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1 Asia Pacific Journal of Clinical Nutrition
       Volume 24, 2

         (June 2015)


Abstracts

Contents

Abstract PDF

Reviews

Evolution of diabetes management in the 21st century:
the contribution of quality of life measurement in Asians

SHEREEN GIAP KAH GOH, BIN NORDIN RUSLI AND BIN ABDUL KADIR KHALID
Asia Pac J Clin Nutr. 2015;24(2):190-198.

doi: 10.6133/apjcn.2015.24.2.04

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Food system advances towards more nutritious and sustainable mantou production in China
XINZHONG HU, XIALU SHENG, LIU LIU, ZHEN MA, XIAOPING LI AND WUQI ZHAO

Asia Pac J Clin Nutr. 2015;24(2):199-205.

doi: 10.6133/apjcn.2015.24.2.21

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Original Research Communications

Clinical Nutrition or Feeding Studies

Clinical application of the fast track surgery model based on preoperative nutritional risk screening
in patients with esophageal cancer
JIN-YI WANG, XUAN HONG, GUO-HAN CHEN, QIN-CHUAN LI AND ZHONG-MIN LIU

Asia Pac J Clin Nutr. 2015;24(2):206-211.

doi: 10.6133/apjcn.2015.24.2.18

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Risk of regurgitation and aspiration in patients infused with different volumes of enteral nutrition
SHAOZHEN CHEN, WENBIAO XIAN, SHOUZHEN CHENG, CHUNYAN ZHOU, HONGYAN ZHOU, JIEZHEN FENG, LI
LIU AND LING CHEN

Asia Pac J Clin Nutr. 2015;24(2):212-218.

doi: 10.6133/apjcn.2015.24.2.12

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Optimal timing for introducing enteral nutrition in the neonatal intensive care unit
JIE LIU, KAIMENG KONG, YEXUAN TAO AND WEI CAI
Asia Pac J Clin Nutr. 2015;24(2):219-226.

doi: 10.6133/apjcn.2015.24.2.14

 

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Early parenteral nutrition alone or accompanying enteral nutrition in critically ill patients: a systematic review and meta-analysis
XIAO WAN, XUEJIN GAO, FENG TIAN, CHAO WU AND XINYING WANG
Asia Pac J Clin Nutr. 2015;24(2):227-233
.

doi: 10.6133/apjcn.2015.24.2.07

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Nutritional Status, Dietary Intake, and Body Composition

Survey of iodine nutritional status in 2011, Zhejiang, China
GUANGMING MAO, GANGQIANG DING, XIAOMING LOU, RONGHUA ZHANG, PAI ZHENG, ZHE MO, XIAOFENG WANG, WENMING ZHU, JINSHUI ZHOU AND FANG GU
Asia Pac J Clin Nutr. 2015;24(2):234-244.

doi: 10.6133/apjcn.2015.24.2.08

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Calcium intake and the risk of stroke: an up-dated meta-analysis of prospective studies
DAN-YANG TIAN, JIE TIAN, CHANG-HE SHI, BO SONG, JUN WU, YAN JI, RUI-HAO WANG, CHENG-YUAN MAO, SHI-LEI SUN AND YU-MING XU
Asia Pac J Clin Nutr. 2015;24(2):245-252.

doi: 10.6133/apjcn.2015.24.2.22

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Maternal and Clild Nutrition

 

Anemia in Cambodia: a cross-sectional study of anemia, socioeconomic status and other associated
risk factors in rural women

CHRISTOPHER V CHARLES, CATE E DEWEY, ANN HALL, CHANTHARITH HAK, SON CHANNARY AND ALASTAIR
JS SUMMERLEE
Asia Pac J Clin Nutr. 2015;24(2):253-259.

doi: 10.6133/apjcn.2015.24.2.09

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Diagnostic value of maternal anthropometric measurements for predicting low birth weight in developing countries: a meta-analysis
EITA GOTO
Asia Pac J Clin Nutr. 2015;24(2):260-272.

doi: 10.6133/apjcn.2015.24.2.05

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Maternal zinc status is associated with breast milk zinc concentration and zinc status in breastfed infants aged 4-6 months
ORAPORN DUMRONGWONGSIRI, UMAPORN SUTHUTVORAVUT, SUTHIDA CHATVUTINUN, PHANPHEN PHOONLABDACHA, AREEPORN SANGCAKUL, ARTITAYA SIRIPINYANOND, USANA THIENGMANEE AND NALINEE CHONGVIRIYAPHAN

Asia Pac J Clin Nutr. 2015;24(2):273-280.

doi: 10.6133/apjcn.2015.24.2.06

 

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Nutritional Epidemiology and Public Health

Nonalcoholic fatty liver disease prevalence in urban school-aged children and adolescents from the Yangtze River delta region: a cross-sectional study
XIAOMIN ZHANG, YANPING WAN, SHIJUN ZHANG, LIPING LU, ZHIQI CHEN, HONG LIU, XIAOMIN JIANG, KAILI LUO AND WEI CAI
Asia Pac J Clin Nutr. 2015;24(2):281-288
.

doi: 10.6133/apjcn.2015.24.2.13

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Low physical activity and energy dense Malaysian foods are associated with non-alcoholic fatty liver disease in centrally obese but not in non-centrally obese patients with diabetes mellitus
WAH-KHEONG CHAN, ALEXANDER TONG-BOON TAN, SHIREENE RATNA VETHAKKAN, PEI-CHIEN TAH, ANUSHYA VIJAYANANTHAN AND KHEAN-LEE GOH
Asia Pac J Clin Nutr. 2015;24(2):289-298.

doi: 10.6133/apjcn.2015.24.2.15

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Comparison of fast food consumption and dietary guideline practices for children and adolescents by clustering of fast food outlets around schools in the Gyeonggi area of Korea
SOONNAM JOO, SEYOUNG JU AND HYEJA CHANG
Asia Pac J Clin Nutr. 2015;24(2):299-307.
doi: 10.6133/apjcn.2015.24.2.03

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Improvement in the technological feasibility of a web-based dietary survey system in local settings
HYUN JU JUNG, SANG EUN LEE, DONGWOO KIM, HWAYOUNG NOH, SUJIN SONG, MINJI KANG, YOON JU SONG AND HEE-YOUNG PAIK

Asia Pac J Clin Nutr. 2015;24(2):308-315.
doi: 10.6133/apjcn.2015.24.2.20

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The biomarker-based validity of a brief-type diet history questionnaire for estimating eicosapentaenoic acid and docosahexaenoic acid intakes in pregnant Japanese women
MIE SHIRAISHI, MEGUMI HARUNA, MASAYO MATSUZAKI, RYOKO MURAYAMA AND SATOSHI SASAKI
Asia Pac J Clin Nutr. 2015;24(2):316-322.

doi: 10.6133/apjcn.2015.24.2.10

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Nutrigenomics

Genetic variants of FADS gene cluster, plasma LC-PUFA levels and the association with cognitive function of under-two-year-old Sasaknese Indonesian children
UMI FAHMIDA, MIN KYAW HTET, CHRIS ADHIYANTO, RISATIANTI KOLOPAKING, MIZA AGRIA YUDISTI, ALLAY MAUDUDI, DWI ANITA SURYANDARI, DRUPADI DILLON, LYDIA AFMAN AND MICHAEL MÜLLER

Asia Pac J Clin Nutr. 2015;24(2):323-328.

doi:10.6133/apjcn.2015.24.2.17

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Effects of Fok-I polymorphism in vitamin D receptor gene on serum 25-hydroxyvitamin D, bone-specific alkaline phosphatase and calcaneal quantitative ultrasound parameters in young adults
RIEKO TANABE, YUKA KAWAMURA, NAOKO TSUGAWA, MAYU HARAIKAWA, NATSUKO SOGABE, TOSHIO
OKANO, TAKAYUKI HOSOI AND MASAE GOSEKI-SONE

Asia Pac J Clin Nutr. 2015;24(2):329-335.

doi: 10.6133/apjcn.2015.24.2.01

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Clinical Nutrition Guidelines

Guidelines for parenteral and enteral nutrition support in geriatric patients in China
JUNMIN WEI, WEI CHEN, MINGWEI ZHU, WEIXIN CAO, XINYING WANG, HANPING SHI, BIRONG DONG, JIANQIN SUN, HUAIHONG CHEN, YEPING ZHOU, SUMING ZHOU AND JINGYONG XU
Asia Pac J Clin Nutr. 2015;24(2):336-346.

doi: 10.6133/apjcn.2015.24.2.11

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Attitudes toward the American nutrition guidelines for the critically ill patients of Chinese intensive care physicians
XIAO-LING XU, JIAN-CANG ZHOU, KONG-HAN PAN, HONG-CHEN ZHAO AND KE-JING YING
Asia Pac J Clin Nutr. 2015;24(2):347-358.

doi: 10.6133/apjcn.2015.24.2.02

 

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Future Events

Asia Pac J Clin Nutr. 2015;24(2):359.

 

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Evolution of diabetes management in the 21st century: the contribution of quality of life measurement in Asians
SHEREEN GIAP KAH GOH, BIN NORDIN RUSLI AND BIN ABDUL KADIR KHALID
Diabetes mellitus (DM) is a complex and chronic disease with multiple complications leading to increased mortality and poor quality of life. Current studies have shown that lowering glycosylated haemoglobin (HbA1c) confers protection against microvascular complications. However, with more intensive glucose control to achieve HbA1c of less than 6.5%, there seems to be a significant increased risk of mortality and cardiovascular events. The current recommendation worldwide is for “tailoring” of DM management to risk and also quality of Life (QOL) which is a crucial component in determining the success or failure of DM management. In Asia, DM has become a health crisis but there is a lack of QOL assessment tool that is specific for Asians with wide spectrum of ethnicity, languages, religions and socio-economic differences. In this review, we discuss the evolution of DM management over the decade and the issues pertaining to QOL among people living with diabetes in Asia.
Key Words: quality of life, Asians, diabetes mellitus
 

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二十一世纪糖尿病管理的发展:在亚洲生活质量指标的贡献
糖尿病(DM)是一种复杂的慢性病,它的多种并发症能够导致死亡率增加和生活质量变差。目前的研究表明降低糖化血红蛋白(HbA1c)能够预防微血管并发症。然而,随着更严格的血糖控制使HbA1c 低于6.5%,似乎死亡和心血管事件的风险显著增加。当前全世界糖尿病管理的建议是 “权衡”风险和生活质量(QOL),这是决定糖尿病管理成功或失败的关键组成部分。在亚洲,糖尿病已经成为一个健康危机,但缺乏针对有很多种族、语言、宗教和社会经济差异的亚洲人的生活质量评估工具。本综述讨论了过去十年糖尿病管理的发 展和亚洲糖尿病患者生活质量相关的问题。
关键词:生活质量、亚洲人、糖尿病

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Food system advances towards more nutritious and sustainable mantou production in China
XINZHONG HU, XIALU SHENG, LIU LIU, ZHEN MA, XIAOPING LI AND WUQI ZHAO
Mantou, a traditional Chinese food, is widely consumed in the North China due to its nutritional value and good mouth-feel. However, its current family-style production is impeded due to short shelf-life caused by mold and starch retrogradation. The current packaging and storage methods are not efficient enough for mantou preservation. Recently, a novel, hot online package technology has attracted attention due to its high processing efficiency and low cost. Most importantly, by using this methodology, secondary contamination by microbes can be avoided and starch retrogradation can be markedly delayed, with mantou shelf-life under room temperature extended from a few to at least 90 days without any additives. In this review, the mechanisms of mantou quality deterioration are explained and the advantages of hot package technology addressed and compared with other packaging methods, such as frozen chain storage. In this way, not only wheat, but also other grains (including whole-grains) and ingredients may be mantou constituents, to enhance nutrition of traditional mantou. There is now a technological opportunity for mantou to become a more nutritious, sustainable and affordable foodstuff in local communities.
Key Words: mantou, whole-grain, shelf life, starch retrogradation, hot packaging

 

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在中国粮食体系馒头生产朝着更营养和可持续的方向发展
馒头因营养佳、口感好,是中国北方地区广泛消费的传统主食。但市场上馒头因霉菌污染和淀粉老化问题而严重地影响了货架期,目前常用的包装和贮存方法已不能满足馒头的保藏需求。最近,一种高效实惠的新型馒头在线包装技术引起了市场的普遍关注。该方法可同时实现控制馒头的二次污染和延缓淀粉老化,在不添加任何食品添加剂的条件下馒头可常温下保鲜从几天延至90 天。本综述介绍了馒头的品质劣变机理,并将热包装与传统的冷链贮存进行了技术对比分析。采取热包装技术,不但可进行小麦馒头的生产,而且还可添加较多 的全谷物面粉以及其他谷物原料生产全谷物馒头,改善其营养价值。无菌在线热包装技术已成为中国新的营养、可持续以及实用的新型加工技术。
关键词:馒头、全谷物、货架期、淀粉老化、热包装

 

 

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Clinical application of the fast track surgery model based on preoperative nutritional risk screening in patients with esophageal cancer
JIN-YI WANG, XUAN HONG, GUO-HAN CHEN, QIN-CHUAN LI AND ZHONG-MIN LIU

Objectives: To investigate the clinical application of the fast track surgery (FTS) model based on preoperative nutritional risk screening (NRS) in patients with esophageal cancer. Methods: 180 patients with esophageal cancer who underwent surgery between January 2008 and April 2014 were randomly divided into study and control groups based on matched-pairs. The study group underwent assessment using the NRS 2002 and received treatment before surgery and the control group was treated by the conventional method. Postoperative indicators including time to first exsufflation, time to defecation, time to chest tube removal, hospitalization duration, and postoperative complications were examined after surgery. Results: Compared with the control group, the postoperative indicators including time to first exsufflation (88.4±2.76 vs 57.83±2.68 hours), time to first defecation (4.68±1.71 vs 3.28±1.34 days), time to chest tube removal (4.30±0.25 vs 2.70±0.33 days), postoperative hospitalization durations (11.71±1.39 vs 9.00±0.78 days), and total complication rate (18.9% [17/90] vs 6.67% [6/90]) were all significantly reduced in the study group (p<0.05). Conclusions: The FTS model based on NRS can effectively promote postoperative rehabilitation of patients, reduce the incidence of postoperative complications, and shorten hospital stay.
Key Words: esophageal cancer, perioperation, nutrition risk screening, fast track surgery, postoperative indicator

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基于营养风险筛查的快速康复外科在食管癌围手术期中的应用
目的:探讨基于营养风险筛查(nutritional risk screening, NRS)的快速康复外科(fast track surgery, FTS)模式在食管癌患者围手术期治疗中的临床应用。方法:选取2008年01月至2014年04月同期住院食管鳞癌适宜手术治疗的患者180例 随机分为两组(n=90):研究组术前采用营养风险筛查2002 (NRS2002)方法进行评估并予以干预性治疗;对照组按传统围手术期方法(conventional perioperative management)治疗。观察两组病例术后首次排气、排便时间、拔除胸腔引流管时间、术后住院时间以及手术并发症等情况。结果:两组手术时间差异无统计学意义(p>0.05)。与对照组比较,研究组术后首次排气时间[88.4±2.76 h vs 57.8±2.68 h]、首次排便时间[4.68±1.71 d vs 3.28±1.34 d]、拔除胸腔引流管时间[4.30±0.25 d vs 2.70±0.33 d]、术后住院时间[11.7±1.39 d vs 9.00±0.78 d]以及总并发症发生率[18.9%(17/90)vs 6.67%(6/90)]等均显著减少,其差异具有统计学意义(p<0.05)。 结论:应用基于营养风险筛查的FTS模式,可有效促进 食管癌患者术后的康复,减少术后并发症的发生率,缩短住院时间,从而改善患者的临床疗效。
关键词:食管肿瘤、围手术期、营养风险筛查、快速康复外科、术后指标


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Risk of regurgitation and aspiration in patients infused with different volumes of enteral nutrition
SHAOZHEN CHEN, WENBIAO XIAN, SHOUZHEN CHENG, CHUNYAN ZHOU, HONGYAN ZHOU, JIEZHEN FENG, LI LIU AND LING CHEN
Background: Patients with stroke suffer from nutrition impairments and often rely on enteral nutrition (EN), which is associated with respiratory complications such as regurgitation and aspiration. Objective: To evaluate the incidence of regurgitation and aspiration in patients with severe stroke infused with different volumes of EN. Methods: A randomized controlled trial was conducted on 210 patients with severe stroke undergoing EN therapy. Patients were randomly assigned into two groups. Subjects in the treatment group received EN with an initial rate defined according to the total volume and the infusion rate was adjusted based on gastric residual volume (GRV) assessed every 4 hours. Subjects of the control group received EN without monitoring the GRV and reached the target infusion volume within 72 hours. The incidence of reflux and aspiration was recorded. Results: The incidences of regurgitation and aspiration were significantly lower in treatment group (6.3% and 7.9%, respectively) than control group (18.8% and 17.5%, respectively). In the treatment group, 1 patient developed regurgitation while 2 developed aspiration when EN was 500 mL. When EN increased to 1000 mL, 2 patients developed regurgitation and 2 developed aspiration, and 5 patients developed regurgitation and 6 had aspiration when EN was 1500 mL. There was no significant difference in the risk of reflux and aspiration when total volume of EN increased from 500 to 1500 mL. Conclusions: During EN therapy for patients with stroke, using feeding pump with a continuous infusion for 20 hours and adjusting infusion rate based on GRV could reduce the incidence of respiratory complications.
Key Words: stroke, enteral nutrition, gastroesophageal reflux, aspiration, gastric residual volume
 

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肠内营养不同输注总量出现反流和误吸的风险
背景:脑卒中患者容易伴发营养不良,通常依靠肠内营养(EN)来维持。但肠内营养也存在反流和误吸等呼吸系统方面的并发症。目的:探讨重症脑卒中患者在不同EN 输注总量之间反流及误吸风险的差异。方法:选择重症脑卒中患者210 例进行随机对照研究,患者随机分为2 组:治疗组患者初始速度根据EN 总量调节,输注过程中通过每4 小时测定胃残留量(GRV)的情况进行调速。对照组患者不监测GRV,在72 小时内缓慢增速至EN 目标量。比较两组患者反流和误吸的风险。结果:治疗组患者反流和误吸的发生率分别为6.3%和7.9%显著低于对照组的18.8% 和17.5%。在治疗组中,500 mL 输注时有1例患者发生反流和2 例患者发生误吸;当输注量增至1000 mL 时,2 例患者发 生反流,2 例患者发生误吸;1500 mL 输注时,5 例患者发生反流,6 例患者发生误吸。EN 输注总量从500 mL 增至1500 mL 时,并未显著增加反流和误吸的风险。结论:脑卒中患者EN 治疗过程中,采用以营养泵持续20 小时匀速输注,初始速度按总量调节,输注过程中通过监测GRV 调整速度可显著减少呼吸系统的并发症。
关键词:脑卒中、肠内营养、胃食管反流、误吸、胃残留量

 

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Optimal timing for introducing enteral nutrition in the neonatal intensive care unit
JIE LIU, KAIMENG KONG, YEXUAN TAO AND WEI CAI

Objective: To identify the optimal time for introducing enteral nutrition to critically ill neonates. Methods: This prospective cohort study included all eligible critically ill neonates who were admitted to a multidisciplinary tertiary neonatal intensive care unit (NICU) between 1st June and 30th November 2013. Nutrient intake and clinical outcomes during NICU stay were recorded. The effect of early (<24 hours after NICU admission) and delayed (≥24 hours) enteral nutrition introduction on clinical outcomes was assessed. Results: Energy deficit in critically ill neonates was frequent: 84.7% could not achieve the caloric goal during the NICU stay. Growth retardation was common especially among the preterm: the frequency of neonates whose weight was below the 10th percentile increased significantly from 21.6% on admission to 67.6% at discharge. Compared with delayed enteral nutrition, early enteral nutrition was associated with better median time to starting weight gain (0 vs 6 days, p=0.0002), a lower chance of receiving parenteral nutrition (41.7% vs 95.9%, p<0.0001), shorter NICU stays (196 vs 288 hours, p=0.0001), fewer hours on mechanical ventilation and a lower chance of developing pulmonary infection (37.5% vs 56.0%, p=0.005). The accumulated energy deficit to the subjects who were exposed to delayed nutrition could not be compensated by subsequent nutrition. Neonates who underwent mechanical ventilation had suboptimal nutrient delivery: they took longer to gain weight and were more likely to develop respiratory distress and receive parenteral nutrition. Conclusions: Early enteral nutrition initiation (<24 hours) is recommended. Neonates with mechanical ventilation should be monitored with particular attention.
Key Words: neonates, feed introduction, intensive care unit, enteral nutrition, parenteral nutrition
 

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重症监护室的危重新生儿行肠内营养的最佳时机
目的:确定危重新生儿行肠内营养(enteral nutrition,EN)的最佳时间。方法:本研究为前瞻性队列研究,观察时间为2013 年6 月1 日至2013 年11 月30 日。纳入对象是进入新生儿重症监护室(NICU)接受治疗且日龄为1-28 天的所有危重新生儿。记录这部分患儿在NICU 期间营养摄入情况和临床结局相关指标,评价早期EN(入监护室24 hrs 内)和延迟开始的EN(大于24 hrs)对患儿临床结局的影响。结果:热卡摄入不足在危重症新生儿中很普遍:84.7%的患儿住NICU 期间热卡摄入无法达到推荐摄入量。生长迟缓在患儿住NICU 期间普遍存在,尤其是早产儿:低于同日龄体重第10 百分位的患儿入院时的比例为21.6%,出院时增加到 67.6%。入院24 hrs 内开始EN 相比延迟开始EN,可以缩短入院后体重持续下降时间(0 d vs 6 d, p=0.0002),减少肠外营养使用率(41.7% vs 95.9%,p<0.0001)和肺炎发生率(37.5% vs 56%,p=0.005), 缩短住NICU 时间(195.5 hrs vs 288 hrs,p=0.0001)和呼吸机使用时间,并且增加患儿住NICU 期间平均每天能量摄入量。使用机械通气患儿与非机械通气患儿相比:入院后体重持续下降时间长,呼吸窘迫发生率和肠外营养使用率高。 结论:危重新生儿需尽早开始EN 支持治疗,推荐入NICU 后24 hrs 内进行,机械通气新生儿住NICU 期间营养摄入情况应引起重视。
关键词:新生儿、喂养介绍、新生儿重症监护室、肠内营养、肠外营养

 

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Early parenteral nutrition alone or accompanying enteral nutrition in critically ill patients: a systematic review and meta-analysis
XIAO WAN, XUEJIN GAO, FENG TIAN, CHAO WU AND XINYING WANG
Background: Although several large-scale clinical trials shave examined the relationship between early parenteral nutrition (ePN) and critically ill patients, a consensus has not been reached. In addition, no meta-analysis in this area has yet been published. The objective of this meta-analysis was to examine the effect of ePN, alone or accompanying enteral nutrition, in critically ill patients. Methods: A meta-analysis was performed to evaluate risk ratios (RR) and mean differences with 95% confidence intervals (CIs) between the ePN and control groups. Subgroup analyses were conducted to evaluate combinations of early enteral nutrition (eEN). Results: Five randomized control trials (RCTs) were included. Compared with controls, ePN had no effect on mortality (RR: 1.05, 95% CI: 0.96, 1.16). Secondary outcomes were variable: compared with the control group, the ePN group required fewer days of ventilation (p=0.007, RR: -0.95, 95% CI: -1.64, -0.27), but a longer hospital stay (p<0.001, RR: 3.76, 95% CI: 2.25, 5.28). Conclusion: Overall, this meta-analysis from RCTs indicates that provision of ePN within 24-48 hours has no benefit on the survival rate in critically ill patients. Thus, provision of ePN in patients is not needed in those who have contraindications to enteral nutrition or can tolerate a low volume of enteral nutrition.
Key Words: early, parenteral nutrition, critically ill, enteral nutrition, mortality

 

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危重症患者行早期肠外营养治疗临床疗效的meta 分析
背景:尽管一些大样本临床研究已经探究了早期肠外营养(early parenteral nutrition,ePN)在危重症患者的作用,但对于其疗效并没有达成共识,而且在这一领域也未见相关的meta 分析报道。本研究的目的就是探究早期肠外营养在危重症患者中的治疗作用。方法:选取含有早期肠外营养的临床治疗的文献,对其数据进行meta 分析,并根据患者是否合并使用早期肠内营养(early enteral nutrition,eEN)再进行亚组分析。结果:本研究总计纳入5 篇随机对照研究(randomized control trials,RCTs)。结果显示,早期肠外营养组患者与对照组患者死亡率无明显差异(相对危险度:1.05, 95%置信区间:0.96, 1.16) 。此外, 与对照组相比, 早期肠外营养组患者机械通气时间缩短(p=0.007,相对危险度:-0.95,95%置信区间:-1.64, -0.27),但是总住院时间延长(p<0.001,相对危险度:3.76,95%置信区间:2.25, 5.28)。结论:本meta 分析表明,入院24-48 小时以内的早期肠外营养并不会影响危重症患者死亡率。因此,肠内营养禁忌或者仅可使用低剂量肠内营养的患者无需使用早期肠外营养进行补充。
关键词:早期、肠外营养、危重、肠内营养、死亡率


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Survey of iodine nutritional status in 2011, Zhejiang, China
GUANGMING MAO, GANGQIANG DING, XIAOMING LOU, RONGHUA ZHANG, PAI ZHENG, ZHE MO, XIAOFENG WANG, WENMING ZHU, JINSHUI ZHOU AND FANG GU
Background: Universal salt iodization (USI) was introduced in China in 1995, but whether the iodine status is optimal is questionable. This study was conducted to assess the iodine nutrition among Zhejiang population in coastal regions in China. Methods: A cross-sectional survey for iodine nutritional status was conducted with general population (n=10,350), including pregnant and lactating women (n=450 each) selected by stratified multistage sampling. Iodine content in drinking water, table salt and urine, were determined using arsenic-cerium catalytic spectrophotometry, the direct titration and the arsenic-cerium catalytic spectrophotometry, respectively, and daily iodine intake was estimated by 3 days of 24-hour recall method. Results: The median iodine content in drinking water was 2.46 μg/L, Zhejiang belonged to the region of iodine deficiency in outer environment according to China standard. The median iodine content in table salt was 27.9 mg/kg, conforming to the standard requirements; the household coverage rate of qualified iodized salt reached 76.8%, which does not reach the standard requirement of WHO >90%. The dietary iodine intake of a reference individual averaged 379 μg/d, which indicated that the current iodine intake in diet was appropriate. In addition, the median urinary iodine concentration (UIC) was 162 μg/L in general population, and 130 μg/L in pregnant women, which didn’t reach the standard requirements. Conclusion: The current dietary iodine intake in Zhejiang was generally sufficient and safe, but there is a risk of iodine deficiency among pregnant women and the population who do not consume iodized salt.
Key Words: iodine deficiency disorder (IDD), universal salt iodization (USI), urinary iodine concentration (UIC), dietary iodine intake, iodine excess
 

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2011 年中国浙江省碘营养状况调查
背景:中国自1995 年即开始实施全民食盐加碘为主的碘缺乏病综合防治策略,但目前居民的碘营养水平是否处于最佳水平仍存在疑问。本研究的目的是评估中国沿海地区浙江省居民的碘营养状况。方法:采用分层多级抽样方法对10350例的普通人群、450 例的孕妇以及450 例的哺乳期妇女进行横断面碘营养水平调查。分别采用砷铈催化分光光度法、直接滴定法以及砷铈催化分光光度法对饮用水水样、盐样和尿样进行碘含量测定。日常的碘估计摄入量使用3 天24 小时回顾法。结果:饮用水水碘中位数2.46 μg/L,根据中国的标准浙江属于外环境碘缺乏地区;盐碘中位数为27.9 mg/kg,符合标准要求;合格碘盐食用率为76.8%,未达到WHO 要求的大于90%;标准人均日膳食碘的摄入量为379μg/d,其摄入量适宜。此外,普通人群尿碘中位数为162 μg/L,孕妇尿碘中位数为130 μg/L,其中孕妇碘营养水平未达到标准要求。结论:目前,浙江省居民膳食碘摄入量总体是充足和安全的,但孕妇和非食用碘盐人群其碘缺乏的风险容易隐藏在全民食盐加碘的政策之下。
关键词:碘缺乏病(IDD)、全民食盐加碘(USI)、尿碘浓度(UIC)、膳食碘摄入、碘过量


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Calcium intake and the risk of stroke: an up-dated meta-analysis of prospective studies
DAN-YANG TIAN, JIE TIAN, CHANG-HE SHI, BO SONG, JUN WU, YAN JI, RUI-HAO WANG, CHENG-YUAN MAO, SHI-LEI SUN AND YU-MING XU
Background and Purpose: Calcium intake has been associated with stroke risk in a prior meta-analysis, however, newly published results are inconsistent. Dairy food benefits on stroke incidence may involve a calciumrelated mechanism. We have therefore updated this meta-analysis with particular references to any possibility of a calcium-mediated dairy food risk reduction of stroke risk. Methods: We searched multiple databases and bibliographies for prospective cohort studies. Reports with multivariate-adjusted relative risk (RR) and corresponding 95% confidence intervals (CI) for the association of calcium intake with stroke incidence were considered. Results: Ten studies with 371,495 participants and 10,408 stroke events were analyzed. The pooled analysis showed no statistically significant association of the risk of total stroke (RR=0.96; 95% CI: 0.89-1.04) and stroke subtypes with the highest and lowest calcium intake quantiles. Nevertheless, high dairy calcium intake was significantly associated with an approximately 24% reduction of stroke risk. (RR=0.76; 95% CI: 0.66-0.86). Furthermore, a long-term follow-up (≥14 years) was helpful to reduce the risk of stroke (RR=0.67; 95% CI: 0.51-0.88). Additionally, a non-linear dose-response relationship was predicted between calcium intake and stroke risk. Conclusions: Dairy calcium intake is inversely associated with stroke incidence. There is a non-linear dose-response relationship between calcium intake and stroke risk. However, when the follow-up time is long enough, the inverse relationship is independent of dose. Additional large cohort studies are required to illustrate this relationship in detail.
Key Words: stroke, calcium intake, meta-analysis, prospective cohort studies, dose-response
 

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钙的摄入与脑卒中风险:一项更新前瞻性研究的荟萃分析
背景与目的:尽管关于钙的摄入与脑卒中发生的关系已有meta 分析研究,但新的研究结果与之前的分析结果并不一致。乳制品影响脑卒中发生可能与其中的钙摄入有关,因此,我们更新了现有的meta 分析,以进一步研究摄入钙,尤其是含钙乳制品与脑卒中发生之间的关系。方法:利用计算机检索多个数据库中研究钙的摄入与脑卒中发生风险之间的关系的前瞻性队列研究,同时追索纳入文献的参考文献,检索文献自建库至2014 年6 月,按照纳入排除标准收集文献,根据the Newcastle-Ottawa Scale,对纳入文献进行严格的质量评价, 应用STATA 软件对符合标准的研究进行meta 分析。结果:纳入10 篇原始文献,共涉及371495 例研究对象,其中10408 例患者发生脑卒中。钙摄入的最高剂量范围与最低剂量范围相比,其脑卒中的发生并无显著性差异(RR=0.96; 95% CI: 0.89, 1.04),脑卒中类型的亚组分析结果同样无显著性差异。然而,乳制品中高的钙摄入量与脑卒中的发生风险降低有关(RR=0.76; 95% CI: 0.66, 0.86)。当随访时间大于14 年时,钙的摄入与脑卒中呈显著负相关(RR=0.77; 95% CI: 0.63, 0.95),在进行剂量相关的meta 分析时,发现钙摄入与脑卒中的发生风险有着非线性的剂量关系。结论:乳制品中的钙摄入较高可降低脑卒中的发生风险。当随访时间足够长时,钙的摄入对于脑卒中的发生是保护性因素,钙的摄入与脑卒中发生风险呈非线性剂量关系。此结果仍需大型队列研究进一步确认。

关键词:卒中、钙摄入、meta 分析、前瞻性队列研究、剂量反应关系

 

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Anemia in Cambodia: a cross-sectional study of anemia, socioeconomic status and other associated risk factors in rural women
CHRISTOPHER V CHARLES, CATE E DEWEY, ANN HALL, CHANTHARITH HAK, SON CHANNARY AND ALASTAIR JS SUMMERLEE

Iron deficiency and associated anemia are severe public health problems, which are prevalent in the developing world. We conducted a cross-sectional survey, comprised of written interview questions and laboratory analysis of blood biomarkers, in Kandal Province, Cambodia. The objective of this study is to examine possible factors that are associated with anemia in rural Cambodia. Data on socioeconomic status, water source/treatment practices, and meat consumption was also collected. Of the 297 women surveyed, 51.2% were anemic. Of those women found to be anemic, iron deficiency was implicated in 9.7% of cases (SF <15 ng/L), with an additional 18.5% reported to be borderline iron deficient (serum ferritin=15-30 ng/L). Meat consumption was very low, with nearly one-half of the women consuming meat one time per month or less. This study highlights the multi-faceted etiology of anemia in Cambodia and emphasizes the need for comprehensive nutrition surveying in order to better inform prevention and treatment programming and policy development.
Key Words: anemia, socioeconomic status, meat consumption, Cambodia, risk factor

 

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柬埔寨农村妇女中贫血与社会经济状况和其他相关危险因素的横断面研究
缺铁性贫血是发展中国家一个严重的公共卫生问题。我们在柬埔寨干丹省做了一个横断面调查,有书面问卷和血样分析。本研究的目标是检测柬埔寨农村与贫血相关的潜在因素。同时也收集了社会经济状况、水来源/处理措施和肉类消费数据。接受调查的297 名妇女中,51.2%患有贫血。这些贫血的妇女中,9.7%缺铁(血清铁蛋白<15ng/L),还有18.5%是临界缺铁(血清铁蛋白=15-30ng/L)。肉类消费很少,将近一半的妇女每月仅摄入一次或少于一次的肉类。本研究重点在于对柬埔寨贫血的多元病因分析,强调了营养普查的必要性,以便更好地发展防治规划和政策。
关键词:贫血、社会经济状、肉类消、柬埔寨、危险因素


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Diagnostic value of maternal anthropometric measurements for predicting low birth weight in developing countries: a meta-analysis
EITA GOTO
Objective: Weighing scales are often lacking at home birth in developing countries. Therefore, simple, reliable, and inexpensive methods for detecting low birth weight especially before birth would be useful. This study was performed to evaluate the diagnostic value of maternal anthropometric measurements for predicting low birth weight. Methods: Bivariate diagnostic meta-analysis was conducted to construct hierarchical summary receiver operating characteristic curves. All English language studies included in the meta-analysis enrolled apparently healthy pregnant women and provided the data necessary to construct two-by-two tables (i.e., true positive, false positive, false negative, and true negative values). Ten data bases, including PubMed, were searched to identify these studies. Results: A sufficient number of studies involving 309,419 women paired with their newborns in Africa, Asia, Europe, Latin America, the Middle East, and Oceania, included data on maternal height, weight, arm circumference, body mass index, and weight gain during pregnancy (n=85, 80, 23, 51, and 16, respectively) to provide generalizable findings. However, sensitivity of 0.46 (95% confidence interval (CI)=0.35-0.56) to 0.63 (95% CI=0.54-0.71), specificity of 0.55 (95% CI=0.42-0.67) to 0.71 (95% CI=0.61-0.80), and diagnostic odds ratios of 2 (95% CI=2-2) to 4 (95% CI=3-5) were not sufficiently high for primary screening. The generalizability of abdominal circumference data could not be guaranteed due to the limited sample (one article). Conclusions: Maternal anthropometric measurements are unsuitable for predicting low birth weight.
Key Words: anthropometry, low birth weight, meta-analysis, pregnant women, sensitivity and specificity
 

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发展中国家孕妇人体测量指标预测低出生体重的诊断价值:一个荟萃分析
目的:发展中国家在家出生的婴儿往往没有进行称重。因此,尤其是在出生前检测低出生体重的简单、可靠和廉价的方法是很有用的。本研究为评估产妇人体测量指标预测婴儿低出生体重的诊断价值。方法:采用二元诊断荟萃分析,以构建多层次综合的受试者工作特征曲线。所有英语报道的看上去健康的孕妇并提供了构建2×2 表(即真阳性、假阳性、假阴性和真阴性值)必要资料的研究均纳入本荟萃分析。在PubMed 等10 个数据库中进行检索确定这些研究。结果:检索到了包括来自非洲、亚洲、欧洲、拉丁美洲、中东和大洋洲的309,419 名妇女及其新生儿的大量研究,其提供的可推广的研究结果包括母亲的身高、体重、上臂围、体质指数和怀孕期间体重增加(n 分别为85、 80、23、51 和16)。然而, 0.46(95% CI=0.35-0.56)到0.63 (95% CI=0.54-0.71)的灵敏度, 0.55(95% CI=0.42-0.67)到0.71(95% CI=0.61- 0.80)的特异度和2(95% CI=2-2)到4(95% CI=3-5)的诊断比值比对初步筛查是不够高的。由于样本有限(1 篇文章),腹围数据无法推广。结论:产妇人体测量指标不适合预测低出生体重。
关键词:人体测量学、低出生体重、荟萃分析、孕妇、灵敏度和特异度

 

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Maternal zinc status is associated with breast milk zinc concentration and zinc status in breastfed infants aged 4-6 months
ORAPORN DUMRONGWONGSIRI, UMAPORN SUTHUTVORAVUT, SUTHIDA CHATVUTINUN, PHANPHEN PHOONLABDACHA, AREEPORN SANGCAKUL, ARTITAYA SIRIPINYANOND, USANA THIENGMANEE AND NALINEE CHONGVIRIYAPHAN
Breast milk provides adequate nutrients during the first 6 months of life. However, there are some reports of zinc deficiency in breastfed infants. This study was conducted to determine the prevalence of zinc deficiency in infants aged 4-6 months and the associated factors. Healthy infants aged 4-6 months and their mothers were enrolled. They were classified by feeding types as breastfed (BF), formula-fed (FF), and mixed groups (MF). Data collection included demographic data, perinatal data, given diets, and anthropometric measurement. Blood from infants and lactating mothers, and breast milk samples were collected to assess plasma and breast milk zinc concentrations. From 158 infants, the prevalence of zinc deficiency (plasma level below 10.7 mol/L) was 7.6%, and according to feeding groups 14.9%, 5.3%, and 2.9% in the BF, the FF, and the MF groups, respectively. Breastfed infants with zinc deficiency had significantly lower maternal zinc concentrations compared with those without zinc deficiency. There was a higher proportion of maternal zinc deficiency in zinc-deficient infants than those without zinc deficiency (66.7% vs 16.2%, p=0.02). There was a positive correlation between zinc concentrations in breast milk and plasma zinc concentrations of infants (r=0.62, p=0.01) and plasma zinc concentrations of lactating mothers (r=0.56, p=0.016). Using the regression analysis, infant zinc status was associated with maternal plasma zinc concentrations among breastfed infants. The results of this study suggest that breastfed infants aged 4-6 months may have a risk of zinc deficiency and that risk is associated with maternal zinc status and breast milk zinc concentrations.
Key Words: zinc deficiency, breastfeeding, breast milk zinc, infant zinc status, lactating women
 

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母亲锌营养状况与母乳锌浓度和母乳喂养的4-6 个月婴儿的锌营养状况的关系
母乳为生命的前6个月提供了充足的营养素,然而,有些报道称母乳喂养婴儿存在锌缺乏。本研究为确定4-6个月婴儿锌缺乏的患病率及相关因素。4-6个月的健康婴儿和他们的母亲被纳入研究,根据喂养类型将他们分为母乳喂养组(BF)、配方奶喂养组(FF)和混合喂养组(MF)。收集的数据包括人口学资料、围产期资料、喂奶和人体测量资料。收集婴儿和乳母的血样本和乳汁样本来分析血浆和母乳中的锌浓度。158 名婴儿锌缺乏(血浆浓度低于10.7mol/L)的发生率为7.6%。根据喂养方式,BF、FF 和MF 锌缺乏的发生率分别为14.9%、5.3%和2.9%。与没有锌缺乏的母乳喂养儿相比,锌缺乏的母乳 喂养儿其母亲的锌浓度显著低。锌缺乏婴儿的母亲锌缺乏比例高于不缺锌婴儿的母亲( 66.7% 比16.2% ,p=0.02 ) 。母乳中的锌浓度与婴儿( r=0.62, p=0.01)和乳母(r=0.65,p=0.016)血浆中的锌浓度呈正相关。回归分析发现母乳喂养的婴儿锌营养状况与乳母血浆锌浓度相关。本研究表明母乳喂养的4-6 个月婴儿存在锌缺乏风险,这种风险与乳母锌营养状况和乳汁锌浓度有关。
关键词:锌缺乏、母乳喂养、母乳锌、婴儿锌状态、哺乳期妇女

 

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Nonalcoholic fatty liver disease prevalence in urban school-aged children and adolescents from the Yangtze River delta region: a cross-sectional study
XIAOMIN ZHANG, YANPING WAN, SHIJUN ZHANG, LIPING LU, ZHIQI CHEN, HONG LIU, XIAOMIN JIANG, KAILI LUO AND WEI CAI
Purpose: To determine the prevalence of nonalcoholic fatty liver disease (NAFLD) and explore the relationship of NAFLD with anthropometric parameters among school children from the Yangtze River delta region. Methods: A cross sectional study on childhood NAFLD was conducted using the stratified cluster sampling method in four regions of the Yangtze River delta in September 2009 to October 2011. In all, 7,229 students, aged 7-18 years, from 12 primary, middle and high schools participated in the study. Height, weight, and waist circumference were measured; body mass index (BMI) and waist to height ratio (WHtR) were calculated and liver ultrasonography was performed. Results: The overall NAFLD prevalence was 5.0%; 7.5% in boys, 2.5% in girls, 5.6% in subjects with peripheral obesity, 12.9% in those with abdominal obesity and 44.8% in those with mixed obesity. The prevalence was also increased with regional difference. Binary logistic regression analysis showed that WHtR was the major independent risk factor for childhood NAFLD, causing a 14.4-fold increase in NAFLD risk. Receiver operating characteristic curve analysis also showed that WHtR was the best obesity index to evaluate the presence of NAFLD in Chinese schoolchildren with the optimal cutoff of 0.47. Conclusions: Mixed obesity had the strongest association with NAFLD. Male gender and regional urbanization also influenced NAFLD prevalence among schoolchildren. WHtR may be an effective indicator to predict NAFLD.
Key Words: fatty Liver, children, obesity, prevalence, risk factors

 

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中国长三角地区在校学生儿童非酒精性脂肪性肝病流行病学调查
目的:调查中国长三角地区在校学生儿童非酒精性脂肪肝发生率及其与体格指标之间的关系。方法:2009年9月至2011年10月,长三角地区分层抽取4个城市,12所中小学,7229名7-8岁在校学生纳入本次调查。所有研究对象均测量身高、体重、腰围、计算腰围身高比和体重指数,并进行肝脏超声检查。结果:调查显示该地区在校学生儿童非酒精性脂肪肝总发生率为5%,其中男生7.5%,女生2.5%。非酒精性脂肪肝在外周型肥胖,腹型肥胖及混合型肥胖人群中的发生率分别为5.6%,12.9%,44.8%。4所城市在校学生儿童非酒精性脂肪肝发生率也有不同。二元logistic回归分析显示腰围身高比是儿童非酒精性脂肪
肝的主要危险因素,每升高0.1,患病风险增加14.4倍。ROC分析显示,腰围身高比同样是该病的最佳预测体格指标,适宜切点值在0.47。结论:混合型肥胖与儿童非酒精性脂肪肝密切相关。男性,地区等因素同样影响该病在儿童青少年群体中的发生。腰围身高比能有效预测非酒精性脂肪肝的发生。
关键词:脂肪肝、儿童、肥胖、患病率、危险因素


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Low physical activity and energy dense Malaysian foods are associated with non-alcoholic fatty liver disease in centrally obese but not in non-centrally obese patients with diabetes mellitus
WAH-KHEONG CHAN, ALEXANDER TONG-BOON TAN, SHIREENE RATNA VETHAKKAN, PEI-CHIEN TAH, ANUSHYA VIJAYANANTHAN AND KHEAN-LEE GOH
Objective: To study the dietary intake and level of physical activity (PA) of patients with diabetes mellitus and the association with non-alcoholic fatty liver disease (NAFLD). Methods: Consecutive adult patients with type 2 diabetes mellitus seen in our hospital diabetes clinic were enrolled. The Global Physical Activity Questionnaire and a semi-quantitative food-frequency questionnaire were used to assess PA and dietary intake, respectively. Diagnosis of NAFLD was ultrasound-based and following exclusion of significant alcohol intake and other causes of chronic liver disease. Results: Data for 299 patients were analyzed (mean age 63.3±10.5 years old, 41.1% male). Prevalence of NAFLD was 49.2%. Patients with low PA were more likely to have NAFLD (OR=1.75, 95% CI=1.03-2.99, p=0.029). There was no significant difference in energy intake, intake of macronutrients and percentage energy intake from each macronutrient, high sugar food, high cholesterol food and high SFA food between patients with and without NAFLD. Among centrally obese patients, patients with low PA and in the highest quartile of percentage energy intake from fat (OR=4.03, 95% CI=1.12-15.0, p=0.015), high cholesterol food (OR=3.61, 95% CI=1.37-9.72, p=0.004) and high SFA food (OR=2.67, 95% CI=1.08-6.67, p=0.019) were most likely to have NAFLD. Among those who were not centrally obese, PA and percentage energy intake from fat, high cholesterol food and high SFA food was not associated with NAFLD. Conclusion: Low PA and high percentage energy intake from fat, high cholesterol food and high SFA food is associated with NAFLD in centrally obese but not in non-centrally obese patients with diabetes mellitus.
Key Words: diet, physical activity, non-alcoholic fatty liver disease, diabetes mellitus, obesity
 

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低体力活动和高能量马来西亚食物与糖尿病患者中向心性肥胖者的非酒精性脂肪肝病有关,而与非向心性肥胖者无关
目的:研究糖尿病患者的膳食摄入和体力活动水平以及与非酒精性脂肪肝病 (NAFLD)的关系。方法:连续到我院糖尿病门诊就诊的成年2 型糖尿病患者报名参加课题。分别用国际体力活动问卷和半定量食物频率问卷评估体力活动和膳食摄入。NAFLD 的诊断是基于超声并排除酒精摄入和其它原因引起的严重慢性肝病。结果:299 名患者的数据被纳入分析,平均年龄为63.3±10.5岁,其中41.1%为男性。NAFLD 的患病率为49.2%。低体力活动的患者更容易患NAFLD(OR=1.75,95% CI =1.03-2.99,p=0.029)。2 型糖尿病患者患NAFLD 与否在能量摄入,宏量营养素的摄入及其能量百分比,高糖食物、高胆固醇食物和高饱和脂肪酸食物的摄入之间没有显著差异。低体力活动并处于脂肪来源能量百分比的最高四分之一( OR=4.03, 95% CI=1.12-15.0, p=0.015)、摄入高胆固醇食物(OR=3.61, 95% CI=1.37-9.72, p=0.004)和高饱和脂肪酸食物(OR=2.67, 95% CI=1.08-6.67, p=0.019)的向心性肥胖患者更容易发生NAFLD。在没有向心性肥胖的患者中,体力活动和能量百分比来自脂肪、高胆固醇食物和高饱和脂肪酸食物均与NAFLD 无关。结论:低体力活动和能量百分比来自高脂肪、高胆固醇食物和高饱和脂肪酸食物均与糖尿病患者中向心性肥胖者的非酒精性脂肪肝病有关,而与非向心性肥胖者无关。
关键词:膳食、体力活动、非酒精性脂肪肝、糖尿病、肥胖
 

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Comparison of fast food consumption and dietary guideline practices for children and adolescents by clustering of fast food outlets around schools in the Gyeonggi area of Korea
SOONNAM JOO, SEYOUNG JU AND HYEJA CHANG
Objectives: This study investigated the distribution density of fast food outlets around schools, and the relationship between dietary health of children and adolescents and the density of fast food outlets in Korea. Methods: A distribution map of fast food outlets was drawn by collecting information on 401 locations of 16 brands within a 15-minute walk (800 meter) of 342 elementary and secondary schools in Suwon, Hwaseong and Osan. A questionnaire was used to gather data on the dietary life of 243 sixth and eighth grade students at eight schools. Schools in the upper 20% and lower 20% of the fast food outlet distribution were classified as high-density and low-density groups, respectively. The practice rate of dietary guidelines published by the Health and Welfare Ministry and the fast food consumption pattern of children and adolescents from low and high density groups were determined. Results: The number of schools with a fast food outlet within 200 meters or in the Green Food Zone around its location was 48 of 189 (25.4%) in Suwon and 14 of 153 (9.2%) in Hwaseong and Osan. Students in the low-density group visited fast food outlets less often than those in the high-density group (p<0.01). Dietary guideline practice scores for children did not show a significant difference between the two groups. Conclusion: The distribution map of fast food outlets within 200 meters of schools was useful for identifying the effectiveness of the Green Food Zone Act and nutrition education programs.
Key Words: distribution map, fast food outlets, fast food consumption, dietary guideline practices, Green Food Zone
 

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通过聚类分析韩国京畿道地区学校周围的快餐店来比较儿童青少年快餐的消费和膳食指南实践
目的:本研究调查了学校周围快餐店的分布密度,分析了韩国儿童青少年的饮食健康与快餐店密度之间的关系。方法:通过收集Suwon、Hwaseong 和 Osan 的342 所小学和中学周围步行15 分钟范围内(800 米)的16 个品牌快餐店的401 个位置信息,绘出了快餐店的分布图。采用问卷收集了八所学校243名六年级和八年级学生的饮食生活数据。在快餐店分布密度的上20%和下20%的学校分别被定义为高密度组和低密度组。确定了高、低密度组儿童青少年快餐消费模式与卫生和福利部发布的膳食指南的实践率。结果:200 米以内有快餐店或其周围的绿色食品区有快餐店的学校,Suwon 有48(共有学校189所,占25.4%)所,Hwaseong 和Osan 有14 所(共有学校153 所,占 9.2%)。低密度组的学生去快餐店的频率低于高密度组(p<0.01)。孩子的膳食指南实践得分两组之间无显著性差异。结论:学校200 米范围内快餐店的分布图有助于识别绿色食品区和营养教育计划的有效性。
关键词:分布图、快餐店、快餐消费、膳食指南实践、绿色食品区


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Improvement in the technological feasibility of a web-based dietary survey system in local settings
HYUN JU JUNG, SANG EUN LEE, DONGWOO KIM, HWAYOUNG NOH, SUJIN SONG, MINJI KANG, YOON JU SONG AND HEE-YOUNG PAIK
The feasibility of a dietary survey tool is crucial for successful nutritional assessment via a community survey and for nutritional epidemiology. In 2012, we identified a newly developed computerized dietary survey system, the Diet Evaluation System (DES), which could be successfully applied to a community survey delivered during home visits using notebook computers when the internet environment was adequate, using either a WiBro modem or a smartphone as a tethered modem. In 2013, we retested DES feasibility using various mobile devices and in a larger number of subjects. We conducted a total of 430 interviews, representing two for each of 215 subjects of various ages, using tablet personal computers (PCs) and laptops. In addition, a group discussion with the interviewers was conducted. The interview success rate was improved to 84% (compared to 67% in 2012). Completing each interview took 14 min 1 s, and data processing was conducted automatically. The subjects’ age, gender, and the type of mobile device used influenced the DES interview time. This study implies that the DES is an effective one-stop dietary survey system for use in a local setting. The interviewers’ group discussion revealed that a one-stop system using the DES is convenient and that DES optimization for tablet PCs and continued database updating is needed.
Key Words: feasibility, dietary survey tool, computer program, automatic data processing, community survey
 

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在当地进行网络饮食调查系统可操作性的技术改进
饮食调查工具的易操作性是成功进行社区营养评估和了解营养状况至关重要的因素。2012 年,我们确认了新开发的计算机饮食调查系统(DES)的实用性,无论是使用无线宽带调制解调器还是使用智能手机连接调制解调器连接网络,只要网络畅通,此系统均可成功地用笔记本电脑进行社区内家庭式访问。2013年,我们在各种移动设备上对大批人群重新测试了DES 的可行性。我们使用平板电脑和笔记本电脑,共调查了430 位受访者,分两组,每组215 人,分别涵盖各个年龄段。此外,还进行了访问者的小组讨论。访问的成功率提高了84%(与2012 年的67%相比)。完成一次访问需14 分1 秒,访问同时系统自动对 数据进行处理。影响DES 访问时间有受访者的年龄、性别以及使用何种移动设备上网。此研究表明,DES 是一项足不出户就可进行饮食调查的有效工具。受访的小组讨论表明,DES 的一站式调查是非常方便有效的。此外,DES 在平板电脑上的优化以及数据库的持续升级也是极为必要的。
关键词:可操作性、饮食调查工具、计算机程序、自动数据处理、社区调查

 

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The biomarker-based validity of a brief-type diet history questionnaire for estimating eicosapentaenoic acid and docosahexaenoic acid intakes in pregnant Japanese women
MIE SHIRAISHI, MEGUMI HARUNA, MASAYO MATSUZAKI, RYOKO MURAYAMA AND SATOSHI SASAKI
Objectives: Maternal docosahexaenoic acid (DHA) intakes is important for brain development in fetuses. Accurate assessment of EPA and DHA intakes is required in clinical settings to identify women with deficiency of these nutrients and provide an appropriate intervention for them. We examined the validity and reproducibility of a brief-type self-administered diet history questionnaire (BDHQ) for evaluating EPA and DHA intakes of pregnant Japanese women, to establish an easily administered dietary assessment tool. Methods: A total of 105 women in the second trimester and 102 women in the third trimester were studied at a university hospital in Tokyo, between November 2010 and February 2012. The reference values for the validation study were plasma concentrations of EPA and DHA. For the reproducibility study, 54 women completed the BDHQ twice, within a 4-week period in the second trimester. Results: Energy-adjusted intakes of EPA, DHA, and EPA+DHA were significantly associated with the corresponding plasma concentrations (rs=0.354, rs=0.305, and rs=0.327 in the second trimester; rs=0.391, rs=0.316, and rs=0.358 in the third trimester, respectively). Intraclass correlation coefficients for the two-time BDHQ were 0.543 (EPA), 0.611 (DHA), and 0.581 (EPA+DHA). In the Bland-Altman plots, the intakes of EPA, DHA, and EPA+DHA in the two-time BDHQ showed that the values for most participants were in the accepted range of agreement. Conclusions: BDHQ has an acceptable validity level for assessing EPA and DHA intakes among Japanese women in the second and third trimesters.
Key Words: diet history questionnaire, docosahexaenoic acid, eicosapentaenoic acid, pregnant women, validation
 

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基于生物标志物用于估计日本女性孕期二十碳五烯酸和二十二碳六烯酸摄入简易饮食史问卷的有效性
目的:孕妇二十二碳六烯酸(DHA)的摄入对胎儿大脑发育很重要。在临床上建立一个准确测定EPA 和DHA 的摄入量的方法,可以筛选出缺乏这些营养素的妇女,以便进行适当的干预。我们检测了一个简易的自我管理的饮食史问卷(BDHQ)评价日本孕妇的EPA 和DHA 摄入量的有效性和可重复性,以便建立一个易于管理的膳食评估工具。方法:在2010 年11 月至2012 年2 月期间对东京大学附属医院的105 名孕中期妇女和102 名孕晚期妇女进行了研究。以EPA 和DHA 的血浆浓度作为有效性研究的参考值。以54 名妇女在孕中期4 周内完成两次BDHQ 作为重复性研究的参考值。结果:校正能量的EPA、DHA 、EPA+DHA 摄入量与其血浆浓度显著相关( 孕中期: rs=0.354 、rs=0.305、rs=0.327;孕晚期:rs=0.391、rs=0.316、rs=0.358)。两次BDHQ 的组内相关系数分别为0.543(EPA),0.611 (DHA)和0.581(EPA+DHA)。Bland-Altman 图显示, 两次BDHQ 中大多数参与者的EPA 、DHA 和EPA+DHA 摄入量在许可值的可接受范围内。结论:BDHQ 在评估日本妇女孕中期和孕晚期EPA 和DHA 摄入量时,其有效性在可接受范围内。
关键词:饮食史问卷调查、十二碳六烯酸、二十碳五烯酸、孕妇、验证

 

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Genetic variants of FADS gene cluster, plasma LC-PUFA levels and the association with cognitive function of under-two-year-old Sasaknese Indonesian children
UMI FAHMIDA, MIN KYAW HTET, CHRIS ADHIYANTO, RISATIANTI KOLOPAKING, MIZA AGRIA YUDISTI, ALLAY MAUDUDI, DWI ANITA SURYANDARI, DRUPADI DILLON, LYDIA AFMAN AND MICHAEL MÜLLER
Background/Aims: Long-chain polyunsaturated fatty acids (LC-PUFA) are regarded as essential for child cognition. Genetic variation in fatty acid (FA) desaturase enzyme (FADS) has been recognized as an important effect modifier in the relation between LC-PUFA and child cognitive function. This study aimed to identify the distribution of genetic variant (genotype) SNP rs174468 and to assess plasma FA and developmental outcome by the genotype among under-2 year old Sasaknese Indonesian children. Methods: Data was collected at baseline of a randomized trial (NUPICO, clinicaltrials.gov NCT01504633) in East Lombok district, Indonesia. Breastfed, 12-17 month old children were recruited and 240 subjects were included in the study. Child cognition was assessed as Bayley Mental Developmental Index (MDI). Results: From 206 subjects whose blood samples can be collected, only two genotypes were found (90.3% GG homozygotes, 9.7% AG heterozygotes), and minor allele AG was significantly associated with higher level of arachidonic acid (20:4 n-6), n-6 LC-PUFA and FADS1 index. MDI score was associated with a FADS2 index (DHA:EPA ratio) but not genotype (Adjusted R-square=0.043). Conclusions: FADS2 index was associated with cognitive function. No difference was found between children with GG and AG genotypes who were all breastfed and not low birth weight.
Key Words: cognitive function, FADS, Indonesia, LC-PUFA, under-two-year-old children
 

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FADS 基因簇的基因变异体、血浆LC-PUFA 水平及其与印尼Sasaknese 两岁以下儿童认知功能的关系
背景:长链多不饱和脂肪酸(LC-PUFA)被认为是儿童认知功能必不可少的。脂肪酸(FA)去饱和酶(FADS)的遗传变异被认为是LC-PUFA 和儿童认知功能之间关系的重要效应调节剂。本研究旨在确定印尼Sasaknese 两岁以下儿童中rs174469 基因多态性遗传变异(基因型)的分布,并评估不同基因型下血浆FA 和认知功能发展结果。方法:在印尼东部龙目岛地区进行随机试验收集基线资料(NUPICO, clinicaltrials.gov NCT01504633)。招募母乳喂养月龄为12-17 个月的孩子,240 名对象被纳入本研究。采用贝利智力发育指数(MDI)评估儿童的认知功能。结果:收集到的206 名受试者血样中,只发现两种基因型(90.3%GG 纯合子,9.7%AG 杂合子),并且次要等位基因AG 与更高血液水平的花生四烯酸(20:4 n-6)、n-6 LC-PUFA 和FADS1 指数显著相关。MDI 评分与FADS2 指数(DHA:EPA)有关,但与基因型无关(调整后的R2=0.043)。结论:FADS2 指数与认知功能有关,这种关系在纯母乳喂养且非低出生体重基因型分别为GG 和AG 的婴儿中没有差别。
关键词:认知功能、FADS、印尼、LC-PUFA、两岁以下儿童

 

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Effects of Fok-I polymorphism in vitamin D receptor gene on serum 25-hydroxyvitamin D, bone-specific alkaline phosphatase and calcaneal quantitative ultrasound parameters in young adults
RIEKO TANABE, YUKA KAWAMURA, NAOKO TSUGAWA, MAYU HARAIKAWA, NATSUKO SOGABE, TOSHIO OKANO, TAKAYUKI HOSOI AND MASAE GOSEKI-SONE
Several genes have been implicated as genetic determinants of osteoporosis. Vitamin D receptor (VDR) is an intracellular hormone receptor that specifically binds to the biologically active form of vitamin D, 1-alpha, 25-dihydroxyvitamin D3 [1, 25(OH)2D], and mediates its effects. One of the most frequently studied single nucleotide polymorphisms is the restriction fragment length polymorphism (RFLP) Fok-I (rs2228570). The presence of a Fok-I site, designated f, allows protein translation to initiate from the first ATG. An allele lacking the site (ATG>ACG: designated F), initiates from a second ATG site. In the present study, we explored the effect of the VDR Fok-I genotype on associations among serum bone-specific alkaline phosphatase (ALP), 25-hydroxyvitamin D3 [25(OH)D], 1, 25(OH)2D, and the dietary nutrient intake in healthy young Japanese subjects (n=193). Dietary nutrient intakes were calculated based on 3-day food records before the day of blood examinations. Quantitative ultrasound (QUS) parameters at the right calcaneus (heel bone) were measured. The allele frequencies were 0.622 for the F allele and 0.378 for the f allele in all subjects. Grouped by the VDR genotype, a significant positive correlation between the levels of serum bone-specific ALP and 25(OH)D was observed in the FF-type (p=0.005), but not in the ff-type. In addition, there was a significant positive correlation between the level of serum 25(OH)D and osteo-sono assessment index (OSI) in the FF-type (p=0.008), but not in the ff-type. These results suggest that the level of circulating 25(OH)D is an important factor when assessing the VDR Fok-I polymorphism to prevent osteoporosis.
Key Words: vitamin D receptor Fok-I polymorphism, bone-specific alkaline phosphatase, 25-hydroxyvitamin D3, 1-alpha, 25- dihydroxyvitamin D3, quantitative ultrasound
 

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维生素D 受体基因Fok-I 多态性对青年血清25-羟维生素D 和骨特异性碱性磷酸酶以及跟骨定量超声参数的影响
一些基因已经被证实为骨质疏松症的基因决定性因素。维生素D 受体(VDR)是一种细胞内的激素受体,它可以特异性地与活性状态的维生素D,1-α, 25-二羟基维生素D3 [1,25(OH)2D] 结合,并且调节它的作用。研究最多的单核苷酸多态性是限制性片段长度多态性(RFLP)Fok-I(rs2228570)。在Fok-I 上一个位点,被定为f,使蛋白质转录从第一个ATG 开始。一个等位基因缺失位点ATG>ACG:定为F,转录是从第二个ATG 开始。本研究探究了健康日本青年人群中(n=193)VDR Fok-I 基因型对血清中骨特异性碱性磷酸酶(ALP)、25-羟基维生素D3[25(OH)D]、1,25(OH)2D 以及饮食中营养物的摄入之间的影响。饮食中营养素的摄入是根据验血前3 天的饮食记录计算的。定量超声(QUS)参数通过右侧跟骨测得。在整个样本中,F 等位基因频率为0.622,f 等位基因频率为0.378。根据VCR 基因型分组,在FF 基因型组发现血清中骨特异性ALP 的水平与25(OH)D 有显著正相关(p=0.005),但未在ff 基因型组中发 现。同时在FF 基因型组中发现血清中25(OH)D 水平与骨超声评价指数(OSI)显著正相关(p=0.008),但未在ff 基因型组发现。这些结果表明,当评估VDR Fok-I 多态性时血液中25(OH)D 的水平是预防骨质疏松的一个重要因素。
关键词:维生素D 受体Fok-I 基因多态性 、骨特异性碱性磷酸酶、25-羟基维生素D3、1-α, 25-二羟基维生素D3、定量超声
 

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Guidelines for parenteral and enteral nutrition support in geriatric patients in China
JUNMIN WEI, WEI CHEN, MINGWEI ZHU, WEIXIN CAO, XINYING WANG, HANPING SHI, BIRONG DONG, JIANQIN SUN, HUAIHONG CHEN, YEPING ZHOU, SUMING ZHOU AND JINGYONG XU
The mortality and morbidity of geriatric patients is much higher than for younger patients, especially when critically ill. This may be attributed to a lower reserve capacity in most organs and systems, reduced ability to deal with physical stress and the presence of acute or chronic co-mobidities. Parenteral and enteral nutrition support can improve the clinical condition of the elderly patient and result in better outcomes, such as lower mortality, reduced hospital stay and reduced medical costs. There is a need to standardize nutrition screening and assessment, and the implementation of appropriate evidence based nutritional support of geriatric patients in China. The Chinese Medical Association’s Group of Geriatric Nutrition Support has developed guidelines by researching the present situation in Chinese hospitals and by referring to the guidelines from both American Society for Parenteral and Enteral Nutrition (ASPEN) and the European Society for Clinical Nutrition and Metabolism (ESPEN).
Key Words: guidelines, parenteral nutrition, enteral nutrition, nutrition support, geriatric patients
 

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中国老年患者肠内肠外营养支持指南
老年患者的疾病发病率及死亡率较年轻患者明显升高,特别是危重症老年患者。这与老年人机体储备功能差,抵抗应激能力下降以及合并有多种急慢性疾病有关。肠外与肠内营养支持可以有效的改善老年患者的疾病状态及临床结局,包括降低死亡率、减少住院时间和总体住院费用。因此,在中国亟需针对于老年患者的基于循证医学规范的营养筛查、评估及支持的指南性纲领。中华医学会肠外肠内营养学分会老年学组参考美国肠外肠内营养学会(ASPEN)和欧洲肠外肠内营养学会(ESPEN)发表的临床指南,结合中国的研究进
展,制定了本指南。
关键词:指南、肠外营养、肠内营养、营养支持、老年患者

 

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Attitudes toward the American nutrition guidelines for the critically ill patients of Chinese intensive care physicians
XIAO-LING XU, JIAN-CANG ZHOU, KONG-HAN PAN, HONG-CHEN ZHAO AND KE-JING YING
Nutrition therapy is essential for the management of critically ill patients. Some guidelines have been published to standardize and optimize the nutrition therapy. However, there are still many controversies in nutrition practice and there is a gap between guidelines and clinical nutrition therapy for patients in intensive care units (ICUs). This study aimed to assess attitudes and beliefs toward nutrition therapy of Chinese intensive care physicians by using the American guidelines as a surrogate. A questionnaire was sent to 45 adult ICUs in China, in which surveyed physicians were asked to rate their attitudes toward the American guidelines. A total of 162 physicians from 45 ICUs returned the questionnaires. Physicians were categorized into groups according to their professional seniority, hospital levels and whether they were members of Chinese Society for Parenteral and Enteral Nutrition (CSPEN). Overall, 94% of the respondents thought that nutrition therapy for critically ill patients was very important, and 80% mentioned that they used the American guidelines. There was diversity of opinion on the recommendations pertaining to nutrition assessment, supplemental parenteral nutrition and cutoff values for gastric residual volume, negative or neutral attitudes about these recommendations were 43%, 59% and 41%, respectively. Members of CSPEN were more likely to select a greater strength of recommendation than non-members. In conclusion, the overall attitudes of Chinese intensive care physicians toward the American guidelines were positive. Nevertheless, given the great guideline-practice gap, nutrition-focused education is warranted for many intensive care physicians in China.
Key Words: nutrition therapy, clinical practice guidelines, intensive care units, survey, China
 

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中国ICU 医生对美国重症患者营养指南的认同度调查
营养治疗对重症患者是必不可少的。为规范和优化营养治疗,近年来有不少机构出版了营养治疗指南。然而,目前在营养治疗实践中仍存在着不少争议,重症患者的营养治疗实践与营养指南之间存在着差距。查阅文献资料发现,目前中国ICU 医生临床营养治疗实际情况的数据十分有限。鉴于美国营养指南被中国ICU 医生广泛采用,本文旨在借助于美国营养指南来评价中国ICU 医生营养治疗的理念。我们依据美国营养指南设计了一份调查问卷,并将此问卷通过信件或邮件的方式发送至中国45 家医院的ICU 进行调查。共有来自此45 家医院ICU 的162 位医生进行了有效回复。我们分别依据医生的职称、所在医院等级以及医生是否为中华医学会肠内肠外营养学分会(CSPEN)会员这三方面对该162 位医生进行分类。总的来说,94%的被调查医生肯定了营养治疗对重症患者的重要性,80%的医生表示正在使用美国营养指南。调查发现,对于营养状况评估、补充的肠外营养以及胃残余量截断值的界定这三个方面,被调查医生之间存在较大争议,对指南意见持否定或中立态度的比例分别为43%、59% 和41%。与非CSPEN 会员相比,CSPEN 会员对指南意见有更积极的认同度。我们的研究表明,中国ICU 医生对美国营养指南总体的看法是支持和赞同的,然而,鉴于指南与实践之间的较大差距,对于中国的大多数ICU 医生而言,有必要进行针对营养治疗的系统培训。
关键词:营养治疗、临床实践指南、重症监护室、调查、中国

 

 

 

 

 

Last Updated: June 2015