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1 Asia Pacific Journal of Clinical Nutrition
       Volume 25, 3

         (September 2016)


Abstracts

Contents

Abstract PDF

Reviews

The rise of clinical nutrition science in North-East Asia
MARK L WAHLQVIST
Asia Pac J Clin Nutr. 2016;25(3):437-443.

doi: 10.6133/apjcn.072016.02

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Original Research Communications

Nutritional Measurement & Methodology

Use of knee height for the estimation of body height in Thai adult women
NOPPHANATH CHUMPATHAT, RAM RANGSIN, SUPRANEE CHANGBUMRUNG, NGAMPHOL SOONTHORNWORASIRI, VANIDA DURONGRITICHAI AND KARUNEE KWANBUNJAN
Asia Pac J Clin Nutr. 2016;25(3):444-451.

doi: 10.6133/apjcn.092015.05

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Clinical Nutrition or Feeding Studies

Plasma glutamine and cystine are decreased and negatively correlated with endomysial antibody in children with celiac disease
EYLEM SEVINC, NERGIZ SEVINC, HIMMET HALUK AKAR, BANU DEMET OZELCOSKUN, GÜLTEN CAN SEZGIN, DURAN ARSLAN AND MUSTAFA KENDIRCI
Asia Pac J Clin Nutr. 2016;25(3):452-456.

doi: 10.6133/apjcn.092015.09

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Laboratory nutritional parameters predict one-year mortality in elderly patients with intertrochanteric fracture
JUN LU, YUAN-YUAN CHEN, LIN ZHANG, YONG-GANG LI AND CHEN WANG
Asia Pac J Clin Nutr. 2016;25(3):457-463.

doi: 10.6133/apjcn.092015.04

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The effect of daily consumption of the small fish Amblypharyngodon mola or added vitamin A on iron status: a randomised controlled trial among Bangladeshi children with marginal vitamin A status
ANNA B ANDERSEN, LISE KH SCHMIDT, DANIEL FAURHOLT-JEPSEN, NANNA ROOS, HENRIK FRIIS, KATJA KONGSBAK, MOHAMMED A WAHED AND SHAKUNTALA HARAKSINGH THILSTED

Asia Pac J Clin Nutr. 2016;25(3):464-471.

doi: 10.6133/apjcn.092015.11

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.Contribution of hypoalbuminemia and decreased renal function to the increased mortality after newly diagnosed vertebral fracture in Japanese subjects
TETSUO NAKANO, AKIKO KUWABARA, HIROSHI MIZUTA AND KIYOSHI TANAKA

Asia Pac J Clin Nutr. 2016;25(3):472-477.

doi: 10.6133/apjcn.092015.17

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Single vegetable meal content equivalence as an alternative to fat for satiety: a randomised trial in Japanese women
CHISAKI ADACHI, HISAMI YAMANAKA-OKUMURA, TAKAFUMI KATAYAMA, YUTAKA TAKETANI AND EIJI TAKEDA
Asia Pac J Clin Nutr. 2016;25(3):478-486.

doi: 10.6133/apjcn.092015.25

 

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Randomized, double-blind, placebo-controlled trial of Ficus carica paste for the management of functional constipation
HYANG-IM BAEK, KI-CHAN HA, HYE-MI KIM, EUN-KYUNG CHOI, EUN-OCK PARK, BYUNG-HYUN PARK, HYE JEONG YANG, MIN JUNG KIM, HEE JOO KANG AND SOO-WAN CHAE
Asia Pac J Clin Nutr. 2016;25(3):487-496.

doi: 10.6133/apjcn.092015.06

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Early diet intervention to reduce the incidence of hepatic encephalopathy in cirrhosis patients: post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) findings
LING LUO, SHIYING FU, YUNZHI ZHANG AND JINGXIANG WANG
Asia Pac J Clin Nutr. 2016;25(3):497-503.

doi: 10.6133/apjcn.092015.14

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Efficacy of glutamine-enriched enteral feeding formulae in critically ill patients: a systematic review and meta-analysis of randomized controlled trials
AZADEH MOTTAGHI, MARYAM ZARIF YEGANEH, MAHDIEH GOLZARAND, SARA JAMBARSANG AND PARVIN MIRMIRAN
Asia Pac J Clin Nutr. 2016;25(3):504-512.

doi: 10.6133/apjcn.092015.24

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Nutritional status and feeding practices in gastrointestinal surgery patients at Bach Mai Hospital, Hanoi, Vietnam
LORRAINE S YOUNG, PHAM THI THU HUONG, NGUYEN THI LAM, NGHIEM NGUYET THU, HA THI VAN, NGUYEN LIEN HANH, LE DANH TUYEN, DINH THI KIM LIEN, TRAN HIEU HOC, CHU THI TUYET, NGUYEN QUOC ANH, ELIZABETH G HENRY, CARINE M LENDERS, KATHLEEN M GURA, SHERMAN J BIGORNIA, CAROLINE M APOVIAN AND THOMAS R ZIEGLER
Asia Pac J Clin Nutr. 2016;25(3):513-520.

doi: 10.6133/apjcn.092015.15

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A survey of the enteral nutrition practices in patients with neurological disorders in the tertiary hospitals of China
YING-YING SU, DAI-QUAN GAO, XIAO-YAN ZENG, RUI-JUAN SHA, XIAO-YUAN NIU, CHANG-QING WANG, DONG ZHOU, WEN JIANG, FANG CUI, YI YANG, SU-YUE PAN, XU ZHANG, LIAN-DI LI, LIANG GAO, BIN PENG, CHUN-LONG ZHONG, ZHEN-CHUAN LIU, LI-HONG LI, HONG TAN AND PEI-YUAN LV
Asia Pac J Clin Nutr. 2016;25(3):521-528.

doi: 10.6133/apjcn.092015.20

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Food intolerance prevalence in active ulcerative colitis in southwest China
XINLING MA, YUKE CHEN, FANGYAN HUANG, QIANYING LUO, HUI LV AND HUA LONG

Asia Pac J Clin Nutr. 2016;25(3):529-533.

doi: 10.6133/apjcn.102015.04

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Nutritional Status, Dietary Intake, and Body Composition

Lower body mass index is associated with hospital mortality in critically ill Japanese patients
TOMOAKI YATABE, KOICHI YAMASHITA AND MASATAKA YOKOYAMA

Asia Pac J Clin Nutr. 2016;25(3):534-537.

doi: 10.6133/apjcn.092015.21

 

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25-hydroxy-vitamin D demography and the risk of vitamin D insufficiency in the South East Asian Nutrition Surveys (SEANUTS)
BEE KOON POH, NIPA ROJROONGWASINKUL, BAO KHANH LE NGUYEN, SANDJAJA, ABD TALIB RUZITA, URUWAN YAMBORISUT, TRUONG NGUYEN HONG, FITRAH ERNAWATI, PAUL DEURENBERG, PANAM PARIKH ON BEHALF OF SEANUTS STUDY GROUP
Asia Pac J Clin Nutr. 2016;25(3):538-548
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doi: 10.6133/apjcn.092015.02

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Fibroblast growth factor-23 and phosphorus related factors in young Japanese women: a cross-sectional study
SANAE ITO, HIROMI ISHIDA AND KAZUHIRO UENISHI
Asia Pac J Clin Nutr. 2016;25(3):549-555.

doi: 10.6133/apjcn.092015.22

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Maternal and Clild Nutrition

Changes in body composition of Indian lactating women: a longitudinal study
NEHA A KAJALE, VAMAN V KHADILKAR, ZULF MUGHAL, SHASHI A CHIPLONKAR AND ANURADHA V KHADILKAR
Asia Pac J Clin Nutr. 2016;25(3):556-562.

doi: 10.6133/apjcn.092015.16

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Serum vitamin A status is associated with obesity and the metabolic syndrome among school-age children in Chongqing, China
XIAOPING WEI, RONG PENG, JIAOYANG CAO, YU KANG, PING QU, YOUXUE LIU, XIAOQIU XIAO AND TINGYU LI
Asia Pac J Clin Nutr. 2016;25(3):563-570.

doi: 10.6133/apjcn.092015.03

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Predictive factors for accuracy of perception of parents regarding their overweight or obese children in Taiwan
CHENG-JUNG CHUNG AND YUEH-GUEY HUANG
Asia Pac J Clin Nutr. 2016;25(3):571-577.

doi: 10.6133/apjcn.092015.18

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Nutritional Epidemiology and Public Health

 

Coffee consumption and risk of gastric cancer: an updated meta-analysis
YAN XIE, SHIFENG HUANG, TONGCHUAN HE AND YUXI SU

Asia Pac J Clin Nutr. 2016;25(3):578-588.

doi:10.6133/apjcn.092015.07

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Limitations of studies on school-based nutrition education interventions for obesity in China: a systematic review and meta-analysis
KAIMENG KONG, JIE LIU AND YEXUAN TAO
Asia Pac J Clin Nutr. 2016;25(3):589-601.

doi: 10.6133/apjcn.092015.19

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Instant noodles, processed food intake, and dietary pattern are associated with atopic dermatitis in an adult population (KNHANES 2009-2011)
SUNMIN PARK, HYUN-SEOK CHOI AND JI-HYUN BAE

Asia Pac J Clin Nutr. 2016;25(3):602-613.

doi: 10.6133/apjcn.092015.23

 

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Nutrigenomics

 

The genetic polymorphisms in vitamin D receptor and the risk of type 2 diabetes mellitus: an updated meta-analysis
FEI YU, LINGLING CUI, XING LI, CHONGJIAN WANG, YUE BA, LING WANG, JING LI, CHAO LI, LIPING DAI AND WENJIE LI
Asia Pac J Clin Nutr. 2016;25(3):614-624.

doi: 10.6133/apjcn.092015.12

 

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Case Study

 

Infant feeding concerns in times of natural disaster: lessons learned from the 2014 flood in Kelantan, Malaysia
ZAHARAH SULAIMAN, NORAINI MOHAMAD, TENGKU ALINA TENGKU ISMAIL, NAZIRAH JOHARI AND NIK HAZLINA NIK HUSSAIN
Asia Pac J Clin Nutr. 2016;25(3):625-630.

doi: 10.6133/apjcn.092015.08

 

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Parenteral nutrition combined with rice soup can be a safe and effective intervention for congenital chylous ascites
YI CAO, WEIHUI YAN, LINA LU, YIJING TAO, WEI LU, YINGWEI CHEN, QINGYA TANG AND WEI CAI
Asia Pac J Clin Nutr. 2016;25(3):631-635.

doi: 10.6133/apjcn.092015.10

 

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Clinical Nutrition Guidelines

 

Australasian society for parenteral and enteral nutrition (AuSPEN) adult vitamin guidelines for parenteral nutrition
EMMA J OSLAND, AZMAT ALI, TRUC NGUYEN, MELVYN DAVIS AND LYN GILLANDERS
Asia Pac J Clin Nutr. 2016;25(3):636-650.

doi: 10.6133/apjcn.022016.05

 

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Future Events

Asia Pac J Clin Nutr. 2016;25(3):651.

 

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The rise of clinical nutrition science in North-East Asia
MARK L WAHLQVIST
Effective clinical nutrition practice depends on a sound knowledge of biomedical, societal and environmental science and the skills to diagnose, prevent and manage the health problems related to food patterns, energy equilibrium (mostly to do with physical activity) and nutrient metabolism. Its delivery needs to be accessible, equitable, affordable and sustainable. Ordinarily, this will require both local and widely distributed health services. In North-East (NE) Asia, these requisites are being met to an ever increasing extent. The roots of this progress are steeped in cultures which acknowledge the food-health connections and support education which pays regard to these connections. As elsewhere, however, the food and health systems, their safety and security are threatened by exploitative operatives. In China, a concerted effort was made in the mid-1980s to foster clinical nutrition in major hospitals throughout the country by programs directed at medical graduates, nursing and kitchen staff; dietetics has appeared much more recently. By contrast, Japan has had an extensive and well-trained dietetic workforce for much longer, alongside a vibrant basic nutrition science constituency in its universities and food- nutraceutical industry. South Korea and Taiwan have traversed a similar course to that in Japan. Now, all of these NE Asian economies have gathered rapid momentum in the publication of innovative approaches to public health and clinical nutrition which have the prospect of not only improving health outcomes, but also reducing the societal and financial burden of health care. This is particularly important in rapidly ageing societies, which they are. It is also a growing challenge where climate change threatens to engulf the lives and destinies of hundreds of millions of Asians on account of natural disasters, water and food insecurity.
Key Words: workforce, Evidence-based Nutrition (EBN), Clinical Nutrition Practice Guidelines (CNPG)
 

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蓬勃發展中的東北亞臨床營養科學
有效執行臨床營養仰賴於生物醫學、社會及環境科學,與飲食模式、能量平 衡(大部分與體能活動有關)及營養素代謝的健康相關問題的診斷技能、預防 和管理的知識。它的傳遞需要考慮可近性、公平、可負擔及永續性。一般來 說,這需配合在地及廣泛分布的健康服務。在東北亞,這些先決條正符合一 個持續增加的規模。這個進展的根基與其食物-健康連結及支持教育的文化息 息相關。然而,如同其他地區,其食物及健康系統的安全與保障受被剝削操 作的威脅。在中國,1980 年代中期,臨床營養工作由醫學畢業生、護士及廚 房工作人員管理,加速了全國各大主要醫院臨床營養發展,營養師則是在較 近期才出現。相對的,日本已經長期廣泛訓練膳食療養工作人力,同時在大 學或是食品-營養保健食品業有活躍的基礎營養科學組成。南韓及臺灣走與日 本類似的軌道。如今,這些東北亞經濟體聚集快速動能,大量發表在公共衛 生及臨床營養的創新方法。其前景不僅能改善健康狀況,同時也降低健康照 護的社會及財政負擔。這對於他們所處的快速老化的社會尤其重要。氣候變 遷所帶來的天然災害、水及糧食不安全對於億萬的亞洲人的生命與命運的威 脅是一個日益嚴峻的挑戰。
關鍵字:工作人力、實證基礎營養學、臨床營養實踐指南

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Use of knee height for the estimation of body height in Thai adult women
NOPPHANATH CHUMPATHAT, RAM RANGSIN, SUPRANEE CHANGBUMRUNG, NGAMPHOL SOONTHORNWORASIRI, VANIDA DURONGRITICHAI AND KARUNEE KWANBUNJAN
Knee height has been the most frequently used measure for height prediction where full height is difficult to measure. The aim of this study was to develop and validate predictive equations using knee height to estimate the height of Thai women. The female participants were 18-59 years of age and lived in Bangkok or three surrounding provinces. They were assigned to one of two groups; the equation development group (n=488) and the equation validation group (n=188). Standing height and knee height were measured in duplicate using a stadiometer and a knee height calliper. Age and physical characteristics of the equation development group and the validate group were comparable. The measured heights showed a significant strongly positive correlation with the mean knee height (r=0.84, p<0.001). Mean knee height in a regression model exhibited the most accurate height prediction (adjusted R2=0.718, standard error of estimate=2.80), according to the equation “Height=38.1+2.45 (average knee height) - 0.051(age)”. This study proposes a new height estimation equation for Thai adult women using knee height. The equation shows more estimation power than the previous studies conducted in Thailand.

Key Words: actual height, estimated height, knee height, Thai women, validation


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在泰国成年女性中用膝盖高度估计身高
当身高难以测量时,膝关节高度常被用于身高预测。本研究的目的是使用泰国 妇女膝盖高度估计身高并验证预测方程。选择年龄在18-59岁之间,居住在曼谷 或周边三省的成年妇女作为研究对象。将研究对象分配到两组中的一组,方程 拟合组(488例)和方程验证组(188例)。使用测距仪和膝盖高度卡尺测量站 高和膝盖高度。拟合组和验证组的年龄和身体特征具有可比性。测得的身高与 平均膝盖高度呈显著正相关(r=0.84,0.001)。在回归模型中膝盖高度对身高 具有最准确的预测价值(调整R2=0.718,标准误差=2.80),根据公式“高度 =38.1+2.45(平均膝盖高度)-0.051(年龄)”。这项研究提出了利用泰国成年妇 女膝盖高度估计身高的新的估计方程。该方程比以前在泰国进行的研究具有更 高的估计能力。
关键词:实际身高、估计身高、膝关节高度、泰国女性、证实性

 

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Plasma glutamine and cystine are decreased and negatively correlated with endomysial antibody in children with celiac disease
EYLEM SEVINC, NERGIZ SEVINC, HIMMET HALUK AKAR, BANU DEMET OZELCOSKUN, GÜLTEN CAN SEZGIN, DURAN ARSLAN AND MUSTAFA KENDIRCI

Background and Objectives: Glutamine is a nonessential amino acid which improves intestinal mucosal regeneration and absorption. Glutathione is a vital molecule for antioxidant reactions and is synthesized from cystine. The first aim of the study is to measure the plasma glutamine and cystine in children with celiac disease (CD) and compare them with controls. The second aim of this study is to investigate whether these amino acids are correlated with endomysial antibody (EMA) or not. Methods and Study Design: Fifty children with CD were compared to 50 healthy, age, and sex matched normal children as control. Plasma glutamine and cystine levels of the children were measured by using tandem mass spectrometry. Results: Plasma glutamine (808 vs 870 µmol/L) and cystine (19 vs 48.5 µmol/L) were significantly lower in the celiac group than the controls (p<0.05). The levels of plasma glutamine (797 vs 928 µmol/L, n=42) and cystine (18 vs 31.5 µmol/L, n=8) were lower (p<0.05) in the EMA-positive than the EMA-negative celiac patients. We could not find any statistically significance between EMA-negative celiac patients and controls for the plasma glutamine (928 vs 870 µmol/L) and cystine (31.5 vs 48.5 µmol/L) (p>0.05). Serum EMA was negatively correlated with plasma cystine (r=-0,321, p=0.023), glutamine (r=-0.413, p=0.003). Conclusions: Our study indicated that plasma glutamine and cystine were significantly lower in the celiac children than the controls. Also, these amino acids were negatively correlated with EMA.

Key Words: cystine, glutamine, celiac disease, endomysial antibody

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腹腔疾病儿童血浆谷氨酰胺和胱氨酸水平下降与肌内 膜抗体有关
背景与目的:谷氨酰胺是一种非必需氨基酸,具有提高肠黏膜再生和吸收的 功能。谷胱甘肽是人体一种具有抗氧化的重要分子,由胱氨酸合成。该研究的 主要目的是检测腹腔疾病(CD)患儿血浆谷氨酰胺和胱氨酸水平,并与对照 组比较。其次是探讨这些氨基酸与肌内膜抗体(EMA)是否相关。方法与研 究设计:选择 50名 CD患儿,另选年龄和性别相匹配的 50名健康儿童作为对 照。采用串联质谱法测定儿童血浆谷氨酰胺和胱氨酸的水平。结果:CD 患儿 血浆谷氨酰胺(808 vs 870 µmol/L)和胱氨酸水平(19 vs 48.5 µmol/L)显著 低于对照组儿童(p<0.05,EMA 阳性的患儿血浆谷氨酰胺(797 vs 928 µmol/L, n=42)和胱氨酸水平(18 vs 31.5 µmol/L, n=8)显著低于 EMA阴性的 CD 患儿。我们未发现 EMA 阴性的 CD 患儿和健康对照组儿童血浆谷氨酰胺 (928 vs 870 µmol/L)及胱氨酸水平(31.5 vs 48.5 µmol/L)之间存在差异 (p>0.05)。血清 EMA 与血浆胱氨酸水平(r=-0,321, p=0.023)和谷氨酰胺 (r=-0.413, p=0.003)呈显著负相关。结论:该研究表明,CD患儿血浆谷氨酰 胺和胱氨酸含量明显低于健康对照组。另外,这些氨基酸的含量与 EMA 水平 呈显著负相关。
关键词:胱氨酸、谷氨酰胺、腹腔疾病、肌内膜抗体


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Laboratory nutritional parameters predict one-year mortality in elderly patients with
intertrochanteric fracture


JUN LU, YUAN-YUAN CHEN, LIN ZHANG, YONG-GANG LI AND CHEN WANG
Background and Objectives: The purpose of this study was to investigate the contributing value of nutrition related blood parameters to one-year mortality following intertrochanteric fracture surgery in a Chinese population over the age of 65. Methods and Study Design: Nutritional status was evaluated by using admission serum albumin and total lymphocyte count (TLC). One hundred and seventy-four intertrochanteric fracture patients were entered into this study for nutritional status assessment. Gender differences were evaluated by univariate analysis. The predictive value of the variables for one-year mortality was assessed by multiple logistic regression analysis. Results: The mean albumin was 31.0 g/L with 73% of patients less than 35 g/L and the mean TLC was 1.19×109 cells/L with 81% less than 1.50×109 cells/L. There were no significant differences in albumin (p=0.674) or TLC (p=0.804) between men and women. Survival information was obtained in 149 patients who received surgical treatment. The general one-year mortality was 31% with 35% in men and 29% in women, respectively. The surviving patients were younger and had higher albumin, TLC and calcium than those who died. However, multivariate analysis identified only serum albumin and TLC as independent and significant risk factors associated with one-year mortality; the optimal cut-off points were 29.5 g/L and 0.93×109 cells/L, respectively, based on the receiver operating characteristic (ROC) curve. Conclusions: Malnutrition is a common phenomenon in an aged Chinese population suffering from intertrochanteric fractures. A lower serum albumin level and total lymphocyte count at admission are significant risk factors to predict the one-year mortality.

Key Words: nutritional status, intertrochanteric fractures, mortality, elderly people, albumin
 

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血液营养指标能够预测高龄股骨粗隆间骨折患者术后 一年死亡率
背景和目的:观察术前营养相关的血液指标对中国 65 岁以上股骨粗隆间骨折 患者内固定术后一年死亡率的预测价值。方法和研究设计:将入院时患者血 清白蛋白水平及全血淋巴细胞计数作为评价患者营养状况的主要指标,共 174 例高龄股骨粗隆间骨折患者纳入了本项研究并进行了营养评估,采用单变量分 析方法比较营养指标的性别差异,采用多变量 logistic 回归分析评估不同指标 对患者术后一年死亡率的预测价值。结果:术前平均白蛋白水平为 31.0 g/L, 其中 73%的患者低于正常水平 35 g/L;术前平均淋巴细胞计数水平为 1.19×109 cells/L,其中 81%的患者低于正常水平 1.50×109 cells/L。不同性别患者的白蛋 白和淋巴细胞计数没有显著差异,接受手术治疗并获得最终随访的 149 例患 者,总体死亡率为 31%,其中男性患者为 35%,女性患者为 29%。相对于死 亡的患者,存活的患者更年轻、术前具有更高的白蛋白、淋巴细胞计数和血钙 水平。然而多因素回归分析显示只有白蛋白水平和淋巴细胞计数是预测患者一 年内死亡的独立危险因素。受试者操作特征曲线显示白蛋白和淋巴细胞计数两 项指标的临界值分别为 29.5 g/L 和 0.925×109 cells/L。结论:营养不良在中国 高龄股骨粗隆间骨折人群中是一个普遍现象。患者入院时的血清白蛋白水平和 血液淋巴细胞计数对患者术后一年的死亡率具有预测价值。
关键词:营养状况、股骨粗隆间骨折、死亡率、老年人、白蛋白
 

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The effect of daily consumption of the small fish Amblypharyngodon mola or added vitamin A on iron status: a randomised controlled trial among Bangladeshi children with marginal vitamin A status
ANNA B ANDERSEN, LISE KH SCHMIDT, DANIEL FAURHOLT-JEPSEN, NANNA ROOS, HENRIK FRIIS, KATJA KONGSBAK, MOHAMMED A WAHED AND SHAKUNTALA HARAKSINGH THILSTED

Background and Objectives: Mola (Amblypharyngodon mola) is a nutrient-rich, small fish found in ponds and rice fields in Bangladesh. The aim of the present intervention was to assess the effect of mola consumption on iron status in children with marginal vitamin A status. Methods and Study Design: Bangladeshi children (n=196), aged 3-7 years, with marginal vitamin A status were randomly allocated to one of three intervention groups served different fish curries: mola curry (experimental group); rui (Labeo rohita) curry with added retinyl palmitate (positive control group); or rui curry (negative control group). The intervention meals were served 6 days/week for 9 weeks. The experimental and positive control meals were designed to contain similar amounts of retinol activity equivalents per portion. The mola curry contained four times more iron compared to the rui curries due to different iron content in the two fish species. Haemoglobin, ferritin, serum transferrin receptor and Creactive protein were measured at screening and endpoint. Results: In the experimental group receiving mola, serum transferrin receptor concentration declined 0.73 mg/L (95% CI 0.17, 1.28, p=0.01) compared to the positive control group, while there were no differences between groups in ferritin or haemoglobin. Conclusions: Consumption of mola instead of rui has potentially an effect on iron status in children with marginal vitamin A status, seen as a decrease in serum transferrin receptor concentration.

Key Words: iron status, vitamin A, serum retinol, small nutrient-rich fish, Bangladesh
 

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日常小鱼(翻车鱼)摄入或添加维生素 A 对儿童铁状 况的影响:一项在孟加拉国临界维生素 A 状态儿童中 的随机对照试验
背景和目的:翻车鱼是一种营养丰富在孟加拉国池塘和稻田中发现的小鱼。 该干预研究的目的是评估翻车鱼摄入对临界维生素 A 状态儿童铁含量的影 响。方法和研究设计:196 名年龄在 3-7 岁之间、临界维生素 A 状态的孟加拉 国儿童被随机分配到 3个干预组中的一组,给予不同的鱼咖喱:鱼咖喱(实验 组)、瑞(鲮)添加维生素 A 棕榈酸酯咖喱(阳性对照组);或瑞咖喱(阴 性对照组)。干预膳食为每周 6天共 9周。实验组和阳性对照组给予相同数量 的视黄醇活性当量。翻车鱼铁含量为瑞咖喱铁含量的 4倍。分别在基线和研究 终点测定血红蛋白、铁蛋白、血清转铁蛋白受体和 C-反应蛋白含量。结果: 与阳性对照组相比,鱼咖喱实验组血清转铁蛋白受体的浓度低至 0.73 mg/L (95% CI 0.17,1.28,p=0.01),而两组间铁蛋白和血红蛋白含量无统计学意 义。结论:翻车鱼,而不是瑞咖喱的摄入对临界维生素 A 状态的儿童铁含量 有影响,可作为血清转铁蛋白受体水平下降的标志。
关键词:铁、维生素 A、视黄醇、营养丰富的小鱼、孟加拉国

 

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Contribution of hypoalbuminemia and decreased renal function to the increased mortality after newly diagnosed vertebral fracture in Japanese subjects
TETSUO NAKANO, AKIKO KUWABARA, HIROSHI MIZUTA AND KIYOSHI TANAKA
Background and Objectives: Reports on the mortality and its contributing factors after vertebral fracture (VFx) has been scarce, and limited to prevalent VFx. In this paper, we have studied the factors influencing mortality after freshly diagnosed VFx. Methods and Study Design: 759 subjects aged 78.8±8.5 years old with back or lumbar pain, and diagnosed as fresh VFx by MRI were studied for their age, gender, number of prevalent fracture (s), survival or the date of death, circulating concentrations of Hb, albumin, C reactive protein, and estimated glomerular filtration rate (eGFR). Cox’s proportional hazard analysis was performed to assess the significant predictors for mortality. The cut-off concentrations of the variables for mortality were analyzed using the receiver operator characteristic (ROC) curve. Results: The median observation duration was 3.8 years, and 3-year survival rate was 78.8%. Cox’s proportional hazard analysis has shown that serum albumin concentration (hazard ratio (HR) =0.355) and eGFR (HR=0.993) were significant predictors for mortality. The cut-off concentrations were 3.6 g/dL and 60 mL/min/1.73m2, respectively. Kaplan-Meier curves revealed that survival rates were significantly decreased in patients with both serum albumin concentration and eGFR below these cut-off concentrations. Conclusions: The present study has revealed that malnutrition and impaired renal function were significant predictors for mortality after VFx.

Key Words: fresh vertebral fracture, MRI, mortality, hypoalbminemia, renal function

 

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日本新诊断椎体骨折患者低蛋白血症和肾功能下降对 增加死亡率的贡献
背景与目的:关于椎体骨折(VFx)的报道仅限于患病率,而死亡率和影响因 素的报道却很少。本文研究了新诊断的 VFx 死亡率的影响因素。方法和研究 设计:本研究纳入背或腰椎疼痛,经 MRI 新诊断为 VFx 的 759 名患者(平均 年龄为 78.8±8.5岁)。记录了他们的年龄、性别、骨折发生的次数、生存或死 亡的日期、循环血红蛋白的浓度、白蛋白、C 反应蛋白和估计的肾小球滤过率 (eGFR)。进行 Cox 比例风险分析,以评估死亡率有意义的预测指标。使用 受试者工作特征曲线(ROC)分析死亡率预测指标的截点值。结果:中位观 察时间为 3.8 年,3 年生存率为 78.8%。Cox 比例风险分析表明血清白蛋白 (危险比 HR=0.355)浓度和 eGFR(HR=0.993)是死亡率的重要预测指标, 截点值分别为 3.6 g/dL和 60 mL/min/1.73m2。Kaplan-Meier曲线显示,血清白 蛋白浓度和 eGFR 都低于截点值的患者生存率显著降低。结论:目前的研究表 明,营养不良和肾功能受损是 VFx后死亡率的重要预测指标。
关键词:新发椎体骨折、MRI、死亡率、低蛋白血症、肾功能

 

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Single vegetable meal content equivalence as an alternative to fat for satiety: a randomised trial in Japanese women
CHISAKI ADACHI, HISAMI YAMANAKA-OKUMURA, TAKAFUMI KATAYAMA, YUTAKA TAKETANI AND EIJI TAKEDA
Background and Objectives: Although high energy density foods are highly palatable, their overconsumption leads to obesity because of high fat content. Low energy density foods are more effective for preventing individuals from becoming overweight. We investigated how different amounts of a single vegetable affect the sensory properties of meals with different energy densities. Methods and Study Design: In a randomized crossover design, 40 young Japanese women consumed control and high-fat (HF) lunches. Control meals contained the same amount of rice and hamburger and 80 g (C80), 120 g (C120), 160 g (C160), 200 g (C200), 240 g (C240), or 280 g (C280) of broccoli. HF meals were control meals to which 38.1 g of oil was added (HF80, HF120, HF160, HF200, HF240, and HF280). Sensory properties before intake and 0.5, 1, 2, 3, 4, and 5 h after meals were assessed using a visual analog scale. Results: Fullness was significantly lower with C80 than with C200 and C280 at 0.5 h and all time points, respectively, after consumption. In contrast, satisfaction with all HF meals was similar at all time points. Fullness and satisfaction were higher with almost all HF meals than with control meals; however, fullness and satisfaction were similar between HF200 and all control meals 1-4 h after consumption. Conclusions: Fat increases satiety when a single vegetable is included in the meal; however, at least of 200 g of vegetable in a 500kcal meal with low fat content provides fullness and satisfaction similar to those provided by an HF meal.

Key Words: energy density, vegetable volume, Visual Analog Scale, satiety, dietary guidelines
 

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单一蔬菜膳食含量作为脂肪替代物的饱腹感等效性: 一项在日本女性中的随机试验
背景与目的:虽然高能量密度食物非常可口,由于脂肪含量高,过度消费会 导致肥胖。低能量密度的食物是防止个人超重的更有效方法。我们研究了不同 数量的单一蔬菜如何影响不同能量密度食物的感官特性。方法与研究设计: 在一项随机交叉设计中,40 名年轻的日本妇女摄入正常或高脂肪(HF)午 餐。正常饮食含有相同量的米饭和汉堡和 80 克(C80),120 克(C120), 160 克(C160),200 克(C200)、240 克(C240)或 280 克(C280)西兰 花。HF 控制餐为添加了 38.1 克食用油(HF80、HF120、HF 160、HF200、 HF240 和 HF280)。使用视觉模拟量表评估摄入前及摄入后 0.5、1、2、3、4 和 5 小时后的感官特性。结果:与 0.5h 的 C200 和 C280 相比以及所有时间点 相比,C80 饱腹感明显低。相比之下,各个时间点所有的 HF 膳食的满意度均 相似。与对照组相比,HF 膳食组的饱腹感和满意度更高。然而,HF200 膳食 组和摄食 1-4h 后对照组的饱腹感和满意度相似。结论:当膳食中只有单一蔬 菜时,脂肪能增加饱腹感;然而,500 卡路里低脂肪膳食中至少含有 200 克蔬 菜时,饱腹感和满意度与单纯 HF膳食相似。
关键词:能量密度、蔬菜卷、视觉模拟评分、饱腹感、膳食指南


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Randomized, double-blind, placebo-controlled trial of Ficus carica paste for the management of
functional constipation

HYANG-IM BAEK, KI-CHAN HA, HYE-MI KIM, EUN-KYUNG CHOI, EUN-OCK PARK, BYUNG-HYUN PARK, HYE JEONG YANG, MIN JUNG KIM, HEE JOO KANG AND SOO-WAN CHAE
Background and Objectives: Constipation affects up to 20% of the world’s population. The aim of this study was to investigate whether supplementation with Ficus carica paste could be used to treat constipation in Korean subjects with functional constipation. Methods and Study Design: We conducted a randomized, double-blind, placebo-controlled trial. Subjects with functional constipation were orally supplemented with either F. carica paste (n=40) or placebo (n=40) for 8 weeks. We measured the efficacy and safety of F. carica paste. Primary outcomes (colon transit time) and secondary outcomes (questionnaire related to defecation) were compared before and after the 8-week intervention period. Results: F. carica paste supplementation was associated with a significant reduction in colon transit time and a significant improvement in stool type and abdominal discomfort compared with the placebo. Blood parameters and clinical findings for organ toxicity remained within normal ranges. Conclusion: These results suggest that F. carica paste may have beneficial effects in subjects suffering from constipation. Key Words: Ficus carica, constipation, defecation, colonic transit time, clinical trials
 

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无花果酱对于功能性便秘管理的随机、双盲与安慰剂 对照试验
背景和目的:便秘影响到世界人口的 20%。这项研究目的是探讨无花果酱是 否可以用于韩国功能性便秘患者的治疗。方法与研究设计:我们进行了一项 随机、双盲与安慰剂对照试验。功能性便秘患者摄入无花果酱(n=40)或安 慰剂(n=40)8 周。测定无花果酱的疗效和安全性并且比较 8 周前后干预的主 要疗效(结肠转运时间)和次要疗效(涉及到排便的调查问卷)。结果:与 安慰剂组比较,无花果酱能显著减少结肠转运时间,改善粪便类型和腹部不 适。血液和器官毒性的临床参数均保持在正常范围以内。结论:这些结果表 明无花果酱可能对便秘患者产生有益的影响。
关键词:无花果、便秘、排便、结肠转运时间、临床试验

 

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Early diet intervention to reduce the incidence of hepatic encephalopathy in cirrhosis patients: post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) findings
LING LUO, SHIYING FU, YUNZHI ZHANG AND JINGXIANG WANG

Background and Objectives: Hepatic encephalopathy is a common complication in patients who have received transjugular intrahepatic portosystemic shunt (TIPS) as treatment for cirrhosis. The objective of this study was to reduce the incidence of post-TIPS hepatic encephalopathy for these patients via positive diet intervention. Methods and Study Design: As a control group, 99 cirrhosis patients who underwent TIPS treatment in our department between August 2011 and February 2013 were chosen. Among these, postoperative hepatic encephalopathy occurred in 28 cases. After analyzing the possible causes and incentives of hepatic encephalopathy by applying retrospective analysis, it was seen that hepatic encephalopathy was caused mostly by improper diet (85.7%). The experimental group was comprised of 83 cirrhosis patients who underwent TIPS treatment during the period from May 2013 to September 2014. In view of the influence of improper diet, appropriate intervention measures were taken, including developing a postoperative nursing routine, training nurses about nutrition and the protein content of kinds of various common foods, customizing low-protein meals, training nurses in communication skills to improve the education of patients and establishing family support systems. Results: For the experimental group, hepatic encephalopathy occurred in 10 patients, for an incidence of 12.1%, which is significantly lower than the control group (28.3%). This is a statistically significant difference (p<0.01) in the occurrence of this complication. Conclusions: After TIPS, early positive dietary intervention can significantly improve the compliance of cirrhosis patients to consume a low-protein diet and reduce the incidence of hepatic encephalopathy.

Key Words: early diet intervention, nutrition, TIPS, hepatic encephalopathy, cirrhosis

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早期饮食干预可降低肝硬化患者经颈静脉肝内门体分流术(TPIS)术后肝性脑病的发病率
背景与目的:肝性脑病是肝硬化患者经颈静脉肝内门体分流术(TIPS)术后 常见的并发症。本研究目的是通过积极的饮食干预降低 TIPS 术后肝性脑病的 发病率。方法与研究设计:选择 2011年 8月至 2013年 2月的 99例接受 TIPS 术治疗的肝硬化患者作为对照组。 其中,术后 28 例并发肝性脑病。采用回顾 性研究分析肝性脑病发生的可能原因和诱因,饮食不当为主要诱因,占 85.7%。2013 年 5 月至 2014 年 9 月的 83 例肝硬化 TIPS 术后患者作为实验 组,针对饮食不当这一主要问题采取相应的干预措施:制定 TIPS 术后护理常 规,培训护士关于营养和常见食物中蛋白质含量的知识,定制低蛋白膳食,培 训护士沟通技巧以提高对患者的营养知识教育,帮助建立家庭-社会支持系 统。结果:实验组中有 10 例发生肝性脑病,发病率为 12.1%,与对照组 (28.3%)相比发病率显著降低(p<0.01)。结论:早期积极的饮食干预能显 著提高肝硬化患者 TIPS术后低蛋白饮食的依从性,降低肝性脑病的发生率。
关键词:早期饮食干预、营养、TIPS、肝性脑病、肝硬化


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Efficacy of glutamine-enriched enteral feeding formulae in critically ill patients: a systematic review and meta-analysis of randomized controlled trials
AZADEH MOTTAGHI, MARYAM ZARIF YEGANEH, MAHDIEH GOLZARAND, SARA JAMBARSANG AND PARVIN MIRMIRAN
Critically ill patients usually suffer from catabolic stress that could lead to malnutrition and nutritional support therefore is essential to maintain lean body mass, improve metabolic and immune response and decrease rate of mortality and comorbidity in these patients. This meta-analysis was aimed to evaluate effect of glutamineenriched enteral nutrition in critically ill patients. In order to obtain randomized clinical trial studies (RCTs), international databases including MEDLINE and Google scholar and also electronic resources in Iran, including IRAN MEDEX, IRAN DOC, SID, Magiran were systematically searched without language and publication restriction before December 2014. The final included number of studies for meta-analysis was 10. The methodological quality of eligible studies was assessed by four investigators using the Jadad 5-point scale, a scale containing three items describing randomization, blinding and fate of participants. We analyzed data from the included studies using STATA version 12.0, and calculated a pooled odds ratio for dichotomous data and mean differences for continuous data with 95% confidence intervals (CIs). There was no significant difference in mortality in elevated pooled odds ratios (p-value=0.070). A funnel plot was drawn for evaluation of publication bias, but none was found. The fixed effect model shows significant reduction in gut permeability in who received enteral feeding enriched with glutamine (-0.84, 95% CI=-1.25 to -0.44), moreover the funnel plot did not show publication bias. Based on the available data, our meta-analysis showed that enteral glutamine (Gln) supplementation increased mortality rate, though non-significantly, but decreased gut permeability significantly. Key Words: glutamine, enteral, immune-enhancing formula, critically ill patients, systematic review
 

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谷氨酰胺强化的肠内营养配方对危重症患者的疗效: 随机对照试验的系统综述和 meta分析
重症患者通常患有代谢应激可以导致营养不良,因此营养支持对保持瘦体 重、改善代谢和免疫反应、降低这些病人的死亡率和并发症是必不可少的。 本 meta 分析的目的是评估谷氨酰胺强化的肠内营养对重症患者的疗效。为了 获得随机临床试验研究(RCTs),我们检索了 MEDLINE 和谷歌学术等国际 数据库,以及 MEDEX、IRANDOC、SID和 Magiran等电子资源中 2014年 12 月份以前的文献,不受出版语言限制。最终有 10 个研究纳入了 meta 分析。 由四个研究者采用包括随机化、盲法和研究对象的合格性三个项目的 Jadad5 点量表来评估合格研究的方法学质量。我们用 STATA12.0 分析纳入研究的数 据,计算二分类变量的比值比和连续性变量的标准差及它们的 95%置信区间 (CIs)。死亡率在升高的合并比值比中无显著差异(p-value=0.070)。在绘 制漏斗图中没有发表偏倚。固定效应模型显示接受谷氨酰胺强化的肠内营养 的患者肠道通透性显著降低(-0.84, 95% CI=-1.25到-0.44),而且漏斗图显示 没有发表偏倚。根据现有的资料,我们的 meta 分析表明,肠内谷氨酰胺补充 增加死亡率,虽然没有显著性,但显著降低了肠道通透性。
关键词:谷氨酰胺、肠内、免疫增强配方、危重症患者、系统综述

 

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Nutritional status and feeding practices in gastrointestinal surgery patients at Bach Mai Hospital, Hanoi, Vietnam
LORRAINE S YOUNG, PHAM THI THU HUONG, NGUYEN THI LAM, NGHIEM NGUYET THU, HA THI VAN, NGUYEN LIEN HANH, LE DANH TUYEN, DINH THI KIM LIEN, TRAN HIEU HOC, CHU THI TUYET, NGUYEN QUOC ANH, ELIZABETH G HENRY, CARINE M LENDERS, KATHLEEN M GURA, SHERMAN J BIGORNIA, CAROLINE M APOVIAN AND THOMAS R ZIEGLER
Background and Objectives: The nutritional status and hospital feeding practices of surgical patients in Vietnam are not well documented. Based on a cross-sectional study at Bach Mai Hospital (BMH), the prevalence of malnutrition was found to be 33% in the surgical ward using a body mass index (BMI<18.5 kg/m2. We conducted an observational study over a three month period to evaluate the feeding practices in the gastrointestinal (GI) surgery ward at Bach Mai Hospital (BMH) in Hanoi, Vietnam. Methods and Study Design: Investigators from the U.S. and the Vietnamese National Institute of Nutrition (NIN) enrolled 72 subjects admitted for elective GI surgery in an observational study at BMH. Baseline anthropometrics and changes over time, body mass index (BMI), Subjective Global Assessment (SGA) and daily kcal and protein intake from oral diet, tube feeding, and parenteral nutrition (PN) from admission until discharge were documented. Results: A total of 50% of subjects scored a B or C on the SGA; 48% of subjects had a BMI<18.5, while mean mid upper arm circumference was in the lownormal range (24±4 cm). Nearly all patients (98%) were given PN postoperatively, with oral feeding starting on an average of postoperative day 4. Only one patient was tube fed. Mean daily total calorie intake was 15 kcal/kg/day and protein intake was 0.61 g/kg/day during hospitalization. Micronutrient supplementation was minimal in subjects receiving PN. Conclusions: Hospital malnutrition in surgical patients in Vietnam is a significant problem, peri-operative feeding appears suboptimal and use of early postoperative PN was routine.

Key Words: enteral nutrition, malnutrition, subjective global assessment, parenteral nutrition, Vietnam
 

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越南河内巴赫麦医院胃肠道手术患者的营养状况和喂 养方式
背景与目的:越南手术患者的营养状况和院内喂养方式没有被详细记录。根 据巴赫麦医院的一个横断面研究,在外科病房应用体质指数(BMI<18.5 kg/m2)所判定的营养不良患病率为 33%。我们在越南河内巴赫麦医院的对胃 肠(GI)外科病房的喂养方法进行了观察研究。方法与研究设计:来自美国 和越南国家营养研究所的调查员从巴赫麦医院招募 72 名入院进行择期胃肠手 术的患者参与了这项观察性研究。记录基线人体测量指标及其随时间的变 化,体质指数,主观整体评估(SGA),从入院到出院经口摄食、管饲喂养 和肠外营养的每日能量和蛋白质的摄入量。结果:共有 50%的研究对象 SGA 得分为 B 或 C,48%的研究对象 BMI<18.5,而平均的上臂围为正常水平偏低 (24±4 cm)。几乎所有的患者(98%)在术后给予肠外营养,平均术后 4 天 给予经口喂养,只有一个病人是管饲喂养。住院期间,平均每天总能量摄入 为 15 kcal/kg/day,蛋白质摄入为 0.61 g/kg/day,接受肠外营养者极少补充微 量元素。结论:越南手术患者住院期间营养不良是一个重要问题,围手术期 患者出现喂养不理想和术后早期应用肠内营养是常规。
关键词:肠内营养、营养不良、主观整体评估、肠外营养、越南

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A survey of the enteral nutrition practices in patients with neurological disorders in the tertiary hospitals of China
YING-YING SU, DAI-QUAN GAO, XIAO-YAN ZENG, RUI-JUAN SHA, XIAO-YUAN NIU, CHANG-QING WANG, DONG ZHOU, WEN JIANG, FANG CUI, YI YANG, SU-YUE PAN, XU ZHANG, LIAN-DI LI, LIANG GAO, BIN PENG, CHUN-LONG ZHONG, ZHEN-CHUAN LIU, LI-HONG LI, HONG TAN AND PEI-YUAN LV
Background and Objectives: With the development of enteral nutrition in patients with neurological disorders in China, related guidelines were published in 2011. The Chinese Society for Parenteral and Enteral Nutrition conducted a survey to evaluate the status quo of enteral nutrition practices in these patients. Methods and Study Design: This multicenter prospective investigation was conducted from April 2012 to April 2013 and involved 18 tertiary hospitals in China. The survey using standardized questionnaires sought information about the basic protocols for enteral nutrition (devices and staffing) and specific information about patients with neurological conditions who received nutrition by way of enteral feeding. Results: In the 18 hospitals from 13 provinces, 83.3% patients were configured with an enteral nutrition infusion pump, 77.8% had a percutaneous endoscopic gastrostomy (PEG) device, and 88.9% had a clinical nutrition support group. Four hundred four patients participated in this survey (259 men, 145 women; mean age 61.3±14.7 years), 85.7% had suffered a stroke, 83.9% had impaired consciousness, and 98.0% had dysphagia. Of the 10 guidelines for enteral nutrition practices, setting the energy target, choosing the enteral nutrition tube, and monitoring the patient received unsatisfactory ratings were in poor compliance (56.2%, 30.0% and 38.9%, respectively); the remaining seven guidelines were in good compliance (each >75%). Conclusion: The survey suggested that configuration of the enteral nutritional devices and staffing was adequate in China’s tertiary hospitals. However, some associated practices had not yet reached the desired levels of competency, indicating a need for this to be understood and for improved training.
Key Words: neurological disorders, enteral nutrition, practices, tertiary hospitals, survey

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中国三甲医院神经疾病患者肠内营养支持操作规范调 查
背景和目的:随着中国神经疾病营养支持工作的快速推进,相关指南已于 2011 年发表和推广。中华医学会肠外肠内营养学分会神经疾病营养学组在中 国大城市展开调查,以评估神经疾病营养支持工作的现状。方法和研究设 计:本研究为多中心前瞻性调查研究。调查资料来自 2012 年 4月至 2013 年 4 月中华医学会肠外肠内营养分会神经疾病营养支持学组成员单位的 18 家医 院。内容包括:神经疾病肠内营养支持基本条件(设备配置与人员配备)、 接受肠内营养支持患者相关信息。结果:18 家医院来自 13 个省市自治区, 83.3%配置了肠内营养输注泵,77.8%具有经皮内镜下胃肠造瘘技术,88.9% 配备临床营养支持小组。共调查 404 例成人患者(男性 259 人,女性 145 人;平均年龄为 61.3±14.7 岁),脑卒中占 85.7%,意识障碍占 83.9%,吞咽 障碍占 98%。在具体操作过程中,能量供给目标、营养输注方式和营养输注 过程监测共 3 项操作规范的正确执行率偏低(56.2%,30%和 38.9%);而其 余 7 项规范操作的正确执行率较高(均>75%)。结论:这项调查显示,中国 三甲医院的肠内营养设备和人员配置是足够的。然而,一些相关的做法还没 有达到所需的水平,提示该项工作需要进一步被理解和改进培训。
关键词:神经疾病、肠内营养支持、操作规范、三甲医院、调查


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Food intolerance prevalence in active ulcerative colitis in southwest China
XINLING MA, YUKE CHEN, FANGYAN HUANG, QIANYING LUO, HUI LV AND HUA LONG
Background and Objectives: Food intolerance is believed to be a source of frequent medical problems in ulcerative colitis (UC), which closely correlate with patients’ dietary pattern. Living in an underdeveloped area of China, residents in southwestern region have diverse dietary habits. The objective of this study is to determine the prevalence of food intolerance in the UC patients in this area and to discuss some of the possible risk factors leading to the condition. Methods and Study Design: Food antibodies in serum of 80 patients with active UC were determined by standard enzyme-linked immuno sorbent assay (ELISA). This study examined the risk factors contributing to high titers of food antibodies and the dietary patterns correlating with food intolerance in these demographics. Results: 83.8% of patients (67/80) were found to be seropositive for food intolerance. Patients of female, aged between 20 to 40 and the one who tended to have a high fat diet were tested to be highly seropositive (p<0.05). Neither spicy food intake nor the course the disease manifested any relationship with the presence of food intolerance (p>0.05). Conclusion: Active UC patients in southwestern region of China have showed to be high seropositive in food intolerance, particularly in female and young patients. Dietary patterns with high in fat intake seem to have caused high prevalence of seropositivity in food intolerance. Although rice has been taken as staple food and the spicy food has been popular among citizen in this region, these foods have indicated to no effect on food intolerance in this study.

Key Words: food intolerance, ulcerative colitis, seropositive, dietary patterns
 

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中国西南地区急性溃疡性结肠炎患者食物不耐受流行 情况
背景与目的:溃疡性结肠炎与患者的饮食模式密切相关,食物不耐受被认为 是溃疡性结肠炎患者频繁就医的原因。生活在中国欠发达地区,中国西南地区 居民有着不同的饮食习惯。本研究的目的是确定中国西南地区急性溃疡性结肠 炎患者食物不耐受的患病率,并探讨导致该情况的可能危险因素。方法与研 究设计:运用酶联免疫法检测 80 名急性期溃疡性结肠炎患者血清特定食物抗 体水平,通过调查问卷获取患者饮食模式及人口学资料并分析。结果:本研 究 83.8%(67/80)患者食物不耐受检测阳性,年龄介于 20 至 40 岁倾向于高 脂饮食的女性患者血清食物抗体水平明显高(p<0.05),主食种类、辛辣饮 食、病史等因素组间差别无统计学意义(p>0.05)。结论:中国西南地区急性 溃疡性结肠炎患者食物不耐受阳性率高,尤以女性及中青年患者明显。高脂饮 食模式与食物不耐受显著相关。本研究未发现桂西地区以大米为主食、喜食辛 辣等饮食习惯与患者食物不耐受情况有明显联系。
关键词:食物不耐受、溃疡性结肠炎、血清阳性、饮食模式

 

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Lower body mass index is associated with hospital mortality in critically ill Japanese patients
TOMOAKI YATABE, KOICHI YAMASHITA AND MASATAKA YOKOYAMA
Background and Objectives: A recent observational study conducted in European intensive care units (ICU) showed that body mass index (BMI) is associated with mortality. We hypothesized that a lower BMI amongst critically ill Japanese patients was associated with increased hospital mortality, similar to findings noted among critically ill European patients. Therefore, we retrospectively investigated the relationship between BMI and patient outcomes in an ICU. Methods and Study Design: We included consecutive patients who were admitted to our ICU between January 2012 and December 2013. Patients were divided into 3 groups based on their BMI at ICU admission. The underweight (“lower”) group (group L) included patients with a BMI below 18.5 kg/m2, the normal weight group (group N) included patients with a BMI between 18.5 and 24.9 kg/m2, and the overweight/obese (“higher”) group (group H) included patients with a BMI above 25.0 kg/m2. Patient data were retrospectively obtained from electronic patient records. Results: A total of 1,616 patients were admitted to our ICU. Of these patients, 346 patients were ineligible, and therefore, 1,270 were included in the analysis. There were 169 patients in group L, 779 patients in group N and 322 patients in group H. Overall, the mortality rate was 8.1% and the median hospital stay was 21 days. The mortality rate in group L was significantly higher than that in both group N and group H (13.6% vs 7.8% vs 5.9%, p=0.01). Conclusions: Our retrospective study suggests that lower body mass index may be associated with increased hospital mortality in critically ill Japanese patients.

Key Words: body mass index, outcome, mortality, intensive care unit, Japanese
 

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日本危重症患者低体质指数与住院死亡率相关
背景与目的:最近在欧洲重症监护病房(ICU)进行的一项观察性研究表明, 体质指数(BMI)与死亡率有关。我们假设日本危重症患者低 BMI 与住院死 亡率增加相关,与在欧洲危重患者中的发现相似。因此,我们在一个 ICU 回 顾性调查 BMI 和患者的预后之间的关系。方法与研究设计:我们连续纳入 2012年 1月到 2013年 12月之间的 ICU患者。根据患者进入 ICU时的 BMI, 将患者分为 3组。低体重组(L组)包括 BMI低于 18.5 kg/m2的患者,正常体 重组(N 组)包括 BMI 介于 18.5-24.9 kg/m2 之间的患者,超重/肥胖组(H 组)包括 BMI 大于 25.0 kg/m2 的患者。回顾性从电子病历中获得患者的资 料。结果:共有 1,616 名住我院 ICU 的患者。在这些患者中,346 名不合格, 因此,纳入分析的有 1,270 名。L 组有 169 名患者,N 组有 779 名患者,H 组 有 322 名患者。患者总的死亡率为 8.1%,平均住院时间为 21 天。L组的死亡 率显著高于 N 组和 H 组(13.6%比 7.8%和 5.9%,p=0.01)。结论:我们的回 顾性研究表明,日本危重患者低体质指数可能与住院死亡率增加有关。
关键词:体质指数、结局、死亡率、重症监护病房、日本


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25-hydroxy-vitamin D demography and the risk of vitamin D insufficiency in the South East Asian Nutrition Surveys (SEANUTS)
BEE KOON POH, NIPA ROJROONGWASINKUL, BAO KHANH LE NGUYEN, SANDJAJA, ABD TALIB RUZITA, URUWAN YAMBORISUT, TRUONG NGUYEN HONG, FITRAH ERNAWATI, PAUL DEURENBERG, PANAM PARIKH ON BEHALF OF SEANUTS STUDY GROUP
The South East Asian Nutrition Surveys (SEANUTS) were conducted in 2010/2011 in Indonesia, Malaysia, Thailand and Vietnam in country representative samples totalling 16,744 children aged 0.5 to 12 years. Information on socio-demographic and behavioural variables was collected using questionnaires and anthropometric variables were measured. In a sub-sample of 2016 children, serum 25-hydroxy-vitamin D (25(OH)D) was determined. Data were analysed using SPSS complex sample with weight factors to report population representative data. Children were categorized as deficient (<25 nmol/L), insufficient (<50 nmol/L), inadequate (<75 nmol/L) or desirable (≥75 nmol/L). In Malaysia and Thailand, urban children had lower 25(OH)D than rural children. In all countries, except Vietnam, boys had higher 25(OH)D levels and older children had lower 25(OH)D. Regional differences after correcting for age, sex and area of residence were seen in all countries. In Thailand and Malaysia, 25(OH)D status was associated with religion. The percentage of children with adequate 25(OH)D (≥75 nmol/L) ranged from as low as 5% (Indonesia) to 20% (Vietnam). Vitamin D insufficiency (<50 nmol/L) was noted in 40 to 50% of children in all countries. Logistic regression showed that girls, urban area, region within the country and religion significantly increased the odds for being vitamin D insufficient. The high prevalence of vitamin D insufficiency in the (sub) tropical SEANUTS countries suggests a need for tailored approach to successfully combat this problem. Promoting active outdoor livestyle with safe sunlight exposure along with food-based strategies to improve vitamin D intake can be feasible options.

Key Words: vitamin D, 25(OH)D, children, SEANUTS, aetiology
 

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东南亚营养调查中 25-羟基维生素 D人口学特征和维生 素 D缺乏的风险
本课题选择了代表 2010/2011 年在马来西亚、印度尼西亚、泰国和越南进行的 东南亚营养调查(SEANUTS)中的 16,744 名年龄在 0.5 到 12 岁之间儿童为样 本。使用问卷调查收集了研究对象的社会人口学和行为学信息,同时检测了人 体测量学参数。在一个 2016 名儿童的子样本中,测定了血清 25 羟基维生素 D(25(OH)D)浓度。使用 SPSS 软件考虑权重因素的复杂样本分析并报告人群代 表性。依据缺乏(<25 nmol/L)、不足(<50 nmol/L),不太足(<75 nmol/L)和 充足(≥75 nmol/L)将儿童分类。在马来西亚和泰国,城市儿童 25(OH)D 水平 低于农村儿童。在除了越南的其它国家中,男童 25(OH)D 水平高,年龄较大 的儿童 25(OH)D 水平低。校正了年龄、性别和居住面积后,地区差异依然存 在。在泰国和马来西亚,25(OH)D 水平与宗教有关。有充足 25(OH)D(≥75 nmol/L)儿童所占的百分比从最低的 5%(印度尼西亚)到 20%(越南)。在所 有国家,40%到 50%的儿童维生素 D 不足(<50 nmol/L)。Logistic 回归分析 显示女孩、城市、农村地区和宗教显著增加维生素 D 缺乏的风险。亚热带 SEANUTS 国家较高的维生素 D 缺乏率,表明需要按各国各地区的具体情况定 制解决维生素 D 缺乏问题。促进以食品为基础的积极户外活动的阳光照射策 略来提高维生素 D的摄入是个可行的选择。

关键词:维生素D、25-羟基维生素D、东南亚营养调查、病因

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Fibroblast growth factor-23 and phosphorus related factors in young Japanese women: a cross-sectional study
SANAE ITO, HIROMI ISHIDA AND KAZUHIRO UENISHI
Phosphorus homeostasis is determined by dietary intake, intestinal absorption, and renal tubular reabsorption of phosphorus. Serum fibroblast growth factor-23 (FGF-23) is considered to be a sensitive early biomarker of disordered phosphorus metabolism in both patients with chronic kidney diseases and healthy subjects. However, the number of studies evaluating serum FGF-23 concentrations in healthy subjects is limited. The objective of this cross-sectional study was to examine the relationship between serum FGF-23 concentrations and phosphorus related factors in 182 young Japanese women (mean age, 19.5±0.4 years). We found that higher serum concentrations of inorganic phosphorus and lower serum concentrations of 1,25-dihydroxy vitamin D as well as lower fat but higher phosphorus and calcium intake were weakly but significantly associated with high serum concentrations of FGF-23, adjusted for postmenarcheal age and body weight. These results suggested that in young Japanese women, serum FGF-23 might be indicative of phosphorus nutrition status. However, it is worthy of note that maturity factors, including postmenarcheal age and physical attributes, such as body weight, might be related to serum FGF-23 concentrations.

Key Words: fibroblast growth factor-23, phosphorus, calcium, bone mineral density, young Japanese women
 

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日本年轻女性中成纤维细胞生长因子 23 和磷相关因子 的横断面研究
磷平衡是由饮食摄入量、肠道吸收和肾小管对磷的重吸收来确定的。血清成纤 维细胞生长因子 23(FGF-23)被认为是慢性肾脏病患者和健康人磷代谢紊乱 的一个早期敏感生物标志物。然而,评估健康人 FGF-23 血清浓度的研究数量 有限。本横断面研究的目的是:在 182 名日本年轻女性(平均年龄为 19.5±0.4 岁)中研究血清 FGF-23 与磷相关因子之间的关系。校正初潮年龄和体重之 后,我们发现较高的血清无机磷浓度与较低的血清 1,25-二羟基维生素 D 浓度 和脂肪、较高的磷和钙摄入存在弱相关,但与较高的血清 FGF-23 显著相关。 这些结果表明,在日本年轻女性中,FGF-23 可能反映磷的营养状态。然而, 值得注意的是包括初潮年龄和身体状况(如体重)等反映成熟的指标,可能与 血清 FGF-23浓度有关。
关键词:成纤维细胞生长因子 23、磷、钙、骨密度、日本年轻女性
 

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Changes in body composition of Indian lactating women: a longitudinal study
NEHA A KAJALE, VAMAN V KHADILKAR, ZULF MUGHAL, SHASHI A CHIPLONKAR AND ANURADHA V KHADILKAR
Background and Objectives: Lactation places enormous demands on maternal bone mineral homeostasis. Indian middle class women (MSC) consume energy dense food supplements to meet these demands post-partum (PP) along with restricted physical activity (PA). Effects of these changes on body composition (BC) of PP women have not been studied. To examine longitudinal changes in: a) bone mineral density (BMD) at total body (TB), AP-spine (APS) and dual femur neck regions (DF) b) BC by body weight, lean mass, fat mass using dual energy X-ray absorptiometry (DXA) at baseline, 6-months and 1-year in urban MSC women. Methods and Study Design: 76-primi-parous (28±3.2 yrs) randomly selected PP women (<7-days) were studied; 70 reassessed at 6months and 42 1-yr PP. Data on anthropometry, BC, BMD at TB, APS & DF by DXA collected (baseline, 6months, 1-yr PP). Results: Weight, waist and body mass index (BMI) decreased both at 6-month & 1-yr PP with respect to baseline (p<0.05). BC changes showed increase in android fat % at 1-yr by 10% over baseline (p<0.05). BMD with initial decline at 6-months (-2.8%, -2.3% and -2.3% respectively) recovered partially by 1-yr (+2.5% +1.2% and +4.8% respectively) at DF and TB with complete recovery at APS (p<0.05). Conclusion: These urban relatively sedentary MSC women consumed fat rich food PP with higher android fat retention and partial recovery of BMD at DF and TB at 1-year. Modifications in activity and dietary nutrient intakes may be necessary to prevent cardiovascular and bone health related risks.

Key Words: body composition, bone mineral density, lactation, android fat percentage, urban Indian women
 

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印度哺乳期妇女体成分变化的纵向研究
背景与研究目的:哺乳期母体对矿物质需求巨大。印度中产阶级女性消费高 能量密度食物来满足产后有限的体力活动的需要。产后妇女这些改变对体成分 变化的影响还没有被研究。本研究的目的是研究下列纵向变化,用双能 X 线 骨密度仪(DXA)测量城市中产阶级妇女基线、产后 6 个月和产后 1 年时的 全身、腰椎和双测股骨颈区的骨密度(BMD),和体重、瘦组织和脂肪组织 等体成分。方法与研究设计:随机选取 76 名产后 7 天之内的初产妇(年龄: 28±3.2岁)进行研究,产后 6个月有 70位、产后 1年有 42位参与重新评估。 分别在基线、产后 6 个月和 1 年时用 DXA 测量产妇全身、腰椎和双股骨颈区 的体成分和 BMD。结果:与基线相比,产妇在产后 6 个月和 1 年体重、腰围 和体质指数均下降(p<0.05)。体成分的改变显示:产后 1 年 android 脂肪百 分比比基线增加了 10%以上(p<0.05)。全身、腰椎和双侧股骨颈区的 BMD 在产后 6 个月时分别下降了-2.8%、-2.3% 和-2.3%,在产后一年时,双侧股骨 颈区和全身部分恢复(分别为+2.5%和+1.2%),而腰椎完全恢复(+4.8%, p<0.05)。结论:这些城市相对久坐的中产阶级妇女,产后摄入高脂肪食物与 产后 1 年较高的 android 脂肪保留和双侧股骨颈区和全身的骨密度部分恢复有 关。为预防心血管和骨骼健康相关风险,修正体力活动和膳食营养摄入可能是 必要的。
关键词:体成分、骨密度、哺乳期、android脂肪比例、印度城市妇女
 

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Serum vitamin A status is associated with obesity and the metabolic syndrome among school-age children in Chongqing, China
XIAOPING WEI, RONG PENG, JIAOYANG CAO, YU KANG, PING QU, YOUXUE LIU, XIAOQIU XIAO AND TINGYU LI
The aim of our study was to examine the association of vitamin A status with obesity and the metabolic syndrome (MS) in school-age children in Chongqing, China. A cross-sectional study was conducted of 1,928 children aged 7~11 years from 5 schools in Chongqing, China. Body height, weight, waist circumference (WC) and blood pressure were measured. Blood glucose, lipids and vitamin A were determined. Overall prevalences for overweight, obesity and MS were 10.1%, 6.7% and 3.5%, respectively. There were 274 (14.2%) marginally vitamin A deficient (MVAD) children and 53 (2.8%) vitamin A deficient (VAD) children, respectively. Serum vitamin A in the obese group was significantly lower than in the overweight and normal weight groups (p<0.001). Body mass index (BMI), WC, high density lipoprotein cholesterol (HDL-C) and glucose were strongly associated with vitamin A status (p<0.05). In a separate model adjusted for age and sex, compared with normal children, participants with obesity had a significantly higher risk of having vitamin A insufficiency (≤1.05 μmol/L) (OR: 2.37; 95% CI: 1.59, 3.55) (p<0.001), and participants with MS had a 1.99-fold (95% CI: 1.14, 3.47) greater risk of having vitamin A insufficiency (p=0.016), while participants with VAD had significantly higher risk of having MS (OR: 3.82; 95% CI: 1.44, 10.2) (p=0.007). Vitamin A insufficiency among Chongqing urban school-age children was found to be a severe health problem, significantly associated with obesity, hypertriglyceridemia and MS. Key Words: vitamin A, metabolic syndrome, obesity, school-age children, body mass index
 

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中国重庆地区学龄期儿童血清维生素 A 营养状况与肥 胖和代谢综合征的关系
本研究旨在观察中国重庆地区学龄期儿童维生素 A 营养状况与肥胖和代谢综 合征的关系。横断面调查重庆市渝中区 5 所小学共 1,928 名学龄期儿童。检查 其身高、体重、腰围和血压水平,检测其血清维生素 A、血糖和血脂水平。结 果显示,调查对象的超重率为 10.1%,肥胖率为 6.7%;代谢综合征发生率为 3.5%;维生素 A 缺乏(VAD)发生率为 2.8%,边缘型维生素 A 缺乏 (MVAD)发生率为 14.2%。肥胖组儿童血清维生素 A 水平显著低于超重组 和正常组。体质指数、腰围、高密度脂蛋白胆固醇和血糖水平与维生素 A 营 养状况有关(p<0.05)。校正年龄和性别后,肥胖儿童发生维生素 A 不足 (≤1.05 μmol/L)的风险是正常儿童的 2.37 倍(95% CI:1.59,3.55), (p<0.001),代谢综合征儿童发生维生素 A 不足的风险是正常儿童的 1.99 倍 (95% CI:1.14,3.47,p=0.016),同时我们发现,VAD 的儿童发生代谢综 合征的风险是正常儿童的 3.82 倍(95% CI:1.44,10.2,p=0.007)。重庆市 城区学龄期儿童 VA不足的发生率较高,是一个较严重的健康问题,维生素 A 不足与肥胖和代谢综合征有关。
关键词:维生素 A、代谢综合征、肥胖、学龄期儿童、体质指数
 

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Predictive factors for accuracy of perception of parents regarding their overweight or obese children in Taiwan
CHENG-JUNG CHUNG AND YUEH-GUEY HUANG
Background and Objectives: Predictive factors for parental accuracy in perception of their children’s weight and state of health have been unknown in Taiwan. Methods and Study Design: Data were obtained on children aged 3-12 years from the 2005 Taiwan National Health Interview Survey (NHIS). The comparison of measured BMI and parents’ perception of their children’s weight operationalized “weight perception”. A structured questionnaire ascertained demographic characteristics, and logistic regression determined demographic variables associated with a weight misperception. Results: The prevalence of parental misperception of children who were overweight or obese was 50%; the ratio was higher in younger parents, parents with younger children, and those with overweight or obese children. In fact, only 1.7% of children whose parents misperceived overweight or obesity were engaged in weight management. Conclusions: Most parents viewed excessive weight in their children as better health than normal weight. Parental age, children’s age, and weight loss management may be predictive factors in parents’ perceptive accuracy regarding children who are overweight or obese.

Key Words: childhood obesity, health status, perception, weight management, Taiwan
 

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台灣家長對體重過重或肥胖兒童體重感知準確性的預 測因數
背景與目的:在台灣,有關家長對於兒童體重及健康狀態的感知準確性的預 測因數目前仍不清楚。方法與研究設計:本研究以國家衛生研究院 2005 年國 民健康訪問暨藥物濫用調查資料庫之 3-12 歲兒童為研究資料。本研究的體重 感知定義為兒童身體質量指數與家長對兒童體重的感知狀態兩者間的相互對 照,另以問卷方式調查個案的背景變項,並以logistic迴歸方式檢驗家長的背景 變項與體重感知錯誤間的關聯性。結果:研究結果發現,在體重過重或肥胖 兒童中有一半的家長皆有體重感知錯誤的現象,其中年紀較輕的家長、年齡較 小的兒童或過重與肥胖的兒童方面皆有較高的體重感知錯誤比例。事實上,在 體重感知錯誤的對象中,只有 1.7%體重過重或肥胖的兒童有進行體重控制與 管理的行為。結論:大部分的家長認為體重過重的兒童健康狀態較體重正常 兒童者為佳。家長年齡、兒童年齡以及是否進行體重控制與管理等因素可能可 以作為家長是否能正確感知兒童體重過重或肥胖的預測因數。
關鍵詞:兒童肥胖、健康狀態、感知、體重管理、台灣

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Coffee consumption and risk of gastric cancer: an updated meta-analysis
YAN XIE, SHIFENG HUANG, TONGCHUAN HE AND YUXI SU
Background and Objectives: Coffee is one of the most widely consumed beverages worldwide, and many studies have investigated the association between coffee consumption and gastric cancer. However, the results are inconsistent. We conducted a systematic analysis of relevant population studies to derive a more precise estimation. Methods and Study Design: Cochrane library, PubMed and Embase databases were searched to identify studies that met predetermined inclusion criterion through July 2014. All epidemiologic studies regarding coffee consumption and gastric cancer risk were selected, and relative risks (RRs) with 95% confidence intervals (CIs) were calculated. Results: Twenty two studies (9 cohort and 13 case-control studies) involving 7,631 cases and 1,019,693 controls were included. The summary RR of gastric cancer was 0.94 (95% CI: 0.80-1.10) for the highest category of coffee consumption compared with the lowest category, and 0.93 (95% CI: 0.88-0.99) for coffee drinkers compared with nondrinkers. We stratified the population by coffee consumption. The pooled RR for the population with <1 cup/day, 1-2 cups/day and 3-4 cups/day coffee consumption compared with nondrinkers were 0.95 (95% CI: 0.84-1.08), 0.92 (95% CI: 0.82-1.03) and 0.88 (95% CI: 0.76-1.02), respectively, indicating that an increase in coffee consumption was associated with a decreased risk of gastric cancer. Furthermore, we stratified the studies by design, sex, population and time. A significant association between coffee intake and decreased gastric cancer risk was shown in case-control studies (RR=0.85, 95% CI: 0.77-0.95) and among the studies published over the last ten years (RR=0.88, 95% CI: 0.77-1.00). Conclusions: Our meta-analysis suggested that coffee consumption might be associated with a decreased risk of gastric cancer.

Key Words: coffee, gastric cancer, meta-analysis, epidemiologic study, risk factor
 

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咖啡饮用量与胃癌发生风险:一个更新的荟萃分析
背景与目的:咖啡是世界上最为广泛的饮料之一,很多研究发现咖啡的饮用 量与胃癌之间存在一定的关系。本研究系统地分析了相关人群的风险以期得 到一个较为肯定的结论。实验方法:搜索 2014 年 7 月之前数据库 Cochrane library, PubMed and Embase中符合设定选入标准的相关研究。所有关于咖啡饮 用量和胃癌之间关系的流行病学研究均纳入研究,计算其相对危险度的 95% 可信区间。结果:22 例研究(9 个队列研究,13 个病例对照研究)中,总共 有 7,631位病例,1,019,693位健康对照。大量与少量咖啡饮用者的胃癌相对危 险度是 0.94(95%可信区间为 0.80-1.10),饮用者与非饮用者的胃癌相对危险 度是 0.93(95%可信区间为 0.88-0.99)。本研究按咖啡饮用的量分组。每天小 于一杯咖啡,1-2 杯咖啡和 3-4 杯咖啡饮用量的人群与不饮咖啡的人群胃癌发 生的相对危险度分别是 0.95(95%可信区间为 0.84-1.08),0.92(95%可信区 间为 0.82-1.03),0.88(95%可信区间为 0.76-1.02)。这表明随着咖啡饮用量 的增加,胃癌的发生率降低。进而,将所有研究按照实验设计、性别、人 群、时间分组,在最近 10 年的病例对照研究(相对危险度 0.85,95%可信区 间为 0.77-0.95)中,咖啡的饮用量与胃癌的发生呈负相关(相对危险度 0.88,95%可信区间为 0.77-1.00)。结论:本 meta 分析的结果提示咖啡的饮 用量与胃癌的发生率呈负相关。
关键词:咖啡、胃癌、meta分析、流行病学研究、危险因素

 

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Limitations of studies on school-based nutrition education interventions for obesity in China: a systematic review and meta-analysis
KAIMENG KONG, JIE LIU AND YEXUAN TAO
Background and Objectives: School-based nutrition education has been widely implemented in recent years to fight the increasing prevalence of childhood obesity in China. Methods and Study Design: A comprehensive literature search was performed using six databases to identify studies of school-based nutrition education interventions in China. The methodological quality and the risk of bias of selected literature were evaluated. Stratified analysis was performed to identify whether different methodologies influenced the estimated effect of the intervention. Results: Seventeen articles were included in the analysis. Several of the included studies had inadequate intervention duration, inappropriate randomization methods, selection bias, unbalanced baseline characteristics between control and intervention groups, and absent sample size calculation. Overall, the studies showed no significant impact of nutrition education on obesity (OR=0.76; 95% CI=0.55-1.05; p=0.09). This can be compared with an OR of 0.68 for interventions aimed at preventing malnutrition and an OR of 0.49 for interventions aimed at preventing iron-deficiency anemia. When studies with unbalanced baseline characteristics between groups and selection bias in the study subjects were excluded, the impact of nutrition education on obesity was significant (OR=0.73; 95% CI=0.55-0.98; p=0.003). An analysis stratified according to the duration of intervention revealed that the intervention was effective only when it lasted for more than 2 years (OR=0.49, 95% CI=0.42-0.58; p<0.001). Conclusion: Studies of school-based nutrition education programs in China have some important limitations that might affect the estimated effectiveness of the intervention.

Key Words: nutrition education, school children, obesity, systemic review, meta-analysis
 

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中国基于学校对小学生肥胖营养教育干预研究的局限 性:系统综述和 meta分析
背景与目的:面对近年来小学生肥胖发病率的不断增长,基于学校的营养教 育在中国广泛开展。方法与研究设计:利用万方、CNKI、CBM、Pubmed、 ISI Web of Knowledge 和 Embase 六个数据库,对中国基于学校针对小学生肥 胖的营养教育的相关文献进行检索。对纳入的文献进行方法学和偏倚风险的评 估,并采用分层分析的方法探索不同方法是否会对干预效果的评估产生影响。 结果:共有 17 篇文献纳入分析,其中有几个研究存在干预时间不足、随机化 方法不当、选择偏倚、干预组和对照组某些基线特征不均衡,以及缺乏样本量 的计算等问题。总体而言,相对于针对小学生营养不良的基于学校的营养教育 干预结果 OR为 0.68,以及缺铁性贫血的干预结果 OR为 0.49,基于学校的营 养 教 育 对 小 学 生 肥 胖 没 有 显 著 影 响 ( OR=0.76 , 95% CI=0.55-1.05 ; p=0.09)。当排除存在研究对象组间某些基线特征不均衡和选择偏倚的相关文 献后,再次分析发现营养教育对肥胖的干预效果显著(OR=0.73,95% CI=0.55-0.98;p=0.003)。另外,根据干预时间进行分层分析,我们发现只有 当干预时间>2 年时,基于学校的营养教育才对小学生的肥胖有效(OR=0.49, 95% CI=0.42-0.58;p<0.001)。结论:中国基于学校的针对小学生肥胖的研究 有一些重要的局限性,可能会影响干预效果的评估。
关键词:营养教育、小学生、肥胖、系统综述、meta分析

 

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Instant noodles, processed food intake, and dietary pattern are associated with atopic dermatitis in an adult population (KNHANES 2009-2011)
SUNMIN PARK, HYUN-SEOK CHOI AND JI-HYUN BAE
Background and Objectives: The incidence of atopic dermatitis (AD) is continuously increasing in industrialized countries, possibly due to dietary and lifestyle changes. However, the association between processed food intake and AD has not been studied in a large adult population. Methods and Study Design: We investigated the association between dietary habits and AD in 17,497 adults in the 2009-2011 Korean National Health and Nutrition Examination Survey (KNHANES). Results: We identified 4 dietary patterns using principal components analysis of a 63-item food frequency questionnaire: the “traditional dietary pattern”, rich in rice and kimchi; the “processed food pattern”, with more meat, instant noodles, soda, and processed foods; the “healthy dietary pattern”, high in grains, vegetables, fruits, and seaweeds; and the “drinking dietary pattern”, mainly drinking coffee and alcohol. Adjusted odds ratios (ORs) for AD were calculated according to dietary patterns after adjusting for potential confounders with incorporation of sample weights for the complex sample design. The “meat and processed food” pattern was associated with a significant 1.57 fold higher OR for atopic dermatitis than the low consumption group. Further analysis revealed that the increased atopic dermatitis was most closely associated with instant noodles. In contrast, the groups with high intake of rice and kimchi exhibited lower ORs, 0.38 and 0.43 folds, compared to the low intake group. Conclusion: Consuming instant noodles, meat and processed foods was associated with increased prevalence of atopic dermatitis, whereas consuming rice and kimchi, and coffee was associated with decreased prevalence of atopic dermatitis.

Key Words: atopic dermatitis, processed foods, coffee, instant noodles, meat consumption
 

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方便面、加工食品的摄入量和膳食模式与成人的特应 性皮炎相关(2009-2011年韩国全国健康和营养调查)
背景与目的:特应性皮炎的发生率在工业化国家持续增加,可能是由于饮食 和生活方式的改变。然而,加工食品与特应性皮炎的关系还没有在大人群中研 究过。方法与研究设计:我们研究了 2009-2011 年韩国全国健康和营养调查中 17,497 名成年人饮食习惯与特应性皮炎的关系。结果:我们采用主成分法分析 了含有 63 个条目的食物频率问卷,确定了 4 个膳食模式:“传统膳食模式”: 富含大米和泡菜;“加工食品模式”:更多的肉、方便面、饮料、加工食品; “健康膳食模式”:高谷物、蔬菜、水果和海藻;“饮用膳食模式”:主要饮用咖 啡和酒精。校正掺入复杂样本设计的样本权重等潜在混杂因素,根据膳食模式 计算校正的比值比(ORs)。“肉和加工食品”模式高摄入组比低摄入组特应性 皮炎的 OR 值高 1.57 倍。进一步分析显示:特应性皮炎的增加与方便面关系 最密切。相反,大米和泡菜高摄入组与低摄入组相比,OR 值较低,分别为 0.38和 0.43。结论:方便面、肉类和加工食品的摄入与特应性皮炎的患病率增 加有关,而大米、泡菜和咖啡的摄入与特应性皮炎的患病率降低有关。
关键词:特应性皮炎、加工食品、咖啡、方便面、肉类摄入

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The genetic polymorphisms in vitamin D receptor and the risk of type 2 diabetes mellitus: an updated meta-analysis
FEI YU, LINGLING CUI, XING LI, CHONGJIAN WANG, YUE BA, LING WANG, JING LI, CHAO LI, LIPING DAI AND WENJIE LI
Background and Objectives: Vitamin D receptor (VDR) genetic polymorphisms are considered to be associated with type 2 diabetes mellitus (T2DM), but this is inconclusive. The aim of this study is to quantify the association between polymorphisms of BsmI and FokI in the VDR gene and T2DM risk through literature review. Methods and Study Design: Original articles published from 1999 to June 2014 were discovered through PubMed, ISI Web of Science, China National Knowledge Infrastructure, Chinese Wanfang Database, and the Chinese Biomedical Literature Database. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with software STATA version 12.0. Results: Twenty-three articles containing 30 case-control studies were included. The association between the BsmI polymorphism and T2DM was weak in two genetic models (Bb vs bb and BB+Bb vs bb). The subgroup analysis showed that this association was only found in the studies with a small sample size (<200). A strong association between FokI polymorphism and T2DM indicated that this gene polymorphism was possibly a risk factor for T2DM (ff vs FF: OR=1.57, 95% CI: 1.28-1.93, p<0.001; Ff vs FF: OR=1.54, 95% CI: 1.31-1.81, p<0.001; ff+Ff vs FF: OR=1.57, 95% CI: 1.35-1.83, p<0.001), especially in Chinese populations. Conclusion: More reliable conclusions about associations between VDR genetic polymorphisms and T2DM will depend on studies with larger sample size and by ethnicity.

Key Words: vitamin D receptor, type 2 diabetes mellitus, genetic polymorphism, association, meta-analysis
 

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维生素 D 受体基因多态性与 2 型糖尿病发病风险:一 个更新的 meta分析
背景与目的:研究发现维生素D受体(VDR)基因多态性与2型糖尿病 (T2DM)的发病关系密切,但相关文献报道结论并不一致。本研究的目的是 通过文献系统综述对VDR受体基因BsmI和FokI位点单核苷酸多态性与T2DM的 关联性进行评价。方法与研究设计:于PubMed 、ISI Web of Science、中国期 刊全文数据库(CNKI)、中国万方数据库和中国生物医学文献数据库 (CBM)中检索1999年至2014年期间发表的所有相关文献。运用Stata 12.0软 件,通过计算OR值和95% CI来评价位点BsmI和FokI变异与T2DM的关联性。 结果:共23篇文献30个病例对照研究纳入本次meta分析中。分析结果显示 BsmI位点单核苷酸多态性与T2DM易患性在两种基因模型中(Bb vs bb 和 BB+Bb vs bb)存在弱的相关性。亚组分析显示这种弱的相关性主要出现在样 本量较小的研究中(<200)。FokI位点单核苷酸多态性与T2DM易患性(ff vs FF:OR=1.57,95% CI:1.28-1.93,p<0.001; Ff vs FF:OR=1.54,95% CI: 1.31-1.81,p<0.001; ff+Ff vs FF:OR=1.57,95% CI:1.35-1.83,p<0.001)存 在强的相关性,提示该位点基因突变是T2DM的危险因素,尤其是在中国汉族 人群中。结论:有关VDR基因与T2DM的关联分析还需要大样本量和不同种族 研究的支持。
关键词:维生素D受体、2型糖尿病、 基因多态性、关联、meta分析

 

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Infant feeding concerns in times of natural disaster: lessons learned from the 2014 flood in Kelantan, Malaysia
ZAHARAH SULAIMAN, NORAINI MOHAMAD, TENGKU ALINA TENGKU ISMAIL, NAZIRAH JOHARI AND NIK HAZLINA NIK HUSSAIN
The flood that hit Kelantan in December 2014 was the worst in Malaysian history. Women and their infants accounted for a large proportion of the people at risk who were badly affected, as almost half of the population in Kelantan was in the reproductive age group. This report serves to raise awareness that breastfeeding mothers and infants are a special population with unique needs during a disaster. Four of their concerns were identified during this massive flood: first, the negative impact of flood on infant nutritional status and their health; second, open space and lack of privacy for the mothers to breastfeed their babies comfortably at temporary shelters for flood victims; third, uncontrolled donations of infant formula, teats, and feeding bottles that are often received from many sources to promote formula feeding; and lastly, misconceptions related to breastfeeding production and quality that may be affected by the disaster. The susceptibility of women and their infant in a natural disaster enhances the benefits of promoting the breastfeeding rights of women. Women have the right to be supported which enables them to breastfeed. These can be achieved through monitoring the distribution of formula feeding, providing water, electricity and medical care for breastfeeding mothers and their infants. A multifaceted rescue mission team involving various agencies comprising of local government, including the health and nutrition departments, private or non-governmental organizations and individual volunteers have the potential to improve a satisfactory condition of women and infants affected by floods and other potential natural disasters.

Key Words: concerns, disaster, flood, infant feeding, Kelantan
 

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自然灾害时期的婴儿喂养问题:吉兰丹马来西亚 2014 年洪水的经验教训
2014 年 12 月,吉兰丹发生了史上最严重的洪水灾害。占人口总数大多数的妇 女和她们的婴儿受到最严重的影响,吉兰丹约一半人口是处于生殖年龄的人 群。该研究旨在报道提高处于灾难中有独特需求的哺乳母亲及婴儿特殊人群的 认知水平。洪水期间需关注四个方面:第一,洪水对婴幼儿营养和健康状况的 负面影响;第二,母亲在洪灾临时避难所受室外缺乏隐私的环境中进行母乳喂 养的舒适度;第三,许多来源的婴幼儿奶粉、奶嘴和奶瓶的捐赠无法控制,促 进配方奶粉喂养;最后,对母乳的产生和质量可能受水灾影响的误解。自然灾 害中妇女及其婴儿易受影响,提高了促进妇女母乳喂养权利的益处。妇女有权 得到支持,使她们能够母乳喂养。这些可以通过监测配方奶喂养的分布情况, 为母乳喂养的母亲和婴儿提供水、电和医疗服务来实现。一个涉及各个部门, 包括地方政府(包括健康和营养部门)、私营或非政府组织、个体志愿者组成的 多方面的救援任务团队,有可能使受洪水和其它潜在自然灾害影响的妇女和婴 儿达到一个满意的状态。

关键词:关注、灾害、洪水、婴儿喂养、吉兰丹

 

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Parenteral nutrition combined with rice soup can be a safe and effective intervention for congenital chylous ascites
YI CAO, WEIHUI YAN, LINA LU, YIJING TAO, WEI LU, YINGWEI CHEN, QINGYA TANG AND WEI CAI
Congenital chylous ascites in the neonatal period is a rare entity. Total parenteral nutrition (TPN), medium chain triglyceride (MCT)-based diet, octreotide and repeated paracentesis are regarded as appropriate medical treatment for congenital chylous ascites, and surgery is recommended when conservative therapy has failed. We present two cases in which ascites were confirmed via an abdominal sonogram and diagnostic paracentesis. In our clinical experience, rice soup combined with PN can be a safe and effective intervention.

Key Words: congenital chylous ascites, neonate, optimal treatment, rice soup, parenteral nutrition
 

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静脉营养联合米汤优化治疗先天性乳糜腹
先天性乳糜腹在新生儿时期较为罕见,目前其主要治疗手段包括全肠外营养、 中链脂肪酸为基础的饮食、奥曲肽以及反复腹腔穿刺引流术,当保守治疗失败 时则建议手术。本文提供了两例通过腹部超声和诊断性腹腔穿刺确诊的先天性 乳糜腹病例。根据我们的临床治疗经验,口服米汤结合肠外营养是先天性乳糜 腹的一种安全有效的治疗方法。
关键词:先天性乳糜腹、新生儿、最佳治疗、米汤、肠外营养

 

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Australasian society for parenteral and enteral nutrition (AuSPEN) adult vitamin guidelines for parenteral nutrition
EMMA J OSLAND, AZMAT ALI, TRUC NGUYEN, MELVYN DAVIS AND LYN GILLANDERS
Background and Objectives: This work represents the second part of a progressive review of AuSPEN’s 1999 Guidelines for Provision of Micronutrient Supplementation in adult patients receiving parenteral nutrition. Methods and Study Design: A systematic literature review was undertaken and recommendations made based on the available evidence and with consideration to specific elements of the Australian and New Zealand (NZ) practice environment. The strength of evidence underpinning each recommendation was assessed. A multidisciplinary steering committee and external reviewers provided feedback on the guidelines. Results: On review of the available literature it appears that the parenteral multivitamin preparations presently available in Australia and NZ are to sufficient avoid deficiency without causing toxicity in most clinical situations for adults receiving PN when provided regularly as part of the PN prescription. Vitamin D is the most vulnerable vitamin for the Australian and NZ PN population. Conclusions: Vitamins are an essential component of PN and should be provided from commencement for all patients receiving PN. With the exception of vitamin D, which is recommended to be monitored annually, routine monitoring of vitamin levels is unlikely to be necessary in patients receiving regular parenteral multivitamin preparations. Clinical judgement is an important element when assessing, prescribing and monitoring patients receiving PN. Areas requiring further research have been identified.

Key Words: vitamins, guidelines, parenteral nutrition, vitamin D, micronutrients
 

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澳大利亚肠外与肠内营养学会(AuSPEN)肠外营养成 人维生素指南
背景与目的:该项工作是对AuSPEN 1999年指南针对接受肠外营养(PN)的成 人患者补充微量元素进行逐步审查的第二部分。方法与研究设计:进行系统文 献综述,基于现有证据,同时考虑澳大利亚和新西兰(NZ)实践环境的特殊因 素提出了推荐。对每一项证据支撑的推荐的强度进行了评估。一个多学科指导 委员会和外部评审员对指南提供了反馈意
见。结果:通过现有文献综述,发现 在澳大利亚和新西兰,现有的肠外复合维生素制剂,对常规接受PN且复合维生 素作为PN处方一部分的成年人,足以避免不足,且不会造成毒性。维生素D是 澳大利亚和新西兰人群最容易缺乏的维生素。结论:维生素是肠外营养的重要 组成部分,应为所有接受PN的患者提供维生素。除了推荐的每年监测维生素D 外,常规监测维生素含量,对接受常规复合维生素制剂的患者未必是必须的。 当评估、开处方以及监测接受PN的患者时,临床评估是个重要的因素。有待进 一步研究的领域也已经确定。
关键词:维生素、指南、肠外营养、维生素D、复合维生素

 

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Last Updated: July 2016