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1 Asia Pacific Journal of Clinical Nutrition
       Volume 24, 4

         (December 2015)


Abstracts

Contents

Abstract PDF

Reviews

Preferred ecosystem characteristics: their food and health relevance to China’s rapid urbanisation
VALERIE GIBSON, YONG-GUAN ZHU, RUBING GE AND MARK L WAHLQVIST
Asia Pac J Clin Nutr. 2015;24(4):556-574.

doi: 10.6133/apjcn.2015.24.4.29

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Original Research Communications

Clinical Nutrition or Feeding Studies

Garlic intake lowers fasting blood glucose: meta-analysis of randomized controlled trials
LI-QIONG HOU, YUN-HUI LIU AND YI-YI ZHANG
Asia Pac J Clin Nutr. 2015;24(4):575-582.

doi: 10.6133/apjcn.2015.24.4.15

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Peri-operative immunonutrition in patients undergoing liver transplantation: a meta-analysis of randomized controlled trials
QIUCHENG LEI, XINYING WANG, HUAZHEN ZHENG, JINGCHENG BI, SHANJUN TAN AND NING LI
Asia Pac J Clin Nutr. 2015;24(4):583-590.

doi: 10.6133/apjcn.2015.24.4.20

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Preoperative Nutritional Risk Index to predict postoperative survival time in primary liver cancer patients
YACONG BO, MINGJIE YAO, LING ZHANG, WOLDE BEKALO SAPA, WEIQUAN LU AND QUANJUN LU

Asia Pac J Clin Nutr. 2015;24(4):591-597.

doi: 10.6133/apjcn.2015.24.4.26

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Relationship between pre-treatment nutritional status, serum glutamine, arginine levels and clinicopathological features in Taiwan colorectal cancer patients
YI-PING PAN, PEI-HUNG CHANG, CHUNG-WEI FAN, WEN-KO TSENG, JEN-SENG HUANG, CHIH-HUNG CHEN, WEN-CHI CHOU, CHENG-HSU WANG AND KUN-YUN YEH

Asia Pac J Clin Nutr. 2015;24(4):598-604.

doi: 10.6133/apjcn.2015.24.4.23

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The adductor pollicis muscle: a poor predictor of clinical outcome in ICU patients
CLAUDIA LEONG SHU-FEN, VENETIA ONG, YANIKA KOWITLAWAKUL, TEH AI LING, AMARTYA MUKHOPADHYAY
AND JEYA HENRY
Asia Pac J Clin Nutr. 2015;24(4):605-609.

doi: 10.6133/apjcn.2015.24.4.22

 

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Association between nutrient adequacy and psychosocial factors with overall rate of weight loss after bariatric surgery
DIVYA VANOH, SUZANA SHAHAR AND NIK RITZA KOSAI NIK MAHMOOD
Asia Pac J Clin Nutr. 2015;24(4):610-619.

doi: 10.6133/apjcn.2015.24.4.11

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Effect of cooling of cooked white rice on resistant starch content and glycemic response
STEFFI SONIA, FIASTUTI WITJAKSONO AND RAHMAWATI RIDWAN
Asia Pac J Clin Nutr. 2015;24(4):620-625.

doi: 10.6133/apjcn.2015.24.4.13

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Association of cystatin C with leptin and TNF-α in elderly Japanese women
AYAKA TSUBOI, MIKA TAKEUCHI, MAYU TERAZAWA-WATANABE, KEISUKE FUKUO AND TSUTOMU KAZUMI
Asia Pac J Clin Nutr. 2015;24(4):626-632.

doi: 10.6133/apjcn.2015.24.4.18

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Nutritional Status, Dietary Intake, and Body Composition

Cohort study examining the association between vegetable consumption and weight gain in a single year among Japanese employees at a manufacturing company
KIMI SAWADA, NOBUKO MURAYAMA, YUKARI TAKEMI AND HIROMI ISHIDA

Asia Pac J Clin Nutr. 2015;24(4):633-638.

doi: 10.6133/apjcn.2015.24.4.08

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Comparison of the dietary intakes of individuals with and without type 1 diabetes in China
LINDSAY M JAACKS, SHUFA DU, MICHELLE A MENDEZ, JAMIE CRANDELL, WEI LIU, LINONG JI, WAYNE ROSAMOND, BARRY M POPKIN AND ELIZABETH J MAYER-DAVIS
Asia Pac J Clin Nutr. 2015;24(4):639-649.

doi: 10.6133/apjcn.2015.24.4.03

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Maternal and Clild Nutrition

Relationship between perinatal antioxidant vitamin and heavy metal levels and the growth and cognitive development of children at 5 years of age
YONGFANG LIU, QIAN CHEN, XIAOPING WEI, LI CHEN, XUAN ZHANG, KE CHEN, JIE CHEN AND TINGYU LI

Asia Pac J Clin Nutr. 2015;24(4):650-658.

doi: 10.6133/apjcn.2015.24.4.25

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Dietary survey of anaemic infants and young children in urban areas of China: a cross-sectional study
NI JIA, SHUAIMING ZHANG, TAO LI, ZANGWEN TAN, YAN YIN, LI CHEN, CAIHONG LI, AIHUA LIU, JACQUES G BINDELS AND YAOHUA DAI

Asia Pac J Clin Nutr. 2015;24(4):659-664.

doi: 10.6133/apjcn.2015.24.4.05

 

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The relationship between socioeconomic development and malnutrition in children younger than 5 years in China during the period 1990 to 2010
LIFANG WU, ZHENYU YANG, SHI-AN YIN, MEI ZHU AND HUIYU GAO
Asia Pac J Clin Nutr. 2015;24(4):665-673
.

doi: 10.6133/apjcn.2015.24.4.24

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Whole grain intake, determined by dietary records and plasma alkylresorcinol concentrations, is low among pregnant women in Singapore
ALASTAIR B ROSS, MARJORELEE T COLEGA, AI LIN LIM, IRMA SILVA-ZOLEZZI, KATHERINE MACÉ, SEANG MEI SAW, KENNETH KWEK, PETER GLUCKMAN, KEITH M GODFREY, YAP-SENG CHONG AND MARY FF CHONG
Asia Pac J Clin Nutr. 2015;24(4):674-682.

doi: 10.6133/apjcn.2015.24.4.19

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Elevated total plasma homocysteine levels are associated with type 2 diabetes in women with hypertension
CHANGYI WANG, QUNHONG WU, LINA ZHANG, YANHUA HAO, RUI FAN, XIAOLIN PENG, SHENGYUAN LIU, ZHONGWEI CHEN, TAO ZHANG, SIHAN CHEN, JIANPING MA, SHIWEI DUAN AND LIYUAN HAN Asia Pac J Clin Nutr. 2015;24(4):683-691.

doi: 10.6133/apjcn.2015.24.4.09

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Nutritional Epidemiology and Public Health

Why is there gender disparity in the body mass index trends among adults in the 1997-2011 China health and nutrition surveys?
YIFEI OUYANG, HUIJUN WANG, CHANG SU, WENWEN DU, ZHIHONG WANG AND BING ZHANG
Asia Pac J Clin Nutr. 2015;24(4):692-700.

doi: 10.6133/apjcn.2015.24.4.06

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Longitudinal study of body mass index in Asian men who immigrate to the US
EVA ERBER OAKKAR, JUNE STEVENS, PATRICK T BRADSHAW, JIANWEN CAI, KRISTA M PERREIRA, BARRY M POPKIN, PENNY GORDON-LARSEN, DEBORAH R YOUNG, NIRUPA R GHAI, BETTE CAAN AND VIRGINIA P QUINN
Asia Pac J Clin Nutr. 2015;24(4):701-709.

doi: 10.6133/apjcn.2015.24.4.10

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Dietary patterns and their association with hypertension among Pakistani urban adults
NILOFER F SAFDAR, ELIZABETH R BERTONE-JOHNSON, LORRAINE CORDEIRO, TAZEEN H JAFAR AND NANCY L COHEN

Asia Pac J Clin Nutr. 2015;24(4):710-719.

doi:10.6133/apjcn.2015.24.4.27

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Correlates of household food insecurity and low dietary diversity in rural Cambodia
CHRISTINE M MCDONALD, JUDY MCLEAN, HOU KROEUN, AMINUZZAMAN TALUKDER, LARRY D LYND AND TIMOTHY J GREEN
Asia Pac J Clin Nutr. 2015;24(4):720-730.

doi: 10.6133/apjcn.2015.24.4.14

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Food systems and life expectancy with rapid urbanisation in provincial China
VALERIE GIBSON, YONG-GUAN ZHU, RUBING GE AND MARK L WAHLQVIST

Asia Pac J Clin Nutr. 2015;24(4):731-743.

doi: 10.6133/apjcn.2015.24.4.28

 

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Dietary health behaviour and beliefs among university students from 26 low, middle and high income countries
SUPA PENGPID AND KARL PELTZER
Asia Pac J Clin Nutr. 2015;24(4):744-752.

doi: 10.6133/apjcn.2015.24.4.21

 

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Case Study

Gaviscon and domperidon responsive apnea episodes associated with gastro-esophageal reflux disease in twins
HUSEYIN BILGIN, ABDULKADIR EREN AND SEMRA KARA
Asia Pac J Clin Nutr. 2015;24(4):753-755.

doi: 10.6133/apjcn.2015.24.4.12

 

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Feeding an infant with high arched palate by high flow rate bottle nipple
ABDULKADIR EREN, HUSEYIN BILGIN AND SEMRA KARA
Asia Pac J Clin Nutr. 2015;24(4):756-758.

doi: 10.6133/apjcn.2015.24.4.16

 

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Seminar Proceedings

Adolescent Pregnancy and the First 1000 Days (the Philippine Situation)
MARIO V CAPANZANA, DIVORAH V AGUILA, CHARINA A JAVIER, TERESA S MENDOZA AND VIRGINIA M SANTOS-ABALOS
Asia Pac J Clin Nutr. 2015;24(4):759-766.

doi: 10.6133/apjcn.2015.24.4.07

 

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Future Events

Asia Pac J Clin Nutr. 2015;24(4):767.

 

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Preferred ecosystem characteristics: their food and health relevance to China’s rapid urbanisation
VALERIE GIBSON, YONG-GUAN ZHU, RUBING GE AND MARK L WAHLQVIST

For most of its history, China has supported a growing population through food systems which have been mutually inclusive of people and their locality. This trajectory has required adequate ecosystem maintenance or humanised reformulation and a high degree of recyclable nutrient flow. The ‘tipping point’ in habitat sustainability has come with the size and demographic structure of China’s population to one that is ageing, with modernisation of its infrastructure and increased expectations of better livelihoods, standards of living and health. In order to meet these expectations, China has embarked on rapid urbanisation for upwards of 300 million people over the next 15-20 years and to do so taking account of the environmental limitations. The process will radically change rural as well as urban China and the systems which connect them. Chief among these will be ecosystems in number and type along with the food and health systems integral to them. To minimise ecological damage and optimise the benefits to people and place, describing, monitoring and managing the process will be paramount. The present paper is a situational analysis of health as it may be ecologically favoured or disordered (Ecosystem Health Disorders) and of the food systems on which the environment and health depend. An effort is made to enumerate the current situation in China in a way that might enable the optimisation of humanised ecosystems.
Key Words: ecosystem health disorders, urbanisation, rural, natural environment, food systems
 

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优选生态系统特征:其在中国快速城市化进程中同食品和健康的关联研究
纵观中国历史,食品系统同人类及其生境相互包容,是支撑人口增长的重要基
础。维续这种关系需要充分的生态系统维护、人为改造以及高度可回收的营养
流。日趋老龄化社会的人口规模和结构、基础设施的现代化改造、以及不断提
高的对于更加优质生活的期望,使得生态环境可持续性迎来拐点。中国要加速
城市化建设以期在未来15-20 年承纳3 亿新增人口,而与此同时还要兼顾环境
的承载力。城市化进程将从根本上改变农村城市,以及联系二者的众多系统,
其中,林林总总的生态系统以及同生态系统紧密联系的食品和健康系统是最重
要的。同时,对该过程的刻画与监管对于降低生态破坏并改善人类社会福祉至
关重要。本研究对于健康进行情景分析,研究有益或有损健康的生态环境;另
一方面对环境和健康依赖的食品系统进行情景模拟。本文通过列表详尽描述中
国的现状,以帮助寻求最优化的人造生态系统方案。
关键字:生态系统健康疾病、城市化、农村、自然环境、食品系统

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Garlic intake lowers fasting blood glucose: meta-analysis of randomized controlled trials
LI-QIONG HOU, YUN-HUI LIU AND YI-YI ZHANG
Garlic is a common spicy flavouring agent also used for certain therapeutic purposes. Garlic’s effects on blood glucose have been the subject of many clinical and animal studies, however, studies reporting hypoglycemic effects of garlic in humans are conflicting. A comprehensive literature search was conducted to identify relevant trials of garlic or garlic extracts on markers of glycemic control [fasting blood glucose (FBG), postprandial glucose (PPG), glycosylated haemoglobin (HbA1c)]. A meta-analysis of the effect of garlic intake on human was done to assess garlic’s effectiveness in lowering glucose levels. Two reviewers extracted data from each of the identified studies. Seven eligible randomized controlled trials with 513 subjects were identified. Pooled analyses showed that garlic intake results in a statistically significant lowering in FBG [SMD=-1.67; 95% CI (-2.80, -0.55), p=0.004]. Our pooled analyses did not include PPG control and HbA1c outcomes. Because only 1 study included in the meta-analysis reported PPG variables and only 2 studies reported HbA1c variables. In conclusion, the current meta-analysis showed that the administration of garlic resulted in a significant reduction in FBG concentrations. More trials are needed to investigate the effectiveness of garlic on HbA1c and PPG.
Key Words: garlic, meta-analysis, glucose, randomized controlled trial, type 2 diabetes

 

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大蒜摄入可降低空腹血糖:随机对照研究的meta分析
大蒜是一种常见的辛辣调味剂,也可用于某些疾病的治疗。目前已有关于大蒜
对血糖影响的临床和动物研究。但各研究结论存在争议。本研究通过meta分析
探讨大蒜对人体血糖的影响。全面检索相关数据库,对符合纳入标准的随机对
照研究,由两位评审员按Cochrane系统评价方法独立进行资料提取、质量评价
并交叉核对后进行meta分析。共纳入7篇随机对照试验文章,合计513人。Meta
分析结果显示:与安慰剂对照组相比,大蒜摄入组空腹血糖水平显著降低
[SMD=-1.67;95% CI (-2.80,-0.55),p=0.004]。由于纳入的研究中仅有1个
研究提供了餐后血糖相关数据,2个研究提供糖化血红蛋白相关数据,故本研
究未对餐后血糖和糖化血红蛋白进行meta分析。总之,本研究结果提示大蒜摄
入可以降低空腹血糖水平。仍需更多研究探讨大蒜对糖化血红蛋白及餐后血糖
的影响。
关键词:大蒜、meta 分析、血糖、随机对照研究、2 型糖尿病

 

 

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Peri-operative immunonutrition in patients undergoing liver transplantation: a meta-analysis of randomized controlled trials
QIUCHENG LEI, XINYING WANG, HUAZHEN ZHENG, JINGCHENG BI, SHANJUN TAN AND NING LI

Background and Objectives: No consensus has been reached concerning the effects of peri-operative immunonutrition in patients undergoing liver transplantation. We conducted a meta-analysis to evaluate the effects of peri-operative immunonutrition on clinical outcomes and liver function in patients undergoing liver transplantation. Methods and Study Design: The Pubmed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and google scholar were searched to identify all available randomized controlled studies which compared peri-operative immunonutrition support (glutamine, ω-3 polyunsaturated fatty acids, arginine and ribonucleic acids) with standard nutrition. The data analysis was performed using Revman 5.2 software. Results: A total of 7 randomized controlled trials (RCTs) involving 501 patients were included. Peri-operative immunonutrition significantly reduced the risk of infectious complications (RR: 0.51; 95% CI: 0.27 to 0.98, p=0.04) and shortened the postoperative hospital stay [weighted mean difference (WMD): -3.89; 95% CI: -7.42 to -0.36; p=0.03]. Furthermore, peri-operative immunonutrition improved liver function by decreasing the levels of aspartate aminotransferase (AST) in the blood (WMD: -25.4; 95% CI: -39.9 to -10.9, p=0.0006). However, we did not find statistically significant differences in serum alanine aminotransferase (ALT), total bilirubin (TB) and direct bilirubin (DB) levels. There were no statistically significant differences in mortality and rejection reaction. Conclusions: Peri-operative nutrition support adding immunonutrients like glutamine, ω-3 polyunsaturated fatty acids, arginine and ribonucleic acids may improve outcomes in patients undergoing liver transplantation. Due to the limited sample size of the included trials, further large-scale and rigorously designed RCTs are needed.
Key Words: immunonutrition, ω-3 polyunsaturated fatty acids, glutamine, liver transplantation, meta-analysis

 

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肝移植患者围手术期的免疫营养支持:一项随机对照试验的meta 分析
背景与目的:关于肝移植患者围手术期免疫营养支持的疗效还没有达到共
识。我们进行一项meta 分析来评价围手术期应用免疫营养支持对肝移植患者
临床结局和肝功能的影响。方法与研究设计:我们通过Pubmed, Embase,
Cochrane Central Register of Controlled Trials, Web of Science 和google scholar
数据库来检索所有有关肝移植患者围手期免疫营养支持(谷胺酰氨、ω-3 多不
饱和脂肪酸、精氨酸与核糖核酸)与标准营养支持比较的随机对照试验。数
据分析采用Revman 5.2 软件。结果:总共有7 项随机对照试验包括501 例患
者纳入研究。围手术期免疫营养支持可明显降低感染并发症风险(RR 0.51;
95% CI 0.27 to 0.98,p=0.04)与缩短术后住院时间(WMD -3.89;95% CI -
7.42 to -0.36,p=0.03)。此外,围手术期免疫营养支持可以通过减少血中天
冬氨酸转氨酶水平(AST)来改善患者肝功能(WMD -25.4;95% CI -39.9 to -
10.9,p=0.0006)。同时,我们没有发现两组患者的血清丙氨酸转氨酶、总胆
红素及直接胆红素水平有统计学差异。两组患者的死亡率和排斥反应发生率
也没有统计学差异。结论:围手术期营养支持添加免疫营养素,如谷胺酰
氨、ω-3 多不饱和脂肪酸、精氨酸和核糖核酸可能会改善肝移植患者的临床结
局。由于纳入研究的样本量小,这个结论需要大规模的、设计严谨的随机对
照试验来进一步证实。
關鍵字: 免疫营养、ω-3多不饱和脂肪酸、谷胺酰氨、肝移植、meta分析


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Preoperative Nutritional Risk Index to predict postoperative survival time in primary liver cancer patients
YACONG BO, MINGJIE YAO, LING ZHANG, WOLDE BEKALO SAPA, WEIQUAN LU AND QUANJUN LU
Background and Objectives: We designed this study to determine the predictive value of Nutritional Risk Index (NRI) for postoperative survival time of patients who had undergone hepatectomy for primary liver cancer. Methods and Study Design: The 620 patients who underwent hepatectomy for primary liver cancer (PLC) in the Department of Hepatobiliary Surgery, Cancer Hospital of Henan Province, Zhengzhou, China from December 1, 2008 to December 1, 2012 were followed up. A nutritional risk index (NRI) was used to screen the patients with malnutrition (NRI <=100). At the same time, the prognosis and survival of the patients were recorded. Kaplan-Meier curve with log-rank test was used to analyze the relationship between malnutrition and prognosis of the subjects. Also the postoperative survival time and its influencing factors were analyzed by Cox proportional hazards model. Results: The cumulative survival probability at 1, 3, and 5 years of the 620 subjects was 49%, 33% and 29% respectively. Kaplan-Meier analysis with log-rank test showed that non-malnourished (NRI values >100) patients had longer postoperative survival time compared with malnourished patients. NRI values >100 was significantly associated with longer postoperative survival time. Cox proportional hazards model showed that NRI was an independent predictor of postoperative survival time and that NRI varied inversely with the risk of death. Conclusion: The patients with NRI values >100 survived longer than those with NRI values <=100.
Key Words: Nutritional Risk Index, postoperative survival time, weight loss, primary liver cancer, hepatectomy
 

 

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术前营养风险指数对原发性肝癌患者术后生存时间的预测
背景与目的:探讨术前营养风险指数(Nutritional Risk Index NRI)对原发性肝
癌肝切除术患者术后生存时间的预测。方法与研究设计:收集河南省肿瘤医
院肝胆外科2008 年12 月1 日到2012 年12 月1 日期间的620 例原发性肝癌经
手术治疗的患者,并对其进行随访。运用NRI 筛选营养不良患者(NRI<=
100),并记录病人的预后和生存状况。运用Kaplan-Meier 和 log-rank 检验
分析患者营养不良和预后的关系。同时采用Cox 比例风险模型分析术后生存
时间的影响因素。结果:620 名患者第1、3 和5 年累积生存概率分别为
49%、33%和29%。Kaplan-Meier 和 log-rank 检验分析表明:与营养不良患者
相比,非营养不良(NRI>100)患者术后存活时间更长。NRI>100 与较长的术
后生存时间显著相关。Cox 比例风险模型显示:NRI 是患者术后生存时间的独
立预测因素,随着NRI 的降低,患者的死亡风险升高。结论: NRI>100 的患
者术后生存时间长于NRI<=100 的患者。
关键词:营养风险指数、术后生存时间、体重减少、原发性肝癌、肝切除术
 

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Relationship between pre-treatment nutritional status, serum glutamine, arginine levels and clinicopathological features in Taiwan colorectal cancer patients
YI-PING PAN, PEI-HUNG CHANG, CHUNG-WEI FAN, WEN-KO TSENG, JEN-SENG HUANG, CHIH-HUNG CHEN, WEN-CHI CHOU, CHENG-HSU WANG AND KUN-YUN YEH

Background and Objectives: To examine the relationship between malnutrition criteria, serum glutamine and arginine concentrations, and clinicopathological features in Taiwan colorectal cancer patients. Methods and Study Design: Three malnutrition criteria (body weight loss >5% over past 6 months, body mass index (BMI)<18.5 kg/m2, and hypoalbuminemia) and serum levels of glutamine and arginine were measured in 164 colorectal patients. Malnutrition status and serum glutamine and arginine concentrations were tested for their association with each other, as well as with the clinicopathological variables. Results: Of the 164 patients, 38 (23.5%) had body weight loss, 19 (11.9%) had low BMI, and 57 (35.8%) had hypoalbuminemia. The univariate analysis showed hypoalbuminemia was correlated with advanced tumour stage, lower concentrations of glutamine, higher C-reactive protein level, and progression-free survival rate. Univariate analysis also showed glutamine levels were lower in advanced tumour stage, but arginine levels were not associated with any clinicopathologic variables. Neither the nutrition criteria used in this study nor glutamine and arginine levels were correlated with hospital stay or progression-free survival rate in multivariate analysis. Conclusions: Different nutrition assessment criteria produced different malnutrition rates in colorectal cancer patients; however, pre-treatment malnourished status and low serum glutamine and arginine concentrations were not correlated with hospital stay and progression free survival rate.
Key Words: body weight loss, low BMI, hypoalbuminemia, glutamine, arginine
 

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台湾地区大肠直肠癌病人治疗前营养状况、血清谷氨酰胺与精氨酸值和临

床病理特征之间的关系
背景与目的:本研究的目的是探讨台湾地区大肠直肠癌病人治疗前营养不良情
形、血清谷氨酰胺与精氨酸值和临床病理特征之间的关系。方法与研究设计:
对164 位直肠癌病人运用三种营养不良诊断标准,包含六个月内体重下降超过
百分之五、身体质量指数小于18.5 kg/m2 及低蛋白血症,评估治疗前营养不良
状况,同时测量治疗前血清中谷氨酰胺与精氨酸浓度,来测试它们之间的关
系,及其与临床病理参数的关系。结果:164 位患者中,有38 位(23.5%)病
人体重下降、19 位(11.9%)病人有较低的身体质量指数及57 位(35.8%)病
人有低蛋白血症。单因素分析发现低蛋白血症与肿瘤前期、低谷氨酰胺浓度、
高C 反应蛋白值和无进展存活率有关。单因素分析还显示肿瘤前期时谷氨酰胺
浓度低,但没有发现精氨酸浓度与临床病理参数有关。在多变量分析中,无论
是营养不良诊断标准或是血清中谷氨酰胺与精氨酸浓度都与住院时间和无进展
存活率无关。结论:台湾地区大肠直肠癌病人治疗前营养不良发生率因不同营
养不良诊断标准而有所差异,但治疗前营养不良状况及低血清中谷氨酰胺与精
氨酸浓度与住院时间和无进展存活率无关。
关鍵词:体重下降、低体质指数、低蛋白血症、谷氨酰胺、精氨酸

 

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The adductor pollicis muscle: a poor predictor of clinical outcome in ICU patients
CLAUDIA LEONG SHU-FEN, VENETIA ONG, YANIKA KOWITLAWAKUL, TEH AI LING, AMARTYA MUKHOPADHYAY AND JEYA HENRY
No nutrition assessment tools specifically tailored for intensive care unit (ICU) patients have been developed and validated in Singapore. Studies conducted in Brazilian populations suggest that the thickness of the adductor pollicis muscle (TAPM) may be used to assess nutritional status and predict mortality of critically ill patients. The aim of this study was to determine if TAPM can be used as a predictive indicator of mortality in Singapore ICU patients. TAPM values were obtained using skinfold calipers in 229 patients admitted to the medical ICU. TAPM measured in both hands showed no significant correlation with either the primary outcome (28-day mortality) or secondary outcomes (hospital outcome and hospital length of stay). This study demonstrated that TAPM does not predict 28-day mortality and hospital outcome, and is not correlated to length of stay in Singapore ICU patients. More studies are necessary to validate the use of TAPM as an anthropometric indicator of ICU outcome in other regions of the world.
Key Words: adductor pollicis, anthropometry, nutritional status, intensive care, clinical outcome

 

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內收拇肌:對加護病房病人是一個差的臨床結果預測因子
在新加坡,尚未有針對加護病房病人量身打造的營養評估工具被發展或驗
證。巴西族群研究,建議內收拇肌(TAPM)的厚度可用於評估重症疾病病人
的營養狀況,及預測死亡風險。本研究目的為評估TAPM 是否可作為新加坡
加護病房病人的死亡預測指標。使用皮脂測量儀,收集229 名在醫療加護病
房的病人其TAPM。雙手的TAPM 測量值與主要結果(28 天死亡率),或次
要結果(住院結果及住院天數)均未達顯著相關。本研究證實TAPM 無法預
測新加坡加護病房病人的28 天死亡率及住院結果,與住院天數也無關。需要
更多研究,才能驗證TAPM 是否可在世界的其他區域當作加護病房結果的體
位測量指標。
關鍵字:內收拇肌、體位測量、營養狀況、重症照護、臨床結果


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Association between nutrient adequacy and psychosocial factors with overall rate of weight loss after bariatric surgery
DIVYA VANOH, SUZANA SHAHAR AND NIK RITZA KOSAI NIK MAHMOOD
This was a cross-sectional study that investigated the relationship between nutrient intake and psychosocial factors with the overall rate of weight loss after bariatric surgery among patients who had undergone sleeve gastrectomy in University Kebangsaan Malaysia Medical Centre (UKMMC). Forty-three subjects (15 men and 28 women) were recruited for this study. Subjects completed assessment questionnaires including the Binge Eating Scale (BES), Beck Depression Inventory (BECK), Family Support Questionnaires, and the Index of Peer Relation (IPR). Results showed that the median overall rate of weight loss was 4.3±5.5 kg/month, which was lower when compared to the rate of weight loss at three months which was 5.0±5.6 kg/month. Pre-operative weight was the predictor of overall rate of weight loss (p<0.05, R²=0.52). Binge eating disorder (BED) and depression were also closely associated with each other after bariatric surgery (p<0.001, R²=0.46). Subjects with good compliance to dietary advice had lower scores on the binge eating scale. The mean caloric and protein intake was very low, only 562±310 kcal/day and 29.6±16.1 g/day. The intake of vitamin A, B-1, B-2, B-3, B-12, C, folate, and iron met the Malaysian Recommended Nutrient Intake (RNI). However, the RNI for calcium, zinc, selenium, vitamin D, and vitamin E was not met. In conclusion, although bariatric surgery had many health benefits, several factors hindered weight loss after bariatric surgery. Health care professionals should closely monitor patients after bariatric surgery.
Key Words: obesity, bariatric surgery, binge eating disorder, depression, rate of weight loss
 

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减肥手术患者营养充足和心理社会因素与总失重率的关系
该研究是一项横断面研究,旨在探讨减肥手术患者营养摄入和社会心理因素
与总失重率的关系。研究对象为来自马来西亚Kebangsaan 大学医疗中心接受
袖状胃切除术的患者(UKMMC)。共招募43 名受试者(15 名男性和28 名
女性)参加了本研究,受试者完成的问卷中有暴饮暴食规模(BES)、Beck
抑郁问卷(Beck)、家庭支持和同伴关系指标(IPR)等。结果表明,总失重
率的中位数为4.3±5.5 千克/月,低于3 个月时的5.0±5.6 千克/月。术前体重是
总失重率的预测因子(p<0.05,R²=0.52)。减肥手术患者暴饮暴食和抑郁之
间有密切相关(p<0.001,R²=0.46)。对饮食建议有良好依从性的患者暴饮暴
食得分较低。减肥手术患者平均热量和蛋白质的摄入量非常低,只有
562310 千卡/天和29.616.1 克/天,维生素A、B-1、B-2、B-3、B-12、C、
叶酸和铁的摄入量达到马来西亚的推荐摄入量(RNI)。然而,钙、锌、
硒、维生素D 和维生素E 的摄入量未达到RNI。总之,虽然减肥手术对健康
有很多好处,有几个因素阻碍了减肥手术后减重,医护人员应密切监测减肥
手术后患者。
关键词:肥胖、减肥手术、暴饮暴食、抑郁、失重率


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Effect of cooling of cooked white rice on resistant starch content and glycemic response
STEFFI SONIA, FIASTUTI WITJAKSONO AND RAHMAWATI RIDWAN
Cooling of cooked starch is known to cause starch retrogradation which increases resistant starch content. This study aimed to determine the effect of cooling of cooked white rice on resistant starch content and glycemic response in healthy subjects. Resistant starch contents were analyzed on freshly cooked white rice (control rice), cooked white rice cooled for 10 hours at room temperature (test rice I), and cooked white rice cooled for 24 hours at 4°C then reheated (test rice II). The results showed that resistant starch contents in control rice, test rice I, and test rice II were 0.64 g/100 g, 1.30 g/100 g, and 1.65 g/100 g, respectively. Test rice II had higher resistant starch content than test rice I, hence used in the clinical study along with control rice to characterize glycemic response in 15 healthy adults. The clinical study was a randomized, single-blind crossover study. In the clinical study, test rice II significantly lowered glycemic response compared with control rice (125±50.1 vs 152±48.3 mmol.min/L, respectively; p=0.047). In conclusion, cooling of cooked white rice increased resistant starch content. Cooked white rice cooled for 24 hours at 4°C then reheated lowered glycemic response compared with freshly cooked white rice.
Key Words: cooling, rice, resistant starch, glycemic response, retrogradation
 

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熟白米饭冷却对抗性淀粉含量和血糖应答的影响
煮熟的淀粉冷却会导致淀粉老化,导致抗性淀粉含量增加。该研究旨在确定冷
却煮熟的白米饭抗性淀粉含量和对健康人群血糖水平的影响。分析刚煮熟白米
饭(对照大米)、白米饭常温冷却10 小时(试验大米I)和白米饭在4°C 中
冷却24 小时后再加热(试验大米II)3 种状态下抗性淀粉含量。结果表明:
对照大米、试验大米I 和试验大米II 抗性淀粉含量分别为0.64 克/100 克、1.30
克/100 克和1.65 克/100 克。试验大米II 比试验大米I 抗性淀粉含量高,因此
在临床研究中,用对照大米作对照,研究了15 名健康成人血糖对试验大米II
的应答。该临床研究是一项随机、单盲交叉的研究。在临床研究中,试验大米
II 比对照大米能显著降低血糖应答(125±50.1 vs 152±48.4 mmol.min/L,
p=0.047)。总之,冷却的熟白米饭增加抗性淀粉含量。与刚煮熟的白米饭相
比,煮熟的白米饭在4°C 中冷却24 小时然后加热,能降低血糖应答。
关键词:冷却、大米、抗性淀粉、血糖应答、老化

 

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Association of cystatin C with leptin and TNF-α in elderly Japanese women
AYAKA TSUBOI, MIKA TAKEUCHI, MAYU TERAZAWA-WATANABE, KEISUKE FUKUO AND TSUTOMU KAZUMI

Background and Objectives: Determinants of cystatin C, a novel marker of mortality in the elderly, have not been extensively studied in Asian elderly population. Methods and Study Design: Associations of cystatin C with anthropometric, cardiometabolic, hematological, nutritional variables and inflammatory markers were examined in 159 community-living elderly Japanese women whose BMI averaged 22.6±2.9 (SD) kg/m2. Results: Serum creatinine and cystatin C averaged 0.73±0.16 mg/dL and 0.85±0.20 mg/L, respectively. Creatinine-based estimated glomerular filtration rate (standardized β, -0.538, p<0.001), age (standardized β, 0.274, p<0.001), serum leptin (standardized β, 0.218, p<0.001) and tumour necrosis factor-α (TNF-α, standardized β, 0.165, p=0.002) emerged as significant predictors of serum cystatin C independent of percentage body fat, homeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein, systolic blood pressure and HDL cholesterol (cumulative R2=0.674). Conclusions: Elevated serum levels of leptin and TNF-α contributed to elevated cystatin C independent of kidney function, fat mass, insulin resistance and inflammation in community-living elderly women and may represent confounders of associations between cystatin C and mortality in this population.
Key Words: cystatin C, leptin, TNF-α, kidney function, elderly

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日本老年女性胱蛋白C 與瘦體素及TNF-α 的相關性
背景與目的:胱蛋白C 為一個老年死亡的新標記,其決定因子在亞洲老年族
群尚未被大規模的探討。方法與研究設計:評估159 名BMI 平均值為
22.6±2.9 (SD) kg/m2 的日本社區老年女性,其胱蛋白C 與體位測量值、心血管
代謝、血液資料、營養狀況及發炎標記之相關。結果:血清肌酸酐與胱蛋白C
平均值分別為0.73±0.16 mg/dL 及0.85±0.20 mg/L。肌酸酐評估腎絲球過濾率
( 標準化迴歸係數-0.538 , p<0.001 ) 、年齡( 標準化迴歸係數0.274 ,
p<0.001)、血清瘦體素(標準化迴歸係數0.218,p<0.001)及腫瘤壞死因子-α
(TNF-α 標準化迴歸係數0.165,p=0.0021)顯示為血清胱蛋白C 的顯著預測
因子,且此結果獨立於體脂肪百分比、胰島素抗性之恆定模式評估、高敏感度
C 反應蛋白、收縮壓及高密度脂蛋白膽固醇(累積R2=0.674)。結論:社區老
年女性血清瘦體素及TNF-α 的增加導致胱蛋白C 的提高,此相關獨立於腎功
能、體脂質量、胰島素阻抗性及發炎反應。這個族群之胱蛋白C 與死亡率的
相關,可能是干擾因子造成的相關。
關鍵字:胱蛋白C、瘦體素、腫瘤壞死因子-α、腎功能、老人


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Cohort study examining the association between vegetable consumption and weight gain in a single year among Japanese employees at a manufacturing company
KIMI SAWADA, NOBUKO MURAYAMA, YUKARI TAKEMI AND HIROMI ISHIDA
Background and Objectives: Overweight and obesity increase the risk of hypertension, type 2 diabetes, and other metabolic disorders and are increasing in Japan, particularly among men. Several prospective studies have suggested that high vegetable intake is inversely associated with weight gain. Here, the association between vegetable consumption and weight gain in a group of food manufacturing workers over the course of one year was investigated. Methods and Study Design: The study was a one-year cohort study of the nutrition and lifestyle survey. The study population consisted of 900 and 910 Japanese employees (aged 19-60 years) from a manufacturing company located in Musashino City, Tokyo, Japan, that were administered the same validated brief selfadministered diet history and dietary lifestyle questionnaire in 2006 and 2007, respectively. Clinical examinations of body weight were also performed to assess changes in weight. We analyzed participants who responded in both 2006 and 2007 (n=478). Results: Risk of weight gain of more than 3 kg was significantly lower in the group consuming the most vegetables than in the group consuming the least, and this difference remained significant after adjustment for baseline age, sex, and consumption of other foods (p for trend=0.028). Conclusions: Weight gain was inversely associated with high consumption of vegetables. Encouraging Japanese employees to consume more vegetables may be an important strategy in controlling weight gain and preventing metabolic syndrome.
Key Words: vegetable consumption, weight gain, Japanese employees, one-year cohort study
 

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队列研究:监测一家日本制造公司的员工中蔬菜摄入量和一年内增重的关系
背景与目的:超重和肥胖会增加高血压、2 型糖尿病和其他代谢性疾病的风
险,这种现象在日本呈现增加趋势,特别是男性。一些前瞻性研究表明,高的
蔬菜摄入量与增重呈负相关。该研究对一家日本制造公司的员工蔬菜摄入量和
增重之间的关系进行了为期一年的研究。方法与研究设计:该研究是一个为期
一年的营养和生活方式的调查研究。在2006 和2007 年,对日本东京武藏野市
一家制造公司的900 和910 名日本员工(年龄在19~60 岁)分别对其进行简
易饮食史和饮食生活方式的问卷调查,同时也进行体重的临床检查以便评估体
重的变化。我们分析了在2006 和2007 均参与调查的478 名对象。结果:摄入
蔬菜最多的人群中,增重超过3 千克的风险显著低于摄入蔬菜最少者;在调整
基线年龄、性别和其他食品消费量的影响后,这种差异仍然存在(趋势
p=0.028)。结论:增重与高的蔬菜摄入量呈负相关。鼓励日本员工多吃蔬
菜,可能是控制增重和预防代谢综合征的重要策略。
关键词:蔬菜消费量、增重、日本员工、一年的队列研究

 

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Comparison of the dietary intakes of individuals with and without type 1 diabetes in China
LINDSAY M JAACKS, SHUFA DU, MICHELLE A MENDEZ, JAMIE CRANDELL, WEI LIU, LINONG JI, WAYNE ROSAMOND, BARRY M POPKIN AND ELIZABETH J MAYER-DAVIS
Background and Objectives: The objective was to compare the dietary intakes of individuals with type 1 diabetes (T1D) to individuals without diabetes in China. Methods and Study Design: Data are from 1) the 3C Nutrition Ancillary Study, a cross-sectional study of individuals with T1D in China, and 2) the China Health and Nutrition Survey. Dietary intake in both samples was assessed using three 24-hour recalls. ANCOVA and multivariable logistic regression, adjusted for sex, age, and urban-rural residence, were used to assess differences in nutrient and food group intake between participants without diabetes (n=1059) and participants with T1D (n=97), who were stratified by insulin regimen (basal-bolus, n=49, versus fixed, n=48). Results: Participants with T1D had a lower percentage of energy from carbohydrates, higher vegetable intake, and were more likely to consume lowfat cakes and fungi/sea weed compared to participants without diabetes (all p<0.05). Distinguishing characteristics of insulin regimen groups also emerged. Participants on fixed regimens had higher intakes of wheat and were less likely to consume fruit and more likely to consume high-fat cakes and dairy compared to participants without diabetes (all p<0.05). Participants on basal-bolus regimens were less likely to consume fried foods and more likely to consume fish/shellfish compared to participants without diabetes (all p<0.05). Conclusions: Differences in dietary intake between participants with and without T1D in China suggest that dietary modifications are common and reflect carbohydrate-conscious nutrition recommendations for individuals with T1D. Future research should focus on the health effects of these modifications.
Key Words: human nutrition, carbohydrate, epidemiology, type 1 diabetes, China
 

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中国1 型糖尿病患者与正常人群的膳食摄入比较研究
背景与目的:比较中国1 型糖尿病患者与正常人群的膳食摄入之间的差异。方
法与研究设计:数据来源于3C 营养辅助研究(中国1 型糖尿病横断面研究)
及中国健康与营养调查,两项研究均的膳食摄入量是采用3 天24 小时回顾法
评估的。本研究经调整年龄、性别及城乡差异,应用协方差分析和多因素
Logistic 回归分析比较1 型糖尿病患者(n=97)及正常人群(n=1059)营养素
和食物组分摄入之间的差异,并对1 型糖尿病患者根据胰岛素治疗方式进行分
层分析(基础餐食方案,n=49;固定剂量方案,n=48)。结果:与正常人群
相比,1 型糖尿病患者能量摄入中碳水化合物占的比例较低,蔬菜类较高,更
倾向于摄入低脂点心、木耳、海带类食物(p<0.05)。不同胰岛素治疗组之间
亦存在差异。与正常人群相比,使用固定剂量胰岛素方案的1 型糖尿病患者摄
入小麦制品、高脂点心及奶制品较多,而水果类较少(p<0.05),使用基础餐
食胰岛素方案的1 型糖尿病患者摄入油炸食品较少而鱼类及海鲜类食品较多
(p<0.05)。结论:中国1 型糖尿病患者与正常人群之间膳食摄入的差异提示
1 型糖尿病患者膳食调整比较常见,更关注碳水化合物摄入的饮食指导建议。
未来需要进一步研究这种膳食调整对健康的影响。
关键词:人类营养、碳水化合物、流行病学、1 型糖尿病、中国

 

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Relationship between perinatal antioxidant vitamin and heavy metal levels and the growth and cognitive development of children at 5 years of age
YONGFANG LIU, QIAN CHEN, XIAOPING WEI, LI CHEN, XUAN ZHANG, KE CHEN, JIE CHEN AND TINGYU LI
To evaluate how prenatal exposure to antioxidant vitamins and heavy metals affects subsequent development. Maternal serum and cord serum levels of antioxidant vitamins (A, E, and C) were determined. Full-state, performance, and verbal intelligence quotients (FSIQ, PIQ, and VIQ, respectively) of 97 children were assessed at 5 years of age. The placental transport ratio (PTR: cord level relative to maternal serum level) of vitamin A (VA) was associated positively with FSIQ score (p=0.041), vitamin E (VE)-PTR was associated positively with PIQ (p=0.002) and FSIQ (p=0.025) scores, and cord serum cadmium (Cd) level was correlated negatively with VIQ score (p=0.025) at 5 years of age. High VE-PTR protected against low PIQ (OR=0.025; p=0.021) and FSIQ (OR<0.001; p=0.004). High maternal age was a protective factor against low VIQ (OR=0.661; 95% CI, 0.500- 0.875; p=0.004) and FSIQ (OR=0.700; 95% CI, 0.512-0.957; p=0.025). A higher maternal education (OR=0.038; 95% CI, 0.003-0.458; p=0.010) and economic level (OR=0.047; 95% CI, 0.004-0.579; p=0.017) were protective against a low FSIQ score. VA-PTR predicted physical growth. VA-PTR and VE-PTR predicted intelligence test performance at 5 years old. High Cd in cord blood may negatively affect subsequent intelligence.
Key Words: antioxidant vitamins, heavy metals, intelligence quotients, cord blood, children

 

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围产期抗氧化维生素和重金属水平与5 岁儿童生长和认知发展之间的关系
为了评估出生前维生素和重金属暴露对出生后生长发育的影响。我们测定了产
妇血清和脐带血中抗氧化维生素(A、E 和C)的含量。本研究共测量了97 名
5 岁儿童的全量表智商、操作智商和语言智商。其中维生素A 的胎盘转运率
(PTR)与全量表智商成正相关(p=0.041),维生素E 的胎盘转运率与操作智
商(p=0.002)和全量表智商(p=0.025)评分成正相关。脐血镉水平与5 岁儿童
的语言智商呈负相关(p=0.025)。较高的维生素E 胎盘转运率是操作智商
(OR=0.025;p=0.021)和全量表智商(OR<0.001;p=0.004)的保护因素。高
龄产妇是语言智商(OR=0.661;95% CI=0.500-0.875;p=0.004)和全量表智商
(OR=0.700;95% CI=0.512-0.957;p=0.025)的保护因素。母亲拥有较高的受
教育水平( OR=0.038 ; 95% CI=0.003-0.458 ; p=0.010 ) 和经济水平
(OR=0.047;95% CI=0.004-0.579;p=0.017)是全量表智商的保护因素。维生
素A 的转运率可以预测出生后的生长发育。维生素A 和维生素E 转运率可以预
测5 岁儿童的智力测试水平。脐血中镉的水平越高可能对出生后的智力造成负
面影响。
关键词:抗氧化维生素、重金属、智商、脐血、孩子


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Dietary survey of anaemic infants and young children in urban areas of China: a cross-sectional study
NI JIA, SHUAIMING ZHANG, TAO LI, ZANGWEN TAN, YAN YIN, LI CHEN, CAIHONG LI, AIHUA LIU, JACQUES G BINDELS AND YAOHUA DAI
Background and Objectives: To explore the diet characteristics of anaemic infants and young children of China, blood tests and diets surveys were conducted in five cities. Methods and Study Design: About 150 children aged 6-36 mo were selected in a typical community health center of each city, and the total sample was 750. Nutritional status was measured through 24h dietary recall method and HEMO Cue was used for Haemoglobin concentration testing. Results: The average prevalence of anaemia was 17.2% in 6-12 mo children, which was higher than in other age groups. Median intakes of 8 nutrients (protein, vitamin A, B-1 and C, calcium, iron, zinc and copper) in anaemic children were less than non-anaemic children (p<0.05) in 6-12 mo olds; at age 12-24 mo the intake of vitamin A in anaemic children was less than in non-anaemic children (p<0.05). Market complementary food was the main source of iron in both anaemic and non-anaemic children (6-12 mo olds: 2.28 and 3.69 mg; 12-24 mo olds: 2.06 and 2.09 mg, respectively). Iron intake from formula was lower in anaemic children than in nonanaemic children (6-12 mo olds: 0.88 vs 2.54 mg; 12-24 mo olds: 1.59 vs 2.87 mg). The proportion of children obtaining continued breastfeeding in anaemic children was significantly higher than in non-anaemic children aged 6-12 mo (65% vs 37%, p<0.05). Conclusions: Appropriate practices around continuing breastfeeding and complementary feeding particularly targeted to breast fed older infants and young children are needed to reduce anaemia in infants and young children.
Key Words: anaemia, infant and young child, diet nutrients, continuing breastfeeding, urban areas
 

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中国城市贫血儿童和非贫血儿童膳食情况调查:一项横断面研究
背景与目的:调查辅食添加期间,贫血和非贫血儿童喂养和膳食情况。方法
与研究设计:选择中国5 个城市(北京、上海、南京、成都和深圳)6-36 月龄
儿童,每个城市选择1 个代表性的地区150 名儿童,其中6-12 月龄、12-24 月
龄和24-36 月龄各50 名,共750 例儿童。通过24 小时回顾法调查其膳食情
况,使用HEMO Cue 检测其血红蛋白。利用食物成份数据计算分析儿童一天
膳食营养情况。结果:总的贫血患病率为9.7%。其中,6-12 月龄儿童最高,
为17.2%。6-12 月龄儿童中,贫血儿童一天膳食摄入的8 种营养素(蛋白质、
维生素A、维生素B-1、维生素C、钙、铁、锌和铜)的中位数比非贫血儿童
低(p<0.05);12-24 月龄儿童中,贫血儿童一天膳食摄入的维生素A 的中位
数比非贫血儿童低(p<0.05)。分析铁的食物来源情况,市售辅食为贫血和非
贫血儿童的铁的主要来源(6-12 月龄儿童分别为2.28 和3.69 mg;12-24 月龄
儿童分别为2.06 和2.09 mg)。贫血儿童配方奶粉的铁来源低于非贫血儿童
(6-12 月龄儿童分别为0.88 和2.54 mg;12-24 月龄儿童分别为1.59 和2.87
mg)。6-12 月龄贫血儿童的继续母乳喂养率显著性高于非贫血儿童(分别为
65% 和37%,p<0.05)。结论:贫血儿童的膳食营养水平比非贫血儿童低,尤
其是6-12 月龄的婴幼儿;继续母乳喂养的儿童,尤其是大年龄母乳喂养的儿
童,需要通过合理的喂养行为改善膳食营养以减少贫血。
关键词:贫血、婴幼儿、膳食营养、继续母乳喂养、城市

 

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The relationship between socioeconomic development and malnutrition in children younger than 5 years in China during the period 1990 to 2010
LIFANG WU, ZHENYU YANG, SHI-AN YIN, MEI ZHU AND HUIYU GAO
Background and Objectives:More than 30 years of socioeconomic development in China has improved living conditions which contributed to a steep decline in malnutrition prevalence of children under 5 years. To elucidate the role of socioeconomic development in improving nutritional status and to identify appropriate policy priorities for intervention in nutrition improvement for younger children. Methods and Study Design: We collected data on socioeconomic development, education, cultural and recreational services, food consumption, average family size and malnutrition prevalence from national surveys. Results: From 1990 to 2010, Gross Domestic Product (GDP) per capita increased from 1644 Chinese Yuan (CNY) to 30,015 CNY; average disposable income and food expenditure per capita significantly increased in urban and rural areas; per capita consumption for education increased from 112 CNY to 1628 CNY and from 15.3 CNY to 367 CNY for other cultural services; illiteracy rate decreased from 15.9% to 4.1%; average family size from 3.97 to 3.10; and prevalence of stunting and underweight decreased from 33.1% to 9.9% and 13.7% to 3.6%, respectively. However, anaemia prevalence did not obviously decline between 1992 and 2000. After adjusting confounding effects of variables, negative relationships were observed between GDP per capita, average family size and stunting or underweight prevalence. However, no association was observed between illiteracy rate and prevalence of stunting and underweight, and there was no correlation between GDP per capita, illiteracy rate, average family size and anaemia prevalence. Conclusions: Our results indicated that economic development cannot solve all nutritional problems and comprehensive national developmental strategies should be considered to combat malnutrition.
Key Words: socioeconomic development, children, malnutrition, anaemia, China
 

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中国社会经济发展与5岁以下儿童营养不良的关系-1990~2010
背景与目的:超过30年的中国社会经济持续发展明显改善了人们的生存环境
,显著降低了5岁以下儿童营养不良率。本研究的目的是为了阐明社会经济发
展在改善营养不良中的作用以及确定幼儿营养改善干预中优先考虑的政策。
方法与研究设计:我们收集了全国调查的社会经济发展、教育、文化和娱乐
设施、食物消费、平均家庭人口以及营养不良率的数据。结果:从1990到
2010年,人均国民生产总值(GDP)从1644元增加到30015元;城乡人均可支
配收入和食品消费均显著增加,人均教育消费支出从112元增加到1628元,用
于其它文化消费支出从15.3元增加到367元;文盲率由15.9%降低到4.1%;平均
家庭人口由3.97降低到3.10;生长迟缓和低体重患病率分别从33.1%和13.7% 下
降到9.9%和3.6%。然而,贫血的患病率从1992年到2000年期间没有明显下降
。调整了混杂因素后,人均GDP、平均家庭人口与生长迟缓和低体重率呈显著
负相关。然而,文盲率与生长迟缓和低体重率间没有相关性,并且人均GDP、
文盲率和平均家庭人口与贫血率间也没有相关性。结论:我们的研究结果表
明,社会经济发展并不能完全解决儿童的营养问题,应考虑全面的国家发展战
略以解决营养不良问题。
关键词:社会经济发展、儿童、营养不良、贫血、中国


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Whole grain intake, determined by dietary records and plasma alkylresorcinol concentrations, is low among pregnant women in Singapore
ALASTAIR B ROSS, MARJORELEE T COLEGA, AI LIN LIM, IRMA SILVA-ZOLEZZI, KATHERINE MACÉ, SEANG MEI SAW, KENNETH KWEK, PETER GLUCKMAN, KEITH M GODFREY, YAP-SENG CHONG AND MARY FF CHONG
Background and Objectives: To quantify whole grain intake in pregnant women in Singapore in order to provide the first detailed analysis of whole grain intake in an Asian country and in pregnant women. Methods and Study Design: Analysis of 24-h diet recalls in a cross-sectional cohort study and analysis of a biomarker of whole grain intake (plasma alkylresorcinols) in a subset of subjects. The Growing Up in Singapore Towards healthy Outcomes-mother offspring cohort study based in Singapore. 998 pregnant mothers with complete 24-h recalls taken during their 26-28th week of gestation. Plasma samples from a randomly select subset of 100 subjects were analysed for plasma alkylresorcinols. Results: Median (IQR) whole grain intake for the cohort and the 30% who reported eating whole grains were 0 (IQR 0, 9) and 23.6 (IQR 14.6, 44.2) g/day respectively. Plasma alkylresorcinol concentrations were very low [median (IQR)=9 (3, 15) nmol/L], suggesting low intake of whole grain wheat in this population. Plasma alkylresorcinols were correlated with whole grain wheat intake (Spearman’s r=0.35; p<0.01). Conclusions: Whole grain intake among pregnant mothers in Singapore was well below the 2-3 (60-95 g) servings of whole grains per day recommended by the Singapore Health Promotion Board. Efforts to increase whole grain intake should be supported to encourage people to choose whole grains over refined grains in their diet.
Key Words: whole grain, Singapore, pregnant women, alkylresorcinols, dietary intake
 

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由饮食记录和血浆烷基间苯二酚浓度确定的新加坡孕妇全谷物摄入量低
背景与目的:为了给亚洲国家提供一个详细的孕妇全谷物摄入量的分析报告,本
文定量分析了新加坡孕妇全谷物的摄入量。方法与研究设计:在一个横断面队
列研究中分析24 小时膳食回顾,并分析一个亚组受试者的全谷物摄入量标志
物(血浆烷基间苯二酚)。在新加坡长大的母亲子代健康结局队列研究。998
名孕妇在她们怀孕26-28 周时完成24 小时膳食回顾。血浆样本采自随机选择的
100 个研究对象组成的亚组,用来分析血浆烷基间苯二酚 。结果:队列中全部
志愿者和队列中30%报告了摄入全谷物的人群其全谷物摄入的中位数分别为0
(0,9)和23.6(14.6,44.2)克/天。血浆烷基间苯二酚浓度非常低(中位数
=9 (3,15) nmol/L),提示该人群全谷物摄入量低。血浆烷基间苯二酚与全谷
物摄入量相关(Spearman’s r=0.35; p<0.01)。结论:新加坡孕妇全谷物摄入
量远远低于新加坡健康促进局推荐的每天摄入全谷物2-3 份(60-95)克。应该
鼓励人们在他们的饮食中选择全谷物而不是精制谷物,以增加全谷物的摄入
量。
关键词:全谷物、新加坡、孕妇、烷基间苯二酚、膳食摄入量

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Elevated total plasma homocysteine levels are associated with type 2 diabetes in women with hypertension
CHANGYI WANG, QUNHONG WU, LINA ZHANG, YANHUA HAO, RUI FAN, XIAOLIN PENG, SHENGYUAN LIU, ZHONGWEI CHEN, TAO ZHANG, SIHAN CHEN, JIANPING MA, SHIWEI DUAN AND LIYUAN HAN
Background and Objectives: There is only limited available evidence of a relationship between total plasma homocysteine (tHcy) levels and type 2 diabetes in hypertensive subjects. Methods and Study Design: A total of 5,935 Chinese essentially hypertensive subjects were recruited by cluster sampling from 60 communities. The cases had diabetes, whereas the controls did not. Anthropometric indices and biochemical parameters were assessed using standard procedures. A multivariable analysis was performed to analyze the association of tHcy and type 2 diabetes susceptibility in hypertensive subjects. Results: The 5,241 controls (women/men: 2,716/2,625) and 594 cases (women/men: 291/303) were recruited consecutively. The level of tHcy was dose- dependently associated with type 2 diabetes in the hypertensive women subjects. After controlling for corresponding confounding factors, a significant trend was only noted in the women subjects, with odds ratios per 5 μmol/L tHcy of 1.11 (95% confidence interval (CI), 1.07-1.16) in the crude model, 1.05 (95% CI, 1.01-1.11) in model 1, and 1.07 (95% CI, 1.02-1.13) in model 2. However, no significant result was found for levels of tHcy ≥15 μmol/L vs <15 μmol/L in the men, women and all hypertensive subjects. Conclusions: When the level of tHcy was divided into quartiles, tHcy was positively associated with type 2 diabetes in hypertensive women subjects. However, when the level of tHcy was separated into hyperhomocysteinemic (≥15 μmol/L) and normal (<15 μmol/L), no significant results were observed.
Key Words: tHcy, type 2 diabetes, hypertension, interaction, population-based study
 

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升高的血浆同型半胱氨酸水平在女性高血压患者中与2型糖尿病的关系
背景与目的:在高血压患者中针对同型半胱氨酸水平与2 型糖尿病之间关系的
研究较少。方法与研究设计:该研究对深圳市南山区60 个社区的5935 名原发
性高血压患者进行了调查。病例组为高血压患者伴发糖尿病,对照组为高血压
患者无糖尿病。采用标准方法对其人口学特征及生化指标进行调查。采用多变
量分析方法分析同型半胱氨酸水平与2 型糖尿病的关系。结果:该研究一共纳
入5241 例对照(男/女:2716/2625)与594 例病例(男/女:291/303)。在女
性高血压患者中,同型半胱氨酸水平与2 型糖尿病之间呈剂量反应关系。在控
制了相应的混杂因素之后,同型半胱氨酸水平每升高5 μmol/L,在原始模型
中,比值比及95%可信区间为1.11 (1.07-1.16),在模型1 中,比值比及95%
可信区间为1.05 (1.01-1.11),在模型2 中,比值比及95%可信区间为1.07
(1.02-1.13)。在高血压患者中,未发现高Hcy 血症分级(≥15 μmol/L vs <15
μmol/L)与2 型糖尿病存在关联。结论:当将同型半胱氨酸水平按照四分位数
进行分级时,女性高血压患者同型半胱氨酸水平与2 型糖尿病之间存在关联。
然而并未发现高Hcy 血症分级(≥15 μmol/L vs <15 μmol/L)与2 型糖尿病存在关
联。
关键词:同型半胱氨酸、糖尿病、高血压、交互、以人群为基础的研究
 

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Why is there gender disparity in the body mass index trends among adults in the 1997-2011 China health and nutrition surveys?
YIFEI OUYANG, HUIJUN WANG, CHANG SU, WENWEN DU, ZHIHONG WANG AND BING ZHANG
Background and Objective: Over the past three decades, the prevalence of overweight and obesity in China has increased greatly. Chinese body mass index (BMI) dynamics have shown much greater rates of changes among men, aged 18-45 years, than among women. This study examined the gender difference in the BMI trends and related factors. Methods and Study Design: We used longitudinal data from the China Health and Nutrition Survey collected in 1997, 2000, 2004, 2006, 2009 and 2011. A total of 10,982 participants (N=5339 men and 5643 women) aged 18-45 years were included in the final analysis. Lambda mu sigma method (LMS) was used to describe changes of BMI distribution. Separate sex-stratified multilevel random intercept-slope growth models were applied to examine effects of individual and community variables on BMI trends of Chinese adults. Results: Male BMI increased by 0.21 kg/m2 overtime, which was larger than female BMI at 0.16 kg/m2. Higher income, drinking and away-from-home food consumption were associated with higher BMI, and these variables were only significant among men. Physical activity (PA) had a negative association for both genders. Conclusions: Since different variables resulted in gender disparity in BMI trends among Chinese adults, separate health policies should be developed for men and for women.
Key Words: body mass index, obesity, overweight, gender disparity, China
 

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1997-2011 年中国成人健康与营养调查中,为何体质指数变化趋势存在性别差异?
背景与目的:过去三十年间,中国成人的超重肥胖率大幅增加。有研究表
明,18-45 岁中国人体质指数呈现逐年增加趋势,特别是男性。本研究主要探
讨该年龄组人群体质指数变化的男女性别差异及影响因素。方法与研究设
计:利用“中国居民健康与营养调查”的纵向数据,提取1997、2000、
2004、2006、2009 和2011 年调查中18-45 岁健康成年居民作为研究对象。样
本共计10892 人,其中男性5339 人,女性5643 人。应用偏度系数-中位数-变
异系数法来拟合体质指数的分布曲线。应用多水平随机截距发展模型从个体和
社区水平来研究男性和女性体质指数变化的影响因素。结果:中国成年人体
质指数随时间变化呈上升趋势,男性每年增加0.21 kg/m2,女性每年增加0.16
kg/m2。较高的收入、饮酒和在外就餐都会导致体质指数的增加,但这些因素
仅在男性有统计学意义。无论男女,增加身体活动都会降低体质指数。结
论:鉴于影响中国成年男性和女性体质指数增加的原因不同,应该针对不同
性别,采取不同的干预措施。
关键词:体质指数、肥胖、超重、性别差异、中国
 

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Longitudinal study of body mass index in Asian men who immigrate to the US
EVA ERBER OAKKAR, JUNE STEVENS, PATRICK T BRADSHAW, JIANWEN CAI, KRISTA M PERREIRA, BARRY M POPKIN, PENNY GORDON-LARSEN, DEBORAH R YOUNG, NIRUPA R GHAI, BETTE CAAN AND VIRGINIA P QUINN
Background and Objectives: Cross-sectional studies indicate that adaptation to Western norms, especially at a younger age, might explain the higher average body mass index (BMI) among Asians living in the United States (US) compared to Asians living in Asia. However, migrants differ from non-migrants in sociocultural factors that are difficult to measure and, thus, longitudinal studies on the same individuals prior to and after immigration are needed. The objective of this study was to determine differences in changes in BMI across age by residence (US or Asia) and age at immigration using longitudinal data on BMI prior to and after immigration. Methods and Study Design: The California Men’s Health Study includes 1,549 foreign-born Asian men who were aged 44-71 at baseline in 2002-03. BMI at ages 30, 40, 50 and 60 was calculated using self-reported weight history and current height. Residence at each age decade and age at immigration were determined. Data were analyzed using generalized estimating equations. Results: Ten-year BMI increases were smaller among Asians who lived in Asia prior to migrating to the US compared to those who already lived in the US. This effect was most evident between ages 30-40 when Asians in Asia had a 0.69 kg/m2 (95% CI: -1.08, -0.30) smaller increase in BMI. Immigrants who moved to the US before age 40 experienced greater increases in BMI than immigrants who moved to the US at an older age. Conclusion: This study is the first to support the hypothesis that living in the US and younger age at immigration results in larger BMI increases in Asian men.
Key Words: Asians, immigration, acculturation, body mass index, residence
 

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移民美国亚裔男性的体质指数的纵向研究
背景与目的:横断面研究表明:适应西方的规范,尤其是在年轻的时候,或
许可以解释生活在美国的亚洲人的平均体质指数(BMI)高于生活在亚洲的亚
洲人。然而,移民和非移民之间社会文化因素难以测量,因此,需要对同一人
群移民前后进行纵向研究。为确定不同年龄BMI 因居住地(美国或亚洲)不
同变化的差别,采用纵向数据记录移民时的年龄和移民前后的BMI。方法和
研究设计:加州男性健康研究包括1549 位2002-03 调查基线时年龄在44-71
岁的亚裔男性。用自己报告的体重历史和当前的身高计算其30、40、50 和60
岁时的BMI。确定每个年龄段的居住地和移民时的年龄。使用广义估计方程
进行数据分析。结果:亚裔男性在移民美国之前,十年BMI 增幅小于已经在
美国生活的亚裔男性。年龄在30-40 岁的人群中这种效果最明显,居住在亚洲
的亚洲人群,其十年间BMI 增幅比在美国生活的亚裔男性低0.69 kg/m2
(95% CI:-1.08,-0.30)。40 岁之前移民到美国其BMI 增幅大于年龄较大时
移民到美国的人群。结论:本研究是第一个支持生活在美国和年轻时移民导
致亚裔男性较大的BMI 增长这一假设的研究。
关键词:亚洲人、移民、文化适应、体质指数、居住地
 

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Dietary patterns and their association with hypertension among Pakistani urban adults
NILOFER F SAFDAR, ELIZABETH R BERTONE-JOHNSON, LORRAINE CORDEIRO, TAZEEN H JAFAR AND NANCY L COHEN
Hypertension is one of the most common chronic diseases affecting more than 25% of adults worldwide. In Pakistan, 33% of the adult population suffers from hypertension. Numerous epidemiological studies have demonstrated the critical role of dietary patterns in the causation, prevention and management of hypertension. There’s a dearth of evidence from South Asia in this regard. The present study aimed to identify the association between dietary patterns and hypertension among 4304 low income urban adults who participated in the Control of Blood Pressure and Risk Attenuation (COBRA) study in Karachi, Pakistan. Dietary information was collected by a 33- item food frequency questionnaire and 3 unique dietary patterns namely; fat and sweet, fruit and vegetable, and seafood and yogurt patterns were derived using principal component factor analyses. We used univariate and multivariable logistic regression to examine the association between dietary patterns and hypertension. Men were more likely to have hypertension, while increase in age, and body mass index were also associated with hypertension (p<0.001). After adjusting for age, gender, education, marital status, body mass index, and tobacco use; the seafood and yogurt pattern was less likely (OR=0.78: 95% CI: 0.63, 0.98; p-value 0.03) to be associated with hypertension, whereas no significant associations were seen for other two dietary patterns. These findings suggest that certain dietary patterns may be associated with hypertension among Pakistani low income urban adults.
Key Words: dietary patterns, factor analysis, Pakistan, hypertension, lifestyle behaviours
 

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巴基斯坦城市居民膳食模式及其与高血压的关系
高血压是一种常见的慢性疾病,全球超过25%的成年人受其影响。在巴基斯
坦,33%的成年人患有高血压。大量的流行病学研究表明膳食模式在高血压的
因果关系、预防和管理中起关键作用。然而,来自南亚的这方面的证据不足。
本研究旨在确定巴基斯坦卡拉奇地区参加高血压控制和风险衰减研究的4304
名城市低收入居民的膳食模式和高血压的关系。采用含33 个条目的食物频率
问卷收集饮食信息,并用主成分因子分析得到3 个独特的膳食模式,分别被命
名为脂肪和甜食、蔬菜和水果、海鲜和酸奶模式。我们采用单因素和多因素
logistic 回归分析研究膳食模式和高血压之间的关系。男性更容易患高血压,
而年龄和体质指数的增加也与高血压有关(p<0.001)。校正年龄、性别、教
育、婚姻状况、体质指数和吸烟之后,海鲜和酸奶模式与高血压呈显著负相关
(OR=0.78:95% CI:0.63, 0.98;p=0.03),而未见另外两种膳食模式与高血
压存在显著相关性。这些发现表明某些膳食模式可能与巴基斯坦城市低收入居
民的高血压有关。
关键词:膳食模式、因子分析、巴基斯坦、高血压、生活方式行为

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Correlates of household food insecurity and low dietary diversity in rural Cambodia
CHRISTINE M MCDONALD, JUDY MCLEAN, HOU KROEUN, AMINUZZAMAN TALUKDER, LARRY D LYND AND TIMOTHY J GREEN
The objective of this study was to identify correlates of household food insecurity and poor dietary diversity in rural Cambodia. Trained interviewers administered a survey to 900 households in four rural districts of Prey Veng Province, Cambodia. The Household Food Insecurity Access Scale (HFIAS) and Household Dietary Diversity Score (HDDS) were used to assess household food insecurity and dietary diversity. Multivariate logistic regression models were constructed to identify independent correlates of household food insecurity and poor dietary diversity (HDDS <=3). The mean±SD HFIAS and HDDS scores were 5.3±3.9 and 4.7±1.6, respectively. The respective prevalence of mild, moderate, and severe food insecurity were 33%, 37%, and 12%; and 23% of households had an HDDS<= 3. In multivariate analyses, several indicators of socioeconomic status, and ownership of agricultural land were associated with household food security status, although the latter association lost its significance in models that adjusted for household income. Similarly, although ownership of agricultural and homestead land was initially associated with poorer dietary diversity, income mitigated these associations. The presence of electricity and vegetable production were the only other variables that were significantly associated with both outcomes. In this rural area of Cambodia, the prevalence of any degree of household food insecurity was very high and dietary diversity was generally low. Interventions to improve food security and dietary diversity should encompass income-generating activities and be targeted toward the poorest households.
Key Words: household food security, dietary diversity, Cambodia
 

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柬埔寨农村家庭食物无保障与低膳食多样性的相关性
本研究的目的是确定柬埔寨农村家庭食物无保障与低膳食多样性之间的相关
性。经过培训的调查员在柬埔寨波萝勉省的四个农村地区调查了900 个家庭。
分别采用家庭食物无保障评估量表( HFIAS ) 和家庭膳食多样性评分
(HDDS)来评估家庭食物无保障和膳食的多样性。构建多因素logistic 回归
模型,以确定家庭食物无保障和低膳食多样性之间的独立相关性(HDDS<=
3)。HFIAS 和HDDS 得分(均数±标准差)分别为5.3±3.9 和4.7±1.6。轻
度、中度和重度食物无保障的发生率分别为33%、37%和12%, 23%的家庭
HDDS 得分<=3。多因素分析发现:社会经济状况的多项指标和农业土地所有权
与家庭食物无保障状况相关,然而校正家庭收入之后,农业土地所有权与家庭
食物无保障状况之间的显著相关性消失。类似地,农业和宅基地所有权最初与
低膳食多样性有关,然而收入减轻了这些关联。电力和蔬菜生产是唯一与家庭
食物无保障和膳食多样性相关的两个其它指标。在柬埔寨农村地区,任何程度
的家庭食物无保障发生率都很高,膳食多样性普遍偏低。改善食物无保障和膳
食多样性的措施应该包括创收活动,并有针对性地偏向最贫困的家庭。
关键词:家庭食物安全、膳食多样性、柬埔寨

 

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Food systems and life expectancy with rapid urbanisation in provincial China
VALERIE GIBSON, YONG-GUAN ZHU, RUBING GE AND MARK L WAHLQVIST
Background and Objectives: Health outcomes such as survival, minimal disability and well-being are presumptively dependent on food and ecosystems. An integral measure of the critical urban food system linkages to health problems is needed. Much of the current health change in cities could be attributed to short-comings in food systems which can pose threats to food security and food safety. Health problems have needed a reconceptualisation of present medical and nutritional constructs. Methods and Study Design: The present study is based on a situational analysis of food and the related ecosystems presumptively affected by rapid urbanisation in China. With an ecological information matrix, an Urban Food System Index with ten indicators which could influence food system outcomes and promote health and well-being has been developed. It uses sixteen data sets from the National Bureau of Statistics for all 31 provinces in China. The indicators were Locality, Climate, Biodiversity, Infrastructure, Transport, Population structure, Livelihood, Recreation and Socialisation, Personal security and Communication. The indicators for each province, scored between 1 (severe) and 5 (best), were used to predict life expectancy for China as a whole by multivariable regression analysis. Results: The best model explained 70% of the variance and had significant beta coefficients for population structure (proportion of juveniles) (-0.52, p<0.0001) and livelihood (food expenditure) (0.31, p<0.05). Conclusions: Population characteristics and livelihoods related to food systems can account for much of life expectancy as a health outcome. An index which captured this information is provided and could evaluate concurrently as well as prospectively food system-related health with urbanisation.
Key Words: ecosystem health disorders, urbanisation, rural, food systems, life expectancy
 

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快速都市化下的中國各省糧食系統及平均餘命
背景與目的:健康指標如存活狀況、失能極小化及安適,被認為與糧食及生態
系統有關。都會糧食系統與健康問題的關連需要一個關鍵且整體的措施。多數
城市目前的健康轉變可歸因於糧食安全及食品安全的糧食系統缺失。健康問題
需要重新建構醫療及營養的概念。方法與研究設計:本研究是基於糧食與相關
生態系統受中國快速都市化影響所推斷的狀況分析。使用一個生態資訊矩,發
展出一個可影響糧食系統結果與促進健康及安適的城市糧食系統十個指標。資
料來源為16 個涵蓋中國31 省的國家統計局資料庫。這些指標包含區域、氣
候、生物多樣性、基礎建設、交通、人口結構、生計、娛樂及社會化、個人安
全及溝通。各省的指標計分為1(嚴重)到5(最佳),將此分數代入複迴歸
分析,以預測中國整體的平均餘命。結果:最佳模式解釋70%的變異,其中人
口結構(未成年人口的比例,-0.52,p<0.0001)及生計(糧食支出,0.31,
p<0.05)的迴歸係數達統計顯著水準。結論:人口特性及生計與糧食安全的相
關,可以大幅解釋平均餘命這個健康指標。提供一個涵蓋這些資訊的指標,能
評估隨著都市化現階段及前瞻糧食系統相關的健康議題。
關鍵字:生態健康失調、都市化、鄉村、糧食系統、平均餘命

 

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Dietary health behaviour and beliefs among university students from 26 low, middle and high income countries
SUPA PENGPID AND KARL PELTZER
The aim of this study was to assess the prevalence of six healthy dietary behaviours and associated factors in university students from 26 low, middle and high income countries. In a cross-sectional survey, we used a selfadministered questionnaire (largely based on the European Health and Behaviour Survey) among 19503 undergraduate university students (mean age 20.8, Standard deviation=2.8, age range of 16-30 years) from 27 universities in 26 countries. Results indicated that for a total of six healthy dietary behaviours, overall, students scored a mean of 2.8 healthy dietary behaviours. More female than male students indicated healthy dietary behaviours. In multivariate linear regression among men and women, living in an upper middle income or high income country, dieting to lose weight, the high importance of dietary health benefits, high non-organized religious activity, high physical activity and currently a non-tobacco user were associated with the healthy dietary behaviour index. The study found a high prevalence of relatively poor dietary healthy behaviours.
Key Words: dietary behaviour, health beliefs, knowledge, university students, multi-country
 

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26 個低、中、高收入國家大學生的飲食健康行為與信念
本研究目的為評估來自26 個低、中、高收入國家大學生,他們的六個健康飲
食行為及相關因子的盛行率。本研究室一個橫斷性調查,我們使用一份自填式
問卷(大部分參照歐洲健康與行為調查)收集來自26 個國家的27 所大學,共
19503 名大學學生(平均年齡為20.8 歲,標準差=2.8 歲,年齡範圍為16-30
歲)的資訊。結果顯示,總共六項的健康飲食行為,整體學生自評健康飲食行
為平均為2.8 項。更多的女學生較男學生表示有健康飲食行為。男女生的多元
線性迴歸,居住在中上或是高收入國家者、為了減重而節食、認為飲食健康益
處的重要性高、常參與非組織宗教活動、高體能活動及目前為非吸菸者與健康
飲食行為指數有關。本研究發現高盛行不良飲食健康行為。
關鍵字:飲食行為、健康信念、知識、大學生、多國

 

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Gaviscon and domperidon responsive apnea episodes associated with gastro-esophageal reflux disease in twins
HUSEYIN BILGIN, ABDULKADIR EREN AND SEMRA KARA
Background: The possible pathophysiology of the relationship between gastro-esophageal reflux disease and apnea of prematurity has been widely investigated. Various physiological protective reflex responses provide a plausible biological link between gastro-esophageal reflux and apnea of prematurity. It is uncertain whether or not there is a causal relationship between the two diseases. Patient’s Findings: Twins were admitted to the neonatal intensive care unit due to feeding problems. Physical examination was normal except for reticulated, blueviolet skin changes. Short apneic attacks occurred on the first day in twin 1 and on the second day in twin 2, and these were initially treated by stimulation and increased ambient O2 concentration. Then, we conducted methylxanthine and continuous positive airway pressure treatment. Laboratory and radiological analysis were normal. As gastro-esophageal reflux disease was thought to be the causes of the treatment-refractory apnea, therapy with gaviscon and domperidon was begun for both cases. Apneic attacks did not recur after gaviscon and domperidon therapy. Conclusion: Pharmacological therapy for gastro-esophageal reflux disease has not definitively been shown to be effective in improving symptoms and hence, should be reserved especially for infants with treatment refractory apnea episodes suspected as being gastro-esophageal reflux in premature infants.
Key Words: apnea, gastro esophageal reflux disease, premature, newborn, treatment
 

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双胞胎呼吸暂停发作对嘉胃斯康和多潘立酮的反应与胃食管反流病相关
背景:胃食管反流病和早产儿呼吸暂停之间可能的病理生理学机制已被广泛
研究。多种生理保护性反射应答为胃食管反流和早产儿呼吸暂停提供了一个合
理的生物学联系,但二者之间是否存在因果关系尚不确定。患者的研究结
果:双胞胎因为喂养问题被送进新生儿重症监护病房,体格检查发现除了网
状蓝紫色皮肤改变,其它正常。双胞胎1 和双胞胎2 分别在第一天和第二天发
生了短暂的呼吸暂停。最初我们采用刺激和增加环境中氧气浓度来治疗,然后
进行了甲基黄嘌呤和持续气道正压通气治疗。实验室和影像学分析均正常。因
为胃食管反流被认为是难治性呼吸暂停的原因,开始用嘉胃斯康 和 多潘立酮
治疗这两种情况,嘉胃斯康 和 多潘立酮治疗后没有再发生窒息。结论:胃食
管反流病的药物治疗没有明确被证明能有效改善症状,因此,尤其在治疗难治
性呼吸暂停疑似有胃食管反流的早产儿时应谨慎。
关键词:呼吸暂停、胃食管反流病、早产、新生儿、治疗

 

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Feeding an infant with high arched palate by high flow rate bottle nipple
ABDULKADIR EREN, HUSEYIN BILGIN AND SEMRA KARA
For infants with high arched palate, feeding is one of the most immediate challenges faced by parents and caretakers. General suggestions for feeding in infants with cleft palate may be adapted to infants with high arched palate. These include oral feeding facilitation techniques and special feeding tools. Here we present a newborn with a high arched palate and serious feeding problems who was fed easily by a large size and a large hole nipple, ordinarily used for infants older than 6 months, instead of specialized feeding equipment.
Key Words: newborn, high arched palate, feeding, nipple, bottle
 

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用高流量奶嘴奶瓶喂养高腭弓婴儿
对于高腭弓婴儿,喂养是父母和被照顾婴儿面临的最直接挑战。对腭裂婴儿喂
养的一般建议或许适用于高腭弓婴儿。这些措施包括口服喂养促进技术和特殊
的喂养工具。这里,我们提出了一个严重高腭弓新生儿的喂养问题,用大尺寸
和大孔奶嘴很容易喂养,通常用来代替专门的喂养设备喂养年龄在6 个月以上
的婴儿。
关键词:新生儿、高腭弓、喂养、奶嘴、奶瓶

 

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Adolescent Pregnancy and the First 1000 Days (the Philippine Situation)
MARIO V CAPANZANA, DIVORAH V AGUILA, CHARINA A JAVIER, TERESA S MENDOZA AND VIRGINIA M SANTOS-ABALOS
The Seminar on Adolescent Pregnancy and the First 1000 Days (the Philippine Situation) was held in Metro Manila on September 2013. The objectives were to: 1) describe the current nutrition and health status of Filipino adolescent females, including those pregnant and lactating; 2) discuss existing programs that address their concerns; and 3) identify gaps in existing knowledge and programs, and ways to address these gaps. Adolescent pregnancy rates had increased from 8% in 2003 to 10% in 2008. In 2008, more than 35 percent of pregnant women below 20years old were considered nutritionally-at-risk. Iodine deficiency and anaemia were major health problems in both pregnant and lactating women of all ages. While government programs exist to address the needs of pregnant women, none were geared towards meeting the specific needs of pregnant adolescents. Conclusions: Studies are needed to find ways to improve adolescent health and to effectively prevent and deal with unwanted pregnancies among adolescents. Recommendations include 1) developing adolescent-friendly health centers, information and education materials to increase reproductive and health awareness among youth and health workers, 2) examining the psychosocial and nutritional factors that determine birth outcomes and nutritional status of pregnant/ non-pregnant adolescents, 3) examining adolescent growth patterns following delivery, 4) evaluating the impact of current programs and interventions geared towards improving adolescent and maternal health, and more importantly, 5) identifying the underlying reasons for the continued rise in adolescent pregnancy in the country.
Key Words: adolescent females, maternal nutrition, adolescent pregnancy, pregnant and lactating women, Philippines
 

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少女怀孕和第一个1000 天(菲律宾形势)
少女怀孕和第一个1000 天(菲律宾形势)研讨会于2013 年9 月在马尼拉举
行。主要目的是: 1)描述目前菲律宾青年女性怀孕和哺乳期营养及健康状
况; 2)讨论引起她们关注的现有计划; 3)找出现有知识和计划之间的差距
以及解决这些差距的方法。少女怀孕率从2003 年的8%上升到2008 年的
10%。2008 年,在20 岁以下孕妇中35%以上被认定为有营养风险。碘缺乏和
贫血是各年龄孕妇和哺乳期妇女的主要健康问题。虽然现行的政府计划也强调
加强孕妇的需要,但没有一个是针对少女怀孕特殊需求的计划。结论:需要开
展提高青少年健康和有效防范和应对少女意外怀孕的研究。建议包括: 1)发
展青少年友好健康中心,在青年和健康工作人员中发放信息和教育材料以提高
生殖和健康意识; 2)检查影响怀孕/非怀孕青少年确定出生结局和营养状况
的心理及营养因素; 3)检查青年女性分娩后的成长模式; 4)评估目前计划
和干预措施对改善青少年和产妇健康的影响;更重要的是, 5)找出菲律宾少
女怀孕持续上升的可能原因。
关键词:菲律宾少女、孕妇营养、少女怀孕、孕妇和哺乳期妇女

 

 

 

 

 

Last Updated: December 2015