1000
Asia Pacific J Clin Nutr (1997) 6(4): 251-255
Asia Pacific J Clin
Nutr (1997) 6(4): 251-255
Food
consumption patterns and nutrient intake among Nepalese living in
the southern rural Terai region
Yoshimi Ohno1 PhD, Kazuko Hirai2
PhD, Noriko Sato3 NT, Masashi Ito3
BSc, Teruko Yamamoto4 BSc, Toshihide Tamura5
MD, PhD and Mathura P Shrestha6 MD, PhD
1 Department of
Food Science and Nutrition, School of Human Environmental Sciences,
Mukogawa Women’ s University, Hyogo, Japan,
2 Department of Nutritional Biochemistry,
Faculty of Human Life Science, Osaka City University, Osaka, Japan,
3 Japan Overseas Cooperation Volunteers (JOCV),
JICA Nepal Office, Kathmandu, Nepal,
4 Department of Food Science and Nutrition,
Himeji College of Hyogo, Hyogo, Japan,
5 Department of Bacteriology, Hyogo College
of Medicine, Hyogo, Japan and
6 Department of Community Health, Institute
of Medicine, Tribhuvan University, Kathmandu, Nepal.
The dietary nutrient intake of persons aged 10-68
years (55 males and 54 females) living in the Chitwan district,
Nepal, was investigated using the 24-hour recall method. The mean
daily consumption of food for males and females averaged 483± 92 and 433± 115 g of cereals, 179± 126 and 167± 126 g of coloured vegetables,
91± 177 and 111± 206 g of milk and dairy products, 67± 91 and 53± 82 g of potatoes, respectively.
These items constituted more than three-fourths of the total food
weight, whereas the amounts and frequency of the consumption of
meats, fish and eggs were very low. Males (464± 80 g) consumed a larger amount of rice than females (408± 105 g, p<0.01). The level of rice consumption 1000 was strongly
related to the level of energy intake (r= 0.60), protein (r= 0.44),
carbohydrate (r= 0.66), vitamin B1 (r= 0.77), niacin
(r= 0.53) and vitamin E (r= 0.54), (p<0.001). The mean amount
of total energy intake for males (2340± 526 kcal) was higher than that of females (1930± 457 kcal, p<0.01). The daily
mean intakes of protein, fat, Ca, vitamin B1 and B2
were 51.9± 13.0 g, 23.0± 9.8 g, 412± 228 mg, 1.88± 0.33 mg and 0.73± 0.27 mg for males and 47.4± 12.5 g, 26.1± 13.8 g, 395± 237 mg, 1.72± 0.39 mg and 0.68± 0.31 mg for females, respectively. The intake levels of Fe and vitamin
E for males (8.5± 3.4 and 4.4± 1.5 mg) were higher than those
of females (6.7± 1.9 and 3.7± 1.2 mg, p<0.01, respectively).
The mean intake of vitamin A, mostly of carotene (about 90% of vitamin
A), was 1614± 1003 and 1561± 1031 IU for males and females,
respectively. The consumption of coloured vegetables was correlated
with the intake of vitamin A (r= 0.96), B2 (r= 0.37)
and C (r= 0.85), (p<0.001, respectively).
Key words: food consumption, nutrient
intake, Nepal, Terai region, Chitwan district, Khargual Village, rural,
Itahari district, BMI (body mass index), blood pressure
Introduction
Malnutrition is still a public health problem in many
developing countries1-3. We have been interested in the
nutritional status in Nepal where little survey work has been done.
Brown et al4 carried out a dietary survey of 19
villages throughout Nepal in 1965 and reported that the Nepalese diet
was generally superior to that reported by FAO for the Far East as
a whole.
We have conducted dietary surveys in a mountain area
in 19755 and in an industrial region (Itahari district,
Terai region) in 19876 to obtain actual data on food consumption
of the Nepalese. Although their dietary patterns were found to be
very simple and similar, the main cereals consumed in the former case
were foxtail millet, Japanese barnyard millet and wheat, whereas in
the latter case, much more rice was consumed. Besides cereals, the
residents in the Itahari district consumed more vegetables and milk
and dairy products than those in the mountain area. The reason for
the variation in findings between the surveys was not clear, but it
could have been related to changes over time, the season of the survey,
income or regional differences. Therefore, for comparison with our
previous findings, we surveyed the dietary intake of Nepalese living
in the Chitwan district of the southern agricultural Terai region
where residents were self 1000 -supporting but lived on a low income.
We found some nutrient deficiencies and discuss the nutritional status
of the people living in this rural region of Nepal.
Subjects
and methods
The subjects were a random sampling from among the
general populace who came to a medical camp for a routine health check
and consisted of over 50% of the population of a village in Khargual
of the Chitwan district, an agricultural Terai region of Nepal. The
study was conducted on 55 males and 54 females of ages ranging from
10 to 68 years (average 28.8± 12.7 years).
The average life-span of the Nepalese is 53-54 years.
The majority of the residents in this district were engaged in agriculture
and were peasants. Most of them were Hindu believers.
Height and body weight were measured for all subjects,
and body mass index (BMI) was calculated as weight/height2
(kg/m2). Systolic (SBP) and diastolic blood pressure (DBP)
were measured for 108 subjects (55 males and 53 females).
The dietary survey was carried out in December, 1989
by the 24-hr dietary recall method. Food models were used to obtain
descriptions of the amounts of food consumed. In addition, information
was obtained from local residents on the usual dietary habits and
the consumption of minor food groups such as seasoning and local foods.
The data were analysed and nutrient intake was calculated from food
tables of India and Japan. Foods not listed in the tables were substituted
with similar items.
All results are expressed as mean ± SD. Student’s unpaired t test
was used to assess the statistical significance of difference. Pearson’s
correlation coefficients were computed to examine the relationship
between the variables. Statistical analysis was performed by using
STAX statistical software (Microcomputers in Medicine, Nakayama Shoten,
Tokyo).
Results
The physical characteristics of the subjects are summarised
in Table 1. The mean values of height and body weight for males were
significantly higher than those for females (p<0.01, respectively).
However, the mean level of BMI was almost the same for both sexes
(18.5± 1.7 for males and 18.0± l.8 for females), showing that
they were rather lean. SBP and DBP were 129.4± 14.1 and 82.6± 7.9 mmHg for males and 123.8± l5.5 and 77.7± 8.9 mmHg for females, respectively (p<0.05 for SBP, p<0.0l for
DBP). These values were not influenced by age.
Table 1. Physical characteristicsa
of subjects.
| Sex |
Subject
|
Height
|
Weight
|
BMI
|
Blood pressure b
|
| |
|
|
|
|
SBP
|
DBP
|
| |
(age) |
(n)
|
(cm)
|
(kg)
|
(kg/m2)
|
(mmHg)
|
| Male |
10-14 |
0
|
|
|
|
|
|
| |
15-19 |
14
|
159± 7
|
43.9± 5.7
|
17.2± 1.2
|
125.0± 9.1
|
80.0± 7.7
|
| |
20-29 |
18
|
161± 16
|
51.7± 5.8
|
18.7± 1.4
|
135.0± 17.1
|
84.6± 8.5
|
| |
30-39 |
12
|
165± 6
|
50.7± 5.9
|
18.6± 1.2
|
129.8± 13.0
|
85.8± 6.9
|
| |
40-49 |
5
|
163± 8
|
49.1± 1.7
|
18.5± 1.5
|
113.0± 8.4
|
77.2± 6.4
|
| |
50-59 |
4
|
164± 4
|
55.6± 6.6
|
20.8± 3.2
|
123.0± 4.8
|
80.0± 7.5
|
| |
60-68 |
2
|
159± 2
|
1000
48.5± 2.1
|
19.3± 1.4
|
150.0± 0
|
83.0± 9.9
|
| |
All c |
55
|
162± 10**
|
49.3± 6.4**
|
18.5± 1.7
|
129.4± 14.1*
|
82.6± 7.9**
|
| Female |
10-14 |
3
|
139± 11
|
28.7± 6.1
|
14.7± 1.1
|
109.3± 1.2
|
64.7± 5.0
|
| |
15-19 |
11
|
152± 6
|
42.5± 5.0
|
18.8± 2.2
|
118.5± 5.8
|
73.1± 5.9
|
| |
20-29 |
19
|
154± 5
|
44.1± 4.8
|
18.6± 1.4
|
128.3± 22.7
|
79.9± 10.0
|
| |
30-39 |
9
|
151± 5
|
38.2± 3.7
|
16.7± 0.9
|
120.2± 10.1
|
78.9± 7.8
|
| |
40-49 |
8
|
147± 5
|
39.8± 2.6
|
18.3± 1.2
|
127.0± 11.6
|
79.8± 7.7
|
| |
50-59 |
4
|
152± 7
|
42.0± 4.0
|
18.3± 1.4
|
130.0± 0
|
84.0± 4.3
|
| |
60-68 |
0
|
|
|
|
|
|
| |
All c |
54
|
151± 6**
|
41.1± 5.6**
|
18.0± 1.8
|
123.8± 15.5*
|
77.7± 8.9**
|
a Mean ± SD; b Total number of subjects
: 55 males and 53 females; c Significant differences between
the sexes, *p<0.05, **p<0.01.
Table 2 shows the average daily food intake of the
subjects. Considerable variation was found among individuals for the
amount of food consumption, although the mean number of food items,
excluding seasoning and alcohol, was 7.2± 2.4 per day. All of the subjects
consumed rice, seasoning and vegetable oil. Vegetables, potatoes and
milk and dairy products were frequently consumed. The proportion of
consumption of rice, coloured vegetables and milk and dairy products
was 65.6 and 72.5% of the total weight of the food intake for males
and females, respectively. The average amounts of rice consumed for
males and females were 464± 80 and 408± 105 g per day, respectively, which constituted almost half of the total
weight of the food intake, and the males consumed more rice than the
females (p<0.01). The males also consumed much more alcohol (13.7%
of the total weight of the food intake), but no significant difference
was observed with age. A significant positive correlation was found
between age (subjects 20-30 years old vs. teenagers and those over
40 years old vs. those 20-30 years old) and the amount of milk and
dairy product intake (r = 0.28, p< 1000 ;0.01) while there was a
negative correlation between age and the amount of rice intake (r=
-0.25, p<0.01). The amounts and frequency of meat, fish or egg
consumption were very low for both sexes, which meant that milk and
dairy products were almost the sole food source of animal origin.
Table 2. Average daily food group consumptiona
of subjects.
| Food group |
All
|
Maleb
|
Femaleb
|
| (g/day) |
(n=109)
|
(n=55)
|
(n=54)
|
| Cereals |
458± 107
|
483± 92*
|
433± 115*
|
| Rice |
436± 97
|
464± 80**
|
408± 105**
|
| Wheat |
5± 22
|
3± 14
|
7± 28
|
| Potatoes |
60± 86
|
67± 91
|
53± 82
|
| Sugar & sweetenings |
4± 6
|
5± 8*
|
2± 4*
|
| Fats & oils |
8± 6
|
7± 5
|
9± 7
|
| Pulses |
8± 15
|
9± 17
|
7± 12
|
| Fruits |
2± 12
|
3± 17
|
0
|
| Vegetable: coloured |
173± 127
|
179± 126
|
167± 129
|
| other |
82± 128
|
71± 99
|
94± 151
|
| Seasoning |
5± 3
|
5± 3*
|
4± 2*
|
| Alcohol c |
86± 193
|
153± 252**
|
18± 43**
|
| Fish |
13± 32
|
13± 31
|
13± 33
|
| Meats |
19± 43
|
14± 41
|
24± 45
|
| Eggs |
2± 14
|
2± 16
|
2± 11
|
| Milk & dairy products |
101± 191
|
91± 177
|
111± 206
|
| Total food weight |
1034± 344
|
1120± 348**
|
946± 320**
|
a Mean ± SD. b Significant difference
between the sexes, *p<0.05, **p<0.01 c alcoholic
beverage, not ethanol, principally fermented liquor or whisky.
The nutrient composition of diets is shown in Table
3. Age was negatively correlated with the average intakes of protein
(r= -0.18, p<0.05), carbohydrate (r= -0.19, p<0.05), vitamin
B1 (r= -0.23, p<0.05), and niacin (r= -0.23, p<0.05).
Energy and intake of carbohydrate, Fe and vitamin E were higher for
males than for females (p<0.01). The average intakes of animal
protein and fat were slightly higher for females, but did not differ
significantly between males and females. The daily mean intakes of
Ca, K, vitamin A, B2 and C were almost the same for both
sexes.
Table 3. Daily average nutrient intakea
of subjects.
| Nutrient |
All (n=109)
|
Male (n=55)b
|
Female (n=54)b
|
| Energy (kcal) |
2137± 532
|
2340± 526**
|
1930± 457**
|
| Protein (g) |
49.6± 12.9
|
51.9± 13.0
|
47.4± 12.5
|
| animal protein
(g) |
8.8± 9.3 |
7.6± 9.6
|
9.9± 8.9
|
| Fat (g) |
24.5± 12.0
|
23.0± 9.8
|
26.1± 13.8
|
| animal fat (g) |
7.9± 9.7
|
6.2± 7.7
|
9.6± 11.1
|
| Carbohydrate (g) |
404± 100
|
449± 96**
|
359± 81**
|
| Dietary fibre (g) |
15.9± 8.7
|
15.9± 5.2
|
15.8± 11.3
|
| Ca (mg) |
404± 232
|
412± 228
|
395± 237
|
| P (mg) |
1160± 283
|
1214± 241*
|
1104± 312*
|
| Fe (mg) |
7.6± 2.9
|
8.5± 3.4**
|
6.7± 1.9**
|
| K (mg) |
2010± 731
|
2080± 774
|
1939± 685
|
| Vitamin A (IU) |
1588± 1013
|
1614± 1003
|
1561± 1031
|
| Vitamin B1
(mg) |
1.80± 0.37
|
1.88± 0.33*
|
1.72± 0.39*
|
| Vitamin B2
(mg) |
0.71± 0.29
|
0.73± 0.27
|
0.68± 0.31
|
| Niacin (mg) |
14.9± 3.7
|
15.6± 3.8*
|
14.2± 3.5*
|
| Vitamin C (mg) |
117± 61
|
12 1000 0± 59
|
114± 63
|
| Vitamin E (mg) |
4.0± 1.4
|
4.4± 1.5**
|
3.7± 1.2**
|
aMean± SD; bSignificant difference between
the sexes, *p<0.05, **p<0.01.
As shown in Table 4, the proportion of energy intake
from protein and fat was higher for females (p<0.01, respectively)
and that of carbohydrate was higher for males (p<0.01). Rice appeared
to contribute most to the total energy intake in both sexes, which
constituted of about 74% of the total energy intake.
Table 4. Contribution of nutrients and rice
to total energy intakea
| Subject |
N
|
Sources of energy (%)
|
| |
|
Protein
|
Fat
|
Carbohydrate
|
Rice
|
| All |
109
|
9.8± 1.6
|
10.8± 4.4
|
79.4± 5.1
|
74.0± 14.2
|
| Males |
55
|
9.4± 1.1**
|
9.3± 3.2**
|
81.3± 3.9**
|
72.5± 15.4
|
| Females |
54
|
10.3± 1.8**
|
12.2± 5.0**
|
77.5± 5.5**
|
75.6± 12.8
|
a Mean± SD. **Significant difference between the
sexes, p<0.01.
The results of correlation analysis among major food
items and nutrient intake for all subjects are presented in Table
5. Rice correlated most strongly with energy intake (r =0.60, p<0.001),
protein (r =0.44, p<0.001), carbohydrate (r = 0.66, p<0.001),
vitamin B1 (r = 0.77, p<0.001), niacin (r =0.53, p<0.001)
and vitamin E (r = 0.54, p<0. 001). Coloured vegetables showed
cor-relations with Ca (r = 0.63, p<0.001), vitamin A (r = 0.96,
p<0.001), B2 (r = 0.37, p<0.001) and C (r = 0.85,
p<0.001). Milk and dairy products were correlated with fat (r =
0.42, p<0.001), Ca (r = 0.63, p<0.001) and vitamin B2
(r = 0.63, p<0.001). However, Fe was only correlated with meats
(r = 0.39, p<0.001). Ca, vitamin A and C were not correlated with
energy. Several other food groups were correlated with only a few
dependent variables (not presented in the table).
Table 5. Correlation among food consumption
and nutrient intake.
| Nutrient |
Rice
|
Fish
|
Meats
|
Milk & dairyproducts
|
Coloured vegetables
|
| Energy |
0.60***
|
0.15
|
0.21*
|
0.12
|
-0.07
|
| Protein |
0.44***
|
0.31***
|
0.43***
|
0.19*
|
0.05
|
| Fat |
0.23*
|
-0.03
|
0.46***
|
0.42***
|
0.02
|
| Carbohydrate |
0.66***
|
0.12
|
0.06
|
0.07
|
-0.10
|
| Ca |
0.01
|
-0.22*
|
-0.01
|
0.63***
|
0.63***
|
| Fe |
0.13
|
0.23*
|
0.39***
|
-0.08
|
0.14
|
| Vitamin A |
--
|
-0.21*
|
0.17
|
0.11
|
0.96***
|
| Vitamin B1 |
0.77***
|
0.24**
|
0.07
|
0.19
|
--
|
| Vitamin B2 |
0.14
|
-0.06
|
0.24**
|
0.63***
|
0.37***
|
| Niacin |
0.53***
|
0.04
|
0.63***
|
0.02
|
0.15
|
| Vitamin C |
-0.05
|
-0.19*
|
0.12
|
0.12
|
0.85***
|
| Vitamin E |
0.54***
|
0.33***
|
0.04
|
--
|
-0.11
|
*p<0.05, **p<0.01, ***p<0.001
Discussion
The mean height of the subjects in this study was
almost the same as that given in the previous report6,
but that of body weight was lower, resulting in lower BMI values.
This might be explained by greater energy expenditure for the subjects
compared with energy intake and also by 1000 the difference in the
daily activities between the two areas (subjects in this study were
peasants while those in the previous one were factory workers). The
blood pressure levels (DBP and SBP) for the subjects were within the
normal ranges by Japanese standards. The mean values of DBP of males
and females were about the same as those of Nepalese in the Itahari
district6 and African Americans7 reported by
Melby et al, while those of SBP were higher than those reported
previously.
Milk and dairy products were almost the sole food
source of animal origin, as found for the Itahari district6.
Food habits such as having milk tea or boiled rice with milk led to
the subjects consuming fairly large amounts of milk. The average daily
consumption of rice and coloured vegetables in this study was higher
than those of Japanese8 and Nepalese in the Itahari district6;
the intake of coloured vegetables was about 3.5 times higher than
in the Itahari district6. This might be explained by the
facts that it was just after the rice harvest and that the land was
also good for cultivating vegetables throughout the seasons compared
with mountain or industrial areas in Nepal.
The dietary pattern was very simple in this area and
similar to that reported previous1y5,6. An average of seven
food items was consumed in this area, which was fewer than the average
of 22 for the Japanese8 and 18 for the Nepalese in the
Itahari district6. This showed that food availability and
cash income greatly influenced food intake. Due to the large amounts
of rice intake, its proportion in the total energy intake of Nepalese
in this study was higher than those in the mountain area9
and in the Itahari district6. The energy percentage of
carbohydrates for Nepalese in this study was almost the same as those
for South Africans9, Polynesians10 and other
Nepalese4-6,11, but was higher than those in developed
coun-tries12,13 and among vegetarians7,14. The
average intake of protein was about the same level as that reported
elsewhere for Nepalese4-6,11 and that of fat was the same
as for the Nepalese in the 19 villages reported earlier4
and in Kathmandu11 but was lower than that in the Itahari
district6. Rice intake contributed to the intake of protein,
fat, vitamin B1, niacin and vitamin E, however, compared
with a previously studied vegetarian diet of 2200 kcal14,
the intake of protein and fat was less and that of Ca, vitamin E,
niacin and Fe was considerably less than the vegetarians. Ca intake
mainly came from consumption of milk and dairy products and coloured
vegetables which was higher than those in the 19 villages4,
in the mountain area5 and in the Itahari district6.
However, the consumption of milk and dairy products was lower in this
study than that in the Itahari district6.
Fe intake was related to meat consumption, but this
was very low in amount and frequency in this study, as found with
the diets of vegetarian adults15. Fe intake in this study
was only 56 to 65% of that in the Itahari district6. We
found that the dietary Fe was not related to the serum Fe concentration
and that the average percent saturation of serum transferrin was around
20-25% in this area (to be published in a separate paper), which tended
to be lower than that of the normal range (20-55%)16. Thus,
there seems to be a latent iron deficiency. Black gram, a kind of
pulse commonly eaten in Nepal, contains about 15 mg/100 g of Fe (unpublished
data). The average intake of pulses for Nepalese in this area was
below one-fifth of that in the Itahari district6. We do
not have precise information on the kind of pulse 1000 s consumed
in the Itahari district, but the difference in the amount of pulse
consumption between these two areas might be the reason for the lower
Fe intake found in this study because the amount of animal origin
food intake did not differ much between the two areas.
Dietary fibre is known to play an important role in
human health17,18 but increasing its amount can disturb
the absorption of nutrients such as protein, fat and minerals19,20.
This would be a problem for children and pregnant or lactating women
in developing countries because of the lower bioavailability of important
nutrients. The average intake values for dietary fibre by males and
females in this study were 15.9± 5.2 and 15.8± 11.3g, respectively, which were about the same as those in the Netherlands
(18g)13 and the United States (15.4± 8g)21 and among the
elderly in Norwich, Great Britain (20.9g for males and 17.4g for females)22,
but they were about half of that of vegetarians (30-40g)7,14.
Thus, although the amount of dietary fibre intake in this area was
not considerably higher, the net amounts of bioavailability of those
nutrients might be affected due to the overall low nutrient intake.
Examining the average intakes of the various nutrients
showed that the level for vitamin A was within the range of the other
reports4-6,11 and was lower than that of the Japanese8.
About 90% of vitamin A was from carotene, which agreed with the lesser
consumption of animal origin food. Carotene is readily available from
vegetables from the people’s gardens throughout the year.
The average intake of vitamin B1 was higher
than those of Japanese8 and Americans12, but
was lower than those in the 19 villages4 and in the Itahari
district6. The average intake of vitamin B2
was the same level as those of the 19 villages4 and in
the mountain area5 but was lower than those in the Itahari
district6 and for Japanese8 and Canadian students23.
Niacin intake for this study was the same level as that in the Itahari
district6 but was lower than that in the 19 villages in
Nepal4 and among Canadian students23. The main
source of both nutrients, vitamin B1 and niacin, was apparently
rice. The residents eat more nutritive half-polished rice than the
all-polished type. The average intake of vitamin C, which showed good
correlation with the consumption of coloured vegetables, was the same
as those in the Itahari district6 and in Japan8,
was lower than that in the mountain area5 and was higher
than that in the 19 villages4. The average intake of vitamin
E was the same level as that of 7-11-year-olds in Britain found by
Nathan et al (4.4-5.6 mg)24. Horwitt et al25,26
reported that the vitamin E requirement was 4mg of a-D-tocopherol per day for persons whose polyunsaturated
fatty acid (PUFA) intake was very low. For the Japanese, 8-10mg of
vitamin E is considered to be adequate27. Judging from
the food consumption of Nepalese in this study, 6-8mg of vitamin E
might be sufficient because their PUFA intake was much lower than
that for the Japanese.
In general, the nutritional status of Nepalese in
this study was almost the same as that reported previously. They were
apparently healthy, despite the fact that there may be a latent deficiency
of protein, Ca, Fe, vitamins A and B2 and a lack of high
quality amino acids because of le 1000 sser intake of animal origin
food groups such as meats, fish, or eggs. The status of food consumption
was greatly influenced by food habits, food availability, and socioeconomic
conditions. The residents can grow some agricultural products throughout
the year because they live in a southern arable farm village but the
variety of food is limited due to their 1ow income. The usual diet
in the research area consists of plenty of boiled rice, thin soup
of pulses and cooked vegetables. Although it is very difficult to
change food habits and it takes time to improve the nutritional status,
we would suggest the consumption of thicker soups of pulses, more
variety of vegetables, and animal origin foods. The quality of the
diet rather than its quantity should be improved to raise the nutritional
status as a whole.
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Food consumption patterns and nutrient
intake among Nepalese living in the southern rural Terai region
Yoshimi Ohno, Kazuko Hirai, Noriko
Sato, Masashi Ito, Teruko Yamamoto, Toshihide Tamura and Mathura P
Shrestha
Asia Pacific Journal of Clinical
Nutrition (1997) Volume 6, Number 4: 251-255
Food consumption patterns and nutrient
intake among Nepalese living in the southern rural Terai region
Yoshimi Ohno, Kazuko Hirai, Noriko
Sato, Masashi Ito, Teruko Yamamoto, Toshihide Tamura and Mathura P
Shrestha
Asia Pacific Journal of Clinical
Nutrition (1997) Volume 6, Number 4: 251-255
Copyright © 1997 [Asia Pacific Journal of Clinical
Nutrition]. All rights reserved.
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