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1 Asia Pacific Journal of Clinical Nutrition
       Volume 20, 3

         (September 2011)


Abstracts

Contents

Abstract

Paper

Reviews Soyfoods, hyperuricemia and gout: A review of the epidemiologic and clinical data
MARK MESSINA, VIRGINIA L MESSINA AND PAULINE CHAN
Asia Pac J Clin Nutr. 2011;20(3):347-358.

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A situational review of infant and young child feeding practices and interventions in Viet Nam
PHUONG HONG NGUYEN, PURNIMA MENON, MARIEL RUEL AND NEMAT HAJEEBHOY
Asia Pac J Clin Nutr. 2011;20(3):359-374.

 

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Original Research Communications Clinical Nutrition Trials or Feeding Studies

Micronutrients decrease incidence of common infections in type 2 diabetes outpatientsYINGHUA LIU, HONGJIANG JING, JIN WANG, RONGXIN ZHANG, YUEHONG ZHANG, YONG ZHANG, QING XU, XIAOMING YU AND CHANGYONG XUE
Asia Pac J Clin Nutr. 2011;20(3):375-382.

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Effect of soy drink replacement in a weight reducing diet on anthropometric values and blood pressure among overweight and obese female youths
LEILA AZADBAKHT AND SAFURA NURBAKHSH
Asia Pac J Clin Nutr. 2011;20(3):383-389.

 

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Macro- Micro and Phyto-nutrients

Examination of Chinese habitual dietary protein requirements of Chinese young female adults by an indicator amino acid method
YING TIAN, JIANMIN LIU, YUHUI ZHANG, JIANHUA PIAO, LINGYAN GOU, YUAN TIAN, MIN LI, YIBING JI AND XIAOGUANG YANG
Asia Pac J Clin Nutr. 2011;20(3):390-396.

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Nutritional Epidemiology and Public Health

Prevalence of vitamin D insufficiency and risk factors for type 2 diabetes and cardiovascular disease among African migrant and refugee adults in Melbourne
ANDR MN RENZAHO, CARYL NOWSON, AMBI KAUR, JENNIFER A HALLIDAY, DAVID FONG AND JANINA DESILVA
Asia Pac J Clin Nutr. 2011;20(3):397-403.

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Veganism does not reduce the risk of the metabolic syndrome in a Taiwanese cohort
PENGHUI SHANG, ZHENG SHU, YANFANG WANG, NA LI, SONGMING DU, FENG SUN, YINYIN XIA AND SIYAN ZHAN
Asia Pac J Clin Nutr. 2011;20(3):404-410.

 

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Nutritional Status, Dietary intake and Body Composition

The relationship between habitual dietary phosphorus and calcium intake, and bone mineral density in young Japanese women: a cross-sectional study
SANAE ITO, HIROMI ISHIDA, KAZUHIRO UENISHI, KENTARO MURAKAMI AND SATOSHI SASAKI
 Asia Pac J Clin Nutr. 2011;20(3):411-417.

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Comparison of frequently used, unexplored and newly designed indices for the assessment of segmental and whole body constituents
JONATHAN TRESIGNIE, ALDO SCAFOGLIERI, STEVEN PROVYN AND JAN PIETER CLARYS
Asia Pac J Clin Nutr. 2011;20(3):418-425.

 

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Predicting total fat mass from skinfold thicknesses in Japanese prepubertal children: A cross-sectional and longitudinal validation
TAISHI MIDORIKAWA, MEGUMI OHTA, YUKI HIKIHARA, SUGURU TORII, MICHAEL G BEMBEN AND SHIZUO SAKAMOTO
Asia Pac J Clin Nutr. 2011;20(3):426-431.

 

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Retrospective individual tracking of body mass index in obese and thin adolescents back to childhood
SONG GE, MASARU KUBOTA, AYAKO NAGAI, KIMIYO MAMEMOTO AND CHIAKI KOJIMA
Asia Pac J Clin Nutr. 2011;20(3):432-437.

 

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Progress of Dietary Guidelines in Asia

Progress of Dietary Guidelines in Asia: an introduction

AVITA A USFAR, TOSHIAKI TAKANO AND JACKSON ZHANG Asia Pac J Clin Nutr. 2011;20(3):438.

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The transition of Chinese dietary guidelines and the food guide program
KEYOU GE
Asia Pac J Clin Nutr. 2011;20(3):439-446.

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Taking the Indonesian nutrition history to leap into betterment of the future generation: development of the Indonesian Nutrition Guidelines
SOEKIRMAN
Asia Pac J Clin Nutr. 2011;20(3):447-451.

 

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Nutritional policies and dietary guidelines in Japan
TEIJI NAKAMURA
Asia Pac J Clin Nutr. 2011;20(3):452-454.

 

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Development and promotion of Malaysian Dietary Guidelines
E-SIONG TEE
Asia Pac J Clin Nutr. 2011;20(3):455-461.

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Food- based dietary guidelines for Filipinos: retrospects and prospects
CEKESTE C TANCHOCO
Asia Pac J Clin Nutr. 2011;20(3):462-471.

 

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Dietary Guidelines in Singapore
BENJAMIN LC LEE
Asia Pac J Clin Nutr. 2011;20(3):472-475.

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Food based dietary guidelines (FBDGs) development and promotion in Thailand
PRAPAISRI P SIRICHAKWAL, KITTI SRANACHAROENPONG AND KRAISID TONTISIRIN
Asia Pac J Clin Nutr. 2011;20(3):477-483.

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 Do Indonesians follow its Dietary Guidelines? - evidence related to food consumption, healthy lifestyle, and nutritional status within the period 2000-2010
AVITA A USFAR AND UMI FAHMIDA
Asia Pac J Clin Nutr. 2011;20(3):484-494.

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Food based dietary guidelines in Vietnam: progress and lessons learned
LE THI HOP, TRAN KHANH VAN AND HOANG KIM THANH
Asia Pac J Clin Nutr. 2011;20(3):495-499.

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Future Events

Asia Pac J Clin Nutr. 2011;20(3):500.

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Soyfoods, hyperuricemia and gout: A review of the epidemiologic and clinical data
MARK MESSINA, VIRGINIA L MESSINA AND PAULINE CHAN
Soyfoods have long been a part of traditional Asian diets; they provide plentiful amounts of high-quality protein and have a favourable fatty acid profile. In addition, provocative research suggests soyfoods offer health benefits independent of the nutrients they provide. However, there is a widely-held belief among Asian health profes-sionals and the public that soyfoods increase risk of gout and potentially precipitate acute attacks in patients with this disease. To examine the veracity of this belief, this review critically evaluated the relevant clinical and epi-demiologic data. In addition, background information on the etiology and prevalence of hyperuricemia and gout in Asia is provided along with the results of a small survey of Asian healthcare professionals about their attitudes toward soyfoods. Among the healthcare professionals who responded to the survey, 95% considered soyfoods to be somewhat or very healthy and nutritious. In contrast, 48% expressed the view that soyfoods are likely to cause gout. However, none of the six epidemiologic studies identified provided any evidence that soy intake was associated with circulating uric acid levels, hyperuricemia or gout. Data from the five human intervention studies evaluated indicate soy protein does elevate serum uric levels, but in response to amounts comparable to Asian in-take, the expected rise would almost certainly be clinically irrelevant. Although there is a need for long-term re-search, on the basis of the existing data there is no reason for individuals with gout or at risk of developing gout to avoid soyfoods.

Key Words: soy, vegetarian, gout, hyperuricemia, uric acid

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黄豆食品與高尿酸血症及痛風:流行病學及臨床研究的回顧
黄豆食品长久以来就是亚洲传统饮食的一部分。 它们提供大量的高质量蛋白质及拥有良好的脂肪酸组合。有一些挑戰性的研究更認為,即使不考虑黄豆食品的营养成分,它们本身也可为健康带来好处。但是,一些亚洲的保健人員和大众都广泛地相信,黄豆食品可增加痛风的风险以及会促成痛风病人急性发作的可能。为了考證此观念的真实性,本篇回顧嚴謹地评估了相关的临床及流行病学的资料。此外,亦提供亚洲高尿酸血症和痛风的病因及盛行率的背景资料,同時呈現一份针对亚洲保健從業人員对黄豆食品看法的小型调查报告。在这些保健相關人員当中,有95% 认为黄豆食品相當或非常健康及有营养。相反地,有48% 认为黄豆食品有可能导致痛风。然而,在6个被确定的流行病学研究中,并没有任何一个有证据显示摄取黄豆与尿酸的水平、高尿酸血症或痛风有关联。从评估的5份人群介入研究资料中,虽然显示黄豆蛋白质会提升血液中的尿酸,但基于亚洲人的黄豆摄取量,可预期的尿酸上升程度在临床上几可確定是無意義的。虽然长期的研究仍有必要,但依据目前已有的资料,已患上痛风或有风险患上痛风的人并不需要避免黄豆食品。
關鍵字:黄豆、素食者、痛風、高尿酸血症、尿酸
 

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A situational review of infant and young child feeding practices and interventions in Viet Nam
PHUONG HONG NGUYEN, PURNIMA MENON, MARIEL RUEL AND NEMAT HAJEEBHOY
Sub-optimal infant and young child feeding (IYCF) practices are likely a significant contributor to high undernutrition rates in Viet Nam. To date, however, there has been no comprehensive review of IYCF practices in Viet Nam. The objectives of this paper were to review: 1) patterns/trends in IYCF in Viet Nam; 2) the barriers and facilitators to IYCF practices; and 3) interventions and policies and their effectiveness. Methods used include re-viewing and analyzing existing data, summarizing and organizing the evidence into broad themes based on a pre-defined conceptual framework. Findings show that the proportion of children ever breastfed is almost uni-versal and the median duration of breastfeeding is 13-18 months. However, exclusive breastfeeding for the first six months is low (8-17%) and appears to be declining over time. Information on complementary feeding is limited, but two key challenges are: early introduction, and low nutrient quality of complementary foods. Facilitators of optimal IYCF were support from 1) government progressive policies, 2) non-profit organizations and 3) family members. Barriers to optimal IYCF included 1) the lack of enforcement of, and compliance with the code of marketing breast milk substitutes, 2) inadequate knowledge among health care providers; and 3) maternal poor knowledge. These findings indicate that the evidence base on complementary feeding is weak in Viet Nam and needs to be strengthened. The review also reinforces that program and policy actions to improve IYCF in Viet Nam must target multiple stakeholders at different levels: the family, the health system and the private sector.
Key Words: review, Viet Nam, breastfeeding, complementary feeding, infant
 

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‘越南的嬰幼兒哺餵習慣與介入之狀況回顧

越南不理想的嬰幼兒哺餵習慣(IYCF)似乎是導致高比例營養不良的重要原因。然而到目前為止,並沒有人針對這點做全面地探討。這篇研究主要探討的主題如下:1) 越南嬰幼兒哺餵習慣的模式與趨勢;2) 嬰幼兒哺餵習慣的障礙和成因;3) 介入措施及相關政策的成效。研究方法包括檢視跟分析既有的資料,並且根據預先定義的概念框架來綜整和組織相關證據。結果發現,幾乎所有兒童都曾被哺餵母乳,母乳哺餵期的中位數為13-18個月。然而,頭六個月是純母乳哺餵的比例不高(8-17%),而且此比例隨著時間逐漸降低。關於輔食品的資訊有限,但有兩個關鍵問題待解決,即太早開始餵食輔食品和輔食品的營養品質不佳。理想的IYCF養成有賴政府漸進的政策、非營利組織和家人的支持和協助。養成理想的IYCF的障礙包括:1) 沒有強制執行和遵守母乳替代品行銷的法規;2) 健康照護提供者缺乏適當的知識; 3) 產婦缺乏相關知識。研究發現顯示越南輔食品餵食的相關基礎資料不足,未來需加強研究。本篇回顧也重申,改善越南嬰幼兒哺餵的政策措施與計畫須分別針對不同層次:家庭、衛生體系和私營部門。
關鍵字:回顧、越南、母乳哺餵、輔食品餵食、嬰兒
 

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Micronutrients decrease incidence of common infections in type 2 diabetes outpatients
YINGHUA LIU, HONGJIANG JING, JIN WANG, RONGXIN ZHANG, YUEHONG ZHANG, YONG ZHANG, QING XU, XIAOMING YU AND CHANGYONG XUE
A randomized, double-blind, placebo-controlled trial was carried out to investigate the effects of micronutrients supplementation on immunity and the incidence of common infections in type 2 diabetic outpatients. A total of 196 type 2 diabetic outpatients were randomized to receive tablets of micronutrients (n=97) or placebo (n=99) for 6 months. Individualized dietary energy intake and daily physical activity were recommended. Anthropometric measurements, blood biochemical variables and the incidence of common infections were measured at base-line and at 6 months. Data on diet, exercise and infection (upper respiratory tract infection, skin infection, urinary and genital tract infections, other infections) were recorded 1 month before the study and every month during the study. Blood concentrations of total protein, iron (Fe), folic acid and hemoglobin increased and unsaturated iron-binding capacity(UIBC) levels were decreased in the micronutrients supplementation group compared to the placebo group at 6 months. Moreover, at 6 months, compared to the placebo group, the blood concentrations of IgE, CD4+, CD4+/CD8+, WBC, lymphocyte counts, basophilic leukocyte increased and CD8+ count de-creased in the supplementation group, and the levels of IgA, IgM, IgG and complements C3 and C4 did not differ. The incidence of upper respiratory infection, whitlow, dermapostasis, vaginitis, urinary tract infection, gingivitis and dental ulcer were lower and body temperature and duration of fever greatly improved in the supplementation than the placebo group. These data indicated that supplementation of micronutrients might increase immune function and reduce the incidence of common infections in type 2 diabetic outpatients.
Key Words: type 2 diabetes mellitus, micronutrients, infection, immune function, nutrition
 

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补充微量营养素减少2型糖尿病患者一般感染发生率
按随机双盲安慰剂对照的研究方法,分别给予196例2型糖尿病患者微量营养素制剂(n=97)和安慰剂(n=99),连续服用6个月。推荐每日膳食摄入量及运动量。于研究开始前和结束后进行人体测量、血液生化指标及一般感染发生率检查。研究前1个月及研究期间每月进行随访,收集饮食和运动记录表、感染登记表。研究结束后微量营养素补充剂组与安慰剂组比较,平均血清总蛋白浓度、血清铁和叶酸水平以及血红蛋白浓度、IgE水平、CD4+计数、CD4+/CD8+比例,白细胞计数、淋巴细胞计数、嗜碱性粒细胞计数显著升高,不饱和铁结合力(UIBC)以及CD8+计数显著下降,而IgA、IgM、IgG和补体C3和C4水平两组间无显著性差异。与安慰剂组比较,在研究期间微量营养素补充剂组的上呼吸道感染、咽痛、皮肤脓肿与破溃、阴道炎、泌尿系统感染、牙龈炎、口腔溃疡的平均发生率均显著降低,且发热时体温和持续时间均有明显改善。因此,适量补充微量营养素可提高2型糖尿病患者免疫功能,减少一般感染的发生率。
關鍵字:2型糖尿病、微量营养素、感染、免疫功能、营养


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Effect of soy drink replacement in a weight reducing diet on anthropometric values and blood pressure among overweight and obese female youths
LEILA AZADBAKHT AND SAFURA NURBAKHSH
Background: Soy drink replacement in the diet might have beneficial effects on anthropometric and blood pres-sure values for overweight and obese subjects. Therefore, we are going to determine the effects of soy drink re-placements on the weight, waist circumference and blood pressure among overweight and obese female youths. Patients and Methods: This was a cross-over randomized clinical trial on 23 overweight and obese female sub-jects. All patients were on a weight reducing diet. There were two trial periods for six weeks (soy drink period and cow’s milk period) and a washout period for 3 weeks. In the soy drink period only one glass of soy drink (240 cc) was consumed instead of one glass of cow’s milk. Results: The mean age of the patients was 22±2 years. Mean of BMI was 28.1±0.5. Weight and waist circumference did not changed significantly after the soy drink period compared to the cow’s milk period. Systolic blood pressure reduced significantly following the soy drink period (mean percent change in soy drink period: -4.0±0.9 vs -1.70.5 in the cow’s milk period; p<0.05). Diastolic blood pressure also reduced in the soy drink period (-0.4±0.1 vs 0.4±0.1; p<0.05). Conclusion: Soy drink replacement could reduce both systolic and diastolic blood pressure among overweight and obese female youths. However, this replacement had no significant results on weight and waist circumference.
Key Words: Soy drink, body mass index, waist circumference, females, blood pressure
 

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豆漿對於過重和肥胖年輕女性的體位及血壓的影響
背景:豆漿對於肥胖和過重的人的體位和血壓值可能有益處,所以本篇研究探討豆漿對於過重和肥胖的年輕女性之體重、腰圍和血壓的影響。方法:總共有23位過重和肥胖女性參與交叉的隨機臨床試驗。所有受試者皆採用減肥飲食。每回試驗期(食用豆漿或牛奶)為六週,兩期中間有三週的廓清期。食用豆漿期時,僅有一杯牛奶以一杯豆漿(240 cc)取代。結果:受試者平均年齡22±2歲,BMI平均值為28.1±0.5。比較豆漿期和牛奶期,體重和腰圍並沒有顯著差異。豆漿期時,受試者收縮壓有顯著下降(改變的百分率:豆漿期-4.0±0.9比上牛奶期-1.7±0.5;p<0.05)。舒張壓在豆漿期時也顯著下降(-0.4 ±0.1 比上0.4±0.1; p<0.05)。結論:以豆漿取代牛奶可以改善過重和肥胖年輕女性之收縮壓和舒張壓。然而,對於體重和腰圍並沒有明顯的效果。
關鍵字:豆漿、身體質量指數、腰圍、女性、血壓
 

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Examination of Chinese habitual dietary protein requirements of Chinese young female adults by an indicator amino acid method
YING TIAN, JIANMIN LIU, YUHUI ZHANG, JIANHUA PIAO, LINGYAN GOU, YUAN TIAN, MIN LI, YIBING JI AND XIAOGUANG YANG
Objective: To determine protein requirement of Chinese young female adults on habitual Chinese diet through indicator amino acid oxidation (IAAO) technique. Design: Twenty women with a mean (SD) age of 21.6 (0.9) years were healthy based on questionnaire, physical examinations and screening tests. There were three consecutive periods of 7 days each with six different intakes of protein (0.70, 0.78, 0.86, 0.94, 1.02 and 1.10 g/kgd) within Chinese habitual diets (proportions of good-quality protein were 40 to 45%). Subjects were randomly al-located equally into two groups (1.10, 0.86, 0.78 g/kgd for group 1 and 1.02, 0.94, 0.70 g/kgd for group 2 from period 1 to period 3 in turn). Adaptation days were from day 1 to day 6 and the isotope study day was day 7 in each period. Amino acid kinetics was measured in non-menstrual periods, based on the IAAO technique. Two indicators (rate of release of 13CO2 and rate of leucine oxidation) were used to estimate protein requirement by breakpoint analysis with a two-phase linear regression crossover model. Results: Mean and population safe protein requirements of Chinese habitual diets in non-menstrual periods from the rate of release of 13CO2 were 0.91 and 1.09 g/kgd, respectively. And from the rate of leucine oxidation were 0.92 and 1.10 g/kgd, respectively. Conclusions: The protein requirement of young women on Chinese habitual diets in non-menstrual period was lower than the current protein reference intake for Chinese females. Further studies are necessary to explore female protein requirements during the whole menstrual cycle.

Key Words: protein requirement, indicator amino acid oxidation, mixed diet, stable isotope, women
 

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以指標氨基酸氧化法确定中国青年女性对日常膳食蛋白质的需要量
目的:采用指標氨基酸氧化技术,确定中国青年女性对中国日常膳食蛋白质的需要量。方法:通过问卷调查、体格检查和筛选,選擇20名健康女性作为受试者,平均年龄21.6(±0.9)岁。整个实验共3个连续的实验周期,每周期7天。实验膳食为中国日常混合膳食,优质蛋白占40%-45%,共6个膳食蛋白质摄入水平(0.70、0.78、0.86、0.94、1.02 和1.10 g/kg·d)。受试者被随机平均分为2组,每组受试者在每个实验周期摄入1个蛋白质水平的实验膳食,3个周期依次为:第一组:1.10、0.86、0.78 g/kg·d;第二组:1.02、0.94、0.70 g/kg·d。每个实验周期的第1到6天为适应期,第7天为同位素实验日。在受试者的非月经期,应用指標氨基酸氧化法进行氨基酸代谢动力学的研究。将实验所得的13CO2产生率、亮氨酸(leucine)氧化率两个指标,分别代入兩相回归曲线模型,确定回归曲线的拐点,即蛋白质的生理需要量。结果:通过13CO2产生率计算的中国青年女性非月经期对中国日常混合膳食蛋白质的平均需要量是0.91 g/kg·d,人群安全需要量是1.09 g/kg·d;通过亮氨酸氧化率计算的平均需要量是0.92 g/kg·d,人群安全需要量是1.10 g/kg·d。结论:中国青年女性在非月经期对日常膳食蛋白质的需要量低于目前的膳食推荐摄入量。女性在整个月经周期中的膳食蛋白质需要量,尚需进一步研究探讨。
關鍵字:蛋白质需要量、指標氨基酸氧化法、混合膳食、安定同位素、婦女

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Prevalence of vitamin D insufficiency and risk factors for type 2 diabetes and cardiovascular disease among African migrant and refugee adults in Melbourne
ANDRÉ MN RENZAHO, CARYL NOWSON, AMBI KAUR, JENNIFER A HALLIDAY, DAVID FONG AND JANINA DESILVA
Migration to industrialised countries poses a “double whammy” for type 2 diabetes among sub-Saharan African migrant and refugee adults. This population group has been found to be at an increased risk of obesity and type 2 diabetes, which may be further aggravated by inadequate vitamin D status. Thus, this study aimed to describe the demographics of vitamin D insufficiency, obesity, and risk factors for type 2 diabetes among sub-Saharan African migrants and refugees aged 20 years or older living in Melbourne, Australia (n=49). Data were obtained by a questionnaire, medical assessment, and fasting blood samples. The mean serum 25-hydroxyvitamin D level was 27.3 nmol/L (95% CI: 22.2, 32.4 nmol/L); with 25-hydroxyvitamin D levels <50 nmol/L occurring in 88% of participants. Participants displayed a cluster of risk factors for type 2 diabetes and cardiovascular disease: 62% were overweight or obese, 47% had insulin resistance (HOMA-IR ≥2), 25% had low density lipoprotein cholesterol levels ≥3.5 mmol/L, 24.5% had high density lipoprotein cholesterol levels ≤1.03 mmol/L, 34.6% had borderline or high levels of total cholesterol (≥5.2 mmol/L), 18.2% had borderline or high levels of triglyceride (≥1.7 mmol/L), and 16% had hypertension (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg). These findings suggest that sub-Saharan African migrants and refugees may be at risk of type 2 diabetes and atherosclerosis-related diseases such as ischemic heart disease, stroke, and peripheral vascular disease. Well-designed vitamin D interventions that incorporate lifestyle changes are urgently needed in this sub-population.
Key Words: vitamin D insufficiency, fasting plasma glucose, African migrants and refugees, insulin resistance, obesity
 

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澳洲墨爾本之非洲移民及難民的維生素D不足與第二型糖尿病及心血管疾病風險的盛行率
遷移至工業化國家後,撒哈拉沙漠以南之非洲移民及難民,發生第二型糖尿病之風險可謂雪上加霜。這些族群不單是肥胖及第二型糖尿病風險增高,更可能由於維生素D不足而更惡化。因此,本篇研究目的在描述澳洲墨爾本20歲以上之非洲移民及難民,維生素D不足、肥胖與第二型糖尿病危險因子之人口學變項。資料蒐集自問卷、醫療評估及禁食血液樣本等。結果發現,49位研究對象之血清平均25-羥基維生素D濃度為27.3 nmol/L (95% CI: 22.2, 32.4 nmol/L),其中88%之參予者25-羥基維生素D濃度小於<50 nmol/L。另外也發現研究對象,有第二型糖尿病與心血管疾病風險因子的集群現象:研究對象62% 過重或肥胖、47% 有胰島素抗性(HOMA-IR ≥2)、25% 低密度脂蛋白過高(≥3.5 mmol/L)、24.5% 高密度脂蛋白過低(<1.03 mmol/L)、34.6% 總膽固醇過高(≥5.2 mmol/L)、18.2% 三酸甘油脂過高(≥1.7 mmol/L)、16% 患有高血壓。本篇研究顯示,此族群可能處於第二型糖尿病與心血管相關疾病風險下,如缺血性心臟病、中風及周邊動脈疾病等。目前急需進行良好規劃的維生素D介入並涵蓋生活型態改變的方案。
關鍵字:維生素D不足、空腹血糖、非洲移民及難民、胰島素抗性、肥胖

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Veganism does not reduce the risk of the metabolic syndrome in a Taiwanese cohort
PENGHUI SHANG, ZHENG SHU, YANFANG WANG, NA LI, SONGMING DU, FENG SUN, YINYIN XIA AND SIYAN ZHAN
The purpose of the present study was to assess the risk of the metabolic syndrome (MS) with vegan, pescovegetarian, lactovegetarian and nonvegetarian diets in Taiwan. The design was a retrospective cohort study using secondary data analysis from a Taiwan longitudinal health check-up database provided by MJ Health Screening Center during 1996–2006. A total of 93209 participants were classified as vegans (n=1116), pescovegetarians (n=2461), lactovegetarians (n=4313) and nonvegetarians (n=85319) by food frequency list of self-administered questionnaire at baseline. The association between MS or MS components and different dietary groups was evaluated using Cox proportional-hazards regression models with adjustment for confounders. During the mean 3.75 years of follow up, a total 8006 MS incident cases occurred and the incidence of MS was 229 (95% CI, 224, 234) per 10000 person year. Compared with vegans, hazard ratios of MS for nonvegetarians, pescovegetarians, lactovegetarians were 0.75 (95% CI, 0.64, 0.88), 0.68 (95% CI, 0.55, 0.83) and 0.81 (95% CI, 0.67, 0.97) after adjusting for sex, age, education status, smoking status, drinking status, physical activity at work and leisure, respectively. As for MS components, nonvegetarians and pescovegetarians had 0.72 (95% CI, 0.62, 0.84), 0.70 (95% CI, 0.57, 0.84) times risk of developing low high density lipoprotein cholesterol (HDL-C), while nonvegetarians had 1.16 (95% CI, 1.02, 1.32) times risk of developing high fasting plasma glucose. Our data suggest that the vegan diets did not decrease the risk of metabolic syndrome compared with pescovegetarian, lactovegetarian and nonvegetarian diets in a Taiwanese cohort.
Key Words: vegan, pescovegetarian, lactovegetarian, nonvegetarian, metabolic syndrome
 

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纯素食没有降低代谢综合症的发病风险-台湾回顾性队列研究
摘要:本研究的目的是为了比较台湾人群纯素食者相对鱼类素食、蛋奶素食和非素食者代谢综合症的发病风险。采用回顾性队列的研究方法,采集台湾美兆集团1996-2006年期间的健康体检数据进行二手数据分析。共有93,209名健康体检者纳入研究对象,根据自我调查问卷中的食物摄取频率表,将其分为纯素食、鱼类素食、蛋奶素食和非素食者四种类型。采用COX比例风险模型,分析不同膳食分组者发生代谢综合症和代谢综合症组分的风险。在平均3.75年的观察期内,总共有8006个代谢综合症新发病例,发生率为229 (95% CI, 224, 234)/10000人年。控制性别、年龄、教育程度、吸烟、饮酒、工作勞動、休閒运动等混杂因素的影响后,与纯素食者相比,非素食、鱼类素食和蛋奶素食者代谢综合症发生危险比(HR)分别为0.75 (95% CI, 0.64, 0.88), 0.68 (95% CI, 0.55, 0.83) 和0.81 (95% CI, 0.67, 0.97)。代谢综合症组分发病风险的分析结果显示,与纯素食者相比,非素食和鱼类素食者低的高密度脂蛋白胆固醇发生的HR分别为0.72 (95% CI, 0.62, 0.84) 和0.70 (95% CI, 0.57, 0.84),非素食者高空腹血糖发生的HR为1.16 (95% CI, 1.02, 1.32)。我们的研究结果提示:相对于鱼类素食、蛋奶素食和非素食者而言,纯素食没有降低代谢综合症的发病风险。
關鍵字:纯素食、鱼类素食、蛋奶素食、非素食、代谢综合症

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The relationship between habitual dietary phosphorus and calcium intake, and bone mineral density in young Japanese women: a cross-sectional study
SANAE ITO, HIROMI ISHIDA, KAZUHIRO UENISHI, KENTARO MURAKAMI AND SATOSHI SASAKI
Phosphorus and calcium are essential for bone health. There is a concern that a low calcium/phosphorus intake ratio resulting from low calcium intake coupled with high phosphorus intake may have a negative effect on bone mineral status, especially in Western countries. The objective of this study was to examine cross- sectionally the influence of habitual phosphorus and calcium intake and the calcium/phosphorus intake ratio on the bone miner-al density (BMD) in 441 young Japanese women (aged 18-22) whose calcium/phosphorus intake ratio was assumed to be lower than young Western women. We also ascertained the relationship between dietary intake and serum or urinary measurements of phosphorus and calcium. Parathyroid hormone (PTH) and 25-hydroxy vita-min D (25(OH)D) were also examined for 214 of the 441 subjects. Phosphorus and calcium intake and the calcium/phosphorus intake ratio had significant positive correlations with urinary phosphorus. Calcium intake and the calcium/phosphorus intake ratio independently had positive and significant associations with BMD in the distal radius adjusted for postmenarcheal age, body mass index, and physical activity. There were no significant associations with BMD in the lumbar spine and femoral neck. These results indicate that in young Japanese women, phosphorus intake did not have a significantly negative effect on bone mineral density, and calcium in-take and calcium/phosphorus intake ratio had a small but significant association only in a site-specific manner with BMD.
Key Words: phosphorus, calcium, bone mineral density, parathyroid hormone, young Japanese women
 

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日本年輕女性日常膳食磷與鈣攝取與骨密度之相關性
磷與鈣在骨骼健康上扮演著重要的角色。過去西方國家研究發現,低鈣與高磷攝取,會導致較低的鈣磷比,而對於骨骼密度狀態有負面的影響。本篇橫斷型研究目的,在探討441位日本年輕女性(18-22歲),其日常磷與鈣攝取情形及鈣磷比與骨密度之相關性。本研究並假設日本年輕女性相較於西方年輕女性有較低的鈣磷比。此外,本研究也嘗試釐清,飲食鈣與磷攝取量與血清或尿液鈣與磷之相關性,同時也檢測其中214位女性的血清副甲狀腺素與25(OH)D。結果發現,磷與鈣攝取及鈣磷比與尿液磷呈現顯著正相關。在調整了初經後年齡、身體質量指數及體能活動後,鈣攝取及鈣磷攝取比與橈骨遠端骨密度呈現顯著正相關,但與腰椎骨及股骨頸的骨質密度沒有顯著相關性存在。本篇研究結果指出,日本年輕女性之磷攝取對於骨質密度沒有顯著的負面影響,而鈣攝取與鈣磷比僅與某些特定部位之骨質密度有顯著的相關。
關鍵字:磷、鈣、骨質密度、副甲狀腺素、日本年輕女性
 

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Comparison of frequently used, unexplored and newly designed indices for the assessment of segmental and whole body constituents
JONATHAN TRESIGNIE, ALDO SCAFOGLIERI, STEVEN PROVYN AND JAN PIETER CLARYS
Many constitutional indices, used as screening parameters in public health, have been explored (in-vivo) and applied for many years, but as yet there is no consensus on a universal index. This reflects confusion, or at least lack of agreement, about what a constitutional index should represent. The aim of this study was to explore the direct relationship of frequently used, unexplored and newly designed indices with adipose tissue masses and trunk adipose tissue distribution, on an anatomical 5-component model. Whole body and trunk composition, of 28 white Caucasian cadavers (aged 78.4±6.9 years), were determined at the anatomical tissue-system level by direct dissection. In the male group, the body mass index, the height/3√body volume index and the weight/height-waist circumference-depth index showed good to excellent significant correlations with all adipose tissue masses (r-values between 0.75 and 0.92) and with the internal adipose tissue/adipose tissue ratio (r-values between 0.59 and 0.78). In the female group, the body mass index, the height/3√body volume index and the weight/height-waist circumference index showed moderate to excellent significant correlations with all adipose tissue masses (r-values between 0.58 and 0.87) and with the internal adipose tissue/adipose tissue ratio (r-values between 0.52 and 0.80) and the internal adipose tissue/subcutaneous adipose tissue ratio (r-values between 0.48 and 0.78). The findings suggest that the newly designed indices (e.g. weight to height-waist circumference-depth index in males and weight to height-waist circumference index in females) are better correlates of whole body adipose tissue masses and trunk adipose tissue distribution than the frequently used indices.
Key Words: adipose tissue, body composition, health status indicators, indices, (tissue) dissection
 

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常用的、未探討的或新設計的指標對於評估部分或全身體組成的比較
許多體組成指標做為公共衛生的篩檢項目,已經被研究(活體)且應用很多年,但是到目前為止卻沒有一個大家認同的通用指標。這反映出究竟以什麼體組成指標當作代表仍是混亂的,或至少是缺乏一致性。此研究目的為探討常用的、未探究的及新設計的指標,對於脂肪質量及軀幹脂肪組織分佈在解剖上5項組成份模式的直接相關性。以直接解剖至組織-系統層級,評量28具高加索白人大體(年齡78.4±6.9歲)的全身與軀幹組成。在男性組,身體質量指數、身高/身體體積開立方及體重/身高-腰圍-體厚度指數,顯示與全部脂肪組織質量(r值在0.75-0.92間)及內部脂肪組織/脂肪組織(r:0.59-0.78)具有良好或是極佳的相關性。在女性,身體質量指數、身高/身體體積開立方及體重/身高-腰圍指數,顯示與全部脂肪組織質量(r:0.58-0.87)、內臟脂肪組織/脂肪組織(r:0.52-0.80)及內臟脂肪組織/皮下脂肪組織(r:0.48-0.78)有中度到很好的相關性。研究結果呈現,新設計的指標(例如男性的體重/身高-腰圍-厚度指數及女生的體重/身高-腰圍指數)對於全身脂肪組織質量及軀幹脂肪組織分佈,比起常使用的指標有更好的相關性。
關鍵字:脂肪組織、體組成、健康狀況指標、指數、(組織)解剖

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Predicting total fat mass from skinfold thicknesses in Japanese prepubertal children: A cross-sectional and longitudinal validation
TAISHI MIDORIKAWA, MEGUMI OHTA, YUKI HIKIHARA, SUGURU TORII, MICHAEL G BEMBEN AND SHIZUO SAKAMOTO
The present study was performed to develop regression based prediction equations for fat mass from skinfold thickness in Japanese children, and to investigate the cross-sectional and longitudinal validity of these equations. A total of 127 healthy Japanese prepubertal children aged 6-12 years were randomly separated into two groups: the model development group (54 boys and 44 girls) and the cross-sectional validation group (18 boys and 11 girls). Fat mass was initially determined by using DXA (Hologic Delphi A-QDR whole-body scanner) to provide reference data. Then, fat thickness was measured at triceps and subscapular using an Eiken-type skinfold calipers. Multiple anthropometric and DXA measures were obtained one year later for 28 of the original 127 subjects (longitudinal validation group: 14 boys and 14 girls). Strong significant correlations were observed between total fat mass by DXA measurement and the skinfold thickness × height measures by caliper in the model develop-ment group of boys and girls (R2=0.91-0.92, p<0.01). When these fat mass prediction equations were applied to the cross-sectional and longitudinal validation groups, the measured total fat mass was also very similar to the predicted fat mass. In addition, there were significant correlations between the measured and predicted total fat mass for boys and girls, respectively, although Bland-Altman analysis indicated a bias in cross-sectional validation group. Skinfold-derived prediction equations underestimate for obese children but are generally useful for estimating total fat mass in field research.
Key Words: DXA, fat mass, children, skinfold, prediction equation
 

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以皮脂厚度預測日本青春期前兒童的體脂肪質量:橫斷及縱貫式效度
此研究利用日本兒童的皮脂厚度資料以回歸法發展可預測體脂肪量的公式,且檢定這些公式的橫斷及縱貫效度。總共有127名健康的日本青春期前的兒童,年齡介於6-12歲,被隨機分派到兩組:模式發展組(54名男孩和44名女孩)及橫斷效度組(18名男孩和11名女孩)。脂肪質量先以DXA(Hologic Delphi A-QDR全身掃描儀)測量以提供參考數據。再以Eiken-type皮脂厚度儀測量三頭肌及肩胛骨下皮脂厚度。一年之後取得127名研究對象中28位的多重體位及DXA測量資料(縱貫效度組:14名男孩和14名女孩)。以DXA測得的脂肪量及以皮脂厚度儀測量的皮脂厚度x身高得到的體脂肪量,在模式發展組的男女孩都有顯著的強相關性(R2=0.91-0.92,p<0.01)。當這些脂肪質量預測公式被應用在橫斷及縱貫效度組,測量的與預測的體脂肪量非常相近。此外,男孩或女孩分別的體脂肪測量值與預測值,都具有顯著相關性,儘管Bland-Altman分析顯示有一個誤差在橫斷效度組。以皮脂厚度衍生的預測公式在肥胖兒童可能低估脂肪量,但是用在田野研究中估計總體脂肪量,普遍來說是可行的。
關鍵字:双能X光骨質密度儀、體脂肪量、兒童、皮褶、預測公式
 

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Retrospective individual tracking of body mass index in obese and thin adolescents back to childhood
SONG GE, MASARU KUBOTA, AYAKO NAGAI, KIMIYO MAMEMOTO AND CHIAKI KOJIMA
The objective of this study is to track body mass index (BMI) in obese or thin adolescents from adolescence to childhood on an individual basis. This was performed at a single school with a 12-year combination education system in an urban city in Japan. A total of 617 students in the 3rd grade of senior high school (17 years old) during 2005-2009 were enrolled. Based on the Japanese BMI reference in childhood adjusted for age and gender, obesity and thinness were defined as ≥90th percentile and ≤5th percentile, respectively. Sixty-three (10.2%) and 84 (13.6%) students were found to be obese and thin, respectively. Complete annual tracking of BMI back to the 1st grade of elementary school (6 years old) (1994-1998) was possible in 47 obese (74.6%) and 67 thin students (80.0%). The most common ages when obesity was first detected were 6-8 years for males, and 12-14 years for females, and the most common ages when thinness was first detected were 12-14 years for males, and 15-17 years for females. Once obesity or thinness started, these conditions remained until 17 years old in most students. Obese students whose obesity started earlier tended to have higher BMIs at 17 years old in both genders. This will be the first tracking study of BMI in obese and thin adolescents on an individual basis. A longitudinal study of BMI during childhood is useful for establishing intervention programs to prevent obesity or thinness in adolescence.
Key Words: body mass index, adolescence, thinness, obesity, tracking
 

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回溯追蹤肥胖及過瘦青少年身體質量指數至幼兒期
本篇研究目的為追溯肥胖或過瘦的青少年身體質量指數之變化,每位個體從青少年回顧至幼兒時期。樣本來自日本都市的一所12年級聯合學校,在2005-2009年間,共有617位高三學生(17歲)納入研究。根據日本兒童之身體質量指數參考值,調整年齡及性別,並定義肥胖為≥90個百分位,過瘦定義為≤5個百分位。結果發現有63位(10.2%)學生為肥胖,84位(13.6%)學生為過瘦。其中能追溯至小學一年級(6歲) (1994-1998)的完整記錄,在肥胖的學生有47位(74.6%),在過瘦的學生有67位(80%)。開始肥胖最常見的年齡層,男生為6-8歲,女生為12-14歲;過瘦最常開始發生的年齡層,男生為12-14歲,女生為15-17歲。一旦肥胖或過瘦情況發生後,體位通常會持續至17歲。當肥胖的發生年齡較早時,不論男女性17歲時的身體質量指數皆相對較高。本篇為追蹤肥胖及過瘦青少年個別身體質量指數的首次研究,而本研究方法能提供對於青少年體位問題,建立介入政策之參考依據。
關鍵字:身體質量指數、青少年、過瘦、肥胖、追蹤
 

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The transition of Chinese dietary guidelines and the food guide program
KEYOU GE
China promulgated her first food based dietary guidelines (FBDGs) in 1989. It was proposed by the standing board of Chinese Nutrition Society. The guidelines consisted of 8 items, each followed by a paragraph of explanation words. The second FBDGs came out in 1997, was expanded to include 3 parts i.e. guide lines for general population, for 7 particular population groups (infants, toddlers and preschool children, school-age children, adolescents, pregnant women, lactating mothers and the aged) and a newly formed food guide pagoda (FGP). The last version of the Chinese FBDGs was compelled by Chinese Nutrition Society in 2007, and proclaimed by the Ministry of Health in early 2008. The new guidelines kept the skeleton of three parts, but expanded remarkably in volume and coverage. The guidelines for the general population consisted of 10 items, each containing: core information, a discussion and reference materials. The guidelines for particular groups contained more subgroups, and more detailed recommendations. The revised pagoda kept the previous food grouping and placement but altered the amount of some food groups. An image of a walker and a cup of water were added to the side of the pagoda. Guidelines-2007 called for more coarse grains and less cooking oil consumption. Physical activity is al-so strongly recommended.
Key Words: FBDGs, dietary guidelines, food guide pagoda, China transition
 

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中国居民膳食指南和平衡膳食宝塔的变迁
中国营养学会常务理事会于1989年发布了第一个以食物为基础的膳食指南。这个“我国的膳食指南”共有八条,每条附有一段简要说明。第二个指南---中国居民膳食指南及平衡膳食宝塔,于1997年由中国营养学会公布。此指南扩展为三部分:一般人群膳食指南(八条);七个特定人群膳食指南(婴儿、幼儿、学前儿童和学龄儿童、少年、孕妇、乳母和老年人)及新设计的“平衡膳食宝塔”。近期的“中国居民膳食指南及平衡膳食宝塔” 于2007年完成,2008年初由中国卫生部正式发布。指南2007保留了上一版指南的框架,但对每一部分都做了扩展。一般人群膳食指南共有10条,每条都包含提要、讨论、提示和参考资料几个部分。对特定人群的分组更加细化,建议更为具体。平衡膳食宝塔的食物分组和位置安排没有改变,部分食物的建议摄入量有所变动。重要的变化是在宝塔旁加了一个走步的人和一杯清水,反映对运动和饮水的重视。比较指南2007 和指南1997,更强调要多吃粗粮,少用烹调油和加强身体活动。
關鍵字:中国居民膳食指南、膳食指南、平衡膳食宝塔、中国、变迁
 

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Taking the Indonesian nutrition history to leap into betterment of the future generation: development of the Indonesian Nutrition Guidelines
SOEKIRMAN
Nutrition history in Indonesia began in 1887, when Christiann Eijkman discovered the relationship between vitamin B-1 deficiency and beriberi. In the 1950’s, the socialization of nutrition messages started with the intro-duction of “Healthy Four Perfect Five” (Empat Sehat Lima Sempurna-ESLS). For the next 25 years after that, ESLS became a favorite in nutrition education and was nationally known. Although the ESLS was never evaluated, food consumption pattern of Indonesians are never balanced. Undernutrition is rampant and overnutrition emerged. In 1995 the Indonesian food-based dietary guidelines was launched by the Ministry of Health, and formally incorporated into the nutrition policy. The Guide has 13 messages. Again, the guidelines were never evaluated; in 2010 undernutrition persists and the prevalence of degenerative diseases increased. Thus, it is urgent for Indonesia to have concrete Nutrition Guidelines (Gizi Seimbang) covering messages like: (1) consume a variety of foods; (2) keep clean; (3) be active, exercise regularly; and (4) monitor body weight. The guidelines shall be developed for all age groups. The guidelines were tested to over 300 audiences and the responses were promising. Dissemination of the messages widely within the formal channels is compulsory. The new Nutrition Guideline messages are an open concept ready to be revised accordingly. It is evident that nutrition sciences and its application had undergone rapid changes over time and Indonesia need to adopt accordingly and timely. Al-though, outcomes may not be seen in a short time, longer term output will benefit future generations.
Key Words: Dietary Guidelines, Indonesia, history, nutrition, nutrition guidelines
 

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以印尼營養歷史躍進下一世代的改善:印尼營養指南的發展
印尼的營養歷史始於1887年,Christiann Eijkman發現維生素B1缺乏與腳氣病的關聯。在1950年代,營養資訊的社會化開始於“Healthy Four Perfect Five” (Empat Sehat Lima Sempurna-ESLS)的導入。隨後的25年,ESLS深受營養教育喜愛且被全國廣泛認識。但是ESLS從未被評估,印尼國人的飲食攝取模式也不平衡。營養不良尚無法控制,而營養過剩卻浮現出來。在1995年印尼衛生部頒布食物基礎的飲食指南,且正式的與營養政策結合。這個指南包含13項訊息。同樣,這個指南從未被評估;在2010年營養不良的問題持續,而退化性疾病的盛行率增加。因此,印尼急需具體的營養指南(Gizi Seimbang)包含資訊如:(1)攝取多樣性的食物;(2)保持乾淨;(3)規律的活動及運動;和(4)監測體重。這個指南將可為各年齡層分別研擬。曾經以300名以上的聽眾測試過這個指南,由反應看起來是可行的。營養資訊廣泛地透過正式管道宣傳是必要的。這個新的營養指南資訊是一個開放性的概念,可適時修正。營養科學和其應用已經歷快速變遷,印尼需要適當且及時的採納。或許成果無法在短時間看見,但長期的付出將是對未來世代有益的。
關鍵字:飲食指南、印尼、歷史、營養、營養指南

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Nutritional policies and dietary guidelines in Japan
TEIJI NAKAMURA
The national government settled on "Healthy Japan 21" as the premier preventive policy of lifestyle related diseases in 2000. In 2005, the effectiveness of the campaign was conducted, but the results did not turn out as expected. The Ministry of Health, Labor and Welfare made the “Japanese Food Guide Spinning Top (JFG-ST)” as a practical and easy way to improve eating habits for all of the people. The JFG-ST falls down when the balance of the diets worsens and expresses a stable thing in what a turn (exercise) does. Eyes down quantity to take out of each group per day is shown in the basic form by the 5 distinction from grain dishes, vegetable dishes, fish and meat dishes, milk, and fruits. In 2005, the Basic Law on Dietary Education was enacted to promote the die-tary education about the importance of eating proper meals in order to solve problems such as inappropriate eat-ing habits and nutrition intake, disturbances in diets, increases in lifestyle-related diseases, a fall in the rate of food self-sufficiency and so forth. The Ministry of Education and Science started a program to train people to become "diet and nutrition teacher” in primary school. JFG- ST is developed in a dietary education campaign as a standard method of the dietary education. In May, 2011, the government has announced the second dietary education promotional basic plan to assume five years.
Key Words: nutritional policies, dietary guidelines, Healthy Japan 21, Japanese Food Guide Spinning Top, Basic Law on Dietary Education
 

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日本營養政策與飲食指南
日本政府在2000年訂定“健康日本21”,做為預防生活型態相關疾病的主要政策。在2005年評估此政策實行的效益,但結果並不如預期。日本厚生労働省以實際又簡單的模型-“日本食物指南陀螺(JFG-ST)”來改善全國人民的飲食習慣。若陀螺傾倒,則表示飲食失衡;陀螺轉動可保持穩定,突顯運動維持健康的重要。陀螺從上往下標示五大類食物,及每日建議份量,分別為穀類、蔬菜、魚肉類、奶類和水果。於2005年制定飲食教育基本法,提昇飲食教育,教導民眾適當飲食的重要性,以解決下列問題:不當的飲食習慣和營養攝取、混亂的飲食、生活型態相關疾病的增加、糧食自足率下降等類似問題。文部科学省計劃訓練“飲食營養教師”教導小學生。推動以“日本食物指南陀螺”為飲食教育的標準教材。在2011年5月,政府宣布接下來將進行為期五年的第二期飲食教育計畫。
關鍵字:營養政策、飲食指南、健康日本21、日本食物指南陀螺、飲食教育基本法
 

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Development and promotion of Malaysian Dietary Guidelines
E-SIONG TEE

Development and promotion of dietary guidelines is one of the key activities outlined in the National Plan of Action for Nutrition of Malaysia for the prevention of nutrition-related disorders. The first official Malaysian Dietary Guidelines (MDG) was published in 1999 and was thoroughly reviewed and launched on 25 March 2010. The new MDG 2010 is a compilation of science-based nutrition and physical activity recommendations. These guidelines form the basis of consistent and scientifically sound nutrition messages for the public. There are 14 key messages and 55 recommendations, covering the whole range of food and nutrition issues, from importance of consuming a variety of foods to guidance on specific food groups, messages to encourage physical activities, consuming safe food and beverages and making effective use of nutrition information on food labels. The MDG also has an updated food pyramid. Various efforts have been made to ensure that the revised MDG is disseminated to all stakeholders. The Ministry of Health has organised a series of workshops for nutritionists and other health care professionals, and the food industry. In collaboration with other professional bodies and the private sector, the Nutrition Society of Malaysia has been promoting the dissemination and usage of the MDG to the public through a variety of formats and channels. These include the publication of a series of leaflets, educational press articles, educational booklets, as well as through educational activities for children. It is imperative to monitor the usage and evaluation of these dietary messages.
Key Words: dietary guidelines, healthy eating, food pyramid, physical activity, Malaysia
 

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馬來西亞飲食指南的發展及推廣
為了預防營養相關的疾病,在馬來西亞全國性營養行動計畫中,飲食指南的發展及推廣是關鍵項目之一。第一個馬來西亞官方飲食指南(MDG)是在1999年發表,而經過完整的回顧審定,在2010年3月25日頒布新版本。新的MDG 2010是有科學基礎的營養及體能活動建議的匯集。這些指南形成對大眾具一致性及科學正確性的營養基本資訊。有14項主要訊息及55條建議,涵蓋食品營養議題的整個範疇,從攝取多樣性食物的重要性到特定食物類別的指導、鼓勵體能活動的訊息、攝取安全食物及飲料、及有效地使用食品標籤上的營養資訊。MDG也更新食物金字塔。做了各種努力以確保修訂後的MDG可以傳播到所有相關工作者。衛生部已經為營養學者、其他健康照護專業者及食品業者籌組一系列的研討會。經由與其他專業團體及私部門的合作,馬來西亞營養學會透過各種型式及管道,促進MDG的傳播及大眾的應用。這些包含印製一系列的傳單、發表教導性的文章、宣導小冊子以及透過兒童的教育性活動。監測這些飲食資訊的運用及評估是迫切需要的。
關鍵字:飲食指南、健康飲食、食物金字塔、體能活動、馬來西亞

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Food- based dietary guidelines for Filipinos: retrospects and prospects
CELESTE C TANCHOCO
This paper reviews the formulation of positive, practical and culturally sensitive food-based dietary guidelines (FBDGs) to help Filipinos choose an adequate diet and foster wholesome food and nutrition practices to promote good health; and provide those concerned with a framework and reference for their task of educating the public on proper nutrition practices. An evidence-based approach to evaluate the scientific report used to develop the Nutritional Guidelines for Filipinos (NGF) was published summarizing the scientific bases for its formulation. It highlights the findings of controlled and epidemiological studies and review in scientific journals. The results of the nutrition surveys which depict the food and nutrition situation, data on dietary patterns and practices related to food, food availability and statistics on nutrition-related health problems serve as background for the guide-lines. While the 2000 NGF may have created awareness of the link between nutrients and foods to health, the contribution of these guidelines to outcomes and impact on health and nutrition has been limited. The policy makers and stakeholders involved with FBDGs development should recognize that the process does not end when the messages are formulated. A comprehensive plan that includes implementation, assessment, monitoring and reformulation must be developed. Formulation of a strategy on how the guidelines should be implemented to improve the dietary patterns of Filipinos, combined with the development of a protocol for evaluation of implementation and impact of the guidelines will now be adopted for its revision.
Key Words: food-based, dietary, nutritional, guidelines, Philippines
 

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菲律賓的食物基礎飲食指南:回溯和前瞻
這篇文章回顧如何制訂一個正面的、實際的和符合文化特異性的食物基礎飲食指南(FBDGs),以協助菲律賓人選擇適當的飲食和培養有益的飲食和營養規範以促進良好健康;並提供相關工作者關於教育公眾適當營養規範之架構和參考。菲律賓國家指南(NGF)是依據一些有實證的科學報告衍生出來,而評估這些科學報告的基本考量已被發表。著重在科學性期刊上發表的對照研究和流行病學研究的結果及評論文章。營養調查的結果描述出食品與營養現況、飲食模式和食品相關規範資料、食物可獲性及營養相關健康問題的統計,以此當作指南的背景資料。儘管2000 NGF可能喚起國人注意營養素與食品跟健康的連結,但這些指南對於健康與營養的結果及影響貢獻仍是有限。雖然FBDGs訊息已被制訂,但參與的政策制訂者及相關工作者,應認知這個過程並沒有結束。需要發展一組全面性計畫,包含執行、評估、監測和再規劃。制訂策略以使指南應用於改善菲律賓人的飲食模式,並有一套流程以評估指南的執行及影響,做為將修訂的依據。
關鍵字:食物基礎、飲食、營養的、指南、菲律賓
 

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Dietary Guidelines in Singapore
BENJAMIN LC LEE
The 2011 Dietary Guidelines were developed with the aim of providing guidance on what dietary strategies can best address increasing rates of obesity and non-communicable chronic disease in Singapore. This set of dietary guidelines was developed with a local expert committee based on a review of scientific literature and data on current dietary patterns from the 2010 National Nutrition Survey. Projected nutrient intakes from a diet adhering to the 2011 Dietary Guidelines were calculated using a local food composition database (FOCOS) and validated against nutrient recommendations. Acknowledging that dietary requirements differ between age groups, different sets of dietary guidelines have been developed and customised for different segments of the population. To date, Singapore has produced dietary guidelines for children and adolescents (focusing on establishing healthy life-long eating patterns), adults (focusing on preventing obesity and reinforcing healthy eating patterns), and most recently, guidelines for older adults (>50 years of age) that address the issue of potential dietary insufficiency caused by age-related increases in nutrient requirements combined with a reduction in energy requirements. In Singapore, dietary guidelines have been used to inform and direct public policy and promote dietary patterns that meet nutrient requirements while reducing the risk of non-communicable chronic diseases. Examples of public policy include: national guidelines on food advertising and standards for food served in nursing homes; examples of public health promotion programmes include: the Healthier Choice Symbol Programme for packaged food products and programmes encouraging provision of healthier meals in hawker centres, restaurants, and school or workplace canteens.
Key Words: dietary guidelines, Singapore, nutrition policy, public health
 

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新加坡的飲食指南
新加坡2011飲食指南的推展,主要目標是提供良好的飲食政策以解決增加中的肥胖及非傳染性慢性疾病率。這一套飲食指南是本地專家委員會,依審查科學性文獻及2010國民營養調查的現階段飲食模式數據而制定。使用本地食物成分資料庫(FOCOS) 計算2011飲食指南的每日飲食營養素可獲量並以營養素建議量驗證。因應不同年齡層間飲食需求的差異,發展不同的飲食指南,並依不同族群量身打造。迄今,新加坡已經制定兒童及青少年(著重在建立健康的長期生活飲食模式)、成人(著重在預防肥胖及加強健康的飲食模式)。最近,針對老年人(>50歲)的指南,提出因年齡相關增加的營養素需求合併熱量需求降低所引起的潛在飲食不足議題。在新加坡,飲食指南已經使用在告知及直接的公眾政策去推廣飲食模式,以符合營養素需求,同時降低非傳染性慢性疾病的危險性。公眾政策的例子包含:食品廣告的全國性準則及護理之家的食物供應標準;公共衛生推廣計劃的例子包括:包裝食品的健康選擇標籤方案及在大排檔、餐廳及學校或工作場合食堂推動供應健康飲食。
關鍵字:飲食指南、新加坡、營養政策、公共衛生
 

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Food based dietary guidelines (FBDGs) development and promotion in Thailand
PRAPAISRI P SIRICHAKWAL, KITTI SRANACHAROENPONG AND KRAISID TONTISIRIN
Dietary guidelines based on 5 food groups was used as a main nutrition education tool until 1996 when food based dietary guidelines (FBDGs) were promoted after 2 years of formulation and development. These FBDGs for the general population were designed to promote desirable and culturally acceptable eating behavior. The nine qualitative guidelines of Thai FBDGs include: 1. eat a variety of foods from each of the five food groups and maintain proper weight, 2. eat adequate rice, or alternate carbohydrate, 3. eat plenty of vegetables and fruits regularly, 4. eat fish, lean meats, eggs, legumes and pulses regularly, 5. drink sufficient amount of milk every day, 6. take moderate amounts of fat, 7. avoid excessive intake of sweet and salty foods, 8. eat clean and uncontaminated foods, and 9. avoid or reduce consumption of alcoholic beverages. In 1998, the quantitative part of Thai FBDGs or food guide model was established as “Nutrition Flag” after rigorous test for understanding and acceptability among consumers. Promotion and dissemination of the Thai FBDGs have been carried out at national and community levels through basic health, agricultural and educational services and training activities, as well as periodic campaigning via multiple communication channels and media. Recently in 2009, the FBDGs for infant and preschool children were introduced to replace the previous infant and young child feeding guidelines. There has been no formal evaluation on the impact of promotion of the Thai FBDGs but some periodic testing of knowledge and practices have shown positive results.
Key Words: Thai food based dietary guidelines, development, nutrition flag, eating behavior, general population
 

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泰國的食物基礎飲食指南(FBDGs)的發展及推廣
五大類食物為基礎的飲食指南長久以來被當作營養教育的主要工具,但經過2年的構想及發展,在1996年推動食物基礎飲食指南(FBDGs)。針對一般大眾的FBDGs,其設計理念為推廣合宜且文化上可接受的飲食行為。泰國FBDGs包含9項概念性指南:1.從五大類食物選取多樣性食物並維持適當體重,2.食用適量的米或是另類的多醣食物,3.經常食用足量的蔬菜與水果,4.經常食用魚類、瘦肉、蛋、及豆類,5.每天飲用足量的牛奶,6.攝取適量的油脂,7.避免攝取過量含糖或鹹的食物,8.食用乾淨無汙染的食物,9. 或減少攝取酒精性飲料。經過對消費者進行理解度及接受性的嚴格測試後,在1998年建立泰國FBDGs的量化部分或食物指南模型,以“營養之旗”呈現。泰國FBDGs的推廣及宣傳已經在全國及社區層級進行,經由基礎衛生、農業及教育的系統和訓練活動,並且透過多重傳播管道和媒體舉辦定期性宣導活動。近期在2009年,嬰兒及學齡前的FBDGs被提出,替代之前的嬰幼兒餵食指南。目前尚未對泰國FBDGs的推廣影響做正式評估,但是一些定期性對知識及行為的測試則顯示正向結果。
關鍵字: 泰國食物基礎飲食指南、發展、營養之旗、飲食行為、大眾
 

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Do Indonesians follow its Dietary Guidelines? - evidence related to food consumption, healthy lifestyle, and nutritional status within the period 2000-2010
AVITA A USFAR AMD UMI FAHMIDA
Dietary Guidelines are sets of advisory statements that give dietary advice for population to promote nutritional well-being. They contain information on foods or behaviors that are encouraged and cautionary messages de-rived from scientific evidence-based reviews and specific local conditions. The Indonesian Dietary Guidelines consisting of 13 messages that were publicized by the Ministry of Health in 1995 and have not been reviewed afterward in relation to nutritional status and health outcome of the population. By reviewing studies on different age groups in the past 10 years and comparing the results with the recommended guidelines, this paper aims to identify if messages have been successfully applied and if there are relevant issues not yet covered in the guide-lines. The reviews covered 29 out of 33 provinces, representing studies from sub-district or higher levels (district, provincial, national). Results showed that some messages have been better implemented than others; also that in-formation for some messages was not available for which to conclude of its implementation. In addition, some practices were identified which are prevalent in several age groups and have important public health consequence, but not yet included in the 13-guidelines. These include: smoking, increased intakes of fruit and vegetables, limited intakes of salt and sugar, increased intakes of foods rich in zinc and calcium (besides iron), hand-washing before food preparation and eating, and weight-monitoring. For infants and young children, nutrient density, feeding responsiveness and stimulation should be specifically highlighted. Based on the results, several recommendations in revising the guidelines were given.
Key Words: Dietary Guidelines, Indonesia, food consumption, healthy lifestyle, nutritional status
 

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印尼人是否遵循飲食指南?在2000-2010年期間的食物攝取、健康生活型態和營養狀況回顧
飲食指南是一套建言給予大眾飲食的建議以增進營養福利。它們包含食物上的或行為的資訊,這些鼓勵或是警告的訊息是衍生自科學性實證及本土的特定情形。印尼飲食指南是由13項訊息組成,在1995年由衛生部公布;在那之後,它與民眾的營養狀態和健康結果之相關性從未被評估過。本篇文章回顧過去10年,在不同年齡層的研究,比較其結果與飲食指南的建議,目的為確認指南的訊息是否已成功的被應用及是否有相關的議題未被納入。這個回顧評估的研究涵蓋33個省份中的29個,代表次區級或是較高層級(區、省、全國)。結果顯示,一些訊息已被執行的比其它的好;但有某些訊息缺乏資料,無法斷定它被執行與否。此外,發現一些行為在幾個年齡層中是普遍的,且有重要的公共衛生後果,但是尚未包含在13項指南中。包括:抽菸、增加蔬果攝取、限制鹽及糖的攝取量、增加富含鋅及鈣(除了鐵)的食物攝取、食物製備及食用前先洗手,以及體重監測。對於嬰幼兒,營養密度、餵食反應及外在刺激應被特別注意。基於這些結果,提出幾項修訂飲食指南的建議。
關鍵字:飲食指南、印尼、食物攝取、健康的生活型態、營養狀況
 

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Food based dietary guidelines in Vietnam: progress and lessons learned
LE THI HOP, TRAN KHANH VAN AND HOANG KIM THANH

The food based dietary guidelines (FBDGs) is a crucial tool for nutrition education and communication in Vietnam. Together with the changes of socio-economic situation, Vietnam needs to deal with different nutritional problems including malnutrition, overweight and undiversified diets at the same time. From 1995 to the present, three versions of FBDGs have been developed and revised in a period of every 5 years. The FBDGs, Food Guide Pyramid and Food Square made a good set of nutritional education tool which were disseminated through a wide range of activities and communication channels. The evaluation of FBDGs will be carried out before its revisions to reflect eating patterns and lifestyles of consumers whom the nutritional education programs wish to reach. In developing countries like Vietnam, the socio-economic situation is changing over short period of time. Therefore, the assessment of appropriateness and implementation progress of the FBDGs is necessary and should be done after a period of every 5 or 10 years. The implementation of the FBDGs should be closely con-nected with the activities of the National Plan for Nutrition and should have involvement from multisectoral organizations. Training, monitoring and evaluation for implementation of the FBDGs are essential for the success of guiding consumers to convert advices into action. The lessons learned from previous FBDGs’ implementation can be used to develop a new version of FBDGs that is more appropriate.
Key Words: Dietary guidelines, communication tool, food habit, food culture, food guide
 

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越南的食物基礎飲食指南:進展及經驗教訓
食物基礎飲食指南(FBDGs)在越南是一個營養教育及傳播訊息的重要工具。隨著社經情況的改變,越南需要同時應付不同的營養問題,包含營養不足、體重過重及不夠多樣化的飲食。自1995年至今,每5年為一期,共有三套FBDGs版本被制定及修正。FBDGs、食物指南金字塔及食物方塊形成一組良好的營養教育工具,並透過各式各樣的活動及傳播管道廣為宣導。在FBDGs修訂之前會完成評估工作,以反映營養教育系統希望傳遞訊息的消費者之飲食模式及生活型態。在發展中國家如越南,社經狀況正在短時間內改變。因此,評估FBDGs的適當性及執行進展是必要的,且應該在每隔5或10年內進行。FBDGs的執行需緊密地連結全國營養計畫活動,且應該有多部門機構的參與。FBDGs的執行訓練、監測及評量對於成功的引導消費者將建議轉化為行動是必要的。之前FBDGs執行的經驗與教訓,可以幫助發展一個更適切的FBDGs新版本。
關鍵字:飲食指南、傳播工具、飲食習慣、飲食文化、食物指南

Last Updated: August 2011