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1 Asia Pacific Journal of Clinical Nutrition
       Volume 24, 3

         (September 2015)


Abstracts

Contents

Abstract PDF

Original Research Communications

Nutritional Measurement & Methodology

Cutoff value of HbA1c for predicting diabetes and prediabetes in a Chinese high risk population aged over 45

RUYI ZHANG, JIAO WANG, JINHUA LUO, XIAOYAN YANG, RUI YANG, DEHONG CAI AND HUA ZHANG
Asia Pac J Clin Nutr. 2015;24(3):360-366.

doi: 10.6133/apjcn.2015.24.3.14

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Clinical Nutrition or Feeding Studies

Effect of nutritional support on clinical outcomes in perioperative malnourished patients: a meta-analysis

JING-XIA ZHONG, KAI KANG AND XIAO-LIANG SHU

Asia Pac J Clin Nutr. 2015;24(3):367-378. doi: 10.6133/apjcn.2015.24.3.20

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Emerging malnutrition during hospitalisation independently predicts poor 3-month outcomes after acute stroke: data from a Chinese cohort

JING ZHANG, XINGQUAN ZHAO, ANXIN WANG, YONG ZHOU, BO YANG, NA WEI, DANDAN YU, JINGJING LU, SHENGYUN CHEN, YILONG WANG, CHUNXUE WANG, RONG XUE, YANQIU ZHANG, YANSHENG LI, LING YU, SHAOSHI WANG, ZHENLI CHEN, TIANHENG ZHENG, ZHUO ZHANG, MENG XIA, MAOLIN HE, WEI LI, ZHAOHUI ZHANG, FEI ZENG, SHENGDI CHEN, YI FU, GUIDONG LIU, LIJUAN WANG, ZHIHENG HUANG, JIANGUO MA, FENGQUN MU, YUN XU, RONG HUANG, LIN WANG AND YONGJUN WANG

Asia Pac J Clin Nutr. 2015;24(3):379-386.

doi: 10.6133/apjcn.2015.24.3.13

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Dietary or enteral medium-chain triglyceride usage in a Chinese general hospital

RONGRONG LI, JIANGFENG MAO, KANG YU AND LILIN WANG

Asia Pac J Clin Nutr. 2015;24(3):387-393.

doi: 10.6133/apjcn.2015.24.3.18

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Glucose absorption in nephropathy patients receiving continuous ambulatory peritoneal dialysis XUEZHI ZUO, XIAOLEI YE, FANGYUN SUN, KUN QIAN, SIYUN XIANG, WANGQUN LIANG, GANG XU, YING YAO AND CHENJIANG YING
Asia Pac J Clin Nutr. 2015;24(3):394-402.

doi: 10.6133/apjcn.2015.24.3.16

 

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Effect of vitamin B-12 and n-3 polyunsaturated fatty acids on plasma homocysteine, ferritin, C-reactive protein, and other cardiovascular risk factors: a randomized controlled trial

TAO HUANG, KELEI LI, SAILIMUHAN ASIMI, QI CHEN AND DUO LI
Asia Pac J Clin Nutr. 2015;24(3):403-411
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doi: 10.6133/apjcn.2015.24.3.19

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Effects of supplementation with a combination of β-hydroxy-β-methyl butyrate, L-arginine, and L-glutamine on postoperative recovery of quadriceps muscle strength after total knee arthroplasty KANAE NISHIZAKI, HITOSHI IKEGAMI, YUKIO TANAKA, RYUTARO IMAI AND HAJIME MATSUMURA
Asia Pac J Clin Nutr. 2015;24(3):412-420.
doi: 10.6133/apjcn.2015.24.3.01

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Encapsulated green kiwifruit extract: a randomised controlled trial investigating alleviation of constipation in otherwise healthy adults

SOPHIE KINDLEYSIDES, BARBARA KUHN-SHERLOCK, WILSON YIP AND SALLY D POPPITT
Asia Pac J Clin Nutr. 2015;24(3):421-429.

doi: 10.6133/apjcn.2015.24.3.15

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Determinants of dietary self-care behaviours among Taiwanese patients with type 2 diabetes

CHUNG-MEI OUYANG, JOHANNA T DWYER, PAUL F JACQUES, LEE-MING CHUANG, CATHERINE F HAAS AND KATIE WEINGER
Asia Pac J Clin Nutr. 2015;24(3):430-437.

doi: 10.6133/apjcn.2015.24.3.02

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Diabetes self-care behaviours and clinical outcomes among Taiwanese patients with type 2 diabetes

CHUNG-MEI OUYANG, JOHANNA T DWYER, PAUL F JACQUES, LEE-MING CHUANG, CATHERINE F HAAS AND KATIE WEINGER
Asia Pac J Clin Nutr. 2015;24(3):438-443.

doi: 10.6133/apjcn.2015.24.3.03

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Nutritional Status, Dietary Intake, and Body Composition

Low haemoglobin levels contribute to low grip strength independent of low-grade inflammation in Japanese elderly women

ERIKO YAMADA, MIKA TAKEUCHI, MIKI KURATA, AYAKA TSUBOI, TSUTOMU KAZUMI AND KEISUKE FUKUO

Asia Pac J Clin Nutr. 2015;24(3):444-451.

doi: 10.6133/apjcn.2015.24.3.11

 

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Anaemia prevalence over time in Indonesia: estimates from the 1997, 2000, and 2008 Indonesia Family Life Surveys

JONATHAN S BARKLEY, KATHERINE L KENDRICK, KAREN CODLING, SITI MUSLIMATUN AND HELENA PACHÓN
Asia Pac J Clin Nutr. 2015;24(3):452-455
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doi: 10.6133/apjcn.2015.24.3.22

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Intake and major sources of dietary flavonoid in Korean adults: Korean National Health and Nutrition Examination Survey 2010-2012 YOU JIN KIM, MIN YOUNG PARK, NAMSOO CHANG AND ORAN KWON
Asia Pac J Clin Nutr. 2015;24(3):456-463.
doi: 10.6133/apjcn.2015.24.3.04

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New data for vitamin D in Australian foods of animal origin: impact on estimates of national adult vitamin D intakes in 1995 and 2011-13 JERRY LIU, JAYASHREE ARCOT, JUDY CUNNINGHAM, HEATHER GREENFIELD, JAMES HSU, DAVID PADULA, NORBERT STROBEL AND DAVID R FRASER
Asia Pac J Clin Nutr. 2015;24(3)464-471.
doi: 10.6133/apjcn.2015.24.4.04

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BMI and all-cause mortality among Chinese and Caucasians: the People’s Republic of China and the Atherosclerosis Risk in Communities Studies EVA ERBER OAKKAR, JUNE STEVENS, KIMBERLY P TRUESDALE AND JIANWEN CAI
Asia Pac J Clin Nutr. 2015;24(3):472-479.
doi: 10.6133/apjcn.2015.24.3.12

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The correlation between high body mass index and survival in patients with esophageal cancer after curative esophagectomy: evidence from retrospective studies

WENBIAO PAN, ZHIYONG SUN, YANGWEI XIANG AND WENTAO FANG
Asia Pac J Clin Nutr. 2015;24(3):480-488.

doi: 10.6133/apjcn.2015.24.3.05

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Interrelationship between glucose metabolism and undercarboxylated osteocalcin: a cross-sectional study in a community-dwelling population SHOZO YANO, TORU NABIKA, ATSUSHI NAGAI, TSUYOSHI HAMANO, MASAYUKI YAMASAKI, MINORU ISOMURA, KUNINORI SHIWAKU, SHUHEI YAMAGUCHI, TORU YAMAGUCHI AND TOSHITSUGU SUGIMOTOAsia Pac J Clin Nutr. 2015;24(3):489-495.doi:10.6133/apjcn.2015.24.4.02

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Maternal and Clild Nutrition

A meta-analysis combining parallel and cross-over randomized controlled trials to assess impact of iodine fortified foods on urinary iodine concentration among children

RAMESH ATHE, VISHNU VARDHANA RAO MENDU AND MADHAVAN NAIR KRISHNAPILLAI
Asia Pac J Clin Nutr. 2015;24(3):496-503.

doi: 10.6133/apjcn.2015.24.3.10

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Clinical Nutrition Guidelines

Standard values of rapid turnover proteins and zinc in Japanese children KEI YAMAMOTO, NORIHIKO KITAGAWA AND TETSUYA TAKAMASU
Asia Pac J Clin Nutr. 2015;24(3):504-508.
doi: 10.6133/apjcn.2015.24.4.01

 

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Is parental body weight related with their children’s overweight and obesity in Gao Hang Town, Shanghai?

YANPING WAN, RENYING XU, HAIXIA FENG, YIQUAN ZHOU, XIAOMIN ZHANG, LIPING LU, TAO TAN, YING JIANG, ZHIQI CHEN AND YINGJIE WU
Asia Pac J Clin Nutr. 2015;24(3):509-514.

doi: 10.6133/apjcn.2015.24.3.09

 

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Nutritional Epidemiology and Public Health

Polychlorinated biphenyl and heavy metal exposures among fishermen in the Straits of Malacca: neurobehavioural performance ALINA MOHAMAD, AZRINA AZLAN, MOHD YUSOFF ADON, HOCK ENG KHOO AND MUHAMMAD RIZAL RAZMAN
Asia Pac J Clin Nutr. 2015;24(3):515-524.

doi: 10.6133/apjcn.2015.24.3.06

 

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Effectiveness of a public dietitian-led diabetes nutrition intervention on glycemic control in a community setting in China HUAQING LIU, MIN ZHANG, XUESEN WU, CHUNHUA WANG AND ZHONG LI
Asia Pac J Clin Nutr. 2015;24(3):525-532.

doi: 10.6133/apjcn.2015.24.3.07

 

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Identifying barriers to the implementation of nutrition education in South Korea

JOUNGHEE LEE AND YOUNGSUN HONG
Asia Pac J Clin Nutr. 2015;24(3):533-539.

doi: 10.6133/apjcn.2015.24.3.21

 

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The adherence of packaged food products in Hyderabad, India with nutritional labelling guidelines

ELIZABETH K DUNFORD, RAMA K GUGGILLA, ANENTA RATNESWARAN, JACQUELINE L WEBSTER, PALLAB K MAULIK AND BRUCE C NEAL
Asia Pac J Clin Nutr. 2015;24(3):540-545.

doi: 10.6133/apjcn.2015.24.3.08

 

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Nutrigenomics

Diets high in carbohydrate may not be appropriate for rs328 G carriers with the metabolic syndrome

SHIXIU ZHANG, YIYI MA, HONGWEI GUO, WENTAO WAN AND KUN XUE

Asia Pac J Clin Nutr. 2015;24(3):546-554.

doi: 10.6133/apjcn.2015.24.3.17

 

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Future Events

Asia Pac J Clin Nutr. 2015;24(3):555.

 

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Cutoff value of HbA1c for predicting diabetes and prediabetes in a Chinese high risk population aged over 45

RUYI ZHANG, JIAO WANG, JINHUA LUO, XIAOYAN YANG, RUI YANG, DEHONG CAI AND HUA ZHANG
Objective: To evaluate the cutoff value of HbA1c for predicting diabetes and prediabetes in a Chinese high risk population aged over 45. Methods: A total of 619 people aged over 45 without diabetes were randomly recruited to complete the Finnish Diabetes Risk Score (FINDRISC) questionnaire. 208 high-risk individuals (defined by Diabetes Risk Score ≥9) had OGTT and HbA1c determined at the same time. Results: In a Chinese population aged over 45, the best cutoff values of HbA1c for detecting diabetes and prediabetes were 5.8% and 5.4% respectively. The area under the receiver operating characteristic (AUROC) curve of HbA1c for detecting diabetes was 0.85 (95% CI: 0.80-0.90) and prediabetes was 0.62 (95% CI: 0.54-0.70). The combined use of HbA1c and fasting blood glucose (FPG) had a larger AUROC than HbA1c alone (0.88, 95%CI: 0.83-0.92 in detecting diabetes vs 0.75, 95% CI: 0.67-0.82 in prediabetes), and had a higher sensitivity in predicting diabetes and higher specificity and positive predictive value (PPV) in predicting prediabetes. However, the AUROC between HbA1c alone and combined use in predicting diabetes was not significantly different (p=0.173). Conclusions: FINDRISC is a feasible tool to screen people who are at high risk of diabetes. The cutoff values of HbA1c to diagnose diabetes and prediabetes in a Chinese high risk population aged over 45 were 5.8% and 5.4%, respectively. The sensitivity and specificity of HbA1c for detecting diabetes and prediabetes were relatively low, so that the combined use of HbA1c and FPG may be more effective in prediction.
Key Words: cutoff, HbA1c, diabetes, prediabetes, risk
 

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糖化血红蛋白在中国45岁以上糖尿病高危人群糖尿病及糖尿病前期诊断的界点
目的:探讨糖化血红蛋白(HbA1c)在中国中老年糖尿病高危人群中是否存在诊断糖尿病及糖尿病前期的界点。方法:随机抽取广州市5个社区619名45岁或以上的中老年人填写芬兰糖尿病风险积分表(FINDRSC),积分≥9分定义为糖尿病高危人群。随后对筛查出的糖尿病高危人群(共208例)进行生化指标的检测,同时使用口服葡萄糖耐量试验(OGTT)及HbA1c诊断糖尿病及糖尿病前期,使用受试者工作特征(ROC)曲线下面积判断HbA1c或HbA1c联合空腹血浆血糖(FPG)在诊断糖尿病及糖尿病前期的诊断效能。结果:在这组糖尿病高危人群中,HbA1c诊断糖尿病及糖尿病前期的界值分别为5.8%及5.4%,其ROC曲线下面积分别为0.85(95% CI:0.80-0.90)及0.62(95% CI:0.54-0.70);而HbA1c联合FPG诊断糖尿病及糖尿病前期的ROC 曲线下面积均比前者大,且在诊断糖尿病中具有更高的灵敏度,而在诊断糖尿病前期中具有更高的特异度及阳性预测值。但是单用HbA1c或联合FPG诊断糖尿病的ROC曲线下面积之间差异无统计学意义(p=0.173)。结论: FINDRSC是筛查糖尿病高危人群的有效量表。在中国45岁或以上的中老年糖尿病高危人群中HbA1c诊断糖尿病及糖尿病前期的界值分别为5.8%及5.6%,但是其特异度及敏感度相对较低,因此需要联合FPG增加其预测疾病的可靠性。
关键词:诊断界值、糖化血红蛋白、糖尿病、糖尿病前期、风险

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Effect of nutritional support on clinical outcomes in perioperative malnourished patients: a meta-analysis
JING-XIA ZHONG, KAI KANG AND XIAO-LIANG SHU
Malnutrition is an independent risk factor for complications, mortality, wound healing, length of hospital stay, and costs. Associations between nutritional support and surgical patients remain controversial. Databases, including Pubmed, EMBASE, Web of Science, CNKI, VIP, and the Cochrane Library, were searched to find randomized controlled trials (RCTs) that assessed the effect of nutritional support on clinical outcomes in perioperative malnourished patients. The methodological quality of each included trial was assessed. A meta-analysis was conducted with Rev Man 5.2. Fifteen RCTs, involving 3831 patients, were included in this meta-analysis. Compared with control group, results showed that nutritional support was more effective in decreasing the incidence of infectious [relative risk (RR): 0.58; 95% CI: 0.50, 0.68; p<0.01] and non-infectious complications (RR: 0.74; 95% CI: 0.63, 0.88; p<0.01), and shortening the length of hospital stay [weighted mean difference (WMD): -2.64; 95% CI: -5.13, -0.16; p<0.05]. Moreover, the incidence of infectious complications in the immune nutrition group was significantly lower than that in the standard nutrition group (RR: 0.75; 95% CI: 0.58, 0.97; p<0.05). However, changes in hospital costs (WMD: 894; 95% CI: -1140, 2928; p>0.05) and postoperative mortality (RR: 0.77; 95% CI: 0.41, 1.44; p>0.05) between the nutritional support group and control group were not significantly different. In conclusion, perioperative nutritional support was superior in improving clinical outcomes in malnourished patients, which could significantly reduce the incidence of complications and effectively shorten the length of hospital stay.
Key Words: malnutrition, perioperative, nutritional support, meta-analysis, prognosis

 

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营养支持对围手术期营养不良患者临床结局的影响:一项Meta 分析
营养不良是增加术后并发症发生率及病死率,延缓创伤愈合,延长住院时间和增加住院费用的独立危险因素。营养支持适用于所有手术患者这一观点仍存在争议。本Meta 分析检索6 个生物医学数据库( 包括Pubmed 、EMBASE、Web of Science、CNKI、VIP、The Cochrane Library) 的文献资料。对纳入的随机对照研究进行方法学质量评定。应用Rev Man 5.2 软件进行Meta 分析。本Meta 分析共纳入15 项符合标准的随机对照研究(n=3831)。分析结果显示,与对照组比较,营养支持可明显降低患者术后感染性并发症发生率(RR:0.58;95% CI:0.50,0.68; p<0.01),降低术后非感染性并发症发生率( RR : 0.74 ; 95% CI : 0.63 , 0.88 ; p<0.01 ) , 缩短住院时间(WMD:-2.64;95% CI:-5.13,-0.16;p<0.05)。此外,实施免疫营养支持较常规营养支持可以更有效地降低感染并发症发生率(RR:0.75;95% CI:0.58,0.97;p<0.05)。但营养支持组与对照组患者之间住院费用(WMD:894;95% CI:-1140,2928;p>0.05)和病死率(RR:0.77;95% CI:0.41, 1.44;p>0.05)无显著性差异。综上,围手术期营养支持对改善营养不良患者临床结局具有优越性,可显著降低其并发症的发生率,缩短住院时间。
关键词:营养不良、围手术期、营养支持、Meta 分析、预后

 

 

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Emerging malnutrition during hospitalisation independently predicts poor 3-month outcomes after acute stroke: data from a Chinese cohort
JING ZHANG, XINGQUAN ZHAO, ANXIN WANG, YONG ZHOU, BO YANG, NA WEI, DANDAN YU, JINGJING LU, SHENGYUN CHEN, YILONG WANG, CHUNXUE WANG, RONG XUE, YANQIU ZHANG, YANSHENG LI, LING YU, SHAOSHI WANG, ZHENLI CHEN, TIANHENG ZHENG, ZHUO ZHANG, MENG XIA, MAOLIN HE, WEI LI, ZHAOHUI ZHANG, FEI ZENG, SHENGDI CHEN, YI FU, GUIDONG LIU, LIJUAN WANG, ZHIHENG HUANG, JIANGUO MA, FENGQUN MU, YUN XU, RONG HUANG, LIN WANG AND YONGJUN WANG

Objective: Questions exist regarding the causal relationship between malnutrition and stroke outcomes. This study aimed to determine whether nutritional status changes or malnutrition during hospitalisation could predict 3-month outcomes in acute stroke patients. Methods: During a 10-month period, patients who suffered their first stroke within 7 days after stroke onset were included in this prospective multi-centre study. The demographic parameters, stroke risk and severity factors, malnutrition risk factors and dysphagia were recorded. Nutritional status was assessed by 3 anthropometric and 3 biochemical indices. Changes in nutritional status were defined by comparing the admission values with the 2-week values. A Modified Rankin Scale score of 3-6 was defined as a poor outcome at the 3-month follow-up. Univariate and multiple logistic regression analyses were used to investigate the power of nutritional status changes in predicting poor patient outcomes. Results: Data from 760 patients were analysed. Poor outcomes were observed in 264 (34.7%) patients. Malnutrition prevalence was 3.8% at admission and 7.5% after 2-weeks in hospital, which could not predict 3-month outcome. Emerging malnutrition was observed in 36 patients (4.7%) during the 2-week hospitalisation period and independently predicted poor 3-
month outcomes after adjusting for confounding factors (odds ratio 1.37, 95% confidence interval, 1.03-1.83). Conclusions: Emerging malnutrition during hospitalisation independently predicted poor 3-month outcomes in acute stroke patients in this study.
Key Words: malnutrition, deterioration, predict, outcome, acute stroke

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急性脑卒中患者住院期间新出现的营养不良独立预测3个月后的不良结局:来自一个中国人队列的数据
目的:营养不良和脑卒中结局之间的因果关系仍然存在疑问。本研究的目的是确定住院期间营养状态的变化或者营养不良能否预测急性脑卒中患者3个月后的结局。方法:在10个月期间,首次卒中7天内的患者纳入该前瞻性多中心研究。记录人口统计学参数、脑卒中危险因素和严重程度、营养不良的危险因素及是否有吞咽障碍。营养状态由3个人体测量学指标和3个生化指标来评估。营养状态的变化是对比入院时和住院2周时的6个指标的变化。3个月随访时改良的Rankin评分3-6分者认为是不良结局。单因素和多因素Logistic回归分析用于检测营养状态的变化对不良结局预测的力度。结果:共有760例患者的数据纳入分析,其中存在不良结局的有264(34.7%)例。入院时营养不良的患病率是3.8%,住院2周时是7.5%,而这均不能预测3个月后的结局。住院2周内新出现营养不良的患者有36例(4.7%),在纠正了混杂因素后仍可独立预测3个月后的结局(OR:1.37;95% CI:1.03-1.83)。结论:本研究中急性卒中患者住院期间新出现的营养不良可以独立预测3个月后的不良结局。
关键词:营养不良、恶化、预测、结局、急性卒中


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Dietary or enteral medium-chain triglyceride usage in a Chinese general hospital
RONGRONG LI, JIANGFENG MAO, KANG YU AND LILIN WANG
Objectives: Medium chain triglycerides (MCTs) are of nutritional interest for their unique properties on ingestion, absorption and metabolism. However, dietary and enteral MCTs usage in hospitalized patients in China requires evaluation. Methods: A retrospective analysis was conducted on 46 hospitalized patients who were administered MCTs therapy between January, 2012 and December, 2013 in Peking Union Medical College Hospital. The clinical parameters of subjects were evaluated 2 weeks after intervention. All indications and outcomes of MCTs therapy underwent evidence-based evaluation. A survey was conducted on a random sample of 77 doctors to clarify the awareness and knowledge of MCTs therapy among clinicians. Results: Among 46 cases undergoing MCTs therapy, there were 21 with gastrointestinal dysfunction (with improvement in 15 cases), 15 with lymphatic anomalies (with improvement in 7 cases), 5 with dyslipidemia (with improvement in 3 cases), 4 with exocrine pancreatic insufficiency (with improvement in 2 cases) and 1 with epilepsy (without improvement). All indications were evidence -based. Although MCTs were being utilized in an increasing number of patients, the survey revealed poor knowledge of their physicochemical properties, medical indications and the therapeutic basis of their use among clinicians. Conclusions: MCTs therapy is of benefit in the management of gastrointestinal malabsorption, pancreatic exocrine insufficiency, intestinal lymphangiectasia and dyslipidemia. However, randomized controlled trials with adequate sample size and longer follow-up are required to evaluate further their efficacy, and more educational programs are needed to ensure clinical competence for MCT therapy.
Key Words: medium-chain triglycerides, diet, enteral nutrition, indication, outcome
 

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中国综合医院中链甘油三酯膳食及肠内临床应用现状
目的:中链甘油三酯(median chain triglycerides,MCTs)由于其摄入、吸收、代谢方面的特殊作用而广受关注,但目前其在中国住院患者的膳食及肠内临床应用尚无报道且现状不明。本文首次报告MCTs 临床应用现状,以期进一步阐明其应用的指征和规范。方法:回顾性分析纳入北京协和医院2012 年1 月至2013 年12 月两年间应用MCTs 进行膳食及肠内营养干预的住院患者46 例次及其治疗2 周后临床情况变化。所有患者的治疗指征及治疗结局均进行循证评价。同时,随机选取77 名临床医师进行问卷调查,进一步阐明临床医师对MCTs 营养治疗的认知度。结果:46 例次接受MCTs 营养干预的患者临床表现及MCTs 应用指征各异,其中包括21 例胃肠消化功能障碍(15 例治疗2 周后好转),15 例淋巴循环障碍(7 例好转),5 例血脂异常(3 例好转),4 例胰腺外分泌功能不全(2 例好转)以及1 例癫痫发作(未好转)患者。病例的MCTs 治疗指征均进行循证评价。针对医师的问卷调查显示,尽管应用MCTs 治疗的患者例数正在逐渐增加,临床医师对MCTs 的理化特点、应用指征以及MCTs 治疗机制的认知仍存在普遍不足。结论:MCTs 治疗可改善胃肠道吸收不良、胰腺外分泌功能不全、小肠淋巴管扩张以及血脂异常患者的临床表现,但目前尚需针对较大样本人群、具有足够随访时间的临床随机对照试验以进一
步评价其疗效。同时更多的MCTs 知识宣教应在临床医师中进行普及以提高临床医务人员对其的认知程度。
关键词:中链甘油三酯、膳食、肠内营养、指征、结局
 

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Glucose absorption in nephropathy patients receiving continuous ambulatory peritoneal dialysis
XUEZHI ZUO, XIAOLEI YE, FANGYUN SUN, KUN QIAN, SIYUN XIANG, WANGQUN LIANG, GANG XU, YING YAO AND CHENJIANG YING

Objectives: Peritoneal dialysis patients are at risk of glucose absorption from peritoneal dialysate, not only because of energy imbalance but also the toxic effects of high glucose. The current widely applied formulae may be not suitable for estimation of glucose absorption in continuous ambulatory peritoneal dialysis (CAPD) patients. This study examined the actual glucose absorption in a cohort of CAPD patients and compared the results with estimates from four current formulae. Methods: We conducted a survey of glucose absorption of a cohort of 72 CAPD patients and compared actual dialysate glucose absorbed and estimates using K/DOQI formula, Grodstein formula, Bodnar formula, or a percentage estimate of 60%. Results: The total dialysate glucose infused each day varied from 54.4 to 191 g/day with average of 102±27.9 g. The average of glucose absorbed was 65.7 g (ranging from 19.5 to 131 g) by actual measurements. The mean absorption rate was 64.4% (ranging from 30.6% to 92.4%). The glucose absorbed from dialysate accounted for 13.8% (ranging from 5.0% to 30.1%) of total energy intake. The average errors of absolute values between actual measurements and estimates were greater than 10 g or 20 g glucose (p<0.001). The average errors in percentages were greater than 20% or 40%, dependently on estimating methods. Conclusions: The applications of current estimating methods may have limitations. The actual measurement provides dietitians and doctors with more exact information of absorbed glucose and energy compared to the current estimating methods.
Key Words: glucose absorption, actual measurement, estimating methods, continuous ambulatory peritoneal dialysis, dietary survey
 

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持续非卧床腹膜透析肾病病人的葡萄糖吸收
目的:从透析液中吸收的葡萄糖不仅会造成腹膜透析病人能量失衡,还会对机体产生毒性作用。但目前广泛应用的葡萄糖吸收量估算公式可能不适合中国的持续性非卧床腹膜透析(CAPD)病人。本文在一个CAPD 队列中探讨四种估算方法与实测值的差异。方法:测量72 例CAPD 病人透析液来源的葡萄糖吸收量,并与K/DOQI 公式、Grodstein 公式、Bodnar 公式以及60%葡萄糖吸收率公式的估算结果进行比较。结果:CAPD 病人每日使用的透析液所含葡萄糖总量平均为102±27.9 g(范围54.4 到191 g)。葡萄糖吸收量实际测量值平均为65.7±23.3 g(范围19.5 到131g),平均吸收率为64.4%(范围30.6%到92.4%),透析液来源的葡萄糖供能占总能量的比例为13.8%(范围5.0%到30.1%)。实际测量值与四种不同公式估算值平均差值大于10 g 或20 g(p<0.001),平均差值百分比大于20%或40%(p<0.001)。结论:目前应用的葡萄糖吸收量估算方法存在局限性,与目前使用的估计方法相比,实际测量值可以更准确地为营养师和医生提供葡萄糖和能量的吸收信息。
关键词:葡萄糖吸收、实际测量、估算方法、持续非卧床腹膜透析、膳食调查

 

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Effect of vitamin B-12 and n-3 polyunsaturated fatty acids on plasma homocysteine, ferritin, C-reactive protein, and other cardiovascular risk factors: a randomized controlled trial
TAO HUANG, KELEI LI, SAILIMUHAN ASIMI, QI CHEN AND DUO LI
Objectives: Vitamin B-12 and n-3 polyunsaturated fatty acids (PUFA) decrease blood homocysteine (Hcy) concentrations. However, the combined effect of these nutrients on Hcy and ferritin, and C-reactive protein is limited and inconclusive. The objective was to examine the synergistic effect of vitamin B-12 in combination of n-3 PUFA on plasma Hcy, ferritin, and other biochemical markers. Methods: In a randomized controlled trial, thirty eligible subjects were randomly divided into three groups, and assigned to receive 1000 μg of vitamin B-12, 2 g fish oil, or 1000 μg vitamin B-12 and 2 g fish oil, respectively, for 8 weeks. Plasma phospholipids (PL) fatty acids and biochemical markers were determined. This study was registered under ClinicalTrials.gov Identifier: NCT01762072. Results: Plasma PL 20:5n-3, 22:6n-3 and n-3 PUFA was increased after 4 and 8 week supplementation of fish oil, and vitamin B-12+fish oil. Plasma concentrations of triacylglycerol, uric acid, C-reactive protein, and ferritin were significantly decreased after 4 and 8 week supplementation of fish oil, and vitamin B-12+fish oil. In all groups, significant changes in plasma Hcy were observed during the study period. Vitamin B-12, fish oil, and vitamin B-12+fish oil supplementation lowered plasma Hcy concentrations by 22%, 19%, and 39%, respectively. Conclusions: The combination of vitamin B-12 and fish oil has a synergistic effect on lowering plasma concentrations of Hcy.
Key Words: homocysteine, vitamin B-12, fish oil, ferritin, C-reactive protein

 

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维生素B-12 和欧米伽3 多不饱和脂肪酸对血浆同型半胱氨酸、铁蛋白、C 反应蛋白和其它心血管危险因素的影响:一项随机对照临床试验
目的:维生素B-12 和欧米伽3 多不饱和脂肪酸能够降低血液同型半胱氨酸浓度。但是,这两种营养元素是否对同型半胱氨酸、铁蛋白、C 反应蛋白有协同效应仍不清楚。方法:为进一步解决该问题,我们开展了一项随机对照实验,38 位参与者随机分为三组,每天分别食用1000 μg 维生素B-12、2 g 鱼油、1000 μg 维生素B-12+2 g 鱼油。八周以后,收集受试者血样,测定血浆磷脂脂肪酸组成,生物标志物等。结果:四周或者八周干预以后,鱼油组和鱼油+维生素B-12 组的血浆磷脂20:5n-3、22:6n-3 和总欧米伽3 脂肪酸显著升高,然而,血浆甘油三酯、尿酸、C 反应蛋白以及铁蛋白显著降低。维生素B-12 组、鱼油组、维生素B-12+鱼油组,血浆同型半胱氨酸分别降低22%、19%和39%。结论:维生素B-12 和鱼油在调节同型半胱氨酸代谢过程中存在协同效应。
关键词:同型半胱氨酸、维生素B-12、鱼油、铁蛋白、C 反应蛋白


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Effects of supplementation with a combination of β-hydroxy-β-methyl butyrate, L-arginine, and L-glutamine on postoperative recovery of quadriceps muscle strength after total knee arthroplasty
KANAE NISHIZAKI, HITOSHI IKEGAMI, YUKIO TANAKA, RYUTARO IMAI AND HAJIME MATSUMURA
Objectives: Total knee arthroplasty (TKA) performed in knee osteoarthritis patients is reported to be immediately followed by a decrease in quadriceps muscle strength. We investigated the effects of supplementation with a combination β-hydroxy-β-methyl butyrate, L-arginine, and L-glutamine (HMB/Arg/Gln) on the postoperative recovery of quadriceps muscle strength in patients after TKA. Methods: Study subjects were 23 patients (12 women; mean age: 70.5) who underwent TKA. The patients were randomly allocated into the control group or the group that consumed HMB/Arg/Gln supplementation (HMB/Arg/Gln group). HMB/Arg/Gln supplementation or control food were consumed for 5 days before the surgery and for 28 days after the surgery, and maximal quadriceps strength was measured at 7 days before the surgery, and at 14, 28 and 42 days after the surgery. During the study, total energy expenditure was measured using a lifestyle recording device. The two groups followed the rehabilitation in the same way. Results: The maximal quadriceps strength was 1.1±0.62 Nm/Kg before surgery and 0.7±0.9 Nm/Kg after surgery 14 days in the control group (p=0.02), and 1.1±0.3 Nm/Kg before surgery and 0.9±0.4 Nm/Kg after surgery 14 days in the HMB/Arg/Gln group. Although the control group experienced a significant loss of muscle strength after the surgery, the HMB/Arg/Gln group did not. There was no significant difference in total energy expenditure between the two groups. Conclusions: Consuming HMB/Arg/Gln supplementation may suppress the loss of muscle strength after TKA. Intervention with exercise and nutrition appears to enable patients to maintain their quadriceps strength.
Key Words: β-hydroxy-β-methyl butyrate (HMB), nutritional food, quadriceps muscle strength, total knee arthroplasty (TKA), knee osteoarthritis
 

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联合补充β 羟基β - 甲基丁酸、L-精氨酸和L-谷氨酰胺对全膝关节置换术后股四头肌肌肉力量恢复的效果
目的:有报道称膝关节炎病人全膝关节置换术后,紧接着就是股四头肌肌肉力量的减小。我们研究了联合补充β 羟基β - 甲基丁酸、L-精氨酸和L-谷氨酰胺(HMB/Arg/Gln)对全膝关节置换患者术后股四头肌肌肉力量恢复的效果。方法:研究对象为进行全膝关节置换的23 位患者(平均年龄为70.5 岁,其中12 名为女性)。患者被随机分配进对照组和HMB/Arg/Gln 补充组。手术前补充5 天和手术后补充28 天的HMB/Arg/Gln 或对照食物。分别在术前7 天,术后14 天、28 天和42 天测定最大股四头肌力量。在研究过程中,使用一个生活方式记录装置测定总的能量消耗。随后两组以同样的方式康复。结果:对照组手术前最大股四头肌力量为1.1±0.62 Nm/Kg,手术后14 天为0.7±0.9 Nm/Kg(p=0.02 ); HMB/Arg/Gln 组手术前最大股四头肌力量为1.1±0.3 Nm/Kg,手术后14 天为0.9±0.4 Nm/Kg。对照组手术后肌肉力量损失显著,但HMB/Arg/Gln 组没有。两组之间能量消耗没有显著差异。结论: 补充 HMB/Arg/Gln 可以抑制全膝关节置换术后肌肉力量的损失。运动和营养干预似乎能够让患者保持他们的股四头肌力量。
关键词:β 羟基β - 甲基丁酸(HMB)、营养食物、股四头肌肌力、全膝关节置换术(TKA)、膝关节骨性关节炎


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Encapsulated green kiwifruit extract: a randomised controlled trial investigating alleviation of constipation in otherwise healthy adults
SOPHIE KINDLEYSIDES, BARBARA KUHN-SHERLOCK, WILSON YIP AND SALLY D POPPITT
Objectives: Previous clinical trials have shown bowel function is improved through consumption of whole kiwifruit (Actinidia deliciosa). This study investigated whether encapsulated kiwifruit extract (1 g/day) could alleviate constipation in otherwise healthy adults. Methods: Forty adults with confirmed constipation entered this trial, of which 32 completed with >80% compliance. Two capsules were self-administered morning and evening for 2 periods, each of 3 weeks duration, separated by a 3+ week washout in a double blind, randomised, placebo controlled crossover. Inclusion criteria included constipation with ≤3 bowel movements (BM) per week. Daily records of defecation frequency and stool characteristics were obtained throughout treatment, as well as a measurement of gastrointestinal symptoms rating scale (GSRS) and quality of life (QoL) before and after each intervention arm. Results: There was no difference in total BM over 3 weeks (p>0.05) or mean BM during each of weeks 1, 2 and 3 (p>0.05) between the kiwifruit extract and placebo when assessed from a faecal diary. There was also no detectable difference in defecation related scores of BM ease of defecation, volume, consistency or BM type assessed using Bristol stool chart scores. Nor was there a significant change in GSRS or QoL between pre and post treatment measures, when compared to placebo (p>0.05). Conclusions: This trial showed that improvement in bowel function or comfort was not achieved through supplementation with 1 g/day freeze dried kiwifruit extract. Efficacy from prior kiwifruit powder and whole fruit trials indicate that investigating higher doses of encapsulated kiwifruit extract may be worthwhile.
Key Words: actinidin, bowel function, constipation, defecation frequency, kiwifruit extract
 

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绿色猕猴桃提取物胶囊:一项缓解健康成人便秘的随机对照试验
目的:以前的临床试验显示食用整个猕猴桃能够改善肠道功能。本研究探讨猕猴桃提取物胶囊(1 g/天)是否能够缓解健康成人便秘。方法:四十个便秘的成年人进入该试验,其中32 人完成了试验,达标率为80%。这是一个双盲、随机、安慰剂对照的交叉试验,每期3 周,每日2 粒胶囊早晚各服一粒,两期间是一个3 周的洗脱期。纳入标准为便秘,即每周排便≤3 次。在整个治疗期间,每天记录排便频率和粪便特征,每次干预前后用消化道症状评定量表(GSRS)和生活质量(QoL)问卷评估胃肠道症状。结果:当通过粪便日记评估时,没有发现猕猴桃提取物和安慰剂之间在3 周干预期总的大便次数 (p>0.05)或第1、第2 和第3 周两组之间平均大便次数有差异(p>0.05)。也没有检测到用布里斯托尔大便图表测得的用于评估排便的容易性、大便的体积、排便的连贯性或大便的类型的得分之间有差异。与安慰剂相比,也没有发现干预前后GSRS 或QoL 有显著变化(p>0.05)。结论:本实验表明,通过每天补充1 g 冷冻干燥的猕猴桃提取物不能改善肠道功能或舒适度。之前的猕猴桃粉和全果的实验疗效表明:探讨高剂量的猕猴桃提取物胶囊可能值得一试。
关键词:猕猴桃蛋白酶、肠道功能、便秘、排便频率、猕猴桃提取物

 

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Determinants of dietary self-care behaviours among Taiwanese patients with type 2 diabetes
CHUNG-MEI OUYANG, JOHANNA T DWYER, PAUL F JACQUES, LEE-MING CHUANG, CATHERINE F HAAS AND KATIE WEINGER

The effects of patient characteristics on reported adherence to dietary self-care behaviours in 184 Taiwanese outpatients 40 years or older with type 2 diabetes was assessed. Patient characteristics included the presence of predisposing factors affecting diabetes adherence (knowledge and attitudes about the disease, self-efficacy, and the absence of psychological problems), enabling factors (understanding of diabetes and environmental factors affecting it), and reinforcing factors (presence of medical and social support) which were evaluated using a 72 item self-administered questionnaire with 8 subscales. Adherence was assessed by patients’ reports of carrying out 7 self-care behaviours (following a diabetic meal plan, following the diabetes exchange system, eating meals providing the same amount of carbohydrate every day, counting carbohydrates, reducing dietary fat, consuming high fiber foods, and keeping a daily food record). Reported adherence ranged from 17% to 74%. No single predisposing, enabling, or reinforcing factor predicted adherence to all of the dietary self-care behaviours. However, more self-efficacy, better understanding, and a better attitude toward diabetes were associated with performing five or more of the dietary self-care behaviours examined. With respect to specific self-care behaviours, women were more likely than men to count carbohydrates (OR=5.75) and reduce fat in their diets (OR=2.57). Patients who attended more nutrition education sessions were more likely to follow diabetes meal plans (OR=2.11) and the diabetes exchange system (OR=3.07). Efforts are needed to encourage providers to teach diabetes self-care behaviours to patients and to capitalize upon demographic and psychosocial characteristics that can enhance patient adherence.
Key Words: type 2 diabetes mellitus, Taiwan, self-care behaviours, patient education, dietary adherence

 

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台湾2 型糖尿病病患饮食自我照顾行为之决定因素
此研究调查了184 位门诊40 岁以上之2 型糖尿病病患,评估病患特质对饮食自我照顾行为配合度之影响。利用一份72 题(共八面向)之调查问卷,评估病患之特质,包括影响糖尿病患配合度之内在因素(此疾病相关之知识与态度、自我效能和心理问题)、能力因素(对糖尿病的理解度和环境因素),以 及加强因素(医疗和家庭支持)。有关病患饮食自我照顾行为之配合度,共调查了七项饮食行为(遵循糖尿病饮食计划、食物代换表、每餐固定醣量、醣类计算、减少油脂、增加纤维摄取,和记录饮食日志)。病患饮食行为配合度调查结果为17%至74%。没有单一(内在、能力和加强)因素可预测所有的饮食行为配合度;然而,自我效能越强、理解度越佳、和有较好糖尿病的态度,则与五项以上的饮食行为配合度表现相关。特别的自我照顾行为,如女性在醣类计算上可能较男性佳(OR=5.75),在减少脂肪摄取上亦同(OR=2.57);病患参加较多次的营养教育课程, 则较可能遵循糖尿病饮食计划(OR=2.11),和糖尿病食物代换(OR=3.07)。需鼓励卫教者对糖尿病自我照顾行为教育的努力,和留意在病患人口统计学与社会心理学特质上的价值,以提升病患的配合度。
关键词:2 型糖尿病、台湾、自我照顾行为、病患教育和饮食配合度


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Diabetes self-care behaviours and clinical outcomes among Taiwanese patients with type 2 diabetes
CHUNG-MEI OUYANG, JOHANNA T DWYER, PAUL F JACQUES, LEE-MING CHUANG, CATHERINE F HAAS AND KATIE WEINGER
We examined the influences of patients’ background characteristics on the frequency of performing five diabetes self-care behaviours that 185 Taiwanese outpatients reported. All patients had type 2 diabetes diagnosed for more than a year and attended an outpatient clinic at a large university hospital where they had received at least one dietitian-led individual nutrition education session and one nurse-led diabetes education session during the course of their care. Seventy nine percent of the patients regularly (defined as responses often or always on the questionnaire) took their medications and over half followed recommended meal plans and exercised, but fewer performed foot care (38%) or checked their blood glucose levels (20%) regularly. The associations between patients’ demographics and disease-related characteristics and their performance of self-care behaviours were assessed with logistic regression. Although checking blood glucose levels and performing diabetes foot care were unrelated to any clinical outcome examined, patients who took their diabetes medications had lower hemoglobin A1c levels and fewer chronic complications than those who did not. Furthermore, patients who followed a diabetes meal plan also had lower hemoglobin A1c levels, and those who exercised regularly had healthier body mass indices (BMI) than those who did not.
Key Words: type 2 diabetes mellitus, Taiwan, self-care behaviours, patient education, clinical outcomes
 

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台湾2 型糖尿病患者自我照顾行为与临床结果
我们研究了185位台湾门诊病人的背景特征对五种糖尿病自我照顾行为表现频率的影响。所有受试者皆为到一所大学附属医院门诊就诊的被诊断为2 型糖尿病一年以上的患者,并且他们在就诊过程中曾经在门诊接受过至少一次营养师主导的个体营养教育会议和一次护士主导的糖尿病教育会议。79%的受试者有 规律服药(问卷调查回答为经常或总是),超过半数患者会遵守饮食和运动建议,但仅有少数患者做足部保健(38%)或自我血糖监测(20%)。采用逻辑回归方法分析患者的人口学和疾病相关特征与其自我照顾行为之间的相关性。虽然自我血糖监测和足部护理与临床结果并不相关,但按时服药的患者比不按时服药的患者有较低的糖化血色素值(A1C)和较少的慢性并发症。另外,遵循糖尿病饮食计划的患者也有较低的糖化血色素值,有规律运动者较未规律运动者有较健康的身体质量指数(BMI)。
关键词:2 型糖尿病、台湾、自我照顾行为、患者教育、临床结果

 

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Low haemoglobin levels contribute to low grip strength independent of low-grade inflammation in Japanese elderly women
ERIKO YAMADA, MIKA TAKEUCHI, MIKI KURATA, AYAKA TSUBOI, TSUTOMU KAZUMI AND KEISUKE FUKUO
Muscle strength declines with age. However, factors that contribute to such declines are not well documented and have not been extensively studied in elderly populations of Asian origin. Correlations of grip strength with a broad range of factors associated with declines in muscle strength were examined in 202 community-living elderly Japanese women. After adjustment for age, grip strength was positively correlated with body weight, height, serum albumin, haemoglobin, high-density lipoprotein cholesterol (HDL-C) and serum iron and inversely with serum copper, and log high-sensitivity C-reactive protein (hsCRP). Multiple linear regression analysis with grip strength as a dependent variable showed that 47.0% of variability of grip strength could be accounted for by height, age and haemoglobin in order of increasing R2. In conclusion, low haemoglobin may contribute to low muscle strength independently of age, anthropometric, nutritional, and inflammatory markers in the elderly, and may represent an important confounder of the association between grip strength and functional decline in community-living Japanese elderly women.
Key Words: grip strength, haemoglobin, height, age, elderly women
 

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日本老年妇女低血红蛋白水平是独立于轻度炎症影响低握力强度的因素
肌肉强度随年龄增长而下降。然而,导致这种下降的因素没有好的相关文献记录和广泛研究。该研究分析了202 名社区居住的老年日本妇女握力强度相关因素与肌肉强度下降的关系。结果表明调整了年龄的影响后,握力强度与体重、身高、血清白蛋白、血红蛋白、高密度脂蛋白胆固醇(HDL-C)、血清铁、血清铜的倒数、高敏C 反应蛋白(hsCRP)的对数呈正相关。多重线性回归分析显示:以握力强度作为因变量,依据增加的吻合度,握力强度的47%可以被身高、年龄和血红蛋白所解释。总之,在老年人群中,低血红蛋白是独立于年龄、人体测量学、营养和炎症标志物影响低肌肉强度的因素,对社区生活的日本老年妇女,低血红蛋白可能是握力强度和功能减退之间关系的一个重要混杂因子。
关键词:握力强度、血红蛋白、身高、年龄、老年妇女

 

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Anaemia prevalence over time in Indonesia: estimates from the 1997, 2000, and 2008 Indonesia Family Life Surveys
JONATHAN S BARKLEY, KATHERINE L KENDRICK, KAREN CODLING, SITI MUSLIMATUN AND HELENA PACHÓN
Objective: To summarize anaemia prevalence data for children, women, and men using data from the second, third and fourth waves of the Indonesia Family Life Surveys (IFLS), which were conducted in 1997/8, 2000, and 2007/8, respectively. Methods: Anaemia prevalence was determined for children 0 to 5 years, 5 to 12 years, 12 to 15 years, non-pregnant women at least 15 years, pregnant women at least 15 years, and men at least 15 years, based on haemoglobin adjusted for altitude and smoking status. Results: Compared with 1997/8 estimates, anaemia prevalence estimates were lower in 2007/8 for all groups, with the greatest relative decline occurring in children 5 to 12 years (25.4%). Trend analysis found anaemia significantly declined over the survey years for all groups (χ² p=0.005 for pregnant women, χ² p<0.001 for all other groups). Conclusions: IFLS anaemia estimates for different population groups decreased between 1997/8 and 2007/8 and were consistent with estimates from Southeast Asia, and with other studies conducted in Indonesia. While the prevalence of anaemia consistently decreased in all groups, anaemia remains a moderate public health problem for children 0 to 5 years, children 5 to 12 years, and non-pregnant and pregnant women.
Key Words: anaemia, haemoglobin, Indonesia, IFLS, Southeast Asia

 

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印尼歷年貧血盛行率:1997、2000 及2008 年印尼家庭生活調查估計
目的:本研究整理從1997/8、2000 及2007/8 年執行的第二次、第三次及第四次的印尼家庭生活調查(IFLS)獲得的兒童、女性及男性的貧血盛行率。方法:貧血盛行率為評估0-5 歲、5-12 歲、12-15 歲的兒童,至少15 歲以上的非懷孕及懷孕婦女以及至少15 歲以上的男性,以調整家戶所在地的海拔高度及抽菸狀況的血紅蛋白作為評量標準。結果:與1997/8 年的估計值相比,2007/8 年所有族群的貧血盛行率估計值均較低,其中在5-12 歲兒童有最大的相對降幅(25.4%)。趨勢分析發現全部族群的貧血顯著的隨著調查年份而降低(懷孕婦女X2 p=0.005,所有其他組別X2 p<0.001)。結論:從1997/8 到2007/8 年,不同族群的IFLS 貧血估計值與東南亞及其他印尼研究結果一致。儘管所有族群的貧血盛行率均降低,貧血依然是0-5 歲幼兒、5-12 歲兒童及非懷孕及懷孕婦女中等的公共衛生問題。
關鍵字:貧血、血紅蛋白、印尼、IFLS、東南亞


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Intake and major sources of dietary flavonoid in Korean adults: Korean National Health and Nutrition Examination Survey 2010-2012
YOU JIN KIM, MIN YOUNG PARK, NAMSOO CHANG AND ORAN KWON
With an effort to investigate possible relationship between flavonoids and health, an accurate estimation of flavonoid intake is valuable. We estimated dietary flavonoid intake and identified the major food sources. Subjects were healthy adults aged ≥19 y (n=11,474) who completed the 24-h dietary recall of the Korean National Health and Nutritional Examination Survey (2010-2012). The US Department of Agriculture and newly estimated or published values for typical Korean foods were combined into a Korean-targeted flavonoid database. The mean intake of total flavonoid was 107±1.47 mg/d, with a higher intake in women than in men after energy-adjustment. Quercetin, cyanidin, genistein, daidzein, epigallocatechin 3-gallate, epicatechin, hesperetin, and luteolin were identified as major flavonoid compounds. Across the age range studied, flavonols and flavones showed a reversed U-shape curve; flavan-3-ol and flavanones showed a decreasing pattern; and anthocyanidins and isoflavones showed an increasing pattern. Forty-five food items were identified as contributing >2% of at least one flavonoid compound’s intake. Kimchi was the major food source of total flavonoids, followed by green tea, persimmons, and soybeans. Single food items accounting for more than 50% of the intake of a specific flavonoid included persimmons (cyanidin), green tea (epigallocatechin, epicatechin-3-gallate, and epigallocatechin 3-gallate), black tea (thearubigin), tangerines (hesperetin and naringenin), and onions (isorhamnetin). This study provides information on Korean flavonoid intake to enable international comparisons, along with insight into how the sources and intake of various flavonoids vary according to age and gender. This work should facilitate future investigations of the association between flavonoid intake and health.
Key Words: flavonoid intake, major food source, adult, major food contributors, national survey
 

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韩国成年人膳食类黄酮摄入量和主要食物来源:韩国全国健康和营养检查调查2010-2012
为了探讨类黄酮与健康的关系,对类黄酮的摄入量进行准确估计是有价值的。我们估计膳食类黄酮摄入量,识别主要的食物来源。11474 名年龄≥19 岁的健康成年人完成了国家健康和营养检查调查(2010-2012)的24 小时膳食回顾调查。美国农业部及新近估计或公布的典型的韩国食品相关数据被整合进韩国有针对性的黄酮类化合物数据库。总黄酮平均摄入量为107±1.47 mg/d,经能量调整后女性比男性的摄入量更高。经鉴定槲皮素、飞燕草素、染料木素、大豆黄素、表没食子儿茶素3-酸酯、表儿茶素、橙皮素和木犀草素为主要的黄酮类化合物。在整个研究年龄范围内,黄酮醇和黄酮呈倒U 型曲线关系、黄烷-3-醇和黄烷酮类呈下降模式、花青素和异黄酮呈升高模式。经检测有45 种食品至少含1 种黄酮类化合物占该食物重2%以上。朝鲜泡菜是总类黄酮的主要食物来源,其次是绿茶、柿子和大豆。能解释50%以上特定类黄酮摄入的单一食物包括柿子(花青素)、绿茶(表儿茶素、表儿茶素 3-酸酯、表没食子儿茶素3-酸酯)、红茶(茶红素)、橘子(橙皮素和柚皮素)、洋葱(异鼠李素)。这项研究提供的韩国的类黄酮摄入量信息便于国际间的比较,同时还深入研究了食物来源和不同黄酮类化合物的摄入随年龄和性别的变化。这项工作对将来调查黄酮类化合物摄入量和健康之间的关系有一定促进作用。
关键词:类黄酮摄入、主要食物来源、成人、主要食物提供者、全国调查

 

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New data for vitamin D in Australian foods of animal origin: impact on estimates of national adult vitamin D intakes in 1995 and 2011-13
JERRY LIU, JAYASHREE ARCOT, JUDY CUNNINGHAM, HEATHER GREENFIELD, JAMES HSU, DAVID PADULA, NORBERT STROBEL AND DAVID R FRASER
Objectives: To assess the potential dietary supply of vitamin D to Australian adults by application of new data for Australian primary foods of animal origin. Methods: New published analytical data on the vitamin D contents of Australian primary foods from animal products were obtained and assessed for reliability. Using food consumption data from Australian population dietary surveys for 1995 and 2011-2013, estimates were made of the likely average daily intakes of vitamin D equivalents from these sources by Australian adults. Results: Meats, chicken, fish, eggs and dairy produce may alone have contributed about 4.2 μg vitamin D equivalents per day to average Australian diets of adults >18 years in 1995 and 4.3 μg in 2011-2013. Conclusions: Dietary vitamin D intake in Australia is likely to be higher than previously estimated because new data from improved analytical methods reveal the contributions to vitamin D supply from foods of animal origin. Absence of reliable vitamin D data for milk and milk products, and the gaps in vitamin D data for many commonly consumed seafood, poultry, eggs and processed animal products greatly limit estimation of dietary vitamin D intakes by Australians.
Key Words: vitamin D, animal origin foods, Australia, adult diets, dietary survey
 

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澳洲動物食物維生素D 新數據:對1995 及2011-13 年全國成人維生素D 攝取量估計的影響
目的:採用澳洲主要動物來源食物的新數據,以評估澳洲成人可能的維生素D 膳食供應。方法:新發表的澳洲主要動物製品其維生素D 含量資料收集及信度評估。食物攝取資料來自於1995 年及2011-2013 年澳洲族群的飲食調查,從澳洲成人的這些食物來源作為近似平均每日維生素D 當量攝取的估計值。結果:1995 年,>18 歲成人,僅肉類、雞、魚、雞蛋及乳製品,即可貢獻約4.2 μg 維生素D 當量,2011-2013 年則約4.3 μg。結論:由於改善動物來源食物的維生素D 含量分析方法,使得澳洲飲食維生素D 的攝取量似乎比之前的估計高。牛奶及乳製品缺乏可信的維生素D 數據,以及許多常吃的海鮮、家禽、蛋類及加工動物製品其維生素D 數據的分歧,使得澳洲人的維生素D 估算極其受限。
關鍵字:維生素D、動物來源食物、澳洲、成人飲食、飲食調查


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BMI and all-cause mortality among Chinese and Caucasians: the People’s Republic of China and the Atherosclerosis Risk in Communities Studies
EVA ERBER OAKKAR, JUNE STEVENS, KIMBERLY P TRUESDALE AND JIANWEN CAI
Background: Lower ethnic-specific body mass index (BMI) cutpoints have been proposed for Asians and adapted in some countries. However, to our knowledge, no study has directly compared Asians to other ethnic groups to test differences in associations between BMI and all-cause mortality using common methods. Objectives: We estimated the association between BMI and all-cause mortality in Chinese Asians and Caucasian Americans to determine if lower Asian-specific BMI cutpoints are warranted. Methods: Extant data of the People’s Republic of China Study (1983-1997) including 5546 Chinese and the Atherosclerosis Risk in Communities Study (1987-2002) including 9932 Caucasians aged 45-64 years at baseline were used. All analyses were performed using Cox proportional regression models. Results: Standardized mortality rates were 6.88 (95% confidence interval (CI): 5.75-8.24) and 5.50 (95% CI: 4.74-6.39) per 1000 person-years for Chinese and Caucasians, respectively. Standardized mortality probabilities by age 70 were similar across all BMI categories among Chinese. Furthermore, the probabilities were similar to those among Caucasians with BMI of 27.5-<32.5 kg/m2. The BMI associated with lowest mortality risk was almost identical between Chinese (25.1 kg/m2) and Caucasians (25.2 kg/m2). The analysis of categorical BMI did not reveal an increased mortality risk at any BMI category among Chinese. In contrast, compared to those with a BMI of 23.0-<25.0 kg/m2, risk was elevated by 35% among Caucasians with a BMI of 30.0-<32.5 kg/m2. Conclusions: These findings do not support different BMI cutpoints for Chinese than Caucasians on the basis of mortality rates.
Key Words: body mass index, all-cause mortality, Chinese, Caucasians, BMI cutpoint
 

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华人和高加索人的BMI 与全因死亡率:中华人民共和国动脉粥样硬化风险的社区研究
背景:一些亚洲国家已经使用了比西方国家低的体质指数切点。但是,据我们所知,还没有研究在亚洲人和其他种族人群中直接使用同样的分析方法来比较体质指数与全因死亡率之间的关系。目的:通过比较华人和高加索人体质指数与全因死亡率之间的关系来判断是否亚洲人适用较低的体质指数切点。方法:使用Cox 比例回归模型分析了5546 名45-64 岁的中国华人和9932 美国高加索人的随访研究数据。结果:华人和高加索人的标化死亡率分别为6.88/1000 人年(95% 可信区间:5.75-8.24/1000 人年)和5.50(95%可信区间:4.74-6.39/1000 人年)。在小于70 岁的华人中,不同体质指数组的标化死亡率相似,另外,其概率与体质指数为27.5 至 <32.5 的美国高加索人相似。华人和美国高加索人分别在体质指数为25.1 和25.2 时死亡风险最低。华人的死亡风险不随体质指数的增加而增加;而在美国高加索人群中,与体质指数为23.0-<25.0 的人相比,体质指数为30.0-<32.5 的人的死亡风险增加了35%。结论:这些研究结果不支持在中国人群中使用和高加索人群不同的体质指数切点。
关键词:体质指数、全因死亡率、华人、高加索人、体质指数切点

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The correlation between high body mass index and survival in patients with esophageal cancer after curative esophagectomy: evidence from retrospective studies
WENBIAO PAN, ZHIYONG SUN, YANGWEI XIANG AND WENTAO FANG
Objective: To investigate the predictive value of high body mass index (H-BMI) on the survival of patients with esophageal cancer (EC) after curative esophagectomy. Methods: Studies were systematically identified to investigate the relationship between overweight and obese (H-BMI) and clinical outcomes in EC patients treated with curative esophagectomy. Measured clinical outcomes were disease-free survival (DFS) and overall survival (OS). The pooled hazard ratio (HR) with 95% confidence interval (CI) was estimated. Subgroup analyses were performed according to tumour type and body mass index (BMI). Results: Fourteen studies with 4823 cases were included in the final pooled quantitative analysis. In EC patients overall, H-BMI was associated with improved DFS (HR, 0.83; 95% CI: 0.75-0.90) and OS (HR, 0.79; 95 % CI: 0.73-0.85), as compared with normal BMI. The results were consistent with those who were overweight. Among patients with esophageal adenocarcinoma (EAC), a better prognosis, as reflected by OS, was observed with H-BMI (HR, 0.81; 95% CI: 0.73-0.89). The same results were also observed in EAC patients who were obese and overweight. In contrast, among patients with esophageal squamous cell carcinoma (ESCC), H-BMI was associated with a worse prognosis, as reflected by DFS (HR, 2.26; 95% CI: 1.29-3.24). Conclusions: H-BMI has distinctly different impacts on the postoperative survival of EAC and ESCC patients. H-BMI is a potential predictor for better prognosis in EC patients overall, and particularly in EAC patients, treated with curative esophagectomy. However, in ESCC patients, H-BMI is a potential predictor for a worse prognosis of postoperative survival.
Key Words: high body mass index, survival, esophageal cancer, esophagectomy, pooled quantitative analysis
 

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高体重指数与食管癌根治性切除术后患者生存关系的回顾性研究
目的:探讨食管癌患者术前高体重指数(high body mass index,H-BMI)对食管癌根治性切除术后长期生存的影响及其预测价值。方法:通过系统、全面的文献检索,收集已公开发表的有关食管癌患者术前H-BMI(包括超重和肥胖)对术后生存期影响的所有临床研究,按累计定量分析的要求对检索到的原始研究的质量进行评估,对符合条件的所有研究结果进行累计定量分析,计算数据合并后的H-BMI 对正常BMI 的危险比(hazard ratio,HR)及95% 置信区间(confidence interval,CI) ,并根据体重指数(body mass index,BMI)及食管癌亚型进行亚组分析,评价术前H-BMI 对食管癌患者根治性切除术后生存期的影响。结果:共14 篇文献符合纳入标准,总样本量4823 例。累计定量分析结果表明,H-BMI 改善了总体食管癌患者术后无疾病生存率( disease-free survival , DFS ) 和总体生存率( Overall survival ,OS),合并的HR 分别为0.83(95% CI:0.75-0.90)和0.79(95% CI:0.73-0.85);在亚组分析的超重患者中也得出了相似结果。根据肿瘤亚型进一步分层分析发现,H-BMI 显著改善了食管腺癌患者术后OS,合并的HR 为0.8195% CI:0.73-0.89),在超重和肥胖的亚组分析中也得出了相似的结果。然而在食管鳞癌中,术前H-BMI 缩短了患者术后DFS,合并的HR 为2.26 (95% CI:1.29-3.24)。结论:H-BMI 对食管鳞癌和食管腺癌患者术后长期生存的影响完全不同。H-BMI 是食管癌总体、特别是食管腺癌术后生存预后较佳的一个潜在性预测指标,而对食管鳞癌来说,H-BMI 则预示着较差的术后生存。
关键词:高体重指数、生存、食管癌、食管切除术、累计定量分析
 

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Interrelationship between glucose metabolism and undercarboxylated osteocalcin: a cross-sectional study in a community-dwelling population
SHOZO YANO, TORU NABIKA, ATSUSHI NAGAI, TSUYOSHI HAMANO, MASAYUKI YAMASAKI, MINORU ISOMURA, KUNINORI SHIWAKU, SHUHEI YAMAGUCHI, TORU YAMAGUCHI AND TOSHITSUGU SUGIMOTO
Objective: Undercarboxylated osteocalcin (ucOC) produced from the bone was recently found to play a regulatory role in the insulin and adiponectin secretion. We performed a cross-sectional study to investigate the relationship between ucOC and diabetes mellitus (DM). Methods: We included 1,870 subjects aged over 50 from participants of a health examination. According to the current medication and past history, 605 subjects had hypertension (HT), 316 had dyslipidemia (DL), and 182 had type 2 DM. Fasting blood samples were collected to measure concentrations of ucOC and the bone turnover marker, tartrate-resistant acid phosphatase 5b (TRACP5b) by ELISA. Results: The serum ucOC level was significantly lower in DM(+) than DM(-) in both men and women. In a logistic regression analysis, a low level of ucOC was significantly associated with the presence of DM in both men and women after adjusting for age, BMI, serum creatinine, triglyceride, and TRACP5b. Multiple regression analysis showed a negative association of ucOC with HbA1c and fasting plasma glucose, and a positive association with the insulin level. In contrast, no association was found between TRACP5b and the indices above, suggesting that the effect of ucOC on the insulin secretion and the glycemic status was independent of bone turnover. Conclusions: The present cross-sectional study showed a significant association between ucOC and glucose metabolism after correction with bone turnover in a community-dwelling population both in men and women, indicating that ucOC may play an important role in the pathogenesis of DM through the pathways independent of bone metabolism.
Key Words: undercarboxylated osteocalcin, glucose metabolism, diabetes mellitus, bone metabolism, TRACP5
 

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葡萄糖代謝與未羧化骨鈣素之相關:一個社區族群的橫斷性研究
目的:近期,骨頭生成的未羧化骨鈣素(ucOC)被發現扮演胰島素及脂聯素分泌的調節角色。我們執行一個橫斷性研究以探討ucOC 與糖尿病的相關性。方法:此研究納入1870 名大於50 歲來自健康檢查的參與者。根據目前藥物治療及過去病史,605 名研究對象有高血壓(HT)、316 名有血脂異常(DL)及182 名有第2 型糖尿病。收集禁食血液樣本以ELSA 測量ucOC 及骨轉換標記、抗酒石酸磷酸酶5b(TRACP5b)濃度。結果:男女性糖尿病患者比起非糖尿病患者都有顯著較低的血清ucOC 濃度。以羅吉斯迴歸分析,校正年齡、BMI、血清肌酸酐、三酸甘油酯及TRACP5b 後,發現男女性低濃度的ucOC 與糖尿病有顯著相關。複迴歸分析顯示ucOC 與HbA1c、禁食血糖為負相關,與胰島素濃度則為正相關。反之,並未發現與TRACP5b 以及上述指標的相關性,意指ucOC 對胰島素分泌及血糖狀態的影響是獨立於骨轉換。結論:此橫斷性研究顯示在社區的男女性,校正骨轉換後,ucOC 及葡萄糖代謝的顯著相關性,這顯示ucOC 可能透過獨立於骨代謝的途徑扮演糖尿病致病重要的角色。
關鍵字:未羧化骨鈣素、葡萄糖代謝、糖尿病、骨代謝、TRACP5
 

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A meta-analysis combining parallel and cross-over randomized controlled trials to assess impact of iodine fortified foods on urinary iodine concentration among children
RAMESH ATHE, VISHNU VARDHANA RAO MENDU AND MADHAVAN NAIR KRISHNAPILLAI
The purpose of this analysis was to combine evidence from parallel and cross-over randomized controlled trials to assess the impact of iodine fortified foods on urinary iodine concentration (UIC) in children. A structured search for studies on iodine intervention studies on MEDLINE, Pro Quest, and the Cochrane Library from Jan, 1990 to Dec, 2012 was carried out. Carry-over effect was estimated by general linear model. We explored two methods to pool continuous outcomes in a meta-analysis by combining parallel and cross-over trial designs. The standard mean difference was calculated for net change in UIC. Fixed or random-effects models were used to summaries fortified food response data. Meta-regression and covariate meta-analysis were performed to explore the influ-ence of confounders on the net pooled effect on UIC. The overall pooled estimate, which combined parallel with cross-over trials in the absence of carry-over effect of UIC from 9 studies, showed a significant increase in the fortified group compared with the control group (n=3448; standard mean difference=2.02 μg/L; 95% CI: 1.30, 2.73; I2=99%, τ2=1.81, p<0.01). Meta-regression analysis indicated that dose of the feeding was positively related to the effect size (regression coefficient=0.014; 95% CI: 0.003, 0.026; p<0.019). The net pooled effect size after removing the confounders was 1.59 (95% CI: 0.953, 2.23) μg/L. There was an association between intakes of io-dine fortified foods and UIC in children. These results suggest that we can combine parallel with cross-over trials for meta-analysis for nutrients such as iodine when absorption is high.
Key Words: iodine fortification, meta-analysis, carry-over effect, meta-regression, covariate meta-analysis
 

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碘强化食品对儿童尿碘浓度的影响评估:一项结合平行和交叉随机对照试验的meta分析
本分析的目的是结合平行和交叉随机对照试验的证据,评估碘强化食品对儿童尿碘浓度(UIC)的影响。进行结构化搜索MEDLINE、Pro Quest和Cochrane数据库中收录的1990年1月份到2012年12月份发表的碘干预研究。采用一般线性模型评估延滞效应。我们通过将平行和交叉试验设计相结合,在一个meta分析中探讨出两种合并连续结果的方法。计算UIC净变化的标准平均差。用固定或随机模型汇总强化食品反应数据。用meta回归和协变量meta分析探讨混杂因素对UIC净合并效应的影响。结合没有UIC延滞效应的9个平行和交叉试验分析结果显示:与对照组相比,强化组整体综合评估显著增加(n=3448,标准平均差=2.02 μg/L; 95% CI:1.30,2.73;I2=99%,τ2=1.81,p<0.01)。Meta回归分析表明,干预剂量与影响大小成正相关(回归系数=0.014,95% CI:0.003,0.026;p<0.019)。去除混杂因素后的净合并效应为1.59(95% CI:0.953, 2.23)μg/L。碘强化食品摄入与儿童UIC有关。这些结果表明,当营养素(比如碘)吸收率高时,我们可以将平行和交叉试验结合起来进行meta分析。
关键词:碘强化、meta分析、延滞效应、meta回归、协变量meta分析
 

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Standard values of rapid turnover proteins and zinc in Japanese children
KEI YAMAMOTO, NORIHIKO KITAGAWA AND TETSUYA TAKAMASU
Measurement of rapid-turnover proteins has an established place in nutrition assessment and is partly dependent on the zinc metallo-enzymes involved. We investigated the reference values of rapid turnover proteins and zinc in Japanese children. This cross-sectional study was conducted at a single center. We collected data from children aged 0 to 12 years with inguinal hernia, umbilical hernia, or hydrocele of the spermatic cord, who had body mass index z scores of -2 to 2. The standard references (mean±2 SD) of transthyretin were 11.5-21.5 mg/dL in infants (≤1.5 years), 13.6-21.5 mg/dL in preschool children (1.6-6 years), and 12.3-23.4 mg/dL in preadolescent children (6.1-12 years). The standard references of retinol binding protein were 1.27-2.55 mg/dL, 1.28-2.54 mg/dL, and 1.27-2.44 mg/dL in each age group, respectively. Rapid turnover proteins did not differ significantly in each group. The transthyretin level was weakly correlated with aging (r=0.284, p=0.003) and estimated lean body mass (r=0.274, p=0.004). Retinol-binding protein was not correlated with aging and anthropometric parameters. We established reference values for rapid turnover proteins with known zinc status in Japanese children. These values were not, or only weakly, correlated with anthropometric parameters for assessing protein energy malnutrition.
Key Words: children, retinol binding protein, transthyretin, zinc, Japanese
 

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日本兒童微量蛋白質與鋅的標準值
微量蛋白質的測量是營養評估的一環,它的營養狀況部分取決於鋅金屬酶。本研究探討日本兒童微量蛋白質與鋅的參考值。這個橫斷性研究在單一中心進行。我們收集腹股溝疝氣、臍疝氣或是精索鞘膜積液(水疝),且身體質量指數z 分數界於-2 至2 的0-12 歲兒童的數據。甲狀腺素運載蛋白的標準參考值(平均值±2 標準差)嬰兒(1.5 歲)為11.5-21.5 mg/dL、學齡前兒童(1.6-6 歲)為13.6-21.5 mg/dL、青春期前兒童(6.1-12 歲)為12.3-23.4 mg/dL。各年齡層的視網醇結合蛋白的標準參考值分別為1.27-2.55 mg/dL、1.28-2.54 mg/dL 及1.27-2.44 mg/dL。微量蛋白質在各組並沒有顯著差異。甲狀腺素運載蛋白濃度與年齡( r=0.284 , p=0.003 ) 及推估的瘦體組織(r=0.274,p=0.004)有弱相關。視網醇結合蛋白與年齡及體位測量值沒有相關性。我們建立日本兒童的微量蛋白質的參考值並確認鋅的狀況。這些數值與評估蛋白質能量營養不良的體位測量值沒有或僅是弱相關。
關鍵字:兒童、視網醇結合蛋白、甲狀腺素運載蛋白、鋅、日本人

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Is parental body weight related with their children’s overweight and obesity in Gao Hang Town, Shanghai?
YANPING WAN, RENYING XU, HAIXIA FENG, YIQUAN ZHOU, XIAOMIN ZHANG, LIPING LU, TAO TAN, YING JIANG, ZHIQI CHEN AND YINGJIE WU
Objectives: This study aimed to evaluate the relationship between parental body weight and their children’s overweight and obesity in school students in Gao Hang Town, Shanghai. Methods: A cross-sectional study was performed in five primary schools in Gao Hang Town, Shanghai. Overall, 2,025 sets of parents and their children (7-13 years, 981 boys/1044 girls) were enrolled. Body mass index (BMI) and waist circumference for each child were measured. Age, gender, birth weight, and breastfeeding history was recorded for each child and the BMI of their parents was obtained by a self-completion questionnaire. Overweight (including obesity) was defined as a BMI of ≥24.0 kg/m2 in parents and a BMI ≥P85 in children according to age- and gender-specific percentiles. Re-sults: The total prevalence of overweight was higher in boys than in girls (35.5% vs 19.5%), while it was the same in fathers compared with mothers (50.6% vs 18.9%). The prevalence of overweight in boys showed a trend with increasing age, but remained stable versus age in girls. Parents were further divided into four subgroups as follows: I) both father and mother had a normal BMI; II) father overweight, mother normal weight; III) father normal weight, mother overweight; IV) both father and mother are overweight. The odds ratio of overweight was 2.26 for group II, 2.71 for group III, and 4.36 for group IV, respectively, compared with group I. Gender, paternal BMI, and maternal BMI were chosen as risk factors for children overweight. Conclusions: Parental BMI affects their offspring overweight and obesity in Chinese school students.
Key Words: overweight, children, parents, body mass index, waist circumference
 

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上海市高行镇父母体重与其子女超重和肥胖有关吗?
目的:以上海市高行镇在校学生为研究对象,观察父母体重与儿童超重和肥胖之间的关系。方法:采用横断面研究方法对上海市高行镇5所小学学生进行调查。总共2025名在校学生(7-13岁,男生981/女生1044)和他们的父母纳入本研究。每位学生均测量身高、体重和腰围。学生年龄、性别、出生体重、母乳喂养史和父母身高、体重由调查问卷获得。体质指数(Body mass index,BMI)=体重(kg)/身高(m)2。父母超重(包括肥胖)的诊断标准为:BMI≥24.0 kg/m2;小学生超重(包括肥胖)的诊断标准则为:BMI≥同龄同性别第85百分位值。结果:男生超重发生率明显高于女生(35.5% vs 19.5%)。与之相类似,父亲超重发生率也明显高于母亲(50.6% vs 18.9%)。男生超重发生率随着年龄增高而逐步升高,女生超重发生率则保持稳定。依据父母的BMI将2025名在校学生分为四组:I) 学生父母双方BMI都处于正常范围;II) 学生父亲超重,母亲BMI处于正常范围;III) 学生父亲BMI处于正常范围,母亲超重;IV) 学生父母双方均超重。同第一组儿童相比,第二、三、四组儿童发生超重的风险因素分别为2.26、2.71和4.36。Logistic回归分析显示性别、父亲和母亲的BMI是儿童发生超重的危险因素。结论:以上海在校学生为研究对象,结果显示父母双方的BMI均是子女发生超重和肥胖的风险因素。
关键词:超重、儿童、父母、体质指数、腰围

 

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Polychlorinated biphenyl and heavy metal exposures among fishermen in the Straits of Malacca: neurobehavioural performance
ALINA MOHAMAD, AZRINA AZLAN, MOHD YUSOFF ADON, HOCK ENG KHOO AND MUHAMMAD RIZAL RAZMAN
The aim of this study was to determine the level of exposure to polychlorinated biphenyls (PCBs) and selected heavy metals among fishermen via dietary intake of fish and other seafood from the eastern coast along the Straits of Malacca. This study determined the neurobehavioural performances (based on neurobehavioural core test battery scores) of the fishermen and evaluated the correlations between scores of neurobehavioural core test battery and exposure factors. Ninety fishermen participated in the study. The total fish intakes of the fishermen were measured using a set of food frequency questionnaires. The PCBs contents in the seafood samples ranged between 0.2 and 0.6 pg/g fresh sample. The concentrations of mercury (Hg), arsenic (As), cadmium (Cd), and lead (Pb) in the seafood samples were 1.1-5.4, 0.3-4.4, 0.6-36.1, and 0.02-0.3 μg/g fresh sample, respectively. The PCBs, Hg, As, Cd, and Pb exposures of the fishermen was estimated to be 2.8, 0.02, 4.5, 0.09, and 0.5 pg/kg body weight/day, respectively. PCB and heavy metal exposures through dietary intake of fish and seafood were within the tolerable daily limits. The results of neurobehavioural core test battery revealed that the neurobehavioural performances of the fishermen were not affected due to PCB and heavy metal intoxication. No correlations were found between the exposure and neurobehavioural performance among the fishermen. These data are useful for policy makers to assure the safety and quality of seafood in relation to sea pollution. Although the levels of exposure were low, periodic assessment of the quality of fish and fish products is required due to the polluted seawater.
Key Words: fish, fishermen, heavy metal, neurobehavioural, polychlorinated biphenyl
 

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马六甲海峡渔民的多氯联苯和重金属暴露:神经行为表现
本研究的目的是根据渔民从马六甲海峡东海岸获取的鱼和其他海鲜的膳食摄入量来确定其暴露于多氯联苯(PCBs)和选定的重金属的水平。这项研究探讨了渔民们的神经行为表现(基于神经行为核心测试分),并评估该神经行为核心测试成绩和暴露因素之间的相关性。九十渔民参与了这项研究。用食物频率问卷测量渔民们的总鱼摄入量。海鲜样品多氯联苯的含量介于0.2 和0.6 pg/g 新鲜样品。海鲜样品中的汞、砷、镉和铅的浓度分别为1.1-5.4、0.3-4.4、0.6-36.1 和0.02-0.3 μg/g 新鲜样品。渔民们的多氯联苯、汞(Hg)、砷(As)、镉(Cd)和铅(Pb)暴露估计分别为2.8、0.02、4.5、0.09 和0.5 pg/kg 体重/天。渔民们每日多氯联苯和重金属通过鱼和海鲜膳食摄入的暴露量均在可接受的限度内。他们的神经行为核心测试结果显示渔民们的神经行为表现不受多氯联苯和重金属中毒的影响。渔民们的神经行为表现与该暴露没有相关性。这些数据有利于政策制定者确保与海洋污染有关的海产品的安全和质量。虽然该暴露水平较低,由于海水受到污染,定期评估鱼和鱼产品质量是必要。
关键词 :鱼、渔民、重金属、神经行为、多氯联苯

 

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Effectiveness of a public dietitian-led diabetes nutrition intervention on glycemic control in a community setting in China
HUAQING LIU, MIN ZHANG, XUESEN WU, CHUNHUA WANG AND ZHONG LI
Objective: Diabetes mellitus requires lifelong treatment, most of which is accomplished in family and community settings. The present study was designed to identify the effectiveness of nutrition intervention provided by public dietitian on glycemic control in a community setting in China. Methods: Two communities were selected and randomly assigned to a routine care group (59 subjects) and a public dietitian-led intervention group (58 subjects) who received diabetic nutrition management for one year. The main measures included fasting plasma glucose, HbA1c, weight, body mass index (BMI), lipid profile, and blood pressure. Results: In the intervention group, there was significant improvement in fasting plasma glucose, HbA1c, cholesterol, and triglyceride levels relative to the control subjects (p<0.05). Over the 12-month period, there was a decrease in energy intake, including reductions in absolute amounts (grams) of protein and fat in the intervention group. The energy percent values of carbohydrate, protein, and fat were 50.7%, 17.0%, and 32.3%, respectively, at baseline and 53.0%, 17.1%, and 29.9% (within the recommended range) after the intervention. There were significant improvements in total energy, absolute amounts of fat and protein, and the energy percent values of carbohydrates and fat. In the control group, however, these values were similar before and after the intervention, and the energy percent values of fat were still above the recommended range. Conclusions: In a community setting, a diabetes nutrition intervention led by a public dietitian significantly improved the glycemic control of type 2 diabetic patients.
Key Words: diabetes, public dietitian, diet, nutrition, community
 

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公共营养师主导的一个社区糖尿病营养干预血糖控制的有效性
目的:作为一种需要终身治疗的慢性疾病,糖尿病患者的大部分治疗时间是在家庭和社区中度过的。本研究旨在探索公共营养师提供的营养干预对社区2型糖尿病患者血糖控制的影响。方法:2个社区被随机分配到常规组(n=58)和干预组(n=59),干预组接受公共营养师主导营养管理1年,评价指标包括空腹血糖、HbA1c、BMI、体重、血脂、血压。结果:与对照组相比,干预组空腹血糖、HbA1c、胆固醇和甘油三酯水平显著改善(p<0.05)。干预组碳水化合物、蛋白质和脂肪供能比分别由干预前的50.7% 、17.0% 和32.3% 变为53.0%、17.1%和29.9%,调整到糖尿病营养治疗指南推荐范围内;总能量、脂肪和蛋白质摄入量显著降低,碳水化合物和脂肪供能比显著改善,而对照组这些指标干预前后无显著变化,脂肪供能比仍然超出指南推荐范围。结论:公共营养师主导的糖尿病营养干预能显著改善社区2型糖尿病患者血糖控制。
关键词:糖尿病、公共营养师、饮食、营养、社区

 

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Identifying barriers to the implementation of nutrition education in South Korea
JOUNGHEE LEE AND YOUNGSUN HONG
To improve the nutritional status of children and adolescents, it is critical to identify the barriers to the implementation of nutrition education in schools. We carried out a cross-sectional study by analyzing data from 121 subjects (45 nutrition teachers and 76 school dietitians). Among the personal, environmental and systematic barriers, the top four barriers to the implementation of nutrition education were heavy workload (4.28 points), lack of a systematic curriculum (4.12 points), lack of perception of nutrition education by school administrators and teachers (4.07 points), and lack of continuing education for nutrition teachers and school dietitians (4.05 points). Additionally, poor working conditions, such as low pay, were identified as significant barriers to nutrition education for school dietitians compared with nutrition teachers (4.33 vs 3.47 points, p<0.001). This research provides useful information for nutrition policy makers to promote nutrition education in schools in South Korea.
Key Words: barriers, nutrition education, nutrition teacher, school dietitian, South Korea
 

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確認南韓執行營養教育的障礙
為了改善兒童及青少年的營養狀況,確認學校執行營養教育時面臨的障礙是必要的。我們執行一個橫斷性研究,共分析121 名研究對象(45 名營養學教師及76 名學校營養師)。在個人、環境及系統障礙間,執行營養教育的前四個障礙為工作負荷量大(4.28 分)、缺乏系統性課程(4.12 分)、學校行政人員及教師缺乏對營養教育的認知(4.07 分)、營養學教師及學校營養師缺乏繼續教育(4.05 分)。此外,相較於營養學教師,工作條件差,例如低薪,被認為是學校營養師執行營養教育的顯著障礙(4.33 vs 3.47 分,p<0.001)。這個研究提供營養政策制定者在促進南韓學校營養教育上有用的訊息。
關鍵字:障礙、營養教育、營養學教師、學校營養師、南韓

 

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The adherence of packaged food products in Hyderabad, India with nutritional labelling guidelines
ELIZABETH K DUNFORD, RAMA K GUGGILLA, ANENTA RATNESWARAN, JACQUELINE L WEBSTER, PALLAB K MAULIK AND BRUCE C NEAL
Background: India is experiencing a nutrition transition with the consumption of processed foods rapidly increasing. Nutrition labels are essential if consumers are to understand the healthiness of these products. The Food Safety and Standards Authority of India have recently introduced regulation defining national nutrition labelling requirements and Codex Alimentarius recommends a global standard. Objectives: To quantify the adherence of the declared nutrients on Indian packaged foods with national and global requirements. Methods: The presence or absence of data for seven required nutrients was recorded for all food products available for sale. Branches of three major retail chains and three smaller stores in Hyderabad, India between October and November, 2010 were surveyed. Results: Data were collected for 4166 packaged products that fell into 14 different food groups. 52% of products displayed nutrient information on energy, protein, carbohydrate, sugar and total fat, meeting the minimum requirements of the Food Safety and Standards Authority of India. Only 27% met the minimum criteria defined by Codex which also requires the reporting of saturated fat and sodium. There was significant variation in compliance for leading brands, country of manufacture and food group (p<0.01 for all). Conclusions: The majority of Indian packaged foods do not meet national and international nutrient labelling guidelines. With the Indian population likely to consume much more packaged food over coming years full and effective food labelling will be essential. The failure of Indian legislation to require labelling of sodium and saturated fat may warrant review.
Key Words: nutritional labelling, processed foods, Codex Alimentarius, India, labelling regulation
 

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印度海得拉巴包装食品对营养标签指南的遵守
背景:印度正在经历一个加工食品消费量迅速增加的营养转型。营养标签是消费者了解这些产品是否健康必不可少的。印度食品安全和标准局最近推出条例,规定了国家营养标签要求和食品法典委员会建议的国际标准。目的:其目的是量化印度包装食品对国家和国际要求的营养素声称的遵守。方法:调查2010 年10 月到11 月期间印度海得拉巴的三大连锁零售超市和三个小商店的所有在售食品,登记所要求的七大必需营养素资料是否存在。结果:共收集了14 个不同的食物组,4166 种包装食品。其中52%的产品标示了能量、蛋白质、碳水化合物、糖和总脂肪等营养信息,满足了印度食品安全和标准局的最低要求。只有27%的产品报告了饱和脂肪和钠,满足食品法典委员会的最低标准。领导品牌、生产国家和食品组之间有显著差异(p<0.01)。结论:大多数印度的包装食品不符合国家和国际营养标签指南。随着印度人口在未来几年消费更多的包装食品,全面有效的食物标签是必不可少的。印度立法要求钠和饱和脂肪标签的失败可能值得审查。
关键词:营养标签、加工食品、食品法典委员会、印度、标签法规

 

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Diets high in carbohydrate may not be appropriate for rs328 G carriers with the metabolic syndrome
SHIXIU ZHANG, YIYI MA, HONGWEI GUO, WENTAO WAN AND KUN XUE
The objective of this study was to test how the genetic polymorphisms located within the lipoprotein lipase (LPL) locus would modulate the relationship between a diet high in carbohydrate and insulin resistance related traits in metabolic syndrome adults. A one year nutritional intervention study focusing on education to increase dietary intake of whole grain, vegetable and fruit, and to reduce the intake of sodium, simple sugar and dietary fat (especially cooking oil and pork lard) was conducted. Two districts in Shanghai, China were randomly selected to be the intervention and control group, and patients (n=235) with metabolic syndrome within these two districts were selected based on a multistage sampling method. Fasting glucose was reduced in rs328 CC homozygotes (p=0.028) but not G carriers (p=0.686) within the intervention group. Also an ancillary study with greater statistical power by combining the baseline measurements across both the intervention and control groups was conducted to test the cross-sectional statistical interactions between carbohydrate/fat and lipoprotein lipase genotypes for homeostasis model assessment of insulin resistance/insulin/fasting glucose. Increased carbohydrate intakes were positively associated with homeostasis model assessment of insulin resistance and insulin in rs328 G carriers but not CC homozygotes (p for interaction was 0.025). These results indicate that diet high in carbohydrate may not be suitable for metabolic syndrome rs328 G carriers, calling for the development of personalized dietary intervention for metabolic syndrome subjects.
Key Words: gene-by-diet interaction, carbohydrate, lipoprotein lipase, metabolic syndrome, insulin resistance
 

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高碳水化合物的饮食可能不适合携带rs328 G 等位基因的代谢综合征患者
本研究旨在探讨代谢综合征人群脂蛋白脂酶基因多态性在调节高碳水化合物饮食与胰岛素抵抗相关参数中的作用。通过多阶段抽样的方法,在上海市的两个城区筛选出代谢综合征患者,并将筛选出的研究对象按照区域划分为对照组和干预组(n=235)。营养干预期为一年,旨在教育研究对象增加全谷类食物、蔬菜、水果的摄入,减少钠、单糖和膳食脂肪(尤其是烹调油和猪油)的摄入。干预组rs328 CC 基因型患者空腹血糖降低(p=0.028),而rs328 G 等位基因携带者血糖没有显著变化(p=0.686)。同时,本文还对合并了干预组和对照组的基线资料进行了一个横断面研究分析,分析碳水化合物或脂肪与脂蛋白脂酶基因多态对稳态模型评估的胰岛素抵抗指数/胰岛素/空腹血糖的交互作用。碳水化合物摄入量与稳态模型评估的胰岛素抵抗指数在rs328 G 等位基因携带者中呈正相关,而在CC 基因型患者中没有关联(交互作用p=0.025)。上述分析结果表明,高碳水化合物饮食可能不适合携带rs328 G 等位基因的代谢综合征患者,不同基因型的代谢综合征患者可能需要不同的饮食方案。
关键词:基因膳食交互作用、碳水化合物、脂蛋白脂酶、代谢综合征、胰岛素抵抗

 

 

 

 

 

Last Updated: September 2015