetarian adults in Taiwan

YUH-FENG WANG, JAINN-SHIUN CHIU, MEI-HUA CHUANG, JING-ER CHIU AND CHIN-LON LIN

Asia Pac J Clin Nutr. 2008;17(1):101-106.

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The relative impact of a vegetable-rich diet on key markers of health in a cohort of Australian adolescents ROSS GRANT, AYSE BILGIN, CAROL ZEUSCHNER, TRISH GUY, ROBYN PEARCE, BEVAN HOKIN AND JOHN ASHTON

Asia Pac J Clin Nutr. 2008;17(1):107-115.

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Clinical Nutrition

Application of refractometry to quality assurance monitoring of parenteral nutrition solutions WEI-KUO CHANG, YOU-CHEN CHAO, MING-KUNG YEH

Asia Pac J Clin Nutr. 2008;17(1):116-122.

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Nutritional Epidemiology and Public Health

Dynamic shifts in Chinese eating behaviors ZHIHONG WANG, FENGYING ZHAI, SHUFA DU AND BARRY POPKIN Asia Pac J Clin Nutr. 2008;17(1):123-130.

 

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Obesity prevalence and time trend among youngsters in China, 1982-2002 YANPING LI, EVERT G SCHOUTEN, XIAOQI HU, ZHAOHUI CUI, DECHUN LUAN AND GUANSHENG MA Asia Pac J Clin Nutr. 2008;17(1):131-137.

 

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Risk factors for excess body fatness in New Zealand children JAMES SCOTT DUNCAN, GRANT SCHOFIELD, ELIZABETH KARNDU DUNCAN AND ELAINE CAROLINE RUSH Asia Pac J Clin Nutr. 2008;17(1):138-147.

 

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Parents’ views of the importance of making changes in settings where children spend time to prevent obesity DAVID CRAWFORD, ANNA TIMPERIO, KAREN CAMPBELL, CLARE HUME, MICHELLE JACKSON, ALISON CARVER, KYLIE HESKETH, KYLIE BALL AND JO SALMON

Asia Pac J Clin Nutr. 2008;17(1):148-158.

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Green tea and gastric cancer risk: meta-analysis of epidemiologic studies YONG ZHOU, NI LI, WEN ZHUANG, GUANJIAN LIU, TAIXIANG WU, XUN YAO, LIANG DU, MAOLING WEI AND XIAOTING WU Asia Pac J Clin Nutr. 2008;17(1):159-165.

 

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Validity and reproducibility of a semi-quantitative food frequency questionnaire for use among pregnant women in rural China YUE CHENG, HONG YAN, MICHAEL JOHN DIBLEY, YUAN SHEN, QIANG LI AND LINGXIA ZENG Asia Pac J Clin Nutr. 2008;17(1):166-177.

 

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Development of food frequency questionnaires and a nutrient database for the Prospective Urban and Rural Epidemiological (PURE) pilot study in south India: methodological issues ANKALMADAGU VENKATASUBBAREDDY BHARATHI, ANURA VISHWANATH KURPAD, TINKU THOMAS, SALIM YUSUF, GOVINDACHAR SARASWATHI AND MARIO VAZ

Asia Pac J Clin Nutr. 2008;17(1):178-185.

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Future Events

Asia Pac J Clin Nutr. 2008;17(1):186.

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Evidence-based nutrition (EBN) in the Asia Pacific region: clinical practice and policy-setting

MARK L WAHLQVIST, MEEI-SHYUAN LEE, JOSEPH LAU, KEN N KUO, CHING-JIAN HUANG, WEN-HARN PAN, HSING-YI CHANG, ROSALIND CHEN AND YI-CHEN HUANG

Evidence–based nutrition (EBN) has gained currency as part of the growing role of evidence-based medicine (EBM) to increase the validity, utility and cost-effectiveness of both clinical practice and, increasingly, public health endeavours. Nutritionally-related disorders and diseases (NRD) account for a relatively large proportion of the burden of ill-health, disease and mortality, especially as the nexus between them and both infectious disease and so-called chronic disease is understood. As resource allocation is increasingly dependent on the evidence for preventive or therapeutic effect, the case for nutrition interventions also needs to be underpinned by evidence. However, feeding studies are not as amenable to the designs familiar to clinical trialists and dietary interventions in public health may be complex in their conduct and interpretation, making other approaches like cohort studies more attractive even if costly and long in the execution. With a number of food system changes in rapid progress or imminent, especially in the populous Asia Pacific region, along with changing demographics, changing disease patterns and concern about present and future food security, a stock-take and scenario analysis of EBN was undertaken by a panel of nutrition scientists, population scientists, agriculturalists, clinicians and policy makers together with consumer and indigenous stake–holders in Taiwan in 2007. They found that clinical practice guidelines and proposals for health and nutrition policies required greater emphasis and expertise in EBN.

Key Words: systematic reviews (SRs), clinical nutrition trials, portfolios of evidence, hierarchies of  evidence, knowledge, traditional diets, evidence based health policy (EBHP)

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實證營養在亞太地區的機會與挑戰:臨床實踐與政策設定

實證營養(EBN)已成為實證醫學(EBM)發展中的角色之一部份,增進臨床實踐及公共衛生努力之效度、效用及成本效益。當營養相關失調及疾病(NRD)之間與感染性疾病及慢性疾病兩者與的關係被瞭解後,說明了一大部份的不健康、疾病及死亡的負擔。當資源分配逐漸依賴預防或治療效果的證據時,營養介入也需要證據支持。然而,餵養研究無法如同臨床試驗者熟悉的設計被檢驗。公共衛生上的膳食介入在執行與闡釋上可能更複雜,使得他如世代研究反倒較具吸引力,即便執行上昂貴且耗時。在人口眾多的亞太地區,隨著快速變化的食物系統、人口學、疾病型態及對現在及為來食物安全的考量,台灣在2007年,由營養、人口及農業學者、臨床醫生與決策者,連同消費者及原住民利害關係人組成專家小組召開一個EBN現況評估與情境分析。他們發現對健康及營養政策的臨床指南與計畫而言,需要對EBN更重視及瞭解。 關鍵字:系統性回顧(SRs)、臨床營養試驗、組合證據、層級證據、知識、傳統飲食、實證衛生政策(EBHP)

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Cardiovascular pathogenesis in hyperhomocysteinemia

TAO HUANG, GAOFENG YUAN, ZHIGUO ZHANG, ZUQUAN ZOU AND DUO LI

Increased plasma homocysteine (Hcy) is a significant and independent risk factor for cardiovascular disease. It can cause multi-disease manifestations such as smooth muscle proliferation, premature occlusive vascular disease, progressive arterial stenosis, haemostatic changes, placental vasculopathy, spontaneous early abortion, birth defects, impaired cognitive function and dementia. This review paper summarizes the role of elevated Hcy levels in cardiovascular and other diseases and the molecular mechanisms and pathophysiology involved in the deleterious manifestations of hyperhomocysteinemia. We have collected data from MEDLINE, Current Contents and scientific journals, which included 112 publications from 1932 to 2007. Cardiovascular pathophysiology in hyperhomocysteinemia is a complicated process, possibly due to direct toxicity of Hcy on tissues, low S-adenosylmethionine, high S-adenosylhomocysteine or thrombotic events triggered by stimulation of procoagulant factors and suppression of anticoagulant factors and platelet activation, thereby enhancing oxidative stress, smooth muscle cell proliferation, formation of reactive oxygen species, hypomethylation, induction of unfolded protein responses and extracellular matrix modification. The mechanisms involved in the increased risk of cardiovascular disease still remains a mystery in many respects, and more studies are needed to elucidate this association.

Key Words: Homocysteine, smooth muscle cell, oxidizing stress, teratogenic action, proinflammatory

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 同型半胱氨酸血症引起心血管疾病的发病机制

血浆同型半胱氨酸升高是心血管疾病的独立危害因子。高同型半胱氨酸血症导致多种疾病发生的主要表现有:平滑肌细胞增殖、闭塞性血管病、动脉狭窄、止血能力的改变、胎盘血管病变、自发性早期流产、出生缺陷、认知能力受损和痴呆。该综述总共搜集了1932年到2007年间发表于MEDLINE以及其他杂志上的112篇文章,概述了血浆同型半胱氨酸的升高在心血管病以及其他疾病发生中的作用,同时阐述其在高同型半胱氨酸血症中的病理生理学分子机制。高同型半胱氨酸血症引起心血管疾病的病理生理学是一个复杂的过程,可能的机制是:同型半胱氨酸直接对组织的毒性作用、高S-腺苷同型半胱氨酸、低S-腺苷甲硫氨酸、通过刺激凝血因子和抑制抗凝血因子及血小板活性而引起的血栓形成,继而引起氧化应急、平滑肌细胞增殖、活性氧系列的形成、低甲基化、非折叠蛋白反应、细胞外基质改变。同型半胱氨酸增加心血管疾病危险的机制在某些方面仍然不是很清楚,有待更多的研究来解开这个谜底。

關鍵字:同型半胱氨酸,平滑肌细胞,氧化应急,致畸作用,促炎症反应。

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Effectiveness of a Taiwanese traditional diet for pain management in terminal cancer patients TSUNG-HSIU WU, TAI-YUAN CHIU, JAW-SHIUN TSAI, CHING-YU CHEN, LIH-CHI CHEN AND LING-LING YANG

In addition to modern medicinal therapy, many cancer patients in Taiwan are treated regularly with herbal medicines or prescribed a traditional herbal diet. In this paper, the effect of a Taiwanese traditional herbal diet (TTHD) on pain in terminal cancer patients was investigated. A total of 2,466 patients diagnosed with a variety of cancers were included.  The most common patient-reported symptoms included troublesome pain (79.2%), weakness (69.0%), anorexia (46.4%), fever (36.5%), dyspnea (31.1%), and leg edema (30.9%). The 2,466 terminal cancer patients included in the study were randomly divided into three groups. The TTHD group (n=1044; 42.3%) were given the TTHD consisting of analgesic herbs (paeony root: licorice root = 1:1) and a Taiwanese tonic vegetable soup (Lilii bulbus, Nelumbo seed, and Jujube fruit). The remaining patients were divided into a reference group, given the regular hospital diet, (n=909, 36.9%) and a control group, given the Taiwanese tonic vegetable soup without analgesic herbs, (n=513, 20.8%).  All patients maintained their assigned diets for one week. A verbal numerical scale was used to assess pain. Results revealed that the patients given TTHD reported enhanced pain relief (p < 0.05) compared to the reference and control groups. We found that TTHD could alleviate the pain among terminal cancer patients thereby supporting the supposition that Eastern and Western medicines can be effectively co-administered to enhance terminal patient’s quality of life.  Further research is warranted. Key Words: Taiwanese traditional herbal diet, terminal cancer patients, verbal numerical scale, pain

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探討藥膳芍藥甘草湯對癌末病人疼痛的評估

在台灣,除了西醫藥物治療外,許多末期癌症病人亦常使用傳統中草藥或藥食膳之治療,本研究即探討台灣傳統藥膳對於末期癌症病人疼痛緩解之效用。本研究共納入2466位病人,臨床主訴症狀分布以疼痛(79.2%)所佔的比例高,其次為全身倦怠(69.0%)、食慾不振(46.4%)、發燒(36.5%)、呼吸困難(31.1%)、水腫(30.9%)。試驗者分成空白組(909)、對照組(513)及藥膳治療組(1044),空白組不給予藥膳,對照組給予米漿,藥膳治療組給予具有鎮痛之芍藥甘草湯加入米漿中,分別投予一週後,利用設計問卷調查以口述數字評分法(Verbal Numerical Scale)評估,研究結果顯示以芍藥甘草藥膳調養病人疼痛症狀有明顯改善(p<0.01),傳統中國食療期能幫助病人支持其精神生活,改善生活品質,相關臨床實證值得進一步評估探討。

關鍵字:芍藥甘草湯、癌末病人、安寧照顧、疼痛。

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Protection of myocardium in streptozotocin-induced diabetic rats by water extracts of Hsian-tsao (Mesona procumbens Hemsl.) MIN YANG, ZHENGPING XU, RONGHUA ZHANG, PIANHONG ZHANG, YAN WENG, YUELIANG SHEN AND XIAOMING ZHANG

The myocardial protective effects of water extracts from Hsian-tsao (Mesona procumbens Hemsl.) on diabetic rats were investigated. Thirty Sprague-Dawley male rats were randomly divided into three groups, “control group” (n=10) with intraperitoneal saline injection, “diabetic group” (n=10) with 60 mg of intraperitoneal streptozotocin injection per kg of body weight and “Hsian-tsao group” (n=10) with intragastric administration of Hsian-tsao extracts every day for 4 weeks after intraperitoneal streptozotocin injection. Body weight and blood sugar concentrations were measured before and after model induction in the three groups. Thrombospondin-1 (TSP-1) expressions in the myocardium were monitored by immunohistochemistry and rt-RT-qPCR analysis. Myocardial ultrastructural changes were also analyzed by using transmission electron microscopy. Our results demonstrated that diabetic myocardial ultrastructural changes included myofibrillar disarrangements, mitochondria disruption, and an increase in nuclear membrane invaginations. These damages were significantly less severe in the Hsian-tsao group compared with the diabetic group. A significant increase of the TSP-1 expression was also observed in the hearts of the diabetic rats (p <0.01), but it was relatively lower in the Hsian-tsao group than in the diabetic group (p <0.01). It suggested that Hsian-tsao treatment in the diabetic rats effectively prevented the pathological alterations in the myocardium and decreased TSP-1 expression. Key Words: rat, Mesona procumbens Hemsl., diabetic cardiomyopathy, Thrombospondin-1, diabetes

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仙草水提物对链脲酶素诱导糖尿病大鼠心肌的保护作用

本研究目的是观察仙草(Mesona procumbens Hemsl.)水提取物对糖尿病大鼠心肌的保护作用。30只雄性SD大鼠随机分为3组,对照组(n=10)腹腔注射生理盐水,糖尿病组大鼠(n=10)腹腔注射链脲酶素(60mg/Kg),仙草组(n=10)腹腔注射链脲酶素后每天仙草提取物灌胃连续4周。于实验前和成模4周后分别测量3组大鼠体重、血糖浓度的变化。成模4周后,处死大鼠在透射电镜下观察各组大鼠心肌超微结构的改变;同时采用免疫组化和rt-RT-qPCR分析的方法测定各组大鼠心肌血小板反应素-1的表达情况。实验结果显示:糖尿病大鼠心肌超微结构的变化包括心肌纤维排列紊乱,线粒体崩解和核膜内陷增加;与糖尿病大鼠比较,仙草组心肌损伤明显较轻。实验同时发现糖尿病大鼠心脏中血小板反应素-1的表达明显增加(p <0.01),而仙草组的增加量明显小于糖尿病组大鼠(p <0.01)。上述结果提示仙草干预可有效预防糖尿病大鼠的心脏病变,降低血小板反应素-1的表达。

關鍵字:大鼠、仙草、糖尿病的心肌病、血小板反应素-1、糖尿病。

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Effect of a milk supplemented with Bifidobacterium lactics Bl on the recovery from acute diarrhea MENG MAO, TAO YU, YING XIONG,  ZHILING WANG, HANMIN LIU, MARTIN GOTTELAND AND OSCAR BRUNSER

Probiotics have been proposed for the management and prevention of acute diarrhoea in infants. A double-blind, randomised, placebo controlled study was carried out in 224 Chinese infants 6 to 36 months of age with severe acute diarrhoea and free from moderate or severe malnutrition. After oral or parenteral rehydration, they were allocated to one of three groups: a lactose-free formula (Control); the same formula but with viable 108CFU B. lactis Bb12 and 5x107CFU St. thermophilus TH4 per gram of powder and, the same formula with the same microorganisms, but with 109CFU/g and 5x108CFU, respectively.  Anthropometric parameters, duration of the diarrhoea and rotavirus shedding were evaluated. Eighty seven percent of the episodes were associated with rotavirus infection. The duration of the diarrhoea was not influenced by the intake of probiotics. However, a decrease of rotavirus shedding was observed in infants fed the formula with 109 Bb12/g, a finding of probable epidemiological importance in the transmission of this agent. Key Words: infants, acute diarrhoea, rotavirus, probiotics, Bifidobacterium lactis Bb12

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補充雙歧桿菌和鏈球菌的無乳糖牛奶配方對急性腹瀉的效應

益生菌已被推薦用於嬰兒急性腹瀉的管理與預防上。在2246-36個月大有嚴重急性腹瀉且沒有中度或嚴重營養不良的嬰兒上,進行一雙盲、隨機及安慰劑控制組的試驗。在由口或靜脈補充水分後,分為3組:無乳糖配方(控制組);無乳糖配方公克奶粉加上108CFU B. lactis Bb12 5x107CFU St. thermophilus TH4;無乳糖配方分別加上108CFU B. lactis Bb12 5x107CFU St. thermophilus TH4。評估體位測量資料、腹瀉持續時間和輪狀病毒量。其中有87%的事件與輪狀病毒感染有關聯。腹瀉持續時間不受益生菌影響。然而,在餵食添加109 Bb12/g的配方奶的嬰兒上觀察到輪狀病毒量下降,使用這個物質可能具有流行病學的重要性。

關鍵字:嬰兒、急性腹瀉、輪狀病毒、益生菌、乳酸雙歧桿菌Bb12

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Glycemic index of common Malaysian fruits S DANIEL ROBERT, AZIZ AL-SAFI ISMAIL, THAN WINN AND THOMAS MS WOLEVER

The objective of the present study was to measure the glycemic index of durian, papaya, pineapple and watermelon grown in Malaysia. Ten (10) healthy volunteers (5 females, 5 males; body mass index 21.18±1.7kg/m˛) consumed 50 g of available carbohydrate portions of glucose (reference food) and four test foods (durian, papaya, pineapple and watermelon) in random order after an overnight fast. Glucose was tested on three separate occasions, and the test foods were each tested once. Postprandial plasma glucose was measured at intervals for two hours after intake of the test foods. Incremental areas under the curve were calculated, and the glycemic index was determined by expressing the area under the curve after the test foods as a percentage of the mean area under the curve after glucose. The results showed that the area under the curve after pineapple, 232±24 mmol×min/L, was significantly greater than those after papaya, 147±14, watermelon, 139±8, and durian, 124±13 mmol×min/L (p<0.05). Similarly, the glycemic index of pineapple, 82±4, was significantly greater than those of papaya, 58±6, watermelon, 55±3, and durian, 49±5 (p<0.05). The differences in area under the curve and glycemic index among papaya, watermelon and durian were not statistically significant. We conclude that pineapple has a high glycemic index, whereas papaya is intermediate and watermelon and durian are low glycemic index foods. The validity of these results depends on the accuracy of the data in the food tables upon which the portion sizes tested were based.

Key Words: glucose, durian, papaya, pineapple, watermelon

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馬來西亞常見水果的昇醣指數

本研究的目的是測量產於馬來西亞的榴蓮、木瓜、鳳梨和西瓜的昇糖指數。10位健康的志願者(5位男性、5位女性;身體質量指數21.18±1.7kg/m˛)在禁食一夜之後以隨機的順序分別食用50g純葡萄糖(參考食物)4種測試水果(榴蓮、木瓜、鳳梨和西瓜)。葡萄糖在不同時間共測試三次,每種受測水果被測試一次。食用這些測試水果後的2小時期間,測量飯後血糖。先計算血糖曲線面積,再由測試食物血糖曲線下面積為葡萄糖平均面積的百分比決定昇醣指數。結果顯示鳳梨曲線下面積(232±24 mmol×min/L)顯著大於木瓜(147±14)、西瓜(139±8)和榴蓮(124±13) (p<0.05)。同樣的,鳳梨的昇醣指數(84±4)也顯著大於木瓜(58±6)、西瓜(55±3)和榴蓮(49±5) (p<0.05)木瓜、西瓜和榴蓮曲線下面積和其個別GI值間並未達統計顯著差異。我們推斷鳳梨有高的昇醣指數,而木瓜居中,西瓜及榴蓮為低昇醣指數食物。因為需用食物成分表來推算食物份量,本研究結果的效度仰賴食物成分表上資料的正確性。

關鍵字:葡萄糖、榴蓮、木瓜、鳳梨、西瓜。

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Iron status among Australian adults: findings of a population based study in Queensland, Australia FARUK AHMED, TERRY COYNE, ANNETTE DOBSON AND CHRISTINE MCCLINTOCK

Objectives: To describe the concentrations of serum ferritin among Australian adults by age and sex. Further, the relationships of various social, lifestyle and health factors with serum ferritin concentrations were explored.  Design: A total of 1634 adults aged >25 years from six randomly selected urban centres in Queensland, Australia participated in the study that was conducted between October and December 2000. Results: Prevalence of depleted iron stores, based on low serum ferritin concentration, was 10.6% among females aged <50 years, 2.8% among females aged >50 years and virtually nil among males. In contrast, 16% of the males and 20% of the females aged >50 years had elevated serum ferritin concentrations. Significantly higher serum ferritin concentrations were found among females of both age groups who consumed alcohol at a rate of >60 drinks/month, and females aged <50 years who were obese.  Lower serum ferritin concentrations were found only among females aged <50 years, with higher education attainment. In multivariable analysis, only the association between higher serum ferritin and obesity was consistent across age-sex groups and statistically significant.  Conclusion: Iron deficiency may be a problem among Australian females of reproductive age. Further research is needed to identify the determinants of low iron concentrations in younger females and elevated concentrations of serum ferritin in males and older females in order to develop preventive measures.

Key Words:  Serum ferritin, iron status, iron deficiency, elevated serum ferritin, anaemia, prevalence, cross-sectional survey

 

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澳大利亞成人鐵狀況:澳洲昆士蘭族群研究的發現 目的:描述性別、年齡別澳大利亞成人血清鐵蛋白濃度。進而探討不同社經地位、生活型態和健康因子與血清鐵蛋白濃度的關係。設計:在200010月至12月間,隨機選取澳洲昆士蘭6個都會中心,共1634位年齡大於等於25歲的成人參與研究。結果:基於低血清鐵蛋白濃度,50歲以下女性鐵存量用盡的盛行率為10.6%;50歲及以上者2.8%,男性差不多為零。相較之下,1650歲及以上的男性及20%的女性為高血清鐵蛋白濃度。兩個年齡層女性每月喝酒大於60杯,年齡小於50歲的肥胖女性,其血清鐵蛋白濃度顯著較高。低血清鐵蛋白濃度只在小於50歲且教育程度較高的女性中發現。在多變項分析中,跨年齡性別,只有高血清鐵蛋白和肥胖的關係一致,並達統計顯著。結論:鐵缺乏可能是澳洲育齡婦女的一個問題。為了發展預防措施,未來研究需要找出年輕女性低鐵濃度及男性和年老女性高血清鐵蛋白濃度的決定因素。 關鍵字:血清鐵蛋白、鐵狀況、鐵缺乏、高血清鐵蛋白、貧血、盛行率、

橫斷性研究。

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Micronutrient deficiencies and anemia among preschool children in rural Vietnam NGUYEN VAN NHIEN, NGUYEN CONG KHAN, NGUYEN XUAN NINH, PHAN VAN HUAN, LE THI HOP, NGUYEN THI LAM, FUSAO OTA, TOMOKI YABUTANI, VU QUYNH HOA, JUNKO MOTONAKA, TAKESHI NISHIKAWA AND YUTAKA NAKAYA

The prevalence of trace elements deficiencies, vitamin A deficiency, anemia, and their relationships were investigated in a cross sectional study involving 243 children aged from 12 to 72 months in rural Vietnam. Serum levels of copper, zinc, selenium and magnesium were determined by inductively coupled plasma mass spectrometer and that of retinol by high performance liquid chromatography. Hemoglobin concentration in whole blood was measured by the cyanmethemoglobin method. The prevalence of deficiencies in zinc, selenium, magnesium, and copper was 86.9%, 62.3%, 51.9%, and 1.7%, respectively. On the other hand, 55.6% were anemic and 11.3% had vitamin A deficiency. Deficiency in two or more micronutrient was found in 79.4% of the children. Parameters associated significantly with anemia were selenium deficiency (OR 2.80 95% CI 1.63-4.80, p = 0.0002) and serum retinol <1.05 µmol/L (OR 1.83, 95% CI 1.10-3.05, p = 0.021). Magnesium deficiency (OR 3.09 95% CI 1.36-7.03) was found to be a risk factor for zinc deficiency and vice versa. The results indicate that micronutrient deficiencies are prevalent among preschool children in Vietnam. In addition, the results also demonstrate a strong relationship between selenium deficiency and anemia. Clearly, sustainable strategies are urgently required to overcome the problems in the country. Key Words: hemoglobin, trace element, vitamin A, zinc, selenium, magnesium

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越南鄉村學齡前兒童微量營養素缺乏和貧血狀況

一橫斷性研究,調查24312-72個月(一歲到六歲)的越南鄉村兒童的微量元素、維生素A的缺乏盛行率,及其與貧血間的相關。血清中銅、鋅、硒及鎂的濃度是用感應耦合電漿質譜儀測量,維生素A是用高效液相層析儀(HPLC),而全血中血紅素濃度則是以氰變性血紅素方法分析。這群兒童的鋅、硒、鎂及銅缺乏盛行率分別為86.9%62.3%51.9%1.7%。另一方面,55.6%兒童有貧血及11.3%有維生素A缺乏的情形。79.4%的兒童缺乏2個或以上的微量營養素。與貧血有顯著相關的參數為硒 (OR 2.80 95% CI 1.63-4.80, p = 0.0002) 和血中維生素A <1.05 µmol/L (OR 1.83, 95% CI 1.10-3.05, p = 0.021)。鎂缺乏是鋅缺乏的危險因子(OR 3.09 95% CI 1.36-7.03);反之亦然。結果指出微量營養素缺乏普遍存在越南學齡前兒童中。另外,結果也顯示硒缺乏與貧血有極大相關。顯然,這國家迫切需要重要的策略來克服這些問題。

關鍵字:血紅素、微量元素、維生素A、硒、鎂。

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An assessment of progress toward universal salt iodization in Rajasthan, India, using iodine nutrition indications in school-ages children and pregnant women form the same households ERIC-ALAIN ATEGBO, RAJAN SANKAR, WERNER SCHULTINK, FRITS VAN DER HAAR AND CHANDRAKANT S PANDAV

Background:  In Rajasthan, an Indian State with significant salt production, the sale of non-iodized salt for human consumption was banned in 1992. This study explored the relationships between the use of iodized salt in Rajasthan and the iodine status of children and pregnant women living in the area. Methods: In a State-wide survey, 30 clusters were selected proportionate-to-population-size and 40 school children, 6 -12 years old, were enrolled by random house-to-house visits in each cluster. Twelve pregnant women from the same households were also sampled. Salt used for cooking and a casual urine sample from each child and pregnant woman were collected. The salt iodine content was measured by titration and the urinary iodine concentration (UIC) by a quality-assured colorimetric method. Results: Salt iodine content was ≥15mg/kg in 41.9% of the households, and 23.0% used non-iodized salt. Median UIC was 139µg/L in children and 127µg/L in pregnant women. In households using non-iodized salt, the median UIC’s were 96µg/L and 100µg/L in children and women, respectively. Disaggregating the UIC distributions by salt iodine levels revealed a consistent, step-wise pattern of UIC in children with increasing salt iodine content. A similar but less steep pattern was observed in pregnant women. The iodine status of both children and pregnant women attained the optimal range only when the salt iodine content was close to 30mg/kg. Conclusion: For optimum iodine status in the population of Rajasthan, the iodization of household salt should be mandated at a higher level than what is practiced at present. Key Words: universal salt iodization, urinary iodine excretion, iodine, ban on non-iodized salt

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以碘營養指標評估印度拉賈斯坦邦同一家戶的學童與孕婦全面食鹽加碘的進展 背景:拉賈斯坦邦為印度重要的食鹽出產地,在1992年開始被禁止販售未加碘食鹽給人食用。本研究探討在拉賈斯坦邦使用加碘食鹽與居住此地區孩童及孕婦的碘狀態之相關性。方法:拉賈斯坦邦全州的調查,依族群大小比例選取30個叢集,並從每個叢集中隨機到府拜訪選取406-12歲的孩童。12名孕婦也選自相同的家戶。收集家戶中使用的烹調用鹽及每名孩童及孕婦的任一時間尿液樣本。使用滴定法及品質保證比色法分別測量鹽中碘含量及尿中碘濃度(UIC)。結果:有41.9%的家庭鹽碘含量≥15mg/kg23%使用未加碘食鹽。孩童的UIC中位數為139µg/L,孕婦為127µg/L。在使用未加碘食鹽的家戶中,孩童及孕婦的UIC中位數分別為96µg/L100µg/LUIC的分佈情形顯示隨著鹽碘含量增加與孩童的UIC是呈現一致的逐步模式。孕婦的狀況類似,但較為緩和。孩童及懷孕婦女碘的狀態只有當鹽碘含量接近30mg/kg時,才能達到理想的範圍。結論:為使Rajasthan的人民能達到理想的碘狀態,應該實施在家戶中的食鹽加比目前更高的碘。 關鍵字:全面食鹽加碘、尿液碘排泄、碘、禁止未加碘食鹽。

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Suburban clustering of vitamin D deficiency in Melbourne, Australia BIRCAN ERBAS, PETER R EBELING, DIANNE COUCH AND JOHN D WARK

Objective: A high prevalence of mild to moderate vitamin D deficiency has been observed in women who have recently arrived from the horn of Africa and living in inner Melbourne. Vitamin D status of women with differing age and ethnic distributions residing in other suburbs is unknown.  Method: A tertiary referral Women’s hospital-based survey of serum 25(OH)D concentrations in 2,690 women aged 14-78 years residing in Melbourne between 1 July 2004 and 30 June 2005. We computed odds of serum 25(OH)D concentrations < 50 nmol/L and used tests of homogeneity across different suburbs in Melbourne, Victoria.  Results: Women with moderate vitamin D deficiency from all suburbs were young [29.1 ± 7.2 years (mean ± standard deviation)]. The odds of moderate vitamin D deficiency were highest in inner suburbs and Greenvale, Coburg, Pascoe Vale South, Fawkner, Broadmeadows and Campbellfield from the Hume-Moreland municipality (p value for homogeneity of odds < 0.001). Conclusion: Vitamin D deficiency appears to be a growing health concern in Australia and may be more prevalent in younger women in Victoria than anticipated. Key Words: vitamin D, ethnicity, young women

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澳洲墨爾本維生素D缺乏的近郊群集情況 目的:最近自非洲角移居澳大利亞墨爾本內的女性被發現有輕微至中度維生素D缺乏的高盛行率。居住於其他近郊不同年齡跟種族分佈之女性,其維生素D狀態目前是不知道的。方法:一個三級轉介婦女醫院研究,從200471日至2005630日期間,調查269014-78歲居住於墨爾本女性的血清25(OH)D濃度。我們計算維多利亞州墨爾本不同郊區血清25(OH)D濃度小於50 nmol/L的勝算,並檢驗其同質性。結果:所有郊區中有中度維生素D缺乏的都是年輕女性【29.1 ± 7.2(平均值±標準差)】。中度維生素D缺乏勝算最大的是在內部郊區及Hume-Moreland自治市的Greenvale, Coburg, Pascoe Vale South, Fawkner, Broadmeadows and Campbellfield(勝算同質性,p< 0.001)。結論:維生素D缺乏的情況成為澳洲一個發展中的健康議題,維多利亞的年輕女性的狀況比預期的高。 關鍵字:維生素D、種族淵源、年輕女性。

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Effects of vitamin D fortified milk on vitamin D status in Mongolian school age children DAVAASAMBUU GANMAA, UUSH TSERENDOLGOR, LINDSAY FRAZIER, ERIKA NAKAMOTO, NYAMJAV JARGALSAIKHAN AND JANET RICH-EDWARDS

Mongolians are at high risk for vitamin D deficiency because of their residence at northern latitude, reduced exposure to UV-B rays during the winter months, and a low availability of vitamin-D fortified foods.  We performed a pilot study in May 2005 to estimate the prevalence of hypovitaminosis D in Mongolian school age children and to determine the feasibility of conducting a longer and larger trial with fortified milk and vitamin D supplements.  In a group of 46 Mongolian children (22 girls and 24 boys) aged 9-11 years, 76% (35) had levels of 25-hydroxyvitamin D (25(OH)D) below 50nmol/L (20ng/mL) and  32% had levels  below 37nmol/L (15ng/mL). After a month of consuming 710 ml of vitamin D-fortified (total 300IU or 7.5µg) milk daily, only 3 of the children were below 50nmol/L (20ng/mL) and none below 37nmol/L (15ng/mL).  These results reveal prevalent and serious 25(OH)D deficiency among Mongolian prepubertal school age children that appears to be ameliorated by a month of consuming approximately 7.5µg of vitamin D3 in fortified milk. Key Words: milk, vitamin D deficiency, growth, rickets, Mongolia

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維生素D強化牛奶對蒙古學齡兒童維生素D狀態之效應

居處在北方高緯度而冬季鮮能接受到UV-B紫外線的照射,以及難以獲得有維生素D強化的食物,使得蒙古人成為缺乏維生素D的高危險群。我們在20055月進行一個先驅研究來估計蒙古學齡兒童中低維生素D的盛行率,並且評估實施一個較長期也較具規模以強化牛奶和維生素D補充劑試驗的可行性。469-11歲的蒙古兒童(22位女孩,24位男孩)76(35)25-羥基維生素D低於50nmol/L (20ng/mL)32%低於37nmol/L (15ng/mL)。在每日食用添加維生素D的牛奶710mL(300IU7.5µg)一個月後,只有3個兒童低於50nmol/L (20ng/mL)、沒有人低於37nmol/L (15ng/mL)。這些結果顯示蒙古青春期前學齡兒童有嚴重的25(OH)D缺乏,可以飲用添加約7.5µg維生素D3的牛奶一個月來改善。

關鍵字:牛奶、維生素D缺乏、生長、軟骨症、蒙古。

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Co-existing micronutrient deficiencies among stunted Cambodian infants and toddlers VICTORIA P ANDERSON, SUSAN JACK, DIDIER MONCHY, NEANG HEM, PHEAROM HOK, KARL B BAILEY AND ROSALIND S GIBSON

The prevalence of malnutrition in Cambodia is among the highest in Southeast Asia, and diarrhea and pneumonia are the leading causes of death among children. Whether these adverse health outcomes are associated with co-existing micronutrient deficiencies is uncertain. We have determined the prevalence of anaemia, as well as iron, zinc, and vitamin A deficiency and their co-existence among stunted children (77 females; 110 males) aged 6–36 mos. Non-fasting morning venipuncture blood samples were taken and analyzed for haemoglobin (Hb), serum ferritin (via IMx system), retinol (via HPLC), and Zn (via AAS), C-reactive protein (CRP) (via turbidimetry) and Hb type (AA, AE, or EE) (via Hb gel electrophoresis). Children with CRP ≥5.0 mg/L (n=34) were excluded. Zinc deficiency defined as serum Zn <9.9 µmol/L had the highest prevalence (73.2%), followed by anaemia (71%) (Hb<110 g/L), and then vitamin A deficiency (28.4%) (serum retinol <0.70 µmol/L). Of the anaemic children, only 21% had iron deficiency anaemia, and 6% had depleted iron stores. Age, log serum ferritin, and Hb type were significant predictors of Hb in the AA and AE children. Serum retinol was unrelated to haemoglobin or serum zinc. The prevalence of two or more micronutrient deficiencies (low Hb, serum retinol, and/or serum zinc) was 44%. Nearly 10% had low values for all three indices, and 18% had just one low value. In conclusion, anaemia, and deficiencies of iron, zinc, and vitamin A are severe public health problems among these stunted Cambodian children. Intervention strategies addressing multiple micronutrient deficiencies are needed. Key Words: anaemia, Cambodia, children, stunted, haemoglobinopathies, iron, zinc, vitamin A

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發育不良柬埔寨嬰幼兒之微量營養素缺乏共存情形 柬埔寨的營養不良盛行率為東南亞之冠,而腹瀉及肺炎是孩童的主要死因。是否這些不利於健康的結果與微量營養素缺乏共存現象有關並不確定。我們評估6-36個月大發育不良的兒童(77名女童;110名男童)他們的貧血以及鐵、鋅和維生素A缺乏的盛行率,以及之間共存現象。收集早上非禁食靜脈血液樣本,分析血紅素(Hb)、血清運鐵蛋白(透過IMx系統)、視網醇(透過高效液相層析儀)C反應蛋白(CRP)(透過比濁法)Hb類型(AA, AEEE)(透過Hb膠體電泳法)。排除CRP ≥5.0 mg/L (n=34)的兒童。鋅缺乏(定義為血清鋅<9.9 µmol/L)的盛行率最高(73.2%),續為貧血(71%) (Hb<110 g/L),及維生素A缺乏(28.4%)(血清視網醇<0.70 µmol/L)。貧血的兒童中只有21%為鐵缺乏貧血,而6%為鐵儲存量耗盡。年齡、 血清運鐵蛋白取對數及Hb類型,為AAAE型孩童Hb的顯著預測因子。血清視網醇與血紅素或血清鋅無相關性。2個或以上的微量營養素缺乏盛行率(Hb、血清視網醇及/或血清鋅)44%。接近10%的人有這三個指標值較低的現象,18%的人只有ㄧ個值較低。綜合上述,在發育不良的柬埔寨兒童中,貧血與鐵、鋅及維生素A的缺乏是嚴重的公共衛生問題,需要有針對多重微量營養素缺乏的介入政策。 關鍵字:貧血、柬埔寨、兒童、發育不良、血色素病變、鐵、鋅、維生素A

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Fatty acid profiles of blood lipids in a population group in Tibet: correlations with diet and environmental conditions PATRIZIA RISÉ, FRANCA MARANGONI, ANTONELLA MARTIELLO, CLAUDIO COLOMBO, CRISTINA MANZONI, CLAUDIO MARCONI, FLAMINIO CATTABENI AND CLAUDIO GALLI

The aim of this study was to compare blood fatty acid profiles of two population groups: Italian and Tibetan, differing with regard to ethnic, life style and environmental aspects. Additionally the collection of two staple foods provided the opportunity to analyze typical Tibetan dishes. A new, simple, rapid, and substantially non invasive method for fatty acid (FA) analysis of blood lipids was applied to healthy Italian (n= 14) and Tibetan (n= 13) subjects. Blood drops obtained from the ear lobe of Tibetans or the fingertip of Italians were adsorbed by a special strip of paper and processed for fatty acid analysis. The fatty acid profiles of the two groups are different, and environmental factors, such as dietary fats and altitudes of Milan, Italy (a low altitude site), and Lhasa, Tibet (a high altitude site) appear to contribute to these differences. More specifically, in Tibetans higher levels of monounsaturated fatty acids, including the 22 and 24 carbon molecules, were found. This appears to be derived mainly from locally consumed fats (mustard seed oil), and are associated with lower levels of total polyunsaturated fatty acids and higher levels of selected omega 3 fatty acids, when compared to the Italians. These relatively higher levels of monounsaturated fatty acids may also indicate means of adaptation to local prooxidant conditions. The observed differences in blood fatty acid profiles in Tibetans vs. Italians appear to result both from dietary factors and adaptation to local environmental conditions such as the high altitude of the Tibetan location. Key Words: Tibetans, Italians, blood fatty acids, dietary fats, altitude

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一個西藏族群血脂的脂肪酸組成:飲食與環境狀況的關聯

從種族、生活型態和環境的觀點,本研究的目的為比較義大利人和西藏人兩族群之血中脂肪酸組成。此外,也收集了兩種主食,提供分析西藏典型食物的機會。使用一種新式、簡單、迅速且不具侵入性的方法,分析健康的義大利人(14人)和西藏人(13人)的血脂中脂肪酸組成。西藏人從耳垂血滴或義大利人的指尖血滴,以一種特殊的試紙吸收後進行脂肪酸分析。兩組人的脂肪酸的組成是不同的,環境因素,諸如膳食脂肪和義大利米蘭的海拔(低海拔地區)和西藏拉薩(高海拔地區)似乎都與這些差異有關。更具體來說,西藏人有較高的單不飽和脂肪酸濃度,包括2224碳分子。與義大利人比較,西藏人下總多元不飽和脂肪酸較低,omega 3脂肪酸較高,應該主要源於當地食用的脂肪(芥子油)。這些相對高的單不飽和脂肪酸也可能適應當地稀氧狀況的方法。西藏人和義大利人血脂肪酸組成的差異,應該是飲食因子和當地環境狀況適應兩者的結果,例如西藏地區的高海拔地勢。

關鍵字:西藏人、義大利人、血脂肪酸、膳食脂肪、海拔。

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Fish consumption and health in French Polynesia ERIC DEWAILLY, LUDIVINE CHÂTEAU-DEGAT AND EDOUARD SUHAS

French Polynesians, like other remote maritime populations are intimately connected to the ocean which nourishes their daily life and culture. Their reliance on fish raises the issue of potential exposure to harmful natural and anthropogenic contaminants as well as providing essential nutrients. The purpose of this study was to assess the risks and benefits of fish consumption in French Polynesia. This cross-sectional study included 195 adults aged 18 years old and over from the Tahiti and Moorea islands. Fatty acids, selenium (Se) and mercury (Hg) blood concentrations were measured in participants and were all very high. Blood concentrations indicate that Hg, Se and omega-3 fatty acids have a common origin, i.e. fish consumption. In comparing the Polynesian group with northern populations, we found that the Polynesian group had levels of Hg similar to those observed in Inuit populations (geometric mean (range): 90.3 (15-420) nmol/L vs. Inuit: m(r): 79.6 (4-560) nmol/L). Similar results were observed with Se blood concentrations. The fatty acid concentration was also similar to that of the Inuit population even though the specific profile of fatty acids differed. For the first time, we report very high blood concentrations of mercury, selenium and omega-3 fatty acids in a fishing population from the South Pacific, comparable to those reported among fishing populations from the Northern hemisphere. Further work is ongoing to better substantiate public health nutritional policies. Key Words: Seafood, mercury, selenium, omega-3 fatty acids, Polynesia

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法屬玻里尼西亞的魚類攝取與健康

法屬玻里尼西亞人像其他偏遠的濱海族群一樣,與養育他們的日常生活和文化的海洋有密切關係。他們依賴的魚類,在提供營養素的同時,也引發了潛在暴露於有害的自然和人造污染物的問題。本研究的目的是要評估在法屬玻里尼西亞攝取魚類的風險及益處。這個橫斷性研究包括了195位來自大溪地及茉莉亞島18歲以上的成人。參與者所測出血液中脂肪酸、硒及汞的濃度皆非常高。血液濃度指出硒、汞及w–3脂肪酸有一個共同的來源,那就是攝取魚類。比較玻里尼西亞人和北方人,我們發現玻里尼西亞人血中汞的濃度和因紐特人相似(幾何平均值:90.3 (15-420) nmol/L vs. 紐特人:79.6 (4-560) nmol/L)。血液中硒的濃度和脂肪酸濃度也有相似結果,儘管其脂肪酸的組成有所不同。我們第一次報告南太平洋捕魚的種族跟北半球捕魚種族血液一樣,含有非常高濃度的汞、硒和w–3脂肪酸。進一步的研究持續中,以能更具體化公共衛生營養政策。

關鍵字:海鮮、汞、硒、w–3脂肪酸、玻里尼西亞。

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Dietary patterns and food choices of a population sample of adults on Guam REBECCA S POBOCIK, ALISON TRAGER AND LORA MORRELL MONSON

This study examined dietary patterns of adults on Guam. Four hundred subjects were selected via a multistage procedure to represent the island’s population. A 24-hour dietary recall was administered via telephone in 1995 to 1996. Diets were computer analyzed. There were 4,913 food items reported, representing 1,042 individual foods. Most respondents, 51.3%, had a “more-frequent” eating pattern, 36.9% had “regular” and 11.8% had “less-frequent.” Energy consumption increased (p < 0.05) with eating frequency. Highest levels of all nutrients (p < 0.05) were at the evening meal. The sexes did not differ in nutrient proportions by meal. Grains, meats, and beverages were eaten most frequently. Meat/fish, mixed dishes, and grains supplied 68% of the energy and 47% to 91% of the micronutrients. Twenty five percent of the carbohydrate was from sweetened drinks and desserts. Rice was the most frequently consumed food. More than half of the subjects had no fruit, a third had no vegetables, and only 38.5% had dairy foods. Calcium came from multiple sources: dairy (27.6%), mixed dishes (23.8%), fish (12.6%), desserts (8.5%) and vegetables (6.6%). Most people, 91.8%, had fiesta meals with median consumption at 6 meals per year (range: 0 to 200). Betel nut was used by 12.3% of the sample with median consumption 0 whole nuts per day (range: 0 to 25). Ethnic differences (p < 0.01) were observed in both fiesta meal and betel nut consumption. The Guamanian diet includes limited use of traditional foods and dietary patterns associated with increased risk for chronic disease. Key Words: dietary patterns, food, Guam, calcium, Chamorro

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關島成年族群樣本的膳食型態及食物選擇 本研究調查關島成年族群的膳食型態。以多段抽樣方式,選取400名研究對象代表島上族群。在1995-1996年間,透過電話實施24小時飲食回憶。膳食資料經由電腦分析。共有4913項次食品被報告,代表1042種食品物。大部份應答者,51.3%頻繁的膳食模式、36.9%經常11.8%偶爾。熱量消耗隨著進食頻率而增加(p<0.05)。所有營養素在晚餐有最高的攝取量(p<0.05)。每餐的營養素百分比,在性別上並沒有差異。榖類、肉類及飲料攝取頻率最高。肉/魚、混合菜和榖類提供68%的熱量和47%-91%的微量營養素。25%的醣類來自含糖飲料及甜點。米飯是攝取頻率最高的食物。超過一半的個案沒有吃水果,三分之ㄧ沒有吃蔬菜以及只有38.5%有攝取乳製品。鈣質來自多種來源:乳類(27.6%)、混合菜餚(23.8%)、魚(12.6%)、甜點(8.5%)及蔬菜(6.6%)。大部分的人,91.8%有節慶飲食,中位數為每年6 (範圍0-200)12.3%嚼食檳榔,中位數為每天攝取0(範圍0-25)。節慶飲食與檳榔使用在種族之間具有差異(p<0.01)。關島飲食包括使用有限的傳統食物及膳食型態與上升的慢性疾病危險性有關。 關鍵字:膳食模式、食品、關島、鈣質、查摩洛人。

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Bone mineral density of vegetarian and non-vegetarian adults in Taiwan YUH-FENG WANG, JAINN-SHIUN CHIU, MEI-HUA CHUANG, JING-ER CHIU AND CHIN-LON LIN

Diet is thought to be one of the leading causes of bone mineral loss in aging people. In this study, we explored the potential impact of a vegetarian diet on bone mineral density (BMD) in adult Taiwanese men and women. This was a cross-sectional study of the relationship between diet (vegetarian versus non-vegetarian) and BMD and the incidence of osteoporosis. Bone mineral density was determined in a cohort of 1865 adult male and female patients who underwent routine examination in a regional teaching hospital in Taiwan between February 2003 and February 2004. Subjects with definite vertebral problems, known osteopathy, or poor posture were excluded. Dual-energy X-ray absorptiometry (DEXA) was used to determine BMD, on the right hip in men and on lumbar vertebrae L2 to L4 in women. The subjects were grouped according to sex and diet, and were then stratified by age within each of the four groups. The outcome measures were the BMD value and the incidence of osteopenia or osteoporosis according to defined criteria. Bone mineral density gradually declined with increasing age in Taiwanese men, while Taiwanese women showed a precipitous decrease in BMD after the 5th decade. However, no statistical differences in BMD were observed between vegetarians and non-vegetarians of either sex. The proportion of subjects with osteopenia or osteoporosis also appeared comparable between vegetarians and non-vegetarians of either sex. BMD shows an age-related decline in Taiwanese men and women, and eating a vegetarian diet does not appear to affect this decline. Key Words: diet, bone mineral density, osteoporosis, vegetarian, non-vegetarian

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台灣地區成年人骨質密度與素食與否之關聯性研究

長期以來,飲食型態一直被認為是與老年人骨質流失的情形有相當的關連性。這個研究中,我們旨在探討素食對於台灣地區成年人的骨質密度的影響,我們以此橫斷性研究來瞭解飲食習性(素食與非素食)與骨質密度間的關係,並同時探討與骨質疏鬆症間的相關性。本研究收集台灣某區域教學醫院自 2003 年二月起至 2004 年二月止接受一般常規骨質密度檢查的成年男性與女性,共 1865 位受試樣本,其中已排除包括脊椎病變、骨病變、或姿態不良者。研究中所採用的骨質密度分析儀為雙能量X光吸收儀,男性受試者偵測右側髖關節、女性受試者收集第二至第四腰椎之骨質密度;受試樣本依其性別、飲食習性區分為四個主要分組,再依年齡層分別進行統計,計算其骨質密度值、骨質流失、以及骨質疏鬆症之發生機率等。結果發現,在台灣的成年男性,其骨質密度隨年齡增長呈現逐漸降低的趨勢,而女性則在 50~59 歲間出現大幅下降的情形。不過,分析結果顯示,不論性別,在素食者與非素食者間對於骨質密度值均沒有顯著的統計差異出現,而對於骨質流失或骨質疏鬆發生的機率也沒有顯著的不同。我們可以由這個研究中歸結:對於台灣地區的成年男女,骨質密度值會隨著年齡的成長呈現下滑的趨勢,然而素食與否,並不影響這個下滑現象。

關鍵字:飲食、骨質密度、骨質疏鬆、素食、非素食。

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The relative impact of a vegetable-rich diet on key markers of health in a cohort of Australian adolescents ROSS GRANT, AYSE BILGIN, CAROL ZEUSCHNER, TRISH GUY, ROBYN PEARCE, BEVAN HOKIN AND JOHN ASHTON

Childhood obesity is a widespread health problem in Australia. Overweight in childhood can lead to adult overweight and the development of risk factors for cardiovascular disease (CVD). Effective strategies for reducing childhood obesity are urgently required. A vegetarian diet has been shown to be an effective prophylactic to many lifestyle diseases in the adult population and may therefore be beneficial in children. However the metabolic demands of adolescents are different to adults and the impact of a vegetarian diet on CVD markers in this demographic is not certain. We compared key physiological and biochemical markers of health against responses to a modified, Schools Physical Activity and Nutrition Survey (SPANS) using one-way and two-way Analysis of Variance. 215 adolescents (14-15yrs) from 5 Adventist secondary schools in the Sydney and Hunter regions of New South Wales, Australia, participated in this study. Adolescents consuming predominantly vegetarian foods showed significantly better scores on markers of cardiovascular health, including, body mass index (BMI), waist circumference, Cholesterol/High density lipoprotein ratio and low density lipoprotein. Adolescents consuming nuts more than once per week, also showed lower scores for BMI and serum glucose irrespective of their vegetarian status. Markers of general health including haemoglobin and average height were not different between groups; however a lower serum level of vitamin B12 was apparent in the vegetarian cohort. Surprisingly, exercise on its own was not statistically associated with any of the risk factors tested suggesting that diet may be the most significant factor in promoting health in this age group.

Key Words: vegetarian, glucose, nuts, BMI, vitamin B12

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富含蔬菜飲食對一個澳洲青少年世代健康主要標誌的相對影響

在澳洲,兒童肥胖是一個普遍的健康問題。孩童時期的體重過重會導致成年時的體重過重,及心血管疾病(CVD)危險因子的發展。迫切需要有效降低孩童肥胖的策略。素食已指出可以有效預防成人族群許多與生活型態相關的疾病,因此也可能有益於孩童。然而青少年的代謝需求與成年人不同,且素食飲食對CVD的影響在這個族群尚未被確定。我們用單元及二元變異數分析,比較學校體能活動與營養調查(SPANS)選項的健康的主要生理及生化標誌,。澳洲新南威爾斯州雪梨及杭特區的5個浸性會中學,215名青少年(14-15)參與這個研究。青少年以攝取素食為主的,其心血管健康標誌分數顯著較好,這些標誌包括:身體質量指數(BMI)、腰圍、膽固醇/高密度脂蛋白比及低密度脂蛋白。青少年每週攝取堅果超過1次,也顯示出有較低的BMI及血清葡萄糖,但這與他們素食狀態無關。一般健康標誌包括:血紅素及平均身高兩組間沒有差異;但是素食族群有較低的血清維生素B12。令人意外的是,運動本身與任何危險因子的分析均沒有統計相關,這說明飲食可能是這個年齡層在促進健康最顯著的因子。

關鍵字:素食者、葡萄糖、堅果、BMI、維生素B12

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Application of refractometry to quality assurance monitoring of parenteral nutrition solutions WEI-KUO CHANG, YOU-CHEN CHAO, MING-KUNG YEH

Parenteral nutrition (PN) solution contains various concentrations of dextrose, amino acids, lipids, vitamins, electrolytes, and trace elements. Incorrect preparation of PN solution could lead to patient death. In this study we used the refractive index as a quality assurance tool to monitor the preparation of PN solution. Refractive indices of single nutrient components and PN solutions consisting of various concentrations of dextrose, amino acids, electrolytes, and lipids were measured. A mathematical equation and its linear plot were generated then used to predict the refractive index of the PN solution. The best-fit refractive index for PN solution (i.e., the predicted refractive index) = 0.9798 × (% dextrose) + 1.2889 × (% amino acids) + 1.1017 × (% lipids) + 0.9440 × (% sum of the electrolytes) + 0.5367 (r2 = 0.99). This equation was validated by comparing the measured refractive indices of 500 clinical PN solutions to their predicted refractive indices. We found that 2 of the 500 prepared samples (0.4%) had less than the predicted refractive index (< 95%). Refractive index can be used as a reliable quality assurance tool for monitoring PN preparation. Such information can be obtained at the bedside and used to confirm the accuracy of the PN solution composition. Key Words: refractometer, refractive index, quality assurance, nutrition, parenteral nutrition

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利用屈光計作為監測靜脈營養輸液品質控制工具

靜脈營養(PN)輸液包含不同濃度的葡萄糖,氨基酸,脂肪,維生素,電解質,及微量元素。製備不正確的PN輸液,可能導致病人死亡。本研究採用屈光計,作為監測製備的PN輸液品質保證工具。 屈光值可測出PN輸液中不同濃度之葡萄糖、氨基酸、脂肪、電解質。藉由數學統計,尋找最佳線性關係,監測調製後PN輸液品質。正確PN輸液預測屈光值 = 0.9798 × (%葡萄糖濃度) + 1.2889 × (%氨基酸濃度) + 1.1017 × (%脂肪濃度) + 0.9440 × (總電解質濃度) + 0.5367 ( R2 = 0.99)。針對500個臨床PN輸液,比較預測屈光值與實測屈光值。我們發現2PN輸液終製品 (0.4),實測屈光值低於預測屈光值 (< 95) 屈光值可作為PN輸液品質保證工具。屈光計可運用於病床邊,監測及確認PN輸液調配的準確性。 關鍵字:屈光計、屈光值、品質保證、營養、靜脈營養。

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Dynamic shifts in Chinese eating behaviors ZHIHONG WANG, FENGYING ZHAI, SHUFA DU AND BARRY POPKIN

The purpose of the study is to examine the dynamic eating behaviors of the Chinese people, focusing on snacking and the choice of cooking methods, and to identify the influences of socioeconomic factors on these eating behaviors. Data for this study were from the China Health and Nutrition Survey (CHNS). There were 11780 subjects, older than two years (y), from the 1991 and 11169 from the 2004surveys respectively. Logistic regressions of pooled data were performed to evaluate how socioeconomic status (SES) was associated with two eating behaviors: snacking and consuming excessive amounts of fried foods. Simulation techniques were used to clarify the effects of the results that included significant interaction terms. Results showed that the rapid shift in the food and nutrient profile of the Chinese population is accompanied by equally profound changes in meal and cooking patterns. Snacking behavior is beginning to emerge and there are shifts away from the steaming and boiling of food to the, less healthy, frying of food. Income is positively associated with the consumption of both snacks and excessive fried food. Urban residents are also more likely to snack and to consume excessive amounts of fried foods than rural residents. These findings indicate that eating behaviors are beginning to change rapidly toward less healthy options in China. SES plays a vital role in the early stages of the eating behavior transition in China. Future health promotion programs targeting the higher-SES population will exert far-reaching effects on the improvement of health status in this group.  Key Words: Socioeconomic status, eating behaviors, trends, diet survey, Chinese

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中國人飲食行為動態變化 本文旨在研究中国人群零食摄入和烹调方法选择等饮食行为的动态变化,并探讨社会经济因素对饮食行为的影响。数据来源于中美合作课题中国健康与营养调查,研究对象为2周岁以上人群(199111780人,200411169)。采用Logistic多元回归方法分析社会经济因素与零食摄入和消费过多油炸食品之间的关系。应用模拟技术探讨交互作用对这种关系的影响。结果显示中国人群食物和营养素摄入的快速变迁,相伴随的是用餐模式和烹饪方法的深刻变化,零食消费行为逐渐显现,烹调模式逐渐从蒸、煮向不健康油炸的方式变迁。家庭收入水平与这两种饮食行为呈显著的正相关关系;与农村居民相比,城市居民消费零食和过多油炸食品的可能性较大。本研究表明中国人群饮食行为正逐渐向不健康的模式变化,社会经济因素在饮食行为变迁的早期阶段起着重要作用,未来健康促进项目以社会经济水平较高的人群为重点将有效改善该人群的健康状况。 关键字:社会经济状况,饮食行为,趋势,膳食调查,中国。

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Obesity prevalence and time trend among youngsters in China, 1982-2002 YANPING LI, EVERT G SCHOUTEN, XIAOQI HU, ZHAOHUI CUI, DECHUN LUAN AND GUANSHENG MA

Purpose of present study is to describe the prevalence and trend of overweight and obesity, as well as its co-existence with stunting, among youngsters in China, from 1982 to 2002. Data from children 7-17 years of age from three cross-sectional national surveys: “1982 China National Nutrition Survey” (5 334 boys and 4 793 girls), “1992 China National Nutrition Survey” (8 048 boys and 7 453 girls) and “2002 China National Nutrition and Health Survey” (23 242 boys and 21 638 girls) were used in this study. Overweight and obesity were defined according to age, sex and specific BMI cut-off points from the International Obesity Task Force, while stunting was defined as height-for-age below -2 standard deviation from the NCHS/WHO reference median value. Results: Overweight prevalence of Chinese youngsters was 1.2%, 3.7% and 4.4%, while the obesity prevalence was 0.2%, 0.9% and 0.9% in 1982, 1992 and 2002, respectively. Both the overweight and obesity prevalence and their increment were higher among boys in urban areas. In 1982, 28.4% of overweight and 69.6% of obese youngsters were stunted, this decreased to 22.0% and 46.4% in 1992, and then to 5.7% and 7.7% in 2002, respectively.  Conclusion: The prevalence of overweight and obesity in Chinese youngsters were low in 1982. There has been a rapid increase since then. If this trend continues, overweight will soon reach epidemic proportions. Stunting among overweight and obese youngsters decreased dramatically at the same time. Key Words: Chinese youngsters, overweight, obesity, trend, stunting

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中国儿童肥胖率1982-2002年间变化趋势

为了了解中国7-17岁儿童超重肥胖现况及其过去二十年间的变化趋势,以及超重肥胖儿童中生长迟缓者所占的比例,利用三个有全国代表性的全国性营养调查,即1982年全国营养调查(男孩5,334人; 女孩 4,793人)、1992年全国营养调查(男孩 8 048人; 女孩 7,453人)和2002年全国营养与健康状况调查(男孩 23,242人;女孩21,638人)。根据国际肥胖工作组推荐的年龄别性别体质指数标准定义儿童超重和肥胖,生长迟缓定义为身高低于NCHS/WHO Z评分标准的2个标准差。结果表明,198219922002年我国7-17岁儿童超重率分别为1.2%3.7%4.4%,肥胖率分别为0.2%0.9%0.9%。城市男孩的超重肥胖率及其增长均最高。1982年有28.4%的超重儿童同时生长迟缓(身高发育不足),肥胖儿童中该比例更高,达到69.6%1992年超重和肥胖儿童中合并生长迟缓的比例分别为22.0%46.4%,到2002年,这两个比例分别降到5.7%7.7%。本研究认为虽然1982年中国儿童肥胖尚不成问题,但从1992年迅速上升。同时,生长迟缓性肥胖在肥胖儿童中的比例逐渐下降。

关键字:中国儿童、超重、肥胖、变化趋势、生长迟缓。

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Risk factors for excess body fatness in New Zealand children JAMES SCOTT DUNCAN, GRANT SCHOFIELD, ELIZABETH KARNDU DUNCAN AND ELAINE CAROLINE RUSH

Objective: To identify demographic and lifestyle risk factors for excess body fatness in a multiethnic sample of New Zealand children. Design: Cross-sectional study. Participants: A total of 1229 European, Polynesian, Asian, and ‘Other’ children aged 5-11 y (603 male, 626 female) living in New Zealand. Measurements: Percentage body fat (%BF) was measured using hand-to-foot bioelectrical impedance analysis, and overfat participants were defined as those with a %BF greater than 25% (boys) and 30% (girls). A parent proxy questionnaire was developed for assessing demographic and lifestyle factors, and multiday memory pedometers were used to estimate physical activity levels over five days. Results: After controlling for differences in sex, age, and socioeconomic status (SES), Asian children were more likely to have excess body fat than European children. The adjusted odds of overfat also increased with age and decreased with SES. Three lifestyle risk factors related to fat status were identified: low physical activity, skipping breakfast, and insufficient sleep on weekdays. Clustering of these risk factors resulted in a cumulative increase in the prevalence of overfat. Active transport, sports participation, lunch bought at school, fast food consumption, sugary drink consumption, and weekend sleep duration were not associated with fat status after adjustment for the selected demographic variables. Conclusion: The findings from this study enhance our understanding of the risk factors for excess body fatness in New Zealand children, and highlight key demographic and lifestyle priorities for future interventions.

Key Words: obesity, ethnicity, diet, physical activity, sleep

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紐西蘭兒童體脂肪過高的危險因子

目的:以多種族樣本,找出紐西蘭兒童體脂肪過高的人口學和生活型態危險因子。設計:橫斷性研究。參與者:共有1229(603位男孩,626位女孩)5-11歲居住在紐西蘭的歐洲、玻里尼西亞、亞洲及其他種族的兒童。測量方法:以手--腳生物阻抗法測量體脂肪百分比(%BF);過胖的定義為%BF大於25(男童)30(女童)。雙親代為回答問卷中人口學、生活型態因子,用多天記憶記步器來估計兒童5天的體能活動程度。結果:在控制性別、年齡和社經地位(SES)的差異後,亞洲兒童比較有可能比歐洲兒童有過高的體脂肪。校正過胖的勝算也隨著年齡的增加而增加及隨著SES增加而下降。三個生活型態的危險因子被找出來與肥胖狀態有關:低體能活動、不吃早餐及平日睡眠不足。這些危險因子的聚集導致過胖的盛行率持續上升。在校正被選出的人口學變項後,主動的交通方式、運動參與、在學校買的午餐、食用速食、含糖飲料飲用和週末睡眠時間長短與肥胖狀態沒有關聯。結論:本研究的發現提高我們對紐西蘭兒童過胖危險因子的瞭解,並指出未來介入計畫的關鍵人口學和生活型態變項的優先順序。 關鍵字:肥胖、種族淵源、飲食、體能活動、睡眠。

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Parents’ views of the importance of making changes in settings where children spend time to prevent obesity DAVID CRAWFORD, ANNA TIMPERIO, KAREN CAMPBELL, CLARE HUME, MICHELLE JACKSON, ALISON CARVER, KYLIE HESKETH, KYLIE BALL AND JO SALMON

Aim: To examine the kinds of changes parents would like to see in those settings where children spend time (kindergartens and schools, child care centres and after-school care facilities, and the local neighbourhood) in policies and practices that impact on children’s risk of obesity, and to establish whether parents might be willing to advocate for changes in these settings. Materials and Methods: 175 parents from five randomly selected primary schools and five randomly selected kindergartens located in suburbs of metropolitan Melbourne completed a questionnaire in which they rated the importance of a number of potential changes to promote healthy eating and increase physical activity in their children. Results: Parents of children in kindergarten most commonly rated changes to the eating environment as important.  In contrast, parents of primary school children believed changes related to both eating and physical activity in school were important.  Ninety-five per cent of parents of kindergarten children and 89% of parents of primary school children believed it was possible for parents to bring about change to provide more opportunities for their child to eat more healthily and be more physically active.  One in four parents reported that they had thought about or had tried to bring about changes in their community. Conclusions: The findings suggest that mobilising parents to take an active role in advocating for change in those settings that have the potential to shape their children’s physical activity and eating behaviours may be feasible. Key Words: kindergartens, schools, obesity prevention, perceptions, parents

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父母對改變兒童花時間的地方以預防肥胖的重要性的看法

目的:調查父母會在政策及實際上,想如何改變兒童長時停留的地方(幼稚園和學校,育兒中心和課後輔導中心和住家鄰近地區),對兒童肥胖風險的影響。並且確認父母是否願意支持改變這些環境。材料與方法:175對父母隨機選自墨爾本郊區的5所小學和5個幼稚園。他們完成一份問卷,針對那些對他們小孩有潛在促進健康的飲食及增加體能活動的改變的重要性予以評分。結果:幼稚園兒童的父母多數認為改變用餐環境是重要的。相對的,小學兒童的父母相信用餐和在學校的體能活動同等重要。95%幼稚園兒童的父母和89%小學兒童的父母相信父母可以帶來改變可以提供更多機會,讓他們小孩吃得更健康及更活躍的體能活動。四對中有一對父母報告他們曾經考慮過或試著為社區帶來改變。結論:本研究指出應該動員父母,讓他們積極倡導改變他們孩子體能活動和用餐行為的環境是可行的。 關鍵字:幼稚園、學校、肥胖預防、認知、父母。

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Green tea and gastric cancer risk: meta-analysis of epidemiologic studies YONG ZHOU, NI LI, WEN ZHUANG, GUANJIAN LIU, TAIXIANG WU, XUN YAO, LIANG DU, MAOLING WEI AND XIAOTING WU

Objective: To evaluate the association between green tea consumption and the risk of gastric cancer. Methods: Electronic search of the Cochrane Library, MEDLINE, EMBASE and Chinese Bio-medicine Database, which have articles published between (1966 and 2006), was conducted to select studies for this meta-analysis. Results: This meta-analysis included 14 epidemiologic studies, with a total number of 6123 gastric cancer cases and 134006 controls. The combined results based on all studies showed that green tea consumption was not associated with the risk of gastric cancer [odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.77-1.24]. The summary OR from all population-based case–control studies showed a minor inverse association between green tea consumption and risk of gastric cancer (OR = 0.68, 95% CI = 0.49-0.92), while no associations were noted from hospital-based case–control studies (OR = 1.12, 95% CI = 0.70-1.77) and cohort studies (OR = 1.56, 95% CI = 0.93-2.60). No associations were noted both in males (OR = 1.10, 95% CI = 0.76-1.60) and females (OR = 0.99, 95% CI = 0.64-1.51). The summary OR from seven studies suggest that the highest consumption level of green tea was more than 5 cups per day and no associations were noted (OR = 0.99, 95% CI = 0.78-1.27). Conclusions: The results of this meta-analysis indicated that there is no clear epidemiological evidence to support the suggestion that green tea plays a role in the prevention of gastric cancer. Key Words: Meta-analysis, green tea, gastric cancer, case-control study, cohort study

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绿茶和患胃癌风:流行病学研究的荟萃分析

目的:评价饮用绿茶和患胃癌风险的关系。方法:检索如下数据库:Cochrance libraryMEDLINEEMBASE 和中国生物医学文摘数据库。其中发表于1966-2006年之间的相关研究文章,用于此项荟萃分析。结果:此项荟萃分析纳入了14个流行病学研究,共纳入6123名胃癌患者和134006名对照。合并结果显示饮用绿茶和患胃癌风险之间没有相关性(OR=0.98, 95%CI=0.77-1.24)。以人群为基础的病例对照研究表明绿茶的饮用量和患胃癌的风险之间有很小的负相关性(OR=0.68,95%CI=0.49-0.92),而在以医院为基础的病例对照研究(OR=1.12, 95%CI=0.70-1.77)cohort 研究(OR=1.56, 95%CI=0.93-2.60)中并没有得到类似结果。男性(OR=1.10, 95%CI=0.76-1.60)和女性(OR = 0.99, 95% CI = 0.64-1.51)均没有发现有相关性。有7个研究的绿茶最高饮用量为每天5杯以上,合并结果也未能显示饮用绿茶和患胃癌风险之间有相关性(OR=0.99, 95%CI=0.78-1.27)结论:此项荟萃分析结果表明目前尚没有明确的流行病学证据支持绿茶能够预防胃癌。

关键字:荟萃分析、绿茶、胃癌、病例对照研究、cohort研究。

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Validity and reproducibility of a semi-quantitative food frequency questionnaire for use among pregnant women in rural China YUE CHENG, HONG YAN, MICHAEL JOHN DIBLEY, YUAN SHEN, QIANG LI AND LINGXIA ZENG

A longitudinal study was conducted to validate a 68-item semi-quantitative food-frequency questionnaire (FFQ) for assessing nutrient intake among pregnant women in rural China. The interview administrated FFQs were conducted at the start of the third trimester (FFQ1) and repeated three months later prior to delivery (FFQ2), and compared with six repeated 24-hour recalls collected between the FFQs. From June to September 2004, 125 women at 23 to 26 weeks of gestation were recruited into the study in two rural counties in Shaanxi province, China. Pearson correlation coefficients for crude nutrients assessed by FFQ1 and FFQ2 had a mean of 0.46, and ranged from 0.31 for thiamin to 0.61 for fat. Pearson correlation coefficients estimated by FFQ2 and 24-hour recalls had a mean of 0.62 for all nutrients, and ranged from 0.53 for cholesterol and carotene to 0.70 for α-vitamin E and potassium. De-attenuated coefficients had a mean of 0.69 for all nutrients, and ranged from 0.58 for cholesterol to 0.77 for α- vitamin E. Bland-Altman plots revealed significant relationships between the difference and the average of the two methods with larger differences at higher average intakes. On average, 74% of participants were classified into the same or adjacent nutrient intake quintiles, while 1% were grossly misclassified to opposite quintiles. In conclusion, this FFQ has adequate reproducibility and validity for most nutrients but would benefit from the addition of wheat porridge to ensure it is suitable for assessing dietary intake in pregnant women in rural China. Key Words: food frequency questionnaire, calibration, pregnancy, diet surveys, China

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半定量食物頻率問卷用於中国贫困地区孕妇的重现性和真实性

本次前瞻性研究的目的是检验针对中国贫困地区孕妇膳食摄入调查的半定量食物频率问卷(68项食物条目)的重现性和真实性。食物频率问卷采用访问式,分别在第三孕期初和分娩前进行,两次访问间隔3个月,在此期间随机完成624小时膳食回顾调查。食物频率问卷与24小时膳食回顾调查的结果进行比较以检验该食物频率问卷的重现性和真实性。20046-9间,在中国陕西省的两个贫困县,共125名孕妇(入组时孕周为23-26)参与并完成了本研究的所有问卷。两次食物频率问卷间营养素的相关系数范围在0.31(硫胺素)0.61(脂肪)之间,均数为0.46。第二次食物频率问卷与24小时膳食调查测量到的营养素之间的相关系数范围从0.53(胆固醇)0.70(α-维生素E和钾),均数为0.62;通过校正个体内变异对相关系数的影响后,相关系数均数为0.69,范围从0.58(胆固醇)0.77(α-维生素E和钾)Bland-Altman图显示食物频率问卷和24小时膳食回顾两种方法得到的营养素摄入的差值和均数之间存在显著相关;平均摄入较高时,两种方法测得营养素摄入存在更大的差异。根据两种膳食调查方法得到的营养素摄入量将受试者分为人数相等的五组,74%的被分到了同一个或相邻的组,1%的被分到了极端对立的两组。本研究结果显示该食物频率问卷,在测量中国贫困地区孕妇营养素摄入情况时有较好的重现性和真实性,尤其在加入面糊这一食物后。 關鍵字:食物頻率問卷、分級、懷孕、飲食調查、中國。

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Development of food frequency questionnaires and a nutrient database for the Prospective Urban and Rural Epidemiological (PURE) pilot study in south India: methodological issues ANKALMADAGU VENKATASUBBAREDDY BHARATHI, ANURA VISHWANATH KURPAD, TINKU THOMAS, SALIM YUSUF, GOVINDACHAR SARASWATHI AND MARIO VAZ

Purpose: To develop Food Frequency Questionnaires (FFQs) and nutrient databases for urban and rural Indian populations with diverse dietary habits for the PURE (Prospective Urban and Rural Epidemiological) pilot study. Procedure: 24 hour dietary recalls were obtained from 84 rural and 60 urban subjects. From a comprehensive food list, separate FFQs were developed for the two groups. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. The FFQs were piloted in 80 urban and 77 rural subjects. Separately for each group, a stepwise regression method was used to identify foods contributing to a cumulative 90 % of variance to total energy intake. Nutrient and food group intakes were compared using an independent t-test. Main Findings: The urban and the rural FFQs contained 129 and 102 foods respectively, of which 82 foods were common to both. Fourteen urban foods and eight rural foods explained a cumulative 90% of variance for total energy intake. Daily intakes for most nutrients and food groups were two to three fold higher in the urban than in the rural group. Conclusions: In Indian populations with diverse dietary habits, using standard methods to develop separate FFQs can capture dietary intakes adequately. To develop nutrient databases, substitution of local food composition tables with data from other sources using standard methods to match foods can be adopted. Key Words: Databases, nutrient assessment, India, epidemiologic methods, questionnaires

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印度南部前瞻性城鄉流行病學(PURE)先驅研究飲食頻率問卷之發展及營養素資料庫:方法學議題 目的:為印度飲食習慣不同的都會及鄉村族群的前瞻性城鄉流行病學 (PURE; Prospective Urban and Rural Epidemiological) 先驅研究發展飲食頻率問卷(FFQs)及營養素資料庫程序:收集84名鄉村及60名城市研究對象之24小時飲食回憶紀錄。從一個完整的食物清單,針對這兩群人,各自發展出一份FFQs。為了FFQ營養素分析的需要,建立了一個營養素資料庫,過程包括食品選擇、食譜研發及應用這些於熟食。以80名城市及77名鄉村的研究對象,進行這兩份FFQs的先驅研究。在兩群人中,各採用逐步迴歸,找出對總熱量攝取的貢獻累積90%變異數的食物。使用獨立樣本t檢定,比較營養素及食物組攝取。主要結果:城市及鄉村的FFQs分別包括129項及102項食物,其中有82種食物兩者都有。14項城市食物及8項鄉村食物可解釋總熱量攝取90%累積變異數。城市組的大部份營養素及食物組的每日攝取量,均較鄉村組高出23倍。結論:在不同飲食習慣的印度族群中,使用標準方法分別發展出來的FFQs可以充分攫取飲食攝取訊息。可採用標準方法找出其他來源相配食物的數據來代替當地的食物成分表,來發展營養素資料庫。 關鍵字:資料庫、營養素評估、印度、流行病學方法、問卷。

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Last Updated: March 2008