Asia
Pacific Journal of Clinical Nutrition
Volume 15, issue 3
(September 2006)
Abstracts
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Abstract
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 Review
Articles
Central obesity and risk of cardiovascular disease in the Asia
Pacific Region
ASIA PACIFIC COHORT STUDIES COLLABORATION
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| Original
Articles |
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Defining
obesity by body mass index in the Thai population: an epidemiologic
study
CHATLERT PONGCHAIYAKUL, TUAN V NGUYEN, VONGSVAT
KOSULWAT, NIPA ROJROONGWASINKUL, SOMSRI CHAROENKIATKUL, CHOOWONG
PONGCHAIYAKUL, PATARA SANCHAISURIYA AND RAJATA RAJATANAVIN
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Relation
of anthropometric parameters to the functional assessment of HDL
particle size in three ethnic cohorts
HAMIDREZA ZAKERI, JIRI J FROHLICH AND SCOTT A LEAR
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Use
Of [14C]-sodium bicarbonate/urea to measure total energy expenditure
in overweight men and women before and after low calorie diet
induced weight loss
NATALIE D LUSCOMBE, CHRISTOPHER TSOPELAS, MAX BELLON, PETER M
CLIFTON, IAN KIRKWOOD AND GARY A WITTERT
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Validity
and reliability of BodyGem for measuring resting metabolic rate
on Taiwanese women
TSAN-HON LIOU, CHING-MIN CHEN, WAN-YU CHUNG AND NAIN-FENG CHU
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Nutrition
education in medical schools in Japan: results from a questionnaire
survey
HIDEO ORIMO, TOSHIRO SHIMURA AND TAKASHI SHIMADA
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Nutritional
status of pregnant women in Northeast Thailand
CHRISTOPH U ANDERT, PATTARA SANCHAISURIYA, KANOKWAN SANCHAISURIYA,
FRANK P SCHELP AND FLORIAN J SCHWEIGERT
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Which
mothers take folic acid and folate containing foods?
COLIN BINNS, JANE SCOTT, NKEONYELU NWAFOR, KATHLEEN GRAHAM, WENDY
ODDY AND ANDY LEE
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Dietary
and blood folate status of Malaysian women of childbearing age
GEOK LIN KHOR, G DURAISAMY, SU PENG LOH, TIMOTHY J GREEN AND C
MURRAY SKEAFF |
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Anaemia
and iron deficiency anaemia among young adolescent girls from
the peri urban coastal area of Indonesia
YUSTINA ANIE INDRIASTUTI KURNIAWAN, SITI MUSLIMATUN, ENDANG L
ACHADI AND
SOEMILAH SASTROAMIDJOJO
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Goitre
prevalence and the state of iodine nutrition in the sundarban
delta of north 24-parganas in West Benegal
AMAR K CHANDRA, SMRITIRATAN TRIPATHY, DISHARI GHOSH, ARIJIT DEBNATH
AND
SANJUKTA MUKHOPADHYAY |
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Determination
of discretionary salt intake in an iodine deficient area of
East Java-Indonesia using three different methods
ANNASARI MUSTAFA, SITI MUSLIMATUN IR, JULIAWATI UNTORO IR, MARIA
CPJ LAN IR AND YOHANES KRISTIANTO
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Effects
of probiotic or prebiotic supplemented milk formulas on fecal
microbiota composition of infants
OSCAR BRUNSER, GUILLERMO FIGUEROA, MARTIN GOTTELAND, ELIZABETH
HASCHKE-BECHER,
CORINE MAGLIOLA, FLORENCE ROCHAT, SYLVIA CRUCHET, RICHARD PALFRAMAN,
GLENN GIBSON, FRANÇOISE CHAUFFARD AND FERDINAND HASCHKE
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A
population-based survey on infant feeding practice (0-2 years)
in Hong Kong: breastfeeding rate and patterns among 3,161 infants
below 6 months old WARREN
TK LEE, SUSAN SH LUI, VERONICA CHAN, ERIC WONG AND JOSEPH LAU
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| Diet,
nutritional knowledge and health status of urban middle-aged Malaysian
women LW
PON, MY NOOR-AINI, FB ONG, N ADEEB, SS SERI, K SHAMSUDDIN, AL
MOHAMED, N HAPIZAH, A MOKHTAR AND HWH WAN |
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Good
oral health, adequate nutrient consumption and family support
are associated with a reduced risk of being underweight amongst
older Malaysian residents of publicly funded shelter homes
RENUKA
VISVANATHAN AND ZAITON AHMAD
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Structured
triglyceride for parenteral nutrition: meta-analysis of randomized
controlled trials
YONG ZHOU, XIAO-TING WU, NI LI, WEN ZHUANG, GUANJIAN LIU, TAIXIANG
WU AND MAO-LING WEI
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The
Glycemic Index of standard and diabetes-specific enteral formulas
ZANDRIE HOFMAN, JENNEKE DE VAN DRUNEN AND HARM KUIPERS
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Low
dose supplementation with two different marine oils does not reduce
pro-inflammatory eicosanoids and cytokines in vivo
KAREN
J MURPHY, KAREN GALVIN, MAIREAD KIELY, PATRICK A MORRISSEY, NEIL
J MANN AND
ANDREW J SINCLAIR |
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Evaluation
of Rhodiola crenulata and Rhodiola Rosea for management of Type
II diabetes and hypertension
YOUNG-IN KWON, HAE-DONG JANG AND KALIDAS SHETTY |
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Potential
of cranberry-based herbal synergies for diabetes and hypertension
management
EMANOUIL APOSTOLIDIS, YOUNG-IN KWON AND KALIDAS SHETTY
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Central
obesity and risk of cardiovascular disease in the Asia Pacific Region
ASIA PACIFIC COHORT STUDIES COLLABORATION
This
paper compares body mass index, waist circumference, hip circumference,
and waist-hip ratio as risk factors for ischaemic heart disease and
stroke in Asia Pacific populations. We undertook a pooled analysis
involving six cohort studies (45 988 participants) and used Cox proportional
hazards regression to assess the associations of the four anthropometric
indices with stroke and ischaemic heart disease by age, sex and region.
During a mean follow-up of six years, 346 stroke and 601 ischaemic
heart disease events (fatal and non-fatal) were documented. Overall,
a one-standard deviation increase in index was associated with an
increase in risk of ischaemic heart disease of 17% (95% CI 7-27%)
for body mass index, 27% (95% CI 14-40%) for waist circumference,
10% (95% CI 1-20%) for hip circumference, and 36% (95% CI 21-52%)
for waist-hip ratio. There were no significant differences between
age groups, sex, and region. None of the four anthropometric indices
had a strong association with risk of stroke. These data indicate
that measures of central obesity such as waist circumference and waist-hip
ratio are strongly associated with risk of ischaemic heart disease
in this region. Therefore, we suggest that, along with calculation
of body mass index, measures of central obesity such as waist circumference
and waist-hip ratio should be undertaken routinely.
Key Words: abdominal obesity, waist circumference, waist hip ratio,
cardiovascular diseases, cohort studies, Asia
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Defining
obesity by body mass index in the Thai population: an epidemiologic
study
CHATLERT PONGCHAIYAKUL, TUAN V NGUYEN, VONGSVAT KOSULWAT, NIPA ROJROONGWASINKUL,
SOMSRI CHAROENKIATKUL, CHOOWONG PONGCHAIYAKUL, PATARA SANCHAISURIYA
AND RAJATA RAJATANAVIN
The
objective of this study was to develop cut-off values and evaluate
the accuracy of body mass index (BMI) in the definition of obesity
in the Thai population. A cross-sectional, epidemiologic study in
340 men and 507 women aged 50 ± 16 yr (mean ± SD; range:
20-84 yr), were sampled by stratified clustering sampling method.
Body composition, including percentage body fat (%BF), was measured
by dual energy X-ray absorptiometry (GE Lunar Corp, Madison, WI).
BMI was obtained by dividing weight (in kg) by height (in m2). The
"golden standard" for defining obesity was %BF 25% in men
and %BF 35% in women. The %BF-based prevalence of obesity in men and
women was 18.8% and 39.5%, respectively. However, using the BMI cut-off
of 30, only 2.9% of men and 8.9% of women were classified as obese.
In the cubic regression model, BMI was a significant predictor of
%BF, such that in men a BMI of 27 kg/m2 would predict a %BF of 25%,
and in women a BMI of 25 kg/m2 would correspond to a %BF of 35%. The
area under the receiver operating characteristic curve for BMI was
approximately 0.87 (95% CI: 0.82-0.92) and 0.86 (95% CI: 0.83-0.90)
in men and women, respectively. In conclusion, for the Thai population,
BMI is a reasonably useful indicator of obesity; however, the cut-off
values of BMI for diagnosing obesity should be lowered to 27 kg/m2
in men and 25 kg/m2 in women.
Key
Words: BMI, percentage body fat, epidemiology, Thailand, Asian
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Relation
of anthropometric parameters to the functional assessment of HDL particle
size in three ethnic cohorts HAMIDREZA
ZAKERI, JIRI J FROHLICH AND SCOTT A LEAR
The
purpose of this study was to characterize the association between
HDL particle size (assessed by fractional esterification rate in apo
B depleted plasma (FERHDL)), and anthropometric measures in men and
women of Chinese, European and South Asian origin and to determine
if ethnic background is a modifier of this relationship. A convenience
sample of apparently healthy men and women of Chinese (n=56), European
(n=66) or South Asian (n=76) descent were recruited and assessed for
body mass index, waist circumference, blood pressure, lipids, insulin,
glucose and FERHDL. Univariate correlations with FERHDL were determined
within each ethnic -gender group. Regression analysis was used to
determine if ethnicity was a significant modifier of the relationship
between FERHDL and waist circumference. FERHDL was significantly correlated
with various anthropometric measures within the ethnic and gender
groups. The relationship between waist circumference and FERHDL was
significantly different between the European, and Chinese and South
Asian groups combined in women but not in men. After adjustment for
age, body mass index and insulin, ethnicity was no longer a significant
predictor. However, ethnic background (European vs. Chinese/South
Asian) was a significant predictor (P=0.034) of the relationship between
FERHDL and waist circumference adjusted for age, gender, body mass
index and insulin in the entire cohort. Increasing adiposity in Chinese
and South Asian men and women is associated with a less protective
HDL particle profile. Ethnic background (Asian compared to European)
is a significant modifier of the relationship between FERHDL and waist
circumference.
Key
Words: anthropometry, lipoproteins, HDL, Asians.
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Use
Of [14C]-sodium bicarbonate/urea to measure total energy expenditure
in overweight men and women before and after low calorie diet induced
weight loss
NATALIE D LUSCOMBE, CHRISTOPHER TSOPELAS, MAX BELLON, PETER M CLIFTON,
IAN KIRKWOOD AND GARY A WITTERT
The
aim of this study was to evaluate the use of the [14C]-sodium bicarbonate/urea
technique to measure the change in total energy expenditure after
weight loss and a period of weight maintenance. Eleven healthy subjects
(6 men and 5 women aged 50 ± 3 yrs, BMI 34.1 ± 2.1 kg/m2,
body fat 38.7 ± 3%) underwent 8 weeks of energy restriction
using a combination of 'Modifast™' formula and one small meal
per day (˜3.3 MJ/day). For an additional 2-weeks, subjects resumed
a solid food diet that contained enough energy to stabilize body weight
at the newly reduced level. Body composition, total energy expenditure
(TEE), resting energy expenditure (REE) and the thermic effect of
a 2.7 MJ test meal (TEF) were measured at both weeks 0 and 10. At
week 10 as compared to week 0, body weight decreased by 12.2 1.6 kg
(12.5%) (P < 0.001). Total fat and lean mass decreased by 8.4 1.0
kg (20.4%) and 3.8 0.7 kg (6.7%), respectively (P < 0.001). REE
decreased by 500 128 kJ/day (5.6 1.3%) (P < 0.002). Decreases in
the TEE (0.18 3.7%) and TEF (1.4 0.9%) were not significant. In conclusion,
although [14C]-sodium bicarbonate/urea was well tolerated and did
not interfere with normal daily activities, it did not have sufficient
sensitivity to accurately measure weight loss induced changes in TEE
in the range of 0.1-10%.
Key Words: energy
expenditure, thermic effect of feeding, weight loss, low calorie diet,
clinical intervention.
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Validity
and reliability of BodyGem for measuring resting metabolic rate on
Taiwanese women
TSAN-HON LIOU, CHING-MIN CHEN, WAN-YU CHUNG AND NAIN-FENG CHU
Resting
metabolic rate (RMR) accounts for about two thirds of total energy
expenditure. The widely used Harris-Benedict equations systematically
overestimate RMR. This study assessed overall reliability and validity
of a handheld indirect calorimeter, BodyGem, on a sample of women.
Thirty healthy nurses participated in this study with an age of 41.9
± 9.0 years old and a body mass index of 24.0 ± 2.8
kg/m2. The Deltatrac Metabolic Monitor was used as the criterion method
to validate BodyGem. Reliability was estimated by repeated measures
of BodyGem to test internal consistency and stability. Analysis indicated
that measurements of Deltatrac and BodyGem are well correlated (r
= 0.76, P < 0.001). The correlation coefficients of two BodyGem
RMR measurements were of large statistical significance (r = 0.96,
P <0.001, mean difference = 15.8±55.8 Kcal/d). A significant
difference (F = 3.81, P = 0.04) in repeated measures ANOVA and post
hoc revealed a difference between BodyGem and Deltatrac. There was
a systematic difference between both methods (mean difference between
BodyGem and Deltatrac = 36.4~52.2 Kcal/d). After adjustment of additional
energy demand by holding BodyGem in position, the difference became
non-significant (F = 1.62, P = 0.22). Bland-Altman plots revealed
that there was no significant trend in both methods, and repeated
measurements of Bodygem. In conclusion, RMR obtained using the BodyGem
has a high degree of reproducibility and an acceptable validity compared
to the Deltatrac. Further validity research is needed in Taiwanese
women..
Key
Words: women, reliability, validity, resting metabolic rate, indirect
calorimeter, Harris-Benedict equations, Taiwan
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Nutrition
education in medical schools in Japan: results from a questionnaire
survey
HIDEO ORIMO, TOSHIRO SHIMURA AND TAKASHI SHIMADA
Diet
is known to play a critical role in the pathogenesis of major age-related
chronic diseases, which are rapidly becoming more common in Japan
and other industrialized countries. However, traditional medical education
has not provided adequate knowledge of nutrition. To understand the
current status of nutrition education in Japan, we sent a questionnaire
to all Japanese medical schools to survey their nutrition curricula.
The questionnaire was sent to 79 medical schools in Japan, which includes
all medical schools except for that of the authors. We also used a
questionnaire to survey second year medical students just after they
received a short nutrition course at Nippon Medical School. Fifty-seven
medical schools (72.2%) responded to the questionnaire: 12 (21.1%
of the responding schools) offered a "nutrition" course
and 3 (5.4%) offered a "clinical nutrition" course. Including
"nutrition" and "clinical nutrition" courses,
14 of the responding medical schools (24. 6 %) offered stand-alone
nutrition courses in their undergraduate education. Although a total
of 48 of the responding medical schools (84.2%) offered some nutrition
topics, only 8 of the responding schools (14.0%) may have offered
substantial nutrition education. No special postgraduate course in
medical or clinical nutrition was offered by any of the schools. Despite
this, more than 80% of the students that appeared to be interested
in a nutrition course recognized the importance of nutrition education
in medical school. This survey showed that nutrition education in
Japanese medical schools remains inadequate and changes are necessary.
Key Words: nutrition education, medical schools, Japan, questionnaire,
curriculum
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Nutritional
status of pregnant women in Northeast Thailand
CHRISTOPH U ANDERT, PATTARA SANCHAISURIYA, KANOKWAN SANCHAISURIYA,
FRANK P SCHELP AND
FLORIAN J SCHWEIGERT
A
comparative study on the nutritional status of primiparous and multiparous
women in the first trimester of pregnancy was conducted in the northeastern
province of Thailand, Khon Kaen, to investigate differences in protein-energy-malnutrition,
iron deficiency anaemia, vitamin A deficiency and carotenoid status
between both parity groups. 94 subjects were recruited at first attendance
of antenatal clinic. Data about weight, height, haemoglobin and haematocrit
were obtained from hospital records. Anthropometric measurements of
mid-upper arm circumference and triceps skinfold were done on a sub
sample. Retinol, carotenoids and a-tocopherol were analysed using
a reversed-phase high-performance liquid chromatography method. Ferritin,
transthyretin and retinol-binding protein were determined by enzyme-linked
immunosorbent assay. Primi-parous women showed lower body mass index,
mid-upper arm circumference, corrected arm muscle area (P <0.001)
as well as lower retinol, cholesterol and triceps skinfold (P <0.05).
After adjusting for age and socio-economical status the significant
difference persisted for all parameters but triceps skinfold. No significant
differences of a-tocopherol, serum proteins, carotenoids and iron
indices could be observed, even though a tendency to higher values
for ferritin, haemoglobin and haematocrit was shown in multiparous
women. Prevalence of protein-energy-malnutrition (body mass index
<18.5 kg/m2) in the primiparous group was significantly higher
compared to the multiparous group (P<0.05). Prevalence of protein-energy-malnutrition,
iron deficiency anaemia and vitamin A deficiency were 15.1%, 6.3 %
and 3.3%, respectively, in the total study population. No differences
between parity groups could be observed for prevalence of iron deficiency
anaemia and vitamin A deficiency.
Key Words: nutritional status, pregnancy, vitamin A, iron,
carotenoids.
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Which
mothers take folic acid and folate containing foods?
COLIN BINNS, JANE SCOTT, NKEONYELU NWAFOR, KATHLEEN GRAHAM, WENDY
ODDY AND ANDY LEE
This
study documented the prevalence (proportion) of mothers taking folic
as supplements or as fortified foods and explored the factors that
determined whether folic acid was taken. A cross sectional analysis
of the baseline data of mothers who participated in the Perth Infant
Feeding Study was performed. A total of 587 mothers who delivered
at the two hospitals in the study completed baseline questionnaires.
The factors associated with the decision to take folic acid supplements
or fortified foods were investigated using multivariate logistic regression.
Main outcome measures were the percentage of mothers taking folic
acid or folic acid fortified foods. A total of 455 (78%) mothers stated
that they took folic acid supplements before or during the first three
months of their pregnancy. Of the 132 who did not take folate supplements
only 35 (6% of all participating mothers) claimed to have taken folate
fortified food or beverages. In the highest income group, 87% of mothers
took folic acid supplements compared to 64% in the poorest group.
The significant factors independently associated with not taking folic
acid supplements or fortified food were "years of education"
(OR '10 years or less' 0.45 (0.23-0.88)), "family income"
(OR <$25000 0.40(0.20-0.80)), and for taking folic acid "the
timing of the pregnancy." (OR 'actively trying' 2.01 (0.1.04-0.3.87)).
There was a significant proportion of mothers who did not take folic
acid periconceptually. The mothers who were not taking folic were
less educated, from lower socio-economic groups and were not actively
trying to fall pregnant at the time they became pregnant. The results
suggest that in order to reach all Australian mothers, mandatory fortification
of foods with folic acid should be required.
Key Words: folic acid, folate, pregnancy, Australia, socio-economic
group.
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Dietary
and blood folate status of Malaysian women of childbearing age
GEOK LIN KHOR, G DURAISAMY, SU PENG LOH, TIMOTHY J GREEN
AND C MURRAY SKEAFF
The
protective role of folic acid taken during the periconceptual period
in reducing the occurrence of neural tube defects (NTD) has been well
documented by epidemiological evidence, randomized controlled trials
and intervention studies. Much of the evidence is derived from western
populations while similar data on Asian subjects is relatively nascent.
Baseline data on folate status of Malaysian women is lacking, while
NTD prevalence is estimated as 10 per 10,000 births. This study was
conducted with the objective of determining the dietary and blood
folate status of Malaysian women of childbearing age. A total of 399
women comprising 140 Malay, 131 Chinese and 128 Indian subjects were
recruited from universities and worksites in the suburbs of Kuala
Lumpur. Inclusion criteria were that the subjects were not pregnant
or breastfeeding, not taking folic acid supplements, not habitual
drinkers or smokers. Based on a 24-hour recall, the median intake
level for folate was 202.4 g (59.4-491.8 g), which amounts to 50.6%
of the Malaysian Recommended Nutrient Intakes level. The median (5-95th
percentiles) values for plasma and red cell folate (RBC) concentrations
were 11
(4-33) nmol/L and 633 (303-1209) nmol/L respectively. Overall, nearly
15.1% showed plasma folate deficiency (< 6.8 nmol/L), with Indian
subjects having the highest prevalence (21.5%). Overall prevalence
of RBC folate deficiency (< 363 nmol/L) was 9.3%, and an almost
similar level prevailed for each ethnic group. Only 15.2% had RBC
concentration exceeding 906 nmol/L, which is associated with a very
low risk of NTD. The result of this study point to the need for intervention
strategies to improve the blood folate status of women of childbearing
age, so that they have adequate protection against the occurrence
of NTD at birth.
Key Words: blood folate, dietary intake, women, Malaysia.
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Anaemia
and iron deficiency anaemia among young adolescent girls from the
peri urban coastal area of Indonesia
YUSTINA ANIE INDRIASTUTI KURNIAWAN, SITI MUSLIMATUN, ENDANG L ACHADI
AND SOEMILAH SASTROAMIDJOJO
Anaemia due to iron deficiency is still a widespread
problem. Among adolescent girls, it will bring negative consequences
on growth, school performance, morbidity and reproductive performance.
This cross sectional study aimed to identify the different nutritional
and iron status characteristics of young adolescent girls 10 - 12
years old with iron deficiency anaemia and anaemia without iron deficiency
in the rural coastal area of Indonesia. Anaemic girls (N = 133) were
recruited out of 1358 girls from 34 elementary schools. Haemo-globin,
serum ferritin, serum transferrin receptor and zinc protophorphyrin
were determined for iron status, whilst weight and height were measured
for their nutritional status. General characteristics and dietary
intake were assessed through interview. Out of 133 anaemic subjects,
29 (21.8%) suffered from iron deficiency anaemia, which was not significantly
related to age and menarche. About 50% were underweight and stunted
indicating the presence of acute and chronic malnutrition. The proportion
of thinness was significantly higher (P <0.05) among subjects who
suffered from iron deficiency anaemia (51.7% vs. 29.8%). Furthermore,
thin subjects had a 5 fold higher risk of suffering from iron deficiency
anaemia (P < 0.05) than non-thin subjects (OR: 5.1; 95%CI 1.34
-19.00). Further study was recommended to explore other factors associated
with anaemia and iron deficiency anaemia, such as the thalassemia
trait and vitamin A deficiency. The current iron-folate supplementation
program for pregnant women should be expanded to adolescent girls.
Key
words: iron, deficiency, anaemia, adolescent, girls, urban,
Indonesia.
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Goitre
prevalence and the state of iodine nutrition in the sundarban delta
of north 24-parganas in West Benegal
AMAR K CHANDRA, SMRITIRATAN TRIPATHY, DISHARI GHOSH, ARIJIT DEBNATH
AND
SANJUKTA MUKHOPADHYAY
The
main objective of this study was to assess the iodine nutritional
status among school children (6-12 yrs) of Sundarban delta in North
24- Parganas district of West Bengal in eastern India. A total of
2050 children were clinically examined for goiter and 240 urine samples
were analyzed for iodine and thiocyanate respectively; iodine content
in 48 water samples and 210 salt samples were also measured. Results
indicate that the studied region is clinically severely goiter endemic
having goiter prevalence 33.1 % (grade 1: 30.4 %; grade 2: 2.7%),
median urinary iodine level 200 µg/l indicating no biochemical
iodine deficiency, 65.2 % salt samples contain recommended level of
iodine and the iodine content in drinking water is sufficient while
mean urinary thiocyanate level was 0.708 0.38 mg/dl. In spite of the
consumption of adequate iodine, the existing goiter prevalence may
be for the consumption of dietary goitrogens/antithyroid substances
that possibly come through food and water.
Key Words: endemic
goiter, goitrogens, school children, urinary iodine, urinary thiocyanate,
West Bengal
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Determination
of discretionary salt intake in an iodine deficient area of East Java-Indonesia
using three different methods
ANNASARI MUSTAFA, SITI MUSLIMATUN IR, JULIAWATI UNTORO IR, MARIA CPJ
LAN IR AND YOHANES KRISTIANTO
As
salt is a potential vehicle for delivering iodine to a population,
study on salt intake is important. Many methods have been used to
measure iodised-salt intake, but the methods were suspected to be
inaccurate. A new method, called a lithium-marker technique, has been
considered as suitable and safe; hence it has been proposed as a gold
standard for measuring the actual salt intake of an individual. We
conducted a study to determine discretionary salt intake using the
lithium marker technique. The study shows that the total salt intake
for children (N =15) and mothers (N =15) were 5.4 2.1 g/d and 5.8
1.7 g/d respectively in which 48.5 17.1% and 50.5 17.3% were discretionary
salt. The discretionary salt intake measured using lithium marker
(2.53 ± 1.2 g/d for children and 2.99 ± 1.5 g/d for
mother) were significantly lower than using 24-hour salt recall (7.01
2.44 g/cap/d) and salt weighing (6.00 1.8 g/cap/d) (P<0.001). In
conclusion, the discretionary salt intake by 24-hour salt recall and
salt weighing were over estimated as compared to the lithium-labelled
salt measurement. It is recommended that the level of iodine fortification
in salt be increased up to 80-100 ppm of KIO3 to provide iodine intake
of 150µg/d.
Key Words: lithium marker technique, 24-hour salt recall, salt
weighing, discretionary salt intake.
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Effects
of probiotic or prebiotic supplemented milk formulas on fecal microbiota
composition of infants
OSCAR BRUNSER, GUILLERMO FIGUEROA, MARTIN GOTTELAND, ELIZABETH HASCHKE-BECHER,
CORINE MAGLIOLA, FLORENCE ROCHAT, SYLVIA CRUCHET, RICHARD PALFRAMAN,
GLENN GIBSON,
FRANÇOISE CHAUFFARD AND FERDINAND HASCHKE
The
aim of the study was to evaluate whether supplementation of milk-formulas
with prebiotic fructo-oligosaccharides or a probiotic, Lactobacillus
johnsonii La1 (La1), could modulate the composition of the fecal microbiota
of formula-fed infants, compared to breastfed (BF) infants. Ninety
infants close to 4 months of age were randomized into one of three
groups to be blindly assigned to receive for 13 weeks: a) an infant
formula (Control), b) the same formula with fructo-oligosaccharides
(Prebio), or c) with La1 (Probio). At the end of this period, all
infants received the control formula for 2 additional weeks. Twenty-six
infants, breastfed throughout the study, were recruited to form group
BF. Fecal samples were obtained upon enrolment and after 7 and 15
weeks. Bacterial populations were assessed with classical culture
techniques and fluorescent in situ hybridisation (FISH). Seventy-six
infants completed the study. On enrolment, higher counts of Bifidobacterium
and Lactobacillus and lower counts of enterobacteria were observed
in BF compared to the formula-fed infants; these differences tended
to disappear at weeks 7 and 15. No major differences for Clostridium,
Bacteroides or Enterococcus were observed between the groups or along
the follow up. Probio increased fecal Lactobacillus counts (P<0.001);
88% of the infants in this group excreted live La1 in their stools
at week 7 but only 17% at week 15. Increased Bifidobacterium counts
were observed at week 7 in the 3 formula groups, similar to BF infants.
These results confirm the presence of higher counts of bifidobacteria
and lactobacilli in the microbiota of BF infants compared to formula-fed
infants before dietary diversification, and that La1 survives in the
infant digestive tract.
Key Words: breastfeeding, milk formula, fructooligosaccharides,
infants, intestinal microbiota, Lactobacillus johnsonii La1, prebiotic,
probiotic.
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A
population-based survey on infant feeding practice (0-2 years) in
Hong Kong: breastfeeding rate and patterns among 3,161 infants below
6 months old
WARREN
TK LEE, SUSAN SH LUI, VERONICA CHAN, ERIC WONG AND JOSEPH LAU
The
prevalence of breastfeeding for the first 6 months in infants has
been low in Hong Kong since the 1970s. In order to develop effective
breastfeeding policies and promotion programs, an appraisal of feeding
practices and factors related to initiation and early cessation of
breastfeeding is necessary. A survey with a population-based representative
sample was conducted to determine social-demographic, personal and
cultural factors that influenced decision, duration and practice of
infant feeding among infants 0-24 months old. This paper focuses on
infants below 6 months old to study factors related to decision, duration
and practice of breastfeeding. In 1993, 7,298 healthy infants were
recruited from 46 Maternal-and-Child-Health-Clinics (MCHC) throughout
Hong Kong, of whom 3161 were below 6 months old. The mother reported
her feeding decision, duration and practice in a questionnaire. Breastfeeding
rate was found to be very low (8.4%) for infants below 6 months old.
Only 50.9% infants were breastfed. Infant formulae were widely given
among partially breastfed infants. 45% mothers were full-time employed.
Most mothers were aware of the benefits of breastfeeding to the infants
and themselves. Husbands (43.3%) were regarded the most influential
on initiation and duration on breastfeeding. Restricted food varieties
(54%), sore nipple and breast engorgement (67%), perceived home confinement
(41.5%) and perceived inadequate milk supply (31.7%) were major concerns
upon breastfeeding. Furthermore, 76.9% mothers turned to MCHC staff
for advice when they encountered difficulties during breastfeeding.
In conclusion, the survey collected population-based representative
data on factors determining initiation and early cessation of breastfeeding
in Hong Kong in 1993. The findings will serve as a cornerstone in
understanding the evolution of breastfeeding practice in Hong Kong.
It merits further study to investigate how the confounders interplay
to modulate initiation, duration and patterns of breastfeeding.
Key Words: : breastfeeding, breastmilk, infant formulae, infants,
Hong Kong.
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Diet,
nutritional knowledge and health status of urban middle-aged Malaysian
women LW PON, MY NOOR-AINI, FB ONG, N ADEEB, SS
SERI, K SHAMSUDDIN, AL MOHAMED, N HAPIZAH,
A MOKHTAR AND HWH WAN GARY
TC KO AND JOYCE SF TANG
The
objective of the study was to assess nutritional and health status
as well as nutritional knowledge in urban middle-aged Malaysian women.
The impact of menopause on diet and health indices was also studied.
The study included 360 disease free women, non users of HRT, aged
=45 years with an intact uterus recruited from November 1999 to October
2001. Personal characteristics, anthropometric measurements and blood
sample were acquired followed by clinical examination. Nutrient intake
and nutritional knowledge was determined by a quantitative FFQ and
KAP. The findings showed that urban middle-aged women, aged 51.65±5.40
years had energy intakes (EI) 11% below RDA, consisting of 53% carbohydrates,
15% protein and a 32% fat which declined with age. The sample which
comprised of 42.5% postmenopausal women had a satisfactory diet and
healthy lifestyle practices. Premenopausal women consumed more dietary
fat (6%) with other aspects of diet comparable to the postmenopausal
women. Iron intake was deficient in premenopausal women, amounting
to 56% RDA contributing to a 26% prevalence of anaemia. Overall, calcium
intake reached 440mg daily but dairy products were not the main source.
The postmenopaused had a more artherogenic lipid profile with significantly
higher total cholesterol (TC) and LDL-C, but more premenopausal women
were overweight/obese (49% versus 35%). EI was the strongest predictor
for BMI and waist circumference (WC), with WC itself an independent
predictor of fasting blood sugar and TC with BMI strongly affecting
glucose tolerance. High nutritional knowledge was seen in 39% whereas
20% had poor knowledge. Newspapers and magazines, followed by the
subject's social circle, were the main sources of nutritional information.
Nutritional knowledge was positively associated with education, household
income, vitamin/mineral supplementation and regular physical activity
but inversely related to TC. In conclusion, middle-aged urban women
had an adequate diet with low iron and calcium intakes. Nutritional
knowledge was positively associated to healthier lifestyle practices
and lower TC. A comparable nutrient intake and lifestyle between pre
and postmenopausal women suggested that health changes associated
with menopause was largely independent of diet.
Key Words: food frequency, perimenopause, knowledge, health, middle-aged,
women, urban, Malaysia
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Good
oral health, adequate nutrient consumption and family support are
associated with a reduced risk of being underweight amongst older
Malaysian residents of publicly funded shelter homes
RENUKA
VISVANATHAN AND ZAITON AHMAD
A
low body mass index in older people has been associated with increased
mortality. The main objective of this study was to identify factors
associated with low body mass indices [BMIs] (< 18.5 kg/m2) in
older residents of shelter care facilities in Peninsular Malaysia.
1081 elderly people (59%M) over the age of 60 years were surveyed
using questionnaires determining baseline demographics, nutritional
and cognitive status, physical function and psychological well being.
Body mass index was also determined. Subjects were recruited from
publicly funded shelter homes in Peninsular Malaysia. 14.3% of residents
had BMIs < 18.5 kg/m2. Multivariate analyses (adjusted for age
and sex) revealed that having no family (RR 1.98 [95%CI 1.40-2.82],
P<0.001) and negative responses to statement 3 [I eat few fruits
or vegetables or milk products] (RR 0.62 [95% CI 0.42-0.90]; P=0.013)
and statement 5 [I have tooth or mouth problems that make it hard
for me to eat] (RR 0.69 [95%CI 0.50-0.96]; P=0.023) of the 'Determine
Your Nutritional Health Checklist' were independently associated with
low BMIs (<18.5 kg/m2). Older people with no family support were
at risk of becoming underweight. Older people who consumed fruits,
vegetables or milk or had good oral health were less likely to be
underweight. Nutrient intake, oral health and social support were
important in ensuring healthy body weight in older Malaysians.
Key Words: Body mass index, oral health, nutrition, social support,
poverty, homeless, elderly, shelter homes, Malaysia.
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Structured
triglyceride for parenteral nutrition: meta-analysis of randomized
controlled trials
YONG ZHOU, XIAO-TING WU, NI LI, WEN ZHUANG, GUANJIAN LIU, TAIXIANG
WU AND MAO-LING WEI
This
study assessed the safety and efficacy of structured triglyceride
(ST) for parenteral nutrition. A meta-analysis of all the relevant
randomized controlled trials (RCTs) was performed. Clinical trials
were identified from the following electronic databases: MEDLINE,
EMBASE, the Cochrane Controlled Trials Register, Chinese Bio-medicine
Database. The search was undertaken in March 2005. Language was restricted
to Chinese and English. Literature references were checked at the
same time. Only RCTs were extracted and evaluated by two reviewers
independently of each other. The statistical analysis was performed
by RevMan4.2 software which was provided by the Cochrane Collaboration.
A P value of <0.05 was considered statistically significant. Ten
RCTs involving 236 patients were included. Eight of them compared
ST with the long-chain triglyceride (LCT), and the combined results
showed that the ST had significant effect on resting energy expenditure
(weighted mean difference [WMD] = 1.54, 95%CI [1.26, 1.82], P<0.00001),
plasma glycerol (WMD = 0.14, 95%CI [0.06, 0.22], P=0.0007), free fatty
acids (WMD = 0.24, 95%CI [0.10, 0.37], P=0.0006), and ß-hydroxybutyric
acid (WMD = 0.14, 95%CI [0.06, 0.22], P=0.0007), but no differences
was found regarding nitrogen balance (standardized mean difference
[SMD] = 0.64, 95%CI [-0.30, 1.59], P= 0.18), respiratory quotient
(WMD = -0.02, 95%CI [-0.04, 0.01], P=0.18), and plasma triglycerides
(WMD = -0.10, 95%CI [-0.30, 0.10], P=0.32). Only two RCTs compared
ST with the physical mixture of medium- and long-chain triglyceride
(MCT/LCT), data from trials were not combined due to clinical differences
between trials, and conclusions can not be drew from the present data.
ST appeared to be safe and well tolerated. Further trials are required,
especially compared with the MCT/LCT, with sufficient size and rigorous
design.
Key Words: structured triglyceride, parenteral nutrition, meta-analysis,
randomized controlled trials.
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The
Glycemic Index of standard and diabetes-specific enteral formulas
ZANDRIE HOFMAN, JENNEKE DE VAN DRUNEN AND HARM KUIPERS
A
recent meta-analysis showed that foods with a low Glycemic Index (GI)
have a clinically useful effect on glycemic control in patients with
diabetes. Although diabetes-specific enteral formulas are commonly
used for diabetic patients with insufficient oral intake, not much
is known about the GI of these formulas. Therefore the purpose of
this study was to assess the GI of several diabetes-specific formulas
and to compare them with standard formulas. The randomised, double
blinded, crossover study included twelve products which were tested
in 7 - 10 individuals from a pool of 14 healthy volunteers. After
an overnight fast, volunteers were given a portion of a product containing
25 grams of carbohydrate or the reference feed (200 ml containing
25 gram glucose) on different occasions in random order. Postprandial
blood glucose levels were measured in venous whole blood for two hours
after intake of the products and positive incremental area under the
curve (AUC) was calculated for both the products and the reference
feed. The GI of the test products was determined by dividing AUC (test
products) by the AUC (reference feed). Enteral formulas varied widely
in their GI values with the diabetes-specific enteral formulas being
characterized by a significant (P=0.004) lower GI (average ±SEM:
19.4 ± 1.8) than standard formulas (42.1 ± 5.9). However,
there was an overlap between the two types of formulas. Three of the
diabetes-specific formulas had significantly lower GI than 3 of the
standard products. Although there is some overlap with the GI of diabetes-specific
and standard formulas, certain diabetes-specific formulas had very
low GI values, which may be clinically beneficial due to better glycemic
control. Therefore the use of diabetes-specific formulas with a low
GI should be the preferred option for the nutritional management of
diabetic patients in need of nutritional support.
Key Words: diabetes, hyperglycemia, clinical nutrition, glycemic
index, nutritional treatment.
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Low
dose supplementation with two different marine oils does not reduce
pro-inflammatory eicosanoids and cytokines in vivo
KAREN J MURPHY, KAREN GALVIN, MAIREAD KIELY, PATRICK A MORRISSEY,
NEIL J MANN AND
ANDREW J SINCLAIR
In
view of the reported potential anti-inflammatory activity of the New
Zealand green lipped mussel (NZGLM), we aimed to compare the effect
of low dose marine oil supplementation, from mussels and fish, in
reducing blood markers of inflammation. Thirty apparently healthy
males and females were recruited from the general public in Melbourne,
Australia to participate in a double blind, randomised, parallel intervention
study. Subjects were consuming approximately 73 mg of omega-3 long
chain polyunsaturated fatty acids (n-3 LCPUFA) daily in their background
diet prior to the commencement of the intervention. Subjects were
randomly assigned to consume either 2 mL/day of the NZGLM oil preparation
(mixed with olive oil and dl- -tocopherol) or fish oil preparation
(also mixed with olive oil and dl- -tocopherol) for six weeks. Two
mL of the oils contained 241 mg and 181 mg of n-3 LCPUFA, respectively.
Neutrophil phospholipid fatty acids, serum thromboxane B2 (TXB2),
stimulated monocyte production of prostaglandin E2 (PGE2), interleukin-1
(IL-1 ) and tumor necrosis factor a (TNFa) were measured. During the
intervention, the total intakes of n-3 LCPUFA from the background
diet and the supplements were 199 mg/d and 173mg/day for the NZGLM
and FO groups, respectively. Following six weeks of supplementation,
both groups showed a small, but significant increase in neutrophil
phospholipid proportion of eicosapentaenoic acid. The NZGLM group
also showed a significant increase in docosahexaenoic acid levels.
There were no significant changes with time or treatment for TXB2,
PGE2, IL-1 or TNFa. This study showed that low dose supplementation
with n-3 LCPUFA from two different marine oil preparations showed
no difference in inflammatory markers in this group of healthy individuals.
Further studies are warranted including dose response trials and studies
in populations with inflammatory conditions.
Key Words: NZGLM; fatty acids; n-3 LCPUFA; eicosanoid; cytokine,
gas chromatography.
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Evaluation
of Rhodiola crenulata and Rhodiola Rosea for management of Type II
diabetes and hypertension
YOUNG-IN KWON, HAE-DONG JANG AND KALIDAS SHETTY
In
the current study, we investigated 2 species of the genus Rhodiola
for the inhibition of a-amylase,
a-glucosidase and angiotensin converting enzyme (ACE) inhibitory activity.
Water extracts of Rhodiola crenulata had the highest a-amylase inhibitory
activity (IC50, 98.1 µg total phenolic/ml) followed by ethanol
extract of R.crenulata (IC50, 120.9 µg total phenolic/ml) and
ethanol extract of R.rosea (IC50, 173.4 µg total phenolic/ml).
Ethanol R.rosea (IC50, 44.7 µg total phenolic/ml), water extract
of R.rosea (IC50, 52.3 µg total phenolic/ml), water extract
of R.crenulata (IC50, 60.3 µg total phenolic/ml) and ethanol
extract of R.crenulata (IC50, 60.2 µg total phenolic/ml) also
showed significant a-glucosidase inhibitory activity. The a-glucosidase
inhibitory activity of the extracts was compared to standard tyrosol,
which was significantly detected in the extracts using HPLC. Tyrosol
had strong a-glucosidase inhibitory activity (IC50, 70.8 µg
total phenolic/ml) but did not have any inhibitory effect on the a-amylase
activity. Results suggested that a-glucosidase inhibitory activities
of both Rhodiola extracts correlated to the phenolic content, antioxidant
activity and phenolic profile of the extracts. The ability of the
above Rhodiola extracts to inhibit rabbit lung angiotensin I-converting
enzyme (ACE) was investigated. The ethanol extracts of R.rosea had
the highest ACE inhibitory activity (38.5 %) followed by water extract
of R.rosea (36.2 %) and R.crenulata (15.4 %).
.
Key Words: Rhodiola, tyrosol, salidroside, antioxidants, amylase,
glucosidase, angiotensin converting enzyme, enzyme inhibitors, type
2 diabetes, hypertension
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Potential
of cranberry-based herbal synergies for diabetes and hypertension
management
EMANOUIL APOSTOLIDIS, YOUNG-IN KWON AND KALIDAS SHETTY
Water
soluble cranberry-based phytochemical combinations with oregano, rosemary,
and Rhodiola rosea were evaluated for total phenolic content, related
antioxidant activity and inhibition of diabetes management- related
a-glucosidase, pancreatic a-amylase inhibition, and hypertension -
related ACE - I inhibitory activities. Water extracts of oregano had
114.9 mg/g DW of phenolics which was highest among all the extracts
tested, whereas the 75% cranberry with 25% oregano combinations had
the highest phenolics (38.9 mg/g DW) among all the combinations tested.
The water extracts of oregano had the highest DPPH radical inhibition
activity (73.6 %), whereas among combinations the 75% cranberry and
25% oregano had the highest DPPH radical inhibition activity (50.8
%). These results indicated a correlation between total phenolic content
and antioxidant activity. The water extracts of pure Rhodiola rosea
had the highest a-glucosidase inhibition, whereas the 75% cranberry
and 25% Rhodiola rosea combination had the highest inhibition among
the combinations. In the case
of?? a-amylase inhibition the water extracts of Rhodiola rosea had
the highest inhibition, whereas the 75% cranberry with 25% Rhodiola
rosea combination had the highest inhibition among the combinations.
All the water extracts tested indicated that they had anti-ACE-I inhibitory
activity. More specifically, among the water extracts 100% cranberry
had the highest ACE-I inhibitory activity and among the combination
the 75% cranberry with 25% rosemary had the highest ACE-I inhibitory
activity. The analysis of a-glucosidase, a - ?amylase, and ACE-I inhibitory
activities suggested that inhibition depend on the phenolic profile
of each unique extract and by bringing together synergistic combinations
to cranberry, health beneficial functionality was enhanced. This enhanced
functionality in terms of high a-glucosidase and a-amylase inhibitory
activities indicate the potential for diabetes management, and high
ACE - I inhibitory activity indicates the potential for hypertension
management.
Key Words: water soluble phenolics, antioxidants, a-amylase, a-glucosidase,
angiotensin converting- I enzyme, inhibitor, type 2 diabetes, hypertension,
synergies, cranberry, rosemary, Rhodiola rosea, oregano
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Updated: May 2006
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