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1 Asia Pacific Journal of Clinical Nutrition
       Volume 22,1

         (January 2013)


Abstracts

Contents

Abstract PDF

Asia Pacific Clinical Nutrition Society Award for 2013: Jim Mann

DUO Li

Asia Pac J Clin Nutr. 2013;22(1):i.

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Mini Review

Vitamin D status and food security in North-East Asia
MARK L WAHLQVIST
Asia Pac J Clin Nutr. 2013;22(1):1-5.
doi: 10.6133/apjcn.2013.22.1.21

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Reviews

Thailand nutrition in transition: situation and challenges of maternal and child nutrition
PATTANEE WINICHAGOON
Asia Pac J Clin Nutr. 2013;22(1):6-15.
doi: 10.6133/apjcn.2013.22.1.17

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Eating beef: cattle, methane and food production
ASA K WAHLQUIST
Asia Pac J Clin Nutr. 2013;22(1):16-24.
doi: 10.6133/apjcn.2013.22.1.04

 

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Original Research Communications

Nutritional Measurement & Methodology

Validation of a self-monitoring device for estimating 24-hour urinary salt excretion
KENICHIRO YASUTAKE, KAYOKO SAWANO, NAOKO SHONO AND TAKUYA TSUCHIHASHI
Asia Pac J Clin Nutr. 2013;22(1):25-31.
doi: 10.6133/apjcn.2013.22.1.03

 

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Clinical Nutrition or Feeding Studies

 

The atherosclerotic risk profile is affected differently by fish flesh with a similar EPA and DHA content but different n-6/n-3 ratio
FRANCESCO SOFI, GIANLUCA GIORGI, FRANCESCA CESARI, ANNA MARIA GORI, LUCIA MANNINI, GIULIANA PARISI, ALESSANDRO CASINI, ROSANNA ABBATE, GIAN FRANCO GENSINI AND BIANCA MARIA POLI
Asia Pac J Clin Nutr. 2013;22(1):32-40.
doi: 10.6133/apjcn.2013.22.1.12

 

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Iodized salt supplementation and its effects on thyroid status amongst Orang Asli in Hulu Selangor, Malaysia
KUANG KUAY LIM, MING WONG, WAN NAZAIMOON WAN MOHAMUD AND NOR AZMI KAMARUDDIN
Asia Pac J Clin Nutr. 2013;22(1):41-47.
doi: 10.6133/apjcn.2013.22.1.02

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Oral carbohydrate loading with 18% carbohydrate beverage alleviates insulin resistance
TAKAHIKO TAMURA, TOMOAKI YATABE, HIROYUKI KITAGAWA, KOICHI YAMASHITA, KAZUHIRO HANAZAKI AND MASATAKA YOKOYAMA
Asia Pac J Clin Nutr. 2013;22(1):48-53.
doi: 10.6133/apjcn.2013.22.1.20

 

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A multicentre assessment of malnutrition, nutritional risk, and application of nutritional support among hospitalized patients in Guangzhou hospitals
SHI FANG, JIANTING LONG, RONGSHAO TAN, HAIYAN MAI, WEI LU, FENG YAN AND JUNSHENG PENG
Asia Pac J Clin Nutr. 2013;22(1):54-59
. doi: 10.6133/apjcn.2013.22.1.01

 

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Nutritional Status, Dietary Intake, and Body Composition

Serum and dietary antioxidant status is associated with lower prevalence of the metabolic syndrome in a study in Shanghai, China
YANRONG LI, HONGWEI GUO, MIN WU AND MING LIU
Asia Pac J Clin Nutr. 2013;22(1):60-68.
doi: 10.6133/apjcn.2013.22.1.06

 

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Regional percent fat and bone mineral density in Korean adolescents: The Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-3), 2009
KAYOUNG LEE
Asia Pac J Clin Nutr. 2013;22(1):69-73.
doi: 10.6133/apjcn.2013.22.1.14

 

 

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The association of weight status with cognitive impairment in the elderly population of a Shanghai suburb
GUO-HONG CUI, HAI-DONG GUO, RUI-FANG XU, GUO-XIN JIANG, SHENG-DI CHEN AND QI CHENG
Asia Pac J Clin Nutr. 2013;22(1):74-82.
doi: 10.6133/apjcn.2013.22.1.18

 

 

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Maternal and Child Nutrition

Prevalence of inappropriate dietary supplement use among pregnant women in Japan
YOKO SATO, TOMOKO NAKANISHI, TSUYOSHI CHIBA, KAORI YOKOTANI, KOUJIROU ISHINAGA, HIDEMI TAKIMOTO, HIROAKI ITOH AND KEIZO UMEGAKI
Asia Pac J Clin Nutr. 2013;22(1):83-89.
doi: 10.6133/apjcn.2013.22.1.08

 

 

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Low body weight gain, low white blood cell counts and high serum ferritin as markers of poor nutrition and increased risk for preterm delivery
WEN-YIN HSU, CHENG-HSUAN WU, CHARLES TSUNG-CHE HSIEH, HUI-CHEN LO, JEN-SHIOU LIN AND MEI-DING KAO
Asia Pac J Clin Nutr. 2013;22(1):90-99.
doi: 10.6133/apjcn.2013.22.1.05

 

 

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The nutritional status of young children and feeding practices two years after the Wenchuan Earthquake in the worst-affected areas in China
JING SUN, JUNSHENG HUO, LIYUN ZHAO, PING FU, JIE WANG, JIAN HUANG, LIJUAN WANG, PENGKUN SONG, ZHENG FANG, SUYING CHANG, SHIAN YIN, JIAN ZHANG AND GUANSHENG MA
Asia Pac J Clin Nutr. 2013;22(1):100-108. d
oi:10.6133/apjcn.2013.22.1.19

 

 

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Nutritional Epidemiology and Public Health

 

Associations between uterine fibroids and lifestyles including diet, physical activity and stress: a case-control study in China
YUAN HE, QIANG ZENG, SHENGYONG DONG, LIQIANG QIN, GUOWEI LI AND PEIYU WANG
Asia Pac J Clin Nutr. 2013;22(1):109-117.
doi: 10.6133/apjcn.2013.22.1.07

 

 

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Isoflavone consumption and risk of breast cancer: a dose-response meta-analysis of observational studies
QI XIE, MING-LIANG CHEN, YU QIN, QIAN-YONG ZHANG, HONG-XIA XU, YONG ZHOU, MAN-TIAN MI AND JUN-DONG ZHU
Asia Pac J Clin Nutr. 2013;22(1):118-127.
doi: 10.6133/apjcn.2013.22.1.16

 

 

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The association of tea consumption with bladder cancer risk: a meta-analysis
SHIHAO WU, FEI LI , XIAO HUANG, QINGSHENG HUA ,TAO HUANG , ZHILE LIU, ZHIXIANG LIU, ZHAOFEI ZHANG, CHUNXIAN LIAO, YUANXIANG CHEN, YUQIANG SHI, RENCHUANG ZENG, MINGEN FENG, XINTAI ZHONG, ZHAOLIN LONG, WANLONG TAN AND XINJI ZHANG
Asia Pac J Clin Nutr. 2013;22(1):128-137.

doi: 10.6133/apjcn.2013.22.1.15

 

 

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Changes in the sodium content of Australian ready meals between 2008 and 2011
ANTHEA KAY CHRISTOFOROU, ELIZABETH KALPIAKA DUNFORD AND BRUCE CHARLES NEAL

Asia Pac J Clin Nutr. 2013;22(1):138-143.

doi: 10.6133/apjcn.2013.22.1.10

 

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Nutrition education in Japanese medical schools: a follow-up survey
HIDEO ORIMO, TAKAHIRO UENO, HIROSHI YOSHIDA, HIROHITO SONE, AKIRA TANAKA AND HIROSHIGE ITAKURA
Asia Pac J Clin Nutr. 2013;22(1):144-149.
doi: 10.6133/apjcn.2013.22.1.13

 

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Nutrigenomics

Insulin receptor substrate 1 (IRS1) variants confer risk of diabetes in the Boston Puerto Rican Health Study
XIANG FENG, KATHERINE L TUCKER, LAURENCE D PARNELL, JIAN SHEN, YU-CHI LEE, JOSE M ORDOVAS, WEN-HUA LING AND CHAO-QIANG LAI
Asia Pac J Clin Nutr. 2013;22(1):150-159.
doi: 10.6133/apjcn.2013.22.1.09

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Associations between serum bone-specific alkaline phosphatase activity, biochemical parameters, and functional polymorphisms of the tissue-nonspecific alkaline phosphatase gene in a Japanese population
NATSUKO SOGABE, RIEKO TANABE, MAYU HARAIKAWA, YUTAKA MARUOKA, HIDEO ORIMO, TAKAYUKI HOSOI AND MASAE GOSEKI-SONE
Asia Pac J Clin Nutr. 2013;22(1):160-165.

doi: 10.6133/apjcn.2013.22.1.11

 

 

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Clinical Nutrition Commentaris

 

Vitamin D in North-East Asian clinical nutrition practice
MARK L WAHLQVIST
Asia Pac J Clin Nutr. 2013;22(1):166-169.

doi: 10.6133/apjcn.2013.22.1.22

 

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Future Events

 

Asia Pac J Clin Nutr. 2013;22(1):170.

 

 

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Vitamin D status and food security in North-East Asia
MARK L WAHLQVIST
The functions of vitamin D are pleiotropic affecting all body organs and systems in some way. Its adequacy depends principally on sunshine for UV light to stimulate its synthesis in skin and on foods which contain it, either animal-derived or obtained from fungi or mushrooms, with the UV-responsive substrates dehydrocholesterol for vitamin D-3 or ergosterol for vitamin D-2, respectively. Thus, vitamin D health is very environmentally dependent. With ecosytem degradation, whether by atmospheric pollution or food systems which do not derive UV irradiation, as with fish farming or mushroom processing, then this nutrient input into human biology may falter. Vitamin D deficiency is now common and widespread in North-East Asia as elsewhere. When discovered early in the 20th century it was linked to rickets in children and osteomalacia in adults and, for a generation or so, children were given fish, usually cod, liver oil to prevent bone disease. Now cod as a species and many edible fish are threatened. Over-exposure to sun-light increases the risk of skin cancer. We may tackle this problem by vitamin D supplementation with an alternative to fish liver. But the demographic pressures of population size and ageing (when the skin is less UV responsive) make the clinical and public health decisions and strategies demanding. Vitamin D health has become indicative of food security whose usual indicator is food diversity; such diversity may allow lesser concentrations to be more effective in organ and system function, but we have little evidence to support this at present.
Key Words: vitamin D, climate change, health, pleiotropic functions
 

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東北亞的維生素D 狀況與糧食安全
維生素D 的功能是透過某些途徑多效地影響全身器官及系統。足量的維生素D 主要靠陽光中的紫外線刺激皮膚合成及含有維生素D 的食物,如來自動物或菇菌類中所含的維生素D-3 與D-2,分別由去氫膽固醇與麥角固醇合成。因此,體內維生素D 的狀況易受到環境影響。隨著生態系統的衰落,不管是大氣污染或是因為養殖漁業、菇類加工使這些食物無法保有經由紫外線輻射而產生的維生素D,此營養素進入人體的機會可能隨之減少。目前東北亞維生素D缺乏的情形和他處一樣常見且普遍。在20 世紀初,維生素D 被發現與孩童佝 僂症和成人的軟骨症有關,當時那一輩的孩童藉由給與魚肝油(通常是鱈魚)來防止骨疾病。然而現在,鱈魚及許多可食的魚類數量均銳減,過度暴露於陽光下則會增加皮膚癌的風險。為了解決此問題,也許應以維生素D 補充劑來取代魚肝。但是人口增加及老化(此時皮膚對紫外線的反應降低)的壓力使得臨床及公共衛生上的決策變得不可或缺。維生素D 狀況已成為糧食安全的代言,其常用指標為食物多樣性;此多樣性或許使得以較少的濃度就能在器官和系統功能更有效率,但目前支持的證據尚不足。
關鍵字:維生素D、氣候變遷、健康、多效作用

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Thailand nutrition in transition: situation and challenges of maternal and child nutrition
PATTANEE WINICHAGOON
Double burden of malnutrition (DBMN), the coexistence of under- and overnutrition in the same population, is an emerging public health concern in developing countries, including Thailand. This paper aims to review the maternal and child nutrition situation and trends as the country moved from a low-income to a middle-income country, using data from large scale national surveys. Protein-energy malnutrition and micronutrient deficiencies predominantly affected mothers and children prior to the 1980s. The situation greatly improved during the 1980s-1990s, with the implementation of multi-sectoral policies and programs focusing on poverty alleviation and primary health care. Economic development, improved access to health services and effective community-based nutrition programs contributed to these positive trends. However, the prevalence of low birth weight remained at 8- 10%, while stunting and underweight declined to about 10% by the 1990s, with small change thereafter. The prevalence of anemia among pregnant women and children decreased by half and vitamin A deficiency is no longer a public health problem. Iodine deficiency, especially during pregnancy is still a major concern. As the country progressed in terms of economic and social development, overnutrition among women and children affected all socio-economic levels. Changes in lifestyles, food access and eating patterns are observed both in urban and rural areas. Although efforts have been made to address these challenges, harmonized policy and strategic programs that address DBMN in the complex social and economic environment are urgently needed. Early life undernutrition should be considered along with measures to address obesity and chronic diseases in children.
Key Words: mothers, children, early life, nutrition transition, Thailand

 

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轉型中的泰國營養狀況:婦幼營養的現況及挑戰
營養不良的雙重負擔(DBMN),係指營養不足及營養過剩同時存在相同的族群,在發展中國家包含泰國,這是一個新近浮現的公共衛生問題。本篇文章使用大規模的國家性調查資料,回顧從低收入轉變為中等收入國家的過程中,婦幼營養的情況及趨勢。1980年代之前,蛋白質熱量營養不良及微量營養素缺乏顯著地影響媽媽及幼兒。這個情況在1980-1990 年代,因多部門政策及計劃致力於執行扶貧及初級健康照護而大幅的改善。經濟的發展,改善健康服務的可近性及有效率的社區基礎營養計畫造就這些正向趨勢。然而,1990 年代低出生體重的盛行率保持在8-10%,生長遲緩及體重過輕下降至約10%,爾後小幅度改變。懷孕婦女及兒童的貧血盛行率減少一半,而維生素A 缺乏不再是公共衛生問題。碘缺乏,特別是懷孕期間,仍然是重要的關注點。當國家朝經濟及社會方面的發展前進,各個社經層面的婦女及兒童都受營養過剩的影響。在市鎮及鄉村地區都觀察到生活型態、食物可近性及飲食模式的改變。儘管已做出努力因應這些挑戰,針對複雜的社經環境中的DBMN 問題,仍迫切需要一致性的政策及計畫。解決兒童肥胖及慢性疾病議題的同時,應考量幼兒期的營養不足。
關鍵字:母親、兒童、幼兒期、營養轉型期、泰國

 

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Eating beef: cattle, methane and food production
ASA K WAHLQUIST
A number of prominent people have advocated eating less meat or becoming a vegetarian to reduce global warming, because cattle produce the greenhouse gas methane. This raises a number of questions including: what will happen to the grasslands that much of the world’s cattle currently graze; how will alternate protein be produced, and what will the greenhouse consequences of that production be? It comes down to production systems. About 70 per cent of the world’s agricultural land is grassland, and the only way to produce food from grasslands is to graze ruminants on it. If domesticated animals do not graze the grasslands, native or feral ruminants, which also produce methane, tend to move in. Feeding high quality grain to cattle is much less defensible. Replacing animal protein with plant proteins like soybeans necessitates more cropping land, water, fuel and chemicals being used. A more rational food system would raise cattle on grasslands but not feed them high quality grains. Instead more of the currently grown crop could be devoted to human consumption.
Key Words: cattle, methane, grassland, grain-fed

 

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吃牛肉:畜牛、甲烷及糧食生產
因為畜牛會產生溫室效應的甲烷氣體,故一些名人提倡少吃肉或是成為素食者,以減少全球暖化。這牽涉幾個問題包含:世界上許多原先放牧畜牛的那些草原會變成如何;替代蛋白質如何被生產以及那個產物的溫室結果將會是什麼?這歸結到生產系統。世界上的農地有70%是草原,從草原生產糧食只有一個方法,就是放牧反芻類動物。假如沒有在草原放牧家畜,原生或是野生反芻類動物會遷移進去,也產生甲烷。餵食畜牛高品質穀類的做法是更難站得住腳的。以植物性蛋白替代動物性蛋白,例如大豆,需要使用較多耕地、水、燃料及化學物質。一個較合理的糧食系統應該是將牛群放養在草原上,而不餵食牠
們高品質穀物。這樣反而有更多現行的作物可提供人類食用。

關鍵字:畜牛、甲烷、草原、穀物餵養

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Validation of a self-monitoring device for estimating 24-hour urinary salt excretion
KENICHIRO YASUTAKE, KAYOKO SAWANO, NAOKO SHONO AND TAKUYA TSUCHIHASHI
Background: The purpose of this study was to investigate the relationship between salt intake and urinary salt excretion and to examine the validity of a self-monitoring device for estimating 24-h urinary salt excretion from overnight urine samples. Methods: Twelve young, healthy female volunteers consumed test meals from days 1 to 14 and estimated urinary salt excretion on days 2–15 by using a self-monitoring device. The salt content of the test meals was as follows: 10 g (days 1–5), 6 g (days 6–8), 13 g (days 9–11), 6 g (day 12), 13 g (day 13), and 6 g (day 14). Results: The average 24-h urinary salt excretion (the ratio of urinary salt excretion to salt intake of the previous day) estimated from the overnight urine samples was as follows: 8.01±1.15 g (0.73±0.11) on days 2–6, 5.86±0.85 g (1.01±0.15) on days 7–9, 9.69±1.64 g (0.74±0.13) on days 10–12, 6.51±1.56 g (1.03±0.25) on day 13, 8.60±3.25 g (0.71±0.14) on day 14, and 6.28±1.31 (1.05±0.22) on day 15. Thus, the salt excretion/salt intake ratio was approximately 0.8 during the high-salt phase and 1.0 during the low-salt phase. Conclusion: The estimation of 24-h urinary salt excretion from overnight urine samples by using a self-monitoring device is a reasonably valid method in this young and healthy female population for detecting daily changes in salt intake.
Key Words: salt intake, urinary salt excretion, self-monitoring device, overnight urine, blood pressure

 

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自我監測裝置之驗證-測量24 小時尿鹽排出
背景:本研究之目的是探討鹽攝取量與尿鹽排出量之相關性,並檢查用來測量24 小時尿鹽排出的自我監測裝置之校度。方法:12 位健康的年輕女性自願者,攝取14 天的實驗餐並藉由自我監測裝置來測量其第2 天到第15 天的尿鹽排出量。實驗餐中所含的鹽量分別如下:10 克(第1 到5 天)、6 克(第6 到8 天)、13 克(第9 到11 天)、6 克(第12 天)、13 克(第13 天)、及6 克(第14天)。結果:由隔夜的尿液樣本中,24 小時平均尿鹽排出量分別為:第2 到6天為8.01 克、第7 到9 天為5.86 克、第10 到12 天為9.69 克、第13 天為6.51 克、第14 天為8.60 克、第15 天為6.28克。因此,在高鹽攝取期,排出鹽量與(前一日)鹽攝取量之比值約為0.8;在低鹽攝取期比值為1.0。結論:在這些健康的年輕女性族群中,藉由使用自我監測裝置來測量24 小時尿鹽排出量,對於偵測每日鹽攝取的改變是一項合理且有效的方法。
關鍵字:鹽攝取、尿鹽排出、自我監測裝置、隔夜尿液、血壓
 

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The atherosclerotic risk profile is affected differently by fish flesh with a similar EPA and DHA content but different n-6/n-3 ratio
FRANCESCO SOFI, GIANLUCA GIORGI, FRANCESCA CESARI, ANNA MARIA GORI, LUCIA MANNINI, GIULIANA PARISI, ALESSANDRO CASINI, ROSANNA ABBATE, GIAN FRANCO GENSINI AND BIANCA MARIA POLI

The aim of this study was to evaluate the effect of consuming gilthead sea bream fillets, with different n-6/ n-3 ratios, on atherosclerotic biomarkers. Twenty healthy subjects were included in a randomised single-blinded cross-over trial. Participants were randomized into 2 groups, both of which received approximately 630 g per week of gilthead sea bream fed with either 100% fishmeal (FM) or partial replacement with plant proteins (PP) over two consecutive 10 week periods, respectively. Group A consumed firstly the FM fillets followed by the PP fillets, whereas the reverse order was adopted for group B. Group A reported a significant decrease of 29.3% (Δ = –26 mg/dL) in total cholesterol after the first phase of the intervention, before returning to baseline levels after the dietary intervention with fish fed with PP. Similarly, in group A, both LDL-cholesterol and triglycerides decreased significantly by 21.6% (Δ = –19 mg/dL) and 11.7% (Δ = –10.7 mg/dL), respectively, before increasing again after the intervention. Improvements in the inflammatory cytokines, interleukin-6 and -8 were also noted. Moreover, whole blood viscosity appeared significantly improved in group A, as seen by a significant increase of 7.59% (Δ = +4.59 mPA) for erythrocyte filtration rate. In conclusion, similar EPA+DHA content with different n- 6/n-3 ratio fish flesh intake was shown to have varied affects on lipid, inflammatory and haemorheological parameters in a group of healthy subjects.
Key Words: fish intake, cardiovascular disease, inflammation, diet, omega-3

 

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攝取EPA 及DHA 含量相似但n-6 與n-3 脂肪酸比例相異的魚肉對於動脈粥狀硬化危險因子之不同效應
本研究目的,在於評估攝取n-6 及n-3 脂肪酸比例不同之黑鯛魚片對於動脈粥狀硬化生化指標的影響。共有20 位健康的受試者參與此隨機單盲交叉試驗。研究初始,隨機將受試者分為A、B 兩組,A 組先給予每週大約630 克黑鯛魚片(FM-以全魚飼料餵養),連續攝食10 週後,更換為以混合50%植物性蛋白飼料餵養的黑鯛魚(PP),B 組則相反。A 組在給予FM 黑鯛魚的介入後,總膽固醇濃度顯著地減少29.3%(-26 mg/dL),然而換成給予PP 黑鯛魚後,又回升至介入前的濃度。且低密度脂蛋白膽固醇(減少21.6%; -19 mg/dL)及三酸甘油酯(減少11.7%; -10.7 mg/dL)也具有相似的現象。FM 黑鯛魚的攝取,同時改善發炎細胞激素、介白素-6 及介白素-8 的濃度。此外,紅血球濾過率顯著提高7.59%(+4.59 mPA),顯示A 組參與者的全血黏度有明顯的改善。總結而論,攝取EPA 及DHA 含量相似,但不同比例n-6 與n-3 脂肪酸之魚肉,對於健康受試者的脂質、發炎及血液動力學參數,具有不同的效應。
關鍵字:魚類攝取、心血管疾病、發炎、飲食、ω-3 脂肪酸

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Iodized salt supplementation and its effects on thyroid status amongst Orang Asli in Hulu Selangor, Malaysia
KUANG KUAY LIM, MING WONG, WAN NAZAIMOON WAN MOHAMUD AND NOR AZMI KAMARUDDIN
Background: This research was performed to determine the prevalence of iodine deficiency disorder (IDD) and the effects of iodized salt supplementation on thyroid status amongst Orang Asli in Hulu Selangor, Malaysia. Methods: Study respondents were from three target groups, i.e. pre-school children (PSC), primary school-going children (SGC) and adult women. Each household was supplied with iodized salt fortified with iodate fortificant for a period of 12 months and the iodine levels in the salt ranged from 20 to 30 μg/L. Samples collected before and after 6 and 12 months of introduction to iodized salt were urine from all groups, as well as serum samples from adult women. Results: A total of 200 respondents were recruited; 58 (29.0%) PSC, 65 (32.5%) SGC and 77 (38.5%) adult women. The median urine-iodine concentration (mUIC) in all groups were of moderately low before the iodized salt intervention, but increased significantly in all study groups after 6 and 12 months of intervention. However, at the end of the study, there was an increase in severe iodine deficiency (mUIC <20 μg/L) from 7.5% to 12% and about 9% of PSC and SGC respondents had mUIC level of more than 300 μg/L while the adult women showed a significant increase in free triiodothyronine (fT3) levels. Conclusion: The study demonstrated that iodized salt supplementation was able to show an improvement in iodine level amongst Orang Asli. However, an increase in severe iodine deficiency and iodine excess indicated that the iodized salt programme needs to be carefully monitored.
Key Words: iodine deficiency disorder, Orang Asli, iodized salt, hyperthyroidism

 

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馬來西亞Hulu Selangor 地區原住民碘鹽補充及其對甲狀腺狀況影響
背景:這個研究的執行是為了評估馬來西亞Hulu Selangor 地區的原住民(Orang Asli)碘缺乏失調(IDD)的盛行率及碘鹽補充對於其甲狀腺的影響。方法:研究的受訪者來自於三個目標族群,即學齡前兒童、小學學童及成年女性。提供每個家戶為期12 個月含碘酸鹽的強化碘鹽,食鹽中的碘含量從20至30 μg/L。收集所有組別其碘鹽使用前及使用後6 個月及12 個月的尿液,成人女性加收血清樣本。結果:總共有200 名受訪者被納入研究;58 名學齡前兒童(29.0%)、65 名小學學童(32.5%)和77 名成年女性(38.5%)。在碘鹽介入前,所有組別的尿碘濃度中位數(mUIC)稍低,但是在介入6 個月及12 個
月後,所有組別都顯著上升。然而,在研究結束時,嚴重碘缺乏(mUIC <20μg/L)從7.5%增加至12%,但約9%的學齡前兒童及小學學童受訪者mUIC 超過300 μg/L,同時成年女性游離三碘甲狀腺素(fT3)的量顯著增加。結論:此研究證實碘鹽的補充可以改善原住民的碘狀況。然而,嚴重碘缺乏及碘過多比例增加,顯示碘鹽計畫需要被小心嚴謹地監測。
關鍵字:碘缺乏失調、馬來半島原住民、碘鹽、甲狀腺機能亢進


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Oral carbohydrate loading with 18% carbohydrate beverage alleviates insulin resistance
TAKAHIKO TAMURA, TOMOAKI YATABE, HIROYUKI KITAGAWA, KOICHI YAMASHITA, KAZUHIRO HANAZAKI AND MASATAKA YOKOYAMA
Preoperative 12.6% oral carbohydrate loading is an element of the Enhanced Recovery After Surgery (ERAS) protocol aimed at alleviating postoperative insulin resistance; however, in Japan, beverages with 18% carbohydrate content are generally used for preoperative carbohydrate loading. We investigated the effect of 18% carbohydrate loading on alleviating insulin resistance. Six healthy volunteers participated in this crossover-randomized study and were segregated into 2 groups: volunteers in the carbohydrate-loading group (group A) who fasted from after 9 pm and ingested 375 mL of a beverage containing 18% carbohydrate (ArginaidWaterTM; Nestle, Tokyo, Japan) between 9 pm and 12 pm, and 250 mL of the same liquid at 6:30 am. Volunteers in control group (group B) drank only water. At 8:30 am, a hyperinsulinemic normoglycemic clamp was initiated. Glucose infusion rate (GIR) and levels of ketone bodies and cytokines (IL-1β, IL-6, and TNF-α) before clamping were evaluated. P<0.05 was considered statistically significant. Levels of blood glucose, insulin, and cytokines at the start of the clamp were similar in both the groups. The GIR in group A was significantly higher than that in group B (11.5±2.4 vs 6.2±2.2 mg/kg/min, p=0.005), while blood ketone body levels were significantly lower in group A (22±4 vs 124±119 μmol/L, p=0.04). Preoperative 18% carbohydrate loading could prevent the decrease in insulin sensitivity and suppress catabolism in healthy volunteers. Thus, carbohydrate loading with a beverage with 18% carbohydrate content might contribute to improvements in perioperative management.

Key Words: carbohydrate loading, insulin resistance, enhanced recovery after surgery, hyperinsulinemic normoglycemic clamp, perioperative management
 

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以含18%醣類的飲料做為口服醣類負載可減輕胰島素阻抗
手術前給予12.6%口服醣類負載(能量儲備)是加速術後康復(ERAS)的療程之一,目的為減輕手術後胰島素阻抗;然而在日本,含18%醣類的飲料普遍被用於術前醣類負載。本研究試驗18%醣類負載對減輕胰島素阻抗的影響。6名健康自願者參與這個隨機交叉研究,並被分為兩組。醣類負載的自願者(A組)從下午9 點後禁食,並在下午9 點至12 點間攝取375 mL 含有18%醣類的飲料,早上6 點半攝取250 mL 相同液體。控制組的自願者(B 組)只攝取水。早上8 點半,開始高胰島素-正常血糖箝制試驗。在箝制前評估葡萄糖流速(GIR)、酮體量及細胞激素(IL-1β、IL-6 和TNF-α)。以P<0.05 認定達統計顯著性。血糖、胰島素及細胞激素量在箝制前兩組是相似的。A 組的GIR 顯著的高於B 組(11.5±2.4 比上6.2±2.2 mg/kg/min,p=0.005);同時A 組的血液酮體量顯著較低(22±4 比上124±119 μmol/L,p=0.04)。在健康的自願者,手術前18%醣類負載可以預防胰島素敏感性的降低及抑制分解。因此,以含18%醣類飲料的醣類負載可能對手術期治理的改善具有貢獻。
關鍵字:醣類負載、胰島素阻抗、加速術後康復、高胰島素-正常血糖箝制試驗、手術期治理


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A multicentre assessment of malnutrition, nutritional risk, and application of nutritional support among hospitalized patients in Guangzhou hospitals
SHI FANG, JIANTING LONG, RONGSHAO TAN, HAIYAN MAI, WEI LU, FENG YAN AND JUNSHENG PENG
Background: To assess nutritional status, the prevalence of nutritional risk, and nutritional support in hospitalized patients in Guangzhou, to determine gender or age associated differences in the prevalence of nutritional risk. Methods: A total of 2550 patients admitted during April to December 2008 from six departments (Gastroenterology, Pulmonology, Neurology, Nephrology, General Surgery and Thoracic Surgery) of four teaching hospitals were screened using the Nutritional Risk Screening 2002 tool. Results: Overall prevalence of undernutrition and nutritional risk was 17.8% and 41.5%, respectively. The department of Pulmonology had the highest prevalence of undernutrition (28.2%) and nutritional risk (55.9%). The prevalence of nutritional risk was significantly higher in patients ≥70 years of age than patients <70 years (64.2% vs 32.6%, p<0.001). No gender difference in the prevalence of nutritional risk was observed in general. In total, 47.6% of “at risk” and 19.4% of “not at risk” patients received nutritional support. Parenteral nutrition accounted for 88.8% of the nutritional support. Conclusions: The present study documented the prevalence of nutritional risk defined by NRS2002 and inappropriate assignment of nutritional interventions in Guangzhou hospitals.
Key Words: nutritional assessment, nutritional status, hospital, malnutrition, nutritional support

 

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对广州医院住院病人营养不良、营养风险及营养支持现状的多中心调查

背景:在广州住院病人中评估其营养现状、营养风险的流行情况及营养支持現况,调查性别或年龄因素在营养风险流行中所造成的差异。方法:从2008年4月到12月,在广州市4家教学医院的六个科室(消化内科、呼吸内科、神经内科、肾内科、普通外科及胸外科),共计2550位病人接受了以“营养风险2002”为工具的筛查。结果:患营养不良或面临营养风险的病人分别占总人数的17.8%和41.5%。其中,呼吸内科病人患营养不良(28.2%)及营养风险(55.9%)的比例在所有科室中是最高的。此外,年龄≥70岁的病人比年龄<70岁的病人更易罹患营养风险(64.2%相对32.6%,p<0.001)。营养风险的流行情况,无性别相关差异。总体而言,47.6%有营养风险的病人与19.4%无营养风险的病人接受了营养支持治疗。肠外营养占营养支持的88.8%。结论:本研究采用了“营养风险2002”为筛查工具,记录了广州医院住院病人中的营养风险流行情况及营养干预的不合理分配情况。

關鍵字:营养筛查、营养状态、医院、营养不良、营养支持

 

 

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Serum and dietary antioxidant status is associated with lower prevalence of the metabolic syndrome in a study in Shanghai, China
YANRONG LI, HONGWEI GUO, MIN WU AND MING LIU

Objective: The aim of our study was to examine the association between the metabolic syndrome (MS) and serum antioxidant status. Methods: A cross-sectional study was conducted with 221 cases and 329 controls aged 18 to 65 years. Weight, height, body mass index, waist circumference, blood pressure, fasting blood glucose and lipids, as well as serum superoxide dismutase, glutathione peroxidase, malondialdehide, vitamins A, E, β-carotene and lycopene were examined. Intakes of antioxidants were also estimated. Results: Mean serum superoxide dismutase activity, β-carotene concentrations were significantly lower, malondialdehide was higher (p<0.05) in persons with the MS (after adjusting for age, sex) than those without. Superoxide dismutase, glutathione peroxidase, and β-carotene also decreased significantly (p<0.05) with increased number of components of the MS. Low levels of serum superoxide dismutase activity and β-carotene concentration appeared to be associated with the MS status. Moreover, dietary energy, carbohydrate, vitamin C, zinc and copper intake in the MS patients were lower, but fat intake were higher. Vitamins E, C and manganese intake decreased with the elevated number of the MS components. For zinc and manganese, a lower risk was observed for other quartile of intake compared with the first one. Inverse links between dietary fat, energy intake and serum antioxidant status were found in MS patients, meanwhile dietary vitamin C was positively related with serum antioxidant level. Conclusions: Serum antioxidant status was associated with a lower prevalence of the MS, and with lower dietary fat, energy intake and higher vitamin C intake.

Key Words: human, antioxidant, serum, diet, metabolic syndrome


 

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中国上海关于血清和膳食抗氧化状态与低代谢综合征患病率相关的研究

目的:本研究是为了探讨代谢综合征与血清抗氧化状态之间的关系。方法:此次研究为横断面调查,共包含年龄在18至65岁的221名代谢综合征患者和329名对照人群。检测调查对象的体重、身高、体质指数、超氧化物歧化酶、谷胱甘肽过氧化酶、丙二醛、维生素A、维生素E、β-胡萝卜素和番茄紅素。同时,还计算膳食中抗氧化物质的摄取情况。结果:校正年龄、性别之后,与对照组相比,代谢综合征患者超氧化物歧化酶、β-胡萝卜素浓度较低,丙二醛含量较高(p<0.05)。代谢综合征的组分数量增加时,超氧化物歧化酶、谷胱甘肽过氧化酶、β-胡萝卜素含量随之降低(p<0.05)。血清低超氧化物歧化酶、β-胡萝卜素与代谢综合征相关。另外,代谢综合征组膳食能量、碳水化合物、维生素C、锌、铜摄入相对较低,而脂质摄入较高。膳食维生素E、维生素C、镁的摄入随之代谢综合征组分数量增加而降低。并且与第一四分位数组相比,锌和镁的其他四分位数组的代谢综合征风险降低。在代谢综合征患者中,膳食脂质、总能量摄入与血清抗氧化水平呈负相关,而维生素C摄入与血清抗氧化水平呈正相关。结论:血清抗氧化水平与低患病风险相关,也与膳食中脂肪、能量低摄入和高维生素C摄入相关。

關鍵字:人類、抗氧化、血清、膳食、代谢综合征

 


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Regional percent fat and bone mineral density in Korean adolescents: The Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-3), 2009
KAYOUNG LEE
The effects of total and regional (trunk, arm, and leg) percent fat on total and regional (arm, leg, rib, thoracic spine, lumbar spine, proximal femur, and pelvis) bone mineral density (BMD) in Korean adolescents were examined using the Fourth Korea National Health and Nutrition Examination Survey, 2009. Percent fat and BMD were measured by dual energy X-ray absorptiometry in a population-based sample of 710 Korean adolescents (365 boys and 345 girls), aged 10-19 years. After adjusting for age, height, weight, serum vitamin D, dietary calcium intake, and menarche for girls in complex sampling linear regression analysis, higher total and regional percent fat were associated with low total BMD and BMD in all regions in boys aged 13-16 years, while the associations were inconsistent for early and late adolescent boys. In girls, the inverse associations were more consistent for those aged 17-19 years than for younger girls. While most of total and regional percent fat were negatively associated with BMD of thoracic and lumbar spine and femur in boys, most of these relationships were not significant in girls. The negative association with total BMD was consistent for trunk percent fat but variable for arm and leg percent fat according to age subgroup and gender. In conclusion, the unfavorable effect of regional percent fat on
all regional BMD is more consistent in boys aged 13-16 years and in girls aged 17-19 years, while the relationship appears to be gender and age subgroup-specific.
Key Words: percent body fat, bone mineral density, gender, development stage, adolescent

 

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韓國青少年之局部體脂肪百分比及骨質密度: 2009 年第四次韓國國民健康及營養狀況調查
本研究藉由第四次韓國國民營養調查資料,評估青少年總脂肪及局部脂肪(軀幹、手臂和大腿)百分比,與總骨質密度及局部骨骼(手臂、大腿、肋骨、胸椎、腰椎、股骨近端及骨盆)骨密度的相關性。利用雙能量X 光吸收儀,測量年齡介於10-19 歲,以人口分佈為基礎抽樣的710 位韓國青少年(365 位男孩及345位女孩)的脂肪百分比及骨質密度。在校正年齡、身高、體重、血清維生素D、膳食鈣攝取量,以及青少女經期等變項後,以複雜樣本線性迴歸分析。結果顯示13 至16 歲的少年,總脂肪及局部脂肪百分比,與整體及局部骨質密度呈現負相關。然而,在其他年齡層的男孩,則不具有一致的相關。女孩方面,比起較低的年齡層,17-19 歲的青少女之脂肪百分比與骨質密度的負相關性較為一致。雖然男孩之總脂肪及局部脂肪百分比,大多與胸椎、腰椎及股骨之骨質密度呈現負相關,但在女孩則多無顯著相關。將性別及年齡分層,軀幹脂肪與總骨密度呈現一致負相關,然而手臂及大腿的脂肪百分比與骨質密度關係則無一致性。結論,13 至16 歲的男孩及17 至19 歲的女孩,其局部脂肪對於所有部位的骨質密度具有不佳的影響,然而此相關只呈現在特定的性別及年齡層。
關鍵字: 體脂百分比、骨質密度、性別、發育階段、青少年
 

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The association of weight status with cognitive impairment in the elderly population of a Shanghai suburb
GUO-HONG CUI, HAI-DONG GUO, RUI-FANG XU, GUO-XIN JIANG, SHENG-DI CHEN AND QI CHENG
Objective: A population-based survey was conducted to analyze the association of under-weight, blood pressure, glucose and lipid metabolism with cognitive impairment in people, 60 years and over, living in 2 towns of Shanghai. Methods: Face-to-face interviews were carried out to collect relevant information with questionnaires. Anthropometric indices of height, weight, waist circumference (WC) and hip circumference were measured. Multivariable logistic regression analyses were performed to evaluate the association of weight status with cognitive impairment. Results: Cognitive impairment were diagnosed in 198 (7.0%) of the 2 809 participants. Compared to the normal BMI category, the under-weight category was significantly associated with the risk of cognitive impairment (OR= 2.47, 95%CI: 1.46-5.23). Subjects with a high WC were 1.5 times (OR= 1.42, 95%CI: 1.10-2.67) more likely and subjects with a high WHR were 1.7 times (OR= 1.68, 95%CI: 1.05-2.84) more likely to be associated with cognitive impairment than the subjects in the reference group. This study demonstrates a significant interaction between hypertension, lipid disorder and WC or WHR on the risk of cognitive impairment in a rural population in Shanghai. Conclusions: Central obesity was significantly associated with the risk of cognitive impairment. A low BMI may be a risk factor for cognitive impairment. A significant interaction between hypertension, lipid disorder and WC or WHR on the risk of cognitive impairment in Shanghai rural population was found.
Key Words: cognitive impairment, waist circumference, waist-to-hip ratio, BMI

 

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上海郊区老年人群体重与认知功能障碍的关系

目的:研究上海郊区2个镇的老年人群低体重、血压、血糖、血脂与认知功能障碍之间的关系。方法:由经过培训的调查人员采用认知功能障碍调查问卷,对研究对象进行面对面的询问,收集相关资料。並進行对身体的测量,包括身高、体重、腰围及臀围。通过非条件多因素逻辑回归分析研究体重、血压、血糖、血脂与认知功能障碍的关系。结果:2,809人的研究对象中,有198 (7.0%)人被诊断为认知功能障碍。在调整了可能的混杂因素后,与正常体重指数(BMI)人群相比,低体重与认知功能障碍之间存在相关关系(OR= 2.47,95%CI: 1.46-5.23);与正常腰围组相比,高腰围与认知功能障碍之间存在相关关系(OR= 1.42,95%CI: 1.10-2.67);与正常腰臀比(WHR)组相比,高腰臀比与认知功能障碍之间亦存在相关关系(OR= 1.68,95%CI: 1.05-2.84)。本研究结果表明,高血压、血脂异常可能通过与腰围、腰臀比之间的交互作用对认知功能障碍的发生产生影响。结论:中心型肥胖与认知功能障碍之间存在相关关系。低体重可能是认知功能障碍的危险因素。高血压、血脂异常与腰围、腰臀比之间存在交互作用。

關鍵字:认知功能障碍、腰围、腰臀比、体重指数

 

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Prevalence of inappropriate dietary supplement use among pregnant women in Japan
YOKO SATO, TOMOKO NAKANISHI, TSUYOSHI CHIBA, KAORI YOKOTANI, KOUJIROU ISHINAGA, HIDEMI TAKIMOTO, HIROAKI ITOH AND KEIZO UMEGAKI
We investigated the characteristics of dietary supplements and their use by 1,076 Japanese pregnant women, the majority of whom were in mid- to late pregnancy. The subjects completed a self-reported survey on their sociodemographic characteristics, supplement use, and attitudes towards diet. The overall prevalence of supplement use did not change before and after pregnancy (75%); however, daily use increased by approximately twofold with pregnancy (20.2% versus 37.2%). After the onset of pregnancy, supplements containing folic acid were taken for fetal health. Daily users were more likely to be older, have a greater awareness of the risk of neural tube defects (NTD), view supplement use as acceptable, have less diet anxiety, and have more advisers regarding diet. Respondents used supplements containing folic acid alone or with other ingredients. Folic acid intake is recommended to reduce the risk of NTD. However, supplement use began after pregnancy recognition, suggesting a lack of knowledge on the appropriate timing of folic acid use. Information about supplements was obtained mostly from newspapers, magazines, flyers, and stores. These results indicate that more accurate information regarding the optimal timing of folic acid intake and the safety of dietary supplements must be disseminated.
Key Words: dietary supplements, pregnancy, folic acid, information, Japan

 

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日本懷孕婦女膳食補充劑不適當使用的盛行率
我們研究1076 名多數為中後孕期的懷孕婦女,其膳食補充劑的使用及其特性。研究對象完成一個自填式問卷,包括社會人口學特性、補充劑使用及飲食態度的調查。整體的補充劑使用盛行率在懷孕前後並未改變(75%);然而,懷孕後每日使用者增加近兩倍(20.2%提高至37.2%)。在剛懷孕後,含葉酸補充劑的使用是為了胎兒健康。每日使用者多數年紀較大、對神經管缺陷(NTD)的風險認知較高、認為補充劑使用是可接受的、較少飲食焦慮並且接觸較多提供飲食意見者。受調查者使用單獨含葉酸或是混合其他成分的補充劑。葉酸攝取被認為可降低NTD 危險性。然而,意識到懷孕後才開始使用補充劑,顯示缺乏對適當時機使用葉酸補充劑的認知。補充劑的資訊獲得大部分來自報紙、雜誌、傳單及商店。這些結果顯示更多關於葉酸攝取的理想時機及膳食補充劑的安全正確資訊需要被傳播。
關鍵字:膳食補充劑、懷孕、葉酸、資訊、日本

 

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Low body weight gain, low white blood cell counts and high serum ferritin as markers of poor nutrition and increased risk for preterm delivery
WEN-YIN HSU, CHENG-HSUAN WU, CHARLES TSUNG-CHE HSIEH, HUI-CHEN LO, JEN-SHIOU LIN AND MEI-DING KAO
This study determined factors of preterm delivery in Taiwan. Healthy women (n=520, age 29.1±4.2 y) at 8–12 weeks of pregnancy were recruited from prenatal clinics. Background information, anthropometrics, biochemical parameters, and dietary intake, collected by 24 h-recall were obtained from the first, second, and third trimesters to delivery. Clinical outcomes of neonates were also collected. The results show that 53.7% of women were primiparous and that the incidence of preterm delivery was 6.2%. Body weight gains in the first trimester and throughout pregnancy were significantly lower in mothers with preterm delivery (preterm group) than in mothers with term delivery (term group, p<0.05). Maternal cholesterol intake, circulating white blood cell counts (WBC) and serum albumin were significantly lower and that serum magnesium and ferritin were significantly higher in the preterm group than in the term group. Maternal weight gain was positively correlated with caloric and nutrient intake (p<0.05). Neonatal birth weight was positively correlated with maternal weight gain and intakes of protein and phosphate during pregnancy; with intakes of calories, vitamin B-1 and B-2 in the first trimester; and with intakes of calcium, magnesium, iron and zinc, as well as circulating WBC in the third trimester. However, neonatal birth weight was negatively correlated with serum iron in the third trimester and with serum iron and ferritin at the time of delivery. In conclusion, maternal weight gain in early pregnancy and WBC, mineral intake and iron status in late pregnancy seem to be major factors affecting delivery and neonatal outcomes.

Key Words: nutrient intake, maternal weight gain, white blood cells, ferritin, preterm delivery
 

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低體重增加、低白血球計數和高血清鐵蛋白可做為較差營養狀況的標記及增加早產的風險
本研究為探討影響臺灣產婦早產發生的因素。以到醫院產檢,懷孕8-12 週的健康孕婦為對象,共收案520 名,平均年齡29.1±4.2 歲。分別在懷孕第一期、第二期與第三期,收集其基本資料和血液,進行體位測量和以24 小時回憶法收集飲食資料。並在其生產時,收集母親的血液和體位資料與新生兒臨床資料。總計53.7%為初產婦,早產率為6.2%。早產組懷孕第一期體重增加和孕期體重增加總重,明顯低於足月組(p<0.05)。早產組母親膽固醇攝取量、白血球數、血清白蛋白顯著低於足月組(p<0.05);而血清鎂和血鐵蛋白則顯著高於足月組(p<0.05)。產婦孕期體重增加總重與熱量和營養素攝取有
顯著正相關(p<0.05)。新生兒出生體重與母親各孕期體重增加和蛋白質及磷攝取量有顯著正相關(p<0.05);並與母親第一期熱量、維生素B-1 和B-2 攝取量及第三期鈣、鎂、鐵和鋅攝取量、白血球數有顯著正相關(p<0.05)。然而新生兒出生體重與母親第三期血清鐵和生產時血鐵蛋白呈現負相關(p<0.05)。總結而論,母親懷孕早期體重增加、白血球數與礦物質攝取量和懷孕晚期血鐵狀況可能為影響懷孕結果的主要因素。

關鍵字:營養素攝取、孕期體重增加、白血球數、血鐵蛋白、早產


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The nutritional status of young children and feeding practices two years after the Wenchuan Earthquake in the worst-affected areas in China
JING SUN, JUNSHENG HUO, LIYUN ZHAO, PING FU, JIE WANG, JIAN HUANG, LIJUAN WANG, PENGKUN SONG, ZHENG FANG, SUYING CHANG, SHIAN YIN, JIAN ZHANG AND GUANSHENG MA
This study was carried out to investigate the nutritional status and feeding practices of young children in the worst-affected areas of China two years after the Wenchuan Earthquake. The sample consisted of 1,254 children 6-23 months of age living in four selected counties from the disaster-affected provinces of Sichuan, Shaanxi and Gansu. Length-for-age, weight-for-age, weight-for-length, and hemoglobin concentration were used to evaluate nutritional status. Interviews with selected children’s caretakers collected basic demographic information, children’s medical history, and child feeding practices. Stunting, underweight, and wasting prevalence rates in children 6-23 months of age were 10.8%, 4.9% and 2.8% respectively, and anemia prevalence was 52.2%. Only 12.3% of children had initiated breastfeeding within the first hour after birth. Overall, 90.9% of children had ever been breastfed, and 87% children 6-8 months of age had received solid, semi-solid or soft foods the day before the interview. The diets of 45% of children 6-23 months of age met the definition of minimum dietary diversity, and the diets of 39% of breastfed and 7.6% non- breastfed children 6-23 months of age met the criteria for minimum meal frequency. The results highlight that a substantial proportion of young children in the earthquake affected disaster areas continue to have various forms of malnutrition, with an especially high prevalence of anemia, and that most feeding practices are suboptimal. Further efforts should be made to enhance the nutritional status of these children. As part of this intervention, it may be necessary to improve child feeding practices.
Key Words: young children, child growth, anemia, complementary feeding, earthquake disaster

 

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中国汶川大地震两年后灾区婴幼儿营养状况和喂养行为研究
本文是中国汶川大地震两年后对受灾严重地区的婴幼儿营养状况和喂养行为
进行的调查研究。本研究在四川、陕西和甘肃三个受灾省份抽取四个县中
1,254 名6-23 月龄婴幼儿作为调查对象。以年龄别身长、年龄别体重、身长别
体重以及血红蛋白水平作为婴幼儿营养状况的评价指标。调查中还采用问卷
向婴幼儿看护人收集了婴幼儿基本信息、婴幼儿父母职业及文化程度、婴幼
儿过去两周腹泻和呼吸系统患病情况,以及婴幼儿膳食摄入和喂养行为等相
关信息。结果顯示,接受调查的婴幼儿之生长迟缓、低体重、消瘦发生率分
别为10.8%、4.9%和2.8%,贫血患病率为52.2%。只有12.3%的婴幼儿在出
生后一小时内开奶,90.9%的婴幼儿为母乳喂养。87%的6-8 月龄婴幼儿在调
查前24 小时内摄入了固体、半固体、或软质食物。45%的婴幼儿达到了
WHO 推荐的最少膳食种类指标,39%的母乳喂养婴幼儿和7.6%的非母乳喂养
的婴幼儿达到了WHO 推荐的最少食物频率指标。调查结果表明受灾地区婴
幼儿存在各种类型的营养不良状况,贫血患病率高,婴幼儿喂养行为状况不
理想。需要更多的投入以提高这些婴幼儿的营养状况,并且
,将改善婴幼儿
喂养行为作为此次营养干预工作内容的一部分是很有必要的。

关键词:婴幼儿、生长发育、贫血、辅食、地震

 

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Associations between uterine fibroids and lifestyles including diet, physical activity and stress: a case-control study in China
YUAN HE, QIANG ZENG, SHENGYONG DONG, LIQIANG QIN, GUOWEI LI AND PEIYU WANG
This study was conducted to investigate the associations between uterine fibroids and lifestyles including diet, physical activity and stress from October 2009 to April 2011 in China. This case-control study composed of 73 women with uterine fibroids and 210 women without fibroids. Uterine fibroid cases were confirmed by ultrasound diagnosis or hysterectomy surgery. Information on women’s dietary habits, physical activity and stress status were collected with a validated self-administered questionnaire. A logistic regression model was used to estimate the odds ratios (OR) after controlling for age, gravidity and parity. We found that vegetable and fruit intakes and occupational intensity played positive effects on uterine fibroids. For premenopausal women, vegetable and fruit intakes (OR = 0.5; 95% CI: 0.3, 0.9) and occupational intensity (OR = 0.2; 95% CI: 0.1, 0.6) significantly decreased the risk of fibroids; conversely, BMI significantly increased the risk (OR = 1.2; 95% CI: 1.0, 1.4). However, the associations for postmenopausal women were not significant. Our findings suggested protective roles for vegetable and fruit intakes and occupational intensity on uterine fibroids, and supported the hypothesis that high BMI only increased the risk of uterine fibroids in premenopausal women.
Key Words: uterine fibroid, diet, physical activity, stress, risk factors

 

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子宫肌瘤与膳食、体力活动及压力等生活方式之间的
关系:中国的病例对照研究

本研究于2009 年10 月至2011 年4 月期间在中国采用病例对照研究探讨子宫
肌瘤与膳食、体力活动及压力等生活方式之间的关系。共纳入73 名子宫肌瘤
患者和210 未患肌瘤的正常女性。子宫肌瘤病例经超声或行子宫切除术进行
诊断。采用自填式问卷收集女性膳食习惯,体力活动和压力等方面的信息。
在控制年龄,孕次和产次等混杂因素后,进行逻辑回归分析,并计算疾病风
险比值(OR)。结果发现蔬菜水果的摄入与职业性体力活动是子宫肌瘤的保护
因素。对于绝经前女性,蔬菜水果的摄入(OR= 0.5;95%CI:0.3,0.9)和职业
性体力活动(OR =0.2;95%CI:0.1,0.6)能显着降低子宫肌瘤的风险;与之相
反,BMI 显着增加子宫肌瘤的患病风险(OR = 1.2;95%CI:1.0,1.4)。这些
关系在绝经后女性中没有统计学意义。研究表明在绝经前女性中,蔬菜水果
的摄入和职业性体力活动是子宫肌瘤的保护因素,而高BMI 是子宫肌瘤的危
险因素。
关键词:子宫肌瘤、膳食、体力活动、压力、危险因素


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Isoflavone consumption and risk of breast cancer: a dose-response meta-analysis of observational studies
QI XIE, MING-LIANG CHEN, YU QIN, QIAN-YONG ZHANG, HONG-XIA XU, YONG ZHOU, MAN-TIAN MI AND JUN-DONG ZHU
Epidemiologic studies that examine whether isoflavone consumption protects against breast cancer have yielded inconsistent results. The controversy focuses on the effects of the menopausal status and exposure dose of isoflavone. We aim to conduct a meta-analysis on the association between isoflavone intake and breast cancer risk by comprehensively assessing isoflavone exposure in the targeted populations. We searched PUBMED and EMBASE databases for case-control and cohort studies that assess the association between isoflavone intake and breast cancer risk. We extracted relative risks (RR) and odds ratios (OR) of different reported categories of isoflavone intake from each study. Fixed- or random-effects models were used to summarize dose-response data. Twenty-two studies were selected for the meta-analysis. Overall, the results showed that isoflavone reduced the breast cancer risk (a combined RR/OR of 0.68, 95% CI: 0.52-0.89) in Asian populations rather than Western populations (a combined RR/OR of 0.98, 95% CI: 0.87, 1.11) for the high-dose category. Further analysis showed that the intake of isoflavone in postmenopausal Asian women 0.46 (95% CI: 0.28-0.78) was better than premenopausal 0.63 (95% CI: 0.50-0.80) but similar in postmenopausal Western women 1.00 (95% CI: 0.98-1.02) and premenopausal 0.99 (95% CI: 0.87-1.12). Exposure to high isoflavone may be associated with a reduced breast cancer risk in Asian populations, especially in postmenopausal women. However, no significant difference in the studies of Western populations may be due to the low intake of isoflavone levels.
Key Words: isoflavone, breast cancer, dose-response, meta-analysis, menopause

 

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大豆异黄酮摄入量与乳腺癌发生风险的关系:观察性研究剂量反应的整合分析

关于大豆异黄酮的摄入能否预防乳腺癌发生风险的流行病学研究结论不一致,而争议主要集中在大豆异黄酮的摄入时间不同和暴露剂量差异对乳腺癌的发生风险是否有影响。研究目标是通过整合分析,探讨大豆异黄酮摄入量与目标人群乳腺癌发生风险的关系。通过检索PubMed和EMBASE数据库中的病例对照研究和队列研究,评估大豆异黄酮摄入量与乳腺癌发生风险的关联。从每一项研究中,提取大豆异黄酮摄入量和对应的相对危险度(RR)或者比值比(OR),利用固定或随机效应模型来评估剂量反应数据。结果符合入选标准的研究有22项。经整合分析后得出,高剂量的大豆异黄酮摄入在亚洲人群(合并RR/OR: 0.68, 95%CI: 0.52-0.89)的效果要好于西方人群(RR/OR: 0.98, 95%CI: 0.87-1.11)。进一步的分析表明,亚洲女性绝经后(RR/OR: 0.46, 95%CI: 0.28-0.78)摄入异黄酮预防乳腺癌的效果好于绝经前摄入(RR/OR: 0.63, 95%CI: 0.50-0.80),而西方女性中绝经后(RR/OR: 1.00, 95%CI: 0.98-1.02)摄入异黄酮预防乳腺癌的效果与绝经前摄入(RR/OR: 0.99, 95%CI: 0.87-1.12)无显著差别。因此,高剂量的异黄酮摄入在亚洲人群中可能降低乳腺癌的发生风险,尤其是在绝经后女性中。然而在西方人群的研究中没有发现显著的差异,可能是由于西方人群异黄酮的摄入量较低。

关键字:异黄酮、乳腺癌、剂量反应、整合分析、绝经期

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The association of tea consumption with bladder cancer risk: a meta-analysis
SHIHAO WU, FEI LI , XIAO HUANG, QINGSHENG HUA ,TAO HUANG , ZHILE LIU, ZHIXIANG LIU, ZHAOFEI ZHANG, CHUNXIAN LIAO, YUANXIANG CHEN, YUQIANG SHI, RENCHUANG ZENG, MINGEN FENG, XINTAI ZHONG, ZHAOLIN LONG, WANLONG TAN AND XINJI ZHANG
The association between tea consumption and bladder cancer has been confirmed in several animal studies, but one epidemiological study in 2001 showed no association between them. In order to provide an accurate assessment of this, we conducted a meta-analysis on tea consumption and bladder cancer risk. Studies were identified by a literature search in PubMed from January 1980 to March 2012 and the reference lists of relevant studies. Random effect models were used to calculate summary relative risk estimates (RR) and their corresponding 95% confidence intervals (CI) based on high contrast to low intake values. Twenty-four publications (6 cohort studies and 18 case-control studies) based on consumption of overall tea, black tea, and green tea to bladder cancer risk were included in this analysis. For overall tea, the summary RR indicated no association between tea consumption and bladder cancer (RR= 1.09, 95%CI: 0.85-1.40). In subgroup analyses, we found a moderate increase of bladder cancer risk in smoking group (RR= 1.77, 95%CI: 1.04-3.01). In the black tea group, no statistically significant association was observed (RR= 0.84, 95%CI: 0.70-1.01). Interestingly, in the subgroup of sex, a protective effect was observed between tea consumption and bladder cancer risk in female (RR= 0.61, 95%CI: 0.38-0.98). For green tea group, there was no relationship associated with bladder cancer risk (RR= 1.03, 95%CI: 0.82- 1.31). In conclusion, our data suggest that high overall tea intake in smokers increased the risk of bladder cancer, and high black tea intake in female may reduce the risk of bladder cancer.
Key Words: bladder cancer, overall tea, black tea, green tea, meta-analysis

 

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喝茶与膀胱癌发生的整合分析
目前有关喝茶与膀胱癌的关系在动物实验中已经得以证实,但在2001 年一篇
研究卻表明,喝茶与人类膀胱癌的发生无相关性。时至今日,为了能更精确
的证明二者的相关性,我们对此进行整合分析。通过Pubmed 检索工具收集
1980 年1 月至2012 年3 月的所有关于喝茶与人类膀胱癌发生的前瞻性和回顾
性研究,并且基于喝茶量的极值(最大值和最小值),利用随机效应模型计
算RR 和CI。最终纳入24 篇相关文献(6 篇为队列研究,18 篇为病例-对照研
究)进行整合分析。研究结果表明,对于未分类的茶而言,喝茶与膀胱癌发
生无相关性(RR= 1.09, 95%CI: 0.85-1.40)。但在亚组分析中,卻发现抽烟人群
喝茶反而轻度增加膀胱癌的发生率(RR= 1.77, 95%CI: 1.04-3.01)。喝红茶与膀
胱癌的发生无相关性(RR= 0.84, CI: 0.70-1.01);但女性喝红茶可略減低膀胱癌
发生的風險(RR= 0.61, 95%CI: 0.38-0.98);喝绿茶与膀胱癌的发生无相关性
(RR= 1.03, 95% CI: 0.82-1.31)。因此,由整合分析的結論為,抽烟人群喝茶可
增加膀胱癌的发生,女性喝红茶則可降低膀胱癌的发生。

关键词:膀胱癌、未分类茶、红茶、绿茶、整合分析

 

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Changes in the sodium content of Australian ready meals between 2008 and 2011
ANTHEA KAY CHRISTOFOROU, ELIZABETH KALPIAKA DUNFORD AND BRUCE CHARLES NEAL
Australians consume substantially more sodium than recommended. Three quarters of dietary sodium derives from processed food and the growing ready meal category is a significant contributor. This study examined changes in sodium levels of Australian ready meal products between 2008 and 2011. Sodium data were systematically collected from all product labels in the same 5 stores each year. Mean sodium levels were calculated overall and compared between ready meal types, and by major brands. The levels of sodium in new, discontinued and established products were also compared. There were 107 ready meal products in 2008, 313 in 2009, 219 in 2010 and 265 in 2011. Overall mean sodium content was unchanged between 2008 and 2011 (279 vs 277 mg/100g). There were clear differences between sodium levels of different brands (222 vs 310 mg/100g in McCain Healthy Choice and McCain products respectively) and marked variation in similar products (240 mg/100g in one brand of frozen cottage pie product vs 425mg/100g in another). The mean sodium content of recently introduced products was lower than discontinued products (289 vs 309 mg/100g), with the sodium level of established products remaining stable. The absence of any overall reduction in sodium levels of Australian ready meal products is discouraging.
The failure of voluntary industry efforts to reduce the saltiness of these foods suggests a regulated approach will be required to drive product reformulation.
Key Words: sodium, ready-to-eat meals, food reformulation, public health nutrition, cardiovascular disease

 

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2008 年至2011 年澳洲即食餐品鈉含量的改變趨勢
澳洲人口之鈉攝取遠超過建議攝取量。其中有四分之三的膳食鈉攝取,來自於加工食品,其中不斷增加的即食餐品,為主要的貢獻者。本研究檢視2008年至2011 年澳洲即食餐品的鈉改變量。鈉含量資料,是藉由每年系統性地蒐集,相同的5 間商店所有即食餐品的標示而得。除了計算整體的平均鈉含量外,尚比較不同型態及不同品牌產品的鈉含量。同時也比較新的、停產的與現有的即食餐品之鈉含量差異。2008 年、2009 年、2010 年及2011 年,分別收集到107、313、219、265 項即食餐品。整體的平均鈉含量在2008 年至2011 年間並未改變(279 比上 277 mg/100 g)。不同品牌產品的鈉含量具有明顯的差異,且同類食品的標示含量也大不同。近期的新產品,平均鈉含量低於已停產的產品,但與現有的產品鈉含量相似。令人失望的,澳洲即食餐品的鈉含量整體並未減低。食品業界顯然缺乏自發性減低食品鹹味的努力,有必要制定規格,以導引新的食品配方。
關鍵字: 鈉、即食餐品、食品新配方、公衛營養、心血管疾病

 

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Nutrition education in Japanese medical schools: a follow-up survey
HIDEO ORIMO, TAKAHIRO UENO, HIROSHI YOSHIDA, HIROHITO SONE, AKIRA TANAKA AND HIROSHIGE ITAKURA
A questionnaire survey was used to determine the status of nutrition education in Japanese medical schools in 2009. A similar survey was conducted in 2004, at which time nutritional education was determined to be inadequate in Japanese medical schools. The current questionnaire was sent to the directors of Centers for Medical Education of 80 medical schools, who represented all medical schools in Japan. Sixty-seven medical schools (83.8%) responded, of which 25 schools (37.3%) offered dedicated nutrition courses and 36 schools (53.7%) did not offer dedicated nutrition courses but offered something related to nutrition in other courses; six schools (9.0%) did not offer any nutrition education. Overall, 61 schools (91.0%) offered at least some nutritional topics in their undergraduate education. Nevertheless, only 11 schools (16.4%) seem to dedicate more than 5 hours to substantial nutrition education as judged by their syllabi. Although the mean length of the course was 11 hours, substantial nutrition education accounted for only 4.2 hours. Of the 25 medical schools that offered dedicated nutrition courses, seven schools offered the nutrition course as a stand-alone course and 18 schools offered it as an integrated course. In conclusion, the status of nutrition education in Japan has improved slightly but is still inadequate.
Key Words: nutrition education, medical schools, Japan, questionnaire, curriculum

 

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日本醫學院的營養教育:一個追蹤調查
以問卷調查評估日本在2009 年醫學院的營養教育狀況。2004 年曾進行類似的調查,在當時日本醫學院的營養教育被認為是不足的。現行的問卷被寄送給80 所醫學院的醫學教育中心的主管,他們代表所有日本的醫學院。計67 所(83.8%)醫學院回覆,其中25 所(37.3%)提供專門的營養課程,36 所學校(53.7%)沒有提供專門的營養課程,但在其他課程有提供營養相關資訊;6 所學校沒有提供任何的營養教育。整體來看,61 所學校(91.0%)在他們的大學學程中,提供至少一些營養主題。不過,依據他們的教學大綱判斷,似乎只有11 所學校(16.4%)給予超過5 小時實質的營養教育。雖然課程的平均長度為11
小時,實質上營養教育只有4.2 小時。提供專門營養課程的25 所醫學院當中,有7 所學校提供獨立的營養課程,另18 所學校的營養課程是整合性課程的一部份。總結,日本營養教育的狀況已經稍微改善但仍然是不足的。

關鍵字:營養教育、醫學院、日本、問卷、課程

 

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Insulin receptor substrate 1 (IRS1) variants confer risk of diabetes in the Boston Puerto Rican Health Study
XIANG FENG, KATHERINE L TUCKER, LAURENCE D PARNELL, JIAN SHEN, YU-CHI LEE, JOSE M ORDOVAS, WEN-HUA LING AND CHAO-QIANG LAI
Objective: Published data concerning associations between IRS1 variants and type 2 diabetes and related traits have been inconsistent. We examined the relationship between common variants in IRS1, type 2 diabetes, and related traits including insulin resistance, hyperglycemia and DNA damage in the Boston Puerto Rican Health Study. Methods: We genotyped six common IRS1 variants in an adult Puerto Rican population (n=1132) and tested for association with risk of type 2 diabetes and related traits. Results: SNPs rs934167 and rs1801123 showed significant association with fasting glucose concentrations (p = 0.005 and p = 0.016, respectively) and rs934167 showed significant association with plasma insulin levels (p = 0.005). Carriers of the rs934167 minor allele had significantly higher HOMA-IR and lower QUICKI (p = 0.001 and p = 0.001, respectively), and a 40% and 58% greater likelihood of being hyperglycaemic or hyperinsulinemic (OR = 1.40 and 1.58; p = 0.013 and 0.002, respectively). However, they exhibited only a marginally significant trend towards having type 2 diabetes (OR=1.27, p = 0.077). Furthermore, carriers of the haplotype C-T of the rs934167 and rs1801123 minor alleles showed consistent patterns of associations after correction for multiple testing. In addition, the G972R (rs1801278) minor allele was significantly associated with higher urinary 8-OHdG concentrations (p = 0.020) and plasma CRP levels (p = 0.035). Conclusions: Our results support IRS1 variants associated with type 2 diabetes risk in adult Puerto Ricans. Moreover, we report the novel finding that IRS1 variant G972R (rs1801278) may contribute to oxidative DNA damage and inflammation.
Key Words: genetic association, IRS1, type 2 diabetes, insulin resistance, DNA damage
 

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胰岛素受体底物1(IRS1)多态性与糖尿病危险因素有关(波士顿波多黎各人群健康研究)

目的:目前关于IRS1多态性与2型糖尿病及危险因素的关联研究结果并不一致。在波士顿波多黎各人群健康研究的对象中研究IRS1基因多态性与2型糖尿病及危险因素,包括胰岛素抵抗、高血糖血症和DNA损伤等的关联作用。对象与方法:测定1132例波多黎各成人中IRS1基因6个SNP並分析其与2型糖尿病及危险因素之间的关联。结果:SNP rs934167和rs1801123与空腹血糖含量有显著性关联(p=0.005和p=0.016),rs934167与血浆胰岛素水平也呈显著性关联(p=0.005)。rs934167小等位基因携带者的HOMA-IR指数显著较高,而QUICKI指数显著较低(p=0.001和p=0.001);他们发生高血糖血症和高胰岛素血症的危险性分别增加了40%和58%(OR=1.40和1.58,p=0.005和p=0.016)。然而,他们罹患2型糖尿病的危险性只是轻度增高(OR=1.27,p=0.077)。进一步发现,rs934167和rs1801123小等位基因单倍型C-T携带者显示了类似的关联(经过多重检验校正后)。此外,G972R(rs1801278)小等位基因与较高的DNA损伤水平-尿8-OHdG(p=0.020)和血浆CRP水平(p=0.035)有显著性关联。结论:在成年波多黎各人中,IRS1基因多态性与2型糖尿病危险因素有关。同时有新的发现,即IRS1多态性位点G972R(rs1801278)可能与DNA氧化损伤和炎症有关。

关键词:基因多态性、IRS1、2型糖尿病、胰岛素抵抗、DNA损伤


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Associations between serum bone-specific alkaline phosphatase activity, biochemical parameters, and functional polymorphisms of the tissue-nonspecific alkaline phosphatase gene in a Japanese
population

NATSUKO SOGABE, RIEKO TANABE, MAYU HARAIKAWA, YUTAKA MARUOKA, HIDEO ORIMO, TAKAYUKI HOSOI AND MASAE GOSEKI-SONE
Introduction: We had demonstrated that single nucleotide polymorphism (787T>C) in the tissue-nonspecific ALP (TNSALP) gene was associated with the bone mineral density (BMD). BMD was the lowest among TNSALP 787T homozygotes (TT-type) and highest among TNSALP 787T>C homozygotes (CC-type) in postmenopausal women. In the present study, we investigated the effects of the TNSALP genotype on associations among serum bonespecific alkaline phosphatase (BAP), serum calcium, and phosphorus in healthy young Japanese subjects. Methods: Young healthy adult subjects (n=193) were genotyped for the polymorphism, and we measured the levels of serum BAP, serum calcium, and phosphorus. Dietary nutrient intakes were calculated based on 3-day food records before the day of blood examinations. Results: Grouped by the TNSALP genotype, a significant negative correlation between serum BAP and phosphorus was observed in 787T>C homozygotes (CC-type), but not in heterozygotes (TCtype), nor in 787T homozygotes (TT-type). Conclusions: In the present study, we revealed that the single nucleotide polymorphism 787T>C in the TNSALP gene had effects on the correlation between serum BAP and phosphorus in young adult subjects. These results suggest that variation in TNSALP may be an important determinant of phosphate metabolism. Our data may be useful for planning strategies to prevent osteoporosis.
Key Words: bone-specific alkaline phosphatase, phosphorus, single nucleotide polymorphism, tissue-nonspecific alkaline phosphatase, young adult subjects

 

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日本族群之血清中骨特異性鹼性磷酸.活性、生化指標及組織非特異性鹼性磷酸.基因的功能多型性之相關
前言:在過去的研究中,我們已證實了在組織非特異性鹼性磷酸.(TNSALP) 基因中的單一核.酸多型性(787T>C)與骨礦物質密度(BMD)有關。在停經婦女中,TNSALP 787T 同型合子(TT 型)者其BMD 最低;而787T>C 同型合子(CC 型)者BMD 則是最高。在本研究中,主要探討健康年輕的日本受試者,其TNSALP 基因型對於血清中骨特異性鹼性磷酸.(BAP)、血清鈣與磷相關性的影響。方法:健康青年受試者共193 位,檢測該基因多型性及測量血清中BAP、鈣與磷。由抽血檢查前3 天的食物記錄來估算其膳食營養素攝取情形。 結果:依據TNSALP 的基因型加以分組,發現基因型為同型合子CC 型者,其血清中BAP 及磷呈顯著負相關;但在異型合子TC 型及同型合子TT 型者身上皆無此相關。結論:在本研究中,顯示了年輕成人受試者,其TNSALP 基因中的單一核.酸多型性(787T>C)會影響血清中BAP 與磷之相關。此結果說明了TNSALP 的變異可能是影響磷代謝的重要決定因子,而此資料對於預防骨質疏鬆症之防治策略可能是有用的。
關鍵字:骨特異性鹼性磷酸.、磷、單一核.酸多型性、組織非特異性鹼性磷酸.、年輕成人受試者

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Vitamin D in North-East Asian clinical nutrition practice
MARK L WAHLQVIST
Sound clinical nutrition practice is grounded in evidence and stimulated by research. Yet, there are unanswered questions about food-health relationships. Clinical nutrition involves the identification of nutritional disorders and the motivation to rectify them with all required care. Vitamin D health exemplifies the biomedical, societal and environmental dimensions of clinical nutrition, its science and practice. It depends most of all on access to sunshine and food and probably represents a paradigm in human health which is still at its beginning. Nevertheless, the problem of its deficiency is much more widespread and common than has been thought since it was first identified as a cause of rickets and osteomalacia. It is now known to spare no body organ or system. The problem in North-East Asia is comparable to much of the rest of the world, but the risk profile for it is exaggerated by atmospheric pollution, cultures with sun-avoidance on account of skin colour and potentially mitigated by foodstuffs like fish, eggs, organ meats and mushrooms which can partially offset sunshine-deficiency. Diagnosis requires a high index of suspicion and confirmation by biochemistry which may not be affordable. Therefore a close working relationship between public health and clinical nutritionist is essential.
Key Words: vitamin D deficiency, ethnicity, atmospheric pollution, food, sunlight, diagnosis, food sources

 

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東北亞的維生素D 臨床營養施行
良好的臨床營養是建立在證據的基礎上並受到研究的啟發。然而,關於食物-健康之關聯仍有許多未解的問題,包含對營養失調的確認,及運用應有之照護來改正營養失調的動力。以維生素D 為例,在臨床營養的科學及治療上就包含了生物醫學、社會與環境這幾個面向。維生素D 主要受到日照的機會及食物所影響;也許它亦是人類健康狀況的指標,但此觀點仍在萌芽階段。然而,自從確認維生素D缺乏造成佝僂症和軟骨症以來,其缺乏的層面比我們所想的還要普遍且常見。現在已知幾乎沒有身體器官或系統不會受其影響。東北亞的問題不比世界其他地方小,但其風險會受到大氣污染、因不喜深膚色而避免曬到太陽的文化而增高;同時可能因攝取某些食物,如魚、蛋、內臟和菇類,部分彌補日照缺乏而減輕風險。維生素D 缺乏的診斷需要高度懷疑的警覺且配合昂貴的生化檢驗確認。因此,公共衛生與臨床營養學家在工作上密切的合作是不可或缺的。
關鍵字:維生素D 缺乏、種族、大氣污染、食物、日照、診斷、食物來源

 

 

Last Updated: January 2013