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1 Asia Pacific Journal of Clinical Nutrition
       Volume 27, 3

        (
May 2018)


Abstracts

Contents

Abstract PDF

Review Articles

Nutritional composition of breast milk in Chinese women: a systematic review
TING YANG, LIANSHENG ZHANG, WEI BAO AND SHUANG RONG
doi:
10.6133/apjcn.042017.13

Asia Pac J Clin Nutr. 2018;27(3):491-502.

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The anti-wasting effects of L-carnitine supplementation on cancer: experimental data and clinical studies
MAHSA ESFAHANI, SAHAR SAHAFI, ALI DERAKHSHANDEH AND AZADEH MOGHADDAS
doi:
10.6133/apjcn.042017.10

Asia Pac J Clin Nutr. 2018;27(3):503-511.

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Original Research Communications

Clinical Nutrition and Feeding Studies

Pancreatic enzyme replacement therapy (PERT) in children with persistent diarrhea: avoidance of elemental diet need, accessibility and costs
ARIANI DEWI WIDODO, RIANTO SETIABUDY, INA S TIMAN, SAPTAWATI BARDOSONO, WIDDY WINARTA AND AGUS FIRMANSYAH

doi: 10.6133/apjcn.082017.05
Asia Pac J Clin Nutr. 2018;27(3):512-518.

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Thalassemia and other hemoglobinopathies among anemic individuals in Metro Manila, Philippines and their intake of iron supplements
MARIO V CAPANZANA, MA ANGELINA L MIRASOL, GEOFFRY SMITH, IMELDA ANGELES-AGDEPPA, LEAH PERLAS, FRANCISCO DE LOS REYES AND MARIA SOFIA AMARRA
doi:
10.6133/apjcn.092017.01

Asia Pac J Clin Nutr. 2018;27(3):519-526.

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Malnutrition and chronic inflammation as risk factors for sarcopenia in elderly patients with hip fracture
JUN-IL YOO, YONG-CHAN HA, HANA CHOI, KYU-HWANG KIM, YOUNG-KYUN LEE, KYUNG-HOI KOO AND KI-SOO PARK
doi:
10.6133/apjcn.082017.02

Asia Pac J Clin Nutr. 2018;27(3):527-532.

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Identifying errors in meals provided to and sourced by patients on therapeutic diets in hospital
MEGAN RATTRAY, BEN DESBROW AND SHELLEY ROBERTS
doi:
10.6133/apjcn.072017.10

Asia Pac J Clin Nutr. 2018;27(3):533-539.

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Prognostic value of preoperative prognostic nutritional index in stage III gastric cancer after curative resection: a retrospective cohort study
HUA-XI WANG, CUN-CHUAN WANG, WAH YANG, LI-LIAN GAO AND SHU-QING YU
doi:
10.6133/apjcn.072017.03

Asia Pac J Clin Nutr. 2018;27(3):540-545.

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The impact of self-efficacy education based on the health belief model in Iranian patients with type 2 diabetes: a randomised controlled intervention study
SHOOKA MOHAMMADI, NORIMAH A KARIM, RUZITA ABD TALIB AND REZA AMANI
doi:
10.6133/apjcn.072017.07

Asia Pac J Clin Nutr. 2018;27(3):546-555.

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Cinnamon improves metabolic factors without detectable effects on adiponectin in women with polycystic ovary syndrome
AZAM BORZOEI, MARYAM RAFRAF AND MOHAMMAD ASGHARI-JAFARABADI
doi:
10.6133/apjcn.062017.02

Asia Pac J Clin Nutr. 2018;27(3):556-563.

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Efficacy of actinidin-containing kiwifruit extract Zyactinase on constipation: a randomised double-blinded placebo-controlled clinical trial
IONA WEIR, QUAN SHU, NENGDING WEI, CHENGKAI WEI AND YI ZHU
doi:
10.6133/apjcn.122017.03

Asia Pac J Clin Nutr. 2018;27(3):564-571.

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Effects of palm olein and olive oil on serum lipids in a Chinese population: a randomized, double-blind, cross-over trial
GUIJU SUN, HUI XIA, YUEXIN YANG, SHUSHU MA, HAITENG ZHOU, GUOFANG SHU, SHAOKANG WANG, XIAN YANG, HUALI TANG, FENGLING WANG, YAQIONG HE, RONG DING, HONG YIN, YANYAN WANG, YANG YANG, HANGJU ZHU AND LIGANG YANG
doi:
10.6133/apjcn.032017.12

Asia Pac J Clin Nutr. 2018;27(3):572-580.

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Effect of probiotic supplements in women with gestational diabetes mellitus on inflammation and oxidative stress biomarkers: a randomized clinical trial
MAJID HAJIFARAJI, FATEMEH JAHANJOU, FATEMEH BBASALIZADEH, NASSER AGHAMOHAMMADZADEH,
MEHRAN MESGARI ABBASI AND NEDA DOLATKHAH
doi:
10.6133/apjcn.082017.03

Asia Pac J Clin Nutr. 2018;27(3):581-591.

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Nutritional Status, Dietary Intake, and Body Composition

Anthropometry to assess body fat in Indonesian adults
JANATIN HASTUTI, MASAHARU KAGAWA, NUALA M BYRNE AND ANDREW P HILLS
doi:
10.6133/apjcn.092017.02

Asia Pac J Clin Nutr. 2018;27(3):592-598

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Association of vitamin D deficiency with diabetic peripheral neuropathy and diabetic nephropathy in Tianjin, China
LEPING FAN, YUE ZHANG, JIE ZHU, YIXUAN SONG AND JINGNA LIN
doi:
10.6133/apjcn.062017.11

Asia Pac J Clin Nutr. 2018;27(3):599-606.

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Maternal and Child Nutrition

Effect of individualised dietary education at medical check-ups on maternal and fetal outcomes in pregnant Japanese women
REIKO TAJIRIKA-SHIRAI, HIDEMI TAKIMOTO, TETSUJI YOKOYAMA, HITOSHI KANEKO, TOSHIRO KUBOTA AND NAOYUKI MIYASAKA
doi:
10.6133/apjcn.082017.01

Asia Pac J Clin Nutr. 2018;27(3):607-616.

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Associations between socioeconomic status and overweight among urban children aged 7-12 years in Chengdu, southwest China
JUNYA ZHAI, HONGMEI XUE, JIAO LUO, LISHI ZHANG AND GUO CHENG
doi:
10.6133/apjcn.022017.12

Asia Pac J Clin Nutr. 2018;27(3):617-623.

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Pre-earthquake national patterns of preschool child undernutrition and household food insecurity in Nepal in 2013 and 2014
SUDEEP SHRESTHA, ANDREW L THORNE-LYMAN, SWETHA MANOHAR, BINOD SHRESTHA, SUMANTA NEUPANE, RUCHITA RAJBHANDARY, RAMAN SHRESTHA, ROLF DW KLEMM, BARENG AS NONYANE, RAMESH K ADHIKARI, PATRICK WEBB AND KEITH P WEST, JR
doi:
10.6133/apjcn.092017.04

Asia Pac J Clin Nutr. 2018;27(3):624-637.

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Nutritional Epidemiology and Public Health

Validation study of a self-administered diet history questionnaire for estimating amino acid intake among Japanese adults
HITOMI SUGA, KEIKO ASAKURA, SATOSHI SASAKI, MASANORI NOJIMA, HITOMI OKUBO, NAOKO HIROTA, AKIKO NOTSU, MITSURU FUKUI AND CHIGUSA DATE
doi:
10.6133/apjcn.072017.09

Asia Pac J Clin Nutr. 2018;27(3):638-645.

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Is high sodium intake associated with hearing impairment? The association between spot urine sodium concentration and hearing threshold in Korean adolescents
HYUN SEUNG CHOI, JUNG HYUN CHANG, JEONG HONG KIM AND JU WAN KANG
doi:
10.6133/apjcn.042017.09

Asia Pac J Clin Nutr. 2018;27(3):646-648.

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Age and CD4 count are dominant factors in the prediction of anaemia in Javanese HIV patients
JOKO WAHYUWIBOWO, STEFANI HARUMSARI, SITI THOMAS ZULAIKHA, ARI SUWONDO, MUCHLIS ACHSAN UDJI SOFRO AND SUHARYO HADISAPUTRO
doi:
10.6133/apjcn.082017.04

Asia Pac J Clin Nutr. 2018;27(3):649-654.

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Glycemic load is associated with diabetes and prediabetes among middle-aged and elderly adults in Guangzhou, China
FENG-YI HE, CHAO-GANG CHEN, DIAO-ZHU LIN, FENG LI, XIU-HONG LIN, ZHI-MIN YUAN AND LI YAN
doi:
10.6133/apjcn.042017.05

Asia Pac J Clin Nutr. 2018;27(3):655-661.

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Food Guide Pagoda and the food safety of women: one-year follow-up study on the effects of the 2008 Sichuan Earthquake
XIANGLONG XU, BING LI, RUIXUE BAI, YUNSHUANG RAO, LINGLI LIU, CESAR REIS, MANOJ SHARMA AND YONG ZHAO
doi:
10.6133/apjcn.092017.08

Asia Pac J Clin Nutr. 2018;27(3):662-670.

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Oral health behavior as a risk factor for high urinary sodium among Korean women
KYUNGDO HAN, NAMRYANG KIM, YOUNGKYUNG KO, YONG-GYU PARK AND JUN-BEOM PARK
doi:
10.6133/apjcn.012018.01

Asia Pac J Clin Nutr. 2018;27(3):671-680.

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Taste sensitivities and diet of Chinese and Indians in Singapore
CLAUDIA LEONG SHU-FEN, CIARÁN G FORDE, SIEW LING TEY AND CHRISTIANI JEYAKUMAR HENRY
doi:
10.6133/apjcn.062017.04

Asia Pac J Clin Nutr. 2018;27(3):681-685.

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Combined effect of eating alone and a poor nutritional status on cognitive decline among older adults in Taiwan
CHENG-LUN LI, HO-JUI TUNG AND MING-CHIN YEH
doi:
10.6133/apjcn.092017.05

Asia Pac J Clin Nutr. 2018;27(3):686-694.

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Eating disorders and body image concerns as influenced by family and media among university students in Sharjah, UAE
HADIA RADWAN, HAYDER A HASAN, LINA NAJM, SARA ZAURUB, FARIDAH JAMI, FAHIMEH JAVADI, LINA ADEEB DEEB AND AMANI ISKANDARANI
doi:
10.6133/apjcn.062017.10

Asia Pac J Clin Nutr. 2018;27(3):695-700.

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Habitual tea drinking associated with a lower risk of type 2 diabetes in Vietnamese adults
CHUNG THANH NGUYEN, ANDY H LEE, NGOC MINH PHAM, VUONG VAN DO, NGHIA DUY NGU, BINH QUANG TRAN AND COLIN BINNS
doi:
10.6133/apjcn.072017.08

Asia Pac J Clin Nutr. 2018;27(3):701-706.

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Nutrigenomics

Association of dopamine receptor D2 gene (DRD2) Taq1 polymorphisms with eating behaviors and obesity among Chinese and Indian Malaysian university students
FANG-YING LEK, HING-HUAT ONG AND YEE-HOW SAY
doi:
10.6133/apjcn.092017.09

Asia Pac J Clin Nutr. 2018;27(3):707-717.

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Effects of MTHFR A1298C polymorphism on peripheral blood folate concentration in healthy populations: a meta-analysis of observational studies
YU XIN, LIHUA WU, XIAOLIN LU, SHAOFANG SHANGGUAN, ZHEN WANG, SHAOYAN CHANG, JIYONG YIN, WEI PIAO, TING ZHANG AND LI WANG
doi:
10.6133/apjcn.122017.02

Asia Pac J Clin Nutr. 2018;27(3):718-727.

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Case Report

Rehabilitation nutrition in pressure ulcer management with type 2 diabetes: a case report
YOKO SAINO, HIDETAKA WAKABAYASHI, KEISUKE MAEDA, SHINTA NISHIOKA, TAKAKO HAO AND KENJI MIMATSU
doi:
10.6133/apjcn.062017.05

Asia Pac J Clin Nutr. 2018;27(3):728-734.

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Future Events

 

 

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Nutritional composition of breast milk in Chinese women: a systematic review
TING YANG, LIANSHENG ZHANG, WEI BAO AND SHUANG RONG
Background and Objectives: As breast milk is considered nature’s best food for infant growth and development, understanding its nutritional composition is crucial for optimising the components of infant formula milk. In this study, we aimed to summarise the available evidence on the nutritional composition of breast milk from Chinese women, in particular, the macronutrients, fatty acids and minerals. Methods and Study Design: We searched PubMed, Embase, and Chinese databases for articles about human breast milk from Chinese women published in English or Chinese between 1999 and 2015. We classified the data in 35 articles from the literature search into three lactation stages: colostral, transitional and mature milk. Results: The content of each component varied greatly during the three lactation stages. Protein content decreased from colostral milk to mature milk (mean±SD, 1.64±0.32 g/dL vs 1.22±0.12 g/dL). In contrast, lipid content increased from colostral milk (2.36±1.17 g/dL) to mature milk (3.39±1.24 g/dL). Colostrum contained more linoleic acid (LA) than transitional and mature milk, while colostrum contained less α-linolenic acid (ALA) than transitional and mature milk. As lactation progressed, the ratios of docosahexaenoic acid (DHA) and arachidonic acid (AA) to total fatty acids decreased while the potassium (K), zinc (Zn), and copper (Cu) concentrations decreased significantly, but their standard deviations were large. Magnesium (Mg) and manganese (Mn) concentrations showed significant differences across the three lactation stages. Conclusions: The stage of lactation was an important factor affecting the nutritional composition of breast milk from Chinese women.

Key Words: human breast milk, nutritional composition, macronutrients, fatty acids, minerals
 

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The anti-wasting effects of L-carnitine supplementation on cancer: experimental data and clinical studies
MAHSA ESFAHANI, SAHAR SAHAFI, ALI DERAKHSHANDEH AND AZADEH MOGHADDAS
Background and Objectives: Cachexia is a paraneoplastic syndrome that affects the large majority of patients with end-stage cancer. No known therapy exists to effectively overcome the severe symptoms of cachexia, which include anorexia, weight loss and fatigue. This study considered the results of both experimental and clinical studies to evaluate the suitability of L-carnitine and its derivatives as potential therapies for cachexia in patients with cancer. Methods and Study Design: All available English-language papers on the use of L-carnitine in patients with cachexia related to cancer, including reviews, case reports, case series, and clinicaltrials, were obtained by searching multiple databases, including all Elsevier publications, Web of Knowledge, PubMed, Scopus, clinical trials, and the Cochrane database of systematic reviews. Results: The protective effects of L-carnitine were extracted from the literature review based on critical mechanisms involved in skeletal muscle loss, including increased proteolysis, impaired protein synthesis, myonuclear apoptosis, oxidative stress, and mitochondrial dysfunction. The results of this process favored L-carnitine supplementation in patients with cancer-related cachexia. Nitrogen balance was improved either through the increase of protein synthesis or by reduction in proteolysis, inhibiting apoptosis or reversing inflammatory processes. Conclusions: Although clinical studies are inconclusive, studies in animal models support L-carnitine administration to prevent oxidative stress and ameliorate mitochondrial function. L-carnitine supplementation leads to beneficial effects on several critical mechanisms involved in pathologic skeletal muscle loss and improved fatigue-related parameters in patients with cancer. However, more well-designed, double-blinded, randomized clinical trials are necessary to establish L-carnitine supplementation as a therapeutic strategy for cachexia.

Key Words: L-carnitine, muscle wasting, cachexia, fatigue, oxidative stress

 

 

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Pancreatic enzyme replacement therapy (PERT) in children with persistent diarrhea: avoidance of elemental diet need, accessibility and costs
ARIANI DEWI WIDODO, RIANTO SETIABUDY, INA S TIMAN, SAPTAWATI BARDOSONO, WIDDY WINARTA AND AGUS FIRMANSYAH

Background and Objectives: Persistent diarrhea has been proven to cause pancreatic exocrine insufficiency, due to decreased stimulation to the pancreas caused by prolonged mucosal injury. Pancreatic enzyme replacement therapy (PERT) given in conjunction to regular treatment is thought to be beneficial in replacing this pancreatic enzyme deficiency, avoiding the need of elemental diet. This study aims to evaluate the benefit of PERT in chil-dren with persistent diarrhea. Methods and Study Design: This is a randomized, two double-blind parallel group, placebo-controlled clinical trial to evaluate the effects of pancreatic enzyme supplementation in persistent diar-rhea. Children age 6-60 months were recruited from pediatric inpatient and outpatient units of five hospitals in Jakarta. Subjects was randomly assigned to either pancreatic enzyme 8371 USP unit of lipase or placebo, 3 times daily for 1 month, as an adjunctive therapy to standard treatment. Subjects were then reevaluated at 2 weeks and 4 weeks interval after administration of enzyme or placebo. Variables observed were length of diarrhea after the start of intervention, change in serum prealbumin, and change in FE-1 between week 0 and week 4. Results: Pan-creatic enzyme supplementation shortens the length of diarrhea by 7 days in the intervention group compared to placebo (p=0.019). Serum prealbumin and FE-1 shows trend that favors the intervention group, although not sta-tistically significant (p>0.05). Conclusion: PERT is clinically effective in reducing the length of diarrhea, thus minimizing the need, accessibility and costs of an elemental diet.
Key Words: persistent diarrhea, pancreatic exocrine insufficiency, pancreatic enzyme supplementation, children, length of diarrhea

 

 

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Thalassemia and other hemoglobinopathies among anemic individuals in Metro Manila, Philippines and their intake of iron supplements
MARIO V CAPANZANA, MA ANGELINA L MIRASOL, GEOFFRY SMITH, IMELDA ANGELES-AGDEPPA, LEAH PERLAS, FRANCISCO DE LOS REYES AND MARIA SOFIA AMARRA
Background and Objectives: Iron deficiency is the most common cause of anemia worldwide. In Southeast Asia, studies showed that genetic hemoglobin disorders also contribute significantly to the burden of anemia. The study aimed to estimate the proportion of thalassemia and other hemoglobinopathies versus iron deficiency and other causes in a sample of anemic individuals; describe the characteristics of thalassemic subjects in terms of severity of anemia, adequacy of iron stores, and hematological profile; examine the intake of iron supplements among individuals with varying causes of anemia. Methods and Study Design: A random sample of 101 anemic individuals living in Metro Manila was examined. Hemoglobinopathy was determined using capillary electrophoresis. Iron deficiency was determined using immunoradiometric assay for serum ferritin. A questionnaire was used to obtain information on the use of iron supplements. Results: The most frequent underlying cause of anemia was iron deficiency (37.6%), followed by anemia due to other causes (34.7%), and hemoglobinopathy (27.8%). The most prevalent form of hemoglobinopathy was alpha-thalassemia trait (20.8%), followed by betathalassemia trait (5%), iron deficiency anemia with concomitant HbE (1%), and beta-thalassemia HbE interacting (1%). Thalassemic subjects exhibited mild anemia, had either normal or excessive iron stores, and did not ingest iron supplements. Conclusion: The majority of anemia (62.5%) in this sample was due to other causes and hemoglobinopathy, rather than iron deficiency. Genetic hemoglobin disorders appear to be common among anemic individuals. Population screening is needed to determine the real prevalence of the disease. Further investigation is needed to identify other causes of anemia among Filipinos.

Key Words: thalassemia, genetic hemoglobin disorders, Philippines, anemia, iron deficiency
 

 

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Malnutrition and chronic inflammation as risk factors for sarcopenia in elderly patients with hip fracture
JUN-IL YOO, YONG-CHAN HA, HANA CHOI, KYU-HWANG KIM, YOUNG-KYUN LEE, KYUNG-HOI KOO AND KI-SOO PARK

Background and Objectives: To evaluate malnutrition and chronic inflammation as risk factors for sarcopenia in elderly patients with hip fractures, as defined by the criteria of the Asian Working Group on Sarcopenia (AWGS). Methods and Study Design: A total of 327 elderly patients with hip fractures were enrolled in this retrospective observational study. The main outcome measure was the nutritional status and nutritional risk factors for sarcopenia in elderly patients. Diagnosis of sarcopenia was made according to the guidelines of the AWGS. Whole body densitometry analysis was used to measure skeletal muscle mass, and muscle strength was evaluated by handgrip testing. Multivariable regression analysis was utilized to analyze the nutritional risk factors for sarcopenia in patients with hip fractures. Results: Of 327 patients with hip fractures (78 men and 249 women), the prevalence of sarcopenia was 60.3% and 30.1% in men and women, respectively. The rates of three indicators of malnutrition in men and women (low BMI, hypoalbuminemia, and hypoproteinemia) in sarcopenia patients with hip fractures were 23.4%, 31.9%, and 53.2% and 21.3%, 21.3%, and 37.3%, respectively. The prevalence of markers of chronic inflammation (increased CRP and ESR) in men and women with sarcopenia and hip fractures were 74.9% and 52.2%, and 49.3% and 85.1%, respectively. After adjusting for covariates, low BMI and hypoproteinemia in women were associated with a 2.9- and 2.1-fold greater risk of sarcopenia than non-sarcopenia, respectively. Conclusions: The present study revealed a strong relationship between sarcopenia and malnutrition and chronic inflammatory factors in elderly patients with hip fractures.

Key Words: chronic inflammation, hip fracture, malnutrition, sarcopenia, elderly
 

 

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Identifying errors in meals provided to and sourced by patients on therapeutic diets in hospital
MEGAN RATTRAY, BEN DESBROW AND SHELLEY ROBERTS
Background and Objectives: Patients requiring therapeutic diets in hospital are at risk of exposer to dietary errors that may pose an acute threat to their safety. This study aimed to determine the prevalence of meal-related errors among hospitalised patients prescribed therapeutic diets, following the implementation of an electronic foodservice system (EFS). Methods and Study Design: This observational study involved six wards in a tertiary metropolitan hospital that used an EFS for meal ordering and plating. Participants were adult medical inpatients receiving a therapeutic diet for medical or nutritional reasons. Meal accuracy was assessed for up to 48-hours per patient by comparing the dietary items placed on patients’ meal trays or personal meals consumed by patients to their therapeutic diet prescription. Inaccuracies were categorised as critical or non-critical errors and were identified as having occurred at one of four steps in the EFS: menu planning (main-meals), meal assembly (mainmeals), meal delivery (mid- and main-meals) and meal consumption (personal-meals). Results: A total of 167 inpatients were included in the study. Of the 906 meals assessed, 69 errors (8%) were observed; with 97% classified as critical. Error rates differed according to the foodservice system step assessed: 17% for menu planning, <1% for meal assembly, 53% for meal delivery: main-meals, 9% for meal delivery: mid-meals and 33% meal consumption. Conclusion: An EFS almost completely eliminated errors associated with meal assembly. However, when foodservice staff and patients selected dietary items at ward level (without a guiding system) a substantial number of potentially critical errors occurred.

Key Words: meal accuracy, food safety, patient safety, meal delivery, specialised diets specialised

 

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Prognostic value of preoperative prognostic nutritional index in stage III gastric cancer after curative resection: a retrospective cohort study
HUA-XI WANG, CUN-CHUAN WANG, WAH YANG, LI-LIAN GAO AND SHU-QING YU
Background and Objectives: Nutrition and inflammation play a crucial role in the development of cancer. The prognostic value of the prognostic nutritional index (PNI) has been confirmed in some types of human cancers. This study analyzed the prognostic significance of the preoperative PNI in patients with stage III gastric cancer after curative surgery. Methods and Study Design: In this retrospective study, we enrolled 274 patients who underwent curative operation for stage III gastric cancer. The correlation between the preoperative PNI and overall survival (OS) was analyzed using Kaplan–Meier curves and multivariate Cox regression analyses. Results: The patients with a high PNI had a significantly higher median OS than did those with a low PNI (46.8 months vs 24.1 months, p=0.01). In the subgroup analysis, the survival benefit of the PNI was limited to the patients with poorly differentiated gastric cancer (high PNI, 46.8 months; low PNI, 21.8 months, p=0.004) and was not observed in those with well and moderately differentiated cancer (high PNI, 30.3 months; low PNI, 26.7 months, p=0.30). In the multivariate analysis, the PNI was an independent prognostic factor for OS. Conclusions: The PNI can be used as an independent prognostic biomarker for operable advanced gastric cancer.

Key Words: prognostic nutritional index, survival, advanced gastric cancer, serum albumin, lymphocytes


 

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The impact of self-efficacy education based on the health belief model in Iranian patients with type 2 diabetes: a randomised controlled intervention study
SHOOKA MOHAMMADI, NORIMAH A KARIM, RUZITA ABD TALIB AND REZA AMANI
Background and Objectives: Type 2 diabetes is a chronic illness which can be managed by patients’ commitment to self-care and self-efficacy behaviors. Methods and Study Design: A randomized controlled intervention study was carried out to determine the impact of self-efficacy education based on the Health Belief Model (HBM) in 240 patients with type 2 diabetes at the Golestan Hospital, Ahvaz, Iran between October 2014 and August 2015. The education duration was three months followed by a 24-week follow-up visit to determine the progress of the subjects. In this study, reliable and validated diabetes educational booklet and questionnaires based on knowledge, health beliefs and quality of life were used. The participants were randomly allocated to either the intervention group (n=120) or to the conventional dietary counseling group as controls (n=120), and assessed at the baseline, week 12 and week 36. The study was divided into primary outcome measurements consisting of glycated hemoglobin A1c (HbA1c), fasting blood glucose, lipid profile, and anthropometric levels. Secondary outcome measures were related to nutrition knowledge, health beliefs and quality of life. Results: The results showed that subjects in the intervention group had significantly better metabolic and glycemic profiles compared with those in the control group. It also showed that knowledge, health belief and quality of life significantly increased in the intervention group. Conclusions: Findings indicate that through tailored self-efficacy education, the quality of life and metabolic profile of diabetes patients can be improved.

Key Words: health belief model, type 2 diabetes, self-efficacy education, quality of life, metabolic profile
 

 

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Cinnamon improves metabolic factors without detectable effects on adiponectin in women with polycystic ovary syndrome
AZAM BORZOEI, MARYAM RAFRAF AND MOHAMMAD ASGHARI-JAFARABADI

Background and Objectives: The objectives of this study were to investigate the effects of cinnamon supplementation on glycemic indices, serum lipids and adiponectin in patients with polycystic ovary syndrome (PCOS). Methods and Study Design: This double-blind randomized controlled clinical trial was conducted on 84 overweight or obese PCOS patients. Subjects in cinnamon (n=42) and placebo (n=42) groups were given 3 cinnamon capsules (each one contained 500 mg cinnamon) or placebo daily for 8 weeks. Fasting blood samples, anthropometric measurements and dietary intake data were collected at the baseline and at the end of the trial. Data were analyzed by independent t test, paired t test and analysis of covariance. Results: Cinnamon significantly decreased serum fasting blood glucose, insulin, homeostatic model assessment for insulin resistance, total cholesterol and low-density lipoprotein cholesterol and weight and increased high-density lipoprotein cholesterol compared with placebo (all p<0.05). Serum triglyceride and body mass index significantly decreased in the cinnamon group, in comparison with baseline values (p=0.001 and p=0.002, respectively). No significant changes were seen in serum adiponectin in either group. Conclusions: Short term supplementation of cinnamon had some favourable effects on metabolic risk factors of women with PCOS and may be useful in management of PCOS complications.

Key Words: polycystic ovary syndrome, cinnamon, glycemic indices, lipid profile, adiponectin

 

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Efficacy of actinidin-containing kiwifruit extract Zyactinase on constipation: a randomised double-blinded placebo-controlled clinical trial
IONA WEIR, QUAN SHU, NENGDING WEI, CHENGKAI WEI AND YI ZHU
Background and Objectives: Zyactinase® is an extract of green kiwifruit, formulated into the consumer healthcare products marketed as Phloe® and Kivia, used to assist in the relief of the symptoms associated with a range of digestive system dysfunction, including constipation and Irritable Bowel Syndrome (IBS). Methods and Study Design: A randomised, double-blind, placebo-controlled clinical trial was undertaken to determine the ef-fects of the kiwifruit extract on bowel movement, stool formation and IBS associated symptoms amongst a sub-ject group of generally healthy individuals experiencing a period of moderate constipation. Fifty-eight partici-pants were randomized to the kiwifruit extract (28) or placebo (30). Selection criterion was decreased number of bowel movements (<3/week), with increased faecal hardness and IBS associated symptoms. The study ran for three weeks, with participants first undergoing a seven-day wash out period, followed by a seven-day dosing pe-riod, and then a seven-day follow up period. Results: There was a significant increase in the defecation frequency (p<0.001), with a significant improvement in faecal score (p<0.01). There was a significant difference in painful defecation and abdominal pain between the two groups (p<0.01). No side effects, including diarrhoea, urgency or abdominal pain, were observed during the trial. Conclusions: The green kiwifruit extract significantly induced normal bowel movements with no adverse effects. The kiwifruit extract relieved constipation and the symptoms of IBS such as bloating, flatulence and abdominal pain.
Key Words: kiwifruit, constipation, IBS, actinidin, Zyactinase
 

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Effects of palm olein and olive oil on serum lipids in a Chinese population: a randomized, double-blind, cross-over trial
GUIJU SUN, HUI XIA, YUEXIN YANG, SHUSHU MA, HAITENG ZHOU, GUOFANG SHU, SHAOKANG WANG, XIAN YANG, HUALI TANG, FENGLING WANG, YAQIONG HE, RONG DING, HONG YIN, YANYAN WANG, YANG YANG, HANGJU ZHU AND LIGANG YANG
Background and Objectives: As the most widely produced edible vegetable oil, palm oil is known as to contain a high level of saturated fatty acid, which was thought to adversely affect serum lipid profiles. However, recent studies have shown no influence or benefits of palm oil on serum lipids. The potential nutritional value of palm oil is attributed to the high mono-unsaturation at the crucial sn2-position of the oil's triacylglycerols, as with the so-called ‘healthy’ olive oil (OO). The aim of this study was to further test this hypothesis and evaluate the effects of consuming palm olein versus olive oil on serum lipid profiles in a Chinese population. Methods and Study Design: In total, 120 participants were recruited from a spinnery in Yixing city and randomly divided into two groups (palm olein or olive oil) to conduct a 2×2 crossover trial for 2 months’ intervention with 2-week washout periods. Each participant was provided 48 g of test oil per day. At the end of each period, anthropometry, and blood lipid indices were measured to determine the effects of palm olein and olive oil. Results: Palm olein and olive oil consumption had no significantly different effect on BMI, on serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triacylglycerol (TG), Apo B, fasting glucose, or insulin
concentrations (all p>0.05). Conclusions: In a dietary crossover trial, palm olein and olive oil had no recognisably different effects on body fatness or blood lipids in a healthy Chinese population.
Key Words: palm olein, olive oil, blood lipids, cross-over trial, population intervention
 

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Effect of probiotic supplements in women with gestational diabetes mellitus on inflammation and oxidative stress biomarkers: a randomized clinical trial
MAJID HAJIFARAJI, FATEMEH JAHANJOU, FATEMEH ABBASALIZADEH, NASSER AGHAMOHAMMADZADEH, MEHRAN MESGARI ABBASI AND NEDA DOLATKHAH
Background and Objectives: Very little is known about the use of probiotics among pregnant women with gestational diabetes mellitus (GDM) especially its effect on oxidative stress and inflammatory indices. The aim of present study was to measure the effect of a probiotic supplement capsule on inflammation and oxidative stress biomarkers in women with newly-diagnosed GDM. Methods and Study Design: 64 pregnant women with GDM were enrolled in a double-blind placebo controlled randomized clinical trial in the spring and summer of 2014. They were randomly assigned to receive either a probiotic containing four bacterial strains of Lactobacillus acidophilus LA-5, Bifidobacterium BB-12, Streptococcus Thermophilus STY-31 and Lactobacillus delbrueckii bulgaricus LBY-27 or placebo capsule for 8 consecutive weeks. Blood samples were taken pre- and post-treatment and serum indices of inflammation and oxidative stress were assayed. The measured mean response scales were then analyzed using mixed effects model. All statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software (version 16). Results: Serum high-sensitivity C-reactive protein and tumor necrosis factor-α levels improved in the probiotic group to a statistically significant level over the placebo group. Serum interleukin-6 levels decreased in both groups after intervention; however, neither within group nor between group differences interleukin-6 serum levels was statistically significant. Malondialdehyde, glutathione reductase and erythrocyte glutathione peroxidase levels improved significantly with the use of probiotics when compared with the placebo. Conclusions: The probiotic supplement containing L.acidophilus LA- 5, Bifidobacterium BB- 12, S.thermophilus STY-31 and L.delbrueckii bulgaricus LBY-2 appears to improve several inflammation and oxidative stress biomarkers in women with GDM.
Key Words: gestational diabetes mellitus, probiotics, inflammation, oxidative stress

 

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Anthropometry to assess body fat in Indonesian adults
JANATIN HASTUTI, MASAHARU KAGAWA, NUALA M BYRNE AND ANDREW P HILLS
Background and Objectives: Anthropometric equations are widely used to estimate body composition however, are only appropriate for use in populations in which they have been developed and validated. The present study developed anthropometric prediction equations for Indonesian adults and cross-validated them with selected equations used in this population. Methods and Study Design: Six hundred Indonesian adults aged between 18– 65 years (292 males and 308 females) were divided equally into development and validation groups. Stature, body weight, skinfold thickness at eight sites, girth at five sites, and bone breadth at four sites were measured. Stepwise multiple regression analysis was used to propose percentage body fat (%BF) prediction equations using measured variables and %BF from the deuterium oxide dilution technique as the reference. The proposed prediction equations were then cross-validated using the validation group and %BF estimated from several existing equations. Results: Proposed prediction equations showed r ranged from 0.82 to 0.86 and Standard Error of the Estimate (SEE) from 4.7 to 5.4%. Cross-validation analysis showed bias with the reference %BF between 0.2 and 3.3% and Pure Error (PE) between 2.8 and 4.0%. Among the existing equations, the Durnin and Womersley equation was applicable in females whilst the equation by Davidson et al. underestimated %BF by 6.3–6.6% and the equation by Gurrici et al overestimated by 2.0–3.4% in both genders (p<0.01). Conclusion: The proposed prediction equations provide better options for accurate prediction of %BF in Indonesian adults.
Key Words: body composition, percentage body fat, prediction equation, anthropometry, Indonesian adults

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Association of vitamin D deficiency with diabetic peripheral neuropathy and diabetic nephropathy in Tianjin, China
LEPING FAN, YUE ZHANG, JIE ZHU, YIXUAN SONG AND JINGNA LIN
Background and Objectives: To evaluate the association of vitamin D deficiency with type 2 diabetic peripheral neuropathy (DPN) and diabetic nephropathy (DN). Methods and Study Design: A total of 287 type 2 diabetic patients were categorized in two ways, and each divided into two groups: DPN (n=164) and non-DPN (NDPN) groups (n=123); and DN (n=148) and non-DN (NDN) groups (n=139). Enzyme-linked immunosorbent assay was used to measure the 25-hydroxy vitamin D [25(OH)D3] level. Correlation analysis between 25(OH)D3 and other indicators was performed. Results: 25(OH)D3 levels were lower in the DPN and DN groups than in the NDPN and NDN groups, and the difference was statistically significant (t =−6.23, −4.38, p<0.0001). Moreover, a higher proportion of patients in the DPN and DN groups exhibited vitamin D deficiency than those in the NDPN and NDN groups (χ2=22.231, 15.973, respectively, p<0.0001). Vitamin D was highly correlated with DPN, DN, diabetes duration, age, sex, fasting plasma glucose, blood urea nitrogen, total cholesterol, low density lipoprotein cholesterol, 24-h urinary microalbumin, and beta-2 microglobulin (r=−0.34 ~ –0.133, p<0.05). Binary logistic regression analysis revealed that vitamin D deficiency is an independent risk factor for DPN and DN (OR=3.53, 95% confidence interval [CI]: 2.06–6.03; OR=2.93, 95% CI: 1.71–5.03; respectively, p<0.0001). Conclusions: Vitamin D deficiency is closely correlated with DPN and DN and can be considered as an independent risk factor for DPN and DN.
Key Words: type 2 diabetes mellitus, vitamin D, peripheral neuropathy, diabetic nephropathy, diabetes duration
 

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Effect of individualised dietary education at medical check-ups on maternal and fetal outcomes in pregnant Japanese women
REIKO TAJIRIKA-SHIRAI, HIDEMI TAKIMOTO, TETSUJI YOKOYAMA, HITOSHI KANEKO, TOSHIRO KUBOTA AND NAOYUKI MIYASAKA
Background and Objectives: An increased prevalence of low maternal weight and insufficient pregnancy weight gain may be responsible for an increase in low birthweight infants in Japan. We aimed to examine the effects of individualised dietary education at medical check-ups on maternal/fetal outcomes in Japanese women. Methods and Study Design: Four hundred and six underweight and normal weight singleton pregnant women,
who attended check-ups at an obstetric facility until ≥30 weeks gestation and delivered at 36-41 weeks gestation, were selected for analyses. Weight gain was assessed at each check-up based on the official “Dietary Guidelines for Pregnant and Lactating Women”. Individual dietary advice was provided by dieticians to those with insufficient or excess weight gain status around 28 weeks gestation. The medical records from uncomplicated singleton deliveries (36-41 weeks gestation) at the same facility from 2008-2010 were used (n=792) to examine the effect of dietary education on maternal/fetal outcomes. Results: Pre-pregnancy underweight was present in >24% of women in both the intervention and non-intervention groups. Adequate weight gain occurred more frequently in the intervention group (p<0.01). There were no significant differences in mean birthweight or the proportion of low birthweight infants. However, the proportion of extremely small for gestational age infants (birthweight <3rd percentile) was lower in the intervention group (p=0.011). There were no differences in the frequency of caesarean
delivery, pregnancy induced hypertension, or infant Apgar scores <7. Conclusions: Dietary education during pregnancy check-ups promotes adequate maternal weight gain and helps prevent extreme fetal growth restraint.
Key Words: dietary education, infant, pregnancy outcomes, weight gain, BMI
 

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Associations between socioeconomic status and overweight among urban children aged 7-12 years in Chengdu, southwest China
JUNYA ZHAI, HONGMEI XUE, JIAO LUO, LISHI ZHANG AND GUO CHENG
Background and Objectives: Income inequality in China has risen steadily over the past decades. This study explored the relationship between socioeconomic status (SES) and overweight among urban children aged 7-12 years in Chengdu, a comparatively prosperous metropolis city located in “the West China”, the backward, less developed region of China. Methods and Study Design: A population-based cross-sectional study was conducted in 2013 among urban children aged 7-12 years old in Chengdu city. A total of 853 urban students were involved in this analysis, with measured heights, weights, and filled in self-administered questionnaires. Overweight, including obesity, was defined according to the Working Group on Obesity in China. SES indicators included family income, parental education and occupation class. Results: Urban girls living in high-income households were more likely to be overweight than those living in low-income households (OR 2.19, 95% confidence interval, 1.02-4.83). However, no significant associations were found among boys and there were also null significant associations between other SES indicators and overweight in children of either sex. Conclusions: Urban girls living in relatively affluent circumstances were at greatest risk for being overweight. This study implies that any future overweight prevention program in Chengdu city is needed to start at the family level beginning with individuals of a high socioeconomic background, especially in urban girls.
Key Words: children, overweight, obesity, socioeconomic status, China

 

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Pre-earthquake national patterns of preschool child undernutrition and household food insecurity in Nepal in 2013 and 2014
SUDEEP SHRESTHA, ANDREW L THORNE-LYMAN, SWETHA MANOHAR, BINOD SHRESTHA, SUMANTA NEUPANE, RUCHITA RAJBHANDARY, RAMAN SHRESTHA, ROLF DW KLEMM, BARENG AS NONYANE, RAMESH K ADHIKARI, PATRICK WEBB AND KEITH P WEST, JR
Background and Objectives: Preschool undernutrition remains a burden in Nepal. This paper reports results of surveys in 2013 and 2014, examining patterns of child nutritional status across the country, associations with household food insecurity and antecedent comparative national data for subsequent evaluations of nutritional sta-tus following the earthquake in Nepal in 2015. Methods and Study Design: A multi-stage sample was drawn comprising 21 sites in 75 districts of the country, representing the mountains, hills and Terai zones, providing proportionate to zonal samples of 4286 and 4947 households and 5401 and 5474 preschool children in each year, respectively. Children 6 to 59 months of age were measured for weight and height, expressed as standardized z-scores for height-for-age (HAZ), weight-for-height (WHZ), and stunting and wasting (<-2 z for each). The household food insecurity access scale (HFIAS) was used to measure food security. Results: Between 2013 and 2014, HAZ decreased from a mean (SD) of -1.46 (1.39) to -1.54 (1.33) z-scores, while the prevalence of stunting increased from 35.5% to 37.4% (p<0.05 for both), evident in the mountains and Terai but not hills. In both years, wasting was highest (~22%) in the Terai versus mountains or hills (~8%). More households were classified food secure in 2014 (73%) than 2013 (59%), evident in all zones. Conclusions: Two midyear surveys in Nepal re-vealed a stable nutritional situation among preschool children, reflecting a pause in the long-term decline in stunt-ing noted in previous years. The same period saw a slight reduction in wasting and improved household food se-curity.
Key Words: malnutrition, household food insecurity, national survey, nutrition surveillance, Nepal
 

 

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Validation study of a self-administered diet history questionnaire for estimating amino acid intake among Japanese adults
HITOMI SUGA, KEIKO ASAKURA, SATOSHI SASAKI, MASANORI NOJIMA, HITOMI OKUBO, NAOKO HIROTA, AKIKO NOTSU, MITSURU FUKUI AND CHIGUSA DATE
Background and Objectives: Despite growing interest in the association between dietary amino acid intake and optimal health, validated dietary questionnaires that can estimate amino acid intake have been scarce. We exam-ined the validity of amino acid intakes estimated using a self-administered diet history questionnaire (DHQ) com-paring with 16-day semi-weighed dietary records (DR). Methods and Study Design: A total of 184 Japanese men and women completed a four-day DR and a DHQ four times, once in each season. Dietary amino acid in-takes were estimated as crude, energy-adjusted, and percentage of total protein intake (% protein) using an amino acid database of Japanese foods. The validity of dietary amino acid intake estimated by the first-time DHQ was examined using the mean of 16 days’ DRs as reference. Results: Mean intakes of almost all amino acids estimat-ed by DHQ were significantly lower than those estimated by the DR for energy-adjusted values in both sexes. Although mean amino acid intakes estimated by DHQ were significantly higher than those estimated by the DR for % protein value, the differences between the DR and DHQ were slight (-0.04 to 0.39% protein for men, -0.05 to 0.37% protein for women). Pearson correlation coefficients between DHQ and the DR showed reasonable ranking ability in % protein values for men (interquartile range (Q1–Q3): 0.31-0.47) and energy-adjusted values for women (interquartile range (Q1–Q3): 0.40-0.45). Conclusion: DHQ showed acceptable ability to estimate mean amino acid intake and to rank individuals in a population according to their amino acid intake for using in large-scale epidemiological studies.
Key Words: diet history questionnaire, amino acid, dietary intake, validation study, Japanese
 

 

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Is high sodium intake associated with hearing impairment? The association between spot urine sodium concentration and hearing threshold in Korean adolescents
HYUN SEUNG CHOI, JUNG HYUN CHANG, JEONG HONG KIM AND JU WAN KANG
Background and Objectives: High sodium intake is a well-known risk factor for diseases such as cardiovascular and renal disease. There may also be links between sodium intake and inner ear symptoms. However, the available data are limited, and clinicians remain suspicious about sodium intake and hearing threshold. We analyzed the relationship between spot urine sodium concentration and sensorineural hearing loss in Korean adolescents. Methods and Study Design: A total of 534 subjects, aged 12–19 years old, were enrolled in this study. Sex, age, hearing threshold, and overnight spot urine sodium concentration were measured. Multivariate logistic regression analysis was performed to estimate the independent effect of sodium intake on hearing level. Results: Higher urine sodium concentrations were observed in subjects with hearing impairment in 2000, 3000 and 4000 Hz. After adjusting for sex, age and BMI, we found an association between urine sodium concentration and sensorineural hearing loss in 500, 2000, 3000 and 4000 Hz. Conclusion: Our results suggest that high sodium intake might be associated with hearing impairment.

Key Words: Sodium intake; Urinary sodium; Hearing threshold; Adolescent; Hearing loss
 

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Age and CD4 count are dominant factors in the prediction of anaemia in Javanese HIV patients
JOKO WAHYUWIBOWO, STEFANI HARUMSARI, SITI THOMAS ZULAIKHA, ARI SUWONDO, MUCHLIS ACHSAN UDJI SOFRO AND SUHARYO HADISAPUTRO
Background and Objectives: Anaemia in Human Immunodeficiency Virus (HIV) infection is multifactorial and an increasingly important variable to consider in the management. This is the first study of anaemia in HIV infection in the Javanese population, which constitutes the largest ethnic group in Indonesia. The aim of this study was to determine the factors which are associated with anaemia in Javanese patients with HIV infection. Methods and Study Design: This study applied a cross-sectional design involving HIV patients in Dr Kariadi Hospital and Balai Kesehatan Paru Masyarakat (BKPM), Semarang, Indonesia. The characteristic data of the subjects were age, gender, BMI, duration of therapy and antiretroviral (ARV) drugs. Haematology tests were conducted using flow cytometry. Results: The prevalence of anaemia in HIV-infected patients was 21 (38.88%). Macrocytic anemia was found as a majority (12; 57.1 %) in anaemic patients. The risk factors which were found to be associated with increase of anaemia were white blood cells (WBC) <5.0 x 109/L and CD4 <200.0 cells/μL (p<0.05). A correlation between anaemia and age (r=0.49, p<0.01), duration of treatment (r=0.35, p<0.01), CD4 count (r=-0.42, p<0.01), total bilirubin (r=-0.28, p<0.05), and unconjugated bilirubin (r=-0.29, p<0.05) was identified. Age (p=0.023) and CD4 count (p=0.07) were the dominant factors in the multivariate analysis. Conclusion: Age and CD4 count are the dominant factors in determining of anaemia in Javanese patients with HIV infection.
Key Words: age, CD4, anaemia, HIV, Javanese

 

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Glycemic load is associated with diabetes and prediabetes among middle-aged and elderly adults in Guangzhou, China
FENG-YI HE, CHAO-GANG CHEN, DIAO-ZHU LIN, FENG LI, XIU-HONG LIN, ZHI-MIN YUAN AND LI YAN
Background and Objectives: Previous studies have obtained conflicting findings regarding the possible associations between glycemic load (GL) indices and diabetes. In the present study, we examined cross-sectional associations between several GL indices, including the total dietary GL, the energy-adjusted GL, and the prevalence of abnormal glucose metabolism, including prediabetes and diabetes. Methods and Study Design: This study was conducted in Guangzhou, China from July 2011 to December 2011. It included 2,022 participants (602 men and 1,420 women), between 45 and 75 years of age. The prevalence of abnormal glucose metabolism was compared across the quartiles of GL indices to discover any potential linear correlations. Stratified analysis was conducted according to the body mass index (BMI) and waist circumference (WC) measurements. Results: Energy-adjusted GL was positively associated with the prevalence of diabetes and the multivariable-adjusted estimate of the OR comparing the highest versus the lowest quartile was 2.50 (95% CI, 1.49-4.19). For the stratified analysis by sex, BMI or WC, similar associations were observed. For the overweight and obese (BMI ≥24.0 kg/m2) or centrally obese (WC ≥85 cm for men or ≥80 cm for women) participants, compared to participants in the lowest quartile of energy-adjusted GL, those in the highest quartile showed an increased risk of abnormal glucose metabolism. The OR estimates were 2.25 (95% CI: 1.45-3.52) and 1.54 (95% CI: 1.06-2.25), respectively. Conclusions: High dietary energy-adjusted GL is associated with the prevalence of diabetes as well as abnormal glucose metabolism among middle-aged and elderly adults.
Key Words: carbohydrate, glycemic load, prediabetes, diabetes, obesity
 

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Food Guide Pagoda and the food safety of women: one-year follow-up study on the effects of the 2008 Sichuan Earthquake
XIANGLONG XU, BING LI, RUIXUE BAI, YUNSHUANG RAO, LINGLI LIU, CESAR REIS, MANOJ SHARMA AND YONG ZHAO
Background and Objectives: Women are a dominant force in the family’s diet and nutrition in China. The shortterm effects of the 2008 Sichuan Earthquake were found. However, the long-term effects of the 2008 Sichuan Earthquake on the food safety, energy, and intake frequency of women remain unclear. This study analyzed the effects of the 2008 Sichuan Earthquake on the dietary behaviors of women one year after the earthquake. Methods and Study Design: In this cross-sectional study, a total of 207 women were selected using the proportional sampling method. Among them, 91 were from the earthquake-affected area and 116 were from the non-affected area. Results: Women from the earthquake-affected area paid significantly more attention to health, diet, food and water safety after the earthquake (p<0.05 for each category) when compared with those from the non-affected area. Women from the earthquake-affected area also had a significantly higher proportion of adequate understanding of low-energy food, properly separated their raw food from cooked food, ate high-energy food, and picky eating habits (p<0.05 for each category) than those from the non-affected area. In addition, women from the earthquake-affected area were more likely to adhere to the 2007 Chinese Food Guide Pagoda (FGP) guidelines for eating rice than those from the non-affected area (OR=2.25, 95% CI [1.13, 4.51]). Conclusion: The female survivors of the 2008 Sichuan Earthquake preferred high-energy food, paid more attention to food safety, and were more likely to adhere to FGP when compared to those that did not undergo the same tragedy.
Key Words: Food Guide Pagoda, food safety, follow-up study, the 2008 Sichuan Earthquake, women
 

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Oral health behavior as a risk factor for high urinary sodium among Korean women
KYUNGDO HAN, NAMRYANG KIM, YOUNGKYUNG KO, YONG-GYU PARK AND JUN-BEOM PARK
Background and Objectives: The purpose of the present study was to investigate the association between urinary sodium, urinary sodium/creatinine, and urinary sodium/urine specific gravity and oral health behavior using nationally representative data. Methods and Study Design: Data from the Korea National Health and Nutrition Examination Survey were used; the sample analyzed in this study consisted a total of 15,013 respondents over 19 years old who had no missing values for the urinalysis or outcome variables. Urinary sodium was significantly lower in fem ales (p<0.05). Results: The rate of hypertension and diabetes was significantly lower in women (p<0.05). Adjusted odds ratios of urinary sodium and their 95% confidence intervals in relation to the frequency of tooth brushing (≤1, 2, and ≥3 times per day, respectively) were 1, 0.898 (0.704, 1.145), and 0.734 (0.573, 0.939) for women (p<0.05). This association between sodium uptake and oral health behavior was independent of various potential confounding factors such as age, body mass index, smoking, drinking, exercise, diabetes, and hypertension. Conclusions: Poor oral health behavior was associated with higher sodium consumption in women. Oral health behavior may be considered an independent risk indicator for high urinary sodium in Korean women.
Key Words: epidemiology, dietary sodium, kidney diseases, oral health, urinalysis
 

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Taste sensitivities and diet of Chinese and Indians in Singapore
CLAUDIA LEONG SHU-FEN, CIARÁN G FORDE, SIEW LING TEY AND CHRISTIANI JEYAKUMAR HENRY
Background and Objectives: Taste perception plays a key role in consumer acceptance and food choice, which has an important impact on human health. Our aim was to examine the relationship between recognition thresholds for five basic tastes (sweet, salty, sour, bitter, and umami) in Chinese and Indians in relation to their dietary intake. Methods and Study Design: This cross-sectional study included 114 subjects (60 Chinese, 54 Indians). Taste thresholds were determined using a forced choice method and dietary intakes were assessed using an estimated three-day food diary. Results: Indians had significantly higher recognition thresholds for sweet, salty, sour, umami and bitter tastes compared to Chinese (all p0.047). Overall energy intake was not significantly different between the Chinese and Indians. Correlations between taste and diet between the Chinese and Indians were not significant (p>0.05). Conclusion: Future work is needed to further understand how differences in taste perception may influence dietary intakes between ethnic groups.
Key Words: diet, human health, Chinese, Indian, taste
 

 

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Combined effect of eating alone and a poor nutritional status on cognitive decline among older adults in Taiwan
CHENG-LUN LI, HO-JUI TUNG AND MING-CHIN YEH
Background and Objectives: Nutritional status is not only associated with older individuals’ physical health but also has an impact on their cognitive functioning. Evidence indicates that a socially integrated lifestyle in the later stages of life protects against cognitive decline and dementia. This study tested the combined effect of two hazards, the risk of malnutrition and eating meals alone, on the cognitive changes among a representative sample of older Taiwanese individuals over an 8-year period. Methods and Study Design: Data were taken from the Taiwan Longitudinal Survey on Aging. In 1999, 2584 respondents aged 65 years were surveyed, and follow-up surveys were performed in 2003 and 2007. The Short Portable Mental Status Questionnaire (SPMSQ) and Mini Nutritional Assessment were used to evaluate participants’ cognitive functioning and nutritional status, respectively. Nutritional status and eating alone data assessed at baseline were combined to predict changes in SPMSQ scores longitudinally. Generalized estimating equations were used to evaluate the longitudinal changes from baseline to 2007. Results: Findings suggest that nutritional status was a salient predictor for cognitive decline among the older Taiwanese adults over the 8-year period. Female respondents who had a compromised nutritional status at baseline and who were eating their meals alone exhibited a greater decrease in SPMSQ scores compared with those who had a normal nutritional status and who were eating their meals with others. Conclusion: Nutritional programs for the elderly should focus on what they eat as well as who they eat their meals with to prevent social isolation, especially among older women.
Key Words: mini nutrition assessment, cognitive functioning, eating alone, older adults, Taiwan
 

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Eating disorders and body image concerns as influenced by family and media among university students in Sharjah, UAE
HADIA RADWAN, HAYDER A HASAN, LINA NAJM, SARA ZAURUB, FARIDAH JAMI, FAHIMEH JAVADI, LINA ADEEB DEEB AND AMANI ISKANDARANI
Background and Objectives: Eating disorders (ED) can be influenced by psychological and socio-cultural factors. The aim of this study was to explore the association between parental and media influences and body image concerns as factors in the onset of ED. Methods and Study Design: A cross-sectional study was conducted among 662 students (407 women and 255 men) attending one of three universities in United Arab Emirates (UAE). The study employed an online self-administered questionnaire with validated scales: Eating Attitudes Test-26 (EAT-26), Body Shape Questionnaire (BSQ), Media Influences Scale, and Family Influences Scale (FIS). Results: About 33% of the sample had EAT- 26 scores 20 and 45% showed mild to marked concerns about their body shape. Women students were significantly more concerned about their shape, and more influenced by media than men. There were significant differences in the means of all scores, except for media influence, among the four BMI groups. The EAT-26 score showed strongest correlation with BSQ (r=0.48), followed by FIS, Media and BMI (r=0.419, r=0.276 and r=0.18 respectively). The BSQ was the best predictor of ED and was inversely associated with the EAT-26 score (B=-1.51, OR=0.219, 95% CI: 0.152-0.316, p<0.001). Conclusions: The findings of this study indicate that ED and body shape concerns are highly prevalent among the university student sample, and highlight the strong influence that both the media and families exert on the development of ED among young adults. These findings provide baseline data for future longitudinal studies to investigate factors influencing ED.
Key Words: eating disorders, mass media, parental factors, body shape, university students
 

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Habitual tea drinking associated with a lower risk of type 2 diabetes in Vietnamese adults
CHUNG THANH NGUYEN, ANDY H LEE, NGOC MINH PHAM, VUONG VAN DO, NGHIA DUY NGU, BINH QUANG TRAN AND COLIN BINNS
Background and Objectives: The association between tea consumption and type 2 diabetes risk remains inconsistent in Asian populations. This case-control study investigated the association between habitual tea consumption and the risk of type 2 diabetes among Vietnamese adults. Methods and Study Design: A hospital-based case-control study was conducted during 2013-2015 in Vietnam. A total of 599 newly diagnosed diabetic cases (aged 40-65 years) and 599 hospital-based controls, frequency matched by age and sex, were recruited. Information about frequency, quantity, and duration of tea drinking, together with demographics, habitual diet and lifestyle characteristics, was obtained from direct interviews using a validated and reliable questionnaire. Unconditional logistic regression analyses were performed to assess the association between different metrics of tea consumption and the type 2 diabetes risk. Results: Control subjects reported higher tea consumption levels than the cases in terms of duration, frequency, and quantity of tea drunk. After accounting for confounding factors, increasing tea consumption was found to be associated with a reduced risk of type 2 diabetes; the adjusted odds ratio (95% confidence interval) was 0.66 (0.49, 0.89) for participants drinking >2 cups/day, relative to those drinking <1 cup/day. Significant inverse dose-response relationships were also observed for average number of cups consumed daily and years of tea drinking (p<0.01). Conclusions: Habitual tea consumption is associated with a reduced risk of type 2 diabetes among Vietnamese adults.
Key Words: case-control study, green tea, tea consumption, risk factors, type 2 diabetes
 

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Association of dopamine receptor D2 gene (DRD2) Taq1 polymorphisms with eating behaviors and obesity among Chinese and Indian Malaysian university students
FANG-YING LEK, HING-HUAT ONG AND YEE-HOW SAY
Background and Objectives: This study investigated the association of DRD2 Taq1A, Taq1B and Taq1D gene polymorphisms with eating behavior, the preference/intake frequency/craving of high-fat foods and obesity in 394 Malaysian adults (161 males, 233 females; 308 Chinese, 86 Indians; 67 obese, 327 non-obese). Methods and Study Design: Eating behaviors namely Cognitive Restraint, Uncontrolled Eating and Emotional Eating scores were assessed by the Three Factor Eating Questionnaire-R18. The preference/intake frequency/craving of 26 common high-fat Malaysian foods was assessed using a 7-point hedonic scale. Anthropometric measurements were taken and Taq1 gene polymorphisms were genotyped by PCR-Restriction Fragment Length Polymorphism using DNA extracted from mouthwash samples. Results: The overall minor allele frequencies of Taq1A, Taq1B and Taq1D according to ethnicities (Chinese/Indian) were 0.37/0.29, 0.39/0.28, 0.06/0.30, respectively; genotype and allele distributions of Taq1B and Taq1D were significantly different between ethnicities. Eating behaviorscores were not significantly different between gender and ethnicities. Those with A1 or B1 allele had lower Cognitive Restraint score and higher Uncontrolled Eating score, while those with A1/A1 or B1/B1 genotype had higher fast food preference. D1 allele was associated with increased starchy food craving and mamak (Malaysian Indian-Muslim) food preference, but not eating behavior scores. All three gene variants were not associated with obesity and adiposity. Conclusion: Taken together, we posit that three DRD2 Taq1 gene polymorphisms influence the eating behavior and preference/intake frequency/craving of certain high-fat foods in Malaysian adults, but their role in obesity and adiposity is still inconclusive and needs further investigation.
Key Words: DRD2 gene Taq1 polymorphisms, eating behavior, obesity, Malaysia, university students
 

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Effects of MTHFR A1298C polymorphism on peripheral blood folate concentration in healthy populations: a meta-analysis of observational studies
YU XIN, LIHUA WU, XIAOLIN LU, SHAOFANG SHANGGUAN, ZHEN WANG, SHAOYAN CHANG, JIYONG YIN, WEI PIAO, TING ZHANG AND LI WANG
Background and Objectives: Methylenetetrahydrofolate reductase (MTHFR) irreversibly converts 5,10- methylenetetrahydrofolate to 5-methyltetrahydrofolate, which is the main form of folate used in the body. Previous studies suggest that MTHFR polymorphism influences folate metabolism, but conflicting results are reported. We performed a meta-analysis to accurately characterize the association between MTHFR A1298C polymorphism and peripheral blood folate concentration in healthy populations. Methods and Study Design: Studies focusing on MTHFR A1298C polymorphism and folate concentrations were identified and subjected to a metaanalysis using Review Manager 5.1. Standard mean differences (SMD) with 95% confidence intervals (95% CI) were used to assess the association between these variables. Results: A total of 14 studies with 5616 healthy individuals were included in this meta-analysis. Significant differences in folate concentration were found in the MTHFR homozygote model (SMD=0.12, 95% CI=0.00-0.24, I2=17%, p=0.04) and the dominant model (SMD=0.07, 95% CI=0.01-0.14, I2=22%, p=0.02) in the general population excluding the elderly. While abnormal folate concentrations are more common in elderly, no association between MTHFR A1298C polymorphism and peripheral blood folate concentration was found in the meta-analysis when elderly were included. Conclusions: This meta-analysis indicates that, in the general population excluding the elderly, the C allele of MTHFR 1298 polymorphism is associated with the risk for an increased folate concentration.
Key Words: methylenetetrahydrofolate reductase, A1298C, polymorphism, folate concentration, meta-analysis

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Rehabilitation nutrition in pressure ulcer management with type 2 diabetes: a case report
YOKO SAINO, HIDETAKA WAKABAYASHI, KEISUKE MAEDA, SHINTA NISHIOKA, TAKAKO HAO AND KENJI MIMATSU
Background and Objectives: Severe infection, inadequate food intake, and pressure ulcers in patients with type 2 diabetes can result in malnutrition. We describe a case in which rehabilitation nutrition was effective for treat-ing a pressure ulcer in a malnourished patient with type 2 diabetes. Methods and Results: A 58-year-old man with type 2 diabetes was diagnosed with hidradenitis suppurativa on the left buttock and thigh and a severe pres-sure ulcer on his left kneecap. Malnutrition was related to hypermetabolism caused by chronic hidradenitis suppu-rativa and inadequate protein-energy intake before admission. We initiated a rehabilitation nutrition intervention to improve physical function and to treat a pressure ulcer by prescribing 2,000 kcal/day of food, including 80 g of protein, and physical rehabilitation for 40 minutes/day. The patient showed good progress in terms of his physical function and healing of the pressure ulcer. After prescribing 2,250 kcal/day of food, including 85 g of protein, and physical rehabilitation for 60 minutes/day, HbA1c levels increased to 7.4%. The energy prescription was de-creased to 2,000 kcal/day to improve glycemic levels. Then, the patient’s weight decreased and his hand grip strength became weaker. On day 134 and discharge the patient could walk independently with a t-cane and ankle supporter. By day 14 after discharge, the pressure ulcer had epithelialized. Conclusion: Rehabilitation nutrition management improved physical function and facilitated pressure ulcer healing in a malnourished patient with type 2 diabetes. Close conjoint management of hyperglycemia was also necessary.
Key Words: nutritional intervention, diabetes mellitus, wound healing, malnutrition, physical function

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Last Updated: May 2018