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1 Asia Pacific Journal of Clinical Nutrition
       Volume 21, 2

         (June 2012)


Abstracts

Contents

Abstract 摘要

Reviews

The development of a global program for the elimination of brain damage due to iodine deficiency
BASIL S HETZEL
Asia Pac J Clin Nutr. 2012;21(2):164-170.

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Anemia in Cambodia: prevalence, etiology and research needs
CHRISTOPHER V. CHARLES, ALASTAIR J.S. SUMMERLEE AND CATE E DEWEY
Asia Pac J Clin Nutr. 2012;21(2):171-181.

 

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Original Research Communications

Nutritional Measurement & Methodology

A digital Calliper for training and study purposes
MARIA T RESTIVO, TERESA F AMARAL, MARIA F CHOUZAL, CELINA P LEÃO, RITA S GUERRA, ELISA MARQUES,
JOAQUIM MENDES, MANUEL QUINTAS AND JORGE MOTA
Asia Pac J Clin Nutr. 2012;21(2):182-190.

 

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Validity and correspondence of non-invasively determined hemoglobin concentrations by two trans-cutaneous digital measuring devices
CAITLIN CROWLEY, GABRIELA MONTENEGRO-BETHANCOURT, NOEL W SOLOMONS, KLAUS SCHŰMANN
Asia Pac J Clin Nutr. 2012;21(2):191-200.

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Adding glycaemic index and glycaemic load functionality to DietPLUS, a Malaysian food composition database and diet intake calculator
SANGEETHA SHYAM, TONY NG KOCK WAI AND FATIMAH ARSHAD
Asia Pac J Clin Nutr. 2012;21(2):201-208.

 

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Clinical Nutrition Trials or Feeding Studies

 

Chicken-based formula is better tolerated than extensively hydrolyzed casein formula for the management of cow milk protein allergy in infants
PIPOP JIRAPINYO, NARUMON DENSUPSOONTORN, CHANNAGAN KANGWANPORNSIRI AND RENU WONGARN
Asia Pac J Clin Nutr. 2012;21(2):209-214.

 

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Nutritional Status, Dietary Intake, and Body Composition

 

Weight-related behaviors among non-overweight adolescents: results from the Korean national survey from 2005 to 2007
KAYOUNG LEE
Asia Pac J Clin Nutr. 2012;21(2):215-219.

 

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Diagnostic value of anthropometric indices for initial stage of atherosclerosis in adult women
MOTAHAR HEIDARI-BENI, MASOUD HAJIMAGHSOOD, MEHRANGIZ EBRAHIMI-MAMAGHANI, MOHAMMAD ASGHARI JAFARABADI, SEYED MOHAMMAD HOSEIN MOUSAVI-JAZAYERI AND JAVAD MOHTADINIA
Asia Pac J Clin Nutr. 2012;21(2):220-226.

 

 

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Prevalence of metabolically healthy obesity and its impacts on incidences of hypertension, diabetes and the metabolic syndrome in Taiwan
LEE-CHING HWANG, CHYI-HUEY BAI, CHIEN-AN SUN AND CHIEN-JEN CHEN
Asia Pac J Clin Nutr. 2012;21(2):227-233.

 

 

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Growth and Child Nutrition

Relationship between child feeding practices and malnutrition in 7 remote and poor counties, P R China
HONG ZHOU, XIAO-LI WANG, FANG YE, XIAOPEI LILY ZENG AND YAN WANG
Asia Pac J Clin Nutr. 2012;21(2):234-240.

 

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Greater length-for-age increases the odds of attaining motor milestones in Vietnamese children aged 5-18 months
SHIBANI KULKARNI, USHA RAMAKRISHNAN, KIRK A. DEARDEN, DAVID R. MARSH, TRAN THU HA, THACH DUC TRAN AND HELENA PACHÓN
Asia Pac J Clin Nutr. 2012;21(2):241-246.

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Intrauterine nutrition and carotid intimal media thickness in young Thai adults
KITTIPAN RERKASEM, ANTIKA WONGTHANEE, AMARAPORN RERKASEM, PIEN CHIOWANICH, PIYAMITR SRITARA, SAKDA PRUENGLAMPOO AND AMPIKA MANGKLABRUKS
Asia Pac J Clin Nutr. 2012;21(2):247-252.

 

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Nutritional Epidemiology and Public Health

 

Trends in Chinese snacking behaviors and patterns and the social-demographic role between 1991and 2009
ZHIHONG WANG, FENGYING ZHAI, BING ZHANG AND BARRY M POPKIN
Asia Pac J Clin Nutr. 2012;21(2):253-262.

 

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Relationship between dietary patterns and serum uric acid concentrations among ethnic Chinese adults in Taiwan
YI-TSEN TSAI, JEN-PEI LIU, YU-KANG TU, MEEI-SHYUAN LEE, PEY-RONG CHEN, HSIU-CHING HSU, MING-FONG CHEN AND KUO-LIONG CHIEN
Asia Pac J Clin Nutr. 2012;21(2):263-270.

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Cluster analysis reveals important determinants of cardiometabolic risk patterns in Filipino women
NIHA ZUBAIR, CHRIS W KUZAWA, THOMAS W MCDADE AND LINDA S ADAIR
Asia Pac J Clin Nutr. 2012;21(2):271-281.

 

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Pacific parents’ rationale for purchased school lunches and implications for obesity prevention
TASILETA TEEVALE, ROBERT SCRAGG, GAVIN FAEAMANI AND JENNIFER UTTER

Asia Pac J Clin Nutr. 2012;21(2):282-290.

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Nutrigenomics

Serum folate, total homocysteine levels and methylenetetrahydrofolate reductase 677C>T polymorphism in young healthy female Japanese
TAKASHI TAGUCHI, HIDEKI MORI, ATSUMI HAMADA, YUKIO YAMORI AND MARI MORI
Asia Pac J Clin Nutr. 2012;21(2):291-295.

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Association of the adiponectin gene (ADIPOQ) +45 T > G polymorphism with the metabolic syndrome among Han Chinese in Sichuan province of China
XIAOTONG LI, DAYING WEI, HUIJING HE, JIANHUA ZHANG, CHUNXIU WANG, MINGJU MA, BIN WANG, TAO YU, LI PAN, FANG XUE, HAIQING HE, WEIWEI XU, TINGFANG PAN, QIAN ZUO, LINDBLAD ULF, GUANGLIANG SHAN
Asia Pac J Clin Nutr. 2012;21(2):296-301.

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Association and interaction between dietary pattern and VEGF receptor-2 (VEGFR2) gene polymorphisms on blood lipids in Chinese Malaysian and Japanese adults
ROSELINE WAI KUAN YAP, YOSHIHIRO SHIDOJI, WEI MIN HON AND MOTOFUMI MASAKI
Asia Pac J Clin Nutr. 2012;21(2):302-311.

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 Association between the Xba I polymorphism of APOB gene and plasma lipid level in Mexican patients with coronary artery disease
MARTHA P GALLEGOS-ARREOLA, YADIRA VALDEZ, MARCO ZÚÑIGA-CORONA, LUIS E FIGUERA, LISETTE ARNAUD-LÓPEZ, JOSÉ A ROBLES-CERVANTES, MANUEL GONZÁLEZ-ORTIZ, ESPERANZA MARTÍNEZ-ABUNDIS, ANA M PUEBLA-PÉREZ AND GUILLERMO M ZÚÑIGA-GONZÁLEZ
Asia Pac J Clin Nutr. 2012;21(2):312-318.

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Future Events

 

Asia Pac J Clin Nutr. 2012;21(2):319.

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The development of a global program for the elimination of brain damage due to iodine deficiency
BASIL S HETZEL
Iodine deficiency is the most common preventable cause of brain damage with more than 2 billion people from 130 countries at risk. The global problem of iodine deficiency has been redefined by a readily transmitted population concept, with an easy acronym – the concept of the iodine deficiency disorders (IDD) – referring to all the effects of iodine deficiency in a population, that can be totally prevented by correction of iodine deficiency with special emphasis on brain damage and not just to goitre and cretinism (1983). This was followed by the creation of the International Council for Control of Iodine Deficiency Disorders (ICCIDD) supported by WHO and UNICEF with 700 multidisciplinary professionals from more than 100 countries, committed to providing technical assistance to national programs for the elimination of IDD (1986). The WHO policy of Universal Salt Iodization (USI) has been widely adopted which requires iodization of all food for human and animal consumption by the use of iodized salt (25-40 mg I/kilo). Simple practical methods for monitoring – by the measurement of salt iodine and urine iodine were developed and promoted on a large scale with the technical assistance of the ICCIDD.
Key Words: brain, ICCIDD, IDD, iodine deficiency disorders, monitoring, salt iodization, USI

 

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發展全球計畫以消除因碘缺乏所導致的腦損傷
碘缺乏是造成腦損傷中常見且可預防的原因,在130 個國家中有超過20 億人有
此風險。全球性碘缺乏問題已被用一個較容易傳達的族群觀念重新定義(1983
年),也就是用簡單的字母縮寫- IDD(碘缺乏疾病群)的觀念。 IDD 是指族群中碘
缺乏的所有後果,是可藉由改正碘缺乏來完全預防,特別強調在腦損傷而不只
是甲狀腺腫和呆小症。接著1986 年由世界衛生組織和聯合國兒童基金會支持而
創立國際碘缺乏疾病控制委員會 (ICCIDD),成員為來自100 多個國家的700 位
各領域的專家,旨在提供各國技術性的協助,以消除碘缺乏疾病。世界衛生組
織的全面食鹽加碘(USI)政策已被廣泛採用,以每公斤食鹽中添加25-40 毫克碘
的方式,使人們和動物攝取的所有食物中含碘。在國際碘缺乏疾病控制委員會
技術協助下,能在大量樣本實施的簡單可行監測方法-測量食鹽的含碘量及尿液
中的碘,已被發展並推動。
關鍵字:腦、國際碘缺乏疾病控制委員會、碘缺乏疾病、監測、食鹽加碘、全
面食鹽加碘計劃
 

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Anemia in Cambodia: prevalence, etiology and research needs
CHRISTOPHER V CHARLES, ALASTAIR JS SUMMERLEE AND CATE E DEWEY

Anemia is a severe global public health problem with serious consequences for both the human and socioeconomic health. This paper presents a situation analysis of the burden of anemia in Cambodia, including a discussion of the country-specific etiologies and future research needs. All available literature on the prevalence and etiology of anemia in Cambodia was collected using standard search protocols. Prevalence data was readily identified for pre-school aged children and women of reproductive age, but there is a dearth of information for schoolaged children, men and the elderly. Despite progress in nation-wide programming over the past decade, anemia remains a significant public health problem in Cambodia, especially for women and children. Anemia is a multifaceted disease and both nutritional and non-nutritional etiologies were identified, with iron deficiency accounting for the majority of the burden of disease. The current study highlights the need for a national nutrition survey, including collection of data on the iron status and prevalence of anemia in all population groups. It is impossible to develop effective intervention programs without a clear picture of the burden and cause of disease in the country.
Key Words: anemia, Cambodia, etiology, prevalence, hemoglobin

 

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探討柬埔寨國人貧血之盛行率、病因及未來研究需求
由於貧血嚴重影響人類健康及帶來許多社經問題,使得貧血成為全球共同關
注的公共衛生議題。本研究目的為探討柬埔寨國人貧血之現況,包括討論在
柬埔寨貧血的具體病因與未來相關研究之需求。本篇研究使用標準化流程,
蒐集了所有與柬埔寨貧血病因及盛行率相關之文獻。結果發現,學齡前兒童
與育齡婦女的貧血盛行率資料較多,但缺乏學齡兒童、男性與老人族群的資
訊。儘管過去十年來,有全國性營養相關計劃的推動,貧血依然是柬埔寨一
個重要的公共衛生問題,尤其在女性與孩童族群。由於貧血為一種多面向的
疾病,其病因包括營養及非營養因素,其中最主要導因為鐵質缺乏。本篇研
究結論突顯全國性營養調查的急迫性,包括調查所有族群鐵質的相關指標及
貧血盛行率等。惟有充分掌握本國貧血的概況及病因,才能發展有效的介入
計畫以減少此疾病。
關鍵字:貧血、柬埔寨、病因學、盛行率、血紅素
 

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A digital Calliper for training and study purposes
MARIA T RESTIVO, TERESA F AMARAL, MARIA F CHOUZAL, CELINA P LEÃO, RITA S GUERRA, ELISA MARQUES, JOAQUIM MENDES, MANUEL QUINTAS AND JORGE MOTA

A quick and valid method for evaluating percentage body fat is based on the use of skinfold callipers. However, limitations associated to their use and characteristics led the authors to improve a traditional calliper (Harpenden) and to integrate it with a software application. Such a measuring system, LipoTool, is meant to have better accuracy and reliability, including data processing and digital recording at a very low cost. At first, a sample of 49 older adults was used to evaluate the performance of LipoTool by comparing its results to those obtained with the traditional Harpenden calliper. A strong positive association in %BF was achieved. This digital sensing system was later improved by incorporating wireless communication between the calliper and the software application, adding other functionalities. The software application works in any computer and is flexible to incorporate new coming models, linear regressions or new algorithms. This new system was validated against the standard Dual- Energy X-Ray Absorptiometry system, using a sample of 40 adults with positive results. This solution is a valid and reliable alternative to traditional reference callipers, simplifying the percentage of body fat evaluation and providing a more effective use in daily practice with less expenditure of time and resources. Its implemented guided procedure turns it into a precious training tool based on a non-invasive, portable device, and not requiring special individual preparation. Ongoing activities are focused on the design of a new mechanical structure, with novel functionalities and for exploring other studies.

Key Words: body fat percentage, digital skinfold calliper, training system, wireless data communication, automated process
 

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訓練及研究目的的電子皮褶卡钳
使用皮褶卡钳是一种快速而有效的评价脂肪百分比的方法。然而,皮褶卡钳有
用途和特性方面的局限性,针对此,本研究將传统卡钳(Harpenden)加以改进,
並結合软件应用,提出一种新系统。应用這种LipoTool 测量系统,来获得更佳
的精度和可靠性,以及低成本的数据处理和记录方式。首先,為评价LipoTool
的性能,以49 位老年人的测量数据与传统的Harpenden 卡钳进行比较,结果体
脂肪百分比的相關性良好。然后,透过加進卡钳和软件之间的无线傳輸,使该
系统更提高其功能。并且,该软件可在任何的计算机上操作,可以容入新的模
式、线性回归或新的計算式。使用40 个成人的數据樣本,新系统以标准的双能
X 线吸收儀(DXA)来验证,結果証明效度良好。该方法比传统的皮褶卡钳更可
靠和確實,它可以简化脂肪百分比的评估过程,在日常使用中更加有效,減少
时间和资源的花费。該系統內建的操作指示讓它成為極優的培训工具,是一种
非侵入性、可攜式、不需要特殊准备的测量方法。将来的目標集中在设计更好
的机械结构,及增加其它的新颖的功能以供其他研究。
關鍵字:體脂肪百分比、電子式皮褶卡钳、訓練系統、無線傳輸、自動化過程

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Validity and correspondence of non-invasively determined hemoglobin concentrations by two trans-cutaneous digital measuring devices
CAITLIN CROWLEY, GABRIELA MONTENEGRO-BETHANCOURT, NOEL W SOLOMONS, KLAUS SCHŰMANN
Hemoglobin (Hb) concentration is the central diagnostic indicator for anemia, including nutritional anemia. The objective of this study was to compare the Hb values determined by two portable, non-invasive devices across a wide Hb spectrum against formal laboratory measurements, and with each other. Eighty Guatemalan adults (40 highland men, 40 lowland pregnant women) provided venous blood for formal Hb colorimetric determination. Hb was also registered sequentially on the Rad-87TM pulse CO-Oximeter with Rainbow Set technology (Masimo) and Haemospect® (MBR Optical Systems) by non-invasive skin-probe contact procedures as per manufacturers’ instructions. Whole blood Hb concentrations ranged from 7.8 to 18.5 g/dL (mean, 12.9±2.3 g/dL and median, 13.3 g/dL). Corresponding descriptive statistics were: range, 9.6 to 16.2 g/dL; mean, 12.1±1.5 g/dL; and median, 11.9 g/L, respectively, with the Rad-87TM (nail bed). They were: range, 8.7 to 15.8 g/dL; mean, 12.7±1.8 g/dL; and median, 13.0 g/dL for the Hemospect® for forearm contact. They were: range, 9.1 to 17.5 g/dL; mean, 13.2±2.1 g/dL; and median, 13.4 g/dL for palm contact. The Pearson correlation coefficient of venous blood Hb with the former device’s Hb values was r=0.59 (p<0.001), and r=0.94 (p<0.001) and r=0.90 (p<0.001) with those of the latter device at the palm and forearm, respectively. The inter-site Lin coefficient was r=0.84. Sensitivity and specificity were variable across devices, depending on Hb cut-off and measurement procedures. With Hb cutoff values of <12.0 g/dL for adult, non-pregnant women and <13.0 g/dL for adult men, the Haemospect® device’s performance here would provide adequate potential for screening purposes.
Key Words: hemoglobin, anemia, non-invasive technology, diagnostic screening, Guatemala
 

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兩種經由皮膚的電子測量儀器以非侵入性評估血紅素濃 度的效度及一致性
血紅素(Hb)濃度是貧血的重要診斷指標,包含營養性貧血。此研究目的為比較
兩種具廣範圍Hb 光譜、易攜帶且非侵入性的儀器所測量的Hb 值,並與常規檢
驗法比較。80 名瓜地馬拉成年人(40 名來自高原的男性,40 名為平地的懷孕女
性)提供靜脈血液,以常規比色法測量血紅素。並以兩種儀器,Rad-87TM (Masimo)
和Haemospect® (MBR Optical Systems)以非侵入性的皮膚探針連續記錄
Hb,程序如公司的使用說明。全血的血紅素濃度範圍是7.8-18.5 g/dL(平均值為
12.9±2.3 g/dL;中位數為13.3 g/dL)。相對應的描述性統計為:Rad-87TM (指床)
測出值範圍是9.6-16.2 g/dL;平均值為12.1±1.5 g/dL;中位數為11.9 g/dL。
Hemospect® 前臂測量值範圍8.7-15.8 g/dL;平均值12.7±1.8 g/dL;中位數13.0
g/dL。Hemospect®手掌測量值範圍是9.1-17.5 g/dL;平均值13.2±2.1 g/dL;中位
數13.4 g/dL。靜脈血測出的血紅素與Rad-87TM 所測的值,皮爾森相關係數是
r=0.59 (p<0.001),與Haemospect®分別在手掌及前臂的測量值,相關係數是
r=0.94 (p<0.001)及r=0.90 (p<0.001)。不同部位測量值間的Lin 係數r=0.84。不
同儀器的敏感度及特異度受血紅素的切點及測量程序的影響。當血紅素切點設
定為未懷孕女性<12.0 g/dL,成人男性<13.0 g/dL,Haemospect 儀器的表現,顯
示可能適宜做為貧血篩檢的工具。
關鍵字:血紅素、貧血、非侵入性技術、診斷篩檢、瓜地馬拉
 

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Adding glycaemic index and glycaemic load functionality to DietPLUS, a Malaysian food composition database and diet intake calculator
SANGEETHA SHYAM, TONY NG KOCK WAI AND FATIMAH ARSHAD
This paper outlines the methodology to add glycaemic index (GI) and glycaemic load (GL) functionality to food DietPLUS, a Microsoft Excel-based Malaysian food composition database and diet intake calculator. Locally determined GI values and published international GI databases were used as the source of GI values. Previously published methodology for GI value assignment was modified to add GI and GL calculators to the database. Two popular local low GI foods were added to the DietPLUS database, bringing up the total number of foods in the database to 838 foods. Overall, in relation to the 539 major carbohydrate foods in the Malaysian Food Composition Database, 243 (45%) food items had local Malaysian values or were directly matched to International GI database and another 180 (33%) of the foods were linked to closely-related foods in the GI databases used. The mean ± SD dietary GI and GL of the dietary intake of 63 women with previous gestational diabetes mellitus, calculated using DietPLUS version3 were, 62 ± 6 and 142 ± 45, respectively. These values were comparable to those reported from other local studies. DietPLUS version3, a simple Microsoft Excel-based programme aids calculation of diet GI and GL for Malaysian diets based on food records.
Key Words: glycaemic index, glycaemic load, diet, dietary carbohydrate, Malaysia

 

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新增升糖指數和升糖負荷功能到DietPLUS-馬來西亞的食物成份資料庫和

飲食攝取計算器
本文描述增加升糖指數(GI)和升糖負荷(GL) 功能到DietPLUS的方法。DietPLUS
是利用excel建立的馬來西亞食物營養成分資料庫和飲食攝取計算器。升糖指數
資料來自當地已確認的升糖指數值及國際升糖指數資料庫。以文獻發表過的方
法加以修改,來新增升糖指數值和升糖負荷計算器到資料庫中。增加兩項當地
流行的低升糖指數食物到DietPLUS 資料庫,使得食物項目總數增加到838。整
體來說,馬來西亞食物成份資料庫的539項主要的含醣食物中,有243項(45%)食
物有當地或國際GI資料庫的數據,另外有180項(33%)食物可與GI資料庫中的相
近似食物連結。利用DietPLUS 第3版,計算63名曾患妊娠糖尿病的婦女之飲食
中的升糖指數和升糖負荷,所得到的平均數±標準差分別為62 ± 6 和142 ± 45。
此數值與當地的其他研究結果相近。DietPLUS第3版是一個簡單的,利用excel設
計的軟體,可根據飲食記錄,計算馬來西亞飲食的升糖指數和升糖負荷值。
關鍵字:升糖指數、升糖負荷、飲食、膳食醣類、馬來西亞

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Chicken-based formula is better tolerated than extensively hydrolyzed casein formula for the management of cow milk protein allergy in infants
PIPOP JIRAPINYO, NARUMON DENSUPSOONTORN, CHANNAGAN KANGWANPORNSIRI AND RENU WONGARN
The effective treatment of cow milk allergy in infants consists of elimination of cow milk protein and the introduction of formulas based on an extensively hydrolyzed protein formula or an amino acid-based formula. However, about 10% of these infants are still allergic to an extensively hydrolyzed protein formula and an amino acidbased formula is very expensive. We conducted a study to verify whether the new chicken-based formula will be better tolerated than an extensively hydrolyzed protein formula for the treatment of cow milk allergy in infants. One hundred infants, diagnosed with cow milk allergy by double-blind, placebo-controlled food challenge tests, were enrolled in a double-blind, randomized, cross-over study to compare a response to an extensively hydrolyzed protein formula and the chicken-based formula. Subjects were randomly given one of the two formulas for 2 weeks. There was a 2-week washout period of taking an amino acid-based formula before being switched to the other formula for another 2 weeks. If the subjects showed allergic symptoms during the 2 weeks of test formula, they would be announced as intolerance or allergic to that formula. Sixty seven of 80 confirmed subjects agreed to enroll their infants. Fifty-eight subjects completed the study. Twenty and 33 infants were tolerant whereas and
38 and 25 infants were intolerant to an extensively hydrolyzed protein formula and the chicken-based formula, respectively. The chicken-based formula showed significantly better tolerance than an extensively hydrolyzed protein formula in the management of cow milk allergy in infants.
Key Words: chicken-based formula, cow milk allergy, extensively hydrolyzed protein formula, infant, Thailand

 

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牛奶蛋白過敏兒對於雞肉配方的耐受性優於高度水解酪 蛋白配方
對於牛奶過敏兒治療之組成配方,主要是將牛奶蛋白去除,改以高度水解蛋白
配方或是胺基酸配方取代之。然而,使用高度水解蛋白配方之過敏兒仍約有
10%未得到改善,而胺基酸配方非常昂貴。因此,本研究欲釐清,對牛奶過敏
兒來說,是否使用新的雞肉配方相對於高度水解蛋白配方有較好的耐受性。共
招募100 位牛奶過敏兒,先經過双盲、安慰劑對照的食物攝取測試,以確定診
斷。利用双盲、隨機的交叉實驗設計比較攝食高度水解蛋白配方與雞肉配方之
過敏兒反應。首先受試者被隨機分派至其中一種配方組別中,持續2 個星期,
接著有2 星期的洗滌期,在此期間內所有受試者皆攝取胺基酸配方。洗滌期過
後,再交換使用另一組不同的配方,一樣維持2 星期。若受試者在接受測試配
方的期間,出現過敏症狀,則會被認為對於此配方有耐受不良或過敏的情形。
在80 位確診的受試者中,有67 位的父母同意配合實驗進行,而最後共有58 位
完成試驗。結果發現,共38 位過敏兒對於高度水解蛋白配方產生耐受不良,而
有25 位對於雞肉配方耐受不佳。因此本篇結論為,對牛奶過敏兒而言,雞肉配
方相較於高度水解蛋白配方,其耐受性明顯較佳。
關鍵字:雞肉配方、牛奶蛋白過敏、高度水解蛋白配方、嬰兒、泰國

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Weight-related behaviors among non-overweight adolescents: results from the Korean national survey from 2005 to 2007
KAYOUNG LEE
This study aimed to assess the prevalence of overweight misperception, unhealthy diet practices, and factors associated with these weight-related behaviors among Korean adolescents. The subjects were a nationally representative sample of non-overweight students (52,515 in 2005, 64,084 in 2006, and 67,113 in 2007) in middle and high schools who completed the Korea Youth Risk Behavior Web-Based Survey. The prevalence of weightrelated behaviors and factors associated with these behaviors were assessed using a complex sampling design. Of non-overweight students, 14.9% of boys and 22.2% of girls reported their weight as overweight/obese. Dieting within the last year was reported by 19.8% of boys and 41.8% of girls. Of those who attempted dieting, 17.1% of boys and 24.6% of girls indicated practicing at least one unhealthy diet behavior within the last month. Overweight misperceptions were independently associated with diet attempts and unhealthy diets after adjustment for weight status, and demographic, social, and psychological factors. Additionally, these weight-related behaviors were also associated with psychosocial factors such as low school achievement, sadness, suicidal ideation, increased stress perception, and cigarette or alcohol use. In conclusion, the high prevalence of inappropriate weight-related behaviors suggests a need for comprehensive approaches to improve weight-related behaviors in non-overweight Korean adolescents.
Key Words: weight-related behavior, non-overweight adolescents, misperceptions about being overweight, diet, sex
 

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非過重青少年的體重相關行為:來自2005-2007 年韓國 國民調查的結果
本篇研究目的是評估韓國青少年他們在過重錯覺、不健康飲食行為和與這些體
重相關行為有關因子的盛行率。研究對象是一群具國家代表性且完成韓國青少
年危險行為網路調查的非過重初級及高級中學生(2005 年52,515 人、2006 年
64,084 人、2007 年67,113 人)。與體重相關行為以及和這些行為攸關因子盛行
率的評估是使用複雜抽樣設計。非過重學生中,有14.9%男孩和22.2%女孩自
述他們的體重是過重或肥胖;自述在過去一年裡曾節食的男孩有19.8%和
41.8%的女孩。在那些曾節食的學生中,有17.1%男孩和24.6%女孩表示,他們
上個月裡至少有一次不健康的飲食行為。在調整體重狀況、人口學、社會和心
理因素後,過重錯覺和嘗試節食、不健康飲食具獨立相關。此外,這些與體重
相關行為也和社交心理因素,例如低學校成就、悲傷、自殺想法、自覺壓力增
加、抽菸或飲酒具有相關性。總之,由不適當體重相關行為的高盛行率顯示,
需要有全面性的方案來改善非過重韓國青少年的體重相關行為。
關鍵字:體重相關行為、非過重青少年、過重錯覺、飲食、性別


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Diagnostic value of anthropometric indices for initial stage of atherosclerosis in adult women
MOTAHAR HEIDARI-BENI, MASOUD HAJIMAGHSOOD, MEHRANGIZ EBRAHIMI-MAMAGHANI, MOHAMMAD ASGHARI JAFARABADI, SEYED MOHAMMAD HOSEIN MOUSAVI-JAZAYERI AND JAVAD MOHTADINIA
Excess body weight is a cardiovascular risk factor. The relationship between anthropometric indices and cardiovascular health is not completely understood. Carotid Intima-Media Thickness (CIMT) is a subclinical marker of atherosclerosis. This study aimed to investigate the best anthropometric obesity indicator for diagnosis of initial stage of atherosclerosis by CIMT. This cross-sectional study included 100 adult women, aged 18-50 years. Anthropometric indices were measured with standard protocol and CIMT was measured by non-invasive ultrasound. Receiver Operating Characteristics (ROC) curve analysis was carried out to determine the optimal cut-off values of anthropometric indices, and the best indices for atherosclerosis diagnosis. On ROC curve analysis the suggested appropriate cut-offs of waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), body mass index (BMI) and percentage body fat (%BF) were 96 cm, 0.86, 0.64, 31.29 kg/m2 and 30.42%, respectively. The area under the ROC curve of BMI (AUC=0.74, 95%CI=0.62-0.86) and WHtR (AUC=0.74, 95%CI=0.63-0.85) were greater than other anthropometric indices. The AUC for WHR was the lowest among the studied obesity indices AUC=0.68 (95% CI=0.54-0.81). In our study, WHtR and BMI were the best diagnostic parameters of initial stage of atherosclerosis while WHR was the worst based on AUC.
Key Words: anthropometric indices, atherosclerosis, carotid arteries, cut-off values, ROC analysis
 

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成人女性的體位測量指標對初期動脈硬化之診斷值
體重過重是心血管疾病的危險因子。體位測量指標與心血管健康的關聯性尚未
完全明瞭。頸動脈中層厚度(CIMT)是動脈硬化的臨床前期標記。此研究目的為
找出以CIMT 診斷的初期動脈硬化之最佳體位肥胖指標。這個橫斷性研究包含
100 名18-50 歲的成人女性。體位測量值是依據標準流程進行測量,而CIMT 則
是以非侵入性的超音波測量。以接受器操作特性曲線(ROC)分析來決定體位測
量指標的理想切點及動脈硬化診斷的最適指標。由ROC 分析所建議的腰圍、腰
臀圍比、腰圍身高比、身體質量指數(BMI)及體脂肪比率的最適切點,分別是
96 公分、0.86 、0.64 、31.29 kg/m2 及30.42 。身體質量指數(AUC=0.74 ,
95%CI=0.62-0.86)和腰圍身高比(AUC=0.74,95%CI=0.63-0.85)的ROC 曲線下面
積較其他體位測量指標高。腰臀圍比的曲線下面積是這些肥胖指標中最低的
(AUC=0.68,95%CI=0.54-0.81)。在本研究中,依據AUC 結果顯示,腰圍身高
比及身體質量指數是動脈硬化初期最佳的診斷參數,而腰臀圍比是最差的。
關鍵字:體位測量指標、動脈硬化、頸動脈、切點、接受器操作特性曲線

 

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Prevalence of metabolically healthy obesity and its impacts on incidences of hypertension, diabetes and the metabolic syndrome in Taiwan
LEE-CHING HWANG, CHYI-HUEY BAI, CHIEN-AN SUN AND CHIEN-JEN CHEN
Obesity is an epidemic health problem related to morbidity and mortality of metabolic and cardiovascular diseases. However, little is known regarding the development of cardiometabolic diseases in an obese subgroup with a healthy metabolic risk profile. This study examined the prevalence of baseline metabolically healthy obese subjects and its impacts on the incidences of cardiometabolic diseases using a nation-wide population cohort. Metabolically healthy obese were prevalent in 8.2% of the baseline population and 28.5% of the obese subjects. Subjects included were 1,547 men and women (age range, 18–59 years), who were free of components of the metabolic syndrome except waist criteria. During an average 5.4-year follow-up, the cumulative incidences of hypertension, type 2 diabetes and the metabolic syndrome were 7.8%, 1.2% and 5.6%, respectively. The hazard ratios (95% CIs) for the metabolic syndrome incidence were significantly higher at BMI levels of ≥23.0 kg/m2 [4.68 (2.22-9.86)] for BMI of 23-24.9 kg/m2; 8.82 (4.01-19.4) for BMI of 25-26.9 kg/m2; and 24.4 (12.3-48.4) for BMI of ≥27 kg/m2). The hazard ratios for diabetes or hypertension incidence were significantly higher at BMI levels of≥25.0 kg/m2. Each kg/m2 of BMI gained was associated with an 18% increase in the risk of developing hypertension and a 26% increase in risk for the metabolic syndrome. We conclude that metabolically healthy obese individuals are at higher risk to develop hypertension, type 2 diabetes and the metabolic syndrome than their nonobese counterparts. Our data provide further evidence that opposes the notion of metabolically healthy obese as harmless conditions.
Key Words: metabolically healthy obesity, type 2 diabetes mellitus, hypertension, the metabolic syndrome, incidence
 

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正常代謝水準之肥胖狀態在台灣之盛行率及其對於高血 壓、糖尿病和代

謝症候群發生率的影響
肥胖是與代謝疾病和心臟血管疾病罹病率及死亡率密切相關之流行性健康問
題。然而,對於具有正常代謝水準之肥胖狀態,其罹患代謝疾病和心臟血管疾
病的危險性所知有限。本研究是以具有全國代表性之研究世代為研究個案,探
討具有正常代謝水準之肥胖狀態盛行率及其對於代謝疾病和心臟血管疾病發生
率的影響。納入分析之研究個案數為1,547 人(年齡介於18-59 歲)。這些納入分
析的研究個案在基礎收案時,除了腰圍一項外,並未具有代謝症候群之其他危
險因子。研究結果發現,在此一研究世代族群中,具有正常代謝水準而肥胖之
盛行率為8.2%;而在肥胖族群中具有正常代謝水準之比率為28.5%。在平均
5.4 年的追蹤過程中,研究世代之高血壓、第二型糖尿病及代謝症候群之累積
發生率分別為7.8%、1.2%及5.6%。罹患代謝症候群之相對危險性隨著身體質
量指數的增加而顯著的增加:相對於身體質量指數為18.5-22.9 kg/m2,身體質
量指數為23.0-24.9 kg/m2 者之相對危險性為4.68 (95%信賴區間為2.22-9.86);
身體質量指數為25.0-26.9 kg/m2 者之相對危險性為8.82 (95%信賴區間:4.01-
19.4);身體質量指數≧27.0 kg/m2 者之相對危險性為24.4 (95%信賴區間:12.3-
48.4)。同時,身體質量指數每增加1 kg/m2,罹患高血壓的危險性提高了
18%,而罹患代謝症候群之危險性增加26%。本研究結果顯示,具正常代謝水
準之肥胖狀態仍有罹患高血壓、第二型糖尿病及代謝症候群的高危險性。本研
究結果並不支持具有正常代謝水準之肥胖狀態為一無健康危害狀態的論點。
關鍵字:正常代謝水準的肥胖、第二型糖尿病、高血壓、代謝症候群、發生率


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Relationship between child feeding practices and malnutrition in 7 remote and poor counties, P R China
HONG ZHOU, XIAO-LI WANG, FANG YE, XIAOPEI LILY ZENG AND YAN WANG
The World Health Organization reported that inappropriate feeding in children is responsible for one-third of the cases of malnutrition. This cross-sectional study aimed to determine the prevalence of malnutrition and identify the relationship between feeding practices and malnutrition in children below 5 years, in 7 remote and poor counties of China. A sample of 2201 children and 1978 caregivers were obtained with multistage cluster random sampling. A survey about feeding practices among the caregivers was implemented using a structured questionnaire, and the health status of children was evaluated using anthropometric measurements. We found 5 problems: first, high prevalence of stunting, underweight and wasting in children below 5 years old (19.3%, 13.1% and 5.5%); second, short duration of breastfeeding for children below 36 months; third, low prevalence of exclusive breastfeeding among children below 6 months of age and continued breastfeeding to 1 year (17.5% and 32.2%). Fourth, although most of the infants (81.1%) between 6 and 8 months of age were given complementary foods, some of the 6- to 8-month-old infants did not receive any complementary foods. Last, a higher prevalence of stunting among Chinese children who had never been breastfed, who had been breastfed for less than 1 year, or had been fed with semi-solid foods of poor quality. Therefore, we suggest that more programs to increase caregivers' feeding knowledge and practices be conducted, to improve the health of children in remote and poor areas in China.
Key Words: malnutrition, stunting, feeding practice, breast milk, complementary food
 

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中国7个边远贫困县儿童的喂养行为与营养不良关系的研究
世界卫生组织报道大约有三分之一的儿童营养不良与不恰当的喂养行为有关。
本研究通过现况调查了解中国7 个偏远贫困地区的5 岁以下儿童营养不良的发
生情况,探索喂养行为与5 岁以下儿童营养不良发生之间的关联。调查主要采
用分层整群随机抽样方法获得样本,共完成了1978 名5 岁以下儿童看护人调查
和2201 名5 岁以下儿童的身体检查。采用结构式问卷询问儿童看护人有关儿童
的喂养行为,采用体格检查(身高、体重)来评价儿童的生长发育状况。调查主
要发现了五方面的问题:第一,5 岁以下儿童中生长迟缓、低体重和消瘦的发
生率较高(分别为19.3%,13.1%和5.5%);第二,3 岁以下儿童中母乳喂养时间
短;第三,6 个月以下儿童中纯母乳喂养率低(17.5%)、持续母乳喂养至儿童1
周岁的比例较低(32.2%);第四,6-8 月龄的儿童辅食添加率为81.1%,说明被
调查地区仍有接近五分之一的6-8 个月龄儿童没有接受过任何辅食;第五,从
未吃过母乳的、母乳喂养持续时间少于一年的、辅食添加质量有问题的儿童中
出现生长迟缓的比例较高。因此,未来的项目干预应该重点关注儿童看护人的
喂养知识和行为,以进一步改善中国偏远贫困地区儿童的健康状况。
关键词:营养不良、生长迟缓、喂养、母乳、辅食
 

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Greater length-for-age increases the odds of attaining motor milestones in Vietnamese children aged 5-18 months
SHIBANI KULKARNI, USHA RAMAKRISHNAN, KIRK A. DEARDEN DRPH, DAVID R. MARSH, TRAN THU HA, THACH DUC TRAN AND HELENA PACHÓN
Early childhood malnutrition has been associated with delayed development. Limited data exist however about the timing of developmental delay early in life. We assessed motor milestone (MM) achievement using the World Health Organization’s windows of achievement for gross motor milestones. We performed secondary analysis of baseline data of 158 Vietnamese children aged 5-18 months from a randomized community intervention trial. Median age of motor milestone achievement was compared to WHO reported medians. Multivariate logistic regression was used to identify socioeconomic, anthropometric and dietary factors associated with motor milestone achievement during the windows of achievement. Thirty four per cent of the children were stunted. Median age of MM achievement of Vietnamese children lagged by 2.4-3.7 months, compared to the WHO median for all MMs. Greater length-for-age increased the odds for walking with assistance, standing alone and walking alone by more than 3 times. Greater weight-for-age increased the odds by 3.6 for hand-and-knees crawling. Likewise, frequency of daily complementary feeding raised the odds by 3.6 for standing with assistance. In this first application of WHO windows of achievement in Viet Nam, pre-schoolers achieved motor milestones later than WHO reported median age. High prevalence of stunting and association of length-for-age with motor milestone achievement underscore the importance of addressing chronic malnutrition to optimize children’s growth and development.
Key Words: development, growth, Viet Nam, preschool children, motor milestones

 

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越南5-18 個月的幼兒較高的年齡別身長有利於達到動作發展里程碑
幼兒早期的營養不良與延緩成長具有相關性。然而關於幼年期成長遲緩的時間
點之資料有限。使用世界衛生組織(WHO)的粗大動作發展時程來評估動作里程
碑(MM)的達到性。針對158 名來自隨機社區介入試驗的5-18 個月的越南幼兒
執行第二次基線資料分析。比較達到動作里程碑的年齡中位數與WHO 報告的
中位數。使用多變項邏輯斯迴歸分析以確認社經地位、體位及飲食因素與達到
動作里程碑之相關性。計有34%的兒童為發育遲緩。越南兒童達到MM 的年齡
中位數比起WHO 的所有MM中位數慢了2.4-3.7 個月。較高的年齡別身長增加
在協助行走、自行站立及獨立行走的動作達到機率3 倍以上。較重的年齡別體
重提高用手腳爬行動作的機率3.6 倍。同樣的,每日副食品餵食提高了3.6 倍協
助站立的動作達到機率。這是第一次將WHO 動作發展時程應用在越南,顯示
學齡前兒童達到動作里程碑的年齡中位數晚於WHO 的報告。發育遲緩的高盛
行率和年齡別身長與達到動作里程碑的相關性,突顯出解決慢性營養不良對理
想的生長及發育的重要性。
關鍵字:發育、生長、越南、學齡前兒童、動作里程碑
 

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Intrauterine nutrition and carotid intimal media thickness in young Thai adults
KITTIPAN RERKASEM, ANTIKA WONGTHANEE, AMARAPORN RERKASEM, PIEN CHIOWANICH, PIYAMITR SRITARA, SAKDA PRUENGLAMPOO AND AMPIKA MANGKLABRUKS
Several studies show that intrauterine nutrition restriction is associated with vascular disease. Animal studies have shown that atherosclerosis can be affected by a constrained intrauterine diet, but this relationship in humans is controversial. The purpose of this study was to investigate the relationship between maternal intake during pregnancy and carotid intimal media thickness (CIMT). We measured CIMT in 565 twenty year old young adults whose mothers, while pregnant, participated in a nutritional study during 1989-1990 at two hospitals in Chiang Mai, Thailand. Maternal diet during pregnancy was assessed by two methods in each trimester, namely, the 24 hours food recall method and the food frequency method. Carotid intimal media thickness was greater in males and participants who showed higher blood glucose, higher body mass index and higher systolic blood pressure. Maternal protein intake during the first trimester was negative correlated with thickness of CIMT (p=0.02). The mean CIMT of participants whose mothers were in the lowest quarter of the distribution of protein intake in the first trimester was 0.45 mm (95% confidence interval (CI): 0.44-0.46) more than that of those whose mothers were in the highest quarter of the distribution (0.43 mm 95% CI: 0.42-0.44). In conclusion, lower maternal protein intake during early pregnancy may increase CIMT in adolescents.
Key Words: intrauterine nutrition, carotid intimal medial thickness, maternal diet, vascular disease, atherosclerosis

 

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泰國年輕成人子宮內營養與頸動脈中層厚度的關聯
數個研究顯示子宮內營養限制與成長後血管疾病具有相關性。動物實驗顯示受
限的妊娠期飲食可影響後代的動脈硬化,但是這個相關性在人體仍具爭議。此
研究旨在研究母親懷孕期間的飲食攝取與其子女頸動脈中層厚度(CIMT)之相關
性。我們測量565 名20 歲年輕成人的CIMT,他們的母親在懷孕期間參加
1989-1990 年在泰國清邁兩間醫院執行的一個營養研究。母親孕期的飲食是以
24 小時飲食回憶法及食物頻率法兩種方法評估。參與者是男性或有較高的血糖
值、身體質量指數及收縮壓者,呈現較高的頸動脈中層厚度。母親在第一孕期
的蛋白質攝取量與CIMT 的厚度為負相關(p=0.02)。這些參與者,若母親在第一
孕期的蛋白質攝取量分佈在最低四分位者,其CIMT 平均為0.45 mm(95%CI:
0.44-0.46),高於那些分佈在最高四分位者(0.43 mm; 95%CI: 0.42-0.44)。總而言
之,母親在懷孕初期較低的蛋白質攝取量可能增加青少年的CIMT。
關鍵字:子宮內營養、頸動脈中層厚度、妊娠飲食、血管疾病、動脈硬化
 

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Trends in Chinese snacking behaviors and patterns and the social-demographic role between 1991 and 2009

ZHIHONG WANG, FENGYING ZHAI, BING ZHANG AND BARRY M POPKIN
This study investigates the dynamic shifts in snacking behaviors and patterns in China. Using four waves (1991, 2004, 2006, and 2009) from the China Health and Nutrition Survey (CHNS), with full socioeconomic and demographic data and 3-day, 24-hour dietary recall data, 45,402 individuals age two and older were studied. Multiple logistic regressions were performed to examine the association of social-demographic factors on snacking behaviors. Results show that snacking prevalence, frequency of daily snacking occasions, and percentage of total daily energy intake (EI) from snacks increased significantly across all ages between 1991 and 2009, with a dramatic increase after 2004. Snacking was much more prevalent among children and higher-income, urban, and educated populations over time. Evening was the preferred snacking occasion, and the proportion of total daily EI from snacks varied between 4.1% and 12.3% for all snackers. Fruits, grains, and beverages were the most popular snacks and the highest contributors to snacking EI over all age groups. A marked transition from a tradition of two or three meals per day toward meals combined with snacks is underway. Further research is needed to develop a better understanding of the nutritional implications of Chinese snacking behaviors.
Key Words: snacking behaviors, snacking patterns, Chinese, social-demographic factors, trend
 

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中國居民1991-2009 年零食攝入行為和模式的變遷與社會人口因子的角色
本文旨在调查中国居民零食摄入行为和模式的动态变迁。利用中美合作课题“中
国健康与营养调查”1991 年、2004 年、2006 年和2009 年的四轮调查数据,研究
对象为2 岁及以上的人群,且有完整的社会经济和人口数据及连续3 天24 小时
膳食回顾数据。应用Logistic 多元回归模型调查了社会经济因素对零食摄入行
为的影响。结果显示1991-2009 年间中国各年龄人群的零食摄入率、每日零食
摄入频次、零食提供能量占总能量的百分比均呈显著的增加趋势,自2004 年后
增加极为迅速。零食摄入行为在儿童、高收入人群、高教育水平人群和城市居
民中较为盛行。晚餐后是选择吃零食比较多的时间。在选择零食的人群中,零
食供能比占总能量的4.1%-12.3%。水果、谷类和饮料是最经常的零食选择,也
是各年龄组人群中提供能量最多的零食种类。本研究表明中国居民传统的每日
两或三餐正在向每日正餐和零食摄入共存的模式变迁。零食摄入行为和模式的
变迁对中国居民营养状况的影响有待进一步深入研究。
關鍵字:零食攝入行為、零食模式、中國人、社會人口因素、趨勢

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Relationship between dietary patterns and serum uric acid concentrations among ethnic Chinese adults in Taiwan
YI-TSEN TSAI, JEN-PEI LIU, YU-KANG TU, MEEI-SHYUAN LEE, PEY-RONG CHEN, HSIU-CHING HSU, MING-FONG CHEN AND KUO-LIONG CHIEN
The evidence for a relationship between dietary patterns and uric acid concentrations is scanty. Here, we used a validated food frequency questionnaire for an ethnic Chinese population in Taiwan to investigate the relationship between dietary patterns and uric acid concentrations. A cross-sectional study on 266 adults, who were interviewed with a 38-item food frequency questionnaire, was conducted and serum uric acid levels were measured. Three dietary patterns were derived from the questionnaire by exploratory factor analysis. Participants in the higher vegetable and fruit pattern quartiles were more likely to have a lower uric acid concentration (6.5 for the first, 5.7 for the second, 6.0 for the third, and 6.0 mg/dL for the fourth quartile, p = 0.030). For uric acid-prone patterns, as the quartiles increased, the adjusted mean uric acid concentrations increased significantly (5.88, 5.93, 5.99 and 6.38 mg/dL for each quartile, respectively, p = 0.04). However, the significance level was attenuated after adjusting for additional confounding factors. In conclusion, three dietary patterns were identified for ethnic Chinese in Taiwan, and the relationship between these dietary patterns and uric acid was not significant after adjustment.
Key Words: uric acid, dietary pattern, exploratory factor analysis, food frequency questionnaire, validation study

 

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飲食型態與尿酸濃度在台灣華人族群之相關性
過去針對飲食型態與尿酸濃度相關的證據仍然缺乏,因此我們利用一具有效度
的食物頻率問卷在台灣華人族群研究飲食型態及尿酸濃度的相關。在一橫斷式
研究收集266 位成年人的38 項食物頻率問卷及其血液尿酸濃度值,利用探索性
因素分析得到三類飲食型態因子。我們發現在較高的蔬菜水果攝食因子四分位
的參與者有比較低的尿酸值(分別是第一四分位為6.5,第二四分位為5.7,第三
四分位為6.0 及第四四分位為6.0 mg/dL,p 值為0.030)。而高尿酸食物因子
中,隨著四分位值增加,尿酸值呈現有意義的增加(四分位尿酸值分別為5.88、
5.93、5.99 及6.38 mg/dL,p 值為0.04)。然而,當調整其他干擾因子之後則呈
現沒有統計上相關。總結而言,在台灣華人族群可發現有三類飲食型態因子,
然而這些飲食型態因子與尿酸濃度在多變數調整後並無顯著的相關。
關鍵字:尿酸、飲食型態、探索性因素分析、食物頻率問卷、效度研究
 

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Cluster analysis reveals important determinants of cardiometabolic risk patterns in Filipino women
NIHA ZUBAIR, CHRIS W KUZAWA, THOMAS W MCDADE AND LINDA S ADAIR
With modernization, the Philippines has experienced increasing rates of obesity and related cardiometabolic diseases. Studying how risk factors cluster in individuals may offer insight into cardiometabolic disease etiology. We used cluster analysis to group women who share the following cardiometabolic biomarkers: fasting triglycerides, HDL-C and LDL-C, C-reactive protein, systolic and diastolic blood pressure, homeostasis model assessment of insulin resistance, and fasting glucose. Participants included 1,768 women (36-69 years) in the Cebu Longitudinal Health and Nutrition Survey. We identified five distinct clusters characterized by: 1) low levels of all risk factors (except HDL-C and LDL-C) or “healthy”; 2) low HDL-C in the absence of other risk factors; 3) elevated blood pressure; 4) insulin resistance; and 5) high C-reactive protein. We identified predictors of cluster membership using multinomial logistic regression. Clusters differed by age, menopausal status, socioeconomic status, saturated fat intake, and combinations of overweight (BMI >23) and high waist circumference (>80 cm). In comparison to the healthy cluster, overweight women without high waist circumference were more likely to be in the high CRP cluster (OR=2.26, 95% CI=1.24-4.11), while women with high waist circumference and not overweight were more likely to be in the elevated blood pressure (OR=2.56, 95% CI=1.20-5.46) or insulin resistant clusters (OR=4.05, 95% CI=1.39-11.8). In addition, a diet lower in saturated fat uniquely increased the likelihood of membership to the low HDL-C cluster. Cluster analysis identified biologically meaningful groups, predicted
by modifiable risk factors; this may have implications for the prevention of cardiometabolic diseases.
Key Words: cluster analysis, the metabolic syndrome, cardiovascular disease, waist circumference, Asia
 

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集群分析顯示菲律賓女性心血管代謝疾病風險的重要決定因子
隨著生活的現代化,菲律賓民眾肥胖以及相關心血管代謝疾病的比率也隨之增
加。對於個體中危險因子聚集的研究,可提供心血管疾病在病因學的深入了
解。使用集群分析的方式將女性依心血管代謝生化指標進行分組,其生化指標
包括:空腹三酸甘油酯、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、C-反應
蛋白、舒張壓及收縮壓、穩定模式評估的胰島素阻抗(HOMA-IR)以及空腹血糖
值。參與者為宿霧長期營養與健康調查中的1,768位女性,年齡介於36-69歲。
我們定義了五組不同特性的集群:1)所有危險因子風險皆低(除了高密度脂蛋白
膽固醇以及低密度脂蛋白膽固醇)或是健康的;2)較低濃度的高密度脂蛋白膽固
醇,但無其他危險因子;3)血壓較高的;4)高胰島素阻抗;5)高濃度C-反應蛋
白。利用多元邏輯斯迴歸分辨各集群的預測因子。各集群在年齡、經期狀態、
社經地位、飽和脂肪攝取量以及合併過重(BMI>23)與高腰圍(>80 cm)方面有差
異。當與健康的集群比較,過重但沒有高腰圍的女性落在高濃度C-反應蛋白集
群的風險較高(OR=2.26; 95% CI=1.24-4.11);然而具高腰圍但無過重的女性落在
高血壓(OR=2.56; 95% CI=1.20-5.46) 或是胰島素阻抗集群(OR=4.05; 95%
CI=1.39-11.8)的風險相對較高。此外,飲食含飽和脂肪較低者,特異地增加成
為低濃度高密度脂蛋白膽固醇集群者的機率。集群分析可鑑別不同生物意義的
組別且找出可修飾的風險預測因子,而這可能應用於預防心血管代謝疾病。
關鍵字:集群分析、代謝症候群、心血管疾病、腰圍、亞洲


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Pacific parents’ rationale for purchased school lunches and implications for obesity prevention
TASILETA TEEVALE, ROBERT SCRAGG, GAVIN FAEAMANI AND JENNIFER UTTER
Pacific children and adolescents are burdened with higher prevalences of obesity compared to other groups in New Zealand. Previous research shows Pacific young people purchase their lunch food items significantly more than other groups. The aim of this study is to describe school lunch food consumption patterns and the influences on these among low-income Pacific adolescents and their parents. Using mixed-methodology design; a selfcompletion questionnaire was administered to 4216 students who participated in the New Zealand arm of the Obesity Prevention In Communities (OPIC) project. Thirty Pacific households (33 adolescents and 35 parents) were interviewed in the qualitative phase of the study. Results found a greater proportion of Pacific students purchased school food items compared to other ethnic groups. Purchasing school food was related to having higher amounts of daily food money (≥NZD 6-15) and this was associated with increased quantities of soft drink consumption and after-school food purchasing of high-fat, high-sugar snack foods. There were no differences in school food purchasing behaviour by Pacific weight status (n=2485), with both Healthy weight (67.6%) and Obese students (66.9%) sourcing lunch from school canteens or shops outside of school rather than from home. Time-constrained parents confirmed convenience, poverty compensation and valuing students’ independence as three reasons for choosing to make money available for students to purchase lunch food items. The social effects of poverty affect the health-promoting behaviours of Pacific communities in New Zealand. Social policies that decrease social inequities should be the intervention priority.
Key Words: Polynesian, adolescent, obesity, diet, New Zealand
 

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太平洋裔家戶對於購買上學午餐的理由及其對肥胖預防之影響
居住於紐西蘭之太平洋裔兒童及青少年,與其他種族相比,肥胖盛行率較高,
而且在選購午餐時購買較多的食物項目。本篇研究目的為探討低收入之太平洋
裔青少年的上學午餐食物攝取型態,及家庭對此之影響。利用混合方法論設計
進行研究。提供自填式問卷給4216 位參與肥胖預防計畫(OPIC)之學生。研究的
質性部份,是對30 個太平洋裔家戶(33 位青少年及35 位家長)進行面訪。結果
顯示,與其他種族相比,有較高比例的太平洋裔學生在上學時購買食物,而這
樣的行為與較多的食物零用錢(≥NZD 6-15) 有關,並與含糖飲料攝取較多及課後
購買高脂高糖點心的行為相關。另外也發現,太平洋裔學生,不論體重為何,
其購買上學食物之行為沒有明顯差異;有67.6%的正常體重者與66.9%的肥胖
者,未從家中帶午餐來,而去學校餐廳或校外商店購買。研究結果也指出,時
間緊迫的父母承認給與小孩金錢去購買上學食物,乃是基於便利、貧窮的代償
反應、及看重學生自主性等三點理由。鑑於貧窮的社會效應著實影響太平洋裔
社群的健康攸關行為,因此以降低社會不公為目標的社會政策應為優先。
關鍵字:玻里尼西亞、青少年、 肥胖、 飲食、 紐西蘭
 

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Serum folate, total homocysteine levels and methylenetetrahydrofolate reductase 677C>T polymorphism in young healthy female Japanese
TAKASHI TAGUCHI, HIDEKI MORI, ATSUMI HAMADA, YUKIO YAMORI AND MARI MORI
Environmental and genetic factors influence serum total homocysteine (tHcy), a risk factor for vascular diseases. The gene polymorphism of methylenetetrahydrofolate reductase (MTHFR) is reported to be a genetic factor for influencing tHcy. However, it is not clear whether MTHFR polymorphism influences tHcy in the younger generation. To investigate the influence of MTHFR polymorphism on vascular disease risks in young Japanese females, we determined dietary intakes, serum folate and tHcy, and examined the influence of MTHFR 677C>T polymorphism in healthy junior and high school students (n=192, 12-18y). The relationships between MTHFR polymorphism and folate intake, serum folate or tHcy were investigated by dividing participants into CC, CT and TT types. Among individuals with the TT genotype, folate and tHcy levels were significantly lower (p<0.05) or higher (p<0.0001), respectively, than in those with the other genotypes; although there were no significant differences in the intake of folate among genotypes. In addition, a significant inverse correlation between folate and tHcy (p<0.05) was noted in all genotypes, even in young females, so far not examined in Asian populations. Therefore, MTHFR genotypes were proven to be a significant determinant for folate and tHcy concentrations. However, the association of increased folate intake with lower tHcy concentration, even in cases of the mutation TT type, indicates the importance of folate intake in young Japanese females for early detection of risk, as well as the prevention of vascular diseases.
Key Words: MTHFR, polymorphism, folate, homocysteine, young female

 

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日本年輕健康女性的血清葉酸與總同半胱胺酸濃度及甲基四氫葉酸
還原酶677C>T 基因多型性
環境及基因會影響血清中總同半胱胺酸(tHcy)濃度,此為血管疾病的危險因子
之ㄧ。甲基四氫葉酸還原酶(MTHFR)的基因多型性被認為是影響tHcy 的基因因
子。然而,在年輕世代的MTHFR 基因多型性是否影響tHcy 並不清楚。為研究
年輕日本女性的MTHFR 基因多型性對血管疾病的影響,我們測量膳食攝取、
血清葉酸及tHcy,並評估健康的中學生(n=192,12-18 歲)MTHFR 677C>T 基因
多型性對它們的影響。依據參與者的MTHFR 基因多型性分為CC、CT 及TT
型三組,並分析基因型態與葉酸攝取、血清葉酸或tHcy 的相關性。雖然葉酸攝
取量在各基因型組沒有顯著差異,但具TT 基因型的參與者比起其他基因型
者,有顯著較低的血清葉酸(p<0.05)與較高的血清tHcy 量(p<0.0001)。此外,所
有基因型的年輕女性均顯示葉酸與tHcy 有顯著負相關,這到目前為止在亞洲族
群尚未被探討過。因此,MTHFR 基因型被證明是血清葉酸與tHcy 濃度的重要
決定因子。再者即使在TT 突變型,也呈現葉酸攝取的增加與較低的tHcy 濃度
有相關,這指出日本年輕女性的葉酸攝取在早期危險性監測及預防血管疾病的
重要性。
關鍵字:甲基四氫葉酸還原酶、基因多型性、葉酸、同半胱胺酸、年輕女性
 

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Association of the adiponectin gene (ADIPOQ) +45 T > G polymorphism with the metabolic syndrome among Han Chinese in Sichuan province of China
XIAOTONG LI, DAYING WEI, HUIJING HE, JIANHUA ZHANG, CHUNXIU WANG, MINGJU MA, BIN WANG, TAO YU, LI PAN, FANG XUE, HAIQING HE, WEIWEI XU, TINGFANG PAN, QIAN ZUO, LINDBLAD ULF, GUANGLIANG SHAN
The metabolic syndrome is a cluster of abnormalities characterized by obesity, impaired glucose metabolism, hypertension or elevated blood pressure, and dyslipidemia. The aim of this study was to investigate the association of the adiponectin gene (ADIPOQ) +45 T > G polymorphism with the metabolic syndrome among Han Chinese in Sichuan province of China. A case-control design was used including 116 patients with the metabolic syndrome and 108 unrelated controls, matched on age and gender. The ADIPOQ +45G allele (TG+GG) had a significant association with risk of the metabolic syndrome (odds ratio=1.88, 95% confidence interval: 1.03-3.44, p=0.039) adjusted for education, physical activity, family history of related diseases, smoking and drinking, compared with subjects with TT genotype. The association between the ADIPOQ +45 T>G polymorphism and the
metabolic syndrome was independent of multiple confounders.
Key Words: the metabolic syndrome, ADIPOQ, polymorphism, case-control study, China


 

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中國四川省漢族居民脂聯素基因+45 T > G 多態性與代謝綜合征的關聯
代謝綜合征是多種異常組分集聚在同一個體的臨床綜合征,異常組分主要包括
肥胖、糖代謝受損、高血壓或血壓升高以及血脂紊亂。本研究的目的是探討中
國四川省漢族居民脂聯素基因+45 T > G 多態性與代謝綜合征的關聯。應用病
例-對照研究的方法,以確診的116 例代謝綜合征患者為病例組,按照年齡和性
別進行頻數匹配,選取108 例非代謝綜合征且無血緣關係者作為對照組。研究
結果顯示,在調整了教育程度、體力勞動強度、相關疾病家族史、吸煙和飲酒
情況後,與攜帶TT 基因型的人相比,脂聯素基因第45 位的G 等位基因
(TG+GG)是代謝綜合征的危險因子(OR=1.88,95%CI=1.03-3.44,p=0.039)。此
結果表明,控制干擾因素後,脂聯素基因+45 T > G 多態性仍是代謝綜合征的獨
立危險因素。
關鍵字:代謝綜合征、脂聯素基因、基因多態性、病例-對照研究、中國
 

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Association and interaction between dietary pattern and VEGF receptor-2 (VEGFR2) gene polymorphisms on blood lipids in Chinese Malaysian and Japanese adults
ROSELINE WAI KUAN YAP, YOSHIHIRO SHIDOJI, WEI MIN HON AND MOTOFUMI MASAKI

Background/Aims: Dietary pattern and genetic predisposition of each population have different impacts on lifestyle-related chronic diseases. This study was conducted to evaluate the association and interaction between dietary patterns and VEGFR2 or KDR gene polymorphisms on physical and biochemical risk factors of cardiovascular disease in two Asian populations (179 Chinese Malaysian and 136 Japanese adults). Methods: Dietary patterns were constructed from food frequency questionnaire using factor analysis. Genotyping of rs1870377 and rs2071559 was performed by real-time PCR using TaqMan probes. Physical measurements: body mass index, systolic and diastolic blood pressures and biochemical parameters: glycated hemoglobin A1c and blood lipids (total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol and total cholesterol/HDL-C ratio) were measured. Results: Two dietary patterns were extracted for: Japanese (‘Japanese diet’ and ‘Western diet’) and Chinese Malaysians (‘Balanced diet’ and ‘Meat, rice and noodles diet’). In Japanese, ‘Western Diet’ and rs2071559 were associated with LDL-C and HDL-C, respectively. In Chinese Malaysians, ‘Meat, rice and noodles diet’ was associated with triglycerides, HDL-C and total cholesterol/HDL ratio while rs1870377 and rs2071559 were associated with total cholesterol and/or LDL-C. The interaction between ‘Western Diet’ and rs2071559 in Japanese and‘Meat, rice and noodles diet’ and rs1870377 in Malaysians had significant effects on blood lipids after adjusting for confounders. Conclusions: The association and interaction of dietary patterns and VEGFR2 gene polymorphisms on blood lipids differ between Chinese Malaysian and Japanese subjects by either decreasing or increasing the risk of cardiovascular disease.
Key Words: dietary pattern, VEGFR2 gene polymorphisms, blood lipids, Chinese Malaysian, Japanese
 

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飲食型態和VEGFR2 基因多型性間的交互作用對於馬來西亞華人和
日本人的血脂之影響
背景/目的:飲食型態和各族群的基因多型性對於和生活型態有關的慢性疾病有
不同的影響。這篇研究探討飲食型態和VEGFR2 或KDR 基因間的交互作用,
對於兩種亞洲族群(179 名馬來西亞華人和136 名日本人)的心血管疾病的生理和
生化上的危險因子的影響。方法:利用因素分析從飲食頻率問卷結果來找出飲
食型態。藉由使用TaqMan 探針的即時聚合酶連鎖反應(real-time PCR)定出
rs1870377 和rs2071559 的基因型。生理測量有身體質量指數(BMI)、收縮壓和
舒張壓。生化測量有糖化血色素和血脂(總膽固醇、三酸甘油酯、低密度脂蛋白
膽固醇、高密度脂蛋白膽固醇、總膽固醇與高密度脂蛋白膽固醇之比值)。結
果:日本人的飲食型態分為日式飲食和西式飲食;馬來西亞華人的飲食型態有
平衡飲食及以肉、飯和麵為主的飲食型態。對日本人而言,西式飲食和LDL-C
有關,而rs2071559 基因型則和HDL-C 相關。對馬來西亞華人而言,以肉、飯
和麵為主的飲食型態跟三酸甘油酯、HDL-C 及總膽固醇/HDL-C 比值有關,而
rs1870377 和rs2071559 的基因型和總膽固醇、LDL-C 有關。經過校正干擾因子
後,日本人的西式飲食與rs2071559 基因型間的交互作用,或馬來西亞華人的
肉、飯和麵為主的飲食與rs1870377 基因型間的交互作用對於血脂有明顯的效
應。結論:飲食型態和VEGFR2 基因間的交互作用,對於馬來西亞華人和日本
人的心血管疾病的風險有不同方向的影響。
關鍵字:飲食型態、VEGFR2 基因多型性、血脂、馬來西亞華人、日本人
 

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Association between the Xba I polymorphism of APOB gene and plasma lipid level in Mexican patients with coronary artery disease
MARTHA P GALLEGOS-ARREOLA, YADIRA VALDEZ, MARCO ZÚÑIGA-CORONA, LUIS E FIGUERA, LISETTE ARNAUD-LÓPEZ, JOSÉ A ROBLES-CERVANTES, MANUEL GONZÁLEZ-ORTIZ, ESPERANZA MARTÍNEZ-ABUNDIS, ANA M PUEBLA-PÉREZ AND GUILLERMO M ZÚÑIGA-GONZÁLEZ
Some studies, that consider polymorphisms of the apolipoprotein B (APOB) gene as risk factors for coronary artery disease (CAD), have reported discordant results. The aim of the present study was to search for associations between plasma lipid profiles with the DNA Xba I polymorphism of the APOB gene in CAD patients diagnosed by angiography (CAD+). In the present study we compared 114 Mexican patients (80 men and 34 women) with CAD+ and 132 control patients (59 men and 73 women) without evidence of ischemia or arterial damage (CAD-). The frequency of X+/X+ genotype of Xba I polymorphism, in CAD+ group, was 23% (26/114) compared with 8% (11/132) in the CAD- (OR 3.25, p = 0.002). The patients with X+/X+ for the Xba I genotype APOB gene had higher concentration of triglycerides (TG) and VLDL in plasma than CAD- (p < 0.05). The genotype X+/X+ in the CAD had an effect increasing the TG and VLDL plasma levels when compared with individuals with X-/X- and X-/X+ genotypes. The present study indicated that the X+X+ genotype of Xba I polymorphism is associated with CAD+ patients and high plasma levels of TG and VLDL, in the Mexican population.
Key Words: apolipoprotein B, cholesterol, polymorphism, plasma lipids, Mexican
 

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罹患冠心病的墨西哥患者之脂蛋白酶元B 基因Xba I 多型性與血脂濃度
的相關性
有些研究認為脂蛋白酶元B(APOB)的基因多型性為冠狀動脈疾病的危險因子,
但其研究結果並不一致。而此研究的目的在於尋找出由血管攝影診斷有冠心病
的患者,其脂蛋白酶元B 基因上的Xba I 多型性與血脂的相關性。在此研究中
比較114 位(80 位男性;34 位女性)罹患冠心病(CAD+)的墨西哥患者與132 位(59
位男性;73 位女性)沒有心肌缺血及動脈損傷的控制組(CAD-)。在患有冠心病的
組別,其Xba I 多型性的基因型為X+/X+的比例為23%,而控制組為8%
(OR=3.25;p=0.002)。在Xba I 基因型為X+/X+的CAD+患者相較於控制組,有
較高的血漿三酸甘油酯以及極低密度脂蛋白(VLDL)(p<0.05)。當與基因型為X-
/X-或X-/X+的冠心病患者比較時,X+/X+基因型的CAD+患者,顯現較高的血
漿三酸甘油酯及極低密度脂蛋白濃度。本研究指出在墨西哥族群中,Xba I 的基
因型為X+/X+者,與冠心病患者的高濃度血漿三酸甘油酯和極低密度脂蛋白具
有相關。
關鍵字:脂蛋白酶元B、膽固醇、基因多型性、血脂、墨西哥人
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Last Updated: April 2012