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1 Asia Pacific Journal of Clinical Nutrition
       Volume 17, 4

         (December 2008)


Abstracts

Contents

Abstract Papers

Review

Alcohol consumption and risk of type 2 diabetes mellitus in Japanese: a systematic review
NOBUKO SEIKE, MITSUHIKO NODA AND TAKASHI KADOWAKI
Asia Pac J Clin Nutr. 2008;17(4):545-551.

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Original Research Communications

Macro-Micro and Phyto-nutrients

Effect of omega 3 and omega 6 fatty acid intakes from diet and supplements on plasma fatty acid levels in the first 3 years of life
CAMILLA HOYOS, CATARINA ALMQVIST, FRANCES GARDEN, WEI XUAN, WENDY ODDY, GUY B MARKS AND KAREN L WEBB
Asia Pac J Clin Nutr. 2008;17(4):552-557.

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Dietary sources of aldose reductase inhibitors: prospects for alleviating diabetic complications
MEGHA SARASWAT, P MUTHENNA, P SURYANARAYANA, J MARK PETRASH AND G BHANUPRAKASH REDDY
Asia Pac J Clin Nutr. 2008;17(4):558-565.

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Nutritional Status, Dietary Intakes, and Body Composition

Nutrient adequacy and food group consumption of Filipino novices and religious sisters over a nine month period
JESSICA A GRIEGER, JERE D HAAS, LAURA E MURRAY-KOLB, PENNY KRIS-ETHERTON AND JOHN L BEARD
Asia Pac J Clin Nutr. 2008;17(4):566-572.

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Comparison of clinical body composition methods in people taking weight-inducing atypical antipsychotic medications
JENNY-KAY SHARPE, NUALA M BYRNE, TERRY J STEDMAN AND ANDREW P HILLS
Asia Pac J Clin Nutr. 2008;17(4):573-579.

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Chronic energy deficiency and its association with dietary factors in Adults of drought affected desert areas of Western Rajasthan, India
MADHU B SINGH, J LAKSHMINARAYANA AND RANJANA FOTEDAR
Asia Pac J Clin Nutr. 2008;17(4):580-585.

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Body composition: validity of segmental bioelectrical impedance analysis
JOE LAFORGIA, SIMON M GUNN AND ROBERT T WITHERS
Asia Pac J Clin Nutr. 2008;17(4):586-591.

 

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Growth and Child Nutrition

Prevalence of overweight and obesity amongst school children in Delhi, India
SUPREET KAUR, SN DWIVEDI, R LAKSHMY AND UMESH KAPIL
Asia Pac J Clin Nutr. 2008;17(4):592-596.

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Parental perception of their children’s weight status, and its association with their nutrition and obesity knowledge
NOOR AZIMAH MUHAMMAD, KHAIRANI OMAR, SHAMSUL AZHAR SHAH, LEELAVATHI A/P MUTHUPALANIAPPEN AND FATIMAH ARSHAD
Asia Pac J Clin Nutr. 2008;17(4):597-602.

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Regional clustering of anthropometric dimensions of primary school children in rural and suburban Vietnam
ANTOON VAN LIEROP, NGUYEN V NAM, COLLEEN DOAK, LE Q HUNG, TRAN Q BINH, JOOST HOEKSTRA AND PETER J DE VRIES
Asia Pac J Clin Nutr. 2008;17(4):603-607.

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Efficacy of modified WHO feeding protocol for management of severe malnutrition in children: a pilot study from a teaching hospital in New Delhi, India
ANKIT PARAKH, ANAND PRAKASH DUBEY, NAVEEN GAHLOT AND K RAJESHWAR
Asia Pac J Clin Nutr. 2008;17(4):608-611.

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Maternal and Women's Nutrition

 

Relationship between dietary fat and fish intake and the prevalence of atopic eczema in pregnant Japanese females: baseline data from the Osaka Maternal and Child Health Study
YOSHIHIRO MIYAKE, SATOSHI SASAKI, KEIKO TANAKA, YUKIHIRO OHYA, ICHIRO MATSUNAGA, TOSHIAKI YOSHIDA, YOSHIO HIROTA AND HAJIME ODA
Asia Pac J Clin Nutr. 2008;17(4):612-619.

 

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Nutritional Epidemiology and Public Health

Iodine deficiency disorders in Bangladesh, 2004-05: ten years of iodized salt intervention brings remarkable achievement in lowering goitre and iodine deficiency among children and women
HARUN KM YUSUF, AKM MUSTAFIZUR RAHMAN, FATIMA PARVEEN CHOWDHURY, M MOHIDUZZAMAN, CADI PARVIN BANU, M ARIF SATTAR AND M NURUL ISLAM
Asia Pac J Clin Nutr. 2008;17(4):620-628.

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Validation and reproducibility of a food frequency questionnaire designed for residents in northern China
XIAOQIN WANG, RINA SA, HONG YAN
Asia Pac J Clin Nutr. 2008;17(4):629-634.

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Consumption of guava (Psidium guajava L) and noni (Morinda citrifolia L) may protect betel quid-chewing Papua New Guineans against diabetes
PATRICK L OWEN, LOUIS C MARTINEAU, DAYNA CAVES, PIERRE S HADDAD, TEATULOHI MATAINAHO AND TIMOTHY JOHNS
Asia Pac J Clin Nutr. 2008;17(4):635-643.

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Nutritionally-Related Disorders and Diseases and Their Risk Factors

Stomach cancer in 67 Chinese counties: evidence of interaction between salt consumption and helicobacter pylori infection
XIAOQIN WANG, PAUL TERRY AND HONG YAN
Asia Pac J Clin Nutr. 2008;17(4):644-650.

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The association of plasma C-reactive protein levels with anthropometric and lipid parameters in elderly Taiwanese
HSIN-JEN TSAI AND ALAN CHUNG-HONG TSAI
Asia Pac J Clin Nutr. 2008;17(4):651-656.

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Delayed effects of coffee, tea and sucrose on postprandial glycemia in lean, young, healthy adults
JIMMY CHUN YU LOUIE, FIONA ATKINSON, PETER PETOCZ AND JENNIE C BRAND-MILLER
Asia Pac J Clin Nutr. 2008;17(4):657-662.

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Natto and viscous vegetables in a Japanese style meal suppress postprandial glucose and insulin responses
AKIKO TANIGUCHI, HISAMI YAMANAKA-OKUMURA, YUKA NISHIDA, HIRONORI YAMAMOTO, YUTAKA TAKETANI AND EIJI TAKEDA
Asia Pac J Clin Nutr. 2008;17(4):663-668.

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Clinical Nutrition Trials or Feeding Studies

Clinical experience with a relatively low carbohydrate, calorie-restricted diet improves insulin sensitivity and associated metabolic abnormalities in overweight, insulin resistant South Asian Indian women
ANDREA C BACKES, FAHIM ABBASI, CINDY LAMENDOLA, TRACEY L MCLAUGHLIN, GERALD REAVEN AND LATHA P PALANIAPPAN
Asia Pac J Clin Nutr. 2008;17(4):669-671.

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Special Report

Nutrition Leadership Training in North-East Asia: an IUNS initiative in conjunction with nutrition societies in the region
MARK L WAHLQVIST, DUO LI, JIANG-QIN SUN, KEYOU GE, HEE-YOUNG PAIK, SUNG HEE CHO, SOO-KYUNG LEE, CHING-JANG HUANG AND MEEI-SHYUAN LEE
Asia Pac J Clin Nutr. 2008;17(4):672-682.

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Future Events

Asia Pac J Clin Nutr. 2008;17(4):683

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Alcohol consumption and risk of type 2 diabetes mellitus in Japanese: a systematic review
NOBUKO SEIKE, MITSUHIKO NODA AND TAKASHI KADOWAKI

Objective: To evaluate the association between alcohol consumption and the risk for type 2 diabetes (DM) in Japanese. Methods: We searched the MEDLINE data base with the key words ‘alcohol intake’ (or ‘alcohol consumption’) and ‘Japanese’ cross-linked with ‘diabetes mellitus’ (or ‘impaired glucose tolerance’). The reports we sought were restricted to prospective cohort studies, randomized controlled trials, meta-analyses and systematic reviews. Computerized and hand searches were conducted in June 2007. Results: Seven prospective cohort studies were adopted. We previously reported that in lean Japanese men (BMI ≤22.0 kg/m2), moderate to heavy alcohol intake is a risk factor for diabetes. One study found heavy alcohol intake to be associated with an increased risk in low-BMI men while moderate alcohol intake was associated with a reduced risk in higher-BMI men. Another study suggested daily alcohol consumption to be a risk factor in low-BMI participants, while being protective in middle-BMI participants. Yet another study demonstrated a U-shaped association between alcohol consumption and the risk of diabetes in men. Three other studies, which did not divide the subjects in terms of BMI values, indicated alcohol intake to be an increased risk for diabetes, two being in men and one being in women, respectively. Conclusion: For a large number of Japanese men who have relatively low BMI, alcohol intake is an established risk factor for diabetes.

Key Words: diabetes mellitus, alcohol, Japanese, body mass index

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日本人酒精消耗量与2型糖尿病之风险关系:系统综述

目的:评价日本人群中酒精消耗量与2型糖尿病(DM)发病风险之间的关系。方法:我们利用关键词‘alcohol intake’(或者‘alcohol consumption’) 和‘Japanese’交叉结合‘diabetes mellitus’(或者‘impaired glucose tolerance’)在MEDLINE数据库中进行了检索。我们查询的文献限于前瞻性群组研究、随机对照试验、荟萃分析以及系统综述。计算机检索与手工检索在2007年6月实施。结果:采用了7项前瞻性群组研究的結果。我们以前的报告曾指出在体瘦的日本男性人群(身体质量指数(BMI)≤22.0 kg/m2)中,中度至重度酒精摄入是糖尿病的一项危险因素。有一项研究发现在低BMI男性中,重度酒精摄入增加了糖尿病风险;而在高BMI男性中,中度酒精摄入却减少了糖尿病风险。另一篇报告提示日常的酒精消费量对于低BMI者是一项危险因素,但是对于中等BMI者却有保护作用。然而,另一个研究顯示在日本男性中,酒精消费量与糖尿病风险呈U-型关系。在另外3项未按照BMI值区分试验对象的研究中,都指出酒精摄取会增高糖尿病的发病风险,其中两项研究的对象为男性,另一项研究針对女性。结论:对于BMI较低的多数日本男性而言,酒精摄入是糖尿病的一项已確認的危险因子。 關鍵字:糖尿病、酒精、日本人、身体質量指数

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Effect of omega 3 and omega 6 fatty acid intakes from diet and supplements on plasma fatty acid levels in the first 3 years of life
CAMILLA HOYOS, CATARINA ALMQVIST, FRANCES GARDEN, WEI XUAN, WENDY ODDY, GUY B MARKS AND KAREN L WEBB

Background: The optimal method for conducting omega (n–)3 polyunsaturated fatty acid (PUFA) supplementation trials in children is unknown. Aim: To assess the impact of n–3 and n–6 PUFA intake from the background diet on plasma levels of n–3 and n–6 PUFA in children aged 0-3 years, with and without n–3 supplementation. Methods: Subjects were randomised antenatally to receive either n–3 PUFA supplements and low n–6 PUFA cooking oils and spreads or a control intervention, designed to maintain usual fatty acid intake. Dietary intake was assessed at 18 months by 3–day weighed food record and at 3 years by food frequency questionnaire. Plasma phospholipids were measured at both time points. Associations were tested by regression. Results: N–3 PUFA intake from background diet did not significantly affect plasma n–3 levels. In contrast, n–6 PUFA intake in background diet was positively related to plasma n–6 levels in both study groups. In addition, n–6 PUFA intake from diet was negatively associated with plasma n–3 levels at 18 months and 3 years (–0.16%/g n–6 intake, 95%CI –0.29 to –0.03 and –0.05%/g n–6 intake, 95%CI –0.09 to –0.01, respectively) in the active group, but not in the control group. Conclusion: Interventions intending to increase plasma n–3 PUFA in children by n–3 supplementation should also minimise n–6 PUFA intake in the background diet.

Key Words: omega–3 fatty acids, omega–6 fatty acids, dietary supplements, plasma, dietary intake

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從飲食及補充品中攝取n–3及n–6脂肪酸對出生3年內血漿脂酸含量的影響

背景:對年幼兒童,如何實施n–3多元不飽和脂酸補充試驗是最合適的,仍然未知。目的:評估0–3歲兒童從飲食攝取n–3及n–6多元不飽和脂酸,及有無補充n–3脂肪酸,對血漿中n–3及n–6多元不飽和脂酸含量的影響。方法:研究對象在出生前被隨機分派到n–3多元不飽和脂酸補充和低n–6烹調油及抹油組或介入控制組(維持一般的脂肪酸攝取)中。在研究對象18個月大及3歲時,分別利用三天飲食秤重記錄法及飲食頻率問卷來評估飲食攝取。並在這兩個時間點分析血漿磷脂質,利用迴歸法來測試相關性。結果:從飲食攝取的n–3多元不飽和脂酸並不會顯著影響血漿n–3脂酸的含量。相反地,兩組幼童從飲食攝取的n–6多元不飽和脂酸與血漿n–6脂酸的比率有顯著的正相關。此外,在實驗組中從飲食攝取的n–6多元不飽和脂酸與18個月大及3歲時的血漿n–3脂酸比率之間呈現負相關(分別是-0.16%/克n–6脂酸,95%CI為-0.29至-0.03以及-0.05%/克n–6脂酸,95%CI為-0.09至-0.01),控制組則無此相關。結論:若想增加兒童血漿中n–3多元不飽和脂酸而介入n–3脂酸補充,應同時使飲食攝取的n–6多元不飽和脂酸降低。

關鍵字:n–3脂肪酸、n–6脂肪酸、膳食補充、血漿、膳食攝取

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Dietary sources of aldose reductase inhibitors: prospects for alleviating diabetic complications
MEGHA SARASWAT, P MUTHENNA, P SURYANARAYANA, J MARK PETRASH AND G BHANUPRAKASH REDDY

Activation of polyol pathway due to increased aldose reductase activity is one of the several mechanisms that have been implicated in the development of various secondary complications of diabetes. Though numerous synthetic aldose reductase inhibitors have been tested, these have not been very successful clinically. Therefore, a number of common plant/ natural products used in Indian culinary have been evaluated for their aldose reductase inhibitory potential in the present study. The aqueous extracts of 22 plant-derived materials were prepared and evaluated for the inhibitory property against rat lens and human recombinant aldose reductase. Specificity of these extracts towards aldose reductase was established by testing their ability to inhibit a closely related enzyme viz, aldehyde reductase. The ex vivo incubation of erythrocytes in high glucose containing medium was used to underscore the significance in terms of prevention of intracellular sorbitol accumulation. Among the 22 dietary sources tested, 10 showed considerable inhibitory potential against both rat lens and human recombinant aldose reductase. Prominent inhibitory property was found in spinach, cumin, fennel, lemon, basil and black pepper with an approximate IC50 of 0.2 mg/mL with an excellent selectivity towards aldose reductase. As against this, 10 to 20 times higher concentrations were required for 50% inhibition of aldehyde reductase. Reduction in the accumulation of intracellular sorbitol by the dietary extracts further substantiated their in vivo efficacy. The findings reported here indicate the scope of adapting life-style modifications in the form of inclusion of certain common sources in the diet for the management of diabetic complications.

Key Words: aldose reductase, aldehyde reductase, sorbitol, dietary inhibitors, red blood cells

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來自飲食的醛醣還原酶抑制劑:減緩糖尿病併發症的展望

當醛醣還原酶活性上升會活化多元醇代謝路徑,這可能是糖尿病多種併發症發展相關的機制之ㄧ。多種人工醛醣還原酶抑制劑已經被測試過,但是並沒有很成功的通過臨床測試。因此本研究評估在印度料理普遍使用的幾種植物/天然產物的醛醣還原酶抑制劑之潛在性。準備22種植物性材料的水溶性萃取物,並評估它們對抗老鼠水晶體及人類重組醛醣還原酶之抑制效能。專一性評估是藉由測試這些萃取物對很近似的的醛類還原酶的抑制能力來比較。在活體外試驗中培養紅血球於高葡萄糖含量基質中被用來顯示防止細胞內山梨醇堆積的效能。在22種被測試的食物材料中,有10種對於老鼠的水晶體及人體重組醛醣還原酶具有潛在的抑制作用。在波菜、小茴香、茴香、檸檬、羅勒及黑胡椒,發現顯著的抑制能力,IC50約為0.2 mg/mL,且對於醛醣還原酶有良好的選擇性。亦即抑制50%的醛類還原酶需要高出10到20倍的濃度。透過膳食萃取物減少細胞內山梨醇的累積,進一步證實它們在有機體的效用。本篇報告指出納入一些普遍食物的生活型態修飾可能可以管控糖尿病之併發症。

關鍵字:醛醣還原酶、醛類還原酶、山梨醇、膳食抑制劑、紅血球

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Nutrient adequacy and food group consumption of Filipino novices and religious sisters over a nine month period
JESSICA A GRIEGER, JERE D HAAS, LAURA E MURRAY-KOLB, PENNY KRIS-ETHERTON AND JOHN L BEARD

Rice is commonly consumed in the Philippines; however the contribution of other foods to the diet is not well defined. Our aim was to determine the nutrient intake and food group intake of Philippine nuns and compare their intakes to the current estimated average requirements (EAR), and food-based recommendations, respectively, and assess any differences in nutrient adequacy and energy intakes between body mass index (BMI) categories. Body weight was assessed at baseline and at nine months; three-day weighed food intakes were recorded once every fortnight (n=187). At baseline, the mean (SD) age and BMI of the women was: 25.0 (4.6) years and 21.8 (17.3) kg/m, respectively. Over the nine months, women with an underweight (n=46; <18.5 kg/m) and acceptable BMI (n=132; 18.5-25 kg/m) lost 5.0 kg (p=0.005) and 1.5 kg (p=0.047), respectively, whereas overweight women maintained their weight. Irrespective of BMI, 98% of women consumed less than the adequate intake for calcium, and no one met the folate EAR. The intake of all food groups (e.g., rice, vegetables, fruit, meat, dairy) was lower than food-based recommendations.  It is evident that the nutrient density of the Philippine diet is poor. In order to meet nutrient requirements, it is recommended that all women increase intake of fruits, vegetables, fish, meat and dairy products, to reduce risk of micronutrient deficiencies. For the overweight women, these nutrient dense foods also are recommended, however it is important that they be substituted for energy dense foods to promote weight loss and prevent weight gain.

Key Words: diet, micronutrients, food groups, female, Philippines

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探討菲律賓見習修女和修女在九個月期間之營養素適當性和食物群組的攝取

在菲律賓米食是常被攝取的食物,然而其他食物的飲食貢獻並沒有得到很好的界定。本研究目的在探討菲律賓修女的營養素和食物群組攝取量,且將其攝取量分別與目前的平均需要估計量(EAR)、食物指南建議量相互比較。並且評估在不同身體質量指數(BMI)組別之間,營養素適當性和熱量攝取的任何差異。在基準日及9個月後測量體重;每兩星期紀錄一次為期3天的食物攝取量(n=187)。在基準日,這些婦女的年齡和BMI平均值(標準差)分別為:25.0 (4.6)歲和21.8 (17.3) kg/m。在九個月中,體重過輕(n=46;<18.5 kg/m)和BMI正常(n=132;18.5-25 kg/m)的婦女分別減少5.0公斤(p=.005)和1.5公斤(p=.047),反之體重過重的婦女仍維持其體重。不論BMI值為何,98%的婦女攝取的鈣量少於適當攝取量,而且葉酸攝取量也無人達到平均需要估計量(EAR)。所有食物群組(如米、蔬菜、水果、肉類、奶製品)的攝取低於食物指南的建議量。很明顯,菲律賓膳食的營養密度是貧乏的。為了滿足營養需求,建議所有的婦女增加攝取水果、蔬菜、魚類、肉類和奶製品,以減低微量營養素缺乏的風險。對於過重的女性,也建議攝取這些營養素稠密食物,但重要的是,以此取代高熱量的食物,以促進體重減輕和預防體重增加。

關鍵字:飲食、微量營養素、食物群組、女性、菲律賓

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Comparison of clinical body composition methods in people taking weight-inducing atypical antipsychotic medications
JENNY-KAY SHARPE, NUALA M BYRNE, TERRY J STEDMAN AND ANDREW P HILLS

The purpose of this study was to compare the accuracy of clinical methods to estimate body fat (%BF) in people who take weight-inducing atypical antipsychotic medications. Forty-seven people (35 males, 12 females) with previously diagnosed psychotic illness who had been taking atypical antipsychotic medications for more than 6 months took part in this study. Percentage body fat was estimated using bioelectrical impedance analysis (BIA) and anthropometry from previously published prediction equations and compared with that measured using the deuterium dilution technique which served as the criterion measure. Bland-Altman analyses were used to assess the agreement between measures. In the males, %BF determined using BIA with the Lukaski equation was the only clinical method with mean differences that were not significant from criterion values. While in the females, %BF determined from BMI was the only method that was significantly different from the criterion values. All of the methods of estimating %BF except Watson equations provided consistent estimates across the weight range. Therefore, this study suggests that in a group of people who predominantly had schizophrenia and were taking atypical antipsychotic medications, BIA using the equation of Lukaski was the best indicator of %BF, although on an individual basis the accuracy was poor. BMI underestimated %BF to a greater significant extent than BIA. The use of BIA rather than BMI may provide a better indicator of adiposity in people who take weight inducing antipsychotic medications.

Key Words: bioelectric impedance, obesity, deuterium dilution, percentage body fat, atypical antipsychotic medication

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臨床體組成評估方法比較之-服用體重誘增的非典型抗精神病藥物的族群

此研究目的為比較評估服用體重誘增的非典型精神病藥物的人體脂肪率(%BF)的臨床方法之準確度。47名患者(35名男性、12名女性)被診斷有精神疾病並以非典型抗精神病藥物治療超過6個月以上,參與此研究。體脂肪百分比的評估分別以生物電阻法(BIA)及以體位按照已發表的預測方程式計算而得,並與重氫稀釋法的測量結果當作標準值來相比。使用Bland-Altman分析評估測量值之間的一致性。在男性,惟有使用BIA及Lukaski方程式評估的體脂肪率,與標準值的平均差異沒有顯著性。但在女性,僅有採用BMI評估的體脂肪率與標準值有顯著差異性。所有評估體脂肪率的方法,除了Watson方程式外,在體重範圍內都提供一致性的評估。因此,此研究建議有精神分裂及服用非典型抗精神病藥物的族群,使用BIA及Lukaski方程式為體脂肪率的最佳預測指標,雖然應用在個體的準確性不佳。BMI低估體脂肪率的情形顯著地大於BIA的預測。BIA比起BMI可以提供服用體重誘增的非典型抗精神病藥物的人更佳的體脂肪預測值。

關鍵字:生物電阻法、肥胖、重氫稀釋法、體脂肪百分比、非典型抗精神病藥物

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Chronic energy deficiency and its association with dietary factors in Adults of drought affected desert areas of Western Rajasthan, India
MADHU B SINGH, J LAKSHMINARAYANA AND RANJANA FOTEDAR

Objective: To asses the impact of drought on nutritional status of adults of a rural population in desert area.  Design: Three-stage sampling technique.  Setting: 24 villages belonging to 6 tehsils (sub units of district) of Jodhpur district, a drought affected desert district of Western Rajasthan, in 2003.  Subjects: 1540 adults were examined for their anthropometry, dietary intake and nutritional deficiency signs.  Results: Overall chronic energy deficiency (CED) was found high (42.7 %). Severe CED was 10.7 percent, significantly higher in males than females. Regarding vitamin A deficiency, overall prevalence of Bitot spot and night blindness was 1.8 and 0.2 percent respectively, higher in females than males. Regarding vitamin B complex deficiency, angular stomatitis, cheliosis, and glossitis was 1.0, 2.6 and 5.4 percent. Anemia was 35.6 percent. Overall mean calorie and protein intake deficit was very high (38 & 16.4 %). The comparison of present drought results with earlier studies in desert normal and desert drought conditions showed higher deficiencies of calories and proteins in their diet.  Conclusions: Severity of malnutrition is critical as CED was more than the cut-off point of 40 percent stated by World Health Organization. Vitamin A and B complex deficiencies, anemia, protein calorie malnutrition along with deficit in calories and proteins in their diet were higher in comparison to non desert areas, which may be due to the harsh environmental conditions in desert areas. Efforts should be made to incorporate intervention measures to ensure the supply of adequate calories and proteins to all age groups.

Key Words: malnutrition, dietary intake, BMI, drought, anemia

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印度乾旱影響的西部Rajasthan沙漠地區之成年人慢性熱量缺乏及其與膳食因子之相關性

目的:評估乾旱對於沙漠地區之鄉村成年人口營養狀況之影響。設計:三階段抽樣方法。地點:在2003年受乾旱影響的印度西部Rajasthan沙漠區域,屬於Jodhpur區的6分區中的24個村落進行此研究。研究對象:1,540位成年人接受體位測量、膳食評估,及臨床營養缺乏症狀檢測。結果:整體有高比率(42.7%)的慢性熱量缺乏(CED),嚴重CED佔10.7%,男性缺乏比率顯著地高於女性。有關維生素A的缺乏,整體Bitot斑及夜盲症的盛行率分別是1.8及0.2%,且女性高於男性。維生素B群缺乏方面,口角炎、唇炎及舌炎的盛行率分別是1.0、2.6及5.4%。貧血者有35.6%。整體平均熱量及蛋白質攝取缺乏率很高(38及16.4%)。比較目前乾旱的結果與之前研究在沙漠正常及沙漠乾旱的情況比較,顯示在他們的飲食更嚴重的缺乏熱量及蛋白質。結論:由CED比率超過WHO的切點40%來看,此地區的營養不良是非常嚴重而緊急的。比起非沙漠地區,此區人口在維生素A及B群缺乏、貧血、蛋白質熱量營養不良及飲食缺乏熱量及蛋白質的比率較高,可能是因為沙漠地區嚴苛的環境所致。當局應致力介入,以確保供應各年齡層適當的熱量及蛋白質攝取。

關鍵字:營養缺乏、膳食攝取、身體質量指數、乾旱、貧血

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Body composition: validity of segmental bioelectrical impedance analysis
JOE LAFORGIA, SIMON M GUNN AND ROBERT T WITHERS

Bioelectrical impedance analysis (BIA) measures the impedance associated with passage of an alternating current through the body which is proportional to total body water (TBW) and therefore can provide expedient estimates of body composition. However, little validity information is available for commercially available bathroom scale type devices which perform whole body estimates from segmental (lower limb) measurements. This study therefore compared body composition estimates between a commercially available segmental BIA device (Tanita BC-532) and four compartment criterion values. Body composition of nine males and nine females (mean SD: 37.7 18.7 yr; 170.7 5.3 cm; 68.38 9.7 kg) was determined via BIA and a four compartment model incorporating measures of body density, TBW and bone mineral mass. While the mean %BF and fat free mass (FFM) values for both methods were not significantly different, considerable intra-individual differences were observed. BIA values varied from the four compartment values by -3.0 to 4.4 %BF and -3.3 to 1.9 kg FFM. The BIA estimates of TBW were significantly different from the criterion measures and intra-individual differences displayed a large range (-0.6 to 3.6 kg). Significant underestimations of TBW via BIA are concerning given that this is the parameter initially established by this method. Furthermore, the BIA data resulted in a FFM hydration value of 68.5% which was significantly (p<0.001) lower than the four compartment value of 72.0%. In conclusion, the BIA device tested displayed poor individual accuracy for the estimation of body composition compared with a four compartment criterion method.

Key Words: total body water, percent body fat, foot-to-foot BIA, four-compartment body composition model, fat free mass

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體組成:部分生物電阻法的效度

生物電阻法(BIA)是測量交流電通過體內的阻抗,此阻抗與體內含水量成比例,因此可作為簡便的體組成估計。市售的浴室型體組計是利用部分生物電阻法去測量(下肢)而推估個體的體組成,但僅有少數的效度資料。因此本研究是將市售的部分生物電阻法儀器(Tanita BC-532)測量值與四種體組成標準量度值相比較。有9名男性及9名女性(平均值標準差: 37.7 18.7歲; 170.7 5.3公分; 68.38 9.7公斤)的體組成各以部分生物電阻法及四種體組成模式法分別評估,體組成模式概括體密度、體內總水分及骨質密度的參數。用兩種方法評估的整體受試者平均體脂肪率及非脂體重都沒有顯著差異,但個體內的差異頗大。BIA測量值與體組成模式評估值在體脂肪率的相差值為-3.0至4.4%,非脂體重的差異為-3.3至1.9公斤。以BIA評估體內總水分與標準測量值有顯著的差異,個體內差異範圍很大 (-0.6至3.6公斤)。BIA顯著地低估體內總水分值得重視,因為這個參數一開始是用這個方法建立的。再者,在非脂組成水合值的BIA數據結果為68.5%,顯著地低於體組成模式估算的72.0% (p <0.001)。總而言之,部分生物電阻法儀器測量體組成,比起以四種體組成標準方法評估,有較差的個體準確性。

關鍵字:身體總含水量、體脂肪比率、双足生物電阻體組計、四種體組成模式、非脂體重

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Prevalence of overweight and obesity amongst school children in Delhi, India
SUPREET KAUR, SN DWIVEDI, R LAKSHMY AND UMESH KAPIL

Obesity has emerged as an epidemic worldwide. The present study was conducted to assess the prevalence of overweight and obesity amongst children in the age group of 5-18 years belonging to low, middle and high income group in National  Capital Territory  NCT of Delhi. A total of 16,595 children (LIG 5087, MIG 5134 and HIG 6368) were covered in the present study. Overweight and obesity were assessed using Body Mass Index (BMI) and Triceps Skin Fold Thickness (TSFT) utilizing age and sex specific cut off points. Considering the BMI cut off points, the prevalence of obesity and overweight in Low Income Group (LIG) school children was 0.1 and 2.7 percent respectively, amongst Middle Income Group (MIG) school children it was 0.6 and 6.5 percent and in High Income Group (HIG) school children was 6.8 and 15.3 percent respectively (p<0001). With regard to the TSFT criteria, the prevalence of obesity and overweight in LIG school children was 1.2 and 2.4 percent, amongst MIG school children it was 2.5 and 4.9 percent and in children belonging to HIG schools was 9.3 and 13.1 percent respectively (p<0.001). The present study documented that the prevalence of overweight and obesity was higher in the HIG children as compared to the MIG and the LIG for all age groups, highlighting the possible role of change in the dietary pattern and physical activities with increase in income levels.

Key Words: obesity, body mass index, triceps skin fold thickness, school children, socio economic status

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印度德里市學童的過重及肥胖盛行率

在全世界,肥胖已經是一個流行性的問題。本研究要評估印度首都-德里區內分屬低、中、高收入族群的5-18歲兒童,他們的過重及肥胖盛行率。總共有16,595個兒童(低收入組有5087位、中收入組5134位、高收入組6368位)納入本研究中。以年齡及性別作分層,利用BMI及三頭肌皮下脂肪厚度(TSFT)來評估過重及肥胖。根據BMI的切點,在低收入族群的學童肥胖及過重盛行率分別為0.1%及0.7%,中收入族群的學童中,肥胖及過重盛行率分別為0.6%及6.5%。而高收入族群中分別為6.8%及15.3%(p<0.001)。以TSFT為標準,在低收入族群的學童,肥胖及過重的盛行率分別為1.2%及2.4%,中收入族群分別為2.5%及4.9%,高收入族群分別為9.3%及13.1%(p<0.001)。本研究證明在所有年齡層中,與中低收入族群的學童做比較,高收入族群學童過重及肥胖的盛行率是較高的,也顯示隨著收入增加而改變的飲食型態及活動量與此可能有相關。

關鍵字:肥胖、身體質量指數、三頭肌皮脂厚度、學童、社經地位

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Parental perception of their children’s weight status, and its association with their nutrition and obesity knowledge
NOOR AZIMAH MUHAMMAD, KHAIRANI OMAR, SHAMSUL AZHAR SHAH, LEELAVATHI A/P MUTHUPALANIAPPEN AND FATIMAH ARSHAD

Background: Worldwide the prevalence of overweight and obesity in children is escalating. Parents’ recognition of overweight or obesity in their own children is very important for a successful intervention in these children. This study examined parental perception of their children’s weight status, and its association with their knowledge on nutrition and obesity. Materials and Methods: This was a cross sectional study of parents with children aged 9 to 12 years, in a primary school of Kuala Lumpur. Parents responded to a self-administered questionnaire which contains parental perception of their child weight status as well as knowledge on nutrition and obesity. The parents’ perception of the children’s weight status was then compared with the actual measured weight status. Results: There were 204 parents who participated in the study. Parents were found to underestimate their child weight status and 38.2% were inaccurate in their perception. The mean score of knowledge on nutrition and obesity was 78.514.4; and this did not associate with the accuracy of their perception on the child weight status. Parents showed inadequate knowledge in food pyramid and preparation of low fat meals. Conclusion: The Malaysian Health Campaigns had resulted in overall good knowledge on nutrition and obesity in the parents except in few domains. However, this was insufficient to make the parents recognize the growing overweight and obesity problem in their children.

Key Words: overweight, obesity, children, parental perception, knowledge

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家長對於孩子體重狀況之認知與他們的營養及肥胖相關知識之關聯

背景:全球兒童之過重及肥胖盛行率有逐步上升之情況。父母對於自己小孩過重或肥胖的認知,對這些兒童體位成功之干預相當重要。本篇探討家長對孩子體重狀況的認知與他們本身營養及肥胖知識之關聯性。材料與方法:本篇為橫斷性研究,受試者為吉隆坡一間小學中9-12歲兒童及其父母。使用自我管理問卷,讓家長回答對孩子體重情況之認知及營養與肥胖知識。將父母對於孩子體重狀況之認定與兒童實際測量之體重相互比較。結果:共有204位家長參與本研究,普遍低估了孩子的體重情況,其中38.2%有不準確之認定。在營養與肥胖知識平均得分為78.5 14.4,但此與小孩體重狀況認定之準確性並無相關。家長在食物金字塔及低脂膳食製備之知識不足。結論:馬來西亞健康宣導,除了少數領域外,整體而言使家長具有良好之營養與肥胖知識,不過父母對日益增加的兒童過重及肥胖問題之認知仍然不足。

關鍵字:過重、肥胖、兒童、父母認知、知識

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Regional clustering of anthropometric dimensions of primary school children in rural and suburban Vietnam
ANTOON VAN LIEROP, NGUYEN V NAM, COLLEEN DOAK, LE Q HUNG, TRAN Q BINH, JOOST HOEKSTRA AND PETER J DE VRIES

Nutrition transition is one of the driving forces of the upcoming global epidemic of diabetes mellitus and cardiovascular diseases. We hypothesized that in previously deprived rapidly changing regions, the progress of the obesity epidemic is clustered per community and that screening with anthropometric school surveys can detect the negative effects of the nutrition transition in its early stages. In 16 different rural and urban communities in Binh Thuan Province, southern Vietnam, anthropometric surveys were conducted in local primary schools. Anthropometry of 2613 children showed a significant difference of the prevalence of wasting, stunting, and overweight between urban and rural communities. During the transition from high stunting rates to overweight, communities pass through an episode with dual burden of both conditions at different pace. Anthropometry of primary school children can reveal inter-community differences and identify the early stages of the nutrition transition.

Key Words: Anthropometry, Child, Obesity, Body Mass Index, Vietnam

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越南鄉村及郊區的小學學童體位測量結果之區域群集現象

營養變遷是即將來臨的全球性糖尿病及心血管疾病流行的強大因素之ㄧ。我們假設在之前貧困但快速改變的區域,肥胖流行的發展會在每個社區聚集,以學校體位測量調查可以偵測營養變遷在早期之負效應。在越南南部Binh Thuan省的16個不同鄉村及城市社區的當地小學執行體位測量調查。 2613名兒童的體位資料顯示城鄉社區在消瘦、發育遲緩及體重過重情況有顯著差異。從高發育遲緩率轉型到體重過重的期間,社區以不同速度的情形下經歷雙重負擔的事件。小學學童的體位測量可以顯示社區間的差異及確認營養變遷的早期階段。

關鍵字:體位測量、兒童、肥胖、身體質量指數、越南

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Efficacy of modified WHO feeding protocol for management of severe malnutrition in children: a pilot study from a teaching hospital in New Delhi, India
ANKIT PARAKH, ANAND PRAKASH DUBEY, NAVEEN GAHLOT AND K RAJESHWAR

Aim: To assess the efficacy of modified World Health Organization (WHO) feeding protocol for severe malnutrition.  Setting: prospective observational study conducted in the nutritional rehabilitation center of a tertiary care teaching hospital of New Delhi, India over four months period from August to November 2007. Methods: 25 children with severe malnutrition (age 6 months to 5 years) were recruited. All children were treated according to Indian Academy of Pediatrics modified WHO guidelines. Daily weight gain and improvement in the clinical status was assessed. Children were followed up at day 15, day 30 and day 45 after discharge or when a new problem emerged. Results: Weight-for-age z score (WAZ) at admission was   -4.820.96, weight-for-height z score (WHZ) was –5.0 0.7, height-for-age z-score (HAZ) was –2.55 + 1.65. All children had diarrhea on admission, two had pneumonia in addition, and one each had otitis, sepsis and hepatitis in addition to diarrhea. The mean duration of admission was 8.32 + 2.87 days. At discharge the mean WAZ was -4.15 + 0.92 and mean WHZ, -3.91+ 0.61 (p value highly significant). Follow up at day 15, 30 and 45 showed significant improvement in WAZ and WHZ. Conclusions: Following modified WHO guidelines is feasible, efficacious and cost effective in resource-limited settings. Early discharge of patients is possible with no complications or mortality.

Key Words: Severe malnutrition, WHO guidelines, IAP malnutrition guidelines, Child Mortality, Diarrhea

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WHO管理嚴重營養不良的兒童餵食方案修訂版的效力:一個印度新德里教學醫院的先驅研究

目的:評估世界衛生組織(WHO)嚴重營養不良餵食方案修訂版之效力。背景:在印度新德里的一個三級教學醫院的營養復原中心,從2007年8月至11月超過4個月的期間,所執行的前瞻性觀察研究。方法:25名有嚴重營養不良的兒童(年齡為6個月到5歲)被納入研究。所有的兒童依據印度小兒科研究院(IAP)修訂的WHO指南治療,評估每日體重的增加及臨床狀況的改善。追蹤兒童出院後的第15天、30天及40天或是有任何新問題出現時。結果:年齡體重Z分數(WAZ)在住院時為-4.820.96、身高體重Z分數(WHZ)為-5.00.7、年齡身高Z分數(HAZ)為-2.551.65。所有兒童在入院時都有腹瀉的現象,2名另有肺炎,有3名還各有耳炎、敗血症及肝炎。平均住院時間為8.322.87天。在出院時平均WAZ為-4.150.92,WHZ為-3.910.61 (p值為高顯著性)。追蹤的第15天、30天及40天,WAZ及WHZ都有顯著改善。結論:在資源受限的區域,WHO指南修訂版是可行的、有效的及有成本效益的,病患未發生併發症或死亡而可能提早出院。

關鍵字:嚴重營養不良、WHO指南、IAP營養不良指南、兒童死亡率、腹瀉

 

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Relationship between dietary fat and fish intake and the prevalence of atopic eczema in pregnant Japanese females: baseline data from the Osaka Maternal and Child Health Study
YOSHIHIRO MIYAKE, SATOSHI SASAKI, KEIKO TANAKA, YUKIHIRO OHYA, ICHIRO MATSUNAGA, TOSHIAKI YOSHIDA, YOSHIO HIROTA AND HAJIME ODA

Dietary factors may be important in the development of atopic eczema. It remains controversial whether n-3 polyunsaturated fatty acid intake is preventive against allergic disorders and whether n-6 polyunsaturated fatty acid intake increases the risk of allergic disorders. The current cross-sectional study examined the association between intake of fatty acids and foods high in fatty acids and the prevalence of atopic eczema. Study subjects were 1002 pregnant Japanese females. Current atopic eczema and atopic eczema after age 18 were defined as present if subjects had been treated with medications at some time in the previous 12 months and after reaching the age of 18, respectively. Information on dietary factors was collected using a validated self-administered diet history questionnaire. Docosahexaenoic acid intake was statistically significantly related to a decreased prevalence of atopic eczema after age 18 and current atopic eczema. Inverse dose-response relationships with regard to consumption of n-3 polyunsaturated fatty acids, eicosapentaenoic acid, and fish and the ratio of n-3 to n-6 polyunsaturated fatty acids with atopic eczema were not observed although these dietary variables in the second tertile were inversely significantly associated with atopic eczema after age 18. Intake of total fat, saturated fatty acids, monounsaturated fatty acids, n-6 polyunsaturated fatty acids, cholesterol, meat, eggs, or dairy products was not related to either of the outcomes for atopic eczema. Docosahexaenoic acid intake may be associated with a reduced prevalence of atopic eczema in pregnant Japanese females.

Key Words: Atopic eczema, eating, fatty acids, fishes, Japan

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日本孕婦在飲食脂肪和魚的攝取與遺傳過敏性溼疹之盛行率之相關性:大阪母親與孩童健康研究之基綜資料

在遺傳過敏性溼疹發展過程中,飲食因子可能是重要的。不論是攝取n-3多元不飽和脂肪酸可防止過敏的論點,或攝取n-6多元不飽和脂酸會增加過敏性的風險都仍然是有爭議的。本篇橫斷性研究就是在檢測脂肪酸和高脂肪食物攝取與遺傳過敏性溼疹之盛行率的相關性。研究對象是1002位日本孕婦。目前的遺傳過敏性溼疹和18歲之後的遺傳過敏性溼疹,被定義為當受試者分別在12個月前和滿18歲後已經接受藥物治療,那就是有遺傳過敏性溼疹。飲食因子資訊,是使用一個有效的自我填答飲食史問卷收集得來的。DHA攝取顯著性地與18歲之後和目前的遺傳過敏性溼疹盛行率的降低有相關。不論n-3多元不飽和脂肪酸、EPA、魚和n-3/ n-6多元不飽和脂肪酸比值對遺傳過敏性溼疹並沒有負的劑量效應,但這些飲食變項的第二個參等分與18歲之後的遺傳過敏性溼疹呈顯著地負相關。總脂肪、飽和脂肪酸、單元不飽和脂肪酸、n-6多元不飽和脂肪酸、膽固醇、肉、蛋或是乳製品攝取與任一項遺傳過敏性溼疹都沒有相關。在日本孕婦中,DHA攝取可能與遺傳過敏性溼疹盛行率的減少有相關性存在。

鍵字:遺傳過敏性溼疹、飲食、脂肪酸、魚類、日本

 

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Iodine deficiency disorders in Bangladesh, 2004-05: ten years of iodized salt intervention brings remarkable achievement in lowering goitre and iodine deficiency among children and women
HARUN KM YUSUF, AKM MUSTAFIZUR RAHMAN, FATIMA PARVEEN CHOWDHURY, M MOHIDUZZAMAN, CADI PARVIN BANU, M ARIF SATTAR AND M NURUL ISLAM

A survey was conducted to monitor the current status of iodine deficiency disorders in children aged 6-12 years and women aged 15-44 years in Bangladesh as measured by goitre prevalence and urinary iodine excretion. Conducted between September 2004 and March 2005, the survey followed a stratified multistage cluster sampling design to provide nationally representative data, with self-weighted rural-urban disaggregation. A total of 7233 children and 6408 women were examined for goitre and 4848 urine samples (2447 from children and 2401 from women) were analyzed for iodine. In addition, 5321 household salt samples were analyzed for iodine. In children, the total goitre rate (TGR) was 6.2%, compared to 49.9% in 1993 and the TGR among women was 11.7%, while in 1993 it was 55.6%. Prevalence of iodine deficiency (Urinary Iodine Excretion <100 μg/L) was 33.8% in children and 38.6% in women (compared to 71.0% and 70.2%, respectively in 1993). Iodine nutrition status in urban areas was considerably better than in rural areas. There was a clear inverse relationship between iodine deficiency and the coverage of households using adequately iodized salt (≥15 ppm). The findings of the survey revealed that Bangladesh has achieved a commendable progress in reducing goitre rates and iodine deficiency among children and women ever since the universal salt iodization programme was instituted 10 years ago. However, physiological iodine deficiency still persists among more than one-third of children and women, which points to the need for all stakeholders to redouble their efforts in achieving universal salt iodization.

Key Words: Iodine deficiency disorders, goitre rate, iodine deficiency, household coverage with adequately iodized salt, Universal Salt Iodization

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2004至2005年孟加拉碘缺乏之疾病:碘鹽介入十年顯著降低兒童和婦女甲狀腺腫及碘缺乏

調查孟加拉6-12歲兒童及15-44歲婦女碘缺乏疾病之現況,以甲狀腺腫之盛行率與尿液碘排泄量來評量。研究時間為2004年9月至2005年3月,自加權城鄉中採用分層多階段叢集,抽取具代表全國性之樣本。共有7233位兒童及6408位婦女接受是否有甲狀腺腫之檢查,其中共有4848位受試者有收集尿液(兒童2447位,婦女2401位)檢測其碘含量。並分析5321家戶使用之食鹽含碘量。發現孩童總甲狀腺腫率(TGR)為6.2%,相對於1993年為49.9%;婦女TGR為11.7%,1993年為55.6%。碘缺乏(尿液中碘排出量<100 μg/L)之盛行率,孩童為33.8%,而婦女為38.6%(於1993年分別為71.0%和70.2%)。碘之營養狀況都市地區大幅優於鄉村地區。家庭使用碘鹽(>15 ppm)則明顯和碘缺乏呈現負相關。調查結果顯示,孟加拉自十年前實施全面食鹽加碘計劃,至今已達成可嘉許的成就,即降低兒童及婦女之甲狀腺腫及碘缺乏疾病。然而仍然有超過三分之一之兒童及婦女生理性缺碘之情況存在,這點需要所有相關工作者加倍努力,完成全民食鹽加碘。

關鍵字:碘缺乏疾病、甲狀腺腫比率、碘缺乏、家戶碘鹽普及率、全面食鹽加碘

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Validation and reproducibility of a food frequency questionnaire designed for residents in northern China
XIAOQIN WANG, RINA SA, HONG YAN

The objective of this study was to evaluate the validity of a Xi’an food frequency questionnaire (FFQ) designed for application in an international case-control colorectal cancer study. The FFQ was administered to 125 participants twice over 1-year interval. Four 24-hour dietary recalls (24-HDRs) were conducted with the same participants in each season of the year. Comparative validation was assessed by comparing the nutrient intakes derived from the 24-HDRs and the FFQ-2, and reproducibility was estimated by comparing the nutrient intakes from two FFQs. In the validation study, the mean deattenuated correlation coefficients for nutrients between the 24-HDRs and the FFQ-2 ranged from 0.35 to 0.84 in the males. The female results were slightly lower than the male’s. The mean percentage of classification into the same quartile was 38% for the males and 35% for the females. In the reproducibility study, the mean crude correlation coefficients between the two FFQs were from 0.41 to 0.68 in the males and from 0.36 to 0.66 in the females. The newly developed Xi’an FFQ appears to be reasonably valid and reliable for most nutrients but would benefit from the addition of nutritional supplements and seasonings for assessing dietary intake in older persons in Xi’an, China.

Key Words: food frequency questionnaire, dietary assessment, reproducibility, 24-hour recalls

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中国北方居民食物频率问卷的信度和效度研究

本研究目的为评价西安食物频率调查问卷(Xi’an FFQ)的信度与效度,该问卷是为一项国际直结肠癌的病例对照研究设计的。 在本研究调查的一年当中,年初和年末各用FFQ调查一次西安老年族群的膳食水平,最终参与者为125位;同时,在此一年中每三个月用24小时膳食回顾问卷(24-HDRs)进行一次24小时膳食调查。通过对比24-HDRs与第二次FFQ测得的营养素结果获得该问卷的相对效度;对比两次的FFQ测得的营养素结果获得该问卷的信度。在效度研究中,男性营养素的去衰减相关系数的均数介于0.35-0.84之间,女性结果稍低于男性;两者歸在同一四分位数上所占的百分比,男性均数为38%,女性为35%。在信度研究中,男性原始相关系数的均数介于0.41-0.68之间,女性介于0.36-0.66之间。该西安食物频率问卷对于大多数营养素而言具有合理的信度和效度,其中加入营养補充剂及调味品的資料,对提高信度和效度有益。

關鍵字:食物频率问卷、膳食调查、信度、24小时膳食回顾

 

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Consumption of guava (Psidium guajava L) and noni (Morinda citrifolia L) may protect betel quid-chewing Papua New Guineans against diabetes
PATRICK L OWEN, LOUIS C MARTINEAU, DAYNA CAVES, PIERRE S HADDAD, TEATULOHI MATAINAHO AND TIMOTHY JOHNS

Rapid increase in the incidence of type 2 diabetes (DM2) in Papua New Guinea, coupled with compelling epidemiological evidence supporting a diabetogenic association with betel quid (BQ) chewing has lead us to investigate dietary strategies that might offer protection from developing DM2.  We investigated the dietary habits of Kalo residents from coastal Central Province who are avid BQ chewers yet have a relatively low incidence of DM2 compared to the ethnically similar and adjacent Wanigelans who abstain from BQ yet have an unusually high incidence of DM2. In Kalo, guava bud (Psidium guajava L) and noni (Morinda citrifolia L) were consumed much more frequently than in Wanigela, whereas the inverse was observed for mangrove bean (Bruguiera gymnorrhiza (L) Lam.).  These plants, along with BQ and its component ingredients areca nut (Areca catechu L) and Piper betle L inflorescence, were assessed for their ability to mediate insulin-dependent and insulin-independent glucose transport in cultured 3T3-L1 adipocytes. A dose-dependent inhibition of glucose uptake from methanolic extracts of BQ, areca nut and P. betle inflorescence supports previous reports of pro-diabetic activity. Conversely, guava bud extract displayed significant insulin-mimetic and potentiating activity. Noni fruit, noni leaf, commercial noni juice and mangrove bean all displayed insulin-like activity but had little or no effect on insulin action. Habitual intake of guava and noni is proposed to offer better protection against DM2 development and/or betel quid diabetogenicity than cooked mangrove bean. These findings provide empirical support that DM2 risk reduction can be accomplished using traditional foods and medicines.

Key Words: Psidium, areca, 3T3-L1 cells, plants, medicinal

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攝取番石榴(Psidium guajava L.)及諾麗果(Morinda citrifolia L.)可能保護嚼食檳榔的巴布亞新幾內亞人對抗糖尿病

第二型糖尿病(DM2)的發生率在巴布亞紐幾內亞快速的上升,而幾個令人注目的流行病學證據支持糖尿病致病與咀嚼檳榔(BQ)具有相關性,這促使我們研究某些膳食對策或許對DM2的發展具有保護作用。我們調查沿海中央省份Kalo居住者的飲食習慣,他們習慣咀嚼檳榔卻有相對較低的DM2發生率;與他們種族相近且是緊鄰的Wanigelans,拒吃檳榔但有不尋常的高DM2發生率。在Kalo地區,番石榴芽(Psidium guajava L.)及諾麗果(海巴戟天)(Morinda citrifolia L.)的攝取是較Wanigela地區頻繁,反之木欖豆(Bruguiera gymnorrhiza (L.) Lam.)的攝取則是較少的。評估這些植物與檳榔嚼塊及其組成物-檳榔果核(Areca catechu L.)與荖藤花(Piper betle L.),它們對培養的3T3-L1脂肪細胞之胰島素依賴型及胰島素非依賴型的葡萄糖運輸能力之調節。檳榔嚼塊、檳榔果核及荖藤花的甲醇萃取物對葡萄糖攝入有抑制作用並呈劑量效應,這結果支持之前的致糖尿病的說法。相反地,番石榴芽萃取物呈現顯著的類胰島素及加強胰島素的活性。諾麗果、諾麗葉、諾麗果汁商品及木欖豆全部顯示類似胰島素活性,但是對於胰島素效能僅輕微或是沒有影響。習慣性食用番石榴或是諾麗果比起煮過的木欖豆,在對抗DM2的發展或檳榔的糖尿病致病性,提供較佳的保護作用。這些發現提供實驗上的支持,亦即使用傳統食物及藥物可達成降低DM2的風險。

關鍵字:番石榴屬、檳榔屬、3T3-L1細胞、植物、藥用

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Stomach cancer in 67 Chinese counties: evidence of interaction between salt consumption and helicobacter pylori infection
XIAOQIN WANG, PAUL TERRY AND HONG YAN

Objective: To examine the interaction between salt-intake and helicobacter pylori (H. pylori)  infection in the development of stomach cancer in an ecological study of 67 Chinese rural counties. Methods: Stomach cancer mortality data of 67 counties were derived from a national survey conducted in China between 1986 and1988. Information regarding the prevalence of H. pylori infection and urinary sodium excretion were collected from the same individuals during a subsequent dietary survey in 1989. Results: In these 67 counties, H. pylori prevalence and urinary sodium were correlated with stomach cancer mortality, with r=0.31 (p=0.01) and r=0.28 (p=0.03), respectively. After stratification, the significant correlation between H. pylori prevalence and stomach cancer mortality only existed in counties with high levels (5.0 mg/mg creatinine/12-hour) of urinary sodium (r=0.5; p=0.002). Similarly, the significant correlation between urinary sodium and stomach cancer mortality was only presented in counties with high (71.6%) H. pylori prevalence (r=0.4; p=0.017). Multivariate regression analysis showed results consistent with the correlation analysis. Conclusion: These findings suggest that there may be an interaction between high salt consumption and H .pylori infection in the development of stomach cancer. Corroborating data from epidemiological, clinical, and experimental studies are needed.

Key Words: helicobacter pylori, stomach cancer, mortality, urinary nitrate, urinary sodium

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食盐的摄入与幽门螺旋杆菌感染在胃癌发生过程中的交互作用—中国67个农村县的生态学研究

目的:通过一项67个中国农村县的生态学研究,评价食盐的摄入与幽门螺旋杆菌感染在胃癌发生过程中的交互作用。方法:1986年至1989年,中国开展了一次全国性癌症死亡率的调查,本次研究的67个县的胃癌死亡率资料来源于该全国调查;1989年中国在相同人群中展开了一次全国膳食调查,本研究的幽门螺旋杆菌感染流行率和尿钠的资料则来源于此。结果:幽门螺旋杆菌流行率和尿钠与胃癌死亡率显著相关,相关系数分别为0.31 (p=0.01) 和 0.28 (p=0.03)。对尿钠水平分层后,幽门螺旋杆菌流行率与胃癌死亡率的显著相关仅存在于尿钠5.0 mg/mg 肌苷/12小时的组,相关系数为0.5,p=0.002;同样对幽门螺旋杆菌流行率水平分层后,尿钠与胃癌死亡率的显著相关仅存在于幽门螺旋杆菌流行率71.6%的组,相关系数为0.4,p=0.017。多元回归结果与相关分析一致。结論:提示食盐的摄入与幽门螺旋杆菌感染在胃癌发生过程中可能有交互作用。这还需要其他流行病、临床和实验性确证研究资料的支持。

關鍵字: 幽门螺旋杆菌、胃癌、死亡率、尿硝酸塩、尿钠

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The association of plasma C-reactive protein levels with anthropometric and lipid parameters in elderly Taiwanese
HSIN-JEN TSAI AND ALAN CHUNG-HONG TSAI

C-reactive protein (CRP), a plasma inflammation marker, has been known to play a role in the development of cardiovascular diseases. This study aims to evaluate the association of CRP with anthropometric and plasma lipid parameters in elderly Taiwanese 65 years or older. Data from the Elderly Nutrition and Health Survey in Taiwan (1999-2000), a national probability sampling study conducted to gain an understanding of the dietary pattern, and nutritional and health status of elderly Taiwanese were analyzed. Results showed that in men, CRP was positively correlated with age and waist-to-hip ratio (WHR) (both p<0.05) whereas in women, CRP was positively correlated with waist and WHR but negatively correlated with HDL-C (all p<0.05). Linear regression analysis showed that log CRP was positively associated with WHR in both genders (p<0.05) after adjusting for confounders. The correlation of CRP with WHR was stronger than that with both waist circumference and body mass index (BMI). Log CRP was inversely associated with HDL-C in women, but not men. The study suggests that among the anthropometric parameters examined, WHR is a stronger predictor for elevated CRP in elderly Taiwanese men and women. Whereas low HDL-C is a predictor among the plasma lipid parameters for elevated plasma CRP, at least in women. Gender differences exist in the association of CRP with anthropometric and lipid parameters.

Key Words: C-reactive protein, elderly, waist-to-hip ratio, high-density lipoprotein-cholesterol, anthropometric indices

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台灣老人血漿C-反應蛋白與體位及血脂指標的關聯

C-反應蛋白(C-reactive protein, CRP)是一已知的發炎指標,在心血管疾病的發展上扮演重要的角色。本研究的目的在探討此C-反應蛋白與體脂肪和各種血脂蛋白的關係。本研究分析老人營養健康狀況調查1999-2000台灣地區65歲以上老人之資料。結果顯示對男性而言,C-反應蛋白與年齡和腰臀圍比(waist-hip ratio)呈正相關(p<0.05);對女性,C-反應蛋白則與腰圍、腰臀圍比呈正相關,但與高密度脂蛋白(HDL-C)呈負相關(p<0.05)。多變項線性迴歸分析,在控制干擾因子條件後,發現無論男或女性腰臀圍比越高,則log C-反應蛋白越高(p<0.05)。且腰臀圍比對log C-反應蛋白的相關性強度大於腰圍和身體質量指數(BMI)。而在老年女性中,高密度脂蛋白越高,則log C-反應蛋白越低。因此在各種肥胖指標中,無論是台灣老年男性或女性,腰臀圍比是一個預測C-反應蛋白較好的指標。而在血脂蛋白指標中,對老年女性而言,高密度脂蛋白則是一個預測C-反應蛋白較好的指標。C-反應蛋白與體脂肪和血脂蛋白指標間具有性別差異。

關鍵字:C-反應蛋白,老年人,腰臀圍比,高密度脂蛋白膽固醇,體位指標

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Delayed effects of coffee, tea and sucrose on postprandial glycemia in lean, young, healthy adults
JIMMY CHUN YU LOUIE, FIONA ATKINSON, PETER PETOCZ AND JENNIE C BRAND-MILLER

In observational studies, habitual coffee consumption has been linked to a lower risk of type 2 diabetes. We hypothesized that the mechanism may be related to delayed effects on postprandial glycemia. The aim of this study is to investigate the glycemic and insulinemic effects of consumption of caffeinated and decaffeinated coffee, sweetened and unsweetened, tea and sucrose, 1 h prior to a high carbohydrate meal. On separate occasions in random order, lean young healthy subjects (n = 8) consumed a potato-based meal 1 hour after consumption of 250 mL of black coffee (COF), black coffee sweetened with 10 g of sucrose (COF+SUC), decaffeinated coffee (DECAF), black tea (TEA), 10 g sucrose (SUC) or hot water (CON). Fingerprick blood samples were taken at regular intervals over 2 h and the glucose and insulin responses quantified as area under the curve. Compared to CON, COF caused a 28% increase in postprandial glycemia (p = 0.022). In contrast, COF+SUC decreased glycemia compared with either COF (-38%, p < 0.001) or CON (-20%, p = 0.100) but had no effect on insulin responses. DECAF, TEA and SUC had no significant effects on postprandial responses. SUC and DECAF reduced the absolute glucose concentration at the start of the meal (p < 0.01). In conclusion, only sweetened coffee significantly reduces postprandial glycemia. This observation may explain the paradoxical findings of observational and clinical studies relating coffee drinking to diabetes risk.

Key Words: coffee, tea, postprandial glycemia, insulinemia, caffeine

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咖啡或茶與蔗糖對健康不過重的年輕人餐後血糖之延緩效應

在觀察研究中,發現長期飲用咖啡和較低的2型糖尿病風險相關。我們假設降低糖尿病風險的機制可能與咖啡對餐後血糖的延後效應有關。本研究目的是探討食用高碳水化合物餐點前1小時飲用一般咖啡(含糖或不含糖)、去咖啡因咖啡、紅茶及糖水對血糖和胰島素反應的影響。在隨機的分別場次中,8名健康苗條的年輕人於飲用250毫升的咖啡(COF)、咖啡加10克蔗糖(COF+SUC)、去咖啡因咖啡(DECAF)、紅茶(TEA)、糖水(含10克蔗糖;SUC)或熱水(CON)的1小時後,進食了以馬鈴薯為主的餐點。餐後2小時期間,定時從指尖抽取血液樣本,量化血糖和胰島素的濃度曲線下面積做為血糖和胰島素的反應。跟對照組(CON)比較,COF令餐後血糖反應上升了28% (p=0.022)。相反地,COF+SUC相比於COF (-38%,p<0.001)或對照組(-20%,p=0.100)都減低了餐後血糖反應,但不影響胰島素反應。去咖啡因咖啡、紅茶及糖水對餐後血糖及胰島素反應並沒有顯著的影響。糖水和去咖啡因咖啡減低了開始用餐時的血糖濃度(p<0.01)。總括來說,只有含糖咖啡(COF+SUC)顯著地降低餐後血糖反應。本研究結果或許可以解釋有關咖啡的飲用及糖尿病風險的觀察研究及臨床實驗中矛盾的發現。

關鍵字:咖啡、茶、餐後高血糖反應、高血胰島素、咖啡因

 

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Natto and viscous vegetables in a Japanese style meal suppress postprandial glucose and insulin responses
AKIKO TANIGUCHI, HISAMI YAMANAKA-OKUMURA, YUKA NISHIDA, HIRONORI YAMAMOTO, YUTAKA TAKETANI AND EIJI TAKEDA

Naturally viscous vegetables and natto, made by fermenting soybeans, are very palatable and considered to be healthy foods in Japan. The objective was to assess whether the consumption of natto and viscous vegetables as part of a traditional Japanese breakfast based on high-glycemic index white rice affects glycemic, insulinemic, lipidemic and satiety responses in healthy subjects. Eleven healthy subjects consumed the reference, control and test meals in a randomized cross-over design. The test meal, comprising 200 g of boiled white rice with viscous meal (50 g natto, 60 g Japanese yams and 40 g okras), and the control meal, comprising 200 g of white rice with non-viscous boiled soybeans, potatoes and broccoli, contained comparable amounts of carbohydrate, fat, protein and fiber. In addition, whiter rice was used as a reference meal. Blood samples over 180 min were analyzed for glucose, insulin, non-esterified free fatty acid and triacylglyceride. Peak glucose and insulin concentrations after the test meal (6.0 mmol/L and 262 pmol/L) were significantly lower than after the control meal (6.8 mmol/L and 360 pmol/L). The incremental areas under the curve for glucose and insulin over 0-120 min after the test meal were also significantly reduced as compared with the control meal (28 and 27%). The consumption of naturally viscous vegetables with white rice reduced acute glycemia and insulinemia. This practical dietary combination would ensure compliance and favorably alter the risk for diabetes and cardiovascular diseases.

Key Words: postprandial glucose, insulin, viscous fiber, white rice, healthy subjects

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日本膳食中納豆及黏性蔬菜可降低飯後血糖及胰島素反應

天然黏性蔬菜及經由黃豆發酵製成的納豆,這兩類食物於日本認為非常可口且健康之食物。實驗目標為評估健康受試者於日本傳統高昇糖指數的米飯早餐中,攝食納豆及黏性蔬菜,是否影響血糖、血中胰島素濃度、血脂及飽食反應。共有11位受試者參與,以隨機交叉設計讓受試者攝取參考餐、對照餐與實驗餐食。實驗餐食中,包200 g白飯及黏性食物(納豆50 g、日本山藥60 g 及秋葵40 g);對照餐食包含200 g白飯及非黏性煮熟之黃豆、馬鈴薯及花椰菜,兩種餐食含相似量之碳水化合物、脂肪、蛋白質及纖維。此外以白飯作為參考餐。餐後180分鐘內間隔抽取血液樣本分析血糖、胰島素、非酯化游離脂肪酸及三酸甘油酯。攝食實驗餐食,血糖(6.0 mmol/L)及胰島素濃度(262 pmol/L)尖峰顯著低於對照餐食(6.8 mmol/L及360 pmol/L)。實驗餐後0-120分鐘內血糖及胰島素上升面積也顯著低於對照餐(28及27%)。攝食天然黏性蔬菜與白飯可降低急性高血糖及高胰島素濃度。這種實用的飲食結合,較易遵行並有利於減低糖尿病及心血管疾病風險。

關鍵字:餐後血糖、胰島素、黏性纖維、白飯、健康受試者

 

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Clinical experience with a relatively low carbohydrate, calorie-restricted diet improves insulin sensitivity and associated metabolic abnormalities in overweight, insulin resistant South Asian Indian women
ANDREA C BACKES, FAHIM ABBASI, CINDY LAMENDOLA, TRACEY L MCLAUGHLIN, GERALD REAVEN AND LATHA P PALANIAPPAN

South Asian Indians are at increased risk for cardiovascular disease associated with insulin resistance and a dyslipidemia characterized by high triglyceride and low high-density lipoprotein cholesterol concentrations. The purpose of this study is to determine the effects of a calorie-restricted, relatively low carbohydrate diet on weight loss, insulin sensitivity, and associated cardiovascular disease risk factors in overweight, insulin resistant, but apparently healthy, South Asian Indian women. Twenty-three, overweight, insulin resistant, apparently healthy, South Asian Indian women were advised on a calorie-restricted diet containing 40 percent carbohydrate for 3 months. Change in weight, insulin sensitivity (quantified by the steady state plasma glucose concentration during the insulin suppression test), and associated cardiovascular disease risk factors were measured. Weight fell from 75.5 to 70.5 kg (p < 0.001), associated with significant decreases in diastolic blood pressure, plasma concentrations (mg/dL) of steady state plasma glucose (217 to 176, p < 0.001), triglycerides (137 to 101, p = 0.003), and glucose (98 to 92, p = 0.005). A calorie-restricted diet, moderately lower in carbohydrate, can lead to weight loss, decreased insulin resistance, and reduction in several cardiovascular disease risk factors in overweight, insulin resistant, apparently healthy, South Asian Indian women.

Key Words: weight loss, insulin resistance, cardiovascular disease risk factors, overweight, South Asian Indian

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有過重及胰島素阻抗的印度裔婦女攝取較低醣類及限制熱量飲食可以改善胰島素敏感性及相關的代謝性異常之臨床試驗

南亞印度裔族群有較高的心血管疾病的風險,並與胰島素阻抗及高三酸甘油酯、低的高密度脂蛋白濃度的血脂異常特性有關。此研究目的是評估在過重與有胰島素阻抗但外表健康的印度裔婦女,攝食限制熱量及較低的醣類飲食對於她們的體重降低、胰島素敏感性及相關的心血管疾病危險因子之影響。對23名過重及有胰島素阻抗但外表健康的印度裔婦女建議攝取熱量限制飲食,其中醣類熱量佔40%,為期3個月。測量體重、胰島素敏感性(採用胰島素阻抗測驗,量化穩定狀況下的血糖濃度)及相關的心血管疾病危險因子的改變。平均體重由75.5降到70.5 kg (p < 0.001)並伴隨舒張壓、血漿中(mg/dL)穩定狀況血糖(217 to 176, p < 0.001)、三酸甘油酯(137 to 101, p = 0.003)及空腹血糖(98 to 92, p = 0.005)濃度下降。限制熱量及適度降低醣類的飲食可以促使過重及有胰島素阻抗但外表健康的印度裔婦女體重降低,減少胰島素阻抗性及降低數種心血管疾病危險因子。

關鍵字:體重減輕、胰島素阻抗、心血管疾病危險因子、體重過重、南亞印度裔

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Nutrition Leadership Training in North-East Asia: an IUNS initiative in conjunction with nutrition societies in the region
MARK L WAHLQVIST, DUO LI, JIANG-QIN SUN, KEYOU GE, HEE-YOUNG PAIK, SUNG HEE CHO, SOO-KYUNG LEE, CHING-JANG HUANG AND MEEI-SHYUAN LEE

Food for humans is one of the most important of all global issues. It is a critical determinant of planetary and individual health, of economic development, of how sustainable energy and water supplies are, and its security a powerful determinant of peace or conflict. Those who assume leadership for the integrity of food and health systems have great responsibility. The IUNS (International Union of Nutritional Sciences), regional and national nutrition science and food technology organizations have concern about the leadership capacity available and required in what are rapidly changing and increasingly demanding circumstances. These include persistent poverty and hunger, climate change which threatens the sustainability of food production and fragile financial systems which are making food less affordable for many. North East Asia (NEA) is a major region for its population size, its economic wealth and disparities, its food production, its life expectancies among the best and its global reach. In 2008, for those of Chinese ancestry and of wider Asian origin, Nutrition Leadership training has been conducted in Hangzhou, Shanghai, Seoul and Taiwan (Hsinchu and Zhunan). Ninety prospective young leaders participated in all. Several successful early career Asian nutrition scientists and professionals served as role models. Senior colleagues acted as mentors for groups of 2 or 3. With mentors, the concept of leadership has been examined, careers and roles explored, knowledge and skills honed for a different future, and plans made to network in mutual support. Early feedback indicates that new opportunities have been created and seized.

Key Words: IUNS, Chinese Nutrition Society, Korean Nutrition Society, Taiwan Nutrition Society, capacity building, leadership development, Zhejiang University, Fudan University, Huadong Hospital, Seoul National University, NHRI

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國際營養科學聯盟發起的與地區營養學會聯合舉辦的東北亞營養領導能力培訓

糧食對人類而言是全球最重要的問題之一。它影響到全球和個人健康、經濟發展、以及如何提供可持續的能源和水資源的一個關鍵決定性因素,它的安全性在極大程度上決定了世界和平與衝突。領導被認為對於食品和健康體系應承擔重要的責任。國際營養科學聯盟(IUNS),區域和國家的營養科學與食品科技組織關注的是領導在處理迅速變化和日益惡化的境況時其有效和必需的能力。這些境況包括持續的貧困和饑荒,影響糧食可持續生產的氣候變化以及導致許多人更加負擔不起糧食的脆弱的金融體系。從人口規模、經濟財富和差距、糧食生產、較好的預期壽命以及國際影響來看,東北亞(NEA)是一個重要的地區。2008年,在華人和亞洲地區,營養領導培訓已在杭州、上海、首爾和臺灣(新竹和竹南)進行,共有90名青年領袖參加了培訓。一些成功的年輕職業亞裔營養科學家和專業人員起到了模範作用。資深同仁作為蒙導輔導2到3位青年領袖。與蒙導一起,檢驗營養領導人才的觀念,探索營養領導人才生涯和角色,針對未來可能遇到的各種問題進行了知識和技能的訓練,並建立了相互支援的網絡。從青年營養領導的回饋,營養領導培訓為他們創造了新的機遇,他們有幸抓住了這次良機。

關鍵字:國際營養科學聯盟、中國營養學會、韓國營養學會、台灣營養學會、能力建設、領導發展、浙江大學、復旦大學、華東醫院、首爾國立大學、國家衛生研究院

 

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Last Updated: December 2008