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1 Asia Pacific Journal of Clinical Nutrition
       Volume 20, 4

         (December 2011)


Abstracts

Contents

Abstract PDF

Review Iodine excess or not: analysis on the necessity of reducing the iodine content in edible salt based on the national monitoring results
SUMEI LI, QINGSI ZHENG, JING XU, JONATHAN GORSTEIN, HAIYAN WANG AND HUIJIE DONG
Asia Pac J Clin Nutr. 2011;20(4):501-506.

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Original Research Communications

Clinical Nutrition Trials or Feeding Studies

Association between 24 hour urinary α-tocopherol catabolite, 2,5,7,8-tetramethyl-2(2'-carboxyethyl)-6- hydroxychroman (α-CEHC) and α-tocopherol intake in intervention and cross-sectional studies
ERI IMAI, TOMIKO TSUJI, MITSUE SANO, TSUTOMU FUKUWATARI AND KATSUMI SHIBATA
Asia Pac J Clin Nutr. 2011;20(4):507-5
13.

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Moderate NaFeEDTA and ferrous sulfate supplementation can improve both hematologic status and oxidative stress in anemic pregnant women
XIU X HAN, YONG Y SUN, AI G MA, FANG YANG, FENG Z ZHANG, DIAN C JIANG AND YONG LI
Asia Pac J Clin Nutr. 2011;20(4):514-520.

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Impact of treatment with oral calcitriol on glucose indices in type 2 diabetes mellitus patients
MOHAMMAD HASSAN EFTEKHARI, MARZIEH AKBARZADEH, MOHAMMAD HOSSEIN DABBAGHMANESH AND
JAFAR HASANZADEH
Asia Pac J Clin Nutr. 2011;20(4):521-526.

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Acute effect of a soy protein-rich meal-replacement application on renal parameters in patients with the metabolic syndrome
PETER DEIBERT, LISA LUTZ, DANIEL KÖNIG, SABINE ZITTA, ANDREAS MEINITZER, MARA Z VITOLINS,
GERHILD BECKER AND ALOYS BERG
Asia Pac J Clin Nutr. 2011;20(4):527-534.

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Fortified juice drink improved iron and zinc status of schoolchildren
IMELDA ANGELES-AGDEPPA, CLARITA R MAGSADIA AND MARIO V CAPANZANA
Asia Pac J Clin Nutr. 2011;20(4):535-543.

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Malnutrition in hospitalized people living with HIV/AIDS: evidence from a cross-sectional study from Chengdu, China
WEN HU, HUA JIANG, WEI CHEN, SHENG-HUA HE, BIN DENG, WEN-YUAN WANG, YAN WANG, CHARLES
DAMIEN LU, KAREN KLASSEN AND JUN ZENG
Asia Pac J Clin Nutr. 2011;20(4):544-550.

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Nutritional Status, Dietary Intake, and Body Composition

Anthropometric equation for estimation of appendicular skeletal muscle mass in Chinese adults
XU WEN, MEI WANG, CHONG-MIN JIANG AND YI-MIN ZHANG
Asia Pac J Clin Nutr. 2011;20(4):551-556.

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Waist circumference as an indicator of high blood pressure in preschool obese children
BIN CHEN AND HAI-FEI LI
Asia Pac J Clin Nutr. 2011;20(4):557-562.
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Interactive effects of main genotype, caloric intakes, and smoking status on risk of obesity 563
SANGYEOUP LEE, CHEOL MIN KIM, HYUN JUN KIM AND HYE SOON PARK
Asia Pac J Clin Nutr. 2011;20(4):563-571.

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Growth and child nutrition

Contribution of complementary food nutrients to estimated total nutrient intakes for urban Guatemalan infants in the second semester of life
LIZA HERNÁNDEZ, RAQUEL CAMPOS, ANKE ENNEMAN, MARIA JOSÉ SOTO-MÉNDEZ, MARIEKE VOSSENAAR
AMD NOEL W SOLOMONS
Asia Pac J Clin Nutr. 2011;20(4):572-583.

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Undernutrition status of children under 5 years in Chinese rural areas - data from the National Rural Children Growth Standard Survey, 2006
JING ZHANG, JUNXIN SHI, JOHN H HIMES, YUKAI DU, SENBEI YANG, SHUHUA SHI AND JIANDUAN ZHANG
Asia Pac J Clin Nutr. 2011;20(4):584-592.

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Nutritional Epidemiology and Public Health

Systematic review and meta-analysis of soy products consumption in patients with type 2 diabetes mellitus
BIN YANG, YING CHEN, TONGCHEN XU, YINGHUA YU, TAO HUANG, XIAOJIE HU AND DUO LI
Asia Pac J Clin Nutr. 2011;20(4):593-602.

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Red meat intake may increase the risk of colon cancer in Japanese, a population with relatively low red meat consumption
RIBEKA TAKACHI, YOSHITAKA TSUBONO, KEISUKE BABA, MANAMI INOUE, SHIZUKA SASAZUKI, MOTOKI
IWASAKI, AND SHOICHIRO TSUGANE AND FOR THE JAPAN PUBLIC HEALTH CENTER-BASED PROSPECTIVE
STUDY GROUP
Asia Pac J Clin Nutr. 2011;20(4):603-612.

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Prevalence, influencing factors and control of food insecurity: a model in the northwest of Iran
SAEED DASTGIRI, RAHIM SHARAFKHANI, RASOOL GHARAAGHAJI ASL AND SAEED GHAVAMZADEH
Asia Pac J Clin Nutr. 2011;20(4):613-617.

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Paternal smoking is associated with greater food insecurity among poor families in rural Indonesia
RICHARD D SEMBA, ASHLEY A CAMPBELL, KAI SUN, SASKIA DE PEE, NASIMA AKHTER, REGINA
MOENCH-PFANNER, JEE HYUN RAH, JANE BADHAM, KLAUS KRAEMER AND MARTIN W BLOEM
Asia Pac J Clin Nutr. 2011;20(4):618-623.

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Comparison of dietary habits between migrant and local adolescents in Shenzhen, China
LIJUN WANG, ZHENZHEN ZHANG, YING CHANG, XIAN WANG, MENGJUN HOU, JUN WEI, WENHUA LING AND
HUILIAN ZHU
Asia Pac J Clin Nutr. 2011;20(4):624-631.

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Nutrition risk: cultural aspects of assessment
CAROL A WHAM, LORNA DYALL, RUTH OY THE AND NGAIRE M KERSE
Asia Pac J Clin Nutr. 2011;20(4):632-638.

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 Validation of a food frequency questionnaire to assess dietary cholesterol, total fat and different types of fat intakes among Malay adults
JUI YEE ENG AND FOONG MING MOY
Asia Pac J Clin Nutr. 2011;20(4):639-645.

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Maternal and Women's Nutrition
Validity of predictive equations for resting energy expenditure among Iranian women
MAHBOUBEH SHANESHIN, AREZOO REZAZADEH, MAHSA JESSRI, TIRANG NEYESTANI AND BAHRAM
RASHIDKHANI
Asia Pac J Clin Nutr. 2011;20(4):646-653.

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Future Events

Asia Pac J Clin Nutr. 2011;20(4):654.

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Iodine excess or not: analysis on the necessity of reducing the iodine content in edible salt based on the national monitoring results
SUMEI LI, QINGSI ZHENG, JING XU, JONATHAN GORSTEIN, HAIYAN WANG AND HUIJIE DONG
Using national monitoring data collected between 1995 and 2009, this paper describes the change in trend with regard to the coverage of qualified iodized household salt and iodine status of the population in China since the implementation of universal salt iodization. The review indicates that the iodine content in edible salt increased from 16.2 mg/kg in 1995 to 42.3 mg/kg in 1999, then declined to 30.8 mg/kg in 2005 and has retained this level through the most recent data collection cycle, which is considered sufficient to achieve optimal iodine status. However, the median urinary iodine excretion level for children aged 8-10 at the national level has been consistently classified as “excessive iodine intake” since 1997, suggesting that although three adjustments on the standard of iodine content in edible salt have been made, the current content of salt iodization is still on the high side. The iodine content in edible salt could be lowered, and possibly adapted to local specific conditions such as water iodine content and the average daily intake of salt among the population in order to achieve a balance between preventing deficiency and reducing the risk of excessive intake.
Key Words: iodine deficiency disorders, monitoring, salt iodization, iodine excess, iodine nutrition

 

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碘过量或没有:基于国民监测结果分析食用盐降低碘含量的必要性
本文利用1995 年至2009 年全国监测搜集的数据,描述了自普及食盐加碘 (USI) 以来,中国居民合格碘盐覆盖率和人群碘营养状态的变化趋势。文章指出,中 国居民食盐中碘的浓度1995 年、1999 年和2005 年分别为16.2 mg/kg、42.3 mg/kg 和30.8 mg/kg,直至最近仍维持2005 年的水平,这一水平被认为能够获 得充足的碘营养状态。然而,全国8-10 岁儿童的尿碘水平从1997 年起一直在碘 摄入过量的水平,表明虽然食盐中碘的浓度经过3 次调整,但当前的浓度依然 偏高。食盐中碘的浓度仍有下调的空间,并要适合当地的具体条件,例如水碘 含量和人群平均每日食盐摄入量,以便获得防治碘缺乏和降低碘摄入过量风险 的平衡。
关键词:碘缺乏失调、监测、加碘盐、碘过量、碘营养
 

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Association between 24 hour urinary α-tocopherol catabolite, 2,5,7,8-tetramethyl-2(2'-carboxyethyl)-6-hydroxychroman (α-CEHC) and α-tocopherol intake in intervention and cross-sectional studies
ERI IMAI, TOMIKO TSUJI, MITSUE SANO, TSUTOMU FUKUWATARI AND KATSUMI SHIBATA
The objective is to determine the association between the 24 hour urinary α-tocopherol catabolite, 2,5,7,8-tetramethyl-2(2'-carboxyethyl)-6-hydroxychroman (α-CEHC) and α-tocopherol intake in an intervention and a cross-sectional studies. In the 4-weeks intervention study, Japanese men (n = 10) consumed the test diet in week 1, and the test diet plus varying amounts of α-tocopherol in the three subsequent weeks: 21 μmol/d α-tocopherol in week 2, 63 μmol/d in week 3, and 125 μmol/d in week 4. A significant association between α-tocopherol intake and urinary α-CEHC was observed in this strictly controlled experiment (r = 0.99, p<0.001). In the cross-sectional study, all foods consumed over 4 consecutive days were recorded in 76 free-living young subjects (18-33 years). The association was weak, but a significant relationship was observed (r = 0.29, p<0.05) even in the cross-sectional study. In the cross-sectional study adults, mean estimated α-tocopherol intake calculated by urinary α-CEHC and the excretory ratio was 91% of their mean intake over the 4 days. The results show that urinary α-CEHC level reflected recent α-tocopherol intake in free-living young Japanese adults, and could be used as a measure of intake during the previous few days, both for group means and for individual rankings within a group.
Key Words: α-tocopherol, catabolism, CEHC, urine, biomarker
 

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24 小時尿液α-生育醇代謝產物2,5,7,8-tertranetgyl-2 (2’carboxyethyl)-6-hydroxychroman(α-CEHC)與α-生 育醇攝取之介入及橫斷研究之相關
本研究的目的為評估在介入及橫斷研究中,24 小時尿液的α-生育醇代謝產物 2,5,7,8-tertranetgyl-2(2’carboxyethyl)-6-hydroxychroman (α-CEHC) 與α-生育醇攝取量之相關性。在四週的介入性研究,日本男性 (n=10) 在第一週攝取測試飲食,後續三周攝取添加不同量α-生育醇的測試飲食:第二週為21 μmol/dα-生育醇、第三週為63 μmol/dα-生育醇與第四週為125 μmol/dα-生育醇。在這個嚴格控制的實驗中,觀察到α-生育醇的攝取量與尿液中的α-CEHC 有顯著的相關(r=0.99, p<0.001)。在橫斷性研究,76 名年輕一般研究對象 (18-33 歲) 紀錄連續四天攝取的所有食物。在橫斷性研究這個相關性儘管不強,但是顯著的(r=0.29, p<0.05)。在橫斷性研究中的成年人,以尿液α-CEHC 計算其平均估計α-生育醇攝取量,其排泄率為四日平均攝取量的91%。無論組別平均值或是組別中個體的排序結果,都顯示尿液中的α-CEHC 量可反映年輕日本一般成年人近期的α-生育醇攝取量,且可以當作過去幾天的攝取量測量方法。
關鍵字:α-生育醇、代謝產物、CEHC、尿液、生物標記
 

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Moderate NaFeEDTA and ferrous sulfate supplementation can improve both hematologic status and oxidative stress in anemic pregnant women
XIU X HAN, YONG Y SUN, AI G MA, FANG YANG, FENG Z ZHANG, DIAN C JIANG AND YONG LI
Iron is important general well being, to prevent or treat anemia, and is a cofactor of many enzymes in the antioxidant process. Effect of sodium iron ethylenediaminetetraacetate (NaFeEDTA) and ferrous sulfate on iron bioavailability and oxidative stress in anemic pregnant women was evaluated. A 2-month randomized controlled trial was conducted on 153 anemic pregnant women, with 80≤ Hb <110g/L. They were randomly allocated to three groups: group C (n=51) was the placebo control group, group I (n=51) was supplemented daily with 60 mg iron as ferrous sulfate, and group IE (n=51) with 60 mg iron as NaFeEDTA. Blood samples were collected before and at the end of the intervention for measurements of hematological indices and oxidative stress parameters. Considerable increases of hematologic indicators were observed: 20.5 and 21.8 g/L for Hb (both p values <0.001); 4.81 and 7.19 μmol/L for plasma iron (both p values <0.001), 2.63 and 8.99 μg /L for ferritin (both p values <0.05) in I and IE groups, respectively, compared with the control group. Glutathione peroxidase (GSH-Px) activities increased by 32.6 and 75.3 IU/ml, and malondialdehyde (MDA) levels decreased by 0.70 and 1.12 μmol/L in I and IE groups, compared withthe C group (p values <0.05). Moreover, differences of plasma iron, ferritin and GSH-Px activity were 2.38 μmol/L, 6.36 μg /L and 42.7 IU/ml were also significantly greater in the IE group than in the I group. Moderate iron supplementation may be beneficial to improving iron deficiency and oxidative stress, and NaFeEDTA is better than ferrous sulfate.
Key Words: anemia, pregnant women, NaFeEDTA, ferrous sulfate, oxidative stress
 
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EDTA 铁补充能有效地改善孕妇贫血及氧化应激水平
背景与目的:铁不仅是重要的营养素可预防贫血,而且作为辅酶可参与机体抗氧化反应。本研究拟评价EDTA 钠铁盐 (NaFeEDTA) 和硫酸亚铁盐 (FeSO4) 补充对贫血孕妇铁的生物利用率和氧化应激水平的影响。方法:采用随机对照研究方法,选择153 名贫血孕妇 (血红蛋白在80g/L~110g/L 之间),随机分为3 个组,分别是对照组C 给予安慰剂;FeSO4 组 I,每天补充含60 mg 铁的FeSO4;NaFeEDTA 组IE,每天给予含60 mg 铁的NaFeEDTA,补充干预2个月。结果:干预结束后,与对照组相比,FeSO4和NaFeEDTA补充组血红蛋白水平分别升高了20.5 g/L and 21.8 g/L (p 值均<0.05),血浆铁水平升高了4.81 μmol/L 和7.19 μmol/L (p 值均<0.05),铁蛋白水平上升了2.63 μg/L 和 8.99 μg/L (p 值均<0.05),抗氧化酶谷胱甘肽过氧化物酶 (GSH-px) 活性上升了32.6 IU/ml and 75.3IU/ml (p 值均<0.05),脂质过氧化产物 (MDA) 水平下降了0.70 μmol/L 和1.12μmol/L (p 值均<0.05)。进一步分析发现,NaFeEDTA 补充组血浆铁、铁蛋白水平、GSH-px 活性比FeSO4 组明显升高,分别上升了2.38 μmol/L、6.36 μg /L 及42.7 IU/ml (p 值均<0.05)。结论:孕中期贫血妇女如不及时补铁,在孕晚期可使机体贫血及缺铁情况加重,机体氧化应激水平进一步升高;而及时补铁可明显改善孕妇贫血状况,NaFeEDTA 补充效果明显好于FeSO4 补充效果。
關鍵字:贫血、孕妇、NaFeEDTA、硫酸亚铁、氧化应激

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Impact of treatment with oral calcitriol on glucose indices in type 2 diabetes mellitus patients
MOHAMMAD HASSAN EFTEKHARI, MARZIEH AKBARZADEH, MOHAMMAD HOSSEIN DABBAGHMANESH AND JAFAR HASANZADEH
Introduction: Type 2 diabetes is a major public health problem. Recent epidemiological evidence also points to a potential association of vitamin D insufficiency with adverse metabolic risks, including that for type 2 diabetes. Subjects and method: A double-blind randomized placebo-controlled trial was carried out. Seventy subjects with type 2 diabetes, age 30-75 years old, were randomly assigned in a double-blind fashion to two groups. One group received two capsules of calcitriol (0.25 µg 1,25-dihydroxy cholecalciferol per each capsule) per day. The second group received placebo tablets. At the beginning, middle and the end of the 12 week supplementation trial, serum glucose, insulin, calcium and phosphorous, HbA1c and 25(OH) vitamin D were measured. Results: There was no significant difference between two groups at baseline. At the end of the study, fasting plasma glucose increased in the control group (p=0.038), while it remained unchanged in calcitriol group. Level of insulin and HbA1c increased significantly in both groups (p=0.013 and 0.0004 in treatment and control group). Regarding insulin resistance indices, there was a significant change in HOMA-IR and QUICKI in both groups (p=0.023 and 0.002 in treatment and 0.001 and <0.001 in control group respectively). Insulin secretion as assessed by HOMA-%β, remained relatively unchanged in the control group, while it increased significantly in the treatment group at the end of study (p=0.009). Conclusion: Vitamin D supplementation attenuated the increase in glycemia, and increased insulin secretion, but had no effect on insulin resistance.
Key Words: diabetes mellitus, calcitriol, glucose, insulin resistance, hemoglobin A1C
 

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第2 型糖尿病患者口服鈣三醇對血糖指數的影響前言:糖尿病是公共衛生的一大問題。近來流行病學證據也指出,維生素D 缺乏與不良的代謝性風險有潛在相關。對象與方法:本研究是一個雙盲隨機分派控制組使用安慰劑試驗。70 位第2 型糖尿病患者,年齡在30-75 歲之間,雙盲隨機分派成2 組。一組每天服用2 顆鈣三醇膠囊(每一顆膠囊含0.25 μg 1,25-雙羥膽骨化醇,維生素D-3) ;第二組則是服用安慰劑錠。在為期12 週試驗的開始、中間及結束時分別檢測受試者的血清糖、胰島素、鈣、磷、糖化血色素及25(OH)維生素D 值。結果:兩組在基線時並沒有顯著差異,在研究結束時,控制組的空腹血糖有顯著上升(p=0.038),實驗組則沒有太大變化。兩組的胰島素和糖化血色素值均有顯著增加(實驗組p=0.013、控制組p=0.0004)。在胰島素抗性指數,兩組的HOMA-IR 和 QUICKI 值均有顯著改變(實驗組p=0.023 和0.002;控制組p=0.001 和<0.001)。以HOMA-%β 評估胰島素的分泌,結果控制組並沒有太大改變,但實驗組在研究結束時有顯著增加。結論:服用維生素D補充劑,會降低血糖上升的程度並增加胰島素分泌,但對於胰島素抗性沒有影響。
關鍵字:糖尿病、鈣三醇、葡萄糖、胰島素抗性、糖化血色素
 

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Acute effect of a soy protein-rich meal-replacement application on renal parameters in patients with the metabolic syndrome
PETER DEIBERT, LISA LUTZ, DANIEL KÖNIG, SABINE ZITTA, ANDREAS MEINITZER, MARA Z VITOLINS, GERHILD BECKER AND ALOYS BERG
Background: Soy protein is used for meal replacement therapy in obesity, however the influence on renal function parameters is not adequately investigated. This study evaluates glomerular filtration rate (GFR) and renal plasma flow (RPF) in patients with the metabolic syndrome and healthy controls after ingestion of different amounts of soy protein. Methods: 10 patients with the metabolic syndrome but no signs of kidney disease and 10 healthy controls ingested 1 g protein/kg body weight of a commercial soy-yoghurt-honeypreparation. The patient group was also given a protein challenge of 0.3 g/kg body weight. Results: Baseline GFR and RPF both were significantly higher in the patient group (147±34.8 vs. 116±21.1 ml/min, p=0.01 and 848±217 vs. 637±121 ml/min, p=0.02) and were strongly correlated with body weight. Use of different algorithms to estimate GFR resulted in underestimation of GFR, particularly in the patients with the metabolic syndrome. The challenge with an acute protein load of 1g protein per kilogram body weight induced a significant increase in GFR and RPF in healthy controls (GFR: +12.6±11.0 % (p=0.01), RPF: +13.6±15.6 % (p=0.04)) and even more in patients with the metabolic syndrome (GFR: +31.5±32.2 % (p=0.01); RPF: +19.4±22.7 % (p=0.02)). The ingestion of 0.3 g protein/ kg body weight did not induce significant changes. Conclusions: Basic renal function is changed in patients with the metabolic syndrome, even without microalbuminuria. In addition, there is an elevated susceptibility for protein load. However, the protein amount recommended for use in soy-protein based meal replacement therapy induced no significant changes.
Key Words: renal function, metabolic syndrome, glomerular filtration rate, renal plasma flow, soy protein
 

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大豆蛋白代餐對代謝症候群病人腎臟參數之急性效應
背景:大豆蛋白常被使用在肥胖的代餐治療,然而對於腎臟功能參數的影響尚未被充分研究。本研究評估代謝症候群病人及健康對照,在攝取不同量的大豆蛋白後的腎絲球過濾率(GFR)和腎血漿流量(RPF)。方法:10名患有代謝症候群但沒有腎臟疾病症狀的病人及10名健康對照,攝取每公斤體重1公克蛋白質的大豆-優格-蜂蜜烹調商品。病人組還給予一個蛋白質挑戰,每公斤體重0.3公克。結果:病人組的基礎GFR和RPF均顯著性較高(147±34.8vs.116±21.1ml/min,p=0.01和848±217vs.637±121ml/min,p=0.02),且與體重有強相關。使用不同的演算法去評估GFR導致低估GFR,特別是有代謝症候群的病人。每公斤體重1公克蛋白質的急性蛋白質負荷挑戰,導致健康對照的GFR和RPF增加(GFR:+12.6±11.0%(p=0.01),RPF:+13.6±15.6%(p=0.04)),有代謝症候群病人則增加更多(GFR:+31.5±32.2%(p=0.01);RPF:+19.4±22.7%(p=0.02))。每公斤體重攝取0.3公克蛋白質不會誘發顯著改變。結論:代謝症候群病人,即使在沒有微白蛋白尿的情況下,其基礎腎功能已經改變了。此外,蛋白質負荷量的感受性也升高了。然而,使用在大豆蛋白基礎代餐治療的蛋白質建議量,不會產生顯
著改變。
關鍵字:腎臟功能、代謝症候群、腎絲球過濾率、腎血漿流量、大豆蛋白

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Fortified juice drink improved iron and zinc status of schoolchildren
IMELDA ANGELES-AGDEPPA, CLARITA R MAGSADIA AND MARIO V CAPANZANA
Energy and micronutrient deficiency remain prevalent among Filipino children. Juice drinks are commonly consumed and could be a viable vehicle for fortification to supplement the nutrient gap. This study determined the effects of a newly developed non-carbonated fortified juice drink on the iron, zinc and nutritional status of schoolchildren. One hundred randomly selected anemic children were randomly allocated into two groups in a doubly-masked placebo controlled manner: Group 1 received the fortified juice, Group 2 received the non-fortified juice for 100 days, five days a week under strict supervision. The juice drink was fortified with vitamin A, zinc, iron, vitamin C and lysine. The non-fortified juice was fortified only with vitamin C. All children were dewormed prior to the intervention. Hemoglobin, plasma ferritin and plasma zinc, weight and height were assessed using standard methods before and after intervention. A two-day 24-hour food recall was also collected. The basal prevalence of anemia was significantly reduced in both the fortified group (100% to 13%) and the non-fortified group (100% to 40%) at endline. The mean plasma ferritin levels were similar in both groups at baseline and endline. At endline, mean plasma zinc in the fortified group has significantly increased by 20 μg/dL from a baseline value of 83.9 µg/dL to 103.9 µg/dL, while the non-fortified group remained at similar levels with baseline. Basal weight and height significantly increased among all children at endline. The fortified juice drink was effective in reducing the prevalence of anemia and improved the zinc status of children.
Key Words: anemia, hemoglobin, plasma ferritin, zinc status, fortified juice drink
 

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強化果汁改善學齡兒童體內鐵和鋅的狀態菲律賓的兒童至今仍然有能量和微量營養素缺乏的問題。果汁是常吃的食物,因此可以當作營養強化的載體,來填補營養素的缺口。本篇研究的目的是測定一種新開發非碳酸強化果汁對學齡兒童體內鐵、鋅和營養狀況的影響。從貧血兒童中隨機抽出100位,再隨機分配至2組並採雙盲、安慰劑控制的試驗。第1組接受強化果汁,第2組接受非強化果汁。在嚴格監督下,每週5天,共進行10天。強化果汁添加的物質有維生素A、鋅、鐵、維生素C及離胺酸;非強化果汁只添加維生素C。所有兒童在介入之前已驅完蟲。介入前後利用標準化測量方試來評估血紅素、血漿鐵蛋白和鋅、體重及身高,另外也蒐集了2天的24小時飲食回憶記錄。試驗結束時,強化組(100%降至13%)與非強化組(100%降至40%)的貧血盛行率均顯著下降。強化組的血漿鐵蛋白平均值顯著增加了20 μg/dL,從試驗前的83.9 µg/dL增加至103.9 µg/dL,但非強化組的數值則和試驗前相同; 所有兒童的身高、體重均有顯著增加。強化果汁可以有效地降低貧血的盛行並且改善兒童體內的鋅狀態。 關鍵字:貧血、血紅素、血漿鐵蛋白、鋅狀態、強化果汁

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Malnutrition in hospitalized people living with HIV/AIDS: evidence from a cross-sectional study from Chengdu, China
WEN HU, HUA JIANG, WEI CHEN, SHENG-HUA HE, BIN DENG, WEN-YUAN WANG, YAN WANG, CHARLES DAMIEN LU, KAREN KLASSEN AND JUN ZENG
Objectives: Nutrition support has long been ignored in China’s HIV/AIDS treatment and care. The objectives of this project were to evaluate the prevalence of malnutrition among Chengdu urban HIV positive patients, and to provide evidence for further nutritional intervention. Materials and Methods: HIV-infected adults admitted to an infectious diseases inpatient unit were eligible for this study. Nutritional status was evaluated using Subject Global Assessment (SGA), Malnutrition Universal Screening Tool (MUST), body mass index (BMI), food frequency questionnaire and dietary records. Results: 94 hospitalized HIV positive patients were enrolled from April 2009 to May 2010. The median CD4 T cell count was 44.0/mm3. The prevalence of malnutrition is measured by three tools and ranged from 37.2% (by BMI) to 77.2% (by SGA class B/C or MUST scores≥2). Chi-square test showed significant relationship between opportunistic infections and MUST score (OR=5.67, p<0.005, 95% CI=1.96-16.4). Of patients, 59.6% had insufficient total energy intake; while 54.3% had insufficient protein intake. Conclusions: Malnutrition is highly prevalent among Chengdu urban HIV/AIDS patients who underwent inpatient treatment. Calorie and protein deficiency should be given more attention in HIV/AIDS care programs. Nutrition evaluation and support should be considered an integral parts of national and community HIV/AIDS treatment and care guidelines.
Key Words: HIV/AIDS, malnutrition, nutrition screening tool, hospitalized, China
 

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住院艾滋病患者中的营养不良:基于中国成都一项横断面研究的证据
目的:中国的艾滋病治疗与关怀项目中长期缺乏对营养支持的关注,本研究旨在评估成都市区HIV 阳性患者的营养不良流行率,并为进一步营养干预提供依据。对象与方法:研究对象为成都市传染病医院的住院HIV 感染者/艾滋病患者。采用主观全面评定法(SGA)、营养不良筛查工具(MUST)、体质指数(BMI)、食物频度问卷及膳食回顾法进行营养评估。结果:自2009 年4月-2010 年5 月,纳入94 例住院HIV 阳性患者。本组患者CD4 T 细胞计数中位数为44.0/mm3。采用三种方法进行营养筛查后发现,营养不良患病率从37.2%(BMI)到77.2(SGA B/C 级或MUST 评分≥2)。卡方检验发现机会性感染与MUST 评分显著相关((OR=5.67, p<0.005, 95% CI=1.96-16.4)。59.6%的患者存在能量摄入不足;54.3%的患者存在蛋白质摄入不足。结论:成都市住院HIV/AIDS 患者中普遍存在营养不良。艾滋病关怀项目应该对能量和蛋白质摄入不足问题加以关注。应当将营养评估与营养支持内容纳入国家及社区艾滋病治疗和关怀指南。
關鍵字:艾滋病、营养不良、营养筛查工具、住院患者 、中国

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Anthropometric equation for estimation of appendicular skeletal muscle mass in Chinese adults
XU WEN, MEI WANG, CHONG-MIN JIANG AND YI-MIN ZHANG
The purpose of this study was to develop and cross-validate anthropometric equations for the estimation of appendicular skeletal muscle mass (ASM) in Chinese adults. A total of 763 adults aged 18-69 years (345 men and 418 women) were recruited from residents living in four regions (Jinan, Guangzhou, Xi’an and Chengdu) in China. ASM were measured by fan-beam dual energy x-ray absorptiometry. Participants’ body weight, height, limb circumferences (upper arm, thigh, and calf), waist circumference, and skinfold thicknesses (triceps, thigh, and calf) were measured by trained testers. The participants were randomly assigned to two groups: a model-development group (MD group) and a cross-validation group (CV group). Prediction models were established using the data from the MD group, and cross-validated with the data of the CV group. The results suggested that the developed equations had satisfactory prediction qualities, and could be applied as a practical method of quantifying ASM in Chinese adults.
Key Words: skeletal muscle mass, prediction model, body composition, anthropometry, skinfold
 

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中国成年人四肢骨骼肌含量的体位方程式
本研究的目的是发展和验证中国成年人四肢骨骼肌含量的预测方程式。研究在中国济南、广州、西安、成都四地招募763 名18-69 岁成年人,其中男性345名、女性418 名。通过双能X 光吸收法测量受试者的四肢骨骼肌含量。由经培训的测量员的测量受试者的体重、身高、上臂围、大腿围、小腿围、腰围、皮褶厚度(肱三头肌、大腿、小腿)。将受试者随机分成建模组和验证组,利用建模组数据建立四肢骨骼肌含量预测方程,然后采用验证组数据检验预测方程的效果。研究结果显示,本研究建立的方程具有较好的预测效果,可以应用于中国成年人四肢骨骼肌含量的预测。
關鍵字:骨骼肌质量、预测模式、身体组成、体位测量、皮褶厚度
 

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Waist circumference as an indicator of high blood pressure in preschool obese children
BIN CHEN AND HAI-FEI LI
Objective: To investigate the relationship between waist circumference and blood pressure (BP) to determine if waist circumference was an indicator of BP in preschool children. Methods: Body weight, height, waist circumference (WC), hip circumference, and blood pressure of 939 3-6-year-old preschool children were collected. Results: Systolic blood pressure (SBP) and diastolic blood pressure (DBP) in obese children were significantly higher than that in normal weight children in both sexes (p<0.001). Overweight children had significantly higher SBP and DBP than normal weight boys (p<0.01). Age- and sex-adjusted Body mass index (BMI) correlated significantly with SBP and DBP. In children aged 3-6 years, age-, sex-and BMI-adjusted waist circumference correlated significantly with SBP, but not with DBP. Receiver operating characteristic (ROC) curves showed a significant ability of BMI, WC and waist-to-height ratio (WtHr) to discriminate high blood pressure in children of both sexes. Multiple linear stepwise regression analysis using SBP as the dependent variable showed that BMI and WC were significant independent factors that influence high blood pressure adjusted for age, WtHr and waist-to-hip circumference ratio (WHr) in boys. When using DBP as the dependent variable, BMI was the only significant independent factor that influenced high blood pressure adjusted for age, WtHr and WHr, in both sexes. Conclusion: Waist circumference was independently associated with high blood pressure in boys aged 3-6 years. In addition to BMI, increased waist circumference was found to be an indicator of high blood pressure in the preschool children, especially in boys.
Key Words: preschool children, obesity, waist circumference, blood pressure, body mass index
 

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腰围是一个学龄前儿童高血压的指标
目的:研究学龄前儿童腰围与血压的关系,以探讨腰围对血压的预示作用。方法:测量939 名3-6 岁学龄前儿童的体重、身高、腰围、臀围和血压。结果:肥胖儿童收缩压和舒张压明显高于正常体重儿童(p<0.001),超重男童的收缩压和舒张压明显高于正常体重男童(p<0.01)。校正年龄和性别的体质指数(BMI)与收缩压和舒张压明显相关。校正年龄、性别和BMI 的腰围与收缩压明显相关。接收者操作特征(Receiver operating characteristic,ROC)曲线显示BMI、腰围和腰围-身高比可作为辨别儿童高血压的敏感指标。多重直线逐步回归分析结果表明,BMI 和腰围均为男童收缩压的独立影响因素,仅有BMI 为儿童舒张压的独立影响因素。结论:3-6 岁男童腰围与高血压存在显著相关性。除了BMI 之外,腰围可以作为学龄前儿童高血压的预示指标,尤其对于男童更有意义。
關鍵字:学龄前儿童、肥胖、腰围、血压、体质指数

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Interactive effects of main genotype, caloric intakes, and smoking status on risk of obesity
SANGYEOUP LEE, CHEOL MIN KIM, HYUN JUN KIM AND HYE SOON PARK
The aim of this study was to determine the strong candidate genes increasing susceptibility to obesity among previously reported obesity-related genes in Korean subjects and evaluate gene-environmental interactions in susceptibility to obesity. The study population comprised of 163 adolescents (95 boys and 68 girls) and their parents (97 men and 96 women).We used multivariable-adjusted logistic regression analysis, and classification and regression tree (CART) analysis incorporating both the genetic (ADRB2 R16G genotype) and environmental (overeating, smoking status, and parent’s obese status) variables. The polymorphisms were genotyped with SNP-ITTM assays using the SNPstream 25KTM System (Orchid Biosciences, New Jersey, USA). Arg16 allele of ADRB2 R16G, smoking and overeating were linked to an increased risk of obesity in adults. CART analysis showed that smoking parents who overate and carried the Arg allele, ADRB2 R16G, had an odds ratio (OR) of 11.7 (95% confidence interval (CI), 2.13-64.04) for obesity compared to non-smoking parents who had none of these factors. Among children, the highest risk group for obesity was the overeater with obese parents (OR, 5.20; 95% CI, 1.86-14.53). The results of the study indicate that beta2-adrenoceptor polymorphism may contribute to the development of obesity through gene-environmental interactions. Further replication studies with larger sample size would be needed to confirm our study results.
Key Words: obesity, adrenergic beta-2 receptors, interaction, nutrition, smoking
 

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基因、熱量和抽菸對於肥胖風險的交互作用
這篇研究的主要目的是確認之前發表過的韓國人與肥胖有關的候選基因對於肥胖的易感受性,以及評估與環境間的交互作用。此篇研究族群是163 名青少年(95 名男性和68 名女性)以及他們的雙親(97 名男性和96 名女性)。利用多變量羅吉斯迴歸分析和迴歸分類樹(CART)分析基因(ADRB2 R16G genotype)和環境因子(飲食過量、抽菸、雙親肥胖)。使用SNPstream 25KTM 系統分析基因多型性。ADRB2 R16G、抽菸和飲食過量被認為會增加成人肥胖風險。迴歸分類樹分析結果顯示帶有ADRB2 R16G 基因型、飲食過量且抽菸的雙親者比起雙親不抽菸且無任何一項因子者,其肥胖的OR 值為11.7 (95% CI: 2.13-64.04)。對孩童而言,肥胖高風險群為雙親肥胖且飲食過量(OR, 5.20; 95% CI, 1.86-14.5)。此篇研究指出β2 腎上腺素受體基因多型性或許對於肥胖相關基因和環境間的交互作用有貢獻。未來需要較大樣本的研究來確認本篇研究結果。
關鍵字:肥胖、β2 腎上腺素受體、交互作用、營養、抽菸
 

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Contribution of complementary food nutrients to estimated total nutrient intakes for urban Guatemalan infants in the second semester of life
LIZA HERNÁNDEZ, RAQUEL CAMPOS, ANKE ENNEMAN, MARIA JOSÉ SOTO-MÉNDEZ, MARIEKE VOSSENAAR AMD NOEL W SOLOMONS
Complementary foods (CF) are introduced earlier or later than appropriate in developing societies. They often contribute poorly to overall adequate micronutrient intake during the critical period for growth and development, which constitutes the period from 6 to 12 months of life. The objective of this study was to determine the contribution of the CF nutrients to the total estimated nutrient intake in infants in the second semester of life. Three non-consecutive 24-hour recalls interviews were conducted with mothers of 64 infants, aged 6-12 months on enrolment, from a convenience sample in a marginal urban settlement in Guatemala City. Retrospective recording of early introduction of pre- and post-lacteal feeding and introduction of first foods and beverages was included. Human milk intakes were estimated by a model based on assumptions that human milk plus CF exactly satisfied the infant’s daily energy needs. The WHO/FAO Recommended Nutrient Intakes (RNI) were the standards for adequate nutrient consumption. Instances of exclusive breast feeding to 6 months were rare, with the introduction of CF earlier than recommended. Baby food in jars was mentioned most frequently as the first food offered. The contribution of CF increased with age through the second semester of life. CF contributed more of a nutrient than human milk in all instances. However,CF nutrient density for Ca, Fe, and Zn fell below international standard. Fortified sugar contributed excessive amounts of Vitamin A to the diets. We conclude that for most nutrients, intakes reached or exceeded recommendation levels, unusual within the CF experience in scientific literature.
Key Words: human milk, complementary foods, infant feeding, micronutrient intake, Guatemala

 

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嬰兒副食品對於瓜地馬拉城市6-12 月嬰兒的總營養素 攝取的貢獻
與已開發國家比較,開發中國家嬰兒副食品的使用時機往往過早或過晚。這些副食品對於嬰兒成長和發育的關鍵期,也就是第6 到第12 個月時,所需的微量營養素量並無多大貢獻。本研究主要目的在探討副食品對於嬰兒第二期的營養素攝取量的貢獻。利用便利取樣抽取64 名居住在瓜地馬拉城市邊緣的6-12 個月大的嬰兒,請母親填寫三次非連續的24 小時回憶問卷。問卷包含哺乳前後第一次給予的食物和飲料。母乳的攝取量的評估,是假設母乳加上副食品剛好滿足嬰兒一天的所需熱量。以WHO/FAO 的建議營養素攝取量(RNI)為足夠的營養素攝取量的標準。這六個月只有哺餵母乳的例子相當罕見,而副食品的使用往往早於建議時機;第一次食用的副食品以罐裝最常見。隨著年紀增長,副食品使用也隨之增加。在所有訪視者中,副食品所貢獻的營養素量比母乳多。但是副食品的鈣、鐵和鋅的營養密度低於國際標準。強化糖所給予的維生素A過量。我們結論如下,副食品所提供的多數營養素量都滿足或超過建議量,此與過去關於副食品的文獻結果並不相同。
關鍵字:母乳、副食品、嬰兒餵養、微量營養素攝取量、瓜地馬拉
 

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Undernutrition status of children under 5 years in Chinese rural areas - data from the National Rural Children Growth Standard Survey, 2006
JING ZHANG, JUNXIN SHI, JOHN H HIMES, YUKAI DU, SENBEI YANG, SHUHUA SHI AND JIANDUAN ZHANG
Purpose: To assess the nutritional status among rural children under five years in China relative to WHO Child Growth Standards 2006, and to explore risk factors for undernutrition. Design: Cross-sectional study of rural areas in 10 provinces of China. A total of 84,009 children under five recruited through multi-level sampling. Main findings: A total of 17.92% of children have at least one form of undernutrition. The prevalence of stunting, underweight and wasting, were 14.59%, 7.19% and 3.07%, respectively. The corresponding mean z-score in height-for-age, weight-for-age, and weight-for-height were -0.732, -0.410 and -0.001. An upward trend with age in stunting and underweight was observed, and higher risks noticed among older children in contrast with children under 6 months in terms of stunning and underweight. The inter-provincial variation of undernutrition remains very large. Low birth weight, multi parity, preterm birth, multiple birth, maternal illiteracy, low provincial GDP, and low household income are identified as significant factors associated with stunting. Parity shows no corresponding significant relationship with underweight, and wasting was not found to be associated with either preterm or multiple births. Conclusion: The nutritional status among children under five in rural areas of China, although greatly improved in the past decades, still lags behind the WHO Child Growth Standards. Stunting and underweight occur mostly before two years of age. Intervention strategies and programs should be developed to target the preventable risk factors.
Key Words: undernutrition, children under five years, China, rural area, WHO Child Growth Standard
 

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中国5 岁以下农村儿童的营养状况–2006 年全国农村儿 童成长标准调查
目的:采用世界卫生儿童生长发育标准(2006)评估中国5 岁以下农村儿童的营养状况,探讨儿童营养不良的危险因素。设计:本研究对中国大陆10 个省份进行了横断面调查,采用多阶段抽样方法共纳入84009 名5 岁以下儿童。结果:17.92%的儿童至少存在一种形式的营养不良,矮小,低体重和消瘦的流行率分别为14.59%, 7.19% 和3.07%。年龄别身高,年龄别体重和身高别体重的z值分别为-0.732, -0.410 和-0.001。矮小和低体重的患病率随年龄增长而呈现上升趋势,年长儿童矮小和低体重的风险显著高于6 个月以内儿童。儿童营养不良在各省份间分布十分不平衡。低出生体重、多胎(双胞胎或多胞胎)、早产、多子女、母亲是文盲、所在省份经济状况差以及家庭低收入是导致矮小的危险因素。在上述危险因素中多子女与低体重无显著相关性;多胎和早产则与消瘦无显著相关。结论:中国5 岁以下农村儿童的营养状况虽然有了显著提高,但是仍然落后于世界卫生组织推荐的标准。矮小和低体重仍是目前2 岁以内儿童的主要营养不良问题。应该根据其可控危险因素制定相应干预项目和干预措施,促进中国农村儿童健康。
關鍵字:营养不良、5岁以下儿童、中国、农村地区、世卫儿童成长标准
 

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Systematic review and meta-analysis of soy products consumption in patients with type 2 diabetes mellitus
BIN YANG, YING CHEN, TONGCHEN XU, YINGHUA YU, TAO HUANG, XIAOJIE HU AND DUO LI
Clinical trials have reported the lipid-lowering effect of consuming soy products, and epidemiological studies have shown that soy intake is associated with decreased risk of type 2 diabetes mellitus (T2DM). The aim of this meta-analysis was to systematically review the effects of soy products consumption on serum lipid profiles and glycaemic control in T2DM patients. Potential papers were initially searched from PubMed (1966 to 2010) and Cochrane Library (1984 to 2010) without language limitations. All randomized controlled trials were included in which soy products supplementation was the only intervention in subjects with type 2 diabetes. Weighted mean effect size was calculated for net changes in serum lipids and fasting glucose concentrations using fixed-effect or random-effect models. Previously defined subgroup analyses were performed to identify the source of heterogeneity. Eight studies were included according to the criteria. The intake of soy products was associated with a significant reduction in serum total cholesterol (by 0.42 mmol/L; 95% confidence interval (CI): -0.70, -0.14; p<0.001), triacylglycerol (by 0.22 mmol/L; 95% CI: -0.38, -0.07; p<0.001) and low-density lipoprotein-cholesterol (by 0.30 mmol/L; 95% CI: -0.60, -0.00; p<0.001), and a significant increase in high-density lipoprotein-cholesterol (0.05 mmol/L; 95% CI: 0.04, 0.06; p=0.89). There were no significant effects on fasting glucose, insulin and glycated hemoglobin. It can be concluded that intake of soy and soy products has beneficial effects in T2DM patients in relation to serum lipids.
Key Words: soy products, type 2 diabetes mellitus, lipids, fasting glucose, meta-analysis
 

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二型糖尿病患者大豆制品摄入的系统综述和meta 分析
临床干预研究发现大豆制品具有降血脂的功效。流行病学研究发现大豆摄入与二型糖尿病患病风险呈显著负相关。该meta 分析的主要目的是系统综述大豆制品摄入对二型糖尿病患者血脂水平及血糖的影响。本文从PubMed(1966 到2010)和 Cochrane Library(1984 到2010)数据库收集了所有相关的文献,并选择了关于大豆制品干预二型糖尿病患者的随机对照实验。通过固定模型和随机模型分析了血脂和血糖的加权平均效应值,同时通过亚组分析的方法检测了数据的异质性。根据本文数据的提取标准,最终获得8 篇论文数据。结果发现,大豆制品摄入能够显著降低二型糖尿病患者血清总胆固醇(by 0.42mmol/L; 95% confidence interval (CI): -0.70, -0.14; p<0.001)、甘油三酯(by 0.22mmol/L; 95% CI: -0.38, -0.07; p<0.001) 以及低密度脂蛋白胆固醇的水平 (by0.30 mmol/L; 95% CI: -0.60, -0.00; p<0.001),同时能够显著升高高密度脂蛋白胆固醇的浓度(0.05 mmol/L; 95% CI: 0.04, 0.06; p=0.89)。然而,对空腹血糖、胰岛素和糖基化血红蛋白没有显著作用。因此,大豆制品能够通过调节血脂水平来起到预防二型糖尿病的作用。
關鍵詞:大豆制品、二型糖尿病、血脂、空腹血糖、meta分析

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Red meat intake may increase the risk of colon cancer in Japanese, a population with relatively low red meat consumption
RIBEKA TAKACHI, YOSHITAKA TSUBONO, KEISUKE BABA, MANAMI INOUE, SHIZUKA SASAZUKI, MOTOKI IWASAKI, AND SHOICHIRO TSUGANE AND FOR THE JAPAN PUBLIC HEALTH CENTER-BASED PROSPECTIVE STUDY GROUP
Asian populations have changed from traditional to Westernized diets, with increased red meat intake. They are suggested to be particularly susceptible to the adverse effects of red meat on the development of colorectal cancers, however, few prospective studies of this putative link have been conducted. We examined associations between the consumption of red and processed meat and the risk of subsite-specific colorectal cancer by gender in a large Japanese cohort. During 1995-1998, a validated food frequency questionnaire was administered to 80,658 men and women aged 45-74 years. During 758,116 person-years of follow-up until the end of 2006, 1,145 cases of colorectal cancer were identified. Higher consumption of red meat was significantly associated with a higher risk of colon cancer among women [multivariate hazard ratios (95%CIs) for the highest versus lowest quintiles (HR): 1.48 (1.01, 2.17; trend p=0.03)], as was higher consumption of total meat among men [HR=1.44 (1.06, 1.98; trend p=0.07)]. By site, these positive associations were found for the risk of proximal colon cancer among women and for distal colon cancer among men. No association was found between the consumption of processed meat and risk of either colon or rectal cancer. In conclusion, red meat intake may modestly increase the risk of colon cancer in middle-aged Japanese, although the highest quintile of red meat consumption could be considered moderate by Western standards.
Key Words: meat, colon cancer, rectal cancer, prospective studies, Japan
 

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在一個紅肉攝取相對較低民族日本,攝取較多紅肉會增 加結腸癌罹患風險
亞洲人口飲食從傳統飲食轉變為西式飲食,紅肉的攝取量也隨之增加。然而,一些前瞻性研究已證實,這些人的結腸直腸癌的發展最可能受到攝取紅肉的不良影響。我們在一個日本的大型世代研究,評估男女性在紅肉及加工肉品的攝取與特定部位結腸直腸癌的罹患風險之間的相關性。在1995-1998 年間,80,658 位45-74 歲男女性填寫了一份經過效度測試食物頻率問卷。至2006 年底,共追蹤了758,116 人年,有1,145 個結腸直腸癌病例被診斷。紅肉攝取較高的女性參與者,其罹患結腸癌的風險顯著較高[攝取最多的五分之一比起最低的五分之一,其複迴歸危害比(95%信賴區間):1.48 (1.01, 2.17; 趨勢 p=0.03)];男性則是總肉類攝取較高者,其風險也顯著較高[危害比=1.44 (1.06, 1.98; 趨勢p=0.07)]。就特定部位而言,女性在近端結腸癌具有正相關,而男性則為遠端結腸。加工肉品的攝取與罹患結腸或直腸癌的風險皆不具相關性。總之,以西方的標準而言,中年日本人攝取紅肉最多的五分之一的量僅算中等量,但是已經足以增加罹患風險。
關鍵字:肉、結腸癌、直腸癌、前瞻性研究、日本
 

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Prevalence, influencing factors and control of food insecurity: a model in the northwest of Iran
SAEED DASTGIRI, RAHIM SHARAFKHANI, RASOOL GHARAAGHAJI ASL AND SAEED GHAVAMZADEH
Food insecurity is frequent in both developed and developing countries, affecting from 5% to 25% of the general population. The aim of this study was to assess food insecurity, its influencing factors and control measures in the northwest of Iran. A total population of 15,070 (2,911 households) were studied. A short questionnaire was used for the screening of food insecurity and energy intake in this study. After the screening programme, those families identified as having food insecurity were recruited for the second part of the study which was a community trial. We organized small training campaigns (through peer education) for target households. Six months later, the same techniques were applied again to assess the impact of educational intervention in reducing the rate of food insecurity. Total prevalence of food insecurity in the study population was 59.3 percent (95% confidence interval: 57.4-61.3). Logistic regression showed that apart from the mother’s age and smoking status of the head of the family, there was a significant association between household food insecurity and other variables in the model (mainly economic factors). The prevalence of food insecurity reduced by 7.3 percent after the intervention (p>0.10). The high prevalence of food insecurity in this study indicates that there is an urgent need for a close collaboration between governmental, international and local leadership to identify and implement the key interventional programmes to overcome this ever increasing health problem. According to our findings, a special attention should be paid on the economic improvement in the region.
Key Words: food insecurity, prevalence, causes, control, epidemiology

 

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伊朗西北部糧食不安全盛行狀況及影響因素
糧食不安全常見於已開發及開發中國家,約有5%至25%的一般民眾受影響。本研究主要目的為評估伊朗西北部之糧食不安全及其影響因子。本研究共研究了15,070 人(2,911 家戶)。首先使用簡易問卷篩出糧食不安全的家戶及其及能量攝取。第二階段進入社區試驗,對目標家戶實施小型訓練活動(藉由同儕教育)。於六個月後評估教育介入對於降低糧食危機盛行率之影響。結果發現,本研究族群糧食不安全盛行率為59.3% (95%信賴區間:57.4-61.3)。羅吉斯回歸分析發現,除了母親年齡及家長抽菸狀況以外,其他變項(主要為經濟因素)與家戶糧食不安全具顯著相關。經過教育介入後, 糧食不安全盛行率下降7.3%(p>0.10)。本研究指出此區域的高糧食不安全盛行率亟需政府、國際與當地領導組織密切的合作,來鑑別及實施關鍵的介入計畫,克服這個不斷增加的衛生問題。根據我們的發現,此地區應特別關注經濟的改善。
關鍵字:糧食危機、盛行率、影響因子、控制因子、流行病學

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Paternal smoking is associated with greater food insecurity among poor families in rural Indonesia
RICHARD D SEMBA, ASHLEY A CAMPBELL, KAI SUN, SASKIA DE PEE, NASIMA AKHTER, REGINA MOENCH-PFANNER, JEE HYUN RAH, JANE BADHAM, KLAUS KRAEMER AND MARTIN W BLOEM
Food insecurity is common in developing countries and related to the physical well being of families. Household food insecurity is intended to reflect a household’s access, availability, and utilization of food. The relationship between paternal smoking and household food insecurity has not been well characterized. The objective of this study was to examine the relationship of paternal smoking with household food insecurity among poor families in rural Indonesia. In a cross-sectional study of 26,380 rural households in the Indonesian Nutrition Surveillance System in 2003, we examined the relationship between paternal smoking and household food insecurity score, as measured using a 9-item food security questionnaire. The prevalence of paternal smoking was 72.9%. In families with and without a father who smoked, the mean (standard error) household food insecurity score was 1.83 (0.01) and 1.48 (0.02), respectively (p<0.0001). Paternal smoking was associated with greater household food insecurity score (p<0.0001) in a multivariable linear regression model, adjusting for maternal age, maternal education, weekly household expenditure per capita, and province. Among poor families in rural Indonesia, households with a father who smokes are at greater risk of household food insecurity.
Key Words: food insecurity, Indonesia, poverty, smoking, tobacco
 

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印尼鄉村貧窮家戶其家中父親抽菸狀態與糧食不安全有 關
糧食不安全的現象常見於發展中國家,同時也與家族身體安適有關。家戶糧食不安全正是反映該家戶的食物可近性、可獲性及利用。家中父親抽菸狀態與家戶糧食不足之間的關係仍然不清楚。因此本篇研究目的為探討印尼鄉村中較貧窮的家戶,其家中父親抽菸狀態與家戶糧食不安全之相關性。本篇為一橫斷性研究,使用2003 年印尼營養監測系統資料,共26380 鄉村家戶,同時利用一份9 題的糧食安全問卷,評估家戶糧食不安全程度,探討與家中父親抽菸狀態之相關性。結果發現,家中父親抽菸盛行率為72.9%。另外,若家中父親有否抽菸者,其家戶糧食不安全分數的平均數(標準誤)為1.83 (0.01)與1.48 (0.02)(p<0.0001)。最後結果也發現,在調整了母親年齡、母親教育程度、家戶每人每週消費及地區等變項後,發現家中父親抽菸狀態與家戶糧食不安全分數具有顯著的相關性(p<0.0001)。結論:在印尼鄉村地區貧窮家戶,家中父親是否抽菸,為家戶糧食不安全之危險因子。
關鍵字:糧食不足、印尼、貧窮、抽菸、菸草製品
 

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Comparison of dietary habits between migrant and local adolescents in Shenzhen, China
LIJUN WANG, ZHENZHEN ZHANG, YING CHANG, XIAN WANG, MENGJUN HOU, JUN WEI, WENHUA LING AND HUILIAN ZHU
Background: It is estimated that the number of migrant adolescents in Chinese cities may have reached 25 million. However, little research has been conducted on their dietary habits. The objective of this study was to compare dietary habits between migrant and local adolescents in Shenzhen, China. Methods: A school based cross-sectional study was conducted in 3368 adolescents (aged 11-18 years; 52.5% boys). A self-administered questionnaire completed by adolescents was designed to gather information on socio-demographic characteristics, meal location, food pattern and intake. Results: Of the 3368 adolescents, 58.2% were migrants. Compared with locals, migrant adolescents showed significantly higher percentage of having three meals away-from home. Nearly half of the subjects (45.6 %) skipped breakfast, with a higher proportion among migrant students (48.5 vs 41.5%). Migrant students consumed street food more frequently (12.2 vs 8.5%), while the difference was opposite in Western fast food intake (27.3 vs 32.5%). No significant difference was found in snacks intake between these two groups. Migrant students exhibited lower percentage of vegetables (57.3 vs 63.7%), fruits (27.7 vs 38.3%), meats (37.0 vs 44.3%), soybean (11.6 vs 17.5%) and dairy products (28.4 vs 42.5%) intake daily. After adjusted for socio-demographic confounders, the difference mentioned above still remained except Western fast food. Conclusion: Dietary habits among adolescents showed pronounced household variation. Migrant adolescents are more likely to exhibit unhealthy dietary behavior. Schools and families should collaborate to improve the dietary environment for adolescents, especially those from migrant families.
Key Words: migrant adolescents, dietary habits, nutrition, sociodempgraphic factors, China

 

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中国深圳市流动青少年和当地青少年饮食习惯的比较
背景:据估计,中国城市流动青少年的数量已经达到了2500万。然而,有关于他们饮食习惯的研究却很少。本研究的目的是对深圳市流动青少年和当地青少年的饮食习惯进行比较。方法:选取学校中3368名青少年(1118岁;52.5%是男生)展开横断面调查。调查问卷涵括调查对象社会人口学特征、就餐地点、饮食模式和摄入量等信息,由青少年自主完成。结果:3368名青少年中有58.2%是流动青少年。与当地青少年相比,流动青少年三餐在外就餐率较高。近一半学生(45.6%)不吃早餐,流动青少年不吃早餐的比例更高(48.5vs41.5%)。流动青少年街边食品摄入更频繁(12.2vs8.5%),而当地青少年西式快餐摄入更频繁(27.3vs32.5%)。两组在零食摄入频率上无显著差异。流动青少年每天蔬菜类(57.3vs63.7%)、水果类(27.7vs38.3%)、肉类(37.0vs44.3%)、豆类(11.6vs17.5%)和奶制品类(28.4vs42.5%)频率比当地青少年低。在调整社会人口学混杂因素后,除西式快餐外,上述差异仍然存在。结论:青少年不同户籍间表现出明显的饮食习惯的差异。流动青少年更容易出现不健康的饮食行为。学校和家庭应该共同合作来提高青少年,特别是来自于流动人口家庭青少年的饮食环境。
关键词:流动青少年、饮食习惯、营养、社会人口学因素、中国
 

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Nutrition risk: cultural aspects of assessment
CAROL A WHAM, LORNA DYALL, RUTH OY THE AND NGAIRE M KERSE
Aim: To assess a nutrition risk screening tool amongst Māori and non-Māori of advanced age. Method: A cross sectional feasibility study was conducted in three North Island locations. One hundred and eight community-living residents aged 75- 85 years were assessed for nutrition risk using ‘the validated questionnaire ‘Seniors in the Community: Risk Evaluation for Eating and Nutrition’, Version II (SCREENII) and level of physical activity using the ‘Physical Activity Scale for the Elderly’ (PASE). Physical assessments included height and weight. Results: Fifty-two percent of participants were assessed to be at high nutrition risk (SCREENII score <50; range 29-58; out of maximum score 64). Nutrition risk factors amongst Māori and non-Māori respectively differed for weight change in the previous six months (45.2% and 18.7%, p=0.005), skipping meals (54.8% and 13.3%, p<0.001), fruit and vegetable intake (77.4% and 18.7%, p<0.001) and the use of meal replacements (28.1% and 9.3%, p=0.013). Process evaluation showed that Māori took different meaning from the individual question items in SCREENII. Level of physical activity (PASE score) was higher for Māori, median (IQR): 125 (74) than non-Māori, 72 (74) (p<0.001) especially for leisure-time and household related activity. BMI was higher for Māori median (IQR): 31.5 kg/m2 (6.8) compared to non-Māori 24.7 kg/m2 (5.4) (p<0.001). Conclusions: The nutrition risk tool suggested that Māori were at high risk for malnutrition despite higher BMI and higher levels of activity. Several items of the screening tool were interpreted differently among Māori compared to non-Māori. Further development is needed to ensure accurate assessment.
Key Words: nutrition assessment, malnutrition, aged, culture, New Zealand

 

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營養風險:評估的文化觀點
目的:評估一個年邁的毛利人和非毛利人營養風險的篩檢工具。方法:在北島的三個地方進行橫斷面可行性研究。使用經過效度驗證過的SCREENII問卷評估108名75-85歲社區老人的營養風險,並利用PASE問卷評估這群老人的體能活動程度。身體評估包括體重和身高。結果:五成二的參與者被評估為高營養風險(SCREENII分數<50;範圍29-58;總分64)。毛利人和非毛利人不同的營養風險因素分別為:過去六個月的體重變化(45.2%及18.7%,p=0.005)、誤餐(54.8%及13.3%,p<0.001)、蔬果攝取(77.4%及18.7%,p<0.001)和使用代餐(28.1%及9.3%,p=0.013)。過程評估發現SCREENII中的個別項目對毛利人有不同的意義。體能活動程度(PASE分數)中毛利人得分比非毛利人高,尤其是休閒時間和家庭相關活動部分。毛利人的PASE分數的中位數和四分差分別為125和74。非毛利人的PASE分數的中位數和四分差分別為72和74(p<0.001)。毛利人和非毛利人的BMI中位數和四分差為31.5kg/m2(6.8)和24.7kg/m2(5.4)(p<0.001)。結論:儘管毛利人的BMI體能活動程度較高,但使用上述工具評估結果為營養不良的高風險群。毛利人和非毛利人的某些評分項目的解釋不同。需要更進一步的發展,以確保營養評估的準確性。
關鍵字:營養評估、營養不良、老年人、文化、紐西蘭
 

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Validation of a food frequency questionnaire to assess dietary cholesterol, total fat and different types of fat intakes among Malay adults
JUI YEE ENG AND FOONG MING MOY
Background: Cardiovascular diseases are the major cause of death in Malaysia. Evidence shows that dietary fat intake is one of the important risk factors for cardiovascular disease. However, studies assessing the association of fatty acids and risk of cardiovascular diseases in Malaysia are scarce. Therefore, this study aimed to develop and validate a food frequency questionnaire (FFQ) assessing total fat and different types of fat among Malay adults in Malaysia. Methods: A 100 food item FFQ focused on dietary cholesterol, total fat, saturated fat, monounsaturated fat and polyunsaturated fat intake for the past one month was developed and validated against 3-day dietary record (DR) among 151 Malay participants. Validity was assessed through the reliability and agreement of two methods. Intra-class correlation (ICC) coefficients were used to assess reliability; while regression analysis and classification into categories were used to assess agreement of the two methods. Results: The mean nutrient intakes tended to be higher in FFQ compared to DR. The developed FFQ showed excellent reliability with ICC coefficients ranging from 0.92-0.98. Regression analysis demonstrated an acceptable agreement between FFQ and DR for total fat and different types of fat intakes. There were a relatively high proportion of subjects being correctly classified (into same or adjacent category) and only a small number of grossly misclassification for total energy, fat, dietary cholesterol, saturated fat and unsaturated fat occurred. Conclusion: This FFQ is valid in assessing absolute total energy, total fat and types of fat intakes among Malay adults.
Key Words: food frequency questionnaire, validation, fat, cholesterol, Malay adults
 

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評估馬來人飲食中膽固醇、總脂肪以及不同形式的脂肪 攝取之食物頻率問卷的效度研究
背景:在馬來西亞,心血管疾病為主要的死因。證據顯示,飲食中脂肪的攝取量為導致心血管疾病的一重要危險因子。然而,在馬來西亞,評估脂肪酸與心血管疾病罹患風險的相關研究仍非常稀少。因此,本篇研究的目的為開發評估馬來西亞的馬來人總脂肪和不同形式的脂肪攝取的食物頻率問卷(FFQ)及其效度。方法:該FFQ含100種食物項目,針對過去一個月內飲食膽固醇、總脂肪、飽和脂肪、單元不飽和脂肪、多元不飽和脂肪的攝取,並藉由151位馬來參與者三天的飲食紀錄進行效度評估。效度的評估是透過信度以及頻率問卷及飲食紀錄兩種方式的一致性。信度用組內相關係數來評估; 兩種方法的一致性以迴歸分析和類別資料分析來評估。結果:相較DR,FFQ有較高的平均營養攝取量。這個FFQ有極佳的信度,其組內相關係數範圍為0.92-0.98。迴歸分析指出FFQ和DR兩者在總脂肪以及不同形式的的脂肪攝取,具有可接受的一致性。相對較高比例的參與者被正確分類(相同或相近的類別),只有少數在總能量攝取、脂肪、膳食膽固醇、飽和脂肪和非飽和脂肪被嚴重的錯誤分類。結論:這個FFQ能有效地評估馬來人飲食中總能量攝取、總脂肪和不同形式脂肪攝取量。
關鍵字:食物頻率問卷、效度、脂肪、膽固醇、馬來人
 

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Validity of predictive equations for resting energy expenditure among Iranian women
MAHBOUBEH SHANESHIN, AREZOO REZAZADEH, MAHSA JESSRI, TIRANG NEYESTANI AND BAHRAM RASHIDKHANI
Objectives: To determine the resting metabolic rate (RMR) in a sample of Iranian women, and to evaluate the validity of predictive equations for estimating RMR in normal and obese subjects. Methods: This cross-sectional study was conducted on a total of 187 healthy women aged 18-45 years. Anthropometric data were collected and subjects’ RMR was measured by indirect calorimetry for 15 minutes following an overnight fast. RMR was also predicted using various types of formulas based on subjects’ height, age, weight or fat-free mass. Body composition was estimated by bioelectric impedance analysis (BIA). Results: Measured RMR (mean ± SD) was found to be 1473 ± 296 kcal/day. The abbreviation formula overestimated RMR, while other formulas underestimated it. Harris-Benedict formula was valid among all BMI categories (normal weight, overweight, obese and morbidly obese). Two Schofield formulas were valid in normal weight, overweight and morbidly obese subjects; and Cunningham formula was valid only among overweight and obese women. Overweight and obese Iranian women had higher RMR in comparison with normal weight subjects (p<0.01); although after age and weight adjustment, the differences were not significant in any of the BMI categories. Conclusions: The Harris-Benedict for mula provides a valid estimation of RMR at the group level in a range of normal-weight to morbidly obese Iranians. However, at the individual level, errors might be so high that using a measured value has to be preferred over an estimated value.
Key Words: resting metabolic rate, predictive equations, validity, women, energy metabolism
 

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估計伊朗女性休息代謝率公式之效度
目的:測量伊朗女性之休息代謝率(resting metabolic rate, RMR),同時評估適用於正常與肥胖個體的休息代謝率公式之效度。方法:此橫斷型研究,共187 位年齡介於18-45 歲之間之健康女性參與。收集體位資料,及在空腹狀態下,利用間接測卡法(indirect calorimetry)測得RMR。並根據個案之身高、年齡、體重及瘦體組織等資料,使用各種預測公式,計算對應之RMR。體組成資料則是利用生物電阻法(bioelectric impedance analysis, BIA)獲得。結果:實測的RMR 平均為1473 ± 296 kcal/day。使用較簡單的公式傾向高估RMR,而其他公式則會低估。不論受測者的體位分類(正常體重、過重、肥胖和病態肥胖),Harris-Benedict 公式皆能有效估計RMR。兩個Schofield 方程式在正常、過重及病態性肥胖者能有效估計RMR,然而Cunningham 方程式,只有在過重及肥胖者才能有效估計RMR。另外結果也發現,與正常體重的女性相比,過重與肥胖的女性有較高的RMR (p<0.01),雖然在調整年齡與體重後,此差異不顯著。結論:以群體為單位,Harris-Benedict 公式能有效估計體位介於正常至病態性肥胖的伊朗女性。然而,在個人為單位下,誤差可能會提高,因此實測仍優於估計公式。
關鍵字:休息代謝率、預測公式、效度、婦女、能量代謝

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Last Updated: November 2011