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1 Asia Pacific Journal of Clinical Nutrition
       Volume 22, 4

         (November 2013)


Abstracts

Contents

Abstract PDF

Reviews

Case studies and evidence based nutrition
MARK L WAHLQVIST
Asia Pac J Clin Nutr. 2013;22(4):664-666.

doi: 10.6133/apjcn.2013.22.4.22

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Systematic classification of evidence for dietary refer-ence intakes for Japanese 2010 (DRIs-J 2010) in adults and future prospects of DRIs in Asian countries

MAKIKO NAKADE, ERI IMAI, MEGUMI TSUBOTA-UTSUGI, NOBUYO TSUBOYAMA-KASAOKA AND HIDEMI TAKIMOTO
Asia Pac J Clin Nutr. 2013;22(4):667-682.

doi: 10.6133/apjcn.2013.22.4.17

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Salt intakes and salt reduction initiatives in Southeast Asia: a review
ADA PORTIA M BATCAGAN-ABUEG, JEANETTE JM LEE, PAULINE CHAN, SALOME A REBELLO AND MARIA SOFIA V AMARRA
Asia Pac J Clin Nutr. 2013;22(4):683-
697.

doi: 10.6133/apjcn.2013.22.4.04

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Shiftworking, nutrition and obesity: implications for workforce health- a systematic review
REZA AMANI AND TIM GILL
Asia Pac J Clin Nutr. 2013;22(4):698-708.

doi: 10.6133/apjcn.2013.22.4.11

 

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Original Research Communications

Nutritional Measurement & Methodology

Simplified malnutrition tool for Thai patients
SURAT KOMINDR, THANWARIN TANGSERMWONG AND POOLSUK JANEPANISH
Asia Pac J Clin Nutr. 2013;22(4):516-521.

doi: 10.6133/apjcn.2013.22.4.06

 

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Development and validation of anthropometric prediction equations for estimation of body fat in Indonesian men
JANATIN HASTUTI, MASAHARU KAGAWA, NUALA M BYRNE AND ANDREW P HILLS
Asia Pac J Clin Nutr. 2013;22(4):522-529.

doi: 10.6133/apjcn.2013.22.4.14

 

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Clinical Nutrition or Feeding Studies

 

Glutamine supplementation in preterm infants receiving parenteral nutrition leads to an early improvement in liver function
YING WANG, WEI CAI, YE-XUAN TAO, QING-YA TANG, YI FENG AND JIANG WU
Asia Pac J Clin Nutr. 2013;22(4):530-536.

doi: 10.6133/apjcn.2013.22.4.18

 

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Influence of early enteral nutrition (EEN) on insulin resistance in gastric cancer patients after surgery
KAI YAO, XUELI ZHANG, ZHONGMING HUANG AND XIAOGANG LI

Asia Pac J Clin Nutr. 2013;22(4):537-542.

doi: 10.6133/apjcn.2013.22.4.02

 

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Early initiation of enteral nutrition improves outcomes in burn disease
VESNA KOVACIC VICIC, MAJA RADMAN AND VEDRAN KOVACIC
Asia Pac J Clin Nutr. 2013;22(4):543-547
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doi: 10.6133/apjcn.2013.22.4.13

 

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Effects of a nutrition support team on clinical outcomes, metabolic complications and electrolyte abnormalities in patients receiving parenteral nutrition
PEI FENG CHONG AND THOMAS PARAIDATHATHU
Asia Pac J Clin Nutr. 2013;22(4):548-556.

doi: 10.6133/apjcn.2013.22.4.15

 

 

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Reducing effect of calcium in combination with magnesium and lactulose on body fat mass in middle-aged Japanese women
NOBUO SEKI, YUZOU ASANO, HIROSHI OCHI, FUMIAKI ABE, KAZUHIRO UENISHI AND HIDEKI KUDOU
Asia Pac J Clin Nutr. 2013;22(4):557-564.
doi: 10.6133/apjcn.2013.22.4.07

 

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Effect of traditional Arabic coffee consumption on the glycemic index of Khalas dates tested in healthy and diabetic subjects
JUMA ALKAABI, BAYAN AL-DABBAGH, HUSSEIN SAADI, SALAH GARIBALLA AND JAVED YASIN
Asia Pac J Clin Nutr. 2013;22(4):565-573.
doi: 10.6133/apjcn.2013.22.4.09

 

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Nutritional Status, Dietary Intake, and Body Composition

 

Impact of diet and weight loss on iron and zinc status in overweight and obese young women
HOI LUN CHENG, HAYLEY J GRIFFIN, CHRISTIAN E BRYANT, KIERON B ROONEY, KATHARINE S STEINBECK AND
HELEN T O’CONNOR
Asia Pac J Clin Nutr. 2013;22(4):574-582.

doi: 10.6133/apjcn.2013.22.4.08

 

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Relationship between skipping breakfast and bone mineral density in young Japanese women
TATSUHIKO KURODA, YOSHIKO ONOE, REMI YOSHIKATA AND HIROAKI OHTA.

Asia Pac J Clin Nutr. 2013;22(4):583-589.

doi:10.6133/apjcn.2013.22.4.10

 

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Prevalence and determinants of hyperuricemia in type 2 diabetes mellitus patients with central obesity in Guangdong Province in China
JIAO WANG, RONG-PING CHEN, LEI LEI, QING-QING SONG, RU-YI ZHANG, YAN-BING LI, CHUAN YANG, SHAO-DA
LIN, LI-SHU CHEN, YU-LIN WANG, FAN ZHAO, GAN-XIONG LIANG, BAO-CHUN HU, JIAN-CAI LIN AND DE-HONG
CAI
Asia Pac J Clin Nutr. 2013;22(4):590-598.

doi: 10.6133/apjcn.2013.22.4.16

 

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Leisure time physical activities and dietary quality of the general and indigenous Taiwanese populations are associated with fat distribution and sarcopenia
PO-HUANG CHIANG, MARK L WAHLQVIST, LIN-YUAN HUANG AND YEN-CHEN CHANG
Asia Pac J Clin Nutr. 2013;22(4):599-613.

doi: 10.6133/apjcn.2013.22.4.19

 

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Maternal and Clild Nutrition

 

Prevalence and correlates of zinc deficiency in pregnant Vietnamese women in Ho Chi Minh City
VINH QUANG NGUYEN, AYA GOTO, TU VAN T NGUYEN, KHOA TUAN VO, TUYET MAI T TA, THUY NINH T NGUYEN, TIEN MINH NGUYEN, MY BINH T HO, NGOC ANH T PHAN, HONG HANH T VU, THUC MY TRUONG AND HUNG T NGUYEN
Asia Pac J Clin Nutr. 2013;22(4):614-619.

doi: 10.6133/apjcn.2013.22.4.05

 

 

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Nutritional Epidemiology and Public Health

 

Evaluating dietary quality in diabetes by the Healthy Eating Index
ŞEVKET DIREKTÖR AND EMEL ÖZER

Asia Pac J Clin Nutr. 2013;22(4):620-625.

doi: 10.6133/apjcn.2013.22.4.03

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Associations of body mass index with incident hypertension in American white, American black and Chinese Asian adults in early and middle adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Atherosclerosis Risk in Communities (ARIC) study and the People’s Republic of China (PRC) study
EVA G KATZ, JUNE STEVENS, KIMBERLY P TRUESDALE, JIANWEN CAI, KARI E NORTH AND LYN M STEFFEN
Asia Pac J Clin Nutr. 2013;22(4):626-634.

doi: 10.6133/apjcn.2013.22.4.12

 

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Cognitive impairment and limited dietary diversity or physical inactivity are conjoint precursors of incident diabetes more so in elderly women than men
LI-LI XIU, MARK L WAHLQVIST, MEEI-SHYUAN LEE, ROSALIND CHIA-YU CHEN AND DUO LI
Asia Pac J Clin Nutr. 2013;22(4):635-645.

doi: 10.6133/apjcn.2013.22.4.20

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Nutrigenomics

Effects of gamma-glutamyl carboxylase gene polymorphism (R325Q) on the association between dietary vitamin K intake and gamma-carboxylation of osteocalcin in young adults
MAYU HARAIKAWA, NAOKO TSUGAWA, NATSUKO SOGABE, RIEKO TANABE, YUKA KAWAMURA, TOSHIO OKANO, TAKAYUKI HOSOI AND MASAE GOSEKI-SONE
Asia Pac J Clin Nutr. 2013;22(4):646-654.

doi: 10.6133/apjcn.2013.22.4.06

 

 

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Clinical Nutrition Guidelines

 

CSPEN guidelines for nutrition support in neonates
WEI CAI AND THE WORKING GROUPS OF PEDIATRICS, CHINESE SOCIETY OF PARENTERAL AND ENTERAL NUTRITION, OF NEONATOLOGY, CHINESE SOCIETY OF PEDIATRICS, AND OF NEONATAL SURGERY, CHINESE SOCIETY OF PEDIATRIC SURGERY

Asia Pac J Clin Nutr. 2013;22(4):655-663.

doi: 10.6133/apjcn.2013.22.4.21

 

 

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Future Events

 

Asia Pac J Clin Nutr. 2013;22(4):709.

 

 

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Case studies and evidence based nutrition
MARK L WAHLQVIST
The clinical nutrition case study is a neglected area of activity and publication. This may be in part because it is not regarded as a serious contributor to evidence-based nutrition (EBN). Yet it can play a valuable part in hypothesis formulation and in the cross-checking of evidence. Most of all, it is usually a point at which the operationalisation of nutrition evidence is granted best current practice status.
Key Words: clinical nutrition practice, nutritional epidemiology, hierarchical evidence, portfolio evidence, econutrition

 

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個案研究與實證營養學
臨床營養之個案研究在施行與出版中是一個被忽視的領域。部分原因可能在於,它不被視為實證營養學(EBN)之重要貢獻者。然而,它卻在假說成形與交叉驗證中扮演重要角色。最重要的,在認為營養證據操作化乃是目前最好實行方式下,個案研究確實有其意義。
關鍵字:臨床營養施行、營養流行病學、分級證據、組合證據、生態營養

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Systematic classification of evidence for dietary refer-ence intakes for Japanese 2010 (DRIs-J 2010) in adults and future prospects of DRIs in Asian countries
MAKIKO NAKADE, ERI IMAI, MEGUMI TSUBOTA-UTSUGI, NOBUYO TSUBOYAMA-KASAOKA AND HIDEMI TAKIMOTO
In Asia, the concept of dietary reference values is shifting from recommended dietary allowances (RDAs) to dietary reference intakes (DRIs). To assist Asian countries that are planning to develop or revise their own DRIs, this study summarizes the scientific literature used in the development of the latest DRIs for the Japanese (DRIs-J 2010): it aims to clarify critical issues on- and discuss future prospects for DRIs in Asia. The criteria and studies used to determine reference values in DRIs-J 2010 in adults were extracted from the DRIs-J 2010 report, systematically classified, and summarized for each nutrient in tables according to the type of DRIs. The classification categories were as follows: criteria, subject ethnicity, year of publication, type of study and study design, number of subjects, and study content. In all, 184 studies were extracted and some issues in DRIs-J 2010 were clarified: 1) some nutrients were lacking in studies based on native populations; 2) only a few and relatively old studies determined tolerable upper intake levels for some nutrients; 3) with the same DRIs, there were inconsistencies among the nutrients in the study criteria. These were considered common issues when determining DRIs in other Asian countries. When establishing DRIs, these issues should be considered, in addition to population health status and country-specific needs.
Key Words: nutrition policy, reference values, diet, Asia, Japan

 

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2010日本成人膳食營養素參考攝取量(DRIs-J2010)實證研究之系統性分類及對亞洲國家膳食營養素參考攝取量之未來展望
在亞洲,對膳食參考值的概念正從建議攝取量(RDAs)轉變成膳食營養素參考攝取量(DRIs)。為了協助正計畫發展或修改己國DRIs之亞洲國家,本篇研究綜整所有用來發展日本最新DRIs(DRIs-J 2010)之科學性文獻,目的是釐清當前重要議題並剖析亞洲DRIs之未來展望。DRIs-J 2010中訂定成人參考值的標準與研究主要摘錄自DRIs-J 2010報告,並根據DRIs中的類型,將每一營養素予以系統性分類並匯整於表中。分類項目如下:量測標準、對象種族、出版年份、研究型態與設計、樣本數及研究內容。在所有文獻中,共挑出184篇,並將DRIs-J 2010中的部分議題分成以下幾點說明:1) 部份營養素缺乏以當地族群為主之研究;2) 部分營養素僅賴少數或早期幾篇研究來決定其上限容許攝取量;3)制定相同DRIs,營養素之量測標準卻不一致。以上這些常見議題亦是其他亞洲國家訂定DRIs時會遭遇到。建立DRIs時,除了族群之健康狀態和國家特定之需求外,這些議題也需納入考慮。
關鍵字:營養政策、參考值、飲食、亞洲、日本

 

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Salt intakes and salt reduction initiatives in Southeast Asia: a review
ADA PORTIA M BATCAGAN-ABUEG, JEANETTE JM LEE, PAULINE CHAN, SALOME A REBELLO AND MARIA SOFIA V AMARRA
Increased dietary sodium intake is a modifiable risk factor for cardiovascular disease. The monitoring of population sodium intake is a key part of any salt reduction intervention. However, the extent and methods used for assessment of sodium intake in Southeast Asia is currently unclear. This paper provides a narrative synthesis of the best available evidence regarding levels of sodium intake in six Southeast Asian countries: Indonesia, Malaysia, Philippines, Singapore, Thailand, Vietnam, and describes salt reduction measures being undertaken in these countries. Electronic databases were screened to identify relevant articles for inclusion up to 29 February 2012. Reference lists of included studies and conference proceedings were also examined. Local experts and researchers in nutrition and public health were consulted. Quality of studies was assessed using a modified version of the Downs and Black Checklist. Twenty-five studies fulfilled the inclusion criteria and were included in this review. Full texts of 19 studies including government reports were retrieved, with most studies being of good quality. Insufficient evidence exists regarding salt intakes in Southeast Asia. Dietary data suggest that sodium intake in most SEA countries exceeded the WHO recommendation of 2 g/day. Studies are needed that estimate sodium intake using the gold standard 24-hour urinary sodium excretion. The greatest proportion of dietary sodium came from added salt and sauces. Data on children were limited. The six countries had salt reduction initiatives that differed in specificity and extent, with greater emphasis on consumer education.
Key Words: sodium chloride, dietary, nutrition policy, sodium intake, salt

 

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回顧東南亞的鹽攝取量及減鹽行動
飲食鹽攝取量增加是心血管疾病一個可修飾危險因子。監測族群鈉攝取量是任何減鹽介入的重要部分。然而,東南亞地區評估鈉攝取的程度及方法目前並不清楚。此篇文章提供六個東南亞國家關於鈉攝取量的最佳可用證據的統整性描述:包括印尼、馬來西亞、菲律賓、新加坡、泰國及越南,並描述在這些國家進行的減鹽措施。篩選電子資料庫以確認至2012年2月29日的相關文章,還檢視參考文獻中所列的研究及研討會報告。諮詢營養及公共衛生背景的當地專家及研究學者。使用Downs and Black檢核表修訂版以評估研究品質。計25個研究符合納入標準而被描述於本篇回顧文章中。檢索出有全文的19個研究,包括政府報告,大部分的研究具有良好的品質。關於東南亞的鹽攝取量證據仍不足。飲食資料顯示,大部分的東南亞國家鹽攝取量超過世界衛生組織建議的每日2克。極需要使用24小時尿鈉排泄量當作黃金標準以評估鈉攝取量的研究。飲食鈉攝取量大部分是來自於外加鹽及醬汁。兒童的數據極有限。這六個國家著重於消費者教育的減鹽行動,各有不同的特異性及程度。
關鍵字:氯化鈉、飲食、營養政策、鈉攝取、鹽


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Shiftworking, nutrition and obesity: implications for workforce health- a systematic review
REZA AMANI AND TIM GILL
Background: Shiftworking has long been unrecognised as an occupational health hazard up until now. Methods: Electronic databases were searched using OVID host as the main search engine for Medline, PUBMED and CINHAL during the years 1990-December 2010. Combinations of the keywords yielded 35 full papers and abstracts, of which 16 articles were relevant. One paper was not in English, leaving 15 included in this review after final reconsideration. Studies were categorised into two main titles: studies assessing the association between shift working and obesity and/or BMI (n=8) and studies assessing the association between shift working and nutritional/ dietary patterns (n=7). Type of study was also considered as a part of the search strategy. Results: In total, one interventional, nine cross-sectional and five cohort studies were retrieved. Seven cross-sectional studies and one cohort study showed a higher BMI/obesity prevalence in shiftworks. Interventional, one cross-sectional and three cohort studies showed higher frequency of meal intake or poor nutrition quality/habits in the shift workers compared with the day-shift workers. Another cross-sectional study showed no difference between workers. Conclusion: In terms of obesity or high BMI, majority of cross-sectional studies indicate that shiftwork increases weight gain and the prevalence of obesity. On the other hand, half of cohort studies show higher frequency of meal intake and/or poor nutrition quality in the shift workers. Generally, it is indicated that shift working negatively impacts on health and nutritional status of workforces.
Key Words: shift working, nutrition, obesity, workforce, systematic review

 

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輪班制、營養及肥胖:對於員工健康之意涵 -系統性回顧
背景:直到近期,輪班制才被視為職業健康的危害因子之一。方法:利用OVID搜尋網做為電子資料庫的主要搜尋引擎,搜尋Medline、PUBMED和CINHAL上,從1990年至2010年12月期間發表的文章。藉由關鍵字組合,共搜尋到35篇全文和摘要,其中相關文章有16篇。但有一篇為非英文撰寫,因此最後決定收納15篇。將這些研究分成兩個主題:8篇探討關於輪班工作制和肥胖和/或身體質量指數之間的相關性;另7篇則探討輪班制和營養/飲食型態之相關性。進行搜尋時亦考慮研究的類型。結果:在收納文獻中,包含1篇介入性、9篇橫斷性和5篇世代型研究。由7篇橫斷性和1篇世代研究結果顯示,輪班工作者有較高的身體質量指數/肥胖盛行率;介入性、1篇橫斷性和3篇世代研究結果指出,輪班工作者比起日班工作者,有較高的用餐頻率或較差的營養品質/習慣。另一篇橫斷性研究則顯示,兩種工作制之間並無顯著差異。結論:就肥胖或高身體質量指數而言,大部分橫斷性研究指出,輪班工作會使體重增加幅度加大並提高肥胖盛行率。另一方面,有一半的世代研究顯示輪班工作者有較高的用餐頻率和/或較差的營養品質。總的來說,輪班工作對於員工的健康和營養狀態有負面影響。
關鍵字:輪班工作制、營養、肥胖、勞動力、系統性回顧
 

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Simplified malnutrition tool for Thai patients
SURAT KOMINDR, THANWARIN TANGSERMWONG AND POOLSUK JANEPANISH

Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provides satisfactory results in identifying nutritional risk. Most tools depend on weight and height as criteria for diagnosing malnutrition. Weight is not recorded in many patients and some tools are time-consuming. An inclusive nutrition screening form (Nutrition Alert Form, NAF) was developed and validated. NAF was modified from the original version of Subjective Global Assessment (SGA) by adding in two standard laboratory tests. The severity of the symptom and laboratory changes were scored. NAF was validated in 210 hospitalized Thai patients at Ramathibodi hospital by an experienced clinical nutritionist (physician) at Ramathibodi hospital. Cross validation was carried out between the dietitian and nurse in another 90 patients. Most of the time nurses could complete the nutrition screening in a patient within 5 minutes. One out of four patients could not be weighed on admission. The scores of 5 and 11 were selected as the cut-off scores of different malnutrition levels due to their high sensitivity, specificity and accuracy and scores of 6 to 10 were defined as moderate malnutrition. The diagnostic agreement between the dietitian and nurse for “normal to mild malnutrition”, “moderate malnutrition”, and “severe malnutrition” were 85%, 70% and 72%, respectively. NAF for screening of malnutrition in hospitalized Thai patients is easy to use, concise, does not require nutrition expertise and can be used whether or not body weight is taken.
Key Words: nutrition screening tool, malnutrition, nutritional assessment, prevalence, malnutrition risk

 

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應用於泰國病人的簡易營養不良篩檢工具
營養不良在醫院裡經常沒被發現。目前,沒有滿意的營養篩檢工具以確認營養的風險。大部分診斷營養不良的工具是依據體重及身高當標準,但是很多病人沒有體重記錄,且某些工具是費時的。本文敘述發展一個完整的營養篩檢表單(營養警訊單,NAF)且測試其效度。NAF是修訂自主觀整體評估(SGA)原始版加入兩項標準生化值測量。評量症狀的嚴重性及生化值的改變。NAF的效度測試是由有經驗的臨床營養學者(醫師)評估210名在Ramathibodi醫院住院的泰國病人。交叉驗證是由營養師及護士執行於另90名病人。多數時候,護士可以在5分鐘內完成病人的營養篩檢。四分之一的病人在入院時無法秤體重。由於它們的高敏感度、特異度及準確性,5分和11分被當作不同營養不良程度的切點,6至10分被定義為中度營養不良。營養師及護士之間的診斷一致性,在“正常至輕度營養不良”、“中度營養不良”及“重度營養不良”分別為85%、70%及72%。應用於住院的泰國病人的營養不良篩檢,NAF優點是易使用、簡要、不需要營養專長,且不論是否有體重資料都可以使用。

關鍵字:營養篩檢工具、營養不良、營養評估、盛行率、營養不良

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Development and validation of anthropometric prediction equations for estimation of body fat in Indonesian men
JANATIN HASTUTI, MASAHARU KAGAWA, NUALA M BYRNE AND ANDREW P HILLS
Body composition of 292 males aged between 18 and 65 years was measured using the deuterium oxide dilution technique. Participants were divided into development (n=146) and cross-validation (n=146) groups. Stature, body weight, skinfold thickness at eight sites, girth at five sites, and bone breadth at four sites were measured and body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) calculated. Equations were developed using multiple regression analyses with skinfolds, breadth and girth measures, BMI, and other indices as independent variables and percentage body fat (%BF) determined from deuterium dilution technique as the reference. All equations were then tested in the cross-validation group. Results from the reference method were also compared with existing prediction equations by Durnin and Womersley (1974), Davidson et al (2011), and Gurrici et al (1998). The proposed prediction equations were valid in our cross-validation samples with r=0.77- 0.86, bias 0.2-0.5%, and pure error 2.8-3.6%. The strongest was generated from skinfolds with r=0.83, SEE 3.7%, and AIC 377.2. The Durnin and Womersley (1974) and Davidson et al (2011) equations significantly (p<0.001) underestimated %BF by 1.0 and 6.9% respectively, whereas the Gurrici et al (1998) equation significantly (p<0.001) overestimated %BF by 3.3% in our cross-validation samples compared to the reference. Results suggest that the proposed prediction equations are useful in the estimation of %BF in Indonesian men.

Key Words: anthropometry, prediction equation, deuterium oxide dilution, body fat, Indonesia

 

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對印尼男性體脂肪估計之體位預測方程式的發展和驗證
利用氧化氘稀釋法測量292位,年齡18-65歲男性之體組成。將所有參與者分成發展組(146位)和交叉驗證組(146位),測量其身高、體重、8處皮脂厚度、5處圍長以及4處骨寬,並計算身體質量指數、腰臀比和腰圍身高比。利用多元迴歸分析,將皮脂厚度、骨寬、圍長、身體質量指數及其他指標當做自變項,由氧化氘稀釋法測得的體脂肪百分比(%BF)當參考值,來發展方程式。所有方程式皆用交叉驗證組的指標數值進行驗證。由參考方法得到的結果亦和3個現有的預測方程式-Durnin和Womersley (1974)、Davidson等(2011)和Gurrici等(1998)進行比較。本研究所提出的預測方程式經交叉驗證樣本證明為有效,相關系數0.77- 0.86、偏差0.2-0.5%、純誤差2.8-3.6%。由皮脂厚度產生之方程式預測能力最佳,相關系數0.83、估計標準誤3.7%、赤池信息量準則377.2。Durnin和Womersley (1974)、Davidson等(2011) 2個方程式皆顯著低估(p<0.001)體脂肪百分比分別達1.0和6.9%;而Gurrici等(1998)的方程式則顯著高估(p<0.001)體脂肪百分比達3.3%。以上結果顯示,本研究提出的預測方程式對於印尼男性體脂肪百分比的預測是可行的。

關鍵字:體位測量、預測方程式、氧化氘稀釋、體脂肪、印尼


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Glutamine supplementation in preterm infants receiving parenteral nutrition leads to an early improvement in liver function
YING WANG, WEI CAI, YE-XUAN TAO, QING-YA TANG, YI FENG AND JIANG WU
Objective: The aim of study was to confirm the protective effects of parenteral glutamine supplementation on liver injury in premature infants and determine how quickly effects became evident. Methods: We performed a double-blind, randomized, controlled clinical study to assess the effect of parenteral nutrition (PN) supplemented with glutamine in premature infants. Thirty infants from two children’s centers, were randomly assigned to either a control group (Standard PN; n=15) or a glutamine-supplemented group (GlnPN; n=15). The primary endpoint was hepatic function. The secondary endpoints were total duration of PN, weight and head circumference gain, length of hospitalization, and days on a ventilator. Results: The serum level of alkaline phosphatase (AKP) after parenteral nutrition for 14 days was significantly higher (p<0.05) in the control group. But in the glutaminesupplemented group, the serum concentration of aspartate aminotransferase (AST) and gamma glutamyltransferase (GGT) significantly decreased after PN for 7 days and 14 days (p<0.05), and the level of alkaline phosphatase (AKP) showed no increase. The levels of AKP and GGT were significantly different with time by group interaction. Levels of AKP was higher in control group than glutamine-supplemented group, and GGT level was lower in glutamine-supplemented group compared with controls. There were no significant differences between the groups in terms of total duration of PN, weight gain (g/d), increase in head circumference (cm/w), length of hospitalization, and duration of mechanical ventilation. Conclusion: The longer the duration of parenteral nutrition, the more severe hepatic dysfunction became. Parenteral glutamine supplementation suggested a hepatoprotective effect.
Key Words: parenteral nutrition, glutamine, premature infant, liver function, neonate

 

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静脉补充谷氨酰胺可以早期改善早产儿肝脏功
目的: 本研究目的是证实补充谷氨酰胺肠外营养(PN)对早产儿肝脏功能的保护作用。方法:采用双盲、随机、对照试验,评价补充谷氨酰胺肠外营养对早产儿的作用。来自两家儿童医疗中心的30例早产儿随机分为对照组(标准PN;n=15)和谷氨酰胺组(GlnPN;n=15)。首要终点指标为肝功能。次要终点指标为PN持续时间,体重和头围增长情况,住院天数和呼吸机应用天数。结果:肠外营养应用14天后,血清碱性磷酸酶(alkaline phosphatase, AKP)水平在对照组明显升高(p<0.05)。在谷氨酰胺组,谷草转氨酶(aspartate aminotransferase, AST)水平和γ-谷氨酰转肽酶(gamma glutamyltransferase, GGT)水平在肠外营养应用7天和14天后明显下降(p<0.05),AKP水平无明显升高。AKP水平和GGT水平在两组比较具有统计学差异。AKP水平在对照组较谷氨酰胺组明显升高,GGT水平在谷氨酰胺组下降较对照组明显。肠外营养应用时间、体重和头围增长情况、住院天数和呼吸机应用天数, 两组比较无差异。结论: 肠外营养持续时间越长,肝功能损害越严重,而肠外补充谷氨酰胺具有保护肝脏功能的作用。

关键词:肠外营养、谷氨酰胺、早产儿、肝功能、新生儿


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Influence of early enteral nutrition (EEN) on insulin resistance in gastric cancer patients after surgery
KAI YAO, XUELI ZHANG, ZHONGMING HUANG AND XIAOGANG LI
Objective: To evaluate the benefits of reducing insulin resistance by early enteral nutrition (EEN) in gastric cancer patients after surgery. Methods: Gastric cancer patients were managed to randomly accept traditional total parenteral nutrition (group A) or EEN (group B) after surgical treatment. The patients in group B were fed by tubes with 250-500 mL 5% sodium chloride and glucose injection at 24 h post-surgery, and were fed enteral nutritional emulsion with constant infusion by pump slowly increasing from 20 mL/h to 100 mL/h from 48 h, and then transiting to total enteral nutrition. Insulin sensitivity of patients was detected by Quicki method before operation and at 24 h, 48 h, 72 h, 120 h and 168 h post-surgery. Results: A total of 77 patients were enrolled, with 42 patients in group A, and 35 patients in group B. Baseline characteristics, biochemical indexes and operational characteristics were well balanced between two groups. The time-insulin sensitivity curves of the two groups indicated that IR was present early (day 1 to day 7) in gastric cancer patients and was significantly different between patients who had undergone surgical treatment and those who had not. Insulin sensitivity (SI) of patients in group B were higher than patients in group A with adjusting BMI, age and SI preoperative at 72 h, 120 h and 168 h post-surgery. Conclusions: The management of EEN can alleviate insulin resistance in gastric cancer patients with surgical treatment.
Key Words: early enteral nutritional, gastric cancer, insulin resistance, insulin sensitivity, Glucose tolerance

 

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早期腸道營養對於術後胃癌病人胰島素抗性之影
目的:評估早期腸道營養對於降低術後胃癌病人胰島素抗性之效益。方法:將術後的胃癌病人隨機分成接受傳統全靜脈營養(A組)或早期腸道營養(B組)。術後24小時,利用管灌給予B組病人250-500 毫升5%氯化鈉和葡萄糖;從48小時開始,利用幫浦以連續灌食方式給予腸道營養液,以每小時20毫升的流速緩慢增加至每小時100毫升,接著再轉換至完全腸道營養給予。在術前、術後24、48、72、120和168小時,利用Quicki法檢測病人之胰島素敏感性。結果:共有77位病人參與本試驗,A組42人、B組35人。兩組之基本特性、生化指標、以及手術性質大致相同。藉由兩組在不同時間點所測得的胰島素敏感性曲線指出,胃癌病人在術後早期(第1天到第7天)即出現胰島素抗性,且手術前後有顯著差異。在調整身體質量指數、年齡和術前72、102小時及術後168小時的胰島素敏感性,發現B組病人的胰島素敏感性顯著高於A組。結論:早期腸道營養的施行可減輕術後胃癌病人之胰島素抗性。
關鍵字:早期腸道營養、胃癌、胰島素抗性、胰島素敏感性、葡萄糖耐受性

 

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Early initiation of enteral nutrition improves outcomes in burn disease
VESNA KOVACIC VICIC, MAJA RADMAN AND VEDRAN KOVACIC

Background: Burned patients have increased level of mortality, possibly due to late introduction of enteral feeding. The aim of this study was to compare the benefits and safety of very early enteral nutrition introduction compared to the normal diet among burns patients in an intensive care unit. Participants and Methods: Participants consisted of 101 patients, aged 20-76 years (mean age 48 years), 49 men and 52 women, with burns that covered more than 20% of the body. The intervention group consisted of 52 subjects fed via introduced nasojejunal probe that started within four hours after admission to the hospital. The control group consisted of fifty patients fed in standard manner per os (three standard hospital meals) immediately after the first wound dressing. Results: The average decline BMI in control group was 2.27±0.56 kg/m2, while the average reduction in BMI in the intervention group was 1.77±0.38 kg/m2 (p<0.001). The largest drop of albumin concentration in the control group was 28.5%, whereas in the intervention group was 23.8%. (p<0.001). The greatest decrease of transferrin concentration in the control group was 31.1%, while the average reduction in the intervention group was 18.3%. (p<0.001). C-reactive protein values were statistically higher in control group (p<0.001). Intervention group had lower rate of complications and infection rates. Conclusion: Enteral nutrition in burned patients should begin within few hours of burn onset. Such approach leads to better outcomes, reduces complications, and improves nutritional profile.
Key Words: burn, enteral nutrition, inflammation, albumins, infections

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早期開始的腸道營養改善燒傷的結果
背景:燒傷病人死亡風險的增加,可能是因為腸道進食較晚開始。本研究目的為比較加護病房的燒傷病人,在很早期採用腸道營養比起常規飲食者的益處及安全性。參與者與方法:參與者為101名年齡20-76歲(平均年齡48歲)的病人,有49名男性和52名女性,其身體燒傷面積都超過20%。介入組有52名,在入院後的四小時內透過鼻空腸導管餵食。控制組有50名病人,在第一次換藥後立即以標準程序經口進食(三餐標準醫院餐點)。結果:控制組平均BMI下降2.27±0.56 kg/m2,而介入組平均減少1.77±0.38 kg/m2 (p<0.001)。控制組的白蛋白濃度最大跌幅為28.5%,但在介入組為23.8% (p<0.001)。控制組的運鐵蛋白濃度最大降幅為31.1%,而介入組則平均下降18.3% (p<0.001)。控制組的C-反應蛋白高於介入組,並達統計顯著性(p<0.001)。介入組有較低的併發症及感染率。總結:腸道營養應該開始於燒傷發生後數小時內。該項做法可導致較好的預後、降低併發症及改善營養狀況。
關鍵字:燒傷、腸道營養、發炎、白蛋白、感染


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Effects of a nutrition support team on clinical outcomes, metabolic complications and electrolyte abnormalities in patients receiving parenteral nutrition
PEI FENG CHONG AND THOMAS PARAIDATHATHU
The effectiveness of the Nutrition Support Team (NST) at Hospital Sungai Buloh, a large public hospital in Kuala Lumpur, Malaysia, in optimising parenteral nutrition (PN) has not been evaluated. To evaluate the effects of this NST in optimising patient outcomes, treatment outcomes, and adherence to biochemical monitoring guidelines, two groups of patients, those given PN before (n = 106) NST intervention and those given PN after (n=106) NST intervention, were retrospectively compared. Intervention by the NST significantly reduced metabolic abnormalities, reducing sodium abnormalities from 67% to 44% (p<0.01); potassium abnormalities from 42% to 15% (p<0.01); magnesium abnormalities from 13% to 3% (p<0.05) and phosphate abnormalities from 21% to 9% (p=0.01). Intervention by the NST also significantly reduced the incidence of hypertriglyceridemia from 68% to 45% (p=0.002) and significantly improved adherence to biochemical monitoring guidelines from 46% to 72% (p<0.01). However, the length of hospital stay, patient mortality, and duration of PN were similar in both groups. This study failed to demonstrate that the establishment of a NST gave better outcomes in terms of the common measures of effectiveness. In conclusion, although management by an NST significantly reduced metabolic abnormalities and improved adherence to biochemical monitoring guidelines, the NST did not improve patient mortality rates and length of hospital stay.
Key Words: parenteral, nutrition, support, team, multidisciplinary

 

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營養支持小組對接受腸道外營養病人之臨床預後、代謝併發症及電解質異常的影響
位於馬來西亞吉隆坡的一所大型公立醫院-Sungai Buloh醫院,其營養支持小組(NST)對於優化靜脈營養(PN)的效益尚未被評估。兩組病人,一組為NST介入前給予PN (106位),另一組則在NST介入後給予PN (106位)。回溯性比較以評估NST對於病人的治療結果及生化監測指南的遵從性之優化效果。NST介入顯著降低代謝性異常,降低鈉異常由67%至44% (p<0.01);鉀異常從42%至15% (p<0.01);鎂異常從13%至3% (p<0.05)及磷酸鹽異常從21%至8% (p=0.01)。NST介入也顯著降低高三酸甘油酯血症發生率從68%至45% (p=0.002)及改善生化監測指南的遵從性由46%到72% (p<0.01)。然而,兩組的住院天數、病人死亡率及接受PN期間則相似。以常用的效益測量為指標來看,這個研究無法證明NST有較好的結果。總之,雖然NST的管理顯著地降低代謝性異常及改善生化監測指南遵從性,但並未改善病人死亡率及住院天數。
關鍵字:腸道外、營養、支持、團隊、跨領域健康及疾病發病率調查、學童、過重、馬來西亞、國際肥胖問題工作組人群

 

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Reducing effect of calcium in combination with magnesium and lactulose on body fat mass in middle-aged Japanese women
NOBUO SEKI, YUZOU ASANO, HIROSHI OCHI, FUMIAKI ABE, KAZUHIRO UENISHI AND HIDEKI KUDOU
Background: It has been reported that adequate calcium intake decreases body fat and appropriate intakes of magnesium suppress the development of the metabolic syndrome. Furthermore, lactulose increases the absorption of calcium and magnesium. An optimal combination of calcium, magnesium and lactulose may therefore reduce body fat mass. Methods: An open-label randomized controlled trial was conducted to investigate the body fatreducing effects of a test food containing 300 mg calcium, 150 mg magnesium, and 4.0 g lactulose. Body composition parameters and blood hormone and urine mineral concentrations were measured at baseline and at 6 and 12 months thereafter. Whole-body fat mass was measured with dual-energy x-ray absorptiometry. Results: Seventy-six middle-aged Japanese women (47.5±4.7 years) were randomized to the intake group (n=48) or the nonintake control group (n=28). At 12 months the difference in body fat mass change between the two groups (intake group – control group) was -0.8 kg (95% CI: -1.5 - 0.0 kg, p=0.046), although there were no differences in anthropometric data between the two groups. Body fat percentage at 12 months tended to be lower in the intake group, but the difference was not significant (p=0.09). Conclusions: These findings may suggest that calcium in combination with magnesium and lactulose can reduce body fat mass in middle-aged Japanese women. However, the contribution of magnesium and lactulose are unclear in this study. Further studies are needed to clarify these contributions.
Key Words: calcium, magnesium, lactulose, fat mass, Japanese women

 

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日本中年女性攝取鈣質結合鎂及乳果糖對體脂肪量的降低效果
背景:關於足夠的鈣質攝取可降低體脂肪及適量的鎂攝取可阻斷代謝症候群的發展已有報告。此外,乳果糖可增加鈣及鎂的吸收。因此,鈣、鎂及乳果糖的最佳組合或可降低體脂肪量。方法:以開放式隨機控制實驗測試含300 mg鈣、150 mg鎂及4.0 g乳果糖的食物對體脂肪降低的效果。在基線、6個月及12個月後,分別測量體組成參數、血液中數種激素及尿中礦物質量。以雙能量X光吸收儀測量全身體脂肪量。結果:76名中年日本女性(47.5±4.7歲)被隨機分派為攝取組(n=48)或是非攝取控制組(n=28)。儘管兩組的體位測量值沒有差異,但在12個月後,兩組體脂肪改變量的差異(攝取組-控制組)為-0.8公斤(95% CI:-1.5-0.0公斤,p=0.046)。攝取組在12個月的體脂肪百分比傾向較低,但是這個差異不顯著(p=0.09)。結論:這些發現顯示鈣質結合鎂及乳果糖或可以降低日本中年女性的體脂肪量。然而,在這個研究中,鎂及乳果糖的貢獻並不清楚。需要更進一步的研究去釐清這些效益。
關鍵字:鈣、鎂、乳果糖、體脂肪量、日本女性

 

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Effect of traditional Arabic coffee consumption on the glycemic index of Khalas dates tested in healthy and diabetic subjects
JUMA ALKAABI, BAYAN AL-DABBAGH, HUSSEIN SAADI, SALAH GARIBALLA AND JAVED YASIN
The consumption of dates with coffee is common among Arabs and may affect postprandial hyperglycemia excursion. The study aimed to determine the effect of coffee on the glycemic index of a common variety of dates (Khalas) tested in healthy and type 2 diabetes mellitus individuals. Study subjects were thirteen healthy volunteers (mean age: 40.2±6.7 years) and ten diabetic participants with a mean HbA1c of 6.6±(0.7%) and a mean age of 40.8±5.7 years. Each subject participated in five days of tests with 50 g of glucose and 50 g equivalent of available carbohydrates from the dates (with/without coffee). Capillary glucose was measured in the healthy subjects at 0, 15, 30, 45, 60, 90 and 120 min, and for the diabetics at 0, 30, 60, 90, 120, 150 and 180 min. Glycemic indices were determined as ratios of the incremental areas under the response curves for the interventions. Statistical analyses were performed using the independent samples and paired t-tests. Mean±SE glycemic indices of the Khalas dates for the healthy individuals were 55.1±7.7 and 52.7±6.2 without and with coffee consumption, respectively. Similar values were observed for those with diabetes (53.0±6.0 and 41.5±5.4). Differences between glycemic indices of Khalas with or without coffee were not significant (p=0.124). There were no significant differences in glycemic index between the diabetic and healthy subjects (p=0.834 and p=0.202 without and with coffee respectively). In conclusion, at least in the short term, coffee does not adversely affect capillary glucose levels following Khalas dates consumption in healthy and diabetic volunteers.
Key Words: coffee, glycemic index, postprandial hyperglycemia excursion, dates, type 2 diabetes mellitus

 

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健康及糖尿病者攝取傳統阿拉伯咖啡對Khalas 椰棗的升糖指數影響
阿拉伯人喝咖啡時,食用椰棗是常見的,這可能影響餐後高血糖波動。此研究為評估咖啡對於健康者及第二型糖尿病患者食用普及的Khalas椰棗的升糖指數影響。研究對象為13名健康志願者(平均年齡為40.2±6.7歲)及10名糖尿病參與者,其平均糖化血色素為6.6±0.7%、平均年齡為40.8±5.7歲。每名參與者接受五天測試,給予50公克葡萄糖以及50公克等量碳水化合物的椰棗(有或無喝咖啡)。測量健康參與者在0、15、30、45、60、90及120分鐘與糖尿病者在0、30、60、90、120、150及180分鐘的微血管血糖濃度。升糖指數以介入後的反應曲線下面積增加率為評量依據。統計分析是使用獨立樣本與配對t檢定。健康者無或有攝取咖啡的椰棗升糖指數(平均數±標準誤)分別是55.1±7.7及52.7±6.2。在糖尿病患者觀察到類似的數值(53.0±6.0及41.5±5.4)。Khalas椰棗在有或無咖啡攝取的升糖指數差異沒有達到顯著。糖尿病跟健康者的升糖指數亦沒有顯著差異。結論是,至少就短期效應而言,咖啡對於健康及糖尿病者攝取椰棗後的微血管血糖值沒有影響

關鍵字:咖啡、升糖指數、餐後高血糖波動、椰棗、第二型糖尿病


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Impact of diet and weight loss on iron and zinc status in overweight and obese young women
HOI LUN CHENG, HAYLEY J GRIFFIN, CHRISTIAN E BRYANT, KIERON B ROONEY, KATHARINE S STEINBECK AND HELEN T O’CONNOR
Young overweight women are at risk of iron and zinc deficiency. This study assessed iron, zinc and inflammatory status during a 12-month weight loss trial in young women (18-25 y; BMI ≥27.5 kg/m2) randomised to a higherprotein (HP: 32% protein; 12.2 mg/day iron; 11.7 mg/day zinc) or lower-protein (LP: 20%; 9.9 mg/day; 7.6 mg/day respectively) diet with contrasting haem iron and zinc content. In completers (HP: n=21; LP: n=15), HP participants showed higher median ferritin (52.0 vs 39.0 μg/L; p=0.021) and lower median soluble transferrin receptor-ferritin index (sTfR-F; 0.89 vs 1.05; p=0.024) although concentrations remained within normal range for both diets. Median C-reactive protein (CRP; HP: 3.54; LP: 4.63 mg/L) and hepcidin (HP: 5.70; LP: 8.25 ng/mL) were not elevated at baseline, and no longitudinal between-diet differences were observed for zinc and CRP. Compared to those with <5% weight loss, HP participants losing ≥10% weight showed lower median sTfR-F (0.76 vs 1.03; p=0.019) at six months. Impact of ≥10% weight loss on iron was more apparent in LP participants who exhibited greater mean serum iron (20.0 vs 13.5 μmol/L; p=0.002), transferrin saturation (29.8% vs 19.4%; p=0.001) and lower sTfR (1.24 vs 1.92 mg/L; p=0.034) at 12 months. Results show normal iron and zinc status can be maintained during 12 months of energy restriction. In the absence of elevated baseline inflammation and hepcidin, a more favourable iron profile in those with ≥10% weight loss may reflect stronger compliance or the potential influence of iron regulatory mechanisms unrelated to inflammatory hepcidin reduction.
Key Words: obesity, weight loss, young adult, iron, zinc

 

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飲食和減重對過重和肥胖年輕女性鐵和鋅狀況之影響
鐵和鋅缺乏常見於年輕過重女性。本研究旨在評估,年輕婦女參與12個月減重試驗期間之鐵、鋅和發炎狀況。參與婦女(18-25歲; BMI ≥27.5 kg/m2)隨機分為較高蛋白(HP: 含32%蛋白質; 鐵12.2 mg/日; 鋅11.7 mg/日)或較低蛋白飲食(LP: 含20%蛋白質; 鐵9.9 mg/日; 鋅7.6 mg/日)兩組,兩種飲食所含之血基質鐵和鋅含量不同。在完成試驗者中,雖然兩組皆落在正常範圍內,但HP組有較高的儲鐵蛋白中位數(52.0比39.0 µg/L; p =0.021)及較低的可溶性轉鐵蛋白受體-儲鐵蛋白指數中位數(sTfR-F; 0.89比1.05; p =0.024)。在基線時,C反應蛋白(CRP; HP: 3.54; LP: 4.63 mg/L)和鐵調節素(HP: 5.70; LP: 8.25 ng/mL)中位數值未升高,且兩組間的鋅與C反應蛋白濃度並未隨著試驗進行而有顯著差異。HP組體重減少≥10%者,比起減少<5%者,在第6個月時有較低的sTfR-F中位數(0.76比1.03; p=0.019)。在第12個月時,LP組中體重減少≥10%者,比起減少<5%者,其鐵狀況受到影響較明顯,例如有較高平均血清鐵(20.0比13.5 µmol/L; p=0.002)、轉鐵蛋白飽和度(29.8%比19.4%; p=0.001)和較低的sTfR (1.24比1.92 mg/L; p=0.034)。結果顯示,為期12個月之熱量限制仍舊可以維持正常鐵和鋅濃度。在基線時未發炎和鐵調節素未升高的情況下,體重減少≥10%者呈現較佳鐵指標數值,也許可反映出,這些參與者具較高順從性,或是鐵調節機制潛在影響與發炎性鐵調節素的減少無關。

關鍵字:肥胖、體重減少、年輕成人、鐵、鋅
 

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Relationship between skipping breakfast and bone mineral density in young Japanese women
TATSUHIKO KURODA, YOSHIKO ONOE, REMI YOSHIKATA AND HIROAKI OHTA
Back ground and aims: It is well known that insufficient nutrient intake leads to poor bone status. To find a simple evaluation method for prevention of nutrition intake disorder, a cross-sectional study with 275 healthy Japanese female students aged 19-25 was conducted. Methods: Anthropometric parameters, bone mineral density (BMD) at lumbar and total hip, bone metabolic markers and physical activity were measured in study participants and the frequency of skipping meals (breakfast, lunch, supper), and absolute values for nutrient intakes were assessed using a Diet History Questionnaire. Results: The frequency of skipping breakfast significantly correlate to total energy intake (ρ= -0.276, p<0.001). BMI, total intake of energy, intake of protein, intake of phosphate, and energy expenditure positively correlated significantly to BMD at lumbar and total hip (p<0.05) using simple linear regression. BMI (regression coefficient (b))=0.088, p<0.001), bone alkaline phosphatase (b= -0.050, p=0.012), total energy expenditure (b=0.019,
p<0.001), and frequency of skipping breakfast (b= -0.018, p=0.048) were independent risk factors for lower total hip BMD by multiple regression analysis. The total hip BMD in participants who skipped breakfast three or more times was significantly lower than in those who did not skip breakfast (p=0.007). Conclusions: In conclusion, managing the frequency of skipping breakfast and reducing it to <3 times per week may be beneficial for the maintenance of bone health in younger women.

Key Words: skipping breakfast, bone mineral density, nutrient intake, physical activity, younger women
 

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日本年輕女性不吃早餐與骨密度之相關
背景及目的:已知營養素攝取不足會導致較差的骨質狀況。為尋找一簡單評估方法以預防營養攝取失調,進行此橫斷性研究。共275名年齡在19-25歲的健康日本女學生參與。方法:測量研究參與者的體位參數、腰椎及全臀部的骨密度、骨代謝標記及體能活動;以飲食歷史問卷評估略過三餐(早、中、晚餐)的頻率及營養素攝取的絕對量。結果:未吃早餐的頻率與總熱量攝取量有顯著相關性(ρ= -0.276, p<0.001)。簡單線性迴歸顯示BMI、總熱量攝取量、蛋白質攝取量、磷攝取量及能量消耗與腰部及臀部的骨密度(p<0.05)有正相關。多元回歸分析顯示BMI(迴歸係數(b)=0.088, p<0.001)、骨質鹼性磷酸酶(b= -0.050, p=0.012)、總熱量消耗(b=0.019, p<0.001)及不吃早餐頻率(b= -0.018, p=0.048)是較低的臀部骨密度的獨立危險因子。每週略過早餐3次或以上者,比起那些每天吃早餐者,有較低的臀骨密度(p=0.007)。總結而言,改善年輕女性不吃早餐的頻率,如降低至每週少於3次,可能對於維持骨骼健康有益。
關鍵字:不吃早餐、骨密度、營養素攝取、體能活動、年輕女性


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Prevalence and determinants of hyperuricemia in type 2 diabetes mellitus patients with central obesity in Guangdong Province in China
JIAO WANG, RONG-PING CHEN, LEI LEI, QING-QING SONG, RU-YI ZHANG, YAN-BING LI, CHUAN YANG, SHAO-DA LIN, LI-SHU CHEN, YU-LIN WANG, FAN ZHAO, GAN-XIONG LIANG, BAO-CHUN HU, JIAN-CAI LIN AND DE-HONG CAI
This study investigated the prevalence and determinants of hyperuricemia in Chinese type 2 diabetes mellitus (T2DM) patients with central obesity. A multicentric hospital-based cross-sectional study was carried out in Guangdong Province between August 2011 and March 2012. At each hospital, Chinese T2DM patients with central obesity who were aged over 20 years, whose serum uric acid levels were measured, and who had lived in Guangdong Province for ≥1 year, were recruited. Hyperuricemia was defined as serum uric acid >420 μmol/L in men and >360 μmol/L in women. Binary logistic regression was used to assess associated risk factors for hyperuricemia. A total of 2,917 T2DM patients with central obesity took part. The overall prevalence of hyperuricemia was 32.6% (36.1% for women, 28.4% for men). Binary logistic regression analyses demonstrated that women (OR: 1.576; 95% confidence interval (CI): 1.231, 2.018), high BMI (OR: 1.228; 95% CI: 1.094, 1.379), waist circumference (OR: 1.135; 95% CI: 1.009, 1.276), hypertension (OR: 1.603; 95% CI: 1.263, 2.035), high total cholesterol (OR: 1.133; 95% CI: 1.002, 1.281), triglycerides (OR: 1.134; 95% CI: 1.069, 1.203), low HDLcholesterol (OR: 0.820; 95% CI: 0.677, 0.995) and low estimated glomerular filtration rate (OR: 0.840; 95% CI: 0.815, 0.866) were risk factors associated with hyperuricemia. Hyperuricemia is prevalent in Chinese T2DM patients with central obesity and is significantly positively associated with women, cardiovascular risk factors such as obesity, hypertension and dyslipidemia, and low eGFR.
Key Words: prevalence, risk factors, hyperuricemia, type 2 diabetes mellitus, central obesity

 

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中国广东省腹型肥胖2 型糖尿病患者高尿酸血症的患病 率及危险因素分析
本研究旨在探讨高尿酸血症在中国2型糖尿病合并腹型肥胖患者中的患病率,并分析其相关危险因素。2011年8月至2012年3月期间,在广东省内进行多中心、以医院为基础的横断面调查。在广东省内居住满一年且年龄在20岁以上,确诊2型糖尿病合并腹型肥胖且检测血尿酸水平的患者纳入本研究。高尿酸血症定义:男性血尿酸 >420 µmol/L或女性血尿酸 >360 µmol/L。采用二分类logistic回归分析高尿酸血症的危险因素。共2917名2型糖尿病合并腹型肥胖的患者纳入本研究。高尿酸血症的患病率为32.6%(女性为36.1%,男性为28.4%)。二分类logistic回归分析显示,女性、高体重指数和腰围、高血压、高总胆固醇和甘油三酯、低高密度脂蛋白胆固醇和低肾小球滤过率是高尿酸血症的危险因素。高尿酸血症在中国2型糖尿病合并腹型肥胖患者中盛行,与女性、心血管危险因素如肥胖、高血压、血脂異常症和低肾小球滤过率呈显著相关。关。
关键词:患病率、危险因素、高尿酸血症、2 型糖尿病、腹型肥胖

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Leisure time physical activities and dietary quality of the general and indigenous Taiwanese populations are associated with fat distribution and sarcopenia
PO-HUANG CHIANG, MARK L WAHLQVIST, LIN-YUAN HUANG AND YEN-CHEN CHANG
Indigenous peoples are at greater risk of obesity-related health problems for various reasons. These have been explored in the adulthood (19 yrs) section of the nationally-representative Nutrition and Health Survey in Taiwan (NAHSIT) for 2005-2008 in Indigenous mountain-dwelling (IndT) (n=226) and general (mainly Han Chinese) (GenT) (n=1486) Taiwanese. Physical activity, BMI, fat distribution (waist circumference (WC) and triceps skinfold (TSF)) and mid arm muscle circumference (MAMC) have been compared. Leisure-time physical activities (LTPA) were assigned metabolic equivalents (METs). Comparisons were made by ethnicity-locality. Indigenous men and women were 3.81 and 5.47 times more obese (WHO criteria BMI 30 kg/m2) than the GenT, respectively. Some 55% of the IndT and 34% of the GenT reported no LTPA. All LTPA types were less evident in the IndT. Multivaiable adjusted ORs (95% CIs) against inactivity as referent were, for sarcopenic MAMC, in Indigenes with MVI-LTPA 0.13 (0.03-0.67) and in
the GenT 0.61 (0.37-1.01); in the GenT with LTPA for BMI ≥30 kg/m2 and obese TSF, they were 0.53 (0.31-0.91) and 0.77 (0.60-0.98), respectively. Without dietary quality adjustment, the sarcopenia risk in GenT with LTPA was significant (OR=0.60, 95% CI: 0.37-0.97). Having adjusted for dietary quality, the significance disappeared. Less sarcopenia was found with ambulation in the GenT (OR=2.07, 95% CI: 1.26-3.43). More over-fatness in an IndT than GenT is associated with less LTPA. LTPA reduces sarcopenic risk irrespective of ethnicity, is partly dependent on diet, and reduces obesity indices in the GenT.
Key Words: obesity, exercise, energy expenditure, body composition, muscle

 

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臺灣地區群體與原住民成年人休閒體能活動量及飲食品質與體脂分佈及肌少症之關係
臺灣原住民因為各種原因而有較高與肥胖相關之健康風險。本研究在探討及比較2005-2008年國民營養健康狀況變遷調查的19歲以上臺灣整體樣本(n=1486)與原住民(n=226)的運動、身體質量指數(BMI)、脂肪分佈(腰圍及三頭肌皮脂厚度(TSF))和中臂肌肉圍(MAMC)。以運動代謝當量(METs)計算研究對象休閒體能活動量(LTPA),並進行兩組樣本的比較。結果發現,原住民男性及女性的肥胖(BMI³30 kg/m2)盛行率分別是臺灣整體樣本中成年男性及女性的3.81和5.47倍;約有55%的原住民以及34%的臺灣人沒有休閒運動,而原住民的休閒運動種類也明顯的較少;經過年齡、性別、教育程度、收入、抽菸、飲酒、嚼食檳榔、及飲食品質校正後,適度運動之原住民與台灣整體族群中,有肌少症的風險,分別是沒有運動者的0.13倍(OR=0.13, 95% CI: 0.03-0.67)及0.61倍(OR=0.61, 95% CI: 0.37-1.01);而有運動的台灣成年人中,BMI³30 kg/m2和以TSF定義之肥胖風險,分別是沒有運動者的0.53倍(OR=0.53, 95% CI: 0.31-0.91)及0.77倍(OR=0.77, 95% CI: 0.60-0.98)。在未校正飲食品質之前,有運動對臺灣成人肌少症的風險具有顯著的保護作用(OR=0.60, 95% CI: 0.37-0.97),校正飲食品質後其顯著性則消失。進一步分析運動類型對肥胖之影響,進行步行運動的臺灣成年人被發現有較低的肌少症風險(OR=2.07, 95% CI: 1.26-3.43)。休閒體能活動降低肌少症的風險與種族無關,而在台灣成人中,一定程度上與飲食有關,並且會降低肥胖風險。
關鍵字:肥胖、運動、能量消耗、體組成、肌肉

 

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Prevalence and correlates of zinc deficiency in pregnant Vietnamese women in Ho Chi Minh City

VINH QUANG NGUYEN, AYA GOTO, TU VAN T NGUYEN, KHOA TUAN VO, TUYET MAI T TA, THUY NINH T NGUYEN, TIEN MINH NGUYEN, MY BINH T HO, NGOC ANH T PHAN, HONG HANH T VU, THUC MY TRUONG AND HUNG T NGUYEN
Background: Although Vietnam is a region with a plant-based diet that has a high zinc deficiency, epidemiological data showing how this affects pregnant women are limited. This study explores the prevalence of zinc deficiency and possible correlates in pregnant Vietnamese women in Ho Chi Minh City. Methods: This was a crosssectional study conducted at a general hospital in Ho Chi Minh City, Vietnam. All pregnant women who came to their first antenatal care visit from November 2011 to June 2012 were recruited. Those taking a vitamin and/or mineral supplement were excluded. Serum zinc concentrations, determined by a standard colorimetric method, of 10.7 mol/L-17.5 mol/L (70.0 g/dL-114 g/dL) were classified as normal and under 10.7 mol/L (70.0 g/dL) as zinc deficient. Results: In total, 254 pregnant women were invited and 107 (42%) participated. The mean age of participants was 29 years, and mean gestational age was 10 weeks. Median zinc concentration in serum was 13.6 mol/L, and the prevalence of zinc deficiency was 29% (95% CI=21%-39%). The daily intake of a milk product supplement was the only significant correlate of zinc deficiency of the items investigated (adjusted OR=0.40, 95% CI=0.16-0.99, p=0.049). Discussion: This is the first study reporting that more than 25% of pregnant Vietnamese women in Ho Chi Minh City are zinc deficient. Further academic and clinical input is needed to confirm the scale of this neglected issue and to investigate the potential of milk product supplementation in this population.
Key Words: zinc, deficiency, dietary supplement, pregnant women, Vietnam

 

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胡志明市懷孕的越南婦女鋅缺乏的盛行率及相關因素
背景:儘管越南是一個以蔬食為主而有高的鋅缺乏地區,但是這對於懷孕婦女影響如何,仍缺乏流行病學的數據。本研究探討胡志明市的越南懷孕婦女其鋅缺乏盛行率與可能相關因素。方法:這個橫斷性研究執行於越南胡志明市的一間綜合醫院。自2011年11月到2012年6月第一次來產檢的孕婦為研究對象,但排除那些有服用維生素及/或礦物質補充劑的孕婦。以標準比色法評估血清鋅濃度,濃度範圍10.7 mmol/L-17.5 mmol/L (70.0 g/dL-114 g/dL)被分類為正常組,低於10.7 mmol/L(70.0 g/dL)為鋅缺乏。結果:共有254名孕婦受邀,最後計107名(42%)參與研究。參與者平均年齡為29歲,平均懷孕週數為10週。血清鋅中位數為13.6 mmol/L,鋅缺乏盛行率為29%(95% CI=21%-39%)。在所有研究項目中,只有乳製品補充的每日攝取量與鋅缺乏具有相關性(校正OR=0.40,95%CI=0.61-0.99,p=0.049)。討論:這是第一個研究報告胡志明市懷孕的越南婦女有超過25%鋅缺乏。需要更進一步的學術及臨床的投入,以確認這個被忽視的問題嚴重性,並研究乳製品補充在這個族群的可能性。
關鍵字:鋅、缺乏、膳食補充、懷孕婦女、越南

 

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Evaluating dietary quality in diabetes by the Healthy Eating Index
ŞEVKET DIREKTÖR AND EMEL ÖZER
Diabetes and diabetes-induced complications is a rising health concern in Northern Cyprus. Of the adult population in Northern Cyprus, 12.2% has diabetes and 90% of all individuals suffering from cardiovascular disease are people with diabetes. The aim of this study was to evaluate nutritional habits of people with diabetes in Northern Cyprus in order to make the necessary recommendations to improve their eating habits to prevent diabetesinduced complications. We used the Healthy Eating Index (HEI) to evaluate dietary quality of people with diabetes in Northern Cyprus based on their 24-hour food intake. A total of 200 participants with diabetes were selected randomly from the out-patient clinic of Dr. Burhan Nalbantoğlu central hospital in Nicosia. Individuals were asked to complete a questionnaire to determine their 24-hour food intake and frequency of intake of various food substances. The mean HEI score for the subjects with diabetes was 58.8. The HEI component scores for saturated fat, vegetables, dairy products and meat consumption were less than 5, whereas average scores for fat, cholesterol, fruits, grains, and sodium consumption were more than 5. The meat component of the HEI had the lowest mean score (3.3). There was statistical significance between male and female subjects regarding the HEI scores for meat and nutrient variety intake. In conclusion, the results of the present study suggest that subjects with diabetes in Northern Cyprus should improve their diet by decreasing their intake of saturated fat and by increasing their intake of vegetables, meat and milk.
Key Words: diabetes Mellitus, dietary quality, BMI, nutritional status, nutrient

 

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以健康飲食指標評估糖尿病患者之飲食品質
在北塞普勒斯,糖尿病與糖尿病引發的併發症正逐漸成為重要健康議題。北塞普勒斯成人中,12.2%患有糖尿病;且所有心血管疾病的患者中,90%亦患有糖尿病。本篇研究主要目的是,評估北塞普勒斯糖尿病者的營養習慣,以提出建議來改善其飲食習慣,預防日後糖尿病所導致的併發症。利用健康飲食指標(HEI),根據24小時食物攝取量,來評估北塞普勒斯糖尿病患者的飲食品質。從尼古西亞Dr. Burhan Nalbantoğlu中央醫院的門診病人中隨機挑選200位糖尿病患者為研究對象。參與者需完成24小時食物攝取量和多項食物攝取頻率之問卷。糖尿病參與者的HEI平均分數為58.8分。健康飲食指標分項分數,如飽和脂肪、蔬菜、乳製品和肉類攝取的分數皆低於5分;然而,脂肪、膽固醇、水果、穀類和鈉攝取的平均分數皆高於5分。 健康飲食指標之分項中,以肉類的平均分數3.3分為最低。肉類與營養素多樣性攝取的分項分數,在男女性間有顯著差異。總之,本篇研究結果顯示,北塞普勒斯糖尿病患者,應藉由減少飽和脂肪攝取,並增加蔬菜、肉類和奶類攝取,以改善其飲食。
關鍵字:糖尿病、飲食品質、身體質量指數、營養狀況、營養素

 

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Associations of body mass index with incident hypertension in American white, American black and Chinese Asian adults in early and middle adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Atherosclerosis Risk in Communities (ARIC) study and the People’s Republic of China (PRC) study
EVA G KATZ, JUNE STEVENS, KIMBERLY P TRUESDALE, JIANWEN CAI, KARI E NORTH AND LYN M STEFFEN
The association of body mass index (BMI) with blood pressure may be stronger in Asian than non-Asian populations, however, longitudinal studies with direct comparisons between ethnicities are lacking. We compared the relationship of BMI with incident hypertension over approximately 9.5 years of follow-up in young (24-39 years) and middle-aged (45-64 years) Chinese Asians (n=5354), American Blacks (n=6076) and American Whites (n=13451). We estimated risk differences using logistic regression models and calculated adjusted incidences and incidence differences. To facilitate comparisons across ethnicities, standardized estimates were calculated using mean covariate values for age, sex, smoking, education and field center, and included the quadratic terms for BMI and age. Weighted least-squares regression models with were constructed to summarize ethnic-specific incidence differences across BMI. Wald statistics and p-values were calculated based on chi-square distributions. The association of BMI with the incidence difference for hypertension was steeper in Chinese (p<0.05) than in American populations during young and middle-adulthood. For example, at a BMI of 25 vs 21 kg/m2 the adjusted incidence differences per 1000 persons (95% CI) in young adults with a BMI of 25 vs those with a BMI of 21 was 83 (36-130) for Chinese, 50 (26-74) for Blacks and 30 (12-48) for Whites; among middle-aged adults it was 137 (77-198) for Chinese, 49 (9-88) for Blacks and 54 (38-69) for Whites. Whether hypertension carries the same level of risk of stroke or cardiovascular disease across national or ethnic groups remains uncertain.
Key Words: blood pressure, multi-ethnic, obesity, African American, cardiovascular disease
 

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探討早中成人期美國白人、黑人與中國亞洲人身體質量指數和高血壓發生之相關性:來自CARDIA、ARIC以及PRC 研究
比起非亞裔人群,亞洲人之身體質量指數(BMI)與血壓有較密切之相關性。然而,直接比較種族間差異的縱貫性研究尚顯不足。本篇研究主要比較,年輕(24-39歲)和中年(45-64歲)的中國亞洲人(5354人)、美國黑人(6076人)與白人(13451人)之BMI與追蹤約9.5年間高血壓發生率之關聯。本研究利用邏輯斯迴歸模式估計風險差,並計算調整後發生率與發生率差。為使種族間比較更具意義,同時校正了共變項,包括年齡、性別、抽菸、教育程度和研究地區,加上BMI與年齡的平方項。以加權最小平方迴歸模式統合分析不同BMI之間,特定族群發生率之差異。根據卡方分佈進行Wald統計分析並計算p值。在成人早期與中期,中國人BMI與高血壓發生風險之差異較美國人大(p<0.05)。舉例來說,年輕成人BMI為25與21之調整發生率差,中國人每千人是83 (36- 130)、美國黑人50 (26-74),而白人為30 (12-48);而對中年人來說,中國人每千人是137 (77-198)、美國黑人49 (9-88)、白人54 (38-69)。然而,高血壓對於未來中風或心血管疾病發生之風險影響,在不同國家或種族之間是否有差異,仍舊不確定。
關鍵字:血壓、多種族的、肥胖、非裔美國人、心血管疾病

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Cognitive impairment and limited dietary diversity or physical inactivity are conjoint precursors of incident diabetes more so in elderly women than men
LI-LI XIU, MARK L WAHLQVIST, MEEI-SHYUAN LEE, ROSALIND CHIA-YU CHEN AND DUO LI
OBJECTIVES: To establish whether elderly people with impaired cognition are at greater risk for the development of type 2 diabetes. DESIGN: Prospective population-based cohort study. SETTING: The Elderly Nutrition and Health Survey in Taiwan (NAHSIT Elderly). PARTICIPANTS: One thousand and four hundred ninety-three diabetes-free people ≥65 years were followed for incident diabetes in relation to cognitive status for up to 8 years. MEASUREMENTS: The association between cognitive impairment and diabetes incidence was analyzed with Cox proportional hazards models with exclusion of people who had diabetes within one year of cognitive function assessments. RESULTS: Cognitively-impaired women, but not men, had increased diabetes incidence density (DID). Age, gender, ethnicity and personal behavior adjusted hazard ratios (HR) and 95% confidence intervals (CI) for type 2 diabetes with normal cognition as referent were 2.43 (95% CI: 1.27-4.63) for women and 1.55 (95% CI: 0.48-5.07) for men. These gender differences and the HR significances remained with adjustments for age, ethnicity, financial status, dietary quality as a dietary diversity score, physical function, physical activity, fasting glucose, indices of body composition, body mass index, waist circumference, mid-arm muscle circumference, perceived and mental health status. There were extensive significant interactions with the covariates in women. CONCLUSION: Cognitive impairment in later life is associated with greater risk of type 2 diabetes in women and considerable potential risk enhancement.
Key Words: cognitive impairment, type 2 diabetes, dietary, physical activity, body composition

 

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認知功能障礙伴隨單調飲食或缺乏運動是老年女性而非男性罹患糖尿病的前導因子
已有研究發現患有糖尿病的老人易發生認知功能障礙,對於患有認知功能障礙的老人是否更易發生糖尿病,也就是老人糖尿病和認知功能障礙發生是否存在雙向性影響,目前不可知。本研究的目的為觀察患有認知功能障礙的老人是否更容易發生糖尿病。以參與1999-2000年臺灣老人營養和健康調查中1493位年齡超過65歲,且沒有糖尿病的老人為研究對象,追蹤8年,研究糖尿病發生率和認知功能的關係。認知功能障礙和糖尿病的發生率以Cox比例風險迴歸模型來分析。結果發現有認知功能障礙的女性其糖尿病發生率顯著提高,但在男性中沒有觀察到這樣的結果。以正常認知功能組做為參照組,在校正年齡,性別,種族和個人行為之後,認知功能障礙老年女性二型糖尿病風險比值(HR)為2.43 (95%信賴區間: 1.27-4.63),男性為1.55 (95%信賴區間: 0.48-5.07)。在分別校正年齡,種族,個人行為和經濟狀況,飲食品質,身體活動功能,運動,空腹血糖值,身體質量指數,腰圍及中臂肌圍等可能影響糖尿病發生的變數後,性別差異和風險比顯著性仍然存在。在女性中,上述共變數對糖尿病的發生存在顯著交互作用。飲食品質差及少運動,會增加認知功能障礙老年女性患糖尿病的風險比。
關鍵字:認知功能障礙、第二型糖尿病、飲食、運動、身體組成

 

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Effects of gamma-glutamyl carboxylase gene polymorphism (R325Q) on the association between dietary vitamin K intake and gamma-carboxylation of osteocalcin in young adults
MAYU HARAIKAWA, NAOKO TSUGAWA, NATSUKO SOGABE, RIEKO TANABE, YUKA KAWAMURA, TOSHIO OKANO, TAKAYUKI HOSOI AND MASAE GOSEKI-SONE
Introduction: It has been demonstrated that single nucleotide polymorphism (SNP) (R325Q, 974G>A) in the gamma-glutamyl carboxylase (GGCX) gene is associated with the bone mineral density (BMD). In the present study, we investigated the effect of GGCX polymorphism (974G>A) on the correlations among the vitamin K intake, level of serum vitamin K, and ratio of undercarboxylated osteocalcin (ucOC) to intact osteocalcin (OC) in healthy young Japanese subjects. Methods: Healthy young adult subjects (n=189) were genotyped for the polymorphism, and we measured the levels of serum vitamin K, intact OC, ucOC, and dietary nutrient intakes. Results: Dietary vitamin K intake from vegetables was significantly correlated with the level of serum phylloquinone (PK), and vitamin K intake from fermented beans, natto, was also significantly correlated with the level of serum menaquinone-7 (MK-7). Moreover, the total dietary vitamin K intake showed a significant negative correlation with the ratio of ucOC to intact OC. Interestingly, on grouping by the GGCX genotype, there was a significant interaction between the ratio of ucOC to intact OC with vitamin K intake in homozygotes (GG-type) and heterozygotes (GA-type) (p<0.001). These results suggest that an adequate nutritional strategy is necessary for people with high-risk genotypes (GG- or GA-type). Conclusions: We demonstrated the effects of SNP (974G>A) in the GGCX gene on the correlation between dietary vitamin K intake and gamma-carboxylation of serum OC. Our data may be useful for planning strategies to prevent osteoporosis.

Key Words: vitamin K intake, phylloquinone (PK), menaquinone-7 (MK-7), single nucleotide polymorphisms (SNP), gamma-glutamyl carboxylase (GGCX)
 

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γ-麩胺醯羧化酶基因多型性(R325Q)對於年輕成人飲食 中維生素K 攝取和骨鈣素γ-羧化相關性之影響
前言:γ-麩胺醯羧化酶(GGCX)基因的單核苷酸多型性(SNP)與骨骼礦物質密度(BMD)之相關性已被證實。本篇研究探討,在日本的健康年輕受試者中,其GGCX多型性(974G>A)對於維生素K攝取、血清中維生素K濃度和羧化不全骨鈣素(ucOC)與完整骨鈣素(OC)比值之間關聯性的影響。方法:共有189位健康年輕成人進行基因多型性檢測,並測量其血清中維生素K、OC、ucOC濃度和飲食中營養素攝取量。結果:飲食中攝取來自蔬菜的維生素K與血清中維生素K1(PK;葉綠醌)有顯著相關;而攝取來自發酵豆類-納豆的維生素K也與血清中維生素K2(MK-7;甲萘醌-7)有顯著相關。此外,從飲食中攝取的總維生素K和ucOC與OC比值有顯著負相關。值得注意的是,將GGCX基因型分組時發現,同型結合子(GG-type)和異型結合子(GA-type)兩組的ucOC與OC比值和維生素K攝取有顯著交互作用(p<0.001)。以上結果顯示,適當的營養策略對於具有高風險基因型(GG-或GA-type)的人是必要的。結論:本研究證實GGCX基因中的SNP(974G>A)多型性對於飲食維生素K攝取與血清骨鈣素γ-羧化相關性之效應。本資料對於規劃預防骨質疏鬆症之策略也許會有幫助。
關鍵字:維生素K 攝取、維生素K1(PK)、維生素K2(MK-7)、單核苷酸多型性 (SNP)、γ-麩胺醯羧化酶(GGCX)

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CSPEN guidelines for nutrition support in neonates
WEI CAI AND THE WORKING GROUPS OF PEDIATRICS, CHINESE SOCIETY OF PARENTERAL AND ENTERAL NUTRITION, OF NEONATOLOGY, CHINESE SOCIETY OF PEDIATRICS, AND OF NEONATAL SURGERY, CHINESE
SOCIETY OF PEDIATRIC SURGERY

In the last few decades, there has been a significant increase in survival rate of preterm infants, especially very low birth weight infants. The nutrition problems have become particularly relevant in neonates, and nutrition support is usually required for preterm infants and most sick term infants. The actual amount of nutrition must be calculated (not estimated) in neonates. The goals of nutrition support are to maintain development and growth while avoiding nutrition related complications. Nutrition requirements (enteral nutrition and parenteral nutrition) should be adjusted according to different weights and gestational age. Parenteral nutrition (PN), which allows the infant’s requirements for growth and development to be met, is indicated in infants for whom feeding via the enteral route is impossible, inadequate, or hazardous. Enteral nutrition (EN) should be gradually introduced and should replace PN as quickly as possible in order to minimize any side-effects from exposure to PN. Inadequate substrate intake in early infancy can cause long-term detrimental effects in terms of metabolic programming of the risk of illness in later life. Optimal nutrition care of the preterm infant offers the opportunity to improve outcomes for children. This guideline aims to provide proposed advisable ranges for nutrient intakes in neonates. These recommendations are based on a considered review of available scientific reports on the subject, and on expert consensus for which the available scientific data are considered inadequate.
Key Words: parenteral nutrition, enteral nutrition, premature infant, neonate, nutrition support

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中国新生儿营养支持指南
在过去的几十年里,早产儿的存活率明显升高,尤其是极低出生体重儿。新生儿的营养问题也变得越来越重要。早产儿和大多数疾病状态的足月儿通常需要营养支持。新生儿的营养需要量必要经过實際计算(而不是估计)。营养支持的目标是维持正常的营养状况和生长需要的同时,避免营养相关并发症的发生。不同体重和胎龄的新生儿营养需要(肠内营养和肠外营养)是不同的。 在患儿无法进行肠内营养、肠内营养摄入不足或肠内营养会造成危害的情况下,肠外营养(PN)可以满足患儿生长及發育的需求。肠内营养(EN)应逐步添加并尽快取代PN,以减少PN的并发症 。早期摄入量不足,可造成远期代谢疾病的不利影响。合適的营养支持可以改善早产儿的預後狀況。本指南旨在为新生儿合理营养支持提供推荐摄入量。这些建议是基于对相关文献进行分析,以及在资料不足情况下达成的专家共识。。
关键词:肠外营养、肠内营养、早产儿、新生儿 、营养支

 

Last Updated: November 2013