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1 Asia Pacific Journal of Clinical Nutrition
       Volume 21, 1

         (March 2012)


Abstracts

Contents

Abstract 摘要

Asia Pacific Clinical Nutrition Society Award for 2012: Citation for Professor Colin Binns
DUO Li
Asia Pac J Clin Nutr. 2012;21(1):i.

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Commentary

The Asia Pacific Journal of Clinical Nutrition: its philosophy and a brief history
MARK L WAHLQVIST
Asia Pac J Clin Nutr. 2012;21(1):1-2.

 

 

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Original Research Communications

Clinical Nutrition Trials or Feeding Studies

Effects of vitamin A, vitamin A plus zinc, and multiple micronutrients on anemia in preschool children in Chongqing, China
LI CHEN, YONG-FANG LIU, MIN GONG, WEI JIANG, ZHEN FAN, PING QU, JIE CHEN, YOU-XUE LIU AND TING-YU LI
Asia Pac J Clin Nutr. 2012;21(1):3-11.

 

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Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled study
SUPATRA PORASUPHATANA, SUTHI SUDDEE, ATINUCH NARTNAMPONG, JULRAHT KONSIL, BUSAKORN
HARNWONG AND ADICHAI SANTAWEESUK
Asia Pac J Clin Nutr. 2012;21(1):12-21.

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Nutritional Status, Dietary Intake, and Body Composition

 

Behavioral change during weight loss program and one-year follow-up: Saku Control Obesity Program (SCOP) in Japan
MAKIKO NAKADE, NAOMI AIBA, NAOMI SUDA, AKEMI MORITA, MOTOHIKO MIYACHI, SATOSHI SASAKI, SHAW WATANABE FOR SCOP GROUP
Asia Pac J Clin Nutr. 2012;21(1):22-34.

 

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Rice intake, weight change and risk of the metabolic syndrome development among Chinese adults: the Jiangsu Nutrition Study (JIN)
ZUMIN SHI, ANNE W TAYLOR, GANG HU, TIFFANY GILL AND GARY A WITTERT
Asia Pac J Clin Nutr. 2012;21(1):35-43.

 

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Decline in anthropometric evaluation predicts a poor prognosis in geriatric patients
RIE TSUTSUMI, YASUO M TSUTSUMI, YOUSUKE T HORIKAWA, YOZO TAKEHISA, TOSHIO HOSAKA, NAGAKATSU HARADA, TOHRU SAKAI AND YUTAKA NAKAYA
Asia Pac J Clin Nutr. 2012;21(1):44-51.

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Macro- Micro and Phyto-nutrients

Low aglycone content in commercial soy drink products
HUONG TT NGUYEN, MO POURIAN, BIRGITTA BYSTRÖM, INGRID DAHLIN, PHAM TM DUC, TUAN V NGUYEN, BO VON SCHOULTZ AND ANGELICA L HIRSCHBERG
Asia Pac J Clin Nutr. 2012;21(1):52-56.

 

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Growth and Child Nutrition

Preferences of healthy and unhealthy foods among 3 to 4 year old children in Mexico
CYNTHIA DE LIRA-GARCÍA, MONTSERRAT BACARDÍ-GASCÓN AND ARTURO JIMÉNEZ-CRUZ
Asia Pac J Clin Nutr. 2012;21(1):57-63.

 

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Interactive effects of family socioeconomic status and body mass index on depression in school-aged children
FU-GONG LIN, YU-HSIN HSIEH AND HO-JUI TUNG
Asia Pac J Clin Nutr. 2012;21(1):64-72.

 

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Risk of asthma associated with energy-dense but nutrient-poor dietary pattern in Taiwanese
children
SHU-CHEN LEE, YAO-HSU YANG, SHAO-YUAN CHUANG, SHAW-CHEN LIU, HSIN-CHOU YANG AND WEN-HARN PAN
Asia Pac J Clin Nutr. 2012;21(1):73-81.

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Maternal and Women's Nutrition

 

Associations of the pre-pregnancy body mass index and gestational weight gain with pregnancy
outcomes in Taiwanese women
I-HSIEN TSAI, CHIH-PING CHEN, FANG-JU SUN, CHIA-HSUN WU, SUNG-LING YEH
Asia Pac J Clin Nutr. 2012;21(1):82-87.

 

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Nutritional Epidemiology and Public Health

 

Continuous metabolic syndrome risk score for predicting cardiovascular disease in the Chinese population
GUO-DONG KANG, LU GUO, ZHI-RONG GUO, XIAO-SHU HU, MING WU AND HAI-TAO YANG
Asia Pac J Clin Nutr. 2012;21(1):88-96.

 

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Validity and reproducibility of a food frequency questionnaire (FFQ) for dietary assessment in Malay adolescents in Malaysia
ABDULLAH NURUL-FADHILAH, PEY SZE TEO AND LENG HUAT FOO
Asia Pac J Clin Nutr. 2012;21(1):97-103.

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Special Report

Symposium on nutrition and cognition: towards research and application for different life stages
DAVID BENTON, PATTANEE WINICHAGOON, TZE PIN NG, E SIONG TEE AND MIA ISABELLE
Asia Pac J Clin Nutr. 2012;21(1):104-124.

 

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The Fourth Asian Network Symposium on Nutrition

 

Program Participants
Asia Pac J Clin Nutr. 2012;21(1):125.

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Overview of nutrition education program for national health promotion in Asian countries: current situation and future direction
SHINKAN TOKUDOME AND SHIGERU YAMAMOTO
Asia Pac J Clin Nutr. 2012;21(1):126-127.

 

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Present status and issues of school nutrition programs in Korea
JIHYUN YOON, SOOYOUN KWON AND JAE EUN SHIM
Asia Pac J Clin Nutr. 2012;21(1):128-133.

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The practices and needs of dietitian in school lunch program in Taiwan
YUECHING WONG AND YU-JHEN CHANG
Asia Pac J Clin Nutr. 2012;21(1):134-138.

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 School meal program in Ho Chi Minh city, Vietnam: reality and future plan
DUC SON NGUYEN TRUNG LE
Asia Pac J Clin Nutr. 2012;21(1):139-143.

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Nurturing healthy dietary habits among children and youth in Singapore
LETTY KWOK CHONG SHIU, WONG MUN LOKE, K VIJAVA AND NIMRTA KAUR SANDHU
Asia Pac J Clin Nutr. 2012;21(1):144-150.

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School meal program in India: background, objectives and components
ALKA MOHAN CHUTANI
Asia Pac J Clin Nutr. 2012;21(1):151-154.

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School lunch program for health promotion among children in Japan
NOBUKO TANAKA AND MIKI MIYOSHI
Asia Pac J Clin Nutr. 2012;21(1):155-158.

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School-based “Shokuiku” program in Japan: application to nutrition education in Asian countries
MIKI MIYOSHI, NOBUYO TSUBOYAMA-KASAOKA AND NOBUO NISHI
Asia Pac J Clin Nutr. 2012;21(1):159-162.

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Future Events

 

Asia Pac J Clin Nutr. 2012;21(1):163.

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Effects of vitamin A, vitamin A plus zinc, and multiple micronutrients on anemia in preschool children in Chongqing, China
LI CHEN, YONG-FANG LIU, MIN GONG, WEI JIANG, ZHEN FAN, PING QU, JIE CHEN, YOU-XUE LIU AND TING-YU LI
This study is to clarify the impact of vitamin A or vitamin A combined with other micronutrients supplementation on anemia and growth in preschoolers. In the present study, a total of 290 preschoolers, aged 36-72 months old were randomly assigned to 3 treatment groups: vitamin A (A group), vitamin A plus zinc (AZ group), and vitamin A combined with additional multiple-micronutrient (AMM group). After 6-month supplementation, the height and height-for-age z-score gains of the AZ group were significantly higher than the other groups; the weight gain of the AMM group was greater than the other groups. Compared with baseline values, the concentrations of hemoglobin, and zinc at the end significantly increased in all 3 groups. The incremental concentrations of hemoglobin in the AMM group were significant higher than in the other two groups. Furthermore, the incremental concentrations of serum retinol in the AMM group, and the increase in serum zinc concentrations in the AZ group were significantly higher, respectively, than in the other groups. These 3 kinds of supplements in the present study are effective in enhancing height gains and are effective in reducing the prevalence of anemia. Supplementation of zinc plus vitamin A is a better way for improving children’s height and height-for-age z-score. Vitamin A combined with multiple-micronutrient is more effective in improving the hemoglobin concentrations in preschool children.
Key Words: anemia, vitamin A, zinc, multiple-micronutrient, supplementation

 

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維生素A、維生素A 加鋅及微量营养素复合补充对中國 重慶的学龄前儿童贫血及体格生长的影响
为进一步明确维生素A(VA)、VA 与其他微量营养素复合补充对学龄前儿童贫血及体格生长的影响,本研究共纳入290 名36-72 个月的学龄前儿童,并随机 分为3 个强化补充组:VA 组(A 组)、VA 加锌组(AZ 组)以及VA 与复合微量营养素组(AMM 组)。强化补充6 个月后,AZ 组受试儿童的身高及身高Z 评分(HAZ)增长显著高于其他两组;AMM 组体重增长优于其余各组;各组受 试儿童血红蛋白(Hb)及血清锌浓度均较补充前明显增加,且AMM 组受试儿 童Hb 浓度增长显著高于其余两组。此外,AMM 组血清VA、AZ 组血清锌浓度增长均显著高于其他各组。3 种不同强化补充方式均能促进受试儿童身高增长并 降低贫血患病率。补充VA 加锌对受试儿童身高及HAZ 的促进作用最优;而补 充VA 与复合微量营养素对改善学龄前儿童Hb 浓度更加有效。
关键词:贫血、維生素A、鋅、复合微量营养素、補充
 

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Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled study
SUPATRA PORASUPHATANA, SUTHI SUDDEE, ATINUCH NARTNAMPONG, JULRAHT KONSIL, BUSAKORN HARNWONG AND ADICHAI SANTAWEESUK
Despite well-controlled blood glucose levels, diabetic complications still inevitably take place via several mechanisms including excessive generation of free radicals in patients who suffer from diabetes mellitus (DM). A randomized double-blind placebo-controlled clinical trial to investigate the effectiveness of oral supplementation of DL-alpha-lipoic acid (ALA) on glycemic and oxidative status in DM patients was conducted. Thirty eight outpatients with type 2 DM were recruited and randomly assigned to either placebo or treatment in various doses of ALA (300, 600, 900, and 1200 mg/day) for 6 months. Following the treatment, all subjects were evaluated for glucose status and oxidative biomarkers. Results showed that fasting blood glucose, HbA1c trended to decrease in a dose-dependent manner. Increase of urinary PGF2alpha-Isoprostanes (F2 -IsoP) was noted in placebo but not ALA-treated groups, indicating possible suppressing action of ALA on lipid peroxidation in DM subjects. 8- Hydroxy-2’-deoxyguanosine (8-OHdG) levels, however, were similar in both placebo and ALA groups as well as urinary microalbumin and serum creatinine. Safety evaluation was monitored and treatment was found to be well tolerated despite some minor side effects. Results from this study reflected the benefits of ALA in glucose status with slight efficiency on oxidative stress-related deterioration in DM patients.
Key Words: alpha-lipoic acid (ALA), diabetes, PGF2alpha-Isoprostanes (F2alpha-IsoP), 8-Hydroxy-2’-deoxyguanosine (8- OHdG), oxidative stress
 

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補充硫辛酸對於第 2 型糖尿病患的血糖和氧化壓力 的影響:隨機雙盲對照研究
對糖尿病患而言,即使血糖獲得良好控制,仍會由於體內自由基過多而誘發併發症。此次隨機雙盲臨床對照實驗想瞭解補充硫辛酸對於糖尿病患者的血糖和氧化壓力的影響。從門診招募38 名第2 型糖尿病患者,隨機分配到安慰劑組或試驗組(硫辛酸劑量分別為每日300、600、900、1200 mg)。實驗進行6 個月。實驗期前後,測量受試者的血糖值和氧化壓力指標。實驗結果顯示隨著硫辛酸服用劑量越高,空腹血糖和糖化血色素有逐漸下降的趨勢。安慰劑組的尿中 F2alpha-IsoP 濃度在實驗期後升高,服用硫辛酸者則未增加,表示硫辛酸或許有助於抑制糖尿病患者的脂肪過氧化作用。然而各組尿液中8-OHdG 及微白蛋白濃度和血清肌酸酐並無明顯差異。安全性評估方面,受試者除一些輕微副作用外,試驗劑量都在可忍受範圍。整體而言,硫辛酸有利於改善糖尿病患者的血糖值,也對防止氧化傷害稍有效益。
關鍵字:硫辛酸、糖尿病、PGFalpha-Isoprostanes(F2alpha-IsoP)、8-羥脱氧鳥苷(8 OHdG)、氧化壓力
 

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Behavioral change during weight loss program and one-year follow-up: Saku Control Obesity Program (SCOP) in Japan
MAKIKO NAKADE, NAOMI AIBA, NAOMI SUDA, AKEMI MORITA, MOTOHIKO MIYACHI, SATOSHI SASAKI, SHAW WATANABE FOR SCOP GROUP
This study evaluated effects of a behavioral approach which placed emphasis on tailored behavior counseling, diet, weight loss and weight maintenance. A one-year randomized controlled trial was conducted among 235 overweight/ obese adults in Japan. The intervention group (n=119) received individual-based counseling using a behavioral approach and the changes made in the diet and physical activity were dependent on each participant as much as possible. One year later, the intervention group lost significantly more weight than the control group (- 5.0 kg vs. 0.1 kg for men and -3.9 kg vs. -0.2 kg for women). Compared to the control group, the male intervention group reduced overall energy, cereals and dairy products consumption significantly, while increasing green and yellow vegetable intake, and the female intervention group significantly reduced intake of dairy products. Regarding behaviors, both male and female intervention groups increased the number of walking steps and women improved their irregular eating habits compared to those in the control groups. Behavior changes were related to weight loss; participants who maintained the action/maintenance stage or moved to later stages lost significantly more weight than participants who remained in the pre-contemplation/contemplation/preparation stages or regressed to earlier stages. After one-year follow-up, the intervention group maintained significantly lower weights, lower energy intakes and improvements in irregular eating habits. Our behavioral approach led to diet and behavior modification, weight loss and maintenance. Because modified variables differed between men and women, gender-specific approaches may be necessary.
Key Words: behavior therapy, body weight changes, randomized controlled trial, follow-up studies, diet
 

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減重計畫期間及一年追蹤期的行為改變:日本的Saku 控制肥胖計畫(SCOP)
此研究為評估行為改變的效應,在行為改善對策中強調個別的行為諮詢、飲食、減重、及體重的維持。有235 位過重或肥胖的日本成人,參與為期一年的隨機對照試驗。其中介入組(119 位)接受個人諮詢,利用行為改善對策,儘可能依據參與者個別情況,建議其飲食及體能活動的改變。一年後,介入組顯著比對照組下降更多體重(男性介入組減5 公斤,對照組增0.1 公斤;女性則兩組分別減3.9 公斤與0.2公斤)。與對照組相比,介入組的男性顯著地減少總能量、穀類及乳製品的攝取,同時增加綠色及黃色蔬菜的攝取;而介入組女性則顯著地減少乳製品的攝取。在行為方面,相較於對照組,介入組男女性皆增加走路的步數,另外介入組女性改善了不規律的飲食習慣。行為的改變與體重降低具有相關;介入組的參與者若保持在行動或持續行動,或進展至行動階段,相較 於仍處於未考慮、考慮或準備階段或退回至行動前階段的參與者,體重下降較顯著。試驗期後追蹤一年,介入組顯著比對照組,維持較低體重、低能量攝取及改善不規律飲食習慣。本研究的行為改善對策,促使飲食及行為的改變、體重減輕並且維持。由於男女性改善的變項不同,顯示可能需要依性別,採取專 一的行為改善對策。
關鍵字:行為治療、體重改變、隨機對照試驗、追蹤研究、飲食

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Rice intake, weight change and risk of the metabolic syndrome development among Chinese adults: the Jiangsu Nutrition Study (JIN)
ZUMIN SHI, ANNE W TAYLOR, GANG HU, TIFFANY GILL AND GARY A WITTERT
Objectives: To examine the association between rice intake, staple food patterns (measured by percentage of rice in staple food (PRS)), weight change and the risk of the metabolic syndrome development. Methods: We followed 1231 adults, aged 20 and older, from 2002 to 2007. Food intake was assessed using a food frequency questionnaire. Body weight, height, waist circumference, blood pressure and fasting plasma glucose and lipids were measured. The metabolic syndrome was defined according to the International Diabetes Federation definition. Results: Rice consumption of ≥401 g/day was associated with less weight gain (-2.08 kg, 95%CI: -2.75, -1.41, p<0.001), and 42% less risk of hypertension, as compared to rice consumption of <200 g/day (p=0.024). A strong linear association between rice intake and hyperglycemia was found: the odd ratios for incident hyperglycemia across rice intake <200, 201-400, ≥401 g/day were: 1, 1.96, 2.50 (95%CI: 1.37, 4.57) (p for trend 0.005). A positive association between rice intake and incident abnormal high-density lipoprotein was observed. There was no association between rice intake and incident high triglycerides. Every 10% increase in PRS was associated with a 0.28 kg less in weight gain, 22% increase in hyperglycemia risk and 9% decrease in hypertension risk. Rice intake and PRS were not associated with the risk of the metabolic syndrome. Conclusion: Rice intake and PRS were inversely associated with weight gain, and PRS was inversely associated with hypertension, but positively associated with fasting blood glucose elevation. No association between rice intake and PRS with the metabolic syndrome was found.
Key Words: rice intake, weight change, the metabolic syndrome, Chinese, cohort study
 

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中国成年人大米摄入及体重变化与代谢综合症风险间的关系研究

目的:分析大米摄入、主食模式(大米占主食的百分比;PRS)及体重变化与代 谢综合症风险间的关系。方法:对1231 名年齡20 岁及以上的成年人进行了五 年跟踪(2002-2007)。食物摄入情况采用食物频率问卷获得。对被调查者进行 体重、身高、腰围、血压、空腹血糖和血脂测量。代谢综合症诊断采用国际糖尿病联盟的标准。结果:与每天摄入大米小于200 克的人群相比,大米摄入量 每天大于401 克的人群,体重增长少2.08 公斤(95%可信区间:2.75-1.41; p<0.001)、高血压风险低42%(p=0.024)。大米摄入和高血糖风险呈线性关 系:大米摄入量水平<200、201-400 及≥401 克/天的高血糖风险OR 值分别为 1、1.96 及2.50 (95%可信区间: 1.37-4.57;趋势效应p=0.005)。大米摄入与高密 度脂蛋白异常发生率呈正相关,但与甘油三酯异常风险无关。PRS 每增加 10%,体重就减少0.28 公斤、高血糖风险增加22%、高血压风险降低9%。大 米摄入、PRS 与代谢综合症风险无关。结论:大米摄入、PRS 与体重增长呈负 相关,PRS 与高血压风险呈负相关,但与血糖升高呈正相关。未发现大米摄入 及PRS 与代谢综合症相关。
關鍵字:大米摄入、体重变化、代谢综合症、中国人、队列研究
 

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Decline in anthropometric evaluation predicts a poor prognosis in geriatric patients
RIE TSUTSUMI, YASUO M TSUTSUMI, YOUSUKE T HORIKAWA, YOZO TAKEHISA, TOSHIO HOSAKA, NAGAKATSU HARADA, TOHRU SAKAI AND YUTAKA NAKAYA
Objective: Malnutrition is frequent in the geriatric population and is often undetected and untreated. Although we often use serum albumin as a nutritional marker, it has limitations in elderly patients in terms of predicting diseases and infections. Anthropometric measurements are not commonly used, despite their simple, easy, and effective characteristics. We evaluated the associations between anthropometric measurements with other nutritional factors and examined its relationship with mortality, decubitus ulcer, length of hospital stay and antibiotic usage. Research methods and procedures: We enrolled 223 patients, performed anthropometric measurements and then followed them for a mean of 24 months. Results: Patients with hypoalbuminemia but with normal body measurements tended to increase serum albumin levels over the next 24 months and had more favorable outcomes including being discharged. Patients with normal albumin but decreased body measurements resulted in a progressive drop in serum albumin and had a higher mortality rate. Additionally, patients with hypoalbuminemia had higher antibiotic usage than patients without hypoalbuminemia. Decreases in anthropometric measurements were related to mortality, length of hospital stay, and decubitus ulcer. Conclusions: Anthropometric measurements are easily obtained and closely associated with mortality, decubitus ulcer, and length of hospital stay. Anthropometric measurements used in conjunction with serum albumin are more predictive of patient outcome then serum albumin alone.
Key Words: renal function, metabolic syndrome, glomerular filtration rate, renal plasma flow, soy protein
 

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體位指標偏低可預測年老病人較差的預後
目的:老年人經常有營養不良的現象,且常未被察覺及治療。雖然血清白蛋白通常被當做一個營養指標,但它對於年老的病人疾病及感染的預測力有限。儘管體位測量簡單、容易及有效,卻不常被使用。我們評估體位測量值與其他營養因素的相關性,並且檢測它們與死亡率、褥瘡性潰瘍、住院天數及抗生素使用量之關聯。研究方法及流程:納入223名病人,執行體位測量,隨後平均追蹤24個月。結果:血清白蛋白偏低但體位測量指數正常的病人,在接下來的24個月裡,血清白蛋白量有增加的趨向,且預後較佳,包括出院。病人有正常的血清白蛋白但是體位測量值偏低者,追蹤結果顯示血清白蛋白值會逐漸降低,且有較高死亡率。此外,血清白蛋白偏低的病人,比起沒有低白蛋白血症者,有較高的抗生素使用劑量。體位測量值偏低與死亡率、住院天數及褥瘡性潰瘍具有相關性。結論:體位測量值較容易取得,並與死亡率、褥瘡性潰瘍及住院天數有密切相關。結合體位測量值與血清白蛋白值,比起單獨檢視血清

白 蛋白,可更佳預測病人出向。
關鍵字:體位測量、老年人、血清白蛋白、死亡率、褥瘡性潰瘍

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Low aglycone content in commercial soy drink products
HUONG TT NGUYEN, MO POURIAN, BIRGITTA BYSTRÖM, INGRID DAHLIN, PHAM TM DUC, TUAN V NGUYEN, BO VON SCHOULTZ AND ANGELICA L HIRSCHBERG
The effectiveness of soy isoflavones to prevent bone loss in postmenopausal women is controversial. While consumption of soy in Vietnam is very high, we recently reported a prevalence of osteoporosis comparable to that of many Western populations. In the present study, we analyzed the isoflavone content of soy drink products commercially available in Vietnam and Sweden, and we also compared these products to “home-made” soy drink from beans of different origin. The amounts of the bioactive aglycones (daidzein, glycitein and genistein) and their glycoside isomers were quantified by high-pressure liquid chromatography. We found that the total isoflavone content was low in all preparations, around 70-100 mg/L and of this only 10% were bioactive aglycones. Of these, the Vietnamese products contained significantly lower levels of glycitein than the products from Sweden and “home-made” soy drink preparations. The results show that consumption of several liters of soy drink per day would be needed to achieve threshold levels for a protective effect on bone. There was no significant association between total protein and isoflavone content in different products. Accurate labeling of soy drink and other products eg of aglycone and glycoside content would allow health professionals and researchers to better explore the possible benefits of soy in dietary intervention studies.
Key Words: isoflavones, HPLC, soy drink, osteoporosis, Vietnam
 

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越南市售黃豆飲品之低異黃酮素含量

對於黃豆異黃酮預防停經後婦女骨質流失之效益仍具有爭議。雖然越南人民攝取高量黃豆製品,但骨質疏鬆盛行率卻與許多西方國家族群相當。本篇研究分析越南與瑞典兩國市售黃豆飲品之異黃酮含量,並選取不同來源黃豆,自製成飲品,以比較它們的異黃酮含量。異黃酮含量以高效液相層析法測量,包括具 生物活性的醣苷配基(aglycones)形式的異黃酮素(木質素黃酮、黃豆素黃酮與金雀素黃酮),以及其醣苷配體異構物。結果發現,總異黃酮素含量在所有製品中皆不如預期,約70-100 mg/L,其中只有10%醣苷配基具生物活性。同時也 發現,越南國內製造的黃豆飲品,所含的黃豆素黃酮(glycitein),顯著低於瑞典 製品以及自製的不同來源之黃豆飲品。這樣的結果顯示,每天必須喝下數公升的黃豆飲品,才能達到可預防骨質流失的黃豆異黃酮量。不同的黃豆飲品之總蛋白質含量與異黃酮量並沒有顯著之相關性。黃豆相關飲料製品應具備更精確 的異黃酮素含量標示,以便未來研究者在飲食介入研究中,能更容易闡明黃豆 相關製品對人體健康之益處。

關鍵字:異黃酮素、高效液相層析、黃豆飲品、骨質疏鬆症、越南

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Preferences of healthy and unhealthy foods among 3 to 4 year old children in Mexico
CYNTHIA DE LIRA-GARCÍA, MONTSERRAT BACARDÍ- GASCÓN AND ARTURO JIMÉNEZ-CRUZ
Objective: To evaluate the preference of healthy and unhealthy foods among pre-school children attending daycare and its association with that of their parents, body mass index and socio-demographic variables. Methodology: We asked children and parents to depict their food preferences through 54 pictures of different food items. The association between the preferences and socio-demographic variables was done using the Phi correlation, chi-squared, Fisher’s correlation, as well as univariate and multivariable logistic regression. Results: Twohundred and sixty-five parent-child pairs participated in the study. Ice cream, potato chips and lollypops were the foods most preferred by children. On the other hand, quince jelly, coffee and avocado were the least preferred. Overweight and obese children had a higher preference for quince jelly, preserved fruits, and vegetable soup. With univariate logistic regression, children of low-income homes (OR= 2.56, p=0.007) and attending public daycare centers (OR= 6.2, p=0.0001) preferred less healthy fruits. When the father’s education was added in a multivariable model including family income, only children whose fathers had ≤9 years of education showed a higher preference for less healthy food. When parent’s education, family income, and parent’s preference for healthy foods were included to the model only children attending public daycares were more likely to prefer healthy foods. Conclusion: The foods most preferred by children have a high caloric density. The children’s body mass index, their parent’s monthly income, the father’s education and the type of daycare they attended were associated with the preference of healthy or unhealthy foods.
Key Words: food preferences, preschool children, over-weight, obesity, Mexico
 

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墨西哥3 至4 歲小孩喜愛的健康及不健康食物
目的:評估日間照護的學齡前兒童喜好的健康及不健康食物,以及這與他們的父母、身體質量指數及社會人口學變項之相關性。方法:透過54張不同食物項目的圖片,詢問兒童及父母親的食物喜好。這些喜好與社會人口學變項的相關性以Phi相關、卡方檢定、費雪氏相關以及單變項和多變項邏邏輯斯迴歸分析。結果:265對父母親與兒童參與這個研究。冰淇淋、洋芋片及棒棒糖是兒 童最喜愛的食物。相反地,榅桲果凍、咖啡及酪梨是最不受歡迎的食物。體重 過重或是肥胖的兒童較喜愛榅桲果凍、蜜餞及蔬菜湯。由單變項邏輯斯迴歸分 析,顯示低收入家庭(OR=2.56, p=0.007)和參加公立托兒所(OR=6.2, p =0.0001)的兒童喜愛低健康的水果加工品。當父親的教育程度加入包含家戶收入的多變項模式中,只有父親受教育少於9年的兒童,顯示較喜愛低健康食物。當父母親教育程度、家戶收入及父母親喜愛健康食物一起放入模式中,只有加入公立 托兒所的兒童較可能傾向健康食物。結論:最受兒童喜愛的食物都是較高熱量 密度的。兒童的身體質量指數、父母親的月收入、父親的教育程度及日間照護 的形式,與他們喜愛健康或不健康食物具有相關性。
關鍵字:食物喜好、學齡前兒童、體重過重、肥胖、墨西哥


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Interactive effects of family socioeconomic status and body mass index on depression in school-aged children
FU-GONG LIN, YU-HSIN HSIEH AND HO-JUI TUNG
Depression is an important health problem in children and the onset of depression is occurring at a younger age than previously suggested. The associations of being overweight and low socioeconomic status in childhood depression have been well documented; nevertheless few studies have addressed the combined effects of socioeconomic status and body weight, with depression in school-age children. We intended to examine if the relationship between socioeconomic status and childhood depression could be modified by abnormal body weight. A cross-sectional study was performed with a total of 559 subjects from 29 elementary schools in Taiwan. A depression scale was used to determine the depression status. Children receiving governmental monetary assistance for after-school class were categorized as being in the lower socioeconomic group. Data for depression-related demographic characteristics, family and school variables were collected. Children in the lower socioeconomic status group have a higher prevalence of depression (23.5%) than those in higher socioeconomic status groups(16.4%). Being overweight demonstrates the opposite effect on depression risk in the different socioeconomic groups. In lower socioeconomic families, the risk of depression in overweight children is three times higher than that for normal weight children; whereas in higher socioeconomic families, overweight children have a lower risk for depression than normal weight children. We concluded that a qualitative interactive effect existed between being overweight and socioeconomic status with childhood depression. More attention should be paid to overweight children from lower socioeconomic status families to prevent depression in school-age children.
Key Words: depression, socioeconomic status, body mass index, interaction, elementary school
 

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學齡兒童的家庭社經狀況與身體質量指數對憂鬱的交互 影響
近年來,憂鬱發生的年齡層逐漸下降,憂鬱也成為兒童心理健康的一個重要課題。與兒童憂鬱攸關的重要因素,如體重、家庭社經地位等陸續被提出,然而對於體重與社經地位兩者對兒童憂鬱的交互作用則較少被研究,本篇研究主要 目的為檢驗社經地位對兒童憂鬱的影響是否會隨著兒童體重的不同而改變。研究設計為橫斷式研究,樣本來自台灣苗栗縣29 所小學,3-6 年級共計559 位學 童,分別收集人口學、家庭與學校相關之變項,兒童憂鬱情形以「兒童及青少年憂鬱篩選量表」測量。接受政府課後安親班補助的學童定義為較低社經地位 者。結果發現家庭社經地位較低之學童,相對於較高社經地位學童,有較高之鬱比率(23.5%比16.4%)。學童過重的因素對於憂鬱風險,在不同社經地位間則呈現迴異的修飾效果,在家庭社經地位較低的學童,體位過重者憂鬱的風險 為正常體位學童的3倍;但在較高社經地位家庭的學童,體位過重反而呈現出對憂鬱風險的保護作用。由結果可看出學童體位過重與家庭社經地位間呈現出 一質性的交互作用,在低社經地位家庭中,學童體位過重者為憂鬱的高風險族 群,需要更加注意其心理健康的發展。
關鍵字:憂鬱、社經狀況、身體質量指數、交互作用、小學

 

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Risk of asthma associated with energy-dense but nutrient-poor dietary pattern in Taiwanese children
SHU-CHEN LEE, YAO-HSU YANG, SHAO-YUAN CHUANG, SHAW-CHEN LIU, HSIN-CHOU YANG AND WEN-HARN PAN
Childhood asthma has rapidly increased over the past few decades, possibly due to changes in lifestyle and dietary patterns. We aimed to determine associations between dietary patterns and asthma in schoolchildren in Taiwan. The Nutrition and Health survey in Taiwan Elementary School Children was carried out by using a multistaged complex sampling design. A total of 2,082 elementary school children with complete data on dietary, lifestyle, demographics and asthma were included in the analysis. We used a Chinese version of the International Study of Asthma and Allergies in Childhood questionnaire to generate an asthma symptom score and to define asthma outcomes. Dietary intake was assessed by a food frequency questionnaire. Reduced rank regression (RRR) was used to identify the dietary pattern associated with the asthma symptoms score. Asthma outcomes included; current asthma, current severe asthma, nocturnal cough, exercise-induced wheeze and asthma ever. The RRRderived dietary pattern was characterized by high consumption of fast foods, high-fat snacks, candy, and cheese; and low consumption of fruit, vegetables and rice. The RRR-derived dietary pattern was associated with an increased risk of current asthma (OR [95% CI]) (2.42 [1.19-4.93] for Q4/Q1, p-for-trend=0.01), current severe asthma (3.21 [1.11-9.25] for Q3/Q1, 4.45 [1.59-12.5] for Q4/Q1; p-for-trend=0.003), and nocturnal cough (1.79 [1.06-3.05] for Q2/Q1, 1.74 [1.02-2.97] for Q3/Q1, 1.82 [1.07-3.11] for Q4/Q1; p-for-trend=0.049). Our results suggest that a diet with a high intake of fat and simple sugars and low intake of fruit, vegetables and rice is associated with an increased risk of asthma in Taiwanese children.
Key Words: asthma, children, dietary pattern, risk factors, reduced rank regression
 

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高熱量與營養素貧乏的飲食型態會增加學童的氣喘罹 患風險
小兒氣喘盛行率在過去幾十年間快速增加,研究認為可能與生活形態與飲食習 慣的改變有關。本研究目的在探討台灣國小學童之飲食與氣喘的相關性。研究 分析的資料來源為臺灣國小學童營養健康狀況調查(2001-2002),共2082位具有完整飲食、生活形態、社會人口學及氣喘資料的學童資料納入分析。使用中 文版的國際兒童氣喘過敏研究標準問卷產生氣喘症狀分數,並定義氣喘狀況, 包括:目前有氣喘、嚴重氣喘、深夜乾咳、運動後誘發氣喘及曾經被診斷有氣 喘。飲食的攝取狀況則以飲食頻率問卷進行評估。以減維度迴歸分析法來找尋 與氣喘症狀分數有關的飲食型態。本研究歸納出與氣喘最有相關的飲食型態特徵為:攝取高頻率的速食、高脂零食、糖果及乳酪,及低頻率的蔬菜、水果與 米飯。分析結果顯示此飲食型態會增加氣喘、嚴重氣喘及深夜乾咳的罹患風 險。因此,本研究指出多攝取油脂及精緻糖、少攝取蔬菜水果及米飯的飲食型 態,可能增加台灣學童罹患氣喘的風險。
關鍵字:氣喘、兒童、飲食型態、危險因子、減維度迴歸分析


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Associations of the pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in Taiwanese women
I-HSIEN TSAI, CHIH-PING CHEN, FANG-JU SUN, CHIA-HSUN WU, SUNG-LING YEH
BACKGROUND: Pre-pregnancy weight and gestational weight gain (GWG) are important factors in both maternal and infant outcomes. Little information is available in relation to different levels of pre-pregnancy body mass index (BMI) and body weight gain on obstetric outcomes in Taiwan. This study investigated the associations between pregnancy complications with pre-pregnant BMI and GWG, in Taiwanese women. METHODS: Data were extracted from a delivery room information bank on all women delivering singleton babies in a medical center. Eight hundred and sixty pregnant women were included. The collected variables included basic information, GWG, and pregnancy and neonatal outcomes. Pregnant women were categorized according to their pre-pregnant BMI and GWG to evaluate the impacts of pre-pregnant BMI and maternal weight gain on the risk of pregnancy complications. Univariate and multivariable logistic regression analyses were performed, and odds ratios were calculated. RESULTS: Pre-pregnancy BMI≥24 kg/m2 increased the risks of gestational diabetes mellitus, preeclampsia, and preterm labor. Preeclampsia and Cesarean delivery were positively associated with high weight gains (>18 kg), whereas a low birth weight and preterm labor were strongly associated with low weight gains (<10 kg). A higher birth weight was found with a GWG of >14 kg in women who were underweight and normal weight before pregnancy. CONCLUSION: An appropriate maternal BMI (18.5-24 kg/m2) at conception followed by a suitable gestational weight gain (10-14 kg) has substantial impact on the overall health of pregnant women and would lead to better obstetric management for Taiwanese women.
Key Words: body mass index (BMI), pre-pregnancy weight, gestational weight gain (GWG), pregnancy outcomes, low birth weight
 

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懷孕前身體質量指數及懷孕期體重增加量與台灣孕婦懷孕結果相關性之研究
背景:懷孕前體重及懷孕期體重增加量對產後母親及嬰兒併發症的發生有非常重要的影響。但是在台灣,懷孕前身體質量指數與懷孕期體重增加量對懷孕結果的相關資料很少,故本研究探討台灣懷孕婦女其懷孕前不同身體質量指數與 懷孕期體重增加量對懷孕結果的相關性。方法:這是一個回顧式的世代研究,符合本研究個案數為860名。資料來源為某醫學中心建置之產房資料庫,輔以病歷查詢,內容包括孕婦基本資料、懷孕前身高與體重、懷孕期體重變化、懷孕期併發症等。孕婦根據其懷孕前身體質量指數,及懷孕期體重增加量分組,來評估不同身體質量指數及體重增加量對懷孕期風險指標的相關性。本研究使用多元邏輯迴歸分析法,並計算勝算比。結果:當產婦懷孕前身體質量指數≥24kg/m2,其發生懷孕型糖尿病、子癇前症及早產的風險增加。懷孕期體重增加量≥18公斤與發生子癇前症及剖腹產的風險呈正相關。而懷孕期體重增加量<10公 斤則與嬰兒早產及出生體重過低的風險有強相關性。懷孕前體重過輕或正常而懷孕期間體重增加量>14 公斤與嬰兒體重過重相關。結論:孕婦在懷孕前有適 當的身體質量指數(18.5-24 kg/m2),且懷孕期間體重增加量維持在10-14 公斤, 對於懷孕婦女整體的健康狀況有正面影響並有較佳的懷孕結果。
關鍵字:身體質量指數、懷孕前體重、懷孕期體重變化、懷孕結果、低出生體

 

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Continuous metabolic syndrome risk score for predicting cardiovascular disease in the Chinese
population

GUO-DONG KANG, LU GUO, ZHI-RONG GUO, XIAO-SHU HU, MING WU AND HAI-TAO YANG
Although the metabolic syndrome (MetS) is a predictor of cardiovascular disease (CVD), the current dichotomous definition of MetS cannot be used to evaluate context-specific identification or for efforts to reduce the risk of CVD in the population. In this study, we assigned MetS a continuous risk score for predicting the development of CVD. In total, 3,598 participants recruited from the Jiangsu Province of China were followed for a median of 6.3 years. A total of 82 participants developed CVD during the follow-up period. Receiver operating characteristic (ROC) curve was used to analyze the association between components of MetS and CVD. The results show that systolic blood pressure (SBP) was associated with CVD more intimately (area under receiver-operator characteristic curve (AUC)=0.72, 95% confidence interval (CI), 0.66-0.77) than other features of MetS. When each MetS component was assigned according to the magnitude of regression coefficients in the Cox regression hazard model, the AUC of the continuous MetS risk score (AUC=0.80, 95% CI, 0.75-0.84) exceeded that of the dichotomized definition of MetS (AUC=0.63, 95% CI, 0.56-0.69) (p<0.01). The incidence of CVD increased with the MetS risk score. This prospective cohort study suggests that the use of continuous MetS risk score would significantly improve the capability for predicting the development of CVD compared to current definition of MetS. Further, the appropriate cut-off points need to be verified in other races and regions.
Key Words: the metabolic syndrome, cardiovascular disease, risk factors, prospective study, receiver operating characteristic curve

 

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應用連續性代謝綜合征評分預測中國人群心血管疾病發病風險
儘管代謝綜合征(MetS)是心血管疾病(CVD)的一個預測因子,但目前代謝綜合 征的二分法歸類無法用來評估心血管疾病特定風險或用於減小CVD 發病的風 險。在本研究中,賦予代謝綜合征連續性的風險評分,並應用來預測CVD 的病風險。共納入3598 名來自中國江蘇省的研究對象,隨訪的中位年限為 6.3 年。隨訪期間共發生心血管疾病82 例。利用接受者操作特徵曲線(ROC)來 分析MetS 與CVD 的關係。結果顯示收縮壓(SBP)較其他組分與CVD 的關係 更為密切;曲線下面積(AUC)=0.72,95%可信區間:0.66-0.77。根據COX 回 歸風險模式的回歸係數對MetS 各組分進行評分,結果連續性MetS 評分的曲線下面積(AUC=0.80,95%可信區間:0.75-0.84)超過MetS 二分法歸類的面積 (AUC=0.63,95%可信區間:0.56-0.69)(p<0.01)。CVD 發病率隨著MetS 評分 增加。本研究顯示,連續性MetS 評分比起當前的MetS 定義更有助於提高 CVD 發病風險的預測能力。代謝綜合征各組分合理的切點需要在其他人種和區進一步證實。
關鍵字:代謝綜合征、心血管疾病、危險因素、前瞻性研究、接受者操作特徵曲線
 

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Validity and reproducibility of a food frequency questionnaire (FFQ) for dietary assessment in Malay adolescents in Malaysia
ABDULLAH NURUL-FADHILAH, PEY SZE TEO AND LENG HUAT FOO
Background: Food frequency questionnaire (FFQ) must be tailored to the target populations because dietary habits vary within the populations due to differences in cultural and lifestyles practices. Limited information is available to assess the validity of FFQ used among Malaysian adolescents. Objective: To construct the validity and reproducibility of a newly developed FFQ in assessing habitual nutrients intake over the past year of 170 Malay adolescent boys and girls in Kelantan, Malaysia. Methods: The FFQ that consisted of 124 food items was assessed, whereas three days of 24-hours dietary recalls (DR) was administered as the standard criteria method. Results: Estimated mean intake for most nutrients assessed by the FFQ were higher as compared to the three DRs (p<0.05). Pearson correlation coefficients for energy-adjusted nutrients intake between both methods were ranged from 0.22 (zinc) to 0.68 (calcium) with a median r-value of 0.43. The cross classification of quartile analysis showed that most nutrients were classified into the same or adjacent quartiles (median=52.7%). For the reproducibility of FFQ, the correlation of nutrients ranged from 0.43 for carotene to 0.86 for total fat intake (median= 0.67), after adjusting for total energy intake. Conclusion: The newly developed dietary FFQ is a relatively good and valid tool in assessing habitual nutrients intake for the past year among Malay adolescents in Malaysia.
Key Words: Food frequency questionnaire (FFQ), 24-hours dietary recall, validity, reproducibility, adolescents
 

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馬來西亞的馬來青少年膳食評估的飲食頻率問卷效度及信度
背景:由於文化及生活習慣的差異,使得族群間的飲食習慣多樣化,因此飲食頻率問卷必須設計至適用於目標族群。很少研究評估馬來西亞青少年的飲食頻率問卷之效度。目的:以新發展的飲食頻率問卷評估170名馬來西亞吉蘭丹州(Kelantan)的馬來青少年過去一年的慣常營養素攝取量,並建構其效度及信度。方法:評估由124個食物項目組成的飲食頻率問卷,並以三天24小時飲食紀錄當作黃金標準。結果:以飲食頻率問卷估算的大部分營養素平均攝取量高於三天的飲食紀錄(p<0.05)。兩者的熱量校正營養素攝取量,皮爾森積差相關係數範圍從0.22(鋅)到0.68(鈣),中位數r值為0.43。以四分位分組分析顯示,大部分的營養素被分類到同一組或相鄰組別(中位數=52.7%)。飲食頻率問卷的信度,在校正總熱量攝取量後,營養素相關性範圍從胡蘿蔔素的0.43到總脂肪攝取的0.86(中位數=0.67)。總結:評估馬來西亞的馬來青少年過去一年的日常營養素攝 取量,這個新發展的飲食頻率問卷是一個相當良好且有效的工具。

關鍵字:飲食頻率問卷(FFQ)、24 小時飲食紀錄、效度、信度、青少年
 

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Symposium on nutrition and cognition: towards research and application for different life stages
DAVID BENTON, PATTANEE WINICHAGOON, TZE PIN NG, E SIONG TEE AND MIA ISABELLE
A Symposium on Nutrition and Cognition: Towards Research and Application for Different Life Stages was held on October 2010 in Malaysia. The influence of diet and nutrition on the cognitive development of the child and on cognitive decline in later life was reviewed. Central to the study of such topics is the assessment of cognitive functioning. Cognitive functioning falls into six main areas: executive functioning, memory, attention, perception, psychomotor and language skills, although each domain can be further subdivided. As it is in the nature of human functioning that the performance on any cognitive test can reflect aspects of many of these domains, ideally a battery of tests should be used to establish the basis of any difference in performance. In intervention studies, frequently there has been a failure to demonstrate a beneficial influence of changes in diet. A possible reason is that studies have failed to acknowledge the time scale and critical ages over which diet has an impact. Diet may have a slow and progressive influence making it difficult for short-term studies to show an improvement. In addition, as many factors influence human behaviour, dietary interventions should only be one part of a coordinated approach; the effect of diet will depend on the social and psychological context in which an individual lives. Placing diet into a broader social and psychological context greatly increases the chance of generating significant findings. This report highlights and reviews presentations and discussions at the symposium.
Key Words: aging, brain development, cognition, cognitive decline, nutrition
 

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營養與認知研討會:關於不同生命期的研究與應用
於 2010 年10 月在馬來西亞舉辦「營養與認知研討會:關於不同生命期的研究與應用」。回顧飲食與營養對兒童認知發展及生命後期認知衰退的影響。這類主題的研究,其關鍵點在認知功能的評估。認知功能主要包含六個領域:執行功能、記憶、專注力、理解力、知動能力及語言能力,每個領域還可進一步細分。由於人類功能的自然本質,任何認知測驗皆反映數項功能領域的綜合表現;理想的作法,應該用一系列的測試來呈現認知表現的任何差異。在介入性研究中,經常未能顯現飲食改變的有利影響;一個可能原因是研究無法確認飲食效益的時間範圍和關鍵年齡。飲食的影響是緩慢漸進的,使得短期研究很難看到有所改善。此外,因為許多因子會影響人類行為,飲食介入應只是整體對策的一部分;飲食的效應依個人生活的社會與心理情況而有所不同。將飲食放 在較廣的社會與心理層面上,會大大提昇產生重要發現的機會。本篇報告就研討會中的簡報與討論做重點描述與回顧。
關鍵字:老化、腦部發展、認知、認知衰退、營養

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Present status and issues of school nutrition programs in Korea
JIHYUN YOON, SOOYOUN KWON AND JAE EUN SHIM
School nutrition programs are essential for children’s long-term nutrition and health promotion. The last decade has been the most dramatic years in the history of school nutrition programs in Korea. The percentage of schools serving school lunches reached almost 100% in 2003. In 2006, School Meals Act was significantly revised after serial outbreaks of food-borne illness among students having eaten school lunches. The safety and nutritional quality of school meals had remained as the biggest issue until the middle of 2000s, and then eco-friendly and universal free school lunches have become the main issues related to school meal service and are still under debate. Implementation of the Nutrition Teacher System in 2006 was the turning point of school-based nutrition education in Korea. In addition, two new laws, Special Act on Children’s Dietary Life Safety Management of 2008 and Dietary Life Education Support Act of 2009, started to make meaningful changes in school nutrition environment and practices. The next decade is expected to be very critical in the development of school nutrition programs in Korea as the new systems and laws are to be settled. Significant effort is needed from both the academia and the field to make the related issues to be debated and answered to progressive direction for the school nutrition programs in Korea.
Key Words: school nutrition, school lunch, school meals, nutrition education, nutrition teacher
 

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韓國學校營養系統的目前狀況和議題
學校營養系統對兒童長期營養及健康促進是必要的。過去十年韓國的學校營養系統歷史有劇烈的變化。在2003 年,提供午餐的學校幾乎達到100%。但是2006 年,在食用學校午餐的學童間連續爆發食物中毒後,學餐法案被大幅度修 訂。迄2000 年代中期,學餐的安全性及營養品質仍然是最大的議題;之後生態友好和全面性免費學校午餐變成學校供餐相關的主要議題,且仍在爭議中。韓國於2006 年執行營養教師系統,這是以學校為基礎的營養教育之轉捩點。此外,兩項新的法案,2008 年的兒童飲食生活安全管理特別法案和2009 年的飲食生活教育支持法案,開始讓學校營養環境及實踐有明顯的改變。韓國在學校營養系統的發展,預期下一個10 年將是非常關鍵的,因為這些新的系統及法律將被實施並檢驗。需要學術理論和實際執行雙方面的努力,提出相關的議題, 加以討論並解答韓國學校營養系統的進步方針。
關鍵字:學校營養、學校午餐、學餐、營養教育、營養教師
 

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The practices and needs of dietitian in school lunch program in Taiwan
YUECHING WONG AND YU-JHEN CHANG
Nutrition-related problems among school-age children nowadays become potentially serious. In order to prevent obesity and other nutritionally related diseases in the young generation, a school lunch program has been proposed and conducted in Taiwan. It is to ensure that students’ nutritional intake meets the daily requirement and to help students develop correct eating habits and maintain a healthy lifestyle. A professional dietitian who has a clear concept regarding food material utilization, cooking methods and nutritional values thus becomes important. However, the majority of schools in Taiwan are unable to offer the post of dietitian due to budgetary constraints and lack of organization. The responsibility of a dietitian is usually held by teachers, school nurses and other administrative staff. This problem has hindered the nutritional education in schools and made school lunches less beneficial to the children’s nutritional needs. For the current status of dietitians in schools, a large gap is found between the currently supplied school lunches and the nutritionally standardized school lunches. It also exists in relation to education and hygiene. One of the solutions requires an infrastructure to support plans and policy, reasonable adequate budget, well human affairs establishment and coordination of all aspects. While the needed infrastructure is being proposed, an access to the professionalism of the currently employed dietitians can bestrategically explored by constructing an education system. Through the system, schools without on-campus dietitians will be able to utilize their expertise with which the improvement of school lunches can be expectedly accomplished.
Key Words: dietitian, school-age children, school lunch program, nutritional education, Taiwan

 

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營養師於台灣學校營養午餐計畫中的業務及需求
現今營養相關問題在全世界學齡兒童間日益嚴重。為了預防年輕世代的肥胖及其他營養相關疾病的發生,因此在台灣,大部分學校均有開辦營養午餐計畫,以確保學生的飲食攝取有符合營養需求量,且可幫助學生發展正確的飲食習慣及維持健康的生活型態。專業營養師對於食材選用、烹調方法及營養價值具有整的概念。然而在台灣因為預算不足及缺乏整體組織規劃,大部分的學校並 沒有聘用專職營養師,營養師的工作通常由老師、校護或行政人員兼任。這個現象不僅不利學校的營養教育,且影響學生的營養素需求。由於缺乏營養師的狀況,目前台灣學童營養午餐實際攝取量與衛生署所建議的攝取量有相當大落差,且存在有教育及衛生方面的問題。解決這些問題的方法,除了需要建立基設施來支持這些計畫及政策外,更需要有合理足夠的預算、良好的人事聘用 制度及加強各單位的協調。然而在這些制度尚未完全落實之前,建議應該建立 一個資源共享平台,將目前已聘任的營養師,透過研討會上課的方式將其專業傳遞出去,使沒有聘任專職營養師的學校,可以透過這個分享系統,改善學校 營養午餐的品質。
關鍵字:營養師、學齡兒童、學校營養午餐、營養教育、台灣


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School meal program in Ho Chi Minh city, Vietnam: reality and future plan
DUC SON NGUYEN TRUNG LE
The socio-economic status in Vietnam has developed during the past decades. People become busier for work, and thus they do not have enough time to prepare meal for their children. The school meal program, organized by Department of Education, was first implemented at a kindergarten in 1977, which has been extended to elementary school since 1980. Up to date, 100% of kindergarten and approximately 90% of elementary schools have school meal programs. The purposes of this program are to provide appropriate meals for students, and to serve as education and communication tool for students. About 90% of school meals are prepared in the school’s kitchen and the rest are provided by food companies. The weekly menu provides approximately 30% of recommended dietary allowances (RDA) for students. To date, there has been is no official dietitian training school in Vietnam. The head of school kitchen, who is not dietitian, is required to participate in a short-term training course, where s/he learns basic nutrition, nutrition requirements and food hygiene and safety. The food companies, which provide meals to school, must be approved for the hygiene and safety condition by the Human Health Services Department of Ho Chi Minh City. In the next plan of national nutrition strategy, establishing dietitian training schools will be prioritized. In addition, the regular nutritional surveillance for school-aged students will be introduced in school system thus we can develop and evaluate the school meal program in terms of nutrients, food safety and nutrition education.
Key Words: School meal program, school kitchen, elementary school, dietary intake, Vietnamese children
 

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越南胡志明市的學餐系統:現況和未來計畫
越南在過去幾十年,社經狀況快速發展。人們變得忙於工作,而沒有足夠的時間為他們的小孩製備餐點。學餐系統由教育局所統籌,於1977 年在幼稚園開始執行,從1980 年後已經擴大至小學。時至今日,100%的幼稚園及90%的小學有學餐系統。這個系統的目的為供應學生適當的餐點,並做為教育及傳訊工具。大約90%的學餐是在學校的廚房製備,而其餘是由食品公司所供應。每周餐點提供學生約占30%的膳食建議攝取量(RDA)。至今,越南還沒有正式營養師訓練學校。學校廚房的領導者,並非營養師,必須要參與短期訓練課程,以學習基礎營養、營養需求及食物衛生與安全。提供餐點給學校的食品公司,則必須通過胡志明市衛生局的衛生安全核可。下一個全國性營養政策將優先建立營養師訓練學校。此外,將在學校系統導入學齡兒童的定期營養監測,如此可以發展及評估學餐系統的營養、食物安全及營養教育。
關鍵字:學餐系統、學校廚房、小學、飲食攝取、越南兒童
 

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Nurturing healthy dietary habits among children and youth in Singapore
LETTY KWOK CHONG SHIU, WONG MUN LOKE, K VIJAVA AND NIMRTA KAUR SANDHU
Healthy diet is a key tenet in the prevention of many chronic diseases. Nurturing healthy dietary habits is especially important in childhood as this is a critical period of growth and development. Furthermore, dietary habits are shaped from an early age with many of them forming even below the age of 5 years. Therefore, the importance of nurturing healthy dietary habits during a child's formative years cannot be underestimated. Reducing fat, salt and sugar intake and at the same time, advocating the consumption of adequate whole-grains, fruit and vegetables among the population remain the cornerstone of the Singapore Health Promotion Board's (HPB) key nutrition initiatives. To achieve this, HPB adopts a multi-pronged approach comprising various strategies to promote healthy eating among children and youth in Singapore. This article provides an overview of these strategies and the broad range of nutrition education efforts targeted at the young.
Key Words: health, diet, children, youth, health promotion

 

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培養新加坡的孩童和青少年健康的飲食習慣
健康飲食對預防疾病扮演很重要的角色。在童年時養成健康的飲食習慣特別重要,因這是生長和發育的關鍵時期;而且飲食習慣很早便會形成,甚至是五歲之前。所以,我們絕對不能輕視培養孩童健康飲食習慣的重要性。減少脂肪、鹽份和糖份的攝取;同時提倡大眾攝取足夠的全穀、水果和蔬菜是新加坡保健促進局營養推廣的重點。要達到這個目的,保健促進局採用多方位的方式,以不同的策略來向新加坡的孩童和青少年推廣健康飲食。這篇文章敘述了這些針對青少年的策略及多元化的營養教育活動。
關鍵字: 健康、飲食、孩童、青少年、健康推廣
 

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School meal program in India: background, objectives and components
ALKA MOHAN CHUTANI
The School Lunch Program in India (SLP) is the largest food and nutrition assistance program feeding millions of children every day. This paper provides a review of the background information on the SLP in India earlier known as national program for nutrition support to primary education (NP-NSPE) and later as mid day meal scheme, including historical trends and objectives and components/characteristics of the scheme. It also addresses steps being taken to meet challenges being faced by the administrators of the program in monitoring and evaluation of the program. This program was initially started in 1960 in few states to overcome the complex problems malnutrition and illiteracy. Mid Day Meal Scheme is the popular name for school meal program. In 2001, as per the supreme court orders, it became mandatory to give a mid day meal to all primary and later extended to upper primary school children studying in the government and government aided schools. This scheme benefitted 140 million children in government assisted schools across India in 2008, strengthening child nutrition and literacy. In a country with a large percent of illiterate population with a high percent of children unable to read or write; governmental and non-governmental organizations have reported that mid day meal scheme has consistently increased enrollment in schools in India. One of the main goals of school lunch program is to promote the health and well-being of the Nation’s children.
Key Words: Mid Day Meal Scheme, malnutrition, education, India, literacy

 

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印度的學校午餐系統:背景、目標及構成要素
印度學校午餐系統(SLP)是最大的食品營養協助系統,每天供給數以千萬的學童。此篇文章提供印度SLP 的背景資訊回顧,涵蓋早期已知的如全國性對小學的營養支持(NP-NSPE)計畫,及後來的午餐供食計畫,包含這個系統的歷史演進、目標和構成要素/特性。也討論行政人員在監測及評估此系統時所遭遇的挑戰及採取的決策。學校午餐系統始於1960 年代,最初在少數幾個州實施,以克服營養不良及未受教育的複雜問題。午餐供食計畫是學餐系統的通俗名稱。在2001 年,由最高法院下令,強制性供應午餐給所有公立及政府資助的小學之學童,後期更擴大到初級中學的學生。這個計畫在2008 年加惠1 億4 千萬學童,遍及全印度的政府扶助之學校,增強兒童的營養及識字率。在印度這個國家有高比例的文盲人口及高比例的兒童無法讀或寫;政府與非政府組織都報告午餐供食計畫穩定地增加就學率。學校午餐系統主要的目標之一為促進全國兒童的健康及福祉。
關鍵字:午餐供食計畫、營養不良、教育、印度、識字
 

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School lunch program for health promotion among children in Japan
NOBUKO TANAKA AND MIKI MIYOSHI
In Japan, the present school lunch program has been implemented under the “School Lunch Act” enacted in 1954. The main purpose of the school lunch program is to promote healthy development of the minds and bodies of school children. Later, “The School Lunch Act” was revised in 2008 and its aim was changed to “promoting Shokuiku”. As of May 2009, approximately 10 million school children participate in the school lunch program. This program itself is an educational activity. School children are responsible for serving lunch and clearing the dishes. They could also learn proper manners, by having meals together with classmates. Furthermore, understanding of balanced diet and food culture can be enhanced through learning the menu of each meal. Recently, as eating disorders and obesity increase among adults and school children, there is rising concern on development of lifestylerelated diseases. Under this circumstance, the Basic Law on Shokuiku was enacted in 2005. Besides, in order to enhance Shokuiku to school children, the Ministry of Education, Culture, Sports, Science and Technology established the Diet and Nutrition Teacher System in April 2007. It is reprted that, in those schools with Diet and Nutrition Teachers, a positive impact has been observed in terms of awareness and interest in diet among teachers and guardians. It is also reported that proportion of children skipping breakfast has decreased, and quality of life has been improved. In this way, the Japanese school lunch program system is essential for fostering healthy mind and bodies for the next generation.
Key Words: school lunch program, The School Lunch Act, Shokuiku, Diet and Nutrition Teacher, Japan
 

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日本學童午餐健康促進計畫
目前日本已根據 1954 年的學校午餐法案,執行學校午餐計畫。學校午餐計畫的主要目的為促進孩童心智及體位健康發展。稍後學校午餐法案在2008 年根據促進飲食營養教育(Shokuiku)之目的而改版。在2009 年9 月,大約一千萬名學童參與學校午餐計畫。此計畫本身是一種教育活動,孩童必須負責午餐服務及清潔餐具,同時讓孩童與同儕共進午餐,學習適當的用餐禮儀。此外,也透過每一餐的菜單,加強孩童了解均衡飲食及食物文化的重要性。近年來,成人與孩童飲食失調及肥胖的情況有增加的情況,因此與生活型態相關疾病的發生越來越受到關切。這樣的情況下,日本於2005 年制定飲食與營養教育基本法案。更為了加強學校孩童飲食營養教育,文部科學省在2007 年4 立飲食與營養教師系統。根據報告,學校有飲食與營養教師後,提升了學校教師與孩童監護者對飲食的注意及興趣。另外也發現,不吃早餐的孩童比例有下降的趨勢,其生活品質也得到改善。因此,日本學校午餐計畫系統被認為有益於下一代健康的心智及體位發展。
關鍵字:學校午餐計畫、學校午餐法案、飲食營養教育、飲食與營養教師、 日本
 

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School-based “Shokuiku” program in Japan: application to nutrition education in Asian countries
MIKI MIYOSHI, NOBUYO TSUBOYAMA-KASAOKA AND NOBUO NISHI
This paper provides the overview of “Shokuiku” in Japan, and discusses the future perspective on application of its concepts to nutrition education in other Asian countries. In Japan, there has been a growing concern on increase of obesity and the metabolic syndrome among middle-aged men. Additionally, child obesity has also become one of the important health problems. The increased obesity among them is possibly associated with inappropriate dietary habits (eg skipping breakfast, excessive fat intake and insufficient vegetable). Under this circumstance, the “Basic Law on Shokuiku” was enacted in 2005, which was the first law that regulates one’s diets and eating habits. For effective implementation of Shokuiku program, dietitians and registered dietitians would play important roles in various settings. Japan has a long history of dietitian system as well as school-lunch programs. Later, in order to further enhance the school-based Shokuiku programs, the Diet and Nutrition Teacher System was established in April 2007. From an international point of view, “nutrition education” programs aim to improve dietary practices so as to ensure adequate energy or nutrient intake and also to reduce obesity and lifestyle- related diseases, whereas the concepts of Shokuiku have very wide approaches. Shokuiku’s efforts expand to support food culture, especially through school-based programs, as well as to improve food environment by providing information on appropriate diets. These approaches can be introduced in nutrition education in other Asian countries, not only to improve one’s health and nutritional status but also to secure food culture and food safety in each country.
Key Words: Shokuiku, food and nutrition education, dietitian, registered dietitian, Japan
 

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日本以學校為基礎的“飲食營養教育”系統:於亞洲國家營養教育的應用
這篇文章提供日本“飲食營養教育(Shokuiku)”的綜述,並討論未來這些觀點在其他亞洲國家營養教育的應用。在日本,中年人的肥胖及代謝症候群的增加已越來越受關注。此外,兒童肥胖也變成一個重要的健康問題。這些肥胖族群的增加可能與不當的飲食習慣有關(例如不吃早餐、脂肪攝取過多及蔬菜攝取不足)。在這個情況下,“飲食營養教育基本法”在2005 年被制定,這是第一個為人飲食及飲食習慣訂定的法案。為了更有效的執行飲食營養教育計畫,地方政府發照的營養師以及厚生労働省發照的營養師在各種場合扮演重要的角色。日本的營養師系統及學校午餐計畫有久遠的歷史。此後,為了更進一步加強以學校為基礎的飲食營養教育計畫,在2007 年4 月設立“飲食與營養教師”系統。從國際的觀點來看,營養教育系統的目的為改善飲食習慣以確保適當的能量及營養素攝取,進而降低肥胖及生活型態相關的疾病,有鑑於此,“飲食營養教育”的觀點有很廣的應用。飲食營養教育的努力,透過以學校為基礎的系統,擴大支持日本飲食文化;並透過提供適當飲食的資訊去改善食物環境。這些作法的觀點可以引入其他亞洲國家的營養教育,不僅助於改善個人健康與營養狀 況,也可穩固每個國家的食物文化及食物安全。
關鍵字:Shokuiku、食物與營養教育、營養師、證照營養師、日本
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Last Updated: March 2012