Asia
Pacific Journal of Clinical Nutrition
Volume 8, issue 3,
1999
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Contents |
Abstract |
Paper
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Manifestation of cardiovascular
risk factors at low levels of body mass index and waist-to-hip
ratio in Singaporean Chinese
MABEL DEURENBERG-YAP, TAN BEE YIAN, CHEW SUOK KAI, PAUL DEURENBERG,
WIJA A VAN STAVEREN
Asia Pac J
Clin Nutr. 1999;8(3):177-183.
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Dietary
factors as determinants of hypertension: A case control study
in an urban Indian population
VIJAYALAKSHMI
KODALI, MALLIKHARJUNA RAO KODAVANTI, PRASANNA KRISHNA TRIPURARIBHATLA,
THUMMALA C RAGHU RAM, PARVATHI ESWARAN, KAMALA KRISHNASWAMY
Asia Pac J
Clin Nutr. 1999;8(3):184-189. |
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Estimation
of glycemic and insulinemic responses to short-grain rice (Japonica)
and a short-grain rice-mixed meal in healthy young subjects
TATSUHIRO MATSUO, YASUHIRO MIZUSHIMA, MAKI KOMURO, AKIKO SUGETA,
MASASHIGE SUZUKI
Asia Pac J
Clin Nutr. 1999;8(3):190-194. |
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Arterial pressures in fish-consuming and non-fish-consuming populations
of coastal south India
GANDHAM
BULLIYYA, PALAKURU CHENGAL REDDY, PALLU REDDANNA
Asia Pac J
Clin Nutr. 1999;8(3):195-199. |
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Food
intake and eating patterns of Indonesian elderly before the
1998 economic crisis
MARTALENA
BR PURBA, WIDJAJA LUKITO, MARK L WAHLQVIST, ANTIGONE KOURIS-BLAZOS,
SUHARYO HADISAPUTRO, LANNY LESTIANI, NAIYANA WATTANAPENPAIBOON,
SUDIYANTO KAMSO
Asia Pac J
Clin Nutr. 1999;8(3):200-206.
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Effect of vitamin C supplementation on concentrations of vitamins
C and E in fasting plasma
IRIS
BENZIE, JJ STRAIN
Asia Pac J
Clin Nutr. 1999;8(3):207-210. |
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Santalbic
acid from quandong kernels and oil fed to rats affects kidney
and liver P450
GWYN P JONES, THOMAS G WATSON, ANDREW J SINCLAIR, ANNE BIRKETT,
NICOLE DUNT, SUDHEERA SD NAIR, SUSAN Y TONKIN
Asia Pac J
Clin Nutr. 1999;8(3):211-215. |
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Eating
your way to a successful old age, with special reference to older
women
CAROLINE
HORWATH, ANTIGONE KOURIS-BLAZOS, GAYLE S SAVIGE, MARK L WAHLQVIST
Asia Pac J
Clin Nutr. 1999;8(3):216-225. |
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The
role of omega-3 polyunsaturated fatty acid-enriched diets in the
prevention of ventricular fibrillation
JOHN
S CHARNOCK
Asia Pac J
Clin Nutr. 1999;8(3):226-230. |
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Clinical
trials in nutrition
MARK L WAHLQVIST, BRIDGET H-H HSU-HAGE, WIDJAJA LUKITO
Asia Pac J
Clin Nutr. 1999;8(3):231-241. |
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Dietary
Guidelines in Asia-Pacific -
book review by
Dr Antigone Kouris-Blazos
Asia Pac J
Clin Nutr. 1999;8(3):242-243. |
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Manifestation
of cardiovascular risk factors at low levels of body mass index and
waist-to-hip ratio in Singaporean Chinese
MABEL
DEURENBERG-YAP, TAN BEE YIAN, CHEW SUOK KAI, PAUL DEURENBERG, WIJA
A VAN STAVEREN
The global
prevalence of obesity, characterised by a body mass index (BMI) 30
kg/m2, is high and is increasing. Obesity is associated with a higher
risk of developing non-communicable diseases such as cardiovascular
disease (CVD) and cancer. In Singapore the prevalence of obesity differs
among the three main ethnic groups (Chinese, Malays and Indians) but
is relatively low compared to Western societies. Despite the low prevalence
of obesity (BMI 30 kg/m2), the morbidity and mortality for CVD are
high in Singapore. In this paper, the odds ratio for presence of risk
factors for CVD was studied in relation to BMI quintiles and in relation
to body fat distribution as measured by waist-to-hip ratio (WHR) quintiles
in a representative sample of adult Singaporean Chinese. The lowest
quintile was used as the reference category. The boundaries for the
BMI quintiles were 18.9, 20.7, 22.6 and 25.0 kg/m2 for females and
20.0, 21.7, 23.5 and 25.6 kg/m2 for males. The boundaries for WHR
quintiles were 0.68, 0.71, 0.74 and 0.79 for females and 0.77, 0.82,
0.85 and 0.89 for males. As observed in other studies, the odds ratios
for high serum total cholesterol, low HDL cholesterol, high total
cholesterol/HDL cholesterol ratio, high serum triglyceride level,
high blood pressure and high fasting blood glucose were higher in
upper BMI and WHR quintiles. The effects were more pronounced in males
compared with females. The odds ratios for having at least one of
the mentioned risk factors in the different BMI quintiles for females
were 1.3 (not significant (ns)), 1.6, 2.1 and 2.7, while in males
they were 2.7, 4.1, 6.2 and 7.3. For the WHR quintiles the odds ratios
were 0.9 (ns), 1.3 (ns), 1.9 and 2.1 for females, while for males
they were 2.1, 4.7, 6.7 and 12.6. As the elevated risks are already
apparent at low levels of BMI and low levels of WHR, it can be queried
whether the cut-off points for obesity based on BMI and for abdominal
fat distribution based on WHR as suggested by the WHO are applicable
to the Singaporean Chinese population. There are indications in the
literature that Asian populations have higher body fat percentages
at lower BMI. This may explain the high odds ratios for CVD risk factors
at low BMI and WHR and the high morbidity and mortality from CVD in
Singapore, despite relatively low population mean BMI and obesity
rates.
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Dietary
factors as determinants of hypertension: A case control study in an
urban Indian population
VIJAYALAKSHMI KODALI, MALLIKHARJUNA RAO KODAVANTI,
PRASANNA KRISHNA TRIPURARIBHATLA, THUMMALA C RAGHU RAM, PARVATHI ESWARAN,
KAMALA KRISHNASWAMY
Hypertension,
an important risk factor for coronary heart disease (CHD), is often
associated with certain dietary habits which can either adversely
affect or decrease blood pressure. Several Western studies have documented
the role of diet, especially excess energy, both quality and quantity
of fat and salt, in the aetiopathogenesis of chronic diseases such
as hypertension, diabetes and CHD. Indians are particularly susceptible
to these chronic diseases. A study was therefore undertaken to investigate
the role of dietary factors in relation to hypertension. A total of
158 newly diagnosed cases were selected from the out-patient department
of the 1000-bed Osmania General Hospital along with 172 age and gender-matched
controls. A detailed diet history was collected and validated. An
energy adjustment method was adopted by transforming the data on a
log scale as all the nutrients depended upon the intake of energy.
A total of 86 hypertensives and 79 controls participated in the study.
Among those classified as hypertensives, men reported higher intakes
of dietary fat and salt while women reported higher intakes of dietary
protein and salt. Risk calculated by Odds ratio revealed that higher
intakes of fat, protein and salt increase the risk for hypertension.
Multivariate stepwise logistic regression identified salt as the risk
factor in men and protein as the risk factor in women. These results
suggest a role for dietary fat, protein and salt in hypertension.
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Estimation
of glycemic and insulinemic responses to short-grain rice (Japonica)
and a short-grain rice-mixed meal in healthy young subjects
TATSUHIRO MATSUO, YASUHIRO MIZUSHIMA, MAKI KOMURO,
AKIKO SUGETA, MASASHIGE SUZUKI
We
estimated glycemic and insulinemic responses to short-grain rice (Japonica)
and a short-grain rice-mixed meal (i.e. short-grain rice and other
ingredients) in three healthy male, and five healthy female subjects
aged 22-31 years. A 50 g carbohydrate portion of dry rice was used
in this study to estimate the glycemic index (GI) of short-grain rice
(Experiment 1). The GI of short-grain rice was 68 (white bread = 100).
In Eperiment 2, the subjects took three mixed meals (rice-, bread-
and cornflakes-mixed) containing 60 g available carbohydrate, 25-29
g fat, 18-22 g protein, 2331-2486 kJ energy, and 67-123 meal GI in
order to detemine whether both the amount and source of carbohydrate
consumed determined postprandial glycemic and insulinemic responses
of mixed meals. Glycemic response after the rice-mixed meal was significantly
lower (P< 0.05) than that after the cereal-mixed meal. The predicted
glycemic and insulinemic responses, based on GI and the amount of
carbohydrate, were related to the observed mean plasma glucose responses.
These results suggest that short-grain rice (Japonica) grown in Japan
should not be classified as a high GI food and that, in a mixed meal,
it is a lower glycemic and insulinemic responder compared with bread
or cereal mixed meals. Moreover, both the amount and source of carbohydrate
consumed determine the glycemic and insulinemic responses after different
mixed meals with variable GI.
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Arterial
pressures in fish-consuming and non-fish-consuming populations of
coastal south India
GANDHAM BULLIYYA, PALAKURU CHENGAL REDDY, PALLU REDDANNA
It has been suggested that fish-consuming populations have lower blood
pressure levels. The aim of this study was to determine and compare
the mean blood pressure levels among fish-consuming populations with
those among populations who do not consume fish, as a risk marker
for cardiovascular disease. A cross-sectional study was conducted
among 1000 healthy Indian adult men and women (aged 20 years) randomly
chosen from two representative age and sex-matched samples, one of
which was fish-consuming (n = 500) and the other of which was non-fish-consuming
(n = 500). The systolic and diastolic blood pressures and pulse rates
were studied. The mean systolic and diastolic blood pressures and
pulse rates were found to be lower in older men and women who were
fish consumers in comparison with those who were non-fish consumers,
and the levels increased with advancing age. The population and sex
differences were significant for certain age groups. The percentile
cut-off values for diagnosis of systolic hypertension showed lower
prevalence in fish consumers than in non-fish consumers. The results
indicate that people who ate fish regularly appeared to have a better
cardiovascular risk profile than did non-fish consumers, which is
of public health significance. The relationship between fish consumption
and blood pressure deserves further studies in normotensive and hypertensive
populations.
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Food
intake and eating patterns of Indonesian elderly before the 1998 economic
crisis MARTALENA BR PURBA, WIDJAJA LUKITO, MARK
L WAHLQVIST, ANTIGONE KOURIS-BLAZOS, SUHARYO HADISAPUTRO, LANNY LESTIANI,
NAIYANA WATTANAPENPAIBOON, SUDIYANTO KAMSO
The Nutrient and Metabolic Study of Indonesian Elderly (NUMSIE) was
conducted in part to identify differences in eating patterns and in
food and energy intakes between elderly people residing in urban metropolitan
Jakarta (JAK) and in urban non-metropolitan Semarang (SEM) in order
to investigate the prevalence of food and energy deficiencies. Data
on food intake were collected from 212 JAK elderly and 238 SEM elderly
aged 60 years and over using a quantitative food frequency questionnaire
(FFQ). Although most of the elderly lived with their families or extended
families, a large proportion of the subjects were eating alone, especially
in the SEM sample. Jakartan elderly had significantly higher intakes
of most food groups, except for added sugar and cow's milk. Total
food intake of JAK subjects was also significantly higher (P< 0.0001)
than that of SEM subjects. The ratio of plant to animal food was lower
among SEM elderly due principally to their higher intake of milk.
Thirty percent of both JAK and SEM elderly consumed less than the
recommended amounts of cereals, followed by vegetables and fruits
(10%, 47% JAK; 22%, 75% SEM, respectively). Finally, it was found
that the range of daily energy intakes was higher in JAK (1251-2079
kcal) than in SEM (939-1579 kcal). This suggests that SEM elderly
were more likely to be energy deficient than were JAK elderly. While
the results of this study indicate that food and energy intakes may
be inadequate in Indonesian elderly, especially in non-metropolitan
areas, more analyses are required to ascertain the true prevalence
of malnutrition in this age group using anthropometric and blood measurements.
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Effect
of vitamin C supplementation on concentrations of vitamins C and E
in fasting plasma
IRIS BENZIE, JJ STRAIN
Vitamin
C may 'spare' vitamin E, but this has not to date been confirmed as
occurring in vivo. The aim of this study was to test the effect of
dietary supplementation with vitamin C on total and lipid standardised
vitamin E concentrations in fasting plasma, the hypothesis being that
increased vitamin C intake leads to improved vitamin E levels. In
this single-blinded study, 12 apparently healthy adults (seven men,
five women) took 1 g/day vitamin C for 28 days, with a 28-day placebo-controlled
run-in cycle and a 28-day placebo-controlled washout cycle. Concentrations
of ascorbic acid, total vitamin E (as total tocopherols) and lipid
standardised vitamin E (Vit ELS, expressed as mol vitamin E/mmol total
cholesterol plus triglycerides) were measured in fasting plasma after
each cycle. Results showed that vitamin C supplementation led to significant
increases in ascorbic acid, total vitamin E and Vit ELS. These findings
indicate that, by a combination of a vitamin E 'sparing' effect perhaps
via improved redox recycling of vitamin E in vivo and a lipid lowering
effect, increased intake of vitamin C could increase plasma vitamin
E levels, and possibly vitamin E status. Further study of possible
in vivo interrelationships between vitamins C and E, and the role
of vitamin C in lipid metabolism, is needed.
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Santalbic
acid from quandong kernels and oil fed to rats affects kidney and
liver P450
GWYN P JONES, THOMAS G WATSON, ANDREW J SINCLAIR, ANNE BIRKETT, NICOLE
DUNT, SUDHEERA SD NAIR, SUSAN Y TONKIN
Kernels
of the plant Santalum acuminatum (quandong) are eaten as Australian
'bush foods'. They are rich in oil and contain relatively large amounts
of the acetylenic fatty acid, santalbic acid (trans-11-octadecen-9-ynoic
acid), whose chemical structure is unlike that of normal dietary fatty
acids. When rats were fed high fat diets in which oil from quandong
kernels supplied 50% of dietary energy, the proportion of santalbic
acid absorbed was more than 90%. Feeding quandong oil elevated not
only total hepatic cytochrome P450 but also the cytochrome P450 4A
subgroup of enzymes as shown by a specific immunoblotting technique.
A purified methyl santalbate preparation isolated from quandong oil
was fed to rats at 9% of dietary energy for 4 days and this also elevated
cytochrome P450 4A in both kidney and liver microsomes in comparison
with methyl esters from canola oil. Santalbic acid appears to be metabolized
differently from the usual dietary fatty acids and the consumption
of oil from quandong kernels may cause perturbations in normal fatty
acid biochemistry.
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Eating
your way to a successful old age, with special reference to older
women
CAROLINE HORWATH, ANTIGONE KOURIS-BLAZOS, GAYLE S
SAVIGE, MARK L WAHLQVIST
A
comprehensive definition of successful ageing would combine the elements
of survival (longevity), health (lack of disability), and life satisfaction
(happiness). Predictors of longevity include being female, being physically
active, not smoking, having good cognitive functioning, higher socio-economic
status and greater life satisfaction. Predictors of life satisfaction
include being healthy (which is in part influenced by nutrition and
physical activity), being socially active, having work satisfaction,
having a high happiness rating and enjoying sexual activity. To age
successfully is therefore the ultimate challenge. This paper cannot
address all variables in the equation to successful ageing, but will
focus on the value of food and physical activity in later life.
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The
role of omega-3 polyunsaturated fatty acid-enriched diets in the prevention
of ventricular fibrillation
JOHN S CHARNOCK
In a number of epidemiological surveys and in two recent intervention
trials in cardiac patients, diets rich in marine omega-3 polyunsaturated
fatty acids (PUFA), which include both eicosapentaenoic acid (EPA)
and docosahexaenoic acid (DHA), have been found to be beneficial in
reducing the susceptibility of developing serious ventricular fibrillation
(VF) or malignant cardiac dysrhythmia and mortality from sudden cardiac
death (SCD). In addition to this information from human studies, there
is strong supporting evidence from laboratory experiments utilizing
the small non-human primate marmoset monkey (Callithrix jacchus).
For example, a diet enriched with tuna fish oil that is high in both
DHA and EPA has been found to increase the electrical threshold current
necessary for inducing VF and to reduce mortality to zero in marmoset
monkeys with experimentally induced ischaemic cardiac dysrhythmia
(ICH). From these and earlier studies in other animals there is also
some evidence which suggests that it may be the DHA rather than the
EPA component of fish oils which is the biologically active fatty
acid responsible for the reduction in susceptibility of developing
VF and ICH. If this possibility could be determined with confidence,
it would greatly assist in the design of future intervention trials,
which are required in order to determine both the nature and amount
of dietary omega-3 PUFA that is necessary to achieve these beneficial
effects. Any simple dietary strategy that could lead to a substantial
decrease in VF and mortality from SCD would be of great medical, social
and economic benefit.
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Clinical
trials in nutrition
MARK L WAHLQVIST, BRIDGET H-H HSU-HAGE, WIDJAJA LUKITO
Trials of nutritional intervention in a wide range
of health and disease states, preventive and therapeutic, are required.
Not only has the emergence of chronic non-communicable disease (CNCD)
with acknowledged nutritional pathogenesis created this imperative
need, but so also have other conditions which, previously, had not
been regarded as nutritionally based. Among the latter are health
problems associated with ageing: the menopause, a decline in immune
function, and a decline in cognitive function. At the same time, there
is a new set of materno-foetal and infant nutrition issues for investigation
which relate to new food exposures and the long-term effects of nutritionally
mediated gene expression. The emergence of the new food science of
phytochemicals with human biological importance also sets the scene
for their evaluation in traditional diets and novel foods. Such trials
are more complex than comparable pharmacotherapeutic studies because
of the complexity of food chemistry, as well as the food behavioural
changes which may accompany a nutritional intervention, and the general
problem of there not being a 'gold standard' for food intake methodology.
Choice of study population is also a key issue in relation to the
extrapolation of findings from a particular trial, with population
representativeness being an advantage. In order to obtain useful information
on manageable sample sizes, either intermediate end-points (short
of morbidity and mortality) need to be studied or high-risk groups
(such as the aged) need to be recruited. There are some unique ethical
issues which must inform clinical nutrition trials. These include
certain preventive imperatives like the right to be fed, the risks
in disruption of food cultures and the need for food security and
sustainability. Rapid changes in the food supply do, however, make
such trials more important, while the value of food-health knowledge
that cannot be obtained by trial must still be appreciated.
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Dietary
Guidelines in Asia-Pacific
Book review - see pdf file
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Last
Updated: September 2004
HEC
PRESS Publisher
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