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1 Asia Pacific Journal of Clinical Nutrition
       Volume 19, 1

         (March 2010)


Abstracts

Contents

Abstract 摘要

The Asia Pacific Clinical Nutrition Society Award for 2009: Citation for Wen-Harn Pan
MARK L WAHLQVIST
Asia Pac J Clin Nutr. 2010;19(1):i.

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Original Research Communications

 

Clinical Nutrition

Economic analysis of a diabetes-specific nutritional meal replacement for patients with type 2 diabetes
STEPHEN RANDOLPH, VIKKIE A MUSTAD, JAMES LEE AND JIANQIN SUN
Asia Pac J Clin Nutr. 2010;19(1):1-7.

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Growth and Child Nutrition 

Composition of weight gain during nutrition rehabilitation of severely under nourished children in a hospital based study from India
KANKIPATI VIJAY RADHAKRISHNA, BHARATI KULKARNI, NAGALLA BALAKRISHNA, HEMALATHA RAJKUMAR, CHANDRAKALA OMKAR AND VEENA SHATRUGNA
Asia Pac J Clin Nutr. 2010;19(1):8-13.

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Correspondence of two procedures to measure abdominal circumference in a convenience sample of urban, middle-class schoolchildren in Guatemala City
VIRGINIA J ALVARADO, EVELYN MAYORGA, SUSANA MOLINA AND NOEL W SOLOMONS
Asia Pac J Clin Nutr. 2010;19(1):14-21.

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Macro- Micro- and Phyto-nutrients 

Dietary patterns by reduced rank regression predicting changes in obesity indices in a cohort study: Tehran Lipid and Glucose Study
ROYA SHERAFAT-KAZEMZADEH, SHAHRYAR EGTESADI, PARVIN MIRMIRAN, MAHMOUD GOHARI, SARA JALALI FARAHANI, FIROOZEH HOSSEINI ESFAHANI, MOHAMMAD REZA VAFA, MEHDI HEDAYATI AND FEREIDOUN AZIZI
Asia Pac J Clin Nutr. 2010;19(1):22-32.

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Maternal and Women’s Nutrition 

Effect of soy isoflavone extract supplements on bone mineral density in menopausal women: meta-analysis of randomized controlled trials
KYOKO TAKU, MELISSA K MELBY, JUN TAKEBAYASHI, SHOICHI MIZUNO, YOSHIKO ISHIMI, TOYONORI OMORI AND SHAW WATANABE
Asia Pac J Clin Nutr. 2010;19(1):33-42.

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Nutritional Assessment and Status

Serum 25-hydroxyvitamin D concentration of Indigenous-Fijian and Fijian-Indian women
CHRISTINA HEERE, C MURRAY SKEAFF, LEPANI WAQATAKIREWA, PENINA VATUCAWAQA, A NISHA KHAN AND TIMOTHY J GREEN
Asia Pac J Clin Nutr. 2010;19(1):43-48.

 

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Hypovitaminosis D and K are highly prevalent and independent of overall malnutrition in the institutionalized elderly
AKIKO KUWABARA, MASAKO HIMENO, NAOKO TSUGAWA, MAYA KAMAO, MINORI FUJII, NOBUKO KAWAI, MIYUKI FUKUDA, YOKO OGAWA, SHOKO KIDO, TOSHIO OKANO AND KIYOSHI TANAKA
Asia Pac J Clin Nutr. 2010;19(1):49-56.

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Nutritional Epidemiology and Public Health 

High prevalence of low HDL-c in the Philippines compared to the US: population differences in associations with diet and BMI
JULIENNE N RUTHERFORD, THOMAS W MCDADE, ALAN B FERANIL, LINDA S ADAIR AND CHRISTOPHER W KUZAWA
Asia Pac J Clin Nutr. 2010;19(1):57-67.

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Family nutritional support improves survival, immune restoration and adherence in HIV patients receiving ART in developing country
CHARLOTTE SERRANO, REMI LAPORTE, MOUSSA IDE, YACOUBA NOUHOU, PIERRE DE TRUCHIS, ELISABETH ROUVEIX, ADIZA ADAMOU, VANESSA PAULY, JEAN-FRANÇOIS MATTEI AND JEAN-ALBERT GASTAUT
Asia Pac J Clin Nutr. 2010;19(1):68-75.

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Nutritional status, Dietary Intake, and Body Composition 

Dietary habits and overweight/obesity in adolescents in Xi’an City, China
MING LI, MICHAEL J DIBLEY, DAVID W SIBBRITT AND HONG YAN
Asia Pac J Clin Nutr. 2010;19(1):76-82.

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Maintained total body water content and serum sodium concentrations despite body mass loss in female ultra-runners drinking ad libitum during a 100 km race
BEAT KNECHTLE, OLIVER SENN, REINHARD IMOBERDORF, IRENA JOLESKA, ANDREA WIRTH, PATRIZIA KNECHTLE AND THOMAS ROSEMANN
Asia Pac J Clin Nutr. 2010;19(1):83-90.

 

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Male ironman triathletes lose skeletal muscle mass
BEAT KNECHTLE, BARBARA BAUMANN, ANDREA WIRTH, PATRIZIA KNECHTLE AND THOMAS ROSEMANN
Asia Pac J Clin Nutr. 2010;19(1):91-97.

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Nutritionally-Related Disorders and Diseases and Their Risk Factors

Prevalence and characteristics of the metabolic syndrome among adults in Beijing, China
GANG LI, MAXIMILIAN DE COURTEN, SHUFANG JIAO AND YAN WANG
Asia Pac J Clin Nutr. 2010;19(1):98-102.

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Folate intake associated with lung function, breathlessness and the prevalence of chronic obstructive pulmonary disease
FUMI HIRAYAMA, ANDY H LEE, KOJI TERASAWA AND YASUO KAGAWA
Asia Pac J Clin Nutr. 2010;19(1):103-109.

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Heath Benefits of Tree Nuts

Health benefits of nuts in prevention and management of diabetes
CYRIL WC KENDALL, AMIN ESFAHANI, JENNIFER TRUAN, KORBUA SRICHAIKUL AND DAVID JA JENKINS
Asia Pac J Clin Nutr. 2010;19(1):110-116.

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The phytochemical composition and antioxidant actions of tree nuts
BRADLEY W BOLLING, DIANE L MCKAY AND JEFFREY B BLUMBERG
Asia Pac J Clin Nutr. 2010;19(1):117-123.

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Nuts, inflammation and insulin resistance
PATRICIA CASAS-AGUSTENCH, MÒNICA BULLÓ AND JORDI SALAS-SALVADÓ
Asia Pac J Clin Nutr. 2010;19(1):124-130.

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 Nuts, blood lipids and cardiovascular disease
JOAN SABATE AND MICHELLE WIEN
Asia Pac J Clin Nutr. 2010;19(1):131-136.

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Nuts and healthy body weight maintenance mechanisms
RICHARD D MATTES AND MARK L DREHER
Asia Pac J Clin Nutr. 2010;19(1):137-141.

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Tree nut consumption improves nutrient intake and diet quality in US adults: an analysis of National Health And Nutrition Examination Survey (NHANES) 1999-2004
CAROL E O’NEIL, DEBRA R KEAST, VICTOR L FULGONI III AND THERESA A NICKLAS
Asia Pac J Clin Nutr. 2010;19(1):142-150.

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Future Events

Asia Pac J Clin Nutr. 2010;19(1):151.

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Economic analysis of a diabetes-specific nutritional meal replacement for patients with type 2 diabetes
STEPHEN RANDOLPH, VIKKIE A MUSTAD, JAMES LEE AND JIANQIN SUN
This study extends nutritional intervention results reported by short-term clinical trials of a diabetes-specific nu-tritional meal replacement by assessing the ten-year impact of the interventions on patient outcomes and costs compared to usual care. We developed and validated a computer simulation of type 2 diabetes based on pub-lished data from major clinical trials. The model tracks patients through microvascular and macrovascular health states and reports cumulative costs and quality adjusted life years. We modeled different scenarios that include a diabetes-specific nutritional meal replacement as part of a structured lifestyle intervention, and also as the only difference between the intervention and usual care treatment groups, and compared them to usual care with diet and physical activity recommendations. We used sensitivity analysis to explore the robustness of results. When a diabetes-specific nutritional meal replacement is the only treatment difference and is considered an equal cost meal replacement, the diabetes-specific nutritional meal replacement interventions are less costly and more ef-fective than usual care. As an added cost meal replacement, the diabetes-specific nutritional meal replacement has an incremental cost-effectiveness ratio between $50,414 and $55,036 depending on improvement in percent glycated hemoglobin. A hypothetical lifestyle intervention using a diabetes-specific nutritional meal replacement has an incremental cost-effectiveness ratio of $47,917. The diabetes-specific nutritional meal replacement was found to be cost-effective under the various conditions simulated.
Key Words: nutrition therapy, type 2 diabetes mellitus, computer simulation, cost analysis, quality adjusted life years
 

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糖尿病专用营养配方的經濟效益分析
本文透过比较结构性干预管理方案与常规治疗方案对糖尿病患者10年治疗效果与医疗费用的差别,研究一种糖尿病患专用营养配方对糖尿病营养治疗的效用。利用现有的临床试验数据,我们研发了一个计算机模擬程式以追踪糖尿病患者微血管和大血管的健康状况、累计医疗费用和生活质量调整的生命年限。这一模擬程式能够建立及比较各种生活方式。当糖尿病专用营养配方的使用是实验组与对照组的唯一差别,在其他开支相同的情况下,糖尿病专用营养配方干预措施成本更低,比常规治疗更加有效。当其作为额外的代餐,根据糖化血红蛋白的改善情况,糖尿病专用营养配方能增加成本效益比50,414到55,036美元。假如将糖尿病专用营养配方用于糖尿病结构性干预管理方案中,则能提高成本效益比47,917美元。综上所述,本研究发现使用糖尿病专用营养配方在各种模擬的方式下皆能提高成本效益。
關鍵字:营养治療、第二型糖尿病、计算机模擬、成本分析、生活质量调整的生命年限
 

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Composition of weight gain during nutrition rehabilitation of severely under nourished children in a hospital based study from India
KANKIPATI VIJAY RADHAKRISHNA, BHARATI KULKARNI, NAGALLA BALAKRISHNA, HEMALATHA RAJKUMAR, CHANDRAKALA OMKAR AND VEENA SHATRUGNA
Concerns are raised that rapid catch up growth during nutrition rehabilitation of severely malnourished children may be associated with disproportionately higher amounts of body fat deposition. This study examined the com-position of weight gain in severely undernourished children who underwent nutrition rehabilitation in a hospital from India. Body composition of 80 severely malnourished children (age 6-60 months) was assessed using skin-fold thickness measurements on admission and after 1 month of supplementary feeding. On admission, children had severe weight and height deficits and were severely wasted. The mean weight for age z score, height for age z score and weight for height z score (WHZ) were -5.0, -4.2 and -4.1 respectively. Children consumed a mixed diet and mean energy intake was 177 kcal/kg/day with a protein energy ratio of 13. Overall, the mean weight gain was 6.1 g/kg/day and fat mass contributed to about 40% of the weight gain. When the composition of weight gain was analysed in tertiles of baseline WHZ score, children in the lowest tertile of WHZ score had sig-nificantly higher weight gain and fat free mass (FFM) gain. Gain in fat mass did not differ in relation to the base-line WHZ score. The study demonstrates that it is possible to achieve rapid weight gain with recovery of lost tis-sue in severely malnourished children with mixed diets. Children with lowest WHZ scores at baseline gained higher FFM during nutrition rehabilitation when compared to the children with relatively higher WHZ score probably in an attempt to recover the lost tissue.
Key Words: protein energy malnutrition, nutrition rehabilitation, body composition, fat mass, fat free mass
 

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印度某醫院嚴重營養不良孩童在營養恢復期增加體重之組成
嚴重營養不良的孩童在營養恢復期快速地成長的現象已引起關切,這也許與不成比例地大量的身體脂肪沉積有關。這個研究是調查在印度一個醫院裡那些嚴重營養不良的孩童,當他們經歷營養恢復期,所增加的體重及其組成。藉由測量入院以及餵食補充品一個月後的皮脂厚度來評估80位嚴重營養不良孩童的身體組成(年齡為6-60個月)。在入院時,孩童有嚴重的體重和身高不足以及極度消瘦。平均體重對年齡的z分數、身高對年齡的z分數以及體重對身高的z分數(WHZ)分別為-5.0、-4.2以及 -4.1。給予孩童混合飲食,平均攝取熱量為每天每公斤體重177大卡,蛋白質佔總熱量的13%。整體來看,孩童平均體重增加為每天每公斤6.1公克,其中脂肪量約佔40%。當以基礎WHZ分數的三分位來分析體重增加的組成時,分數最低組有明顯較高的體重增加以及非脂肪量增加。但脂肪量的增加則與基礎WHZ分數無關。本研究顯示,對於嚴重營養不良的孩童,給予混合飲食可以快速增加體重及恢復耗損的組織。與相對較高的WHZ分數組相比,WHZ分數最低組的孩童在營養復原期有較高的非脂肪量增加,也許是試著使受損的組織恢復。
關鍵字:蛋白質熱量營養不良、營養復原、身體組成、脂肪量、非脂肪重量
 

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Correspondence of two procedures to measure abdominal circumference in a convenience sample of urban, middle-class schoolchildren in Guatemala City
VIRGINIA J ALVARADO, EVELYN MAYORGA, SUSANA MOLINA AND NOEL W SOLOMONS
Background: Given an emerging concern for juvenile overweight and obesity, even in populations of developing countries, techniques to assess central obesity, such as abdominal circumference (AC), are of increasing interest. Objective: To compare two procedures for measuring AC in schoolchildren from a convenience sample of mid-dle-class, urban children aged 72 to 131 months in Guatemala City. Methods: We conducted a cross-sectional study (August 2004- April 2005) in 363 schoolchildren; 190 boys and 173 girls. The AC was recorded using both the conventional natural waist circumference (NWC) and the umbilical-level abdominal circumference (UAC) methods; each of which was measured over a thin T-shirt. Height and weight were also measured. The NWC and UAC methods were compared between genders and age groups. In addition, correlation coefficients and Bland-Altman regression were performed. A reproducibility study was performed on a subsample of 50 children. Results: Mean NWC was 63.210.0 cm for boys and 60.27.7 cm for girls (p=0.001), and mean UAC was 65.911.0 cm for boys and 63.28.8 cm for girls (p=0.008). Both measures of AC generally increased with age. The UAC - NWC difference increased with abdominal girth. The Pearson correlation coefficient of BMI vs. NWC and BMI vs. UAC was r=0.92, CV=0.460.27%. A high test-retest reproducibility (r > 0.98, CV= 0.500.24%) of the NWC and UAC measurements was found. Conclusion: Reliable NWC and UAC measure-ments may be obtained by applying a correction term to account for light clothing. Both measurements are appli-cable methodologies for the collection of data in populations with cultural limitations.
Key Words: juvenile central obesity, natural waist circumference, umbilical abdominal circumference, body mass
index, Guatemala

 
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以瓜地馬拉市的中產階級學童為樣本來看兩種測量腹圍方法的一致性
背景:即使在發展中國家,青少年的過重及肥胖也日益受關注。評估中央肥胖(例如:腹圍)的方法正逐漸受重視。目的:以居住在瓜地馬拉市,年齡為72至131個月的中產階級學童為樣本,比較兩種測量腹圍的方法。方法:在2004年8月至2005年4月,以363位學童(190位男孩與173位女孩)為樣本的橫斷性研究。使用傳統的自然腰圍測量法(NWC)以及以肚臍為基準的腹圍測量法(UAC)來記錄腹圍,而測量時須穿著薄質的圓領汗衫。同時測量身高和體重。將這兩種方法測量值以性別及年齡做比較。另外,使用相關係數及Bland-Altman迴歸方法進行分析。並且以其中50位孩童為次樣本,進行再現性分析。結果:男童的平均自然腰圍為63.2±10.0公分,女童的平均自然腰圍為60.2±7.7公分(p值為0.001);男童以肚臍為基準的平均腹圍為65.9±11.0公分,女童為63.2±8.8公分(p值為0.008)。腹圍的大小大致隨著年齡的增加而增加。自然腰圍測量值及以肚臍為基準的腹圍測量值之間的差異隨著腹圍的增加而增加。BMI對自然腰圍與BMI對腹圍的皮爾森相關係數為0.92,變異係數為0.46±0.27%。自然腰圍測量法以及以肚臍為基準的腹圍測量法的再測量的再現性都高(相關係數大於0.98,變異係數為0.50±0.24%)。結論:藉由對於薄質衣料的校正可獲得可信的自然腰圍測量值及以肚臍為基準的腹圍測量值。這兩種測量方法都適合用以蒐集有文化背景限制的族群的體組成資料。
關鍵字:青少年中央肥胖、自然腰圍、以臍帶為基準的腹圍、身體質量指數,瓜地馬拉
 

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Dietary patterns by reduced rank regression predicting changes in obesity indices in a cohort study: Tehran Lipid and Glucose Study
ROYA SHERAFAT-KAZEMZADEH, SHAHRYAR EGTESADI, PARVIN MIRMIRAN, MAHMOUD GOHARI, SARA JALALI FARAHANI, FIROOZEH HOSSEINI ESFAHANI, MOHAMMAD REZA VAFA, MEHDI HEDAYATI AND FEREIDOUN AZIZI
Objective: To examine the association between dietary patterns and obesity indices (BMI, WC, WHR) among Tehranian adults in a 6-year follow-up study. Methods: Within frame of a cohort study in Tehran (mean follow up 6.6±0.9 years), 141 adults were recruited with: two 24 hour dietary recalls at the beginning, as well as obesity indices at the beginning and end of the study period. Dietary intakes were converted into grams of intakes of food items and categorized into 16 groups. Reduced rank regression analysis derived five patterns with total and polyunsaturated-to-saturated fat intake, cholesterol, fiber and calcium intake as response variables. Factors (die-tary patterns) were generated retaining a corresponding factor loading ≥ |0.17| on the food groups. Changes in obesity indices were scrutinized within quintiles of factor scores. Results: There were high loadings on refined carbohydrates, whole grain, starchy vegetables, other vegetables, red and refined meat, saturated/trans fat, and egg for the first factor named “traditional”. All obesity indices had increasing trend across quintiles of pattern score. The fifth pattern (namely egg pattern) had high loading for eggs, salty snacks, as well as fruits and dry fruits, and negative loadings for red and processed meat, saturated and trans fat, plant oils, and dairy products. This pattern showed increasing trends for WC and WHR after adjustment for potential confounders. Other pat-terns showed non-significant trends for obesity indices. Conclusions: The results were indicative of a traditional pattern which is dominated in the Tehran region and associated with increase in obesity indices.
Key Words: dietary patterns, anthropometry, obesity, reduced rank regression, cohort
 

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減維度迴歸導出的膳食模式預測肥胖指標的改變:德黑蘭脂質與血糖的世代研究
目的:檢測德黑蘭成人在6年的追蹤研究中,其膳食模式和肥胖指標(身體質量指數、腰圍、腰臀比)之間的相關性。方法:在德黑蘭世代研究的架構內,選出141個成人(平均追蹤時間為6.6±0.9年),各有2次起始點的24小時飲食回憶資料,及起始點和追蹤結束時的肥胖指標數據。膳食攝取被轉換為各食物項目的克數重量,並歸類成16個食物群組。以總脂肪、多元不飽和/飽和脂肪比率、膽固醇、膳食纖維及鈣的攝取量為依變項,使用減維度迴歸分析衍生出五類膳食模式。以在食物群組中持有對應的因素負荷 ≥|0.17|來導出各因素(膳食模式)。將因素分數劃為五分位,詳細地檢測肥胖指標的改變。結果:在第一類「傳統膳食模式」的因素中,以精制醣類、全穀類、富含澱粉的蔬菜、其他蔬菜、紅肉和加工肉類、飽和/反式脂肪、蛋類的因素負荷較高。所有的肥胖指標都隨著此膳食模式分數五分位的增加而有增加的趨勢。第五類膳食模式(蛋類模式)在蛋類、鹹的零食類、水果類和乾燥水果有較高的因素負荷,而在紅肉和加工肉類、飽和和反式脂肪、植物油及乳製品則有負的因素負荷。在校正過可能的干擾因子後,該膳食模式顯示出了腰圍和腰臀比有增加的趨勢。其他的膳食模式和肥胖指標則無明顯的趨勢現象。結論:結果顯示在德黑蘭地區,以傳統的膳食模式為主,且與肥胖指標的增加相關。
關鍵字:膳食模式、人體測量、 肥胖、減維度迴歸分析、世代研究
 

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Effect of soy isoflavone extract supplements on bone mineral density in menopausal women: meta-analysis of randomized controlled trials
KYOKO TAKU, MELISSA K MELBY, JUN TAKEBAYASHI, SHOICHI MIZUNO, YOSHIKO ISHIMI, TOYONORI OMORI AND SHAW WATANABE
This study was conducted to clarify the effect of ingesting soy isoflavone extracts (not soy protein or foods con-taining isoflavones) on bone mineral density (BMD) in menopausal women. PubMed, CENTRAL, ICHUSHI, CNKI, Wanfang Data, CQVIP, and NSTL were searched for randomized controlled trials published in English, Japanese, or Chinese reporting the effects of soy isoflavone extracts on lumbar spine or hip BMD in menopausal women. Trials were identified and reviewed for inclusion and exclusion eligibility. Data on study design, par-ticipants, interventions, and outcomes were extracted. Eleven, seven, five, and five trials were finally selected for estimation of the effects on spine, femoral neck, hip total, and trochanter BMD, respectively. Meta-analysis in-cluding data from1240 menopausal women revealed that daily ingestion of an average of 82 (47–150) mg soy isoflavones (aglycone equivalent) for 6–12 months significantly increased spine BMD by 22.25 mg/cm2 (95% CI: 7.62, 32.89; p=0.002), or by 2.38% (95% CI: 0.93, 3.83; p=0.001) compared with controls (random-effects model). Subgroup analyses indicated that the varying effects of isoflavones on spine BMD across trials might be associated with study characteristics of intervention duration (6 vs. 12 months), region of participant (Asian vs. Western), and basal BMD (normal bone mass vs. osteopenia or osteoporosis). No significant effects on femoral neck, hip total, and trochanter BMD were found. Soy isoflavone extract supplements increased lumbar spine BMD in menopausal women. Further studies are needed to address factors affecting the magnitudes of effect on spine and to verify the effect on hip.
Key Words: meta-analysis, isoflavones, dietary supplements, menopause, bone density
 

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大豆異黃酮抽取物的補充劑對停經後婦女骨質密度的效果:隨機對照試驗的後設分析
本研究旨在確認攝取大豆異黃酮抽取物(並非大豆蛋白或含有異黃酮的食品)對停經後婦女骨質密度(BMD)的效果。我們從PubMed,CENTRAL,ICHUSHI,CNKI,Wanfang Data,CQVIP,和NSTL檢索,以英語,日語,或中文發表,並報告大豆異黃酮抽取物對停經後婦女腰椎或髖關節BMD效果的隨機對照試驗論文。依照納入和排除標準,對試驗論文進行鑑別和評閱來判定是否採用。有關研究設計,對象,介入,和結果的數據被抽取出進行分析。最終分別有11、7、5、和5個試驗被採用來評估對腰椎、大腿骨頸部、髖關節全體、和股骨大轉子BMD的效果。包括1240名停經後婦女的後設分析(隨機效果模型)顯示,與對照組相比,每日平均攝取82 (47-150) mg的大豆異黃酮(苷元當量)持續6-12個月,顯著地提高腰椎BMD 22.25 mg/cm2 (95%信賴區間: 7.61,32.89;p=0.002),或提高2.38% (95%信賴區間: 0.93,3.83;p=0.001)。亞組分析顯示,不同試驗間大豆異黃酮對腰椎BMD的效果各異,可能與介入期間(6 或 12個月),對象的區域(亞洲或西方),和基礎BMD(正常骨質或骨質減少症或骨質疏鬆症)的研究特徵相關。我們的後設分析沒有發現對大腿骨頸部,髖關節全體,和股骨大轉子BMD的效果。大豆異黃酮抽取物的補充劑提高了停經後婦女的腰椎BMD。需要更深入的研究去闡明影響其對腰椎效果程度的因素,以及驗證其對髖關節的效果。
關鍵字:後設分析、異黃酮、膳食補充劑、停經、骨密度
 

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Serum 25-hydroxyvitamin D concentration of Indigenous-Fijian and Fijian-Indian women
CHRISTINA HEERE, C MURRAY SKEAFF, LEPANI WAQATAKIREWA, PENINA VATUCAWAQA, A NISHA KHAN AND TIMOTHY J GREEN
Background: Serum 25-hydroxyvitamin D (25OHD) concentrations are lower in Pacific people compared to Caucasians living in New Zealand. However, there are no data on the 25OHD concentrations of Pacific people living in the Pacific Islands. Aim: To assess the vitamin D status of indigenous and Indian Fijian women living in Fiji by measuring 25OHD concentrations. Methods: 25OHD concentrations in a national sample of 511 Fijian women (15-44 y). Results: The mean 25OHD concentration of Fijian women was 76 nmol/L (95% CI: 73, 78). 25OHD was lower in Fijian Indian [70 (66, 74) nmol/L; n=205] women compared to indigenous Fijians [80 (76, 84) nmol/L; n=306] (p<0.0001). The mean 25OHD was higher in rural [77 (74, 80) nmol/L; n=392] than urban [70 (65, 76) nmol/L; n=119] women (p<0.0001). Body mass index (BMI) and age were not predictors of 25OHD concentrations. Of Fijian females, 3%, 11%, and 56% had 25OHD concentrations indicative of 25OHD insuffi-ciency using cut-offs of 37.5, 50 and 80 nmol/L, respectively. Conclusion: Mean 25OHD in Fijian women was generally adequate and exceed concentrations reported in Pacific females living in New Zealand.
Key Words: vitamin D status, women, Fijian, Indigenous, Indian
 

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斐濟本地和斐濟/印度婦女的血清25-羥維生素D水平
背景:與居住在新西蘭的白種人相比,太平洋人的血清25-羥維生素D(25OHD)水平較低。盡管如此,並沒有數據顯示在太平洋群島居住的太平洋人的25OHD水平。目的:通過檢測25OHD水平來評估居住在斐濟的本地婦女以及斐濟/印度婦女的維生素D狀況。方法:在全國範圍內抽樣檢測511名斐濟婦女(15-44歲)的25OHD水平。結果:斐濟婦女25OHD的平均值是76 nmol/L (95% CI: 73, 78)。與斐濟本地婦女相比[80(76, 84)nmol/L;n=306],斐濟/印度婦女的25OHD水平更低[70(66, 74)nmol/L; n=205] (p<0.0001)。農村婦女25OHD的平均值[77(74, 80)nmol/L; n=392]高于城市婦女[70(66, 74)nmol/L; n=119] (p<0.0001)。體質指數(BMI-Body Mass Index)和年齡並不能預測25OHD的水平。采用25OHD水平≤37.5,≤50,≤80 nmol/L作爲指標,分別有3%,11%,以及56%的人沒有足夠的25OHD。總結:斐濟婦女25OHD的平均水平普遍達標並且超過居住在新西蘭的太平洋婦女的維生素D水平。
關鍵字:維生素D狀況,婦女,斐濟,本地人,印度人
 

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Hypovitaminosis D and K are highly prevalent and independent of overall malnutrition in the institutionalized elderly
AKIKO KUWABARA, MASAKO HIMENO, NAOKO TSUGAWA, MAYA KAMAO, MINORI FUJII, NOBUKO KAWAI, MIYUKI FUKUDA, YOKO OGAWA, SHOKO KIDO, TOSHIO OKANO AND KIYOSHI TANAKA
There have been methodological problems for studying hypovitaminosis D and K in the elderly. First, studies were done either by evaluating food intake or measuring their circulating levels, but rarely by both in Japan. In this paper, vitamin D and K intakes and their circulating levels were simultaneously determined. Second issue is whether hypovitaminosis D and K are independent of general malnutrition, prevalent in the elderly. We tried to statistically discriminate them by principal component analysis (PCA). Fifty institutionalized elderly were evalu-ated for their circulating 25 hydroxy-vitamin D (25OH-D), intact parathyroid hormone (PTH), phylloquinone (PK), menaquinone-7 (MK-7) levels, and their food intake. Although average vitamin D intake (7.0 g/day) ex-ceeded the Japanese Adequate Intake (AI) of 5.0 g/day, average serum 25OH-D concentration was in the hy-povitaminosis D range (11.1 ng/mL). Median vitamin K intake was 168 g/day, approximately 2.5 times as high as AI for vitamin K. Nevertheless, plasma PK and MK-7 concentrations were far lower than those of healthy Japanese elderly over 70 years old. PCA yielded four components; each representing overall nutritional, vitamin K2, vitamin D, and vitamin K1 status, respectively. Since these components are independent of each other, vita-min D- and K-deficiency in these subjects could not be explained by overall malnutrition alone. In summary, in-stitutionalized elderly had a high prevalence of hypovitaminosis D and K, and the simultaneous determination of their circulating level and dietary intake is mandatory in such studies. PCA would yield fruitful results for elimi-nating the interference by confounders in a cross-sectional study.
Key Words: hypovitaminosis D, hypovitaminosis K, principal component analysis, adequate intake, institutionalized elderly
 

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居住機構中的老年人有高盛行率的維生素D及維生素K缺乏症且與整體的營養不良無相關
研究老年人的維生素D及維生素K缺乏症有許多方法學上的問題。首先,大多研究是藉由評估食物的攝取或是測量血中的濃度來進行的,但在日本很少同時利用這兩種方法。在本篇文章中,維生素D及維生素K的攝取以及老年人的血中濃度是同步測量的。第二個議題是維生素D及維生素K缺乏症是否與盛行於老年人的一般營養不良情形相關。我們試著藉由統計的主成份分析方法去分辨。評估50位機構中的老年人血中的25-羥化維生素D、副甲狀腺素、維生素K1、維生素K 2濃度,以及食物攝取。雖然平均維生素D攝取量(每天7克)超過日本所訂定的足夠攝取量(每天5克),但平均血清中25-羥化維生素D濃度(11.1 ng/mL)卻屬維生素D缺乏的範圍。維生素K攝取量的中位數為每天168克,這幾乎是維生素K的足夠攝取量的2.5倍。但是,血漿中維生素K1及維生素K 2濃度是遠低於70歲以上健康的日本老人。應用主成份分析法,結果產生4個成份,分別代表整體營養狀況、維生素K 2、維生素D及維生素K1的營養狀況。既然每個成份都各自獨立,則這些老人的維生素D及維生素K缺乏不能用整體營養不良加以解釋。總之,在這些機構中的老年人具有高盛行率的維生素D及維生素K缺乏;爾後這類研究應該同時測量血中濃度及飲食攝取。主成份分析法,可排除橫斷性研究中其他干擾因子的作用,而得到有效的結果。
關鍵字:維生素D缺乏、維生素K缺乏、主成份分析、足夠攝取量、機構中的老年人
 

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High prevalence of low HDL-c in the Philippines compared to the US: population differences in associations with diet and BMI
JULIENNE N RUTHERFORD, THOMAS W MCDADE, ALAN B FERANIL, LINDA S ADAIR AND CHRISTOPHER W KUZAWA
Cardiovascular disease (CVD) is a leading cause of death in the Philippines, although few studies here have ex-amined the lipid profiles underlying disease risk. The isolated low high density lipoprotein cholesterol (HDL-c) phenotype has been implicated as a CVD risk factor, the prevalence of which exhibits significant variation across populations. To assess population variation in individual lipid components and their associations with diet and anthropometric characteristics, we compare lipid profiles in a population of adult Filipino women (n=1877) to US women participating in the National Health and Nutrition Examination Survey (NHANES, n=477). We conducted multiple regression models to assess the relationship between lipid components, body mass index, and dietary variables in the two populations. We measured the prevalence of lipid phenotypes, and logistic regression models determined the predictors of the isolated low HDL-c phenotype. High density lipoprotein cholesterol was lower in the Philippines (40.8±0.2 mg/dL) than in NHANES (60.7±0.7 mg/dL). The prevalence of the isolated low HDL-c phenotype was 28.8%, compared to 2.10% in NHANES. High prevalence among Filipinos was rela-tively invariant across all levels of BMI, but was strongly inversely related to BMI in NHANES and exhibited only at the BMI>25 kg/m2 threshold. Diet did not consistently predict the low-HDL phenotype in Filipinos. Fili-pino women exhibit a high prevalence of the isolated low HDL-c phenotype, which is largely decoupled from anthropometric factors. The relationship of CVD to population variation in dyslipidemia and body composition needs further study, particularly in populations where the burden of cardiovascular and metabolic disease is rap-idly increasing.
Key Words: risk factors, dyslipidemia, low HDL-c, women, epidemiology
 

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菲律賓低的高密度脂蛋白膽固醇盛行率較美國高:其與飲食和身體質量指數的相關性有族群差異
在菲律賓,心血管疾病是主要死因,但很少研究檢測與疾病危險性相關的血脂質型態。高密度脂蛋白膽固醇較低的基因顯型已被認為是心血管疾病的獨立危險因子,而其盛行率在不同族群中呈現顯著的差異。為了檢測個體血脂組成在不同族群中的變異及其和飲食、體位測量間的相關性,我們比較菲律賓成年女性(1877位)和美國參予國家健康營養調查研究(NHANES)的女性(477位)。使用複迴歸模式來評估在兩個族群中,血脂質組成和身體質量指數、飲食因子之間的關係。估量血脂質顯型盛行率,及使用邏輯斯迴歸來決定低的高密度脂蛋白膽固醇顯型之預測因子。高密度脂蛋白膽固醇濃度在菲律賓女性(40.8±0.2 mg/dL)低於美國NHANES的女性(60.7±0.7 mg/dL)。菲律賓女性高密度脂蛋白膽固醇較低的顯型盛行率為28.8%,在NHANES的女性則僅有2.10%。菲律賓女性的高盛行率,在不同身體質量指數間變異不大;但在NHANES的女性中,盛行率在身體質量指數>25 kg/m2才顯現,且和身體質量指數有很強的負相關。在菲律賓女性,飲食不能一致地預測低的高密度脂蛋白膽固醇。總之,菲律賓女性表現出較高盛行率的高密度脂蛋白膽固醇低的顯型,此和體位的因子無相關。心血管疾病和血脂異常及體組成的關係在不同族群中的差異,需要更進一步的研究,尤其在心血管疾病及代謝性疾病快速增加的地區特別重要。
關鍵字:危險因子、血脂異常、低的高密度脂蛋白膽固醇、婦女、流行病學
 

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Family nutritional support improves survival, immune restoration and adherence in HIV patients receiving ART in developing country
CHARLOTTE SERRANO, REMI LAPORTE, MOUSSA IDE, YACOUBA NOUHOU, PIERRE DE TRUCHIS, ELISABETH ROUVEIX, ADIZA ADAMOU, VANESSA PAULY, JEAN-FRANÇOIS MATTEI AND JEAN-ALBERT GASTAUT
In developing countries, access to antiretroviral treatment for persons living with HIV is still in progress. Malnu-trition represents another cause of acquired immunodeficiency and premature death. This evaluation program es-timated the impact of family nutritional support during the first year of antiretroviral treatment in West Africa's sub-Sahara region. Family nutritional support was proposed to patients with CD-4 cell count <200 /mm3 and/or developing a WHO stage III/IV or with body mass index <18.5 kg/m² and receiving antiretroviral treatment. Fol-low-up of 62 patients receiving support was compared to 118 patients who had only received antiretroviral treatment the year before. Average body mass index, CD-4 cell count were 20.7 and 20.5, 217 and 191/mm3 re-spectively in supported and control groups (NS). Twenty-two (36%) and 56 (48%) were WHO stage III/IV (NS) respectively in supported and control groups. One patient who received support and twelve controls died (Mor-tality Ratio=0.19; p<0.05). Increase in CD-4 cell count was around 1.7 times higher (+ 114 vs. + 68 CD-4 cells/mm3 respectively in supported and control groups; p<0.05) and observance was improved in supported group (p<0.005). The evolutions of WHO stage and body mass index were not different but the study period was short. Family nutritional support for persons living with HIV initiating antiretroviral treatment in a developing country showed a positive impact after six months. This family intervention could be integrated into AIDS inter-ventions as an effective and comprehensive community-based primary care.
Key Words: AIDS, developing country, nutritional support, survival, immunologic restoration
 

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家庭營養支持改善發展中國家接受抗逆轉錄病毒治療的愛滋病人其存活、免疫修復及依附
在發展中國家,以抗逆轉錄病毒治療有愛滋病毒(HIV)的人仍然在進行中。營養不良是引起後天免疫缺乏及夭折的另一個原因。本評估計劃評量在西非的次撒哈拉區域,家庭營養支持對於第一年接受抗逆轉錄病毒治療的病患之影響。對CD-4細胞計數<200/nm3且/或者病情為WHO等級III/IV,或者身體質量指數<18.5 kg/m2且接受抗逆轉錄病毒治療的病人,提供家庭營養支持。追蹤比較62名接受支持的病人和118名一年前只接受抗逆轉錄病毒治療的病人。家庭營養支持組與控制組的平均身體質量指數分別為20.7與20.5,他們的CD-4細胞計數平均為217與191/mm3(兩組無顯著差異)。支持組與控制組分別有22名 (36%)及56名 (48%)屬於WHO等級III/IV(兩組無顯著差異)。有1名接受家庭營養支持及12名控制組病人過世(死亡比例=0.19;p<0.05)。支持組CD-4細胞計數增加約高1.7倍(支持組與控制組分別增加+114與+68 CD-4細胞/mm3;p<0.05),對治療的遵循度亦較佳(p <0.005)。WHO等級進程及身體質量指數沒有改變,或許是因為這個研究期限不長。對於發展中國家開始接受抗逆轉錄治療的愛滋病人,給予家庭營養支持,在6個月後顯示有正向的效果。這項家庭介入可以結合愛滋病治療介入,成為一個有效且完整的社區基礎的初級照護。
關鍵字:後天免疫缺乏症候群、發展中國家、營養支持、存活、免疫修復
 

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Dietary habits and overweight/obesity in adolescents in Xi’an City, China
MING LI, MICHAEL J DIBLEY, DAVID W SIBBRITT AND HONG YAN
This study explored the association between dietary habits and overweight and obesity in adolescents from Xi’an City, China. A cross-sectional sample of 1804 adolescents was recruited in 2004 from 30 junior high schools in six districts of Xi’an City, northwest China. Weight and height was measured and eating habits assessed using a self-administered questionnaire. Logistic regression was used to identify dietary patterns associated with over-weight and obesity and adjusted for socio-demographic factors. Consumption of foods and beverages outside three main meals, and potato chips was more popular in boys than in girls, while girls consumed more fried food and soft drinks than boys. In boys, an increased consumption of soft drinks was associated with increased risk of overweight and obesity (1100 mL/day, OR: 1.9, 95% CI: 1.1-3.8), while consuming preserved fruit was associ-ated with decreased risk (OR: 0.6, 95% CI: 0.5-0.9). In girls, having breakfast outside the home (OR: 1.7, 95% CI: 1.1-2.3) and an increased consumption of energy-dense foods (OR: 1.7, 95% CI: 1.04-2.9), was associated with increased risk of overweight and obesity, while frequently having foods and beverages outside the three main meals (OR: 0.6, 95% CI: 0.4-0.9) was associated with decreased risk. The consumption of breakfast out-side the home, soft drinks and energy-dense fast foods were positively associated with overweight and obesity in adolescents. Future health education programs to prevent excess weight gain should target such unhealthy eating habits.
Key Words: dietary habits, adolescents, overweight and obesity, cross-sectional, China
 

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中国西安市青少年饮食習惯和超重肥胖
本文探讨中国西安市青少年饮食習惯及其和超重肥胖的关系。2004年从西安市城郊6区30所学校抽取了1804名初中生进行调查。体重身高由统一培训的研究成员测量。饮食習惯由学生填写验证过的问卷采集。饮食習惯和超重肥胖的关系通过回歸分析获得。结果显示:男生三餐之外零食及进食薯条次数明显多于女生;女生喝饮料及吃油炸食物多于男生。男生中,喝软饮料和超重肥胖呈正相关(每日1100 毫升,OR: 1.9;95%可信区间:1.1-3.8);吃果脯为负相关因素(OR: 0.6;95%可信区间:0.5-0.9)。女生中,在外早餐、食用高热量食物显著增加超重肥胖的风险。在这组研究人群中,和超重肥胖显著相关的饮食因素有:在外早餐、喝软饮料、食用高热量快餐食品。预防超重肥胖应当考虑这些饮食習惯。
关键字:饮食習惯、青少年、超重肥胖、横断面调查、中国
 

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Maintained total body water content and serum sodium concentrations despite body mass loss in female ultra-runners drinking ad libitum during a 100 km race
BEAT KNECHTLE, OLIVER SENN, REINHARD IMOBERDORF, IRENA JOLESKA, ANDREA WIRTH, PATRIZIA KNECHTLE AND THOMAS ROSEMANN
We investigated in 11 female ultra-runners during a 100 km ultra-run, the association between fluid intake and prevalence of exercise-associated hyponatremia in a cross-sectional study. Athletes drank ad libitum and re-corded their fluid intake. They competed at 8.0 (1.0) km/h and finished within 762 (91) min. Fluid intake was 4.1 (1.3) L during the race, equal to 0.3 (0.1) L/h. Body mass decreased by 1.5 kg (p < 0.01); pre race body mass was related to speed in the race (r = -0.78, p < 0.05); and change (∆) in body mass was not associated with speed in the race. Change in body mass was positively (r = 0.70; p < 0.05), and ∆ urinary specific gravity negatively (r = -0.67; p < 0.05), correlated to ∆ percent total body water. Changes in body mass were not related to fluid in-take during the race. Fluid intake was not correlated to running speed and showed no association with either ∆ percent total body water nor ∆ [Na] in plasma. Fluid intake showed no relationship with both ∆ haematocrit and ∆ plasma volume. No exercise-associated hyponatremia occurred. Female ultra- runners consuming fluids ad li-bitum during the race experienced no fluid overload, and ad libitum drinking protects against exercise-associated hyponatremia. The reported higher incidence of exercise-associated hyponatremia in women is not really a gen-der effect but due to women being more prone to overdrink.
Key Words: body composition, dehydration, ultra-endurance, water, performance

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女性長跑者在100公里競賽中自由攝取液體可維持體內水份及血鈉濃度
本橫斷性研究調查在100公里的長跑競賽中,11名女性選手其液體攝取與運動低血鈉的相關性。運動選手可自由攝取液體並且記錄喝了多少。他們以時速8.0(1.0)公里進行比賽,並在762(91)分鐘內完成。在比賽中,液體的總攝取量為4.1 (1.3)公升,相當於每小時攝取0.3 (0.1)公升的液體。平均總身體質量減少了1.5公斤(p < 0.01);而賽前的身體質量是與賽中的速度呈負相關 (r = -0.78, p < 0.05);然而總身體質量的改變則和賽中的速度不相關。總身體質量的改變和身體水份百分率改變呈正相關(r = 0.70; p < 0.05),相反地,尿液比重改變則與身體水份百分率改變呈負相關 (r = -0.67; p < 0.05)。身體質量的改變與賽中的液體攝取量無關。液體攝取量也與競跑速度、身體水份百分率改變 、血漿中鈉離子濃度改變、血比容積及血漿體積的變化無關。在賽後,沒有低血鈉的發生。在本篇研究中,女性長跑者在競賽中自由攝取液體,並無液體過度負荷的情形,且避免運動引起的低血鈉。過去報導女性有較高的運動相關低血鈉發生率,可能不是性別的效應,而是女性較傾向於過度攝取液體。
關鍵字:身體組成、脫水、超耐力、水份、競賽表現

 

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Male ironman triathletes lose skeletal muscle mass
BEAT KNECHTLE, BARBARA BAUMANN, ANDREA WIRTH, PATRIZIA KNECHTLE AND THOMAS ROSEMANN
We investigated whether male triathletes in an Ironman triathlon lose body mass in the form of fat mass or skele-tal muscle mass in a field study at the Ironman Switzerland in 27 male Caucasian non-professional Ironman tri-athletes. Pre- and post-race body mass, fat mass and skeletal muscle mass were determined. In addition, total body water, hematological and urinary parameters were measured in order to quantify hydration status. Body mass decreased by 1.8 kg (p < 0.05), skeletal muscle decreased by 1.0 kg (p < 0.05) whereas fat mass showed no changes. Urinary specific gravity, plasma urea and plasma volume increased (p < 0.05). Pre- to post-race change (∆) in body mass was not associated with ∆ skeletal muscle mass. Additionally, there was no association be-tween ∆ plasma urea and ∆ skeletal muscle mass; ∆ plasma volume was not associated with ∆ total body water (p > 0.05). We concluded that male triathletes in an Ironman triathlon lose 1.8 kg of body mass and 1 kg of skeletal muscle mass, presumably due to a depletion of intramyocellular stored glycogen and lipids.
Key Words: body fat, body mass, dehydration, ultra-endurance, triathlon
 

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鐵人三項男選手流失骨骼肌質量
本篇研究調查,在瑞士鐵人競賽中,27名非職業的鐵人三項白人男性運動員,其身體質量在競賽中,是以脂肪或以骨骼肌的形式流失。賽前和賽後的總身體質量、脂肪質量及骨骼肌質量被測量或計算。此外,為了定量身體水合狀態,總身體水份、血液及尿液指標也被測量。結果,總身體質量減少1.8公斤(p < 0.05),骨骼肌減少1.0 公斤(p < 0.05),然而脂肪質量則沒有改變(p > 0.05)。尿液比重,血漿尿素及血漿容積增加(p < 0.05)。賽前和賽後的總身體質量改變和骨骼肌質量的改變不相關(p > 0.05)。此外,血漿中尿素改變和骨骼肌質量改變無關(p > 0.05)。血漿容積的改變和總身體含水量的改變亦無相關(p > 0.05)。結論是,在該鐵人三項競賽中的男性運動員,總身體質量降低了1.8公斤而其中骨骼肌減少了1.0 公斤,推定可能是因肌細胞內的肝醣和脂質的耗損而導致的。
關鍵字:體脂肪、身體質量、脫水、超耐力、鐵人三項
 

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Prevalence and characteristics of the metabolic syndrome among adults in Beijing, China
GANG LI, MAXIMILIAN DE COURTEN, SHUFANG JIAO AND YAN WANG
This study was performed to investigate the prevalence of the metabolic syndrome using a large representative sample in Beijing. Data from a total of 16442 adults (6489 men and 9953 women) aged ≥18 years from a survey of behavioral risk factors for chronic diseases in Beijing, in 2005, was analyzed. The prevalence of the metabolic syndrome increased with age and the age-standardized prevalence of the metabolic syndrome defined by Interna-tional Diabetes Federation IDF and National Cholesterol Education Program Adult Treatment Panel III ATPIII criteria were 23.2% (24.5% in men and 22.7% in women) and 16.2% (16.1% in men and 16.6% in women), re-spectively. The metabolic syndrome was higher in semi-urban areas and associated with higher rates of hyper-tension, central obesity, salt intake and smoking.
Key Words: metabolic syndrome, prevalence, current smoking, China
 

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北京市成年人代谢综合征的患病率和患病特征
本研究通过北京市有代表性的大样本数据来分析代谢综合征的患病率和患病特征。数据来源于2005年北京市成年人慢性病及相关行为危险因素调查,計16,442名年龄大於18岁的成年人(其中男性6,489人,女性9,953人)进入本研究的分析。代谢综合征的患病率随着年龄的升高而升高,年龄标化患病率采用国际糖尿病联盟(IDF)和美国国家第三次胆固醇教育计划(ATPIII)诊断标准分别为23.2% (男性24.5%; 女性22.7%) 和16.2% (男性16.1%;女性 16.6%)。代谢综合征在郊区有更高的患病率,并与高血压,中央型肥胖,高盐摄入和吸烟有相关联。
關鍵字:代谢综合征、患病率、現行吸烟、中国

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Folate intake associated with lung function, breathlessness and the prevalence of chronic obstructive pulmonary disease
FUMI HIRAYAMA, ANDY H LEE, KOJI TERASAWA AND YASUO KAGAWA

A case-control study was conducted in central Japan to investigate the relationship between dietary intake of folate and lung function, breathlessness and chronic obstructive pulmonary disease (COPD). A total of 278 re-ferred patients (244 men and 34 women) aged 50-75 years with COPD diagnosed within the past four years and 340 community-based controls (272 men and 68 women) were assessed for dyspnoea and undertook spirometric measurements of lung function. A structured questionnaire was administered face-to-face to obtain information on demographics, lifestyle and habitual food consumption. Folate intake was derived from the Japanese food composition tables. The COPD patients had significantly lower habitual intake of folate (mean 231, SD 90 μg/day) than control subjects (mean 261, SD 110 μg/day), p<0.001. Lung function measures were found to be positively associated with dietary folate level. Reductions in prevalence of COPD and especially breathlessness were observed, the respective adjusted odds ratio (OR) being 0.74 (95% confidence interval (CI) 0.35 to 1.58) and 0.43 (95% CI 0.21 to 0.91) for the highest versus lowest quartile of folate intake. The corresponding tests for linear trend were also significant (p<0.05). In conclusion, an inverse association was evident between dietary folate intake and the prevalence of breathlessness for Japanese adults, together with a significant dose-response relationship for the COPD risk. Moreover, increased folate intake might be beneficial to lung function.
Key Words: breathlessness, chronic obstructive pulmonary disease, folate, Japan, lung function
 

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葉酸的攝取與肺功能、呼吸困難及慢性阻塞性肺部疾病的盛行率
在日本中部的一個病例對照研究,調查飲食攝取的葉酸與肺功能、呼吸困難及慢性阻塞性肺部疾病(COPD)之間的關聯。共有278位在過去4年內被檢測出罹患COPD的病人,男性244名與女性34名,年齡介於50-75歲;另外以340位同社區居民為對照組,男性272名與女性68名。評估所有對象是否有呼吸障礙,並以肺活量計測量其肺部功能。以面對面方式填寫結構型問卷,用來蒐集人口學、生活型態、日常的飲食攝取資料。使用日本食品成分表算出葉酸的攝取量。比起控制組的人(平均261,標準差110 μg /天),COPD病人日常的葉酸攝取(平均231,標準差90 μg /天)顯著的較低,p<0.001。肺部功能與飲食葉酸攝取量有正相關。葉酸攝取量的最高四分位比上最低四分位,其COPD盛行率與呼吸困難比例皆較低,校正過的勝算比分別為0.74(95%CI 0.35-1.58)與0.43(95%CI 0.21-0.91)。相對應的線性趨勢檢定亦為顯著的(p<0.05)。結論是,在日本成人中,飲食葉酸攝取量和呼吸困難盛行率,呈現一個明顯的負相關,並且和慢性阻塞性肺部疾病風險有顯著的劑量效應關係。此外,增加葉酸的攝取可能對於肺功能是有益的。
關鍵字:呼吸困難、慢性阻塞性肺部疾病、葉酸、日本、肺功能
 

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Health benefits of nuts in prevention and management of diabetes
CYRIL WC KENDALL, AMIN ESFAHANI, JENNIFER TRUAN, KORBUA SRICHAIKUL AND DAVID JA JENKINS
The effects of tree nuts on risk factors for coronary heart disease (CHD), in particular blood lipids, have been in-vestigated in a number of studies and the beneficial effects are now recognized. The beneficial effects of nuts on CHD in cohort studies have also been clearly demonstrated. However, while there is also reason to believe the unique micro- and macronutrient profiles of nuts may help to control blood glucose levels, relatively few studies have investigated their role in diabetes control and prevention. Nuts are low in available carbohydrate, have a healthy fatty acid profile, and are high in vegetable protein, fiber and magnesium. Acute feeding studies indicate that when eaten alone nuts have minimal effects on raising postprandial blood glucose levels. In addition, when nuts are consumed with carbohydrate rich foods, they blunt the postprandial glycemic response of the carbohy-drate meal. Despite the success of these acute studies, only a limited number of trials have been conducted with nuts in type 2 diabetes. These studies have either been of insufficient duration to observe changes in HbA1c, as the standard measure of glycemic control, or have been underpowered. Therefore, more long-term clinical trials are required to examine the role of nuts on glycemic control in patients with prediabetes and diabetes. Overall, there are good reasons to justify further exploration of the use of nuts in the prevention of diabetes and its micro- and macrovascular complications.
Key Words: nuts, cardiovascular disease, coronary heart disease, diabetes, glycemia
 

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核果在糖尿病預防及管理的健康益處
核果對於冠狀動脈心臟病(CHD)危險因子,尤其是血脂的影響,已被廣泛研究且確認它們的有益效用。世代研究中,核果對冠狀動脈心臟病的有益效應也已被清楚的證實。雖然有理由去相信核果的獨特巨量或微量營養素可以幫助血糖的控制,僅有少數研究探究它們在糖尿病控制及管理的角色。核果含有較低的可利用性醣類、健康的脂肪酸組成、高的植物性蛋白、纖維及鎂。急性餵食研究指出,當單獨食用核果,對於餐後血糖值的升高幾乎無影響。此外,當核果與富含醣類的食物一起食用,會減緩醣類食物的餐後血糖反應。儘管有這些成功的急性研究,僅有少數的試驗測試核果在第二型糖尿病的效應。這些研究要不是缺乏足夠的時間去觀察血糖管理基準之糖化血色素的改變,就是統計檢力不夠。因此,需要較長期的臨床研究去評估核果在糖尿病前期或是糖尿病人之血糖管理的角色。整體來說,有很正確的理由去更進一步的探究核果的使用在糖尿病及微血管和大血管的併發症的預防。
關鍵字:核果、心血管疾病、冠狀動脈心臟病、糖尿病、血糖
 

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The phytochemical composition and antioxidant actions of tree nuts
BRADLEY W BOLLING, DIANE L MCKAY AND JEFFREY B BLUMBERG
In addition to being a rich source of several essential vitamins and minerals, mono- and polyunsaturated fatty ac-ids, and fiber, most tree nuts provide an array of phytochemicals that may contribute to the health benefits attrib-uted to this whole food. Although many of these constituents remain to be fully identified and characterized, broad classes include the carotenoids, hydrolyzable tannins, lignans, naphthoquinones, phenolic acids, phytos-terols, polyphenols, and tocopherols. These phytochemicals have been shown to possess a range of bioactivity, including antioxidant, antiproliferative, anti-inflammatory, antiviral, and hypocholesterolemic properties. This review summarizes the current knowledge of the carotenoid, phenolic, and tocopherol content of tree nuts and associated studies of their antioxidant actions in vitro and in human studies. Tree nuts are a rich source of toco-pherols and total phenols and contain a wide variety of flavonoids and proanthocyanidins. In contrast, most tree nuts are not good dietary sources of carotenoids and stilbenes. Phenolic acids are present in tree nuts but a sys-tematic survey of the content and profile of these compounds is lacking. A limited number of human studies in-dicate these nut phytochemicals are bioaccessible and bioavailable and have antioxidant actions in vivo.
Key Words: tree nuts, phytochemicals, flavonoids, resveratrol, antioxidants
 

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木本堅果的植化素成份及抗氧化作用
大部分的木本堅果,除了是許多必需維生素、礦物質、單元不飽和脂肪酸、多元不飽和脂肪酸及纖維的豐富來源之外,它們也提供有益於健康的一系列的植化素。雖然尚有許多組成未完全被辨識及確認,堅果所含的大類成份有:類胡蘿蔔素、可水解單寧、木酚素、萘醌、酚酸、植物固醇、多酚以及生育酚。這些植化素已被證明具有多項生物活性:抗氧化、抑制增生、抗發炎、抗病毒以及降低血膽固醇的特性。本篇回顧概述目前對木本堅果的類胡蘿蔔素、酚酸和生育酚的知識,以及它們在體外與人體中抗氧化作用的相關研究。木本堅果是生育酚和所有酚類的豐富來源,並含有多樣的類黃酮及前花青素。相反地,大部份的木本堅果並非類胡蘿蔔素及二苯乙烯類的良好飲食來源。酚酸存在於木本堅果中,但是目前缺乏對這類化合物的含量及資料的系統化測量及調查。由有限的人體研究資料顯示,這些堅果的植化素是人體可攝取的且具生物可利用性,在體內亦具有抗氧化作用。
關鍵字:木本堅果、植化素、類黃酮、白藜蘆醇、抗氧化物
 

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Nuts, inflammation and insulin resistance
PATRICIA CASAS-AGUSTENCH, MÒNICA BULLÓ AND JORDI SALAS-SALVADÓ
The beneficial effects of nut consumption on cardiovascular disease (CVD) have been widely documented. These protective effects are mainly attributed to the role of nuts in the metabolism of lipids and lipoproteins. As chronic inflammation is a key early stage in the atherosclerotic process that predicts future CVD events and is closely related to the pathogenesis of insulin resistance, many recent studies have focused on the potential effect of nut consumption on inflammation and insulin resistance. Through different mechanisms, some components of nuts such as magnesium, fiber, -linolenic acid, L-arginine, antioxidants and MUFA may protect against in-flammation and insulin resistance. This review evaluates the epidemiologic and experimental evidence in hu-mans demonstrating an association between nut consumption and these two emergent cardio-protective mecha-nisms.
Key Words: nuts, inflammation, insulin resistance, type 2 diabetes, cardiovascular disease
 

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核果類與發炎作用及胰島素抗性
食用核果類對於心血管疾病的益處已被廣泛的證實。這些保護的效應主要歸因於核果類在脂質和脂蛋白代謝上所扮演的角色。慢性發炎是動脈粥狀硬化進程的早期關鍵階段,將預測未來心血管疾病的發生,並且與胰島素抗性的致病密切相關,因此很多近期的研究專注於核果類的食用對於發炎及胰島素抗性的影響。經由不同的機制,一些核果類的成分,例如鎂、纖維、-亞麻油酸、L-精胺酸、抗氧化物及單元不飽和脂肪酸,可能對於發炎及胰島素抗性有保護的作用。本文回顧人類流行病學的研究及人體實驗的證據來論證核果類的攝取與此兩種新興的心血管保護機制之間的關係。
關鍵字:核果類、發炎、胰島素抗性、第II型糖尿病、心血管疾病
 

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Nuts, blood lipids and cardiovascular disease
JOAN SABATE AND MICHELLE WIEN

The aim of this paper is to evaluate nut-related epidemiological and human feeding study findings and to discuss the important nutritional attributes of nuts and their link to cardiovascular health. Frequent nut consumption has been found to be protective against coronary heart disease in five large epidemiological studies across two continents. A qualitative summary of the data from four of these studies found an 8.3% reduction in risk of death from coronary heart disease for each weekly serving of nuts. Over 40 dietary intervention studies have been conducted evaluating the effect of nut containing diets on blood lipids. These studies have demonstrated that intake of different kinds of nuts lower total and LDL cholesterol and the LDL: HDL ratio in healthy subjects or patients with moderate hypercholesterolaemia, even in the context of healthy diets.  Nuts have a unique fatty acid profile and feature a high unsaturated to saturated fatty acid ratio, an important contributing factor to the beneficial health effects of nut consumption. Additional cardioprotective nutrients found in nuts include vegetable protein, fiber, α-tocopherol, folic acid, magnesium, copper, phytosterols and other phytochemicals. Key Words: nuts, fatty acids, cardiovascular disease, blood lipids, cholesterol

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核果類與血脂質以及心血管疾病
這篇論文的目的是評估與核果類相關的流行病學及人體給食研究的結果,並且討論核果類和相關的心血管健康的重要營養特性。在兩大洲的五個大型流行病學研究中指出,經常攝取核果類具有預防冠心病的效用。綜整其中四個研究的定性資料,發現每週攝取一份的核果類,可減少8.3%因為冠心病而死亡的風險。有超過40個飲食介入的研究,針對血脂質來進行飲食中包含核果類的效果評估。這些研究顯示攝取不同種類的核果類,甚至是健康飲食中含有核果類,可降低健康者以及患有中度高膽固醇血脂症患者的總膽固醇、低密度脂蛋白膽固醇以及低密度脂蛋白膽固醇與高密度脂蛋白膽固醇比值。核果類具有特殊的脂肪酸組成,而且有較高的不飽和脂肪酸與飽和脂肪酸比例,這是攝取核果類有益健康效果的一個重要因子。核果類保護心血管的營養成分還包括植物性蛋白、纖維、維生素E、葉酸、鎂、銅、植物固醇以及其他植化素等。
關鍵字:核果、脂肪酸、心血管疾病、血脂質、膽固醇
 

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Nuts and healthy body weight maintenance mechanisms
RICHARD D MATTES AND MARK L DREHER
Nuts are rich sources of multiple nutrients and phytochemicals associated with health benefits, including reduced cardiovascular disease risk. This has prompted recommendations to increase their consumption. However, they are also high in fat and are energy dense. The associations between these properties, positive energy balance and body weight raise questions about such recommendations. Numerous epidemiological and clinical studies show that nuts are not associated with weight gain. Mechanistic studies indicate this is largely attributable to the high satiety and low metabolizable energy (poor bioaccessibility leading to inefficient energy absorption) properties of nuts. Compensatory dietary responses account for 55-75% of the energy provided by nuts. Limited data sug-gest that routine nut consumption is associated with elevated resting energy expenditure and the thermogenic ef-fect of feeding, resulting in dissipation of another portion of the energy they provide. Additionally, trials con-trasting weight loss through regimens that include or exclude nuts indicate improved compliance and greater weight loss when nuts are permitted. Nuts may be included in the diet, in moderation, to enhance palatability, nutrient quality, and chronic disease risk reduction without compromising weight loss or maintenance.
Key Words: nuts, body weight, satiation, metabolizable energy, energy expenditure
 

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核果類與維持健康體重的機制
核果類是多種有益健康的營養素和植化素的良好來源,包括降低心血管疾病的風險。因此倡議增加核果類的攝取。但是核果類亦含高脂肪及高熱量,這些性質與正向能量平衡、體重之間的可能相關性引起對上述建議的疑慮。許多流行病學及臨床研究顯示核果類與體重的增加沒有相關。機制研究指出這主要是由於核果類的高度飽足感以及低代謝能量(低生物可獲性而致熱量吸收效率低)的特性所致。代償性的飲食反應約佔55%-75%由核果類所提供的能量。有限的數據建議,日常攝取核果類與增加靜息能量消耗(REE)、進食產熱效應有關,這些可消耗另一部分核果所提供的能量。此外,減重對比試驗,比較包含或排除核果類的飲食方案,結果顯示在允許攝取核果類的情況下,有助改善遵從性及提昇減重效果。飲食中包含適量的核果類,可增加適口性、營養品質,以及在不影響減重或維持體重的情形下,可減少慢性疾病的風險。
關鍵字:核果、體重、飽足感、代謝能量、熱量消耗
 

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Tree nut consumption improves nutrient intake and diet quality in US adults: an analysis of National Health And Nutrition Examination Survey (NHANES) 1999-2004
CAROL E O’NEIL, DEBRA R KEAST, VICTOR L FULGONI III AND THERESA A NICKLAS
Recent epidemiologic studies assessing tree nut (almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pe-cans, pine nuts, pistachios, and walnuts) consumption and the association with nutrient intake and diet quality are lacking. This study determined the association of tree nut consumption and nutrient intake and diet quality using a nationally representative sample of adults. Adults 19+ years (y) (n=13,292) participating in the 1999-2004 National Health and Nutrition Examination Survey were used. Intake was determined from 24-hour diet re-calls; tree nut consumers were defined as those consuming ≥¼ ounce/day (7.09 g). Means, standard errors, and ANOVA (adjusted for covariates) were determined using appropriate sample weights. Diet quality was measured using the Healthy Eating Index-2005. Among consumers, mean intake of tree nuts/tree nut butters was 1.19 + 0.04 oz/d versus 0.01 + 0.00 oz/d for non-consumers. In this study, 5.5 ± 0.3 % of individuals 19-50 y (n=7,049) and 8.4 ± 0.6 % of individuals 51+ y (n=6,243) consumed tree nuts/tree nut butters. Mean differences (p<0.01) between tree nut consumers and non-consumers of adult shortfall nutrients were: fiber (+5.0 g/d), vitamin E (+3.7 mg AT/d), calcium (+73 mg/d), magnesium (+95 mg/d), and potassium (+260 mg/d). Tree nut consumers had lower sodium intake (-157 mg/d, p<0.01). Diet quality was significantly higher in tree nut consumers (58.0±0.4 vs. 48.5±0.3, p<0.01). Tree nut consumption was associated with a higher overall diet quality score and improved nutrient intakes. Specific dietary recommendations for nut consumption should be provided for consumers.
Key Words: tree nuts, nutrient intake, dietary adequacy, healthy eating index-2005, NHANES
 

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木本核果攝取改善美國成人營養素攝取及飲食品質:1999-2004年國家健康及營養調查的分析
近年來很少有關於木本核果(杏仁、巴西核桃、腰果、榛子、澳洲堅果、美洲山核桃、松子、開心果及核桃)的攝取與營養素攝取及飲食品質之間關係的流行病學研究。本篇研究利用全國代表性的成人樣本來確定木本核果的攝取與營養素攝取及飲食品質之間的關係。對象為參與1999-2004年國家健康及營養調查(NHANES)之19歲以上成人(13,292名)。飲食的攝取以24小時回憶法來決定;有使用木本核果的人定義為每天消耗木本核果0.25盎司(7.09克)及以上者。先經過適當的加權後,計算其平均植、標誤及使用變異數分析(校正共變數)。飲食品質則使用健康飲食指數-2005來評估。有攝取核果或核果油製品的人,平均攝取量為一天1.19±0.04盎司,而被定義為沒有食用的人,平均攝取量為一天0.01± 0.00盎司。在本篇研究中,19-50歲的人(7,049名),其中有5.5±0.3%的人消費核果或核果油製品,而51歲以上的人(6,243名),消費核果或核果油製品的人則佔了8.4±0.6%。有攝取核果的人比較沒有攝取核果的人,在一些成人攝取不足的營養素平均差異(p<0.01)為:纖維(+5.0克/天),維生素E(+3.7毫克 AT/天),鈣(+73毫克/天),鎂(+95毫克/天)及鉀(+260毫克/天)。有食用核果的人有較低的鈉攝取(-157毫克/天, p<0.01)。飲食品質在有消耗核果的人也顯著的較高(58.0±0.4比48.5±0.3, p<0.01)。木本核果的攝取與較高的總飲食品質相關,且營養素的攝取方面也較佳。有關核果攝取的特別飲食建議應提供給消費者。
關鍵字:木本核果、營養素攝取、飲食適當性、健康飲食指數-2005、國家健康及營養調查
 

 

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Last Updated: March 2010