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1 Asia Pacific Journal of Clinical Nutrition
       Volume 18, 2

         (June 2009)


Abstracts

Contents

Abstract 摘要

Original Research Communications

Clinical Nutrition Trials or Feeding Studies

Could dietary seaweed reverse the metabolic syndrome?
JANE TEAS, MANUEL E BALDEÓN, DAVID E CHIRIBOGA, JENNIFER R DAVIS, ALEJANDRO J SARRIÉS AND LEWIS E BRAVERMAN
Asia Pac J Clin Nutr. 2009;18(2):145-154.

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Role of enteral nutrition in adult short bowel syndrome undergoing intestinal rehabilitation: the long-term outcome
JIAN-FENG GONG, WEI-MING ZHU, WEN-KUI YU, NING LI AND JIE-SHOU LI
Asia Pac J Clin Nutr. 2009;18(2):155-163.

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Growth and Child Nutrition 

Volume, frequency and participation in plain drinking water consumption by third and fourth-grade schoolchildren in Quetzaltenango, Guatemala
RAQUEL CAMPOS, GABRIELA MONTENEGRO-BETHANCOURT, MARIEKE VOSSENAAR, COLLEEN M DOAK AND NOEL W SOLOMONS
Asia Pac J Clin Nutr. 2009;18(2):164-170.

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Levels of insulin-like growth factors and their receptors in placenta in relation to macrosomia
HUA JIANG, PENGCHENG XUN, GUANGHUA LUO, QIUWEI WANG, YUNQING CAI, YAYING ZHANG AND BIN YU
Asia Pac J Clin Nutr. 2009;18(2):171-178.

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Macro- Micro- and Phyto-nutrients

The effects of phytosterols/stanols on blood lipid profiles: a systematic review with meta-analysis
T
ING WU, JIA FU, YUEXIN YANG, LISHI ZHANG AND JUNHUA HAN
Asia Pac J Clin Nutr. 2009;18(2):179-186.

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Evaluation of fatty acid content of some Iranian fast foods with emphasis on trans fatty acids
SEDDIGHEH ASGARY, BAHAR NAZARI, NIZAL SARRAFZADEGAN, SAHAR PARKHIDEH, SALBALI SABERI, AHMAD ESMAILLZADEH AND LEILA AZADBAKHT
Asia Pac J Clin Nutr. 2009;18(2):187-192.

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Dietary intake of zinc in the population of Jiangsu Province, China
YU QIN, ALIDA MELSE-BOONSTRA, ZUMIN SHI, XIAOQUN PAN, BAOJUN YUAN, YUE DAI, JINKOU ZHAO, MICHAEL B ZIMMERMANN, FRANS J KOK AND MINGHAO ZHOU
Asia Pac J Clin Nutr. 2009;18(2):193-199.

 

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Maternal and Women’s Nutrition

The female athlete triad among elite Malaysian athletes: prevalence and associated factors
YE VIAN QUAH, BEE KOON POH, LAI OON NG AND MOHD ISMAIL NOOR
Asia Pac J Clin Nutr. 2009;18(2):200-208.

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Nutritional Epidemiology and Public Health

Optimal cut-off levels to define obesity: body mass index and waist circumference, and their relationship to cardiovascular disease, dyslipidaemia, hypertension and diabetes in Malaysia
ZAKI MORAD MOHD ZAHER, ROBAYAAH ZAMBARI, CHAN SIEW PHENG, VADIVALE MURUGA, BERNARD NG, GEETA APPANNAH AND LIM TECK ONN
Asia Pac J Clin Nutr. 2009;18(2):209-216.

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Correlation of anthropometric indices with common cardiovascular risk factors in an urban adult population of Iran: data from Zanjan Healthy Heart Study
ALI AWSAT MELLATI, SEYED NOURADDIN MOUSAVINASAB, SEPIDE SOKHANVAR, SEYED ALI NAGHI KAZEMI, MOHAMMAD HOSSAIN ESMAILLI AND HOSSAIN DINMOHAMADI
Asia Pac J Clin Nutr. 2009;18(2):217-225.

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Prevalence and risk factors with overweight and obesity among Vietnamese adults: Caucasian and Asian cut-offs
OANH TH TRINH, NGUYEN D NGUYEN, PHILAYRATH PHONGSAVAN, MICHAEL J DIBLEY AND ADRIAN E BAUMAN
Asia Pac J Clin Nutr. 2009;18(2):226-233.

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Prevalence of underweight, overweight and obesity in urban Hanoi, Vietnam
HELEN L WALLS, ANNA PEETERS, PHAM THAI SON, NGUYEN NGOC QUANG, NGUYEN THI THU HOAI, DO DOAN LOI, NGUYEN LAN VIET, PHAM GIA KHAI AND CHRISTOPHER M REID
Asia Pac J Clin Nutr. 2009;18(2):234-239.

 

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Validity and reproducibility of a food frequency questionnaire among Chinese women in Guangdong province
CAI-XIA ZHANG AND SUZANNE C HO
Asia Pac J Clin Nutr. 2009;18(2):240-250.

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Nutritional status, Dietary Intake, and Body Composition

Validation of prediction equations for estimating resting energy expenditure in obese Chinese children
DOROTHY FY CHAN, ALBERT M LI, MICHAEL HM CHAN, HUNG KWAN SO, IRIS HS CHAN, JANE AT YIN, CHRISTOPHER WK LAM, TAI FAI FOK AND EDMUND AS NELSON
Asia Pac J Clin Nutr. 2009;18(2):251-256.

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Adults’ perceptions of being overweight or obese: a focus group study
CHING THON CHANG, KAM HOCK CHANG AND WHYE LIAN CHEAH
Asia Pac J Clin Nutr. 2009;18(2):257-264.

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Body composition and nutrient intake of Buddhist vegetarians
YUJIN LEE AND MICHAEL KRAWINKEL
Asia Pac J Clin Nutr. 2009;18(2):265-271.

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Nutritionally-Related Disorders and Diseases and Their Risk Factors

Predictability and implications of anthropometric indices for metabolic abnormalities in children: nutrition and health survey in Taiwan elementary children, 2001-2002
SHAO-YUAN CHUANG AND WEN-HARN PAN
Asia Pac J Clin Nutr. 2009;18(2):272-279.

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Metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) phenotypes in Koreans: characteristics and health behaviors
KAYOUNG LEE
Asia Pac J Clin Nutr. 2009;18(2):280-284.

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Dietary patterns and the metabolic syndrome in middle aged women, Babol, Iran
MOULOUD AGAJANI DELAVAR, MUNN-SANN LYE, GEOK LIN KHOR, SYED TAJUDDIN B SYED HASSAN AND PARICHEHR HANACHI
Asia Pac J Clin Nutr. 2009;18(2):285-292.

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Factor analysis of the metabolic syndrome components in urban Asian Indian adolescents
NAVAL K VIKRAM, RAVINDRA M PANDEY, ANOOP MISRA, KASHISH GOEL AND NIDHI GUPTA
Asia Pac J Clin Nutr. 2009;18(2):293-300.

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Book Review and Future Events

Asia Pac J Clin Nutr. 2009;18(2):301-302.

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Could dietary seaweed reverse the metabolic syndrome?
JANE TEAS, MANUEL E BALDEÓN, DAVID E CHIRIBOGA, JENNIFER R DAVIS, ALEJANDRO J SARRIÉS AND LEWIS E BRAVERMAN

Incidence of the metabolic syndrome is increasing worldwide, with notable exceptions of some Asian countries where seaweeds are commonly consumed. 13 men (mean age 47.4 ± 9.9 yr) and 14 women (average age 45.6 ± 12.2 yr) with at least one symptom of the metabolic syndrome were recruited in Quito Ecuador to a randomized double-blinded placebo-controlled trial. Subjects were assigned to either Group 1 (1 m placebo, followed by 1 m 4 g/d seaweed [Undaria pinnatifida]) or Group 2 (1 m of 4 g/d seaweed, followed by 1 m of 6 g/d of seaweed). Blood pressure, weight, waist circumference, inflammation biomarkers, and lipids were measured monthly. Re-peated measures analysis of variance with Tukey’s multiple comparison tests were used for statistical analysis. In Group 2, systolic blood pressure decreased 10.5 mmHg after a month of 6 g/d seaweed (95% CI: 4.1, 16.8 mmHg; p < 0.05), primarily in subjects with high-normal baseline blood pressure. Waist circumference changed only for women participants, with a 2.4 cm decrease in Group 1 after treatment with placebo (95% CI: 1.0, 3.7 cm; p < 0.01). In Group 2, women had a mean decrease of 2.1 cm after 4 g/d (95% CI: 0.4, 3.7 cm; p < 0.05) and a further 1.8 cm decrease after 1 m 6 g/d seaweed (95 % CI: 0.1, 3.4, p < 0.05). No other changes were observed. Consumption of 4 to 6 g/d seaweed, typical for most people in Japan, may be associated with low metabolic syndrome prevalence.
Key Words: seaweed, metabolic syndrome, hypertension, waist circumference, iodine, clinical trial
 

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食用海藻是否可以逆轉代謝症候群?
除了一些常吃海藻的亞洲國家外,代謝症候群的發生率在世界各地逐步增加。13名有一項代謝症候群症狀的男性(平均年齡47.4± 9.9歲)及14名女性(平均年齡45.6± 12.2歲)納入Quito Ecuador隨機雙盲安慰劑試驗。研究對象被分派為第1組(1個月安慰劑,之後為1個月 4克/天海菜[Undaria pinnatifida])或是第2組(4克/天海菜1個月,之後為1個月 6克/天海藻)。每個月測量血壓、體重、腰圍、發炎生化指標及血脂。統計分析方法為重複測量變異數分析繼之Tukey’s多重比較。第二組的在吃了一個月6克/天海藻之後,收縮壓降低10.5mmHg(95% CI: 4.1, 16.8 mmHg; p < 0.05),主要是在那些一開始即有較高血壓的人身上。腰圍的改變僅發生在女性,第一組在使用安慰劑一個月之後,腰圍減少2.4公分(95% CI: 1.0, 3.7 公分; p < 0.01)。第二組女性在使用4克/天後,減少了2.1公分(95% CI: 0.4, 3.7 公分; p < 0.001),使用6克/天一個月後,進一步減了1.8公分 (95% CI: 0.1, 3.4公分; p < 0.001)。此外,沒有其他變化。每日食用4到6克的海藻,是大部分日本人的典型,可能與日本有較低的代謝症候群盛行率有關。
關鍵字:海藻、代謝症候群、高血壓、腰圍、碘、臨床試驗
 

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Role of enteral nutrition in adult short bowel syndrome undergoing intestinal rehabilitation: the long-term outcome
JIAN-FENG GONG, WEI-MING ZHU, WEN-KUI YU, NING LI AND JIE-SHOU LI

The objective of this study is to evaluate the long-term clinical significance of enteral nutrition (EN) in weaning adult short bowel patients off parenteral nutrition (PN) undergoing intestinal rehabilitation therapy (IRT). Sixty-one adult patients with small bowel length 47.95 ± 19.37 cm were retrospectively analyzed. After a 3-week IRT program, including recombinant human growth hormone (rhGH, 0.05 mg/kg/d), glutamine (30 g/d), and com-bined EN and PN support, patients were maintained on EN or plus a high-carbohydrate, low fat (HCLF) diet. Continuous tube feeding was used when EN was started. Patients were followed up for 50.34 ± 24.38 months and had an overall survival rate 95.08% (58/61). On last evaluation, 85.24% (52/61) of the patients were free of PN. For 77.42% patients (24/31) with small bowel length <35 cm in jejunoileocolic anastomosis (type III) and <60 cm in jejunocolic anastomosis (type II), weaning off PN was achieved. EN comprised of 52.56 ± 13.47 % of patients’ daily calorie requirements on follow-up. Five patients were maintained on home PN (HPN) plus EN. Nutritional and anthropometric parameters, urine 5-hr D-xylose excretion and serum citrulline levels all in-creased significantly after IRT and on follow-up compared with baseline. In conclusion, with proper EN man-agement during and after IRT, a significant number of SBS patients could be weaned from PN, especially for those who were considered as permanent intestinal failure; continuous tube feeding is recommended for enteral access, and long-term EN support could meet the daily nutritional requirement in majority of SBS patients.
Key Words: short bowel syndrome, enteral nutrition, human growth hormone, nutrition assessment, follow-up studies

 

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成人短腸綜合症患者腸康復治療時腸道營養的應用和長期療效觀察
本研究目的在於評價成人短腸綜合症(SBS)患者在腸康復治療時應用腸道營養(EN)的價值和長期療效。回顧性分析61例成人SBS患者的資料,平均小腸長度47.95±19.37 cm。所有患者均予3週的腸康復治療(IRT),包括重組的人生長激素(0.05 mg/kg/d)、穀氨醯胺(30 g/d)和聯合腸道營養和腸外營養(PN)支持,隨後以腸道營養或加上高醣低脂(HCLF)飲食長期維持。腸道營養是以連續性鼻胃管灌的方式給予。平均隨訪50.34±24.38個月,患者總體存活率為95.08%(58/61)。85.24%(52/61)的患者最終擺脫PN。其中小腸長度<35 cm的III型SBS(空腸-迴腸吻合)和<60cm的II型SBS(空腸-結腸吻合)中有77.42%(24/31)患者擺脫腸外營養。腸道營養提供患者52.56±13.47%的每日熱量需求。有5例患者,除腸道營養外同時需予在家PN支持。IRT結束後及最後一次隨訪時,患者營養狀態及體位指標、尿液5小時D-木糖排泄量和血清瓜氨酸水平,均較基礎值顯著改善。本研究的結果表明,在腸康復治療過程中和治療後採用合適的腸道營養支持策略,有相當一部分SBS患者可擺脫腸外營養,尤其是那些曾被認為是永久性腸衰竭的患者。推薦採用連續性管灌餵食作為腸道營養的通路,長期腸道營養支持可滿足多數成人SBS患者的每日營養需要量。
關鍵字:短腸綜合症、腸道營養、人生長激素、營養評價、隨訪研究

 

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Volume, frequency and participation in plain drinking water consumption by third and fourth-grade schoolchildren in Quetzaltenango, Guatemala
RAQUEL CAMPOS, GABRIELA MONTENEGRO-BETHANCOURT, MARIEKE VOSSENAAR, COLLEEN M DOAK AND NOEL W SOLOMONS
Water intake was described and quantified in samples of urban Guatemalan schoolchildren stratified by gender and socio-economic status.  The frequency of consumption and quantity of plain water drinking was estimated from one-day pictorial registries of all beverages, foods and snacks consumed over a 24-h period collected from 449 3rd and 4th graders from two social classes: 230 from higher SES and 219 from lower SES.  Plain water was reported by 28.1% of participants on the day of registry.  Quantities consumed ranged from 250 to 2250 ml.  For the 449 one-day intake records, a cumulative total of 62,000 mL of water consumption was reported.  This constitutes an average of 138 ± 289 ml across all participants but, when divided by for water consumers only, the mean is 492 ± 352 ml.  Given the relatively low percentage of children consuming water, more attention is needed to ensure freely available, safe, drinking water in the school environment.

Key Words: drinking water, beverage choice, schoolchildren, 24-h food record, Guatemala


 
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瓜地馬拉Quetzaltenango的三、四年級學童飲水攝取量、頻率及使用 居住在瓜地馬拉城市區域的學童,以性別及社經狀態分層次取樣,由描述及量化其飲水攝取。以畫記的方式收集449名3年級及4年級學童的過去24小時所有飲料、食物及點心的攝取量。其中219名來自較低社經階層及230名來自較高社經階層。有28.1%的參與者記錄一天內有喝到飲用水。飲水攝取量從250到2250 mL。449位學童一天的攝取紀錄,總共累積62 L水攝取量。所有參與者平均攝取138 ± 289 mL,若是單以有喝水的學童來估算,平均值為491±350 mL。學童喝水的比例相對性的低,所以需要更多關注,確保學校有安全飲用水的免費供應。 關鍵字:飲用水、飲料選擇、學童、24小時飲食紀錄、瓜地馬拉

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Levels of insulin-like growth factors and their receptors in placenta in relation to macrosomia
HUA JIANG, PENGCHENG XUN, GUANGHUA LUO, QIUWEI WANG, YUNQING CAI, YAYING ZHANG AND BIN YU
Objective: To investigate the associations between mRNA levels that encodes for insulin-like growth factors (IGFS) and their receptors in term placenta, and the risk of macrosomia. Methods: Term placentas were collected from 37 neonates with macrosomia and 37 neonates with normal birth weight in Changzhou Women and Children Health Hospital from March 1 to June 30, 2008. The IGF mRNA levels and their receptors in those placentas were measured by Real-time PCR. Results: The placental weight was positively correlated with the birth weight both in the macrosomia group (r=0.550, p=0.004) and the control group (r=0.678, p=0.000). After adjusting for potential confounders, multivariable adjusted ORs of neonates with macrosomia for those in the increasing two tertiles were 17.3 (95%CI: 2.50-19.2) and 5.94 (95%CI: 0.96, 36.8), respectively, compared with those in the lowest tertile in terms of IGF-ⅡmRNA level. Similarly, multivariable adjusted ORs of neonates with macrosomia for those in the increasing two tertiles of IGF-ⅠR mRNA were 25.3 (95%CI: 3.43-187) and 43.0 (95%CI: 4.89, 378), respectively. Conclusion: These results indicate that the levels of placental IGF-Ⅱand IGF-ⅠR mRNA may be involved in the development of macrosomia.
Key Words: macrosomia, placenta, insulin-like growth factor, receptor, case-control study


 

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胎盘中的IGFs及其受体的表达水平与巨大儿关系的研究 目的:研究足月胎盘中胰岛素样生长因子及其受体的mRNA的表达水平,與巨大儿发生风险的關聯。方法:从2008年3月1日至6月30日,在常州市妇幼保健院,收集足月分娩的37例巨大儿和37例正常体重儿的胎盘组织,采用Real Time PCR技术对胎盘中的胰岛素样生长因子及其受体的mRNA的表达水平进行检测。结果:在巨大儿组与对照组,胎盘的重量与新生儿出生体重均成正相关(r=0.550, p=0.004 及 r=0.678, p=0.000)。采用多因素非条件羅吉斯回归分析,在控制了混杂因素后,与最低IGF-II mRNA水平组相比,IGF-II mRNA中等水平组和高水平组发生巨大儿的OR值分别为17.3 (95%CI: 2.50, 19.2) 和5.94 (95%CI: 0.96, 36.8);而与最低IGF-IR mRNA水平组相比,中等水平组和高水平组IGF-IR mRNA发生巨大儿的OR值分别为25.3 (95%CI: 3.43, 187) 和 43.0 (95%CI: 4.89, 378)。结论:本研究显示胎盘中的IGF-II mRNA和IGF-IR mRNA的表达水平与巨大儿的发生可能有关。 关键词: 巨大儿、胎盘、胰岛素样生长因子、受体、病例对照研究

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The effects of phytosterols/stanols on blood lipid profiles: a systematic review with meta-analysis
TING WU, JIA FU, YUEXIN YANG, LISHI ZHANG AND JUNHUA HAN
The objective of this work is to conduct a systematic review that investigates the efficacy of phytosterols/stanols in lowering lipid concentration in individuals with non-familial hypercholesterolemia. Randomized controlled intervention trials were identified through selected international journal databases and reference lists of relevant publications. Two researchers extracted data from each identified trial and only trials of sufficient quality were included in the review. Main outcomes of interest were differences between treatment and control groups in terms of low density lipoprotein cholesterol, total cholesterol, high density lipoprotein cholesterol and triacylglycerol. Of the studies reviewed, 20 out of 76 studies were of sufficient quality. The results of the systematic review indicated that phytosterols/stanols could significantly decrease low density lipoprotein cholesterol, total cholesterol and triacylglycerol in treatment groups compared with control groups and that the mean differences were [-0.35 mmol/L, 95%CI(-0.47, -0.22), p<0.00001], [-0.36 mmol/L, 95%CI(-0.46, -0.26), p<0.00001] and [-0.1 mmol/L, 95%CI(-0.16, -0.03), p=0.004] respectively. Foods enriched with 2.0 g of phytosterols/stanols per day had a significant cholesterol lowering effect.

Key Words: phytosterol, plant stanol ester, lipids, system review, meta-analysis

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植物甾醇对非家族性高胆固醇血症人群血脂作用的系统评价 为了探讨植物甾醇对非家族性高胆固醇血症人群的降脂作用,本研究通过全面检索Medline、EMbase等国际期刊数据库和相关出版物的参考文献,选择人体随机对照介入试验,以血浆低密度胆固醇、总胆固醇、高密度胆固醇和甘油三酯水平为分析指标进行系统评价。由两位评价者独立阅读相关文献并提取数据,只有文献质量达到要求的研究才被纳入评价。最后在76篇相关文献中共纳入20项研究进行评价。结果显示,与对照组相比,植物甾醇能显著降低试验组的血浆低密度胆固醇、总胆固醇和甘油三酯水平,其平均效应值分别为[-0.35 mmol/L, 95%CI(-0.47, -0.22), p<0.00001]、[-0.36 mmol/L, 95%CI(-0.46, -0.26), p<0.00001]和[-0.1 mmol/L, 95%CI(-0.16, -0.03), p=0.004]。系统评价的结果表明每日随食物摄入2 g植物甾醇对非家族性高胆固醇血症人群有良好的降低血浆胆固醇作用。 关键词:植物甾醇,植物甾烷醇酯,脂质,系统评价,統合分析

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Evaluation of fatty acid content of some Iranian fast foods with emphasis on trans fatty acids
SEDDIGHEH ASGARY, BAHAR NAZARI, NIZAL SARRAFZADEGAN, SAHAR PARKHIDEH, SALBALI SABERI, AHMAD ESMAILLZADEH AND LEILA AZADBAKHT
Although the disadvantages of trans fatty acids (TFAs) are widely mentioned, limited data are available on the TFAs contents of Iranian foods, including fast foods. The aim of this study was to quantify the amounts of common fatty acids in several fast foods in Iran, with specific focus on TFAs. The most commonly consumed fast foods in Iran: sausage, calbas, hamburgers and pizzas, were randomly selected seven times from products available in supermarkets and restaurants. Each time a 10 g sample was drawn and prepared for fatty acid analysis. Total and individual fatty acids were quantified according to standard methods by gas chromatography with 60 meter capillary column and flame ionization detector. The most common saturated fatty acids in Iranian fast foods is stearic acid (C18:0) which ranged from 14.0% to 20.9%. Saturated fatty acid content in calbas was significantly higher than that found in other groups. Trans fatty acids constitute almost 23.6% to 30.6% of total fatty acids of these products. The most common TFA in these fast foods was elaidic acid (C18:1 9t). Total cis unsaturated fatty acid content of tested fast foods varied from 25.3 %( in sausage) to 46.8(in calbas) with oleic acid (C18:1 9c) followed by linoleic acid (C18:2) being the most common fatty acids in these products. This study showed higher TFAs contents in commercially available fast foods compared to the amounts recommended by dietary guidelines in Iran. Further studies must assess the effects of these fatty acids on human health.
Key Words: trans fatty acids, saturated fatty acid, cis unsaturated fatty acid, fast food, gas chromatography

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評估某些伊朗速食品中的脂肪酸,特別是反式脂肪酸 雖然反式脂肪酸的弊害被廣泛的提及,但關於伊朗食物,包括速食品的反式脂肪酸含量的資料卻有限。本研究的目的即是定量伊朗的幾種速食中,一般脂肪酸的量,特別是反式脂肪酸。在伊朗,常吃的速食有香腸、肉餅(calbas)、漢堡、以及比薩。這些食物由超市及餐廳中隨機取樣七次,每次取得10 g樣本以進行脂肪酸分析。總體脂肪酸及個別脂肪酸根據標準方法,以氣相層析儀(60 米毛細管柱及火焰離子偵測器)定量。伊朗速食品中,主要的飽和脂肪酸為硬脂酸(C18:0),含量從14.0%到20.9%。Calbas中飽和脂肪酸含量顯著的高於其他食品。反式脂肪酸約佔這些產品所含總脂肪酸的23.6%到30.6%。這些食品中,主要的反式脂肪酸為反油酸(C18:1 9t)。這些速食中的總順式不飽和脂肪酸含量不同,從25.3%(香腸)到46.8%(calbas),以油酸(C18:1 9c)含量最多,亞麻油酸(C18:2)次之。本研究顯示,與伊朗的飲食指標建議量相比,市面上可得到的速食品中有較高的反式脂肪酸含量。而進一步的研究必須要評估這些脂肪酸對人類健康的影響。 關鍵字:反式脂肪酸、飽和脂肪酸、順式不飽和脂肪酸、速食品、氣相層析

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Dietary intake of zinc in the population of Jiangsu Province, China
YU QIN, ALIDA MELSE-BOONSTRA, ZUMIN SHI, XIAOQUN PAN, BAOJUN YUAN, YUE DAI, JINKOU ZHAO, MICHAEL B ZIMMERMANN, FRANS J KOK AND MINGHAO ZHOU
Objectives: To evaluate dietary zinc and other divalent minerals intake among the population of Jiangsu Province. Methods: 3,867 subjects aged 4-89 years were representatively sampled in two urban and six rural areas of Jiangsu Province. Dietary intake was assessed using 24-hour recalls on three consecutive days. Insufficient zinc intake was calculated based on the Chinese Dietary Reference Intakes. Results: Overall, the percentage of subjects with insufficient intake of zinc was 22.9%, with a declining trend with age. Except for the group ≥50 years, mean zinc intake of all other groups were below the age- and sex- specific Recommended Nutrition Intakes (RNI). Approximately 2/3rds of the subjects ≤17 years of age had insufficient zinc intakes. Compared with the age group below 11 years, risk of insufficient zinc intake increased in the adolescents aged 11-17 years (OR: 2.10, 95% CI: 1.86-2.36), but decreased in adults aged 18-49 years and ≥50 years (OR: 0.76, 95% CI: 0.66-0.8; OR:0.55, 95%CI: 0.47-0.64). Mean intake of iron, copper, magnesium and selenium met the Chinese DRIs respectively, except for selenium in females. The prevalence of insufficient intake of copper, magnesium and selenium was 37.2%, 22.8% and 29.3%, respectively, while the overall prevalence of insufficient iron intake was only 3.4%. Conclusion: Dietary zinc intake of the Jiangsu Province population does not generally meet the Chinese RNI. Children and adolescents in particular have a higher risk of insufficient zinc intake.

Key Words: zinc, minerals, dietary intake, Jiangsu Province, China

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中国江苏省居民膳食鋅摄入量的研究 目的:调查了解中国江苏省民眾食物中锌及其他二价元素摄入情况。方法:在江苏省2个城市和6个农村地区选择代表性的样本,共包括3,867名4-89岁的居民。以連續三天24小时饮食回顾法評估食物营养摄入,并根据中国膳食参考摄入量来定義锌摄入不足。结果:锌摄入量不足率为22.9%,随着年龄的增长而下降。除50岁及以上的组別外,其他年龄组人群平均锌摄入量均低于相应年龄、性别的推荐摄入量。在17岁及以下的受訪者中,锌摄入量不足者约占2/3。与11岁以下年龄组相比,锌摄入量不足的风险在11-17岁的青少年有所增加(OR: 2.10, 95% CI: 1.86-2.36),而在成人18-49岁组和50岁及以上组別都下降(OR: 0.76, 95%CI: 0.66-0.8; OR: 0.55, 95%CI: 0.47-0.64)。在调查群体中,除了女性硒摄入量外,其余各组铁、铜、镁和硒的平均摄入量均达到中国膳食推荐摄入量。铜、镁和硒摄入不足率分别为37.2%、22.8%及29.3%,而铁摄入不足率仅为3.4%。结论:江苏居民膳食锌摄入量不能达到中国膳食推荐摄入量,尤其是儿童和青少年的风险较高。 关键词:锌、礦物質、膳食摄入量、江苏省、中国

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The female athlete triad among elite Malaysian athletes: prevalence and associated factors
YE VIAN QUAH, BEE KOON POH, LAI OON NG AND MOHD ISMAIL NOOR
Women participating in a wide range of competitive sports are at higher risk of developing eating disorders, menstrual irregularities and osteoporosis, which are generally referred to as the ‘female athlete triad’. The objective of this study was to determine the prevalence of female athlete triad and factors associated with this condition among athletes participating in different sports. A total of 67 elite female athletes aged between 13-30 years participated in the study and were subdivided into the ‘leanness’ and ‘non-leanness’ groups. Eating disorders were assessed using a body image figure rating and the Eating Disorder Inventory (EDI) with body dissatisfaction (BD), drive for thinness (DT), bulimia (B) and perfectionism (P) subscales. Menstrual irregularity was assessed with a self-reported menstrual history questionnaire. Bone quality was measured using a quantitative ultrasound device at one-third distal radius. Prevalence of the female athlete triad was low (1.9%), but the prevalence for individual triad component was high, especially in the leanness group. The prevalence of subjects who were at risk of menstrual irregularity, poor bone quality and eating disorders were 47.6%, 13.3% and 89.2%, respectively, in the leanness group; and 14.3%, 8.3% and 89.2%, respectively, in the non-leanness group. Since the components of the triad are interrelated, identification of athletes at risk of having any one component of the triad, especially those participating in sports that emphasise a lean physique, is an important aid for further diagnosis.
Key Words: female athlete triad, eating disorders, menstrual irregularity, bone quality, osteoporosis

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優秀的馬來西亞運動員的女性運動員三症候群:盛行率及其相關因子 女性經常參加競爭性運動,有較高的風險而致罹患飲食失調、月經不規律及骨質疏鬆,這普遍被稱為“女性運動員三症候群”。此研究目的為評估那些參與不同運動的運動員,其女性運動員三症候群的盛行率及相關因子。總共有67 名年齡介于13-30 歲的優秀女性運動員參與這個研究,並且被分為‘精瘦組’與‘非精瘦組’。飲食失調是使用一種體型形象等級評比及飲食障礙調查(EDI)包括:體型不滿意(BD)、對體瘦的渴求(DT)、暴食(B)及完美主義(P)評估。月經不規律是由自填式月經史問卷評估。骨質是使用量化超音波儀器測量1/3 的遠端橈骨。女性運動員三症候群盛行率虽不高(1.9%),但其單一症候盛行率却蛮高,尤其是在精瘦組。研究對象精瘦組有月經不規律、骨質差及飲食失調风险的盛行率分別為47.6%、13.3%及89.2%;在非精瘦組則分別14.3%、8.3%及89.2%。因為三症候群的各組症候是有相互關聯的,因此確認運動員有任何一種症候的风险,尤其是那些強調參與瘦體型運動的運動员,對進一步的診斷有重要幫助。 關鍵字:女性運動家三症候群、飲食失調、月經不規律、骨質、骨質疏鬆
 

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Optimal cut-off levels to define obesity: body mass index and waist circumference, and their relationship to cardiovascular disease, dyslipidaemia, hypertension and diabetes in Malaysia
ZAKI MORAD MOHD ZAHER, ROBAYAAH ZAMBARI, CHAN SIEW PHENG, VADIVALE MURUGA, BERNARD NG, GEETA APPANNAH AND LIM TECK ONN
Many studies in Asia have demonstrated that Asian populations may require lower cut-off levels for body mass index (BMI) and waist circumference to define obesity and abdominal obesity respectively, compared to western populations. Optimal cut-off levels for body mass index and waist circumference were determined to assess the relationship between the two anthropometric- and cardiovascular indices. Receiver operating characteristics analysis was used to determine the optimal cut-off levels. The study sample included 1833 subjects (mean age of 44 + 14 years) from 93 primary care clinics in Malaysia. Eight hundred and seventy two of the subjects were men and 960 were women. The optimal body mass index cut-off values predicting dyslipidaemia, hypertension, diabetes mellitus, or at least one cardiovascular risk factor varied from 23.5 to 25.5 kg/m2 in men and 24.9 to 27.4 kg/m2 in women. As for waist circumference, the optimal cut-off values varied from 83 to 92 cm in men and from 83 to 88 cm in women. The optimal cut-off values from our study showed that body mass index of 23.5 kg/m2 in men and 24.9 kg/m2 in women and waist circumference of 83 cm in men and women may be more suitable for defining the criteria for overweight or obesity among adults in Malaysia. Waist circumference may be a better indicator for the prediction of obesity-related cardiovascular risk factors in men and women compared to BMI. Further investigation using a bigger sample size in Asia needs to be done to confirm our findings.

Key Words: abdominal obesity, body mass index, waist circumference, cardiovascular, Asia

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在馬來西亞定義肥胖的理想切點:身體質量指數和腰圍,與心血管疾病、脂質異常、高血壓和糖尿病的相關性 亞洲許多研究都認為亞洲人比西方人可能需要較低的身體質量指數(BMI)和腰圍切點,以分別定義肥胖和腹部肥胖。訂定適宜的身體質量指數和腰圍切點來評估這兩個體位指標和心血管疾病指標的相關性。應用接受器操作特性曲線(ROC)分析決定理想切點。研究樣本包含來自馬來西亞93個初級醫護診所中的1833個受試者(平均年齡44±14歲)。其中男性872位和女性960位。可預測血脂異常、高血壓、糖尿病或至少一個心血管疾病危險因子的身體質量指數切點範圍,在男性為23.5-25.5 kg/m2,女性為24.9-27.4 kg/m2。至於腰圍的適當切點範圍,男性為83-92 cm,女性為83-88 cm。從我們的研究中顯示,定義馬來西亞成年人的過重或肥胖標準,更適合的身體質量指數的理想切點,男性和女性分別為23.5 kg/m2和24.9 kg/m2;男性和女性腰圍的理想切點都為83 cm。腰圍相較於身體質量指數,可能是一個評估男性和女性肥胖相關的心血管危險因子更好的預測指標。在亞洲,可能需要進一步使用一個更大的樣本數調查,以證實我們的發現。 關鍵字:腹部肥胖、身體質量指數、腰圍、心血管疾病、亞洲

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Correlation of anthropometric indices with common cardiovascular risk factors in an urban adult population of Iran: data from Zanjan Healthy Heart Study
ALI AWSAT MELLATI, SEYED NOURADDIN MOUSAVINASAB, SEPIDE SOKHANVAR, SEYED ALI NAGHI KAZEMI, MOHAMMAD HOSSAIN ESMAILLI AND HOSSAIN DINMOHAMADI
The purpose of this study was to determine the anthropometric index that best predicts common cardiovascular risk factors. A total of 2768 individuals (1310 men and 1458 women) aged 21-75 years with full relevant data from the Zanjan Healthy Heart Study (a prospective study in Zanjan and Abhar, two main cities of Zanjan Province, Iran) were recruited. Common cardiovascular risk factors (TG, TC, HDL-c, LDL-c, fast blood sugar, blood pressure), anthropometric indices (BMI, WC, WHR, WHtR) were measured using standard process, and their correlated classification was evaluated by partial correlation and Receiver Operator Characteristic (ROC) curve analysis. Area under curve (AUC) of WHtR was the largest for most (6 of 7) of the common cardiovascular risk factors in both men and women; followed by WC (4 of the 7 including ties) in men, while AUCs of three anthropometric indices (WC, BMI, WHR) were the same with the largest for 1 of 7 risk factors in women. These results show that the high prevalence of lipid profiles, as cardiovascular risk factors, need special attention, intervention and appropriate treatment. Consistence with other reports, WHtR is a better discriminator of cardiovascular risk factors compared with the other three indices (BMI, WC, and WHR). We determined its optimal cut-off point of 0.5 for both genders. However, due to differences in reported cut-off values across different ethnic groups, future research and longitudinal data is needed before reaching an internationally accepted simple and appropriate measure that could be effectively used in the clinical and epidemiological fields.

Key Words: WHtR, anthropometric indices, cardiovascular risk factors, obesity, ROC analysis

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伊朗城市成人的體位測量指數與心血管疾病危險因子之相關性:Zanjan健康心臟研究資料 本研究目的,為找出預測心血管疾病危險因子的最佳體位測量指數。由Zanjan健康心臟研究中(一前瞻性研究,於伊朗Zanjan省的Zanjan及Abhar兩大城市進行),找出2768位有完整資料的受試者,包括1310位男性及1458女性,年齡介於21-75歲。常見的心血管疾病危險因子(三酸甘油酯、總膽固醇、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、空腹血糖及血壓)及體位測量指數(身體質量指數、腰圍、腰臀比及腰圍身高比),皆使用標準流程量測。將心血管疾病危險因子及體位測量指數,使用淨相關及接收器運作特性(ROC)曲線分析。ROC曲線分析結果,在男性與女性,共有6項心血管危險因子,都以腰圍身高比的曲線下面積(AUC)最大。在男性,其次為4項心血管危險因子,以腰圍AUC較大;女性受試者,三種體位測量指數(腰圍、身體質量指數及腰臀比)各在1項心血管危險因子中,有最大的AUC。由結果顯示,高盛行率的血脂異常,即心血管疾病之高風險,需特別注意、介入並使用適當方式治療。腰圍身高比,比起其他三種體位測量指數(身體質量指數、腰圍、腰臀比),為心血管危險因子之較好預測因子,與其他研究報告結果相符合。在男性及女性中,決定的最佳切點為0.5。然而因種族不同,其切點也與之前研究不同,需要未來研究及縱貫性資料,以訂定出國際公認簡單、適宜之測量,可有效在臨床及流行病學領域上使用。 關鍵字:腰圍身高比、體位測量指數、心血管危險因子、肥胖、ROC分析

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Prevalence and risk factors with overweight and obesity among Vietnamese adults: Caucasian and Asian cut-offs
OANH TH TRINH, NGUYEN D NGUYEN, PHILAYRATH PHONGSAVAN, MICHAEL J DIBLEY AND ADRIAN E BAUMAN
Objective: To determine the prevalence and factors associated with overweight/obesity among adults in Ho Chi Minh City (HCMC) using Caucasian and Asian cut-offs. Study design: A cross-sectional survey. Methods: In 2005, 1,971 adults aged 25-64 years in HCMC were randomly selected using a proportional to population size sampling method to estimate the prevalence of overweight and obesity, measured by body mass index (BMI) and waist circumference. Multivariable logistic models were used to examine associations between overweight/obesity and socioeconomic status, health-related behaviors, and biochemical indices of chronic disease risk. Results: The prevalence of overweight and obesity using the Caucasian BMI cut-offs were 13.9% and 1.8% respectively, and those with the Asian BMI cut-offs were 27.5% and 5.7%, respectively. The abdominal adiposity rates were higher than the BMI overweight and obesity rates in women, but not in men. Increasing age, low education, high household wealth index, high levels of sitting and reclining time, cholesterol and high blood pressure were significantly associated with overweight and obesity. Current smoking and sedentary leisure time was significantly negatively associated with this status in men. Conclusion: Associations between overweight/obesity and metabolic disorders were evident using both cut-offs. Asian cut-offs identified more risk factors and therefore could be considered for defining at-risk groups. The results highlight the importance of intervention programs to prevent overweight/obesity in young adults.

Key Words: Asians, adults, risk factors, developing countries, obesity

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越南成年人過重與肥胖的盛行率與危險因子:白人和亞洲人的切點 目的:探討胡志明市的體重過重和肥胖的盛行率與相關因子,用白種人及和亞洲人的切點。研究設計:橫斷性研究。研究方法:2005年,使用人口規模比例抽樣方法,隨機選取在胡志明市中1971位的成人,年齡為25-64歲,用以評估過重和肥胖的盛行率,測量包括身體質量指數(BMI)和腰圍。多變量羅吉斯迴歸用以評估過重/肥胖與社經地位、健康相關行為、慢性疾病危險因子的生化指標之相關。結果:若利用白種人BMI切點,過重和肥胖的盛行率,分別為13.9%與1.8%;採用亞洲人BMI切點,則分別為27.5%與5.7%。女性中,腹部肥胖比例高於BMI過重和肥胖率,但此現象不發生於男性中。年齡越大、教育程度低、家庭財富指數高、長時間久坐和斜倚、膽固醇和血壓高,皆與過重和肥胖有顯著相關。男性中,目前抽菸和閒暇時間少運動與過重和肥胖有顯著的逆相關。結論:使用兩種切點,都證實過重和肥胖與代謝疾病是相關的。用亞洲人的切點判定更多的危險因子,因此可確認高危險族群。此結果更突顯,對於年輕的成人,應有介入的計畫予以預防過重及肥胖。 關鍵字:亞洲人、成人、危險因子、發展中的國家、肥胖

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Prevalence of underweight, overweight and obesity in urban Hanoi, Vietnam
HELEN L WALLS, ANNA PEETERS, PHAM THAI SON, NGUYEN NGOC QUANG, NGUYEN THI THU HOAI, DO DOAN LOI, NGUYEN LAN VIET, PHAM GIA KHAI AND CHRISTOPHER M REID
This study aims to assess the prevalence of underweight, overweight and obesity among adults in urban Hanoi, Vietnam; and compare these results to previous estimates among adults in urban Ho Chi Minh City. Survey participants were residents in urban Hanoi, Vietnam and aged between 25-74 years. Data from a cross-sectional biomedical survey conducted in 2004 were collected; which included a questionnaire, physical examination and blood tests.  The age-standardised prevalence of overweight and obesity in 2004, using Asian-specific body mass index cut-offs, were 28.6% and 2.1%, respectively. The prevalence of overweight/obesity (combined) was similar in males (29.7%) and females (31.5%), and generally increased with age. The prevalence of overweight/obesity was considerably lower if the standard cut-off values of the World Health Organization were used. The age-standardised prevalence of underweight was 13.3%; and that of ‘increased risk’/‘substantially increased risk’ waist circumference (combined) was 27.9% in males and 25.7% in females, respectively. Almost one in three adults in urban Hanoi were overweight or obese in 2004 and more than one in ten were underweight (based on Asian-specific cut-off values). This prevalence of overweight/obesity is similar to that for adults in urban Ho Chi Minh City, but the prevalence of underweight is lower.  While low body weight remains a concern, overweight and obesity are an increasing problem for urban Vietnamese adults.

Key Words: underweight, overweight, obesity, BMI, Vietnam

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越南河內市的成人體重過輕、體重過重及肥胖的盛行率 此研究目的為評估在越南河內市區的成人體重過輕、體重過重及肥胖的盛行率,並將這個結果與之前在胡志明市針對成人所做的評估作比較。調查對象為居住在越南河內市區,且年齡在25-74歲之間的成人。資料是來自於2004年收集的一個橫斷性生物醫學調查,其包含一份問卷、身體檢查及血液檢驗。使用亞洲身體質量指數的切點,2004年年齡標準化體重過重及肥胖盛行率分別是28.6%及2.1%。體重過重/肥胖(合併)的盛行率男性(29.7%)與女性(31.5%)相似,且普遍隨著年齡增加。假如採用世界衛生組織的標準切點,則體重過重/肥胖的盛行率則大幅降低。年齡標準化的體重過輕盛行率為13.3%。腰圍在‘危險性增加’/‘大大增加危險性’(合併)的男性及女性分別為27.9%及25.7%。2004年在河內市3位成年人中將近有1位是體重過重或肥胖,並且10位中超過1位是體重過輕(依據亞洲的切點)。這個體重過重/肥胖的盛行率與胡志明市的成年人相似,但體重過輕的盛行率則較低。當體重過低仍然是被關注的議題時,越南城市的成人體重過重與肥胖是一個逐漸增加的問題。 關鍵字:體重過輕、體重過重、肥胖、身體質量指數、越南

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Validity and reproducibility of a food frequency questionnaire among Chinese women in Guangdong province
CAI-XIA ZHANG AND SUZANNE C HO
Objective: To evaluate the validity and reproducibility of a food frequency questionnaire (FFQ) developed for assessing the association between dietary factors and breast cancer risk among Chinese women in Guangdong. Methods: 61 women (24-64 years) were recruited from the community in Guangzhou city. An 81-item FFQ was administered twice, one year apart (FFQ1, FFQ2). In the mean time, six 3-day dietary records (DRs) were collected at two month intervals within the year. Daily consumption of nutrients and foods from the FFQs and DRs, correlation coefficients between the two FFQs and the FFQ with DRs were calculated. Results: Median intakes of nutrients and food group items are higher in FFQ1 than FFQ2. The energy-adjusted Pearson correlation coefficients between the FFQ1 and FFQ2 ranged from 0.46 to 0.71 for nutrients and 0.36 to 0.66 for food group items, respectively. In the validation study, energy-adjusted correlation coefficients were 0.25 to 0.65 for nutrients and 0.30 to 0.68 for food groups. Mean proportion of subjects being classified into the same quartile of nutrients and foods intake from the FFQ and DRs was 36% and 43%, respectively. Mean misclassification of subjects into opposite quartiles was 5% for nutrients and 3% for foods. Bland-Altman analysis showed that no linear trend existed between the differences and means for nutrients. Conclusions: The 81-item FFQ has satisfactory reproducibility and reasonable validity, and is useful in assessing the usual consumption of major nutrients and food groups among Chinese women in Guangdong.

Key Words: food frequency questionnaire, reproducibility, validity, women, China

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中國廣東女性食物頻數問卷效度和信度的評價 目的:爲研究中國廣東女性膳食因素與乳腺癌發病的關係,研製了食物頻數問卷。本研究的目的在于評價該食物頻數問卷(81個食物條目)的效度和信度。方法:61名年齡在24-64歲來自廣州市社區的女性參與本研究,采用三天的膳食記錄法作爲標準方法。調查對象一共完成兩次食物頻數問卷,間隔時間爲一年;在此期間,每隔兩個月完成一次連續三天的膳食記錄,共計六次。計算兩種膳食調查方法所得每日營養素和食物的攝入量以及相關係數。結果:對于營養素和大部分食物條目,第一次食物頻數問卷測得的平均攝入量高于第二次。兩次食物頻數問卷用熱量校正後的營養素相關係數範圍在0.46到0.71,食物的相關係數範圍在0.36到0.66。效度測試方面,熱量校正的營養素相關係數範圍在0.25到0.65之間,熱量校正的食物相關係數範圍為0.30到0.68。根據營養素攝入量,以四分位法將研究對象分組,在兩種膳食調查方法中被分到同一組的調查對象平均佔36%,有5%被分到極端的兩組。對食物來說,平均43%的調查對象被分到同一組,3%的對象被分到極端的兩組。Bland-Altman分析顯示食物頻數問卷和膳食記錄兩種方法測得的營養素攝入的差值和均數之間不存在綫性關係。結論:本研究結果顯示該食物頻數問卷具有滿意的信度和合理的效度,可用于評價中國廣東女性的營養素和食物的攝入。 關鍵詞:食物頻數問卷、信度、效度、女性、中國

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Validation of prediction equations for estimating resting energy expenditure in obese Chinese children
DOROTHY FY CHAN, ALBERT M LI, MICHAEL HM CHAN, HUNG KWAN SO, IRIS HS CHAN, JANE AT YIN, CHRISTOPHER WK LAM, TAI FAI FOK AND EDMUND AS NELSON
Objectives: (1) To examine the validity of existing prediction equations (PREE) for estimating resting energy expenditure (REE) in obese Chinese children, (2) to correlate the measured REE (MREE) with anthropometric and biochemical parameters and (3) to derive a new PREE for local use. Design: Cross-sectional study. Subjects: 100 obese children (71 boys) were studied. Measurements: All subjects underwent physical examination and anthropometric measurement. Upper and central body fat distribution was signified by centrality and conicity index respectively, and REE was measured by indirect calorimetry. Fat free mass (FFM) were measured by DEXA scan. Thirteen existing prediction equations for estimating REE were compared with MREE among these obese children. Fasting blood for glucose, lipid profile and insulin were obtained. Results:  The overall, male and female median MREEs were 7.1 mJ/d (IR 6.2-8.4), 7.3 mJ/d (IR 6.3-9.7) and 6.9 mJ/d (IR 5.6-8.1) respectively. No sex difference was noted in MREE (p=0.203). Most of the equations except Schofield equation under-estimated REE of our children. By multiple linear regression, MREE was positively correlated with FFM (p<0.0001), conicity index (p<0.001) and centrality index (p=0.001). A new equation for estimating REE for local use was derived as: REE = (17.4*logFFM) + (11.4*conicity index) – (2.4*centrality index) – 31.3. The mean difference of new PREE-MREE was -0.011 mJ/d (SD 1.51) with an interclass correlation coefficient of 0.91. Conclusion: None of the existing prediction equations were accurate in their estimation of REE, when applied to obese Chinese children. A new prediction equation has been derived for local use.

Key Words: obese, children, body fat distribution, resting energy expenditure, insulin resistance

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評定靜息能量消耗預測方程在肥胖華裔兒童的效度 目的:(1) 評定現存的靜息能量消耗預測方程(PREE)在肥胖華裔兒童的效度,(2)探討測量的靜息能量消耗(MREE)與體位測量和生化指標的關聯,(3) 建立本地的靜息能量消耗預測方程。設計:橫斷面研究。受試者:100名肥胖兒童,當中71位是男孩。測量:所有受試者均接受身體檢查和體位測量。上身和中央體脂分佈,分別用向心性指標(centrality index)和圓錐度指標(conicity index)表示。靜息能量消耗(REE)是以間接熱量計量度。應用雙能X線吸收測量法(DEXA)量度非脂肪組織(FFM)。以測量肥胖兒童得到的靜息能量消耗和13項現存的靜息能量消耗預測方程進行比較,並記錄空腹血糖、血脂及胰島素的結果。結果:整體、男孩和女孩的MREE中位數分別是7.1 mJ/d (IR 6.2-8.4)、7.3 mJ/d (IR 6.3-9.7)及6.9 mJ/d (IR 5.6-8.1),MREE未見性別差異(p=0.203)。除了Schofield的方程外,大部份的預測方程都低估了我們兒童的REE。應用多元線性回歸發現MREE與FFM(p<0.0001),圓錐度指標(p<0.001)及向心性指標(p=0.001)呈正相關。為本地兒童制定的新方程:REE = (17.4*logFFM) + (11.4*圓錐度指標) – (2.4*向心性指標) – 31.3。新方程的PREE-MREE的平均差值是-0.011 mJ/d (SD 1.51),其組間相關係數為0.91。結論:所有現存的靜息能量消耗預測方程應用在華裔肥胖兒童時皆不能做出準確預測,因此我們為本地兒童制定新的方程。 關鍵字:肥胖、兒童、體脂分佈、靜息能量消耗、胰島素阻抗

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Adults’ perceptions of being overweight or obese: a focus group study
CHING THON CHANG, KAM HOCK CHANG AND WHYE LIAN CHEAH
The objective of this study was to explore the perception of, feelings and attitudes toward overweight or obesity, and the perceived barriers to weight loss among native adults from lower socio-economic background. A total of six gender- and ethnic-specific focus groups consisted of 38 overweight and obese purposefully and criterion se-lected adults (21 women and 17 men), participated in this study. An unstructured discussion guide based on the study objectives were used for the focus groups. The results showed that some participants perceived themselves as ugly, felt ashamed of their body size and were frustrated because they did not desire to be overweight. Due to their excess weight, most also expressed they were less effective in their work performances. Although some participants had negative attitudes toward themselves because of excess weight, this appeared to link to self-stigmatization rather than anti-obesity discrimination. The participants remained in the Pre-contemplation stage of losing weight probably because of perceived barriers such as difficulty to resist eating, lack of know how and previous failed attempts to lose weight. Importantly, this study provided some evidence that individuals in the Pre-contemplation stage are unable to take action to lose weight, even if effective strategies are suggested.

Key Words: overweight and obese natives, rural community, purposive sample, focus groups, Malaysia
 

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成人對過重或肥胖的知覺:焦點團體研究 本篇研究主要探討較低社經背景的馬來西亞原住民成人對於過重與肥胖的認知、感覺與態度,以及他們對於減重的認知障礙。共有6個特定性別和種族的焦點團體,包括38位過重和肥胖,且經由立意取樣及特定標準選擇的成人(21位女性和17位男性)參與本研究。團體座談時,使用符合研究目標的無結構性的討論提示。結果顯示,一些參與者認為自己是醜陋的,他們對於自己的體型感到羞恥和沮喪,因為他們不希望自己是過重。多數表示,由於過重,他們的工作表現成效較差。雖然有些參與者因為過重,而看輕自己,這似乎是自我的烙印,而不是因為對肥胖的歧視。參與者停留在預沉思階段的減重,可能是因為認知障礙,例如抗拒飲食的困難度、不知如何進行減重和以往嘗試減重的失敗。重要的是,本篇研究的證據表明,即使提供有效的策略建議,個人在預沉思階段終究無法採取行動以減輕體重。 關鍵字:過重和肥胖原住民、農村社區、立意取樣、焦點團體、馬來西亞

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Body composition and nutrient intake of Buddhist vegetarians
YUJIN LEE AND MICHAEL KRAWINKEL
We described the body composition and nutrient intake of Buddhist vegetarians and compared the data with that of omnivores in South Korea. Vegetarian subjects were 54 Buddhist nuns, who adhered to a vegetarian diet in accordance with Buddhist teachings. We compared these finding with a group of 31 omnivore Catholic nuns who shared a similar lifestyle but different dietary pattern than those of the Buddhist nuns. All subjects completed the estimated three-day dietary record. Body composition was determined by a segmental multi-frequency-bioelectrical impedance analysis method. No height difference between the dietary groups existed but the vegetarians had a significantly higher body weight, fat free mass, body fat and body mass index (BMI, kg/m2) than the omnivores. The median BMI of both vegetarians and omnivores fell in the normal range (22.6 vs. 20.7 kg/m2). In vegetarians, body fat was inversely correlated with the duration of vegetarianism (p for trend = 0.043). The long duration group of the vegetarians had lower body fat than the short duration group (12.l vs. 15.0 kg, p = 0.032). The status of the nutrient intake of Korean Buddhist vegetarians was comparable to that of omnivores, and the intake of some nutrients in vegetarians was more favorable than in the omnivores.

Key Words: vegetarian, duration of vegetarianism, body fat, BMI, nutrient intake

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信奉佛教的素食者之體組成及營養素攝取 我們說明南韓信奉佛教的素食者之體組成及營養素攝取,並與雜食者的數據作比較。有54名佛教尼姑的素食者為研究對象,她們依佛教的教條而吃素。另外一組31名雜食的天主教修女做比較對象,她們與佛教尼姑有相似的生活型態,卻有不同的飲食模式。所有的受試者完成3天的飲食紀錄。以部份多頻率生物電阻法評估體組成。兩組間沒有身高的差異,但是素食者比起雜食者,有顯著較高的體重、非脂肪重、體脂肪及身體質量指數(BMI, kg/m2)。素食者及雜食者的BMI中位數均屬正常範圍 (22.6及20.7 kg/m2)。在素食者,體脂肪與吃素的持續時間為負相關(p for trend = 0.043)。長期的吃素者比起吃素時間短的受試者有較低的體脂肪(12.1 vs. 15.0 kg, p=0.032)。韓國佛教徒的吃素者之營養素攝取狀況與雜食者是可相比的,且某些營養素的攝取比起雜食者更佳。 關鍵字:素食者、吃素持續時間、體脂肪、身體質量指數、營養素攝取

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Predictability and implications of anthropometric indices for metabolic abnormalities in children: nutrition and health survey in Taiwan elementary children, 2001-2002
SHAO-YUAN CHUANG AND WEN-HARN PAN
Background: To determine whether separate anthropometric screening tools are needed for obesity and the metabolic syndrome in children, we compared the predictability of several anthropometric indices, including waist circumference (WC) and body mass index (BMI), with regard to metabolic disorders. Study design: The Nutrition and Health Survey in Taiwan Elementary School Children (2000-2001) collected data from 2,215 children. Logistic regression analysis was used to study the association between anthropometric indices and metabolic abnormalities, which was defined as two or more of the following conditions: high fasting triglycerides, high fasting glucose levels, high blood pressure and low high-density lipoprotein-cholesterol. The receiver operating characteristic curve was used to study the sensitivity and specificity of these anthropometric indices. Results: predictability was the ranked highest for WC (R2 = 10.69%), followed by BMI (R2 = 9.80%), arm girth (R2 = 9.75%), hip circumference (R2 = 9.43%), scapular skinfold thickness (R2 = 9.28%) and waist-to-height ratio (R2 = 9.25%). Waist circumference or BMI cut-offs for maximal balanced sensitivity and specificity were close to the 60th percentile for each age and gender group. Values were greater in boys than in girls and increased with age. Conclusion: It is justifiable to use the WC criteria to define the metabolic syndrome in children. Due to its practicality, BMI remains the most suitable index for defining overweight/obesity. Only moderate levels of sensitivity and specificity were achieved with these two popular obesity indices with regard to metabolic abnormalities.

Key Words: anthropometric index, children, the metabolic syndrome, waist circumference, body mass index

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學童體位測量指標對代謝異常疾病的預測力與涵義:臺灣地區國小學童營養健康狀況調查, 2001-2002 背景:探討在學童中,對於肥胖與代謝異常症候群的篩檢,個別的體位測量篩檢工具是否需要。我們比較各項體位測量指標對代謝異常疾病的預測力,包括腰圍與身體質量指數。研究設計:臺灣地區國小學童營養健康狀況調查(2000 -2001年),共計收集2,215位學童的資料。羅吉斯回歸被用來評估體位測量指標與代謝異常的關係,代謝異常定義為具兩個或兩個以上的下列危險因子:偏高的空腹三酸甘油脂、偏高的空腹血糖、高血壓與偏低的高密度脂蛋白膽固醇。接受器操作特性曲線(ROC curves)被用來研究各項體位測量指標的敏感度與精確度。結果:預測力最高是腰圍(R2 =10.69% )、依次為身體質量指數(R2=9.80%)、上臂周長(R2=9.75%)、臀圍(R2=9.43%)、肩胛皮下脂肪厚度(R2=9.28%)、腰圍-身高比值(R2=9.25%)。以年齡與性別分層之腰圍或身體質量指數,其理想切點靠近60百分位。切點的數值會隨著年齡而增加,且男孩有較高的切點值。結論:以腰圍的切點標準來定義兒童代謝症候群是合理的。考量實用性,身體質量指數仍然是最適合定義過重或肥胖的指標。對預測代謝異常疾病而言,這兩個常用肥胖指標的敏感度與精確度僅在中等。 關鍵字:體位測量指標、兒童、代謝症候群、腰圍、身體質量指數

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Metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) phenotypes in Koreans: characteristics and health behaviors
KAYOUNG LEE
The purpose of this study was to estimate the prevalence of ‘metabolically obese, but normal-weight’ (MONW) and ‘metabolically healthy, but obese’ (MHO) phenotypes in Korean adults and identify the characteristics and health behaviors related to both phenotypes. Of the 5267 participants (2227 men, 3040 women) from the 3rd Korean National Health and Nutrition Examination Survey, the MONW phenotype (8.7% of total subjects, 12.7% of normal-weight subjects) was defined as individuals of normal weight (BMI < 25) with the metabolic syndrome (MS), and the MHO phenotype (15.2% of total subjects, 47.9% of obese subject) was defined as obese individuals (BMI ³ 25) without the MS. The odds ratio for MONW phenotype was significantly higher for those at older age, those with lower education, those who had moderate alcohol consumption, and time spent participating in moderate-intensity exercise. The odds ratio for MHO phenotype was significantly lower for those at older age, men, those with lower education, and former/current smokers. In conclusion, regardless of weight status, health behaviors should be modified to prevent MS.

Key Words: metabolically obese but normal-weight, metabolically healthy but obese phenotype, prevalence, health behaviors, Korean

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韓國的正常體重代謝性肥胖者(MONW)及肥胖代謝性健康者(MHO)的表現型:特性及健康行為 此研究目的為評估在韓國成年人的‘正常體重但代謝性肥胖者(MONW)’及‘肥胖但代謝性健康者(MHO)’的表現型盛行率,及確認與兩個表現型相關的特性及健康行為。參與第三次韓國國民健康與營養調查的5267名(2227名男性,3040名女性)受試者中,MONW表現型(佔整體的8.7%,佔正常體重者的12.7%)是指正常體重(BMI<25)但有代謝症候群(MS)的個體;而MHO表現型(佔整體的15.2%,佔肥胖者的47.9%)是指肥胖者(BMI³25)但沒有代謝症候群。MONW表現型的危險對比值在那些年齡較高,且教育程度較低,有適量飲酒及參與中等強度運動者顯著性較高。MHO表現型的危險對比值在那些年齡較高、男性且教育程度較低,曾經或目前抽菸者顯著性較低。總之,不管體重狀況,應修正健康行為以預防代謝症候群。 關鍵字:正常體重代謝性肥胖、肥胖代謝性健康、表現型、盛行率、健康行為、韓國人

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Dietary patterns and the metabolic syndrome in middle aged women, Babol, Iran
MOULOUD AGAJANI DELAVAR, MUNN-SANN LYE, GEOK LIN KHOR, SYED TAJUDDIN B SYED HASSAN AND PARICHEHR HANACHI
It is important to elucidate the dietary factors contributing to the development of metabolic syndrome among middle-aged women to better prevent and manage the syndrome. The objective was to determine the relationship between dietary intake and metabolic syndrome in urban Babolian middle-aged women. Systematic random sampling was used to select 984 women 30-50 years of age from urban area of Babol, Mazandaran, Iran. Dietary patterns were evaluated using a food frequency questionnaire. The ATP III criteria were used to classify study participants as having the metabolic syndrome. Correlations of component foods with indices of the metabolic syndrome were assessed using Spearman's rank correlation coefficient (rho). The adjusted odds ratios (OR) and their 95% confidence intervals were obtained for the nutrient groups. Mean total kilocalories consumed per day were 2965. The study suggests that a good dietary pattern that is rich in fruits, legumes, vegetables, cereals, and fish (component 1), as well as high intake of dairy products and eggs (components 4) decrease the likelihood of having metabolic syndrome. The adjusted OR for the metabolic syndrome in women with low fat intake was higher than in women with high and moderate fat (OR= 2.92; 95% CI= 1.36, 6.28). It is necessary to emphasize the benefits of lifestyle modification, including losing weight, and consumption of more fruits, legumes, vegetables, cereals, fish, dairy products in reducing the risk of the metabolic syndrome in middle aged women.
Key Words: dietary patterns, metabolic syndrome, FFQ, women’s health, Iran

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伊朗Babol中年婦女的飲食模式及代謝症候群 闡明飲食因子對於中年婦女代謝症候群發生的影響,有助於預防及管理代謝症候群。此研究目的為評估在Babol市的中年婦女,其飲食攝取與代謝症候群之相關性。使用系統性隨機抽樣,從伊朗Mazandaran省的Babol市區選取984名女性,年齡在30-50歲。使用飲食頻率問卷(FFQ)評估飲食模式。使用ATP III的標準來分類受試者是否有代謝症候群。食物組成與代謝症候群指數的相關性,是用斯皮爾曼等級相關係數(rho)評估。取得營養素組別的校正危險對比值(OR)及其95%信賴區間。受試者平均每天攝取的熱量為2965 kcal。此研究結果顯示,良好的飲食模式為富含水果、豆類、蔬菜、穀類及魚類(組成1),以及攝取高量的乳製品及蛋(組成4)可降低罹患代謝症候群之可能性。攝取低脂肪的婦女比起攝取高脂或中脂的婦女,有較高的代謝症候群校正危險對比值(OR= 2.92; 95% CI= 1.36, 6.28)。有必要去強調生活型態改變的益處,包含減重及攝取較多的水果、豆類、蔬菜、穀類、魚與乳製品,以降低中年婦女罹患代謝症候群之危險性。 關鍵字:飲食模式、代謝症候群、飲食頻率問卷、女性健康、伊朗

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Factor analysis of the metabolic syndrome components in urban Asian Indian adolescents
NAVAL K VIKRAM, RAVINDRA M PANDEY, ANOOP MISRA, KASHISH GOEL AND NIDHI GUPTA
There is paucity of data on the association of various risk factors of the metabolic syndrome in urban Asian Indian adolescents. This cross-sectional study included 948 subjects (527 males; 421 females) aged 14-19 y, selected randomly from New Delhi, India. Principal component factor analysis included variables such as: body mass index (BMI), waist circumference (WC), triceps (TR) and subscapular (SS) skinfold thickness, systolic and diastolic blood pressures, fasting blood glucose, serum triglycerides, high-density lipoprotein cholesterol and fasting insulin. Factor scores were used to generate a cumulative risk scale and identify independent correlates of high cumulative risk. Three factors namely: obesity/insulin factor (BMI, WC, TR, SS and fasting insulin) explained 40.9% and 35.5%, ‘blood pressure’ factor explained 14.1% and 14.2%, and the ‘metabolic’ factor (glucose/triglycerides) explained 10.4% and 10.8% of the variance data in males and females, respectively. Overweight and hyperinsulinemia in both genders and high SS in males were independently associated with high cumulative risk. More than one factor is associated with the metabolic syndrome in Asian Indian adolescents. Obesity (generalized, abdominal and truncal sub-cutaneous) accounts for the maximum variance in clustering and appears to be the stronger correlate of high cumulative risk rather than hyperinsulinemia.
Key Words: factor analysis, metabolic syndrome, hyperinsulinemia, adolescents, Asian Indians

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印度都市的青少年代謝症候群組成因素分析 少有印度都市青少年,其各種代謝症候群危險因子的相關性數據。這個橫斷性研究自印度新德里市,隨機選取948名研究對象(527名男性;421名女性),年齡為14-19歲。主成分因素分析包含的變數有:身體質量指數(BMI)、腰圍(WC)、三頭肌(TR)及肩胛下(SS)皮脂厚度、收縮壓及舒張壓、禁食血糖、血清三酸甘油酯、高密度脂蛋白膽固醇及禁食胰島素。使用因素分數產生累積危險性量表,並找出與高累積危險性的獨立相關性。三類因素可解釋男性及女性的變異量分別為:肥胖/胰島素因子(BMI、WC、TR、SS及禁食胰島素) 40.9%及35.5%,血壓因子14.1%及14.2%,而代謝性因子(葡萄糖/三酸甘油酯) 10.4%及10.8%。男女的體重過重及高胰島素血症及男性的高SS與高累積危險性是獨立相關。與印度青少年代謝症候群相關的因素不只一項。在聚集中,肥胖(全身性、腹部及軀幹皮下脂肪)解釋了最大的變異量,且顯示它與高累積危險性有強相關,而非高胰島素血症。 關鍵字:因素分析、代謝症候群、高胰島素血症、青少年、印度人

 

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Last Updated: June 2009