APJCN

Thickening agents, such as carob bean gum or galactomannan, have been successfully administered for the treatment of gastroesophageal reflux in infants. To study the effect of carob bean gum on gastric emptying and to symptoms of regurgitation, we recruited 20 full term Thai infants (mean age = 13.4 + 7 week; mean body weight = 4943 + 1272gm) without pathological gastroesophageal reflux. Initially, we determined half time gastric emptying (T 1/2 GET) by Tc99m radioscintigraphy method (mean T 1/2 GET = 116.1 + 72 min) in infants consuming standard infant cow's milk formula for 2 weeks. Afterwards, carob bean infant formula was given for 2-4 weeks and weight gain, vomiting symptoms, night cough, colic, flatus, defaecation character and T 1/2 GET were assessed. There were statistically significant improve-ments in symptoms of vomiting (a smaller quantity P<0.001 and frequency of vomiting P<0.0001) and improvements in weight gain per week (W1 = 121.2 + 106.9gm, W2 = 221.3 + 136.1gm; P= 0.005) when infants consumed the carob bean formula. However, there was no significance difference in gastric emptying half time (GET1 = 116.1 + 72, GET2 = 148.5 + 130.9; P= 0.154). In conclusion, carob bean gum, as a thickening agent, improves the clinical symptoms of regurgitating infants, but does not significantly alter the gastric emptying physiology.

Studies in animals and adults have indicated iron deficiency anaemia to be associated with altered thyroid hormone metabolism. The aim of the present study was to determine the effect of iron deficiency anaemia on the thyroid function of young children. Concentrations of thyroxine (T4) and triiodothyronine (T3), free thyroid hormones (fT4 and fT3), thyroxine binding globulin (TBG), and thyroid stimulating hormone (TSH) were measured in the basal state and in response to an intravenous bolus of thyrotropin releasing hormone (TRH) in nine children one to three years of age with iron deficiency anaemia (IDA) before and after treatment with oral iron. The results of the anaemic children were also compared to basal and stimulated concentrations of thyroid hormones, TBG, and TSH of eight iron sufficient, age-matched children. Seven of the IDA and 6 of the control children were male. The mean haemoglobin (Hb) and serum ferritin (SF) in the IDA children at baseline were 93 g/L (range 81-102) and 6 mg/L (range 1-12) which increased to 121 g/L (range 114-129) and 54 mg/L (range 19-175), respectively, after a mean of 2.3 months (SD 0.5) of iron therapy. In the control group, mean Hb and SF were 125 g/L (range 114-130) and 51 mg/L (range 24-144), respectively. The basal values of TBG and thyroid hormones of the IDA children before and after iron treatment were not different from the control children. Similarly, there was no statistical difference in the thyroid hormones in the IDA children before compared to after resolution of the anaemia. Compared to the control children, the TSH response over time to TRH, TSH area under the curve (TSHAUC), and the peak TSH value after stimulation were all lower in the IDA children both before and after resolution of anaemia, but the differences were not significant. Iron therapy and resolution of anaemia had no effect among the IDA children. The time to reach the peak TSH concentration was longer in the IDA children (P = 0.08) than the control children before iron therapy. While the time to peak TSH decreased upon resolution of the anaemia, the difference was not significant. There was no effect of Hb concentration, age, or anthropometry with TSH, TSHAUC, or time to peak TSH after TRH stimulation in the IDA children before treatment. Normal thyroid function was preserved in these children with iron deficiency anaemia, however three of nine children had minor abnormalities of hypothalamic-pituitary function. These results indicate that hypothyroidism is unlikely to be a major cause of impaired psychomotor development or growth in young children with iron deficiency anaemia.

This descriptive cross-sectional study aimed to investigate whether malnutrition occurs in outpatients with liver cirrhosis, and to compare the nutritional status of patients with alcoholic and viral liver cirrhosis using a variety of objective measures. This study also aimed to provide useful information about nutritional education and nutritional therapies for medical teams and patients with liver cirrhosis. Sixty-six Korean men between the ages of 30 and 69 with liver cirrhosis (24 alcohol-related and 42 virus-related) were recruited from the Internal Medicine Centres, Hanyang University Hospital, Seoul, Korea. The results showed that patients with alcoholic liver cirrhosis (ALC) were significantly lower in socio-economic status than patients with viral liver cirrhosis (VLC) (P<0.05). The energy intakes (excluding alcohol-derived energy) were 1448kcal and 1769kcal in the ALC and the VLC groups, respectively (P<0.05). As well, vitamin C intake was found to be higher in the VLC group than the ALC group, yet still more than 125% of the RDA for both groups (P<0.05). Among nutritional indices, only the TSF thickness showed interaction with the aetiology and the severity of the cirrhosis (P<0.05). Thus, these findings indicate that outpatients with liver cirrhosis in this study, particularly those with alcoholic liver cirrhosis, consumed a lower energy intake than suggested, but may not have been in a status of malnutrition. Body fat is more affected than other nutritional parameters in patients with liver cirrhosis.

Algal polysaccharides such as carrageenan are good sources of dietary fibre. Previous studies have shown that carrageenan has hypoglycemic effects, but its cholesterol and lipid-lowering effects have yet to be demonstrated. In this study, carrageenan was incorporated into 4 food items, then fed to 20 human volunteers to determine its effects on blood cholesterol and lipid levels. The study followed a randomized crossover design. Each phase of the study - control and experimental - lasted for 8 weeks separated by a 2-week washout. At control, the subjects consumed their usual food intake; at experimental, they were given test foods with carrageenan partly substituting similar items in their usual diet. Fasting venous blood samples were collected immediately before and after each phase to assay serum cholesterol and triglyceride. The mean serum cholesterol was significantly lower (P < 0.0014) after the experimental phase at 3.64 mmol/L compared with the mean level after the control phase, 5.44 mmol/L. The mean triglyceride level after the experimental phase, 0.87 mmol/L, was significantly lower (P < 0.0006) in comparison to the level after the control phase, 1.28 mmol/L. The mean HDL cholesterol level significantly increased (P < 0.0071) after the experimental phase at 1.65 mmol/L compared to the mean value after the control phase, 1.25 mmol/L. No significant differences were observed between the LDL cholesterol levels after the experimental and the control phases. This study indicates that regular inclusion of carrageenan in the diet may result in reduced blood cholesterol and lipid levels in human subjects.

The effect of aqueous garlic (Allium sativum Linn.) on retinoic acid receptor b (RARb) mRNA expression was investigated in male Syrian hamsters during 12-dimethyl enz[a]anthracene (DMBA)-induced hamster buccal pouch (HBP) carcinogenesis. RARb mRNA expression was analysed by slot blotted hybridization with radiolabelled RAR-b probe. In DMBA-induced HBP tumours, decreased expression of RARb mRNA was observed. Administration of garlic (250 mg/kg body weight) to animals painted with DMBA restored RARb mRNA expression to normal pattern suggesting that this may be one of the mechanisms by which garlic exerts its chemopreventive effects.

Leafy vegetables such as spinach (Spinacia oleracea) are known to contain moderate amounts of soluble and insoluble oxalates. Frozen commercially available spinach in New Zealand contains 736.6 ± 20.4 mg/100g wet matter (WM) soluble oxalate and 220.1 ± 96.5mg/100g WM insoluble oxalate. The frozen spinach contained 90mg total calcium/100g WM, 76.7% of this calcium was unavailable as it was bound to oxalate as insoluble oxalate. The oxalate/calcium (mEq) ratio of the frozen spinach was 4.73. When frozen convenience food is grilled there is no opportunity for the soluble oxalates to be leached out into the cooking water and discarded. Soluble oxalates, when consumed, have the ability to bind to calcium in the spinach and any calcium in foods consumed with the spinach, reducing the absorption of soluble oxalate. In this experiment 10 volunteers ingested 100g grilled spinach alone or with 100g additions of cottage cheese, sour cream and sour cream with Calci-Trim milk™ (180 g) and finally, with 20g olive oil. The availability of oxalate in the spinach was determined by measuring the oxalate output in the urine over a 6-hour and 24-hour period after intake of the test meal. The mean bioavailability of soluble oxalate in the grilled spinach was 0.75 ± 0.48% over a 6-hour period after intake and was 1.93 ± 0.85% measured over a 24-hour period. Addition of sour cream and Calci-Trim milk reduced the availability of the oxalate in the spinach significantly (P<0.05) in both the 6-hour and 24-hour collection periods.

D-Psicose (D -ribo-2-hexulose), a C-3 epimer of D-fructose, is one of the "rare sugars" present in small quantities in commercial carbohydrate complex or agricultural products. We investigated the absorption and excretion of D-psicose when orally administrated (5g/kg body weight) to Wistar rats, and the fermentation of D-psicose was measured as caecal short-chain fatty acids (SCFAs) when fed to rats in controlled diets (0, 10, 20 and 30%). Urinary and faecal excretions of D-psicose over the 24 h, following a single oral administration, were 11-15% of dosage for the former and 8-13% of dosage for the latter. Serum D-psicose concentration and D-psicose in the contents of stomach and small intestines decreased progressively after administration. D-psicose in caecum contents was detected after 3 h and 7 h administration, but not after 1 h. Rats fed on D-psicose diets showed short-chain fatty acid production with caecal hypertrophy. These results suggest that D-psicose is partly absorbable in the digestive tract and is excreted into urine and faeces. As with other poorly absorbed dietary carbohydrates, D-psicose is fermented in the caecum by intestinal microflora.

The custom of allowing British seamen the regular use of fermented liquor is an old one. Ale was a standard article of the sea ration as early as the fourteenth century. By the late eighteenth century, beer was considered to be at once a food (a staple beverage and essential part of the sea diet), a luxury (helping to ameliorate the hardship and irregularity of sea life) and a medicine (conducive to health at sea). In particular, beer and its precursors, wort and malt, were administered with the aim of preventing and curing scurvy. This paper examines the use of malt and beer during late eighteenth century British sea voyages, particularly their use as antiscorbutic agents, focusing on James Cook's three voyages during the period 1768-1780. Cook administered sweet wort (an infusion of malt), beer (prepared from an experimental, concentrated malt extract), and spruce beer (prepared mainly from molasses), among many other items, in his attempts to prevent and to cure scurvy. Despite the inconclusive nature of his own experiments, he reported favourably after his second voyage (1772-1775) on the use of wort as an antiscorbutic sea medicine (for which purpose it is now known to be useless). Cook thereby lent credibility to erroneous medical theories about scurvy, helping to perpetuate the use of ineffective treatments and to delay the discovery of a cure for the disorder.

The aim of this study was to describe the use of nutrition and related claims on packaged food for sale in Australia and measure the compliance of such claims with regulations governing their use. A survey was conducted of the labelling of 6662 products in 40 different food categories on sale in New South Wales in 2001. Levels of compliance were assessed by comparing the claims on the label and data in the nutrition information panel with requirements of the Foods Standards Code and the Code of Practice on Nutrient Claims. Half of the products (51.3%) carried some type of nutrition related claim and 36.2% made at least one nutrient claim, with an average of 1.2 nutrition related claims on every food product. The foods with the highest use of nutrient claims were sports drinks, breakfast cereals, meat substitutes, pretzels and rice cakes, muesli bars and yoghurt. The most common nutrient claims were for fat, cholesterol, vitamins, minerals, and sugar. More than 20% of products carried claims related to additives. Many nutrient claims (12.9%) did not comply with current regulations, especially those in the voluntary Code of Practice. Adoption of mandatory requirements for all claims within the Food Standards Code may improve the levels of compliance. Implications for the regulation of nutrition and related claims are discussed. The impact of nutrition claims on consumer purchasing and consumption behaviour deserves further study.

We investigated whether a structured medium- and long-chain triacylglycerols (MLCT) diet could decrease accumulation of body fat in healthy humans. The study was conducted under a double-blind randomized design. Ninety-three subjects participated in this study. However, 10 subjects could not consume the specified meal, and one subject wished to opt out. Consequently, the study included 82 subjects. The experimental subjects consumed the test bread, which was made with 14 g of MLCT containing 1.7 g MCFA, daily at breakfast during the study period of 12 weeks, and the control subjects consumed bread made with long-chain triacylglycerols (LCT). All subjects consumed the same standard packaged meals. Body composition parameters were body weight, total body fat and abdominal fat, and blood analyses included serum cholesterol, triacylglycerols and phospholipids. Significant decreases of body weight, the amount of body fat, subcutaneous and visceral fat were noted in the MLCT group as compared with those of the LCT group for 12 weeks (P < 0.05). Furthermore, a significant decrease in serum total cholesterol was noted in the MLCT group as compared with that of the LCT group at 8 weeks (P < 0.05). However, other serum parameters were not different between the MLCT and LCT groups. The results suggest that the daily intake of MLCT diet could result in a reduction in body weight and in accumulation of body fat, and, moreover, it could reduce serum total cholesterol.

The aim of this study was to compare the measurement of total body water (TBW) by deuterium (2H20) dilution and bioelectrical impedance analysis (BIA) in patients with cystic fibrosis (CF) and healthy controls. Thirty-six clinically stable patients with CF (age 25.4 + 5.6 yrs) and 42 healthy controls (age 25.4 + 4.8) were recruited into this study. TBW was measured by 2H2O dilution and predicted by BIA in patients and controls. The TBW predicted from BIA was significantly different from TBW as measured using 2H2O in patients (P <0.05) but not in controls. Mean (+SD) values for predicted and measured TBW differed by 5.6 (+9.1) L in patients and 0.4 (+3.6)L in controls. This bias was consistent for all controls but not for patients. In CF, BIA over predicted TBW determined by 2H2O dilution to an increasing extent at larger TBW volumes. There was a strong correlation between height2/impedance and TBW in patients with CF (r = 0.90; y = 0.67x + 2.50) and in controls (r = 0.81; y = 0.57x + 9.60). The slope of the regression lines was similar for both groups, however the y intercepts were significantly different (P < 0.05). BIA overestimates TBW in patients with CF, possibly due to invalid factory installed regression equations within BIA instrumentation. Future studies employing BIA as a measure of TBW or FFM in CF should use alternative predictive equations to those that have been developed for healthy individuals. A large scale study to develop specific regression equations for use in CF is warranted.

The association of central obesity measures and food patterns with metabolic risk factors for coronary heart disease (CHD) were studied among middle aged (³ 30 years) Bengalee Hindu men of Calcutta, India. CHD risk factors included total cholesterol (TC), fasting triglyceride (FTG), fasting plasma glucose (FPG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and very low density lipoprotein cholesterol (VLDL-c). The total sample size in the study was 212 male individuals. Anthropometric measurements, metabolic and food pattern variables were collected from each participant. The relative role of central obesity measures and food pattern variables in explaining metabolic risk factors of CHD were also made in this study. The results revealed that body mass index (BMI) had no significant relation with any of the metabolic risk factors of CHD. Whereas almost all-central obesity measures, namely waist circumference (WC), waist-hip ratio (WHR), and conicity index (CI) were significantly and positively related with TC, FTG, FPG and VLDL-c. Of the food pattern variables, only the frequency of egg, fried snacks and Bengalee sweets consumption were positively and significantly related with all central obesity measures. In contrast, frequency of chicken and fish consumption was negatively associated with central obesity measures. Conicity index (CI) was found to be the most consistent in explaining metabolic variables of CHD. Percent of variance explained by central obesity measures and food patterns were TC (10%), FPG (16%), FTG (6.6%) and VLDL-c (6.7%). Significant negative association of chicken and fish consumption with central obesity measures indicates the beneficial effect of both these items in this population.

Residents from high level (nursing homes) and low-level care facilities (hostel) being served the three common diet texture modifications (full diet, soft/minced diet and pureed diet) were assessed. Individual plate waste was estimated at three meals on one day. Fifty-six males and 156 females, mean age 82.9 ± 9.5 (SD) years, of which 139 lived in nursing homes (NH) and 76 in hostels (H) were included. Mean total energy served from meals was 5.3 MJ/day, 5.1 to 5.6 MJ/day, 95% confidence intervals (CI), in NH which was less than in H, 5.9 MJ/day (CI 5.6 to 6.2 MJ/day) (P = 0.007). Protein and calcium intakes were lower in NH, 44.5g (CI 41.5 to 47.5g), 359.0mg (CI 333.2 to 384.8mg), versus 50.5g (CI 46.6 to 54.3g), 480.5mg (CI 444.3 to 516.7mg) in H (P = 0.017, P < 0.001 respectively). There was no difference in nutrient/energy ratios, except for protein/energy, which was higher in NH 11.7 (CI 11.3 to 12.2) than in H 9.8 (CI 9.4 to 10.3) (P< 0.001). Ability to self-feed had no significant effect on nutrient intakes in NH. The self fed group (N=63) had the following nutrient intakes: energy 4.0 MJ (CI 3.6 to 4.3 MJ), protein 44.6g (CI 40.3 to 48.9g), calcium 356.9mg (CI 316.3 to 397.4mg), fibre 14.9g (CI 13.2 to 16.5g). The assisted group (N=64) had the following nutrient intakes: energy 3.9MJ (CI 3.6 to 4.2MJ), protein 46.0g (CI 40.7 to 49.6), calcium 361.9mg (CI 327.8 to 396.1mg), fibre 14.9g (CI 13.2 to 16.1g). Of NH classified as eating impaired, 36% received no assistance with feeding and had lower intakes of protein 37.8g (CI 33.0 to 42.1g) compared to those receiving some assistance 46.1g (CI 41.3 to 50.9g) (P= 0.026). Reduced energy intake accounted for the differences in nutrient intakes between nursing homes and hostels, except for protein. Strategies to effectively monitor nutrient intakes and to identify those with eating impairment are required in order to ensure adequate nutrition of residents in nursing homes and hostels.

Dietary habits, especially micronutrient intake, and nutritional status of Vietnamese primary school girls were investigated in a cross-sectional survey. We interviewed 284 girls aged 7 to 9 years old, randomly selected from three rural (N=148) and two urban (N=136) primary schools. Dietary data were calculated from the results of 24-h recall interviews over three consecutive days. The dietary micronutrient pattern of the rural group showed deficiency of iron, calcium, phosphorus, potassium, magnesium, beta-carotene, vitamin A and vitamin C. On the contrary, adequate consumption of these elements, except low beta-carotene, was observed in the urban group. Despite a low prevalence of anaemia, the prevalence of rural children with iron deficiency was close to the level regarded as being a public health problem. In contrast, 7.7% of urban children were found to have excessive iron status. Children with exhausted retinol stores (7.1%) requiring immediate retinol supplementation were only found in the rural group. Furthermore, the prevalence of children with marginal retinol stores in both the rural (35.7%) and urban (21.4%) groups was above the level of being a public health problem (20%). In both groups, more than 50% and 20% of children showed beta-carotene and tocopherol levels in the range of severe deficiency, respectively. Thus, nutritional education to improve the dietary habits of the two groups is necessary for Vietnamese primary school children.

The purpose of this study was to obtain a fuller understanding of the association of dietary behaviours, physical status and socio-economic status with academic performance in Korean teenagers. The subjects in this study were 6,463 boys and girls, in grade 5, 8, and 11 in Korea. A self-administered questionnaire and the food-frequency form were used. Grade point average (GPA), height, weight, and physical fitness score for the year were recorded from the school record. The academic performance of students was strongly associated with dietary behaviours, especially with regularity of three meals even after control for parent's education level. Regular breakfast and lunch were more important in grades 5 and 8, while regular dinner was more related with academic performance in grade 11. Small, positive associations of height and physical fitness to academic performance were also found. The relative importance of regularity of meals was greater than that of socio-economic status and physical status in older teenagers. The results of this study suggest that accommodation of better dietary environment and nutrition education for three regular meals is recommended.