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1 Asia Pacific Journal of Clinical Nutrition
       Volume 17, 3

         (September 2008)


Abstracts

Contents

Abstract Papers

Reviews

International trends in nutritionally-related health and their implication for health policy MARK L WAHLQVIST

Asia Pac J Clin Nutr. 2008;17(3):360-369.

 

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How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations

WEN-HARN PAN AND WEM-TING YEH

Asia Pac J Clin Nutr. 2008;17(3):370-374.

 

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Sociocultural factors relating to Tongans’ and Indigenous Fijians’ patterns of eating, physical activity and body size

HELEN M MAVOA AND MARITA MCCABE

Asia Pac J Clin Nutr. 2008;17(3):375-384.

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Original Research Communications

Macro-Micro and Phyto-nutrients

Levels of Omega 3 fatty acids in Australian seafood

SAHR S A M SOLTAN AND ROBERT A GIBSON

Asia Pac J Clin Nutr. 2008;17(3):385-390.

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Determination of trans fatty acid levels by FTIR in processed foods in Australia

JUSTINE MCCARTHY, DANIEL BARR AND ANDREW SINCLAIR

Asia Pac J Clin Nutr. 2008;17(3):391-396.

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Vitamin D intake and its food sources in Taiwanese

MEEI-SHYUAN LEE, HSIN-LU LI, TSUI-HSIA HUNG, HSING-YI CHANG, FEILI LO YANG AND MARK L WAHLQVIST

Asia Pac J Clin Nutr. 2008;17(3):397-407.

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Consumption of purple sweet potato leaves decreases lipid peroxidation and DNA damage in humans

CHIAO-MING CHEN, YA-LING LIN, C-Y OLIVER CHEN, CHING-YUN HSU, MING-JER SHIEH AND JEN-FANG LIU

Asia Pac J Clin Nutr. 2008;17(3):408-414.

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Nutritional Status, Dietary Intakes, and Body Composition

Effect of diacylglycerol on body weight: a meta-analysis

TONGCHENG XU, XIA LI, ZHIGUO ZHANG, XIAOHANG MA AND DUO LI

Asia Pac J Clin Nutr. 2008;17(3):415-421.

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Waist circumference percentile criteria for the pediatric metabolic syndrome in Korean adolescents

KAYOUNG LEE

Asia Pac J Clin Nutr. 2008;17(3):422-428.

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Growth and Child Nutrition

Multiple micronutrient deficiencies persist during early childhood in Mongolia

REBECCA L LANDER, TSERENNADMID ENKHJARGAL, JAMIYAN BATJARGAL, KARL B BAILEY, SARAH DIOUF, TIMOTHY J GREEN, C MURRAY SKEAFF AND ROSALIND S GIBSON

Asia Pac J Clin Nutr. 2008;17(3):429-440.

 

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Calcium, magnesium, potassium and sodium intakes in Japanese children aged 3 to 5 years

TOMIKO SHIBATA, TAEKO MURAKAMI, HARUO NAKAGAKI, NAOKI NARITA, MIHO GOSHIMA, TOMOKO SUGIYAMA AND MAMORU NISHIMUTA

Asia Pac J Clin Nutr. 2008;17(3):441-445.

 

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Maternal and Women’s Nutrition

Vitamin A supplementation in Cambodia: program coverage and association with greater maternal formal education

DAVINDER S GROVER, SASKIA DE PEE, KAI SUN, V K RAJU, MARTIN W BLOEM AND RICHARD D SEMBA

Asia Pac J Clin Nutr. 2008;17(3):446-450.

 

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Hepcidin and iron status among pregnant women in Bangladesh

KERRY J SCHULZE, PARUL CHRISTIAN, INGO RUCZINSKI, AMANDA L RAY, AVINDRA NATH, LEE S-F WU AND RICHARD D SEMBA

Asia Pac J Clin Nutr. 2008;17(3):451-456.

 

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Nutritional Epidemiology and Public Health

Body shape dissatisfaction and obesity among Taiwanese adolescents

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

Asia Pac J Clin Nutr. 2008;17(3):457-460.

 

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High fish consumption in French Polynesia and prenatal exposure to metals and nutrients

ERIC DEWAILLY, ÉDOUARD SUHAS, YOLANDE MOU, RENEE DALLAIRE, LUDIVINE CHATEAU-DEGAT AND RENE CHANSIN

Asia Pac J Clin Nutr. 2008;17(3):461-470.

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A comparison of the prevalence of the metabolic syndrome in the United States (US) and Korea in young adults aged 20 to 39 years

JINKYUNG PARK, JASON A MENDOZA, CAROL E O’NEIL, DAVID C HILMERS, YAN LIU AND THERESA A NICKLAS

Asia Pac J Clin Nutr. 2008;17(3):471-482.

 

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What’s on Malaysian television? - A survey on food advertising targeting children

TILAKAVATI KARUPAIAH, KARUTHAN CHINNA, LOI HUEI MEE, LIM SIAU MEI AND MPHD ISMAIL NOOR

Asia Pac J Clin Nutr. 2008;17(3):483-491.

 

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Nutritionally-Related Disorders and Diseases and Their Risk Factors

Association between obesity and medical care expenditure among Taiwanese adults

HSIAO-YUN HU, YIING-JENQ CHOU, PESUS CHOU, CHENG-HUA LEE, MIAW-CHWEN LEE AND NICOLE HUANG

Asia Pac J Clin Nutr. 2008;17(3):492-504.

 

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Coexistence of anaemia and the metabolic syndrome in adults in Jiangsu, China

ZUMIN SHI, XIAOSHU HU, BAOJUN YUAN, GANG HU, XIAOQUN PAN AND GERD HOLMBOE-OTTESEN

Asia Pac J Clin Nutr. 2008;17(3):505-513.

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Clinical Nutrition Trials or Feeding Studies

An integrated intervention program to control diabetes in overweight Chinese women and men with type 2 diabetes

JIANQIN SUN, YANFANG WANG, XIAFEI CHEN, YANQIU CHEN, YING FENG, XINYI ZHANG, YIRU-PAN, TING HU, JIANHUA XU, LUYUAN DU, WEI ZHOU, HUIPING ZHAO, ROSEMARY E RILEY AND VIKKIE A MUSTAD

Asia Pac J Clin Nutr. 2008;17(3):514-524.

 

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Intraoperative infusion of acetated Ringer solution containing glucose and ionized magnesium reduces ketogenesis and maintains serum magnesium

TAKESHI YOKOYAMA, KUNIO SUWA, FUMIYASU YAMASAKI, REIKI YOKOYAMA, KOICHI YAMASHITA AND EVA SELLDEN

Asia Pac J Clin Nutr. 2008;17(3):525-529.

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Special Reports

Symposium on Understanding and Influencing Consumer Food Behaviours for Health: Executive Summary Report MA SOFIA V AMARRAL, YEONG BOON YEE AND ADAM DREWNOWSKI

Asia Pac J Clin Nutr. 2008;17(3):530-539.

 

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The 2nd International Conference on East-West Perspectives on Functional Foods: Science, Innovations and Claims

RODOLFO F FLORENRINO

Asia Pac J Clin Nutr. 2008;17(3):540-543.

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Future Events

Asia Pac J Clin Nutr. 2008;17(3):544

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International trends in nutritionally-related health and their implication for health policy

MARK L WAHLQVIST

To establish health policy which will be relevant and effectual for a decade or more, let alone the much longer term, is a challenging task for any period of human or planetary history. Presently it is more so than ever because of major demographic, economic, technological and scientific, climatic and territorial changes and uncertainties. There are various scenarios which might be envisaged for food-health relationships before global population size is expected to stabilize by about 2050, dependent on planetary health. These will reflect achieved food intakes which for many will not be optimal but realizable and food systems with varying degrees of safety, security and sustainability. Health patterns themselves are bound to continue to change from those associated with different levels of economic development to those which have more to do with locality, climate, education and equity. Every aspect of health is in some way intertwined with food and this will become more explicit. Decisions about food-health relationships will take into account the United Nations MDGs (Millennium Development Goals), but be strongly influenced by technology, affordability, sustainability and ethics.

Key Words: Health and Nutrition Policy, Scenario planning, food systems, well-being, morbidity, mortality

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國際趨勢在營養相關的健康議題與其衛生政策應用

在人類任何時期或是地球歷史中,建立一個能適合未來十年或更長時期衛生政策,是一項很具挑戰的任務。目前,因為主要的人口、經濟、技術、科學、氣候及地貌的改變與不確定性,使得這個任務比其往常更加艱鉅。在2050年全球人口數達到預期的平衡之前,食物與健康的關係,可想像有各種的狀況,是會依隨地球的健康而異。這些將反映出食物攝取狀況,可想而知,有許多人可能未達到理想狀態,食物系統會有不同程度的安全性、防護性與持續性。健康模式本身將與經濟發展程度而持續改變,此外,也與地域、氣候、教育與公平性更有關聯。健康的每個面向將或多或少與食物相牽扯,並且這將更明朗化。與食物–健康攸關的決定需考慮聯合國千禧發展目標,但是仍強烈受到科技、承受力、持續性及倫理的影響。 關鍵字:健康與營養政策、情境規劃、食物系統、康樂/福利、罹病率、死亡率

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How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations

WEN-HARN PAN AND WEM-TING YEH Metabolic risks are greater in Asians than Caucasians at a given body mass index (BMI). It is generally accepted that the BMI cut-off points for defining overweight and obesity should be lower for Asians. However, the percent body fat at a given BMI and metabolic responses to fatness vary among the different ethnic groups in Asia. Therefore, roughly even-spaced multiple action points (i.e., BMIs of 23, 25, 27.5, 30, 32.5, 35 and 37.5) have been advocated for managing obesity in Asians. We propose here evidence-based ethnicity-specific action points for public awareness, screening, and treatment that take into consideration sensitivity, specificity, and positive/negative predictive values for cardiovascular disease and/or metabolic syndromes, which are the most prevalent adverse consequences of obesity.

Key Words: body mass index, evidence-based, metabolic syndrome, obesity definition, waist circumference

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肥胖定義之省思?延伸亞太地區之建議,建立有實證基礎的三個肥胖指標行動點,以教育民眾、篩選高風險民眾、治療肥胖

近年的文獻顯示,當控制在固定的身體質量指數(BMI)時,亞洲人的代謝徵候群風險比白種人高, 因此一般認為要以較低的BMI切點定義亞洲人的過重與肥胖才好。然而,對於亞洲地區的不同族群而言,即使控制在固定的身體質量指數數值之下,身體脂肪含量和代謝反應仍然有些差距。因此,專家建議從多個大致上間隔相當的「行動點」 (包括23, 25, 27.5, 30 和32.5, 35, 37.5)挑選合宜各國的切點來管理肥胖。 在這裡我們提出以預測心臟血管疾病及代謝症的危險因子之敏感度,特異度,陽性預測值、陰性預測值數據為實證基礎,訂出屬於個別人群的三個身體質量指數行動點以教育民眾、篩選高風險民眾、治療肥胖。 關鍵字:身體質量指數,實證醫學,代謝症候群,肥胖定義,腰圍

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Sociocultural factors relating to Tongans’ and Indigenous Fijians’ patterns of eating, physical activity and body size

HELEN M MAVOA AND MARITA MCCABE

This paper reviews literature between 1974 and 2007 that addresses the impact of sociocultural factors on reported patterns of eating, physical activity (activity) and body size of Tongans and indigenous Fijians (Fijians) in their countries of origin. There have been changes in diet (more imported and fewer traditional foods), activity (reduced, especially in urban settings), residence (rural-urban shift) and body size (increased obesity and at a younger age). The prevalence of overweight/obesity in Tongans and Fijians has increased rapidly over the last two decades and remains among the highest in the world (>80% in Tonga; >40% in Fiji), with more females reported to be obese than males. The few studies that investigated sociocultural influences on patterns of eating, activity and/or body size in this population have examined the impact of hierarchical organisation, rank and status (sex, seniority), values (respect, care, co-operation) and/or role expectations. It is important to examine how sociocultural factors influence eating, activity and body size in order to i) establish factors that promote or protect against obesity, ii) inform culturally-appropriate interventions to promote healthy lifestyles and body size, and iii) halt the obesity epidemic, especially in cultural groups with a high prevalence of obesity. There is an urgent need for more systematic investigations of key sociocultural factors, whilst taking into account the complex interplay between sociocultural factors, behaviours and other influences (historical; socioeconomic; policy; external global influences; physical environment).

Key Words: Food, Physical activity, Tonga, indigenous Fijians, Obesity

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社會與文化因子與東加群島人及斐濟原住民的飲食型態、身體活動量和體型有關

本篇文章回顧了1974到2007年之間,發表對於東加群島人及斐濟人其社會與文化因子對於飲食型態、身體活動量(活動量)和體型之影響的文獻。這段期間在飲食(更多進口食物以及較少的傳統食物)、活動量(減少,特別是居住在城市的居民)、居所(鄉村與城市之間的遷移)以及體型(肥胖增加,特別是在年輕人之中)都有改變。在過去20年,東加群島人及斐濟人過重/肥胖的盛行率迅速的增加,並且保持全世界最高值之一(東加>80% ;斐濟 >40%),而女性肥胖者更多於男性。在為數不多的這些研究中,社會與文化因子如階級組織、地位及身份(性別、資歷)、價值觀(敬重、關心、合作)、和/或角色期待等曾被探討,檢視它們對當地飲食型態、活動量和體型的影響。為了要i)建立可促增肥胖或預防肥胖的因子,ii)告知適當的文化角度介入來促進健康的生活型態及體型,以及iii)終止肥胖的流行性,特別是在有肥胖高盛行率的文化群體中,因此評估社會與文化因子如何影響飲食、活動量、及體型是重要的。針對主要的社會與文化因子更多有系統的研究是必需的,但同時也要考量到社會與文化因子和行為以及其他影響(歷史、社會經濟、政策、外圍全球性的影響、自然環境)之間複雜的交互作用。 關鍵字:飲食、身體活動量、東加、斐濟原住民、肥胖

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Levels of Omega 3 fatty acids in Australian seafood

SAHR S A M SOLTAN AND ROBERT A GIBSON

The aim of this study was to determine the quantity of omega 3 (n–3) fatty acids in commonly consumed species of South Australian fish. Omega 3 fatty acids ranged from 17.7% to 53.7% of total fat with docosahexaenoic acid (DHA, 22:6n–3) as the major omega 3 fatty acid in all 26 species tested (range 9.5 % to 47.1% of total fat). The levels of total omega 6 (n–6) fatty acids ranged from 2.3% to 20.2% of total lipids, chiefly as arachidonic acid (AA, 20:4n–6). Fatty fish such as Gemfish, Atlantic Salmon and Swordfish were found to be good sources of omega-3 fatty acid (1360, 2252 and 2571 mg/100g fish respectively), while low fat fish such as Ling, Deep Sea Bream (Blue Warhou) and Blue Grenadier (0.5, 0.7 and 0.7% fat) had low levels of omega 3 fatty acid (222, 257 and 247 mg/100g). Because most white table fish consumed by Australians are so low in fat they are actually a limited source of omega 3 fats. The amount of fish required to be consumed to provide 1 g of omega 3 fatty acid per day ranged from 40 to 450 g.

Key Words: omega 3 fatty acids, dietary fats, fish, fish oils, diet

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澳大利亞海鮮中n-3脂肪酸的含量

這個研究的目的是要測定南澳大利亞省常食用魚類中n-3脂肪酸的含量。在測試的26個樣本中,n-3脂肪酸佔總脂肪的17.7%到53.7%,最主要為DHA (22:6n-3) ,佔總脂肪的9.5%至47.1%。n-6脂肪酸佔總脂肪的2.3%到20.2%,主要是花生四烯酸(AA,20:4n-6)。脂肪較多的魚類如Gemfish、大西洋鮭魚及箭魚是n-3脂肪酸的良好來源(每100 g魚中分別含1360、2252及2571 mg)。而低脂魚如鱈魚、Blue Warhou 及Blue Grenadier(含脂量為0.5、0.7及0.7%),則含較少的n-3脂肪酸(100 g魚分別含222、257及247 mg)。因為澳大利亞人常吃的大多數白色魚類中脂肪含量很低,能提供的n-3脂肪酸亦有限。每天必需攝取40至450 g的魚才能得到1 g的n-3脂肪酸。 關鍵字:n-3脂肪酸、膳食脂肪、魚、魚油、飲食

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Determination of trans fatty acid levels by FTIR in processed foods in Australia

JUSTINE MCCARTHY, DANIEL BARR AND ANDREW SINCLAIR

Health authorities around the world advise ‘limiting consumption of trans fatty acids’, however in Australia the trans fatty acid (TFA) content is not required to be listed in the nutrition information panel unless a declaration or nutrient claim is made about fatty acids or cholesterol. Since there is limited knowledge about trans fatty acid levels in processed foods available in Australia, this study aimed to determine the levels of TFA in selected food items known to be sources of TFA from previously published studies. Food items (n=92) that contain vegetable oil and a total fat content greater than 5% were included. This criterion was used in conjunction with a review of similar studies where food items were found to contain high levels of trans fatty acids. Lipids were extracted using solvents. Gravimetric methods were used to determine total fat content and trans fatty acid levels were quantified by Attenuated Total Reflectance Fourier Transform Infrared spectroscopy. High levels of trans fatty acids were found in certain items in the Australian food supply, with a high degree of variability. Of the samples analysed, 13 contained greater than 1 g of trans fatty acids per serving size, the highest value was 8.1 g/serving. Apart from when the nutrition information panel states that the content is less than a designated low level, food labels sold in Australia do not indicate trans fatty acid levels. We suggested that health authorities seek ways to assist consumers to limit their intakes of trans fatty acids.

Key Words: trans fatty acids, levels in foods, ATR-FTIR analysis, FSANZ, Australian foods

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以FTIR定量澳洲加工食品的反式脂肪酸含量

全球各地衛生當局都呼籲”限制反式脂肪酸的攝取”。然而在澳洲,其反式脂肪酸(TFA)的含量未被要求明列於營養標示上,除非該食品有做關於脂肪酸或膽固醇的營養宣稱。由於澳洲加工食品中反式脂酸含量的資訊有限,因此,本研究主要目的是挑選一些曾被報導的反式脂酸來源的食物項目,來決定其反式脂酸的含量。挑出的92項食物中,都含植物油且總脂肪含量超過5%。這個準則是根據文獻回顧中,被提及含有高濃度反式脂肪酸的食物項目而歸納出來的。脂質使用溶劑淬取出來,以稱重法決定總脂肪含量。而反式脂肪酸是利用內反射傅立葉轉換紅外線光譜儀(ATR-FTIR)定量。在某些澳洲的食品裡發現含高量反式脂肪酸,且有高變異度。分析的樣本中,有13件每份含超過1 g的反式脂肪酸,最高有達每份8.1 g。除了在營養標示指出含量低於訂定的低劑量外,在澳洲出售的食品標示無法指出反式脂肪酸的含量。我們建議衛生當局應尋求方法幫助消費者能夠限制其反式脂肪酸的攝取量。 關鍵字:反式脂肪酸、內反射傅立葉轉換紅外線光譜儀分析、澳紐食品科學所、澳洲食品

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Vitamin D intake and its food sources in Taiwanese

MEEI-SHYUAN LEE, HSIN-LU LI, TSUI-HSIA HUNG, HSING-YI CHANG, FEILI LO YANG AND MARK L WAHLQVIST

In the early 20th Century, vitamin D was discovered and its Recommended Daily Allowance developed. However, average daily dietary intakes have not been reported until recently in the US. There are no food composition and no intake data for vitamin D available in Taiwan. We have taken advantage of several population representative Nutrition and Health Surveys in Taiwan (NAHSIT) conducted from 1993 onwards of various age groups to examine this possibility systematically. Firstly, we collected and compiled the vitamin D content of foods from various sources to supplement the Taiwanese Food Composition Tables. Though these vitamin D data may not be fully representative of local food items, they serve as a reference point. Secondly, we have used the three NAHSITs databases, which all used the 24-hr recall method to collect dietary intake date and five food frequency questionnaire type questions to collect supplement data, to estimate most gender- and age-specific (include: school children, adults and elderly) vitamin D intakes from food source and supplements. Thirdly, we have defined the sources of vitamin D intake in Taiwanese (gender- and age-specific). Vitamin D intakes of Taiwanese were adequate except for high school girls and indigenous people. Fish and its products, milk, mushrooms were the major vitamin D food sources. Supplement source vitamin D also varied greatly between age and gender groups. Elderly women consumed almost 20% of vitamin D from supplements; 16-18 years old boys consumed 2.47% vitamin D from supplements only.

Key Words: vitamin D, dietary intake, determinants, National Nutrition Survey, adults, women, elderly, school children, DRIs

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台灣地區民眾維生素 D攝取量及主要食物來源

維生素D在二十世紀初被發現,並訂定每日建議攝取量。然而直到最近美國才有其民眾攝取狀況報告。臺灣地區沒有維生素D食物成分資料,也從未有人民維生素D的營養狀況報告。本研究先彙編不同來源之食物維生素D含量,以之估算三個涵蓋不同年齡層且具全國代表性之營養調查(1993-1996,老人,學童)之24小時飲食回憶資料及最多五項的補充劑使用頻率。結果包括性別、年齡(學童、成人、婦女與老人)及地區層別的維生素D攝取(含補充劑)狀況。台灣地區民眾維生素D攝取量一般而言已經足夠,但是高中女學生及原住民,有攝取較少的危險。魚類(鹹水及淡水)、魚肉製品、奶類及蕈類為台灣地區民眾維生素D最重要的食物來源。學童之「鹹水魚」、「魚肉加工製品」及「乳類及其製品」三項佔總攝取量的55%。奶類佔老人總攝取量的四分之一;蛋類在較年輕族群約佔10%,但是在老人就僅剩5%。魚肝油仍是學童及青少年使用最多的維生素D補充劑來源,老年人則使用綜合維生素礦物質;部份鈣片也添加維生素D。維生素D補充劑在學童約佔總攝取的13%(男)及17%(女),13-15歲青少年分別為13%(男)及9%(女),到16-18歲男性只剩下2%。之後緩步上升,到老年期,男女性其補充劑可達16%及19%。 關鍵字:維生素D,膳食攝取量,補充劑,國民營養調查,DRIs

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Consumption of purple sweet potato leaves decreases lipid peroxidation and DNA damage in humans

CHIAO-MING CHEN, YA-LING LIN, C-Y OLIVER CHEN, CHING-YUN HSU, MING-JER SHIEH AND JEN-FANG LIU

Consumption of polyphenols is associated with reduced risk of chronic diseases, possibly via a variety of bio-mechanisms, including antioxidation and anti-inflammation. Purple sweet potato leaves (PSPL) commonly consumed in Asia possess polyphenols. In this study, we aim to investigate antioxidant effect of 200 g/d PSPL containing 902 mg polyphenols in a clinical trial. This randomized, crossover clinical study included 16 healthy adults (7 M, 9 F; aged 20-22 y). After a 1-wk run period, subjects were assigned randomly to receive either PSPL or low polyphenol diet (LPD) for 2 wks, followed by a 2-wk washout period before crossing over to the alternate diet. Fasting blood and 24-h urine samples were collected from each subject at day 0, 7 and 14 of each phase. Our data showed PSPL consumption enhanced urinary total phenol excretion by 24.5% at day 14 as compared to day 0, while the LPD decreased total phenol content in plasma and urine by 3.3 and 16.3%, respectively (p 0.05). Low-density lipoprotein lag time and glutathione concentration in erythrocytes at day 14 was significantly enhanced by 15.0 and 33.3% by PSPL as compared to day 0, respectively, while their values were not altered by the LPD. Urinary 8-hydoxy-deoxyguanosine (8-OHdG) excretion decreased significantly by PSPL consumptoin by 36.7% at day 7 as compared to day 0, yet unchanged by the LPD (p 0.05). In conclusion, our results suggest that polyphenols in 200 g PSPL were bioavailable and could enhance antioxidant defense and decrease oxidative stress in young healthy people.

Key Words: purple sweet potato leaves, 8-hydroxydeoxyguanosine, polyphenols, total antioxidant status, glutathione

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攝取紅甘藷葉飲食可以降低健康成年人體內的脂質過氧化作用及DNA的損傷

攝取富含多酚類的食物,與減少慢性疾病的風險有關,其可能的生化機制包括增強抗氧化及抗發炎等。紅甘藷葉(Purple sweet potato leaves, PSPL)富含豐富的多酚類,是亞洲人經常食用的蔬菜。在這個交叉試驗中,提供16位健康受試者(年齡20-22歲,7男9女),每日200公克紅甘藷葉(包含902毫克總多酚類),以探討其對人體抗氧化的影響。於一星期的適應期之後,將所有受試者隨機分成2組,實驗組每日攝取200公克紅甘藷葉,對照組則攝取低多酚類飲食,持續2週之後再進行2星期的排空期,之後2組飲食對調,再進行持續2週的試驗。分別收集受試者於每個試驗期的第0、7、14天的空腹血液及24小時尿液進行分析。結果顯示,攝取紅甘藷葉14天後,明顯增加受試者尿中多酚類的排泄,比第0天增加了24.5%;但攝取低多酚類飲食2週之後,受試者的血漿及尿液中總多酚類的含量明顯減少,分別為3.3 %及16.3 %。攝取紅甘藷葉14天後,低密度脂蛋白氧化遲滯時間(Low-density lipoprotein lag time)及紅血球中glutathione的濃度,分別比第0天時明顯提升了15% 及33.3%;而攝取低多酚類飲食組則沒有明顯變化。尿中8-hydoxy-deoxyguanosine (8-OHdG) 的排泄方面,在攝取紅甘藷葉7天後,明顯比第0天減少了36.7%;而攝取低多酚類飲食組則沒有明顯變化。綜合以上的結果,200公克紅甘藷葉中的多酚類是可被人體吸收利用的,且可以降低體內脂質過氧化作用、DNA的損傷及增加抗氧化防禦能力,以減少健康年輕人的氧化壓力。 關鍵字: 紅甘藷葉、多酚類、脂質過氧化作用、DNA損傷

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Effect of diacylglycerol on body weight: a meta-analysis

TONGCHENG XU, XIA LI, ZHIGUO ZHANG, XIAOHANG MA AND DUO LI

The effects of diacylglycerol (DAG) on body weight are not consistent in clinical trials. This meta-analysis of randomized controlled trials was conducted to evaluate the efficacy of dietary DAG on body weight. Potential articles were initially searched from the electronic databases of Medline, Embase and Cochrane library using the subject keywords as follows: weight, DAG, triacylglycerol (TAG), reduction and obesity. Inclusion criteria required the trial to be randomized placebo controlled with body weight as an endpoint. Two reviewers independently extracted the information and evaluated the methodological quality using the scoring system developed by Jadad. Meta-analysis was performed with the software of Review Manager 4.2. The robustness of overall analysis was tested by sensitivity analysis and publication bias was visually inspected by funnel plot. Five published trials were included in the statistical pool. The meta-analysis indicated a significant difference in body weight reduction between group receiving DAG and group receiving TAG (weighted mean difference -0.75 kg; 95% CI: -1.11 to -0.39; p < 0.0001). Sensitivity analysis corroborated the result of the overall analysis. Linear regression analysis showed that there was significant correlation between daily dose and body weight reduction (p = 0.044, R2 = 0.889). In conclusion, this meta-analysis suggested that DAG was efficacious for reducing body weight compared with TAG and this effect was influenced by the daily dose.

Key Words: diacylglycerol, triacylglycerol, body weight, reduction, meta-analysis

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甘油二酯对体重影响之后设分析

在临床试验中,关于甘油二酯对体重影响的研究结果尚不一致。本文旨在通过后设分析,进一步评价甘油二酯与体重之间的关系。首先,以体重、甘油二酯、甘油三酯、降低和肥胖为关键词,在Medline、Embase和Cochrane图书馆三个数据库中进行检索,并将所得随机对照实验纳入本文统计库。然后,由两名审稿人独立提取相关数据,并按Jadad评分系统对文章进行评价。采用软件Review Manager 4.2进行后设分析,采用敏感性分析检验所得结果的可靠性,倒漏斗图分析检验发表偏倚的可能性。最终,有5篇文章纳入统计分析。后设分析结果显示,甘油二酯摄入组受试者的体重降低水平显著高于甘油三酯摄入组的体重降低水平(加权均数差:-0.75公斤;95%置信区间:-1.11~-0.39;p < 0.0001)。敏感性分析结果显示上述结果的可靠性较高;线性回归分析结果显示,甘油二酯的功效与剂量之间存在显著相关性(p = 0.044, R2 = 0.889)。结论:与甘油三酯相比,甘油二酯的摄入可以显著降低受试者的体重,且降低作用受日摄入量的影响。 关键词:甘油二酯、甘油三酯、体重、降低、后设分析

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Waist circumference percentile criteria for the pediatric metabolic syndrome in Korean adolescents

KAYOUNG LEE

This study aimed to determine valid waist circumference (WC) thresholds using receiver operating characteristic (ROC) curves for pediatric metabolic syndrome (MS) prediction and to compare validities between the thresholds derived from ROC curves and the WC cut-offs defined by International Diabetes Federation (IDF). Four hundred and sixty four males and 415 females, 10–18 years, who participated in the KNHNES 2005 were included. Subjects were classified as having pediatric MS when a high WC and ≥ 2 of the risk factors defined by IDF were present. High WC was defined using either IDF criterion ( ≥ 90th percentile for age and sex-specific WC based on Korean reference in adolescents 10-15 years of age, ≥ 90cm in males and ≥ 80cm in females 16-18 years of age) or age-adjusted WC thresholds derived from the ROC curves predicting ≥ 2 abnormal risk factors. The AUCs were 0.71-0.81 (sensitivity 74-100%, specificity 52-65%) among males and 0.63-0.76 (sensitivity 71-90%, specificity 37-87%) among females for WC thresholds (55th and 32th percentile for males and females 10-15 years of age, 73cm and 76cm for males and females 16-18 years of age), while the AUCs were 0.65-0.66 (sensitivity 39-45%, specificity 84-93%) among males and 0.53-0.76 (sensitivity 20-57%, specificity 86-96%) among females for IDF-defined WC cut-offs. The prevalence of MS using IDF definition for WC was 4% in males and 2% in females,  while those using WC thresholds were 8% and 5%, respectively. The IDF’s definition of abdominal obesity may be less sensitive in screening adolescents with pediatric MS compared to WC thresholds.

Key Words: waist circumference; metabolic syndrome; adolescents; prevalence, Korea

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腰圍百分位標準預測韓國青少年的小兒代謝症候群

本研究的目的是用接受者操作特徵(ROC)曲線訂出腰圍閾值來做小兒代謝症候群的預測,並與國際糖尿病組織(IDF)訂出的腰圍切點之效度做比較。參與2005年KNHNES的464位男生與415位女生(年齡10-18歲)為研究對象。研究對象若有高腰圍及有兩項或以上IDF定義的危險因子則被歸為有小兒代謝症候群。高腰圍定義或根據IDF標準(10-15歲者是以韓國青少年的參考值,大於或等於同性別及同年齡90百分位為分界;16-18歲者以男生腰圍³90 cm,女生³80 cm為切點)或根據ROC曲線推衍的年齡校正後的腰圍閾值,此閾值能預測兩項或以上的危險因子。以腰圍閾值(10-15歲男生與女生分別為55及32百分位;16-18歲男生腰圍73 cm,女生76 cm)預測男生曲線下面積(AUC)為0.71-0.81(敏感度74-100%,特異度52-65%),女生AUC為0.63-0.76(敏感度71-90%,特異度37-87%)。以IDF的腰圍切點預測男生AUC為0.65-0.66(敏感度39-45%,特異度84-93%),女生AUC為0.53-0.76(敏感度20-57%,特異度86-96%)。使用IDF定義,代謝症候群的盛行率為男生4%,女生2%。但以腰圍閾值預測盛行率為男生8%,女生5%。對腹部肥胖的青少年以IDF的定義預測代謝症候群之敏感度似乎不及腰圍閾值。 關鍵字:腰圍、代謝症候群、青少年、韓國、盛行率

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Multiple micronutrient deficiencies persist during early childhood in Mongolia

REBECCA L LANDER, TSERENNADMID ENKHJARGAL, JAMIYAN BATJARGAL, KARL B BAILEY, SARAH DIOUF, TIMOTHY J GREEN, C MURRAY SKEAFF AND ROSALIND S GIBSON

Data on the prevalence of micronutrient deficiencies in children in Mongolia is limited. We therefore determined the prevalence of anaemia, iron deficiency anaemia (IDA), and deficiencies of iron, folate, vitamin A, zinc, selenium, and vitamin D among young Mongolian children. Anthropometry and non-fasting morning blood samples were collected from 243 children aged 6–36 months from 4 districts in Ulaanbaatar and 4 rural capitols for haemoglobin (Hb), serum ferritin, folate, retinol, zinc, selenium, and 25-hydroxyvitamin D (25-OHD) assays. Children with α-1-glycoprotein >1.2mg/L (n=27) indicative of chronic infection were excluded, except for folate, selenium, and 25-hydroxyvitamin D assays. Of the children 14.5% were stunted and none were wasted. Zn deficiency (serum Zn<9.9 µmol/L) had the highest prevalence (74%), followed by vitamin D deficiency 61% (serum 25-OHD<25 nmol/L). The prevalence of anaemia (24%) and iron deficiency anaemia (IDA) (16%) was lower, with the oldest children (24-36 mos) at lowest risk. Twenty one percent of the children had low iron stores, and 33% had vitamin A deficiencies (serum retinol < 0.70 µmol/L), even though two thirds had received vitamin A supplements. Serum selenium values were low, perhaps associated with low soil selenium concentrations. In contrast, no children in Ulaanbaatar and only 4% in the provincial capitols had low serum folate values (<6.8 nmol/L). Regional differences (p<0.05) existed for anaemia, deficiencies of vitamin A, folate, and selenium, but not for zinc or IDA. Of the children, 78% were at risk of ≥ two coexisting micronutrient deficiencies emphasizing the need for multimicronutrient interventions in Mongolia.

Key Words: Mongolia, children, deficiencies, anaemia, zinc, selenium

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蒙古幼童持續多重微量營養素缺乏

蒙古兒童微量營養素缺乏盛行率的資料相當有限。因此我們評估蒙古幼童之貧血、鐵缺乏貧血(IDA)及鐵、葉酸、維生素A、鋅、硒及維生素D缺乏的盛行率。收集來自烏蘭巴托 (Ulaanbaatar) 的4個行政區及4個鄉村城鎮的243名年齡為6-36個月大的兒童之體位資料及早上非禁食血液樣本,以進行血紅蛋白(Hb)、血清運鐵蛋白、葉酸、視網醇、鋅、硒及25-烴化維生素D(25-OHD)分析。除了葉酸、硒及25烴化維生素D分析外,兒童其α-1-糖化蛋白質如果>1.2mg/L (n=27),表示有慢性感染,即將其值排除。14.5%的兒童有發育遲緩,但是沒有人是枯槁的。鋅缺乏(血清鋅<9.9µmol/L)的盛行率(74%)最高,維生素D缺乏61%(血清25-OHD<25 nmol/L)次之。貧血(24%)及鐵缺乏貧血(16%)的盛行率較低,年紀較大的兒童(24-36個月)其危險性也較低。21%的兒童其鐵儲存量低,雖然有2/3的兒童接受維生素A補充劑,但仍有33%有維生素A缺乏(血清視網醇<0.70 µmol/L)。血清硒的值是低的,可能與土壤硒濃度較低有關。相反的,在烏蘭巴托沒有兒童,而其他省的城鎮只有4%的兒童有低血清葉酸值(<6.8 nmol/L)。貧血、維生素A、葉酸及硒缺乏存在地區差異 (p<0.05),鋅及IDA則沒有。這些兒童中,有78%的人有≥2種的微量營養素缺乏共存之現象,強調蒙古綜合微量營養素介入的需求。 關鍵字:蒙古、兒童、缺乏症、貧血、鋅、硒

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Calcium, magnesium, potassium and sodium intakes in Japanese children aged 3 to 5 years

TOMIKO SHIBATA, TAEKO MURAKAMI, HARUO NAKAGAKI, NAOKI NARITA, MIHO GOSHIMA, TOMOKO SUGIYAMA AND MAMORU NISHIMUTA

The present study aimed to evaluate in preschool children the intakes of Ca, Mg that possibly affect health and tooth formation and the intakes of K and Na that may affect lifestyle-related diseases. Information on dietary intake was collected from 90 preschool children (15 boys and 15 girls each in the 3-, 4- and 5-year old groups) on 3 separate days in the school fiscal year 1999 (April 1999 to March 2000) by the duplicate-diet technique. The Ca, Mg, K, and Na concentrations were determined by atomic absorption spectrometry using wet-ashed samples.  The medians of mean daily intakes of Ca, Mg, K and Na in 3- to 5-year-old children were 432 mg, 110 mg, 1.18 g and 1.60 g, respectively, and no significant differences with regard to gender were observed. Seasonal variation of intake was seen for each mineral. Calcium intake in most preschool children did not meet adequate intake (AI), probably due to low intakes of milk and dairy products in Japan.  Magnesium intake was below the estimated average requirement (EAR) in 13.3% of the subjects, while the K intake met the AI. Sodium intake in a quarter of preschool children exceeded the tentative dietary goal. We concluded that in Japanese children aged 3-5 years; Ca intake is low, Na intake is high, and K intake is adequate, but some children could be at risk for Mg deficiency.

Key Words: duplicate-diet technique, preschool children, seasonal variation, mineral intake, nutrition survey

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日本3至5歲兒童的鈣、鎂、鉀、鈉攝取狀況

此研究目的在於評估學齡前兒童在可能影響健康和牙齒結構的鈣、鎂攝取,及可能影響與生活形態相關疾病的鉀、鈉攝取。在1999學年度(1999年4月至2000年5月)夏、秋、冬季各選1天以複製飲食方法收集90名學齡前兒童攝取的飲食(年齡3歲、4歲及5歲各15名男孩及15名女孩)。將樣品灰化並溶於溶劑後,以原子吸收光譜測量鈣、鎂、鉀、鈉的濃度。3-5歲兒童飲食攝取中的鈣、鎂、鉀、鈉的中位數分別為432 mg、110 mg、1.18 g、1.60 g,在性別上並無顯著的差異。每種礦物質的攝取情形都有季節性的變化。大部分學齡前兒童鈣的攝取沒有達到足夠攝取量,可能由於日本在牛奶及乳製品上的低攝取。13.3%的受試者中鎂的攝取量低於平均需要量,鉀的攝取量都有達到足夠攝取量。四分之一的學齡前兒童在鈉的攝取量超過暫定的飲食目標。結論為3-5歲的日本兒童其鈣攝取量低,鈉攝取量高,鉀的攝取量足夠,但是部分兒童可能有鎂缺乏的風險。 關鍵字:複製飲食方法、學齡前兒童、 季節變化、礦物質的攝取、營養調查

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Vitamin A supplementation in Cambodia: program coverage and association with greater maternal formal education

DAVINDER S GROVER, SASKIA DE PEE, KAI SUN, V K RAJU, MARTIN W BLOEM AND RICHARD D SEMBA

Vitamin A supplementation reduces morbidity, mortality, and blindness among children in developing countries.  The objective of this study is to characterize the coverage of the Cambodian national vitamin A program among preschool children and to identify risk factors for not receiving vitamin A supplementation. The study subjects were preschool children and their families who participated in the 2005 Cambodian Demographic and Health Survey (CDHS), a nationally representative survey. Of 1,547 preschool children, aged 12-59 months, 42.8% received a vitamin A capsule within the last six months. There were no significant differences in paternal education, child age, fever within the last 2 weeks, stunting, underweight, or wasting between children who did or did not receive a vitamin A capsule. Maternal education of ≥10 years (Odds Ratio [OR] 2.09, 95% Confidence Interval [CI] 1.02 – 4.29), 7-9 years (OR 1.46, 95% CI 0.99 – 2.15), 4-6 years (OR 1.71, 95% CI 1.26 – 2.32), and 1-3 years (OR 1.50, 95% CI 1.10 – 2.06) was associated with the child receiving a vitamin A capsule compared to no formal education in multivariate analyses adjusting for other potential confounders. The national vitamin A supplementation program in Cambodia did not reach over one-half of preschool children in 2005. Greater maternal formal education appears to be an important determinant for receipt of a vitamin A capsule by preschool children.

Key Words: Cambodia, morbidity, mortality, nutritional blindness, vitamin A

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柬埔寨的維生素A補充:計劃涵蓋範圍及與母親教育程度較佳有關

在開發中國家,維生素A補充降低兒童的罹病率、死亡率及失明。本研究的目的是確認柬埔寨的學齡前兒童接受維生素A補充者的特徵及找出未能接受補充族群的風險因子。研究對象為參與2005年柬埔寨的全國人口統計與健康調查(CDHS)的學齡前兒童與其家庭。在1,547位學齡前兒童(年齡12-59個月)之中,有42.8%在最後6個月接受過一個維生素A膠囊。父親的教育程度、兒童年齡、兩週以內有發燒、發育遲緩、體重不足或消瘦都與兒童接受維生素A膠囊與否無關。與母親未受教育者相比,在校正可能干擾因子後的多變項分析中,發現母親受教育10年或以上(OR 2.09)、7-9年(OR 1.46)、4-6年(OR 1.71)或1-3年(OR 1.50)都與兒童接受維生素A膠囊有相關性。柬埔寨的全國維生素A補充計劃在2005年還未涵蓋一半的學齡前兒童。母親教育程度較佳似乎是學齡前兒童接受維生素A膠囊的重要決定因子。 關鍵字: 柬埔寨、罹病率、死亡率、營養性失明、維生素A

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Hepcidin and iron status among pregnant women in Bangladesh

KERRY J SCHULZE, PARUL CHRISTIAN, INGO RUCZINSKI, AMANDA L RAY, AVINDRA NATH, LEE S-F WU AND RICHARD D SEMBA

Although hepcidin, a recently discovered peptide hormone, is considered a major regulator of iron metabolism and anemia in chronic inflammation, its role in anemia during pregnancy has not been characterized. Our objective was to characterize the role of hepcidin in anemia during pregnancy. We examined the relationships between urinary hepcidin, iron status indicators, hemoglobin, erythropoietin, alpha-1 acid glycoprotein, and C-reactive protein in a cross-sectional study conducted among 149 pregnant rural Bangladeshi women with biospecimens obtained during home visits. Urinary hepcidin was measured using surface-enhanced laser desorption/ ionization time-of-flight mass spectrometry. Urinary hepcidin, as log(intensity per mmol/L creatinine), was correlated with log ferritin (r = 0.33, p <0.001), the transferrin receptor index (r = -0.22, p = 0.007), and log alpha-1 acid glycoprotein (r = 0.20, p = 0.01), but not hemoglobin (r = 0.07,  p= 0.40), log transferrin receptor (r = -0.07, p = 0.41), log erythropoietin (r = -0.01, p = 0.88) or log C-reactive protein (r = 0.06, p = 0.48). The strength of the relationship between hepcidin and ferritin was maintained in multiple linear regression analyses after enhancing the sample with data from women selected for low iron stores (n = 41). Among pregnant women in a community-based study in rural Bangladesh, urinary hepcidin levels were related to iron status and AGP but not hemoglobin, erythropoietin, or C-reactive protein.

Key Words: anemia, hepcidin, inflammation, iron, pregnancy

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孟加拉懷孕婦女的鐵調素和鐵狀態

雖然近年來發現的胜肽荷爾蒙-鐵調素(hepcidin),被認為是調控鐵代謝和慢性發炎性貧血的主要角色,但是在懷孕期貧血扮演的角色還未被證實。本研究的主要目的是描述hepcidin與懷孕期貧血的關聯性。我們執行一個橫斷性研究,對149位孟加拉鄉村的懷孕婦女做家訪,並獲得生物檢體,檢測尿中hepcidin和鐵狀態指標、血紅素、紅血球生成素、alpha-1酸性糖蛋白(AGP)及C反應蛋白質之間的相關性。尿中hepcidin使用表面增强激光解析電離飛行時間質譜技術(SELDI-TOF MS)測量。尿中hepcidin濃度(intensity per mmol/L creatinine)轉換成對數值和鐵蛋白對數值有相關(r = 0.33, p <0.001),和運鐵蛋白接受器指標相關(r = -0.22, p = 0.007),和AGP對數值亦相關(r = 0.20, p = 0.01),但是和血紅素(r = 0.07,  p= 0.40)、運鐵蛋白接受器對數值(r = -0.07, p = 0.41)、紅血球生成素對數值(r = -0.01, p = 0.88)或C反應蛋白對數值(r = 0.06, p = 0.48)都沒有相關性。以低鐵儲存量的婦女(n = 41)來增加樣本數後,hepcidin和鐵蛋白於複線性迴歸分析中仍維持強的相關性。在孟加拉鄉村社區研究中的懷孕婦女裡,尿中hepcidin濃度相關於體內鐵狀態和AGP,但是與血紅素、紅血球生成素或C反應蛋白質沒有相關。

關鍵字:貧血、鐵調素、發炎、鐵、懷孕

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Body shape dissatisfaction and obesity among Taiwanese adolescents

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

Purpose: The purpose of this study was to estimate the level of body shape dissatisfaction among a large sample of adolescent boys and girls within different weight categories. Methods: A total sample of 883 adolescents aged 12 to 16 was included from junior high schools in Taipei County, Taiwan. The Contour Drawing Rating Scale was used to assess body shape dissatisfaction. Results: Body shape dissatisfaction is prevalent in Taiwanese adolescents, particularly for girls. This is linked to degree of overweight in both boys and girls but is also prevalent in girls who are not overweight or obese. Girls and boys clearly aspire to thinness but some boys would also prefer to be larger. Conclusions: This study extends our understanding of body shape dissatisfaction and its relationship with weight status in eastern cultures such as Taiwan.

Key Words: Body image, body dissatisfaction, obesity, adolescent, Taiwan

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台灣青少年對體態不滿意及肥胖的程度

目的:本研究的目的為評估在不同等級的體重下,一大樣本數中的青少男和青少女對現況體態不滿的程度。方法:調查對象是來自於台灣台北縣的國中生883位,年齡介於12-16歲之間。利用外型描繪評分尺度(The Contour Drawing Rating Scale)來評估年輕族群對現況體態不滿的程度。結果:台灣年輕族群對現況體態不滿的情況是普遍盛行的,尤其是女生。男生或女生對體態不滿的程度與體重過重的程度固然有相關,但有些女生,雖沒有過重或肥胖的問題,卻仍然對現況體態不滿。男生和女生都明顯地嚮往變瘦,但有一些男生則是希望能變得高大。結論:本研究增加對東方文化(如:台灣)中,體態不滿程度與體重狀況相關性的了解。 關鍵字:身體映象、體態不滿、肥胖、青少年、台灣

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High fish consumption in French Polynesia and prenatal exposure to metals and nutrients

ERIC DEWAILLY, ÉDOUARD SUHAS, YOLANDE MOU, RENEE DALLAIRE, LUDIVINE CHATEAU-DEGAT AND RENE CHANSIN

French Polynesians consume high quantities of fish and are therefore exposed to seafood-related contaminants such as mercury (Hg) or lead (Pb) and nutrients such as iodine, selenium and long chain polyunsaturated fatty acids (LC-PUFAs). As the developing foetus is sensitive to contaminants and nutrients, a cross-sectional study was conducted in French Polynesia in 2005-2006 to assess prenatal exposure to contaminants and nutrients through fish consumption. Two hundred and forty one (241) delivering women originating from all islands of French Polynesia were recruited and agreed to answer questions on fish consumption and gave permission to collect umbilical cord blood for metals and nutrients analyses. All parameters were found in high concentrations in cord blood samples except for lead. Mercury concentrations averaged 64.6 nmol/L (or 13 µg/L) with values ranging from 0.25 to 240 nmol/L. Of the sample, 82.5% had Hg concentrations above the US-EPA blood guideline of 5.8 µg/L. Tuna was the fish species which contributed the most to Hg exposure. High selenium and LC-PUFAs may counterbalance the potential risk of prenatal exposure to Hg in French Polynesia. Due to the high fish consumption of mothers, Polynesian newborns are prenatally exposed to high doses of mercury. Although selenium and omega–3 fatty acids may counteract mercury toxicity, informing pregnant women on both the mercury and nutrient content of local fish species is important.

Key Words: mercury, n–3 fatty acids, iodine, selenium, lead, newborns

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法屬玻里尼西亞魚的高攝取量與胎兒時期的金屬與營養素暴露

法屬玻里尼西亞人攝取高量的魚,因此會暴露到海鮮食物相關的汙染物如汞或鉛,及營養素如碘、硒,及長鏈多元不飽和脂酸。胎兒的發展過程中對於污染物及營養素是敏感的,因此2005-2006年在法屬玻理尼西亞做一個橫斷性的研究,去評估胎兒時期經由魚類攝取而暴露到汙染物及營養素的情形。被納入的241名產婦均來自於法屬玻里尼西亞群島,且同意回答有關於魚類的攝取,並允許收集臍帶血以供金屬與營養素分析。除了鉛以外,所有的參數都被發現在臍帶血中具有高濃度。汞濃度平均為64.6 nmol/L (或13 µg/L),範圍為0.25到240 nmol/L。在這些樣本中,有82.5%血液汞的濃度超過US-EPA所訂的標準值5.8 µg/L。鮪魚是魚類中提供汞暴露最多的。高量的硒及長鏈多元不飽和脂酸可能抵銷在法屬玻里尼西亞胎兒暴露到汞的潛在危險性。由於母親攝取高量的魚,玻里尼亞人的新生兒在胎兒時期即暴露到高劑量的汞。雖然硒及omega–3脂肪酸可能相抵汞的毒性,但是告知懷孕婦女當地魚種汞及營養素兩者的含量是重要的。 關鍵字:汞、n-3脂肪酸、碘、硒、鉛、新生兒

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A comparison of the prevalence of the metabolic syndrome in the United States (US) and Korea in young adults aged 20 to 39 years

JINKYUNG PARK, JASON A MENDOZA, CAROL E O’NEIL, DAVID C HILMERS, YAN LIU AND THERESA A NICKLAS

This study estimated and compared the prevalence of the Metabolic Syndrome and its individual components in young adults (ages 20-39 years) in the US and Korea using 2003-2004 US and 2005 Korean National Health and Nutrition Examination Survey data.  The mean body mass index and rate of metabolic abnormalities in the US were significantly higher than in Korea.  The prevalence of the Metabolic Syndrome in the US was nearly three times higher than in Korea using National Cholesterol Education Program-Adult Treatment Panel III and International Diabetes Federation criteria (21.6% vs. 6.9% and 23.0% vs. 6.9%, p<0.001).  The prevalence of abdominal obesity, hyperglycemia, and hypertriglyceridemia was higher in the US while the prevalence of low high density lipoprotein-cholesterol level was higher in Korea. The rate of hypertension showed no significant difference while mean systolic blood pressure and diastolic blood pressure varied between the two countries.  The proportion of subjects having at least one component of Metabolic Syndrome was similar in both countries; however, multiple abnormalities were more common in the US.  These findings indicate the need for the development of race/ethnic-based norms for components of the Metabolic Syndrome and detailed analysis of the risk factors for the Metabolic Syndrome in the two countries.  National health policies designed to prevent the Metabolic Syndrome, its individual abnormalities, and its complications using population-based characteristics of each nation will generate improved outcomes.

Key Words:  National Health and Nutrition Examination Survey, the US, Korea, National Cholesterol Education Program-Adult Treatment Panel III, International Diabetes Federation, metabolic syndrome

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美國與韓國年輕成人(20-39歲)代謝综合症盛行率之比較

本研究采用2003-2004年美国和2005年韩国健康和营养调查的数据来对年轻成年人(20-39岁)中新陈代谢综合症及其个别成分的流行性作了评估和比较。美国年轻成人的平均身体质量指数和代谢异常盛行率比韩国人显著的高。采用美国胆固醇教育计划-ATPIII和国际糖尿病联盟的标准来衡量,美国人代谢综合症盛行率比韩国人約高三倍(21.6%比6.9%及23.0%比6.9%,p<0.001)。腹部肥胖, 高血糖和高甘油三酯症的盛行率在美国比较高,而低的高密度脂蛋白胆固醇的比例在韩国比较高。高血压盛行率並没有显著的差别,但两国年轻成人的平均血管收缩压和舒张压都有差異。具有至少一个代谢综合症成分的对象的比例在这两个国家是相似的,但是有多重异常性的人在美国更常见。这些发现表明: 有必要开发研究基于种族/族群的代谢综合症的成分的标准,以及详细分析代谢综合症在这两个国家的危险因子。制定以每个国家的人口特征为基础的,用以預防代谢综合症以及个别异常症和并发症的国家健康政策,将产生改善效果。 關鍵字:国家健康和营养调查、美国、韩国、美国胆固醇教育计划-ATPIII、国际糖尿病联盟、新陈代谢综合症

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What’s on Malaysian television? - A survey on food advertising targeting children

TILAKAVATI KARUPAIAH, KARUTHAN CHINNA, LOI HUEI MEE, LIM SIAU MEI AND MPHD ISMAIL NOOR

The Malaysian government recently introduced a ban on fast food advertisements targeting children on television. This study reports on data covering 6 months of television food advertising targeting children. Six out of seven of the Nation’s commercial television networks participated (response rate = 85.7%). Based on reported timings of children’s programmes, prime time significantly differed (p<0.05) between weekdays (mean = 1.89 ± 0.18 hr) and weekends (mean = 4.61 ± 0.33 hr). The increased trend during weekends, school vacation and Ramadhan was evident. Over the six-month period, the mean number of food advertisements appearing per month varied greatly between television stations (C = 1104; D = 643; F = 407; B = 327; A = 59; E = 47). Food advertising also increased the most in September (n = 3158), followed by July (n = 2770), August (n = 2431), October (n = 2291), November (n = 2245) and June (n = 2211). Content analysis of advertisements indicated snacks were the highest (34.5%), followed by dairy products (20.3%), sugars and candies (13.4%), biscuits (11.2%), fast food (6.7%), breakfast cereal (6.4%), beverages (4.1%), supplements (0.9%), rice (0.6%), noodles (0.5%), bread (0.3%), miscellaneous and processed foods (0.2%). Paradoxically, we found that the frequency of snack food advertised during children’s prime time was 5 times more than fast foods. The sodium content (mean = 620 mg per 100g) of these snack foods was found to be highest.

Key Words: television, advertising, children, food groups, content analysis

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马来西亚电视在播放什么? – 针对儿童的食物广告调查

近期马来西亚提出严禁播放针对儿童的速食电视广告。本篇報告是对儿童的食物电视广告所做的长达六个月的调查。马来西亚七间商業电视公司当中,有六间参与此项调查(响应率=85.7%)。据所报导的儿童节目时程表,周日(平均数=1.89±0.18小时)与周末(平均数=4.61±0.33小时)的黄金时段,有显著差异(p<0.05)。在周末、学校假期及斋戒月的黄金时段明顯增加。这六个月内,该七间电视台每月所播放的食物广告平均次数各显著不同(C=1104; D=643; F=407; B=327; A=59; E=47)。食物广告也在九月份达到最高播放率(n=3158),接着是七月份(n=2770),八月份(n=2431),十月份(n=2291),十一月份(n=2245)及六月份(n=2211)。广告内容分析显示零食占最高比率(34.5%),接着是乳制品(20.3%),糖果(13.4%),饼干(11.2%),速食(6.7%),早餐谷粮(6.4%),饮料(4.1%),保健食品(0.9%),米(0.6%),麵(0.5%),麵包(0.3%),及其他加工食品(0.2%)。矛盾地,我们发现在儿童节目的黄金时段所播放的零食广告是多达速食广告的5倍。这些零食含有最高的盐含量(平均数=每100克含有620毫克)。 关键词: 电视,广告,儿童,食物种类,内容分析

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Association between obesity and medical care expenditure among Taiwanese adults

HSIAO-YUN HU, YIING-JENQ CHOU, PESUS CHOU, CHENG-HUA LEE, MIAW-CHWEN LEE AND NICOLE HUANG

The aim of this study is to evaluate the relationships between obesity and medical care expenditure among Taiwanese adults and to assess the influence of sex, age and socioeconomic status. Our study sample consisted of 12,250 adults aged 18 years or older from the 2001 National Health Interview Survey (NHIS), who had consented to the linking of their survey responses with their NHI claims records. Obesity was defined by Body Mass Index based on the WHO-Asia Pacific categories. Adjusted expenditure for obese class II and class I men were, respectively, 44.6% (95%CI: 27.1%-68.7%) and 39.5% (95%CI: 39.4%-41.2%) greater than normal weight men. For obese class II and class I women, the adjusted expenditure were, respectively, 93.3% (95%CI: 69.9%-114.6%) and 56.1% (95%CI: 50.4%-61.4%) greater than normal weight women. After adjusting for other factors, higher medical care expenditure was associated with a higher BMI for each age group. The relative magnitude of the association became more apparent as age increased. Annual medical care expenditure increased as the BMI increased among women, which was particularly apparent among low socioeconomic status women. On the other hand, the relationship between BMI and medical care expenditure in men varied by household income. In conclusion, there is a strong positive relationship between higher BMI and increased medical care expenditure and this varies according to sex, age and socioeconomic status. Our findings suggest that projections of future health care costs attributable to obesity will need to take into consideration the demographic make-up of the obese population.

Key Words: obesity, body mass index, medical care expenditure, socioeconomic status, Taiwan

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臺灣成人肥胖與醫療費用之關係

本研究之目的為評估臺灣成人肥胖與醫療費用之關係,並進一步分析性別、年齡及社經地位之影響。研究樣本為2001年國民健康訪問調查中有簽署同意連結健保資料庫之18歲以上受訪者,共計12250人。依據亞太地區身體質量指數作為肥胖定義。研究顯示二級肥胖與一級肥胖的男性相對於正常男性分別高出44.6% (95%CI: 27.1%-68.7%) 及 39.5% (95%CI: 39.4%-41.2%)的醫療費用。而二級肥胖與一級肥胖的女性分別比正常女性高出93.3% (95%CI: 69.9%-114.6%)及56.1% (95%CI: 50.4%-61.4%)的醫療費用。在控制相關因素後,每個年齡層皆呈現BMI越高醫療費用越高,且年齡層越高越明顯。在不同的社經地位也顯示隨著BMI增加醫療費用皆逐漸增加,此現象在低社經地位的女性特別明顯,但卻沒有出現於低收入的男性。整體而言BMI與醫療費用有顯著正相關,且隨著性別、年齡及社經地位有明顯之變化。建議未來擬定肥胖相關醫療費用策略時應進一步考慮相關人口學因素。 關鍵字:肥胖、身體質量指數、醫療費用、社經地位、臺灣

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Coexistence of anaemia and the metabolic syndrome in adults in Jiangsu, China

ZUMIN SHI, XIAOSHU HU, BAOJUN YUAN, GANG HU, XIAOQUN PAN AND GERD HOLMBOE-OTTESEN

Objective: To determine the prevalence of anaemia and the metabolic syndrome with special interest in the coexistence of these two problems as well as the possible links. Research design and method: In a cross-sectional household survey, 1294 men and 1522 women aged 20 years and above were interviewed; anthropometric measurements and blood samples were taken. Metabolic syndrome was defined according to IDF 2005 standard. Anaemia was defined as haemoglobin level below 13 g/dL for men and 12 g/dL for women. Results: The age-adjusted prevalence of metabolic syndrome was 11.2% and of anaemia 24.4%. About 3 percent of the participants had both anaemia and metabolic syndrome. Women had a higher prevalence of both the metabolic syndrome and anaemia than men (14.0 vs 8.4%, 31.5% vs 16.1%). Anaemia coexisted significantly with all the individual components of the metabolic syndrome. Only 7.0% of the sample had anaemia without any individual component of metabolic syndrome. In women, the prevalence of combined anaemia and metabolic syndrome peaked in the age group 50-59 years (9.9%). Women in the highest quartile of serum ferritin had a higher risk of only the metabolic syndrome and coexistence of anaemia and metabolic syndrome. Conclusion: The high prevalence of the metabolic syndrome and anaemia in the area show the urgent need to develop comprehensive strategies aimed at prevention and treatment. In women this coexistence may be related to inflammation but further research is needed.

Key Words: Anaemia, metabolic syndrome, ferritin, adults, China

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贫血和代谢综合征在江苏成人中并存

目的: 描述贫血和代谢综合征的患病率,重点关注这两者在同一个体中的共存及可能的联系。研究设计和方法: 在一横断面的家戶調查中,共計訪視1294名成年(20岁及以上)男性和1522名成年女性,並进行体格测量和血液检测。代谢综合征采用IDF2005标准,贫血定义为血红蛋白在男性低於13 g/dL,女性低於12 g/dL。结果: 年龄调整的代谢综合征和贫血盛行率分别为11.2%和24.4%。约3%的被调查对象同时有贫血和代谢综合征。女性代谢综合征和贫血患病率均高于男性(14.0%比8.4%及31.5%比16.1%)。贫血与代谢综合征的各成分都共存,僅有7.0%的对象只患贫血而没有代谢综合征的任何一个成分。在女性50-59岁年龄组,贫血与代谢综合征共存的比例最高(9.9%)。血清铁蛋白水平高(第四等份)的女性,單患代谢综合征或贫血与代谢综合征共存的風險較高。结论: 该地区贫血和代谢综合征的患病率很高,需儘速發展有效政策以进行預防与治療。在女性,这种共存现象可能与炎症有关,但需要进一步研究。 關鍵字:貧血、代謝症候群、血清鐵蛋白、成人、中國

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An integrated intervention program to control diabetes in overweight Chinese women and men with type 2 diabetes

JIANQIN SUN, YANFANG WANG, XIAFEI CHEN, YANQIU CHEN, YING FENG, XINYI ZHANG, YIRU-PAN, TING HU, JIANHUA XU, LUYUAN DU, WEI ZHOU, HUIPING ZHAO, ROSEMARY E RILEY AND VIKKIE A MUSTAD

This study evaluated a structured and integrated intervention program on diabetes management in individuals with type 2 diabetes in Shanghai, China. Men and women with type 2 diabetes and body mass index > 23 kg/m2 were randomized into a 24-week, prospective, randomized clinical trial. The Reference Group (n=50) received diabetes education including diet and physical activity instruction only; the Intervention Group (n=100) received more intensive intervention, including diabetes education with frequent blood glucose monitoring, nutritional counseling, meal plans with diabetes-specific nutritional meal replacement, and weekly progress updates with study staff. Major study assessments were obtained at baseline, and after 12 and/or 24 weeks of intervention. The Intervention Group improved fasting blood glucose, insulin, systolic and diastolic blood pressures compared to Reference Group (p<0.05). Importantly, HbA1c was lower (p<0.001) in the Intervention Group at 12 weeks (-0.6 ± 0.1%) and 24 weeks (-0.8 ± 0.1%). Weight loss was modest, but significant differences were observed between groups (p<0.05). Weight change from baseline after 12 and 24 weeks was -2.8 ± 0.2% and -3.7 ± 0.3%, respectively, in the Intervention Group vs -1.8 ± 0.4% and -2.5 ± 0.4% in the Reference Group. Additionally, waist and hip circumferences and waist:hip ratio decreased in the Intervention compared to the Reference Group (p<0.05). In conclusion, this study demonstrates that Chinese men and women with type 2 diabetes following an integrated intervention program including diabetes education, frequent blood glucose monitoring and daily use of a diabetes-specific meal replacement, can achieve significant improvements in glycemic control and markers of cardiovascular health.

Key Words:  Type 2  diabetes, Diet therapy, Formulated food, Glycosylated hemoglobin, Metabolic syndrome X

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中国男性和女性超重2型糖尿病控制综合干预研究

本研究是针对中国上海地区2型糖尿病患者进行的结构化综合干预。对体质指数(BMI)≥ 23 kg/m2的男性和女性2型糖尿病患者进行为期24周的前瞻性随机临床试验,对照组(n=50)仅接受包括饮食和运动指导在内的普通糖尿病教育,干预组(n=100)则接受更多的干预措施,包括糖尿病教育、营养咨询、经常性血糖监测、糖尿病专用的膳食替代食物,以及研究人员每周与其进行面对面的个体化饮食指导与随访。主要的研究资料在基线、12周和/或24周收集完成。与对照组相比,干预组的空腹血糖、收缩压和舒张压得到明显改善(p<0.05)。尤其重要的是,干预组的糖化血红蛋白(HbA1c)水平在第12周(-0.6±0.1%)和第24周(-0.8±0.1%)明显下降,p<0.001。体重有轻度下降,干预组体重变化在12周和24周后(-2.8±0.2% ,-3.7±0.3%)与对照组体重均值的变化(-1.8±0.4%,-2.5± 0.4%)相比,差异有显著性p<0.05。此外,与对照组相比,干预组的腰围和腰臀比明显下降(p<0.05)。结论:本研究表明,对中国男性和女性2型糖尿病患者进行综合干预,包括饮食指导、糖尿病教育、经常性的血糖监测以及每日使用糖尿病专用配方作为膳食替代食物,可以达到显著改善血糖控制和心血管健康的作用。 关键词: 2型糖尿病,饮食治疗,糖尿病专用配方食物,糖化血红蛋白,代谢综合症

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Intraoperative infusion of acetated Ringer solution containing glucose and ionized magnesium reduces ketogenesis and maintains serum magnesium

TAKESHI YOKOYAMA, KUNIO SUWA, FUMIYASU YAMASAKI, REIKI YOKOYAMA, KOICHI YAMASHITA AND EVA SELLDEN

The effect of glucose infusion during surgery on glucose metabolism has not been investigated sufficiently. We, therefore, examined the effect after the infusion of 1% glucose acetated Ringer solution containing Mg2+ during surgery on ketogenesis and serum Mg2+ concentrations. Patients, classified as ASA I-II, age 51-80 years, were randomly assigned to receive infusion of acetated Ringer solution. The G/Mg group received infusion with 1% glucose, Na+ 140mEq/L, Mg2+ 2 mEq/L, and the C group received infusion with glucose free solution containing Na+ 130 mEq/L without Mg2+. Both solutions were infused at a rate of 25 mL/kg for the first hour, and maintained at 4 mL/kg/hr thereafter. Blood samples were collected three times: before infusion and at 1 hour and 4 hours after the start of infusion. Electrolytes and glucose metabolism were evaluated at each sampling. After rapid infusion, blood glucose level significantly increased to 170±19mg/dL in the G/Mg group, but it returned to close to baseline after 4 hours and serum ketone bodies did not increase during infusion. In the C group, however, blood glucose never increased beyond 110 mg/dL, but both acetoacetic and hydroxybutyric acids increased significantly at the third measurement.

Key Words: perioperative infusion, glucose metabolism, ketogenesis, insulin, magnesium

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手術期間灌輸含葡萄糖及游離鎂的醋酸格林溶液降低生酮作用及維持血清鎂

手術期間葡萄糖灌輸對葡萄糖代謝的影響並未透徹研究。本研究檢測手術期間灌輸含1%葡萄糖及游離鎂的醋酸格林溶液對生酮作用及血清鎂濃度的影響。歸類為ASA I-II的病人(年齡51-80歲)隨機分組接受醋酸格林溶液灌輸。G/Mg組接受含1%葡萄糖、140 meq/L鈉離子及2 meq/L鎂離子,C組接受130 meq/L鈉離子但不含葡萄糖及鎂的溶液。兩種溶液在第一小時都是以25 mL/Kg速度灌注,隨後維持每小時4 mL/Kg。收集3次血液樣本:灌注前、灌注開始1小時及4小時各一次。分析每個樣本的電解質及葡萄糖代謝。快速灌注後,G/Mg組病人的血糖值顯著上升至170±19 mg/dL,但4小時後即回到基礎值,而血清酮體並未增加。反之,C組病人的血糖值從未超過110 mg/dL,但在第3測量點的酮酸-乙醯乙酸及氫氧化丁酸濃度都顯著升高。 關鍵字:手術間灌輸、葡萄糖代謝、酮酸中毒、胰島素、鎂

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Symposium on Understanding and Influencing Consumer Food Behaviours for Health: Executive

Summary Report

MA SOFIA V AMARRAL, YEONG BOON YEE AND ADAM DREWNOWSKI

Food consumption patterns in Asia are rapidly changing. Urbanization and changing lifestyles have diminished the consumption of traditional meals based on cereals, vegetables and root crops. These changes are accompanied by an increasing prevalence of chronic diseases among Asian populations. ILSI Southeast Asia and CSIRO, Australia jointly organized the Symposium on Understanding and Influencing Food Behaviours for Health, focusing on the use of consumer science to improve food behaviour. The goals of the Symposium were to present an understanding of Asian consumers and their food choices, examine the use of consumer research to modify food choices towards better health, illustrate how health programs and food regulations can be utilized effectively to promote healthier choices, and identify knowledge gaps regarding the promotion of healthy food behaviour in Asian populations. There is no difference in taste perception among Asians, and Asian preference for certain tastes is determined by exposure and familiarity largely dictated by culture and its underlying values and beliefs. Cross-cultural validity of consumer science theories and tools derived from western populations need to be tested in Asia. Information on consumption levels and substitution behaviours for foods and food products, obtained using consumer research methods, can guide the development of food regulations and programs that will enable individuals to make healthier choices. Existing knowledge gaps include consumer research techniques appropriate for use in Asian settings, diet-health relationships from consumption of traditional Asian diets, and methods to address the increasing prevalence of over- and undernutrition within the same households in Asia.

Key Words: consumers, Asia, food consumption, consumer behavior, food choice

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座談會綜論:了解及影響消費者食物行為與健康

亞洲的食物消費型態正快速的改變。都市化以及生活形態的改變減少了以穀類、蔬菜、及塊根類為主之傳統餐食的攝取。這些改變也伴隨著亞洲人口慢性病盛行率的增加。國際生命科學學會東南亞分會(ILSI Southeast Asia)及澳洲聯邦科學暨工業研究所(CSIRO)共同組織了一個座談會:為健康對於食物行為的瞭解及影響,重點放在利用消費者科學來改善食物行為。座談會的目標是要瞭解亞洲消費者及他們的食物選擇,檢測利用消費者研究使他們的食物選擇朝向更健康方向修改,闡明健康計劃及食物管理如何被有效利用來促進較健康的食物選擇,並且找出關於促進亞洲人健康食物行為的知識缺口。在亞洲人中對於味道的感覺並沒有差異,而且亞洲人對於某些味道的偏愛可能是因為文化及其潛在價值和信念的暴露與熟悉所造成的。從西方人口衍生出來的消費者科學原理及工具需在亞洲經過文化交叉的效度測試。利用消費者研究方法得到的訊息,包括消費程度及食物與食物產品的取代行為,可以引導食物管理及計劃的發展,以促使個人有較健康的食物選擇。現存的知識缺口包括適合用在亞洲環境中的消費者研究技巧、傳統的亞洲飲食中食物與健康的關係、以及有什麼方法可以對付在亞洲人家中同時出現的上升的營養過剩及營養不良的盛行率。 關鍵字:消費者、亞洲、食物消費、消費者行為、食物選擇

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The 2nd International Conference on East-West Perspectives on Functional Foods: Science, Innovations and Claims

RODOLFO F FLORENRINO

The 2nd International Conference on East-West Perspective on Functional Foods held in Kuala Lumpur, Malaysia, on November, 2007, discussed the current work on some traditional Asian foods and new technologies that offer both challenges and opportunities for functional foods. The highlight of the conference was on the current regulatory status of nutrition and health claims related to functional foods and the experiences in some countries on the substantiation of claims. Attention was also given to strategies for effective communication of functional foods to consumers. The conference concluded with recommendations to strengthen R&D efforts and harmonization of protocols and methodologies on functional foods within the region.

Key Words: Functional foods, nutrition and health claims

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第二屆國際大會討論功能性食品的東西方觀點:科學、創新及宣稱

在2007年11月於馬來西亞吉隆坡所舉行的功能性食品的東西方觀點之第二屆國際會議,討論一些對傳統亞洲食物的現行研究及新的技術,對功能性食品提供了挑戰以及機會。會議的重點是現行有關功能性食品營養及健康宣稱的管理狀況,以及交換一些國家將這些宣稱實證化上的經驗。並且也將一些重點放在如何有效傳達功能性食品給消費者的策略上。大會結論是建議應加強功能性食品的研究與發展以及整合在區域內功能性食品的規範與方法。

關鍵字:功能性食品、營養與健康宣稱

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Last Updated: September 2008