Inulin-based prebiotics are non-digestible polysaccharides that influence the composition of the gut microbiota in infants and children, notably eliciting a bifidogenic effect with high short chain fatty acid levels. Inulin, a generic term that comprises β-(2,1)-linked linear fructans, is typically isolated from the chicory plant root, and derivatives such as oligofructose and long chain inulin appear to have different physiological properties. The first 1000 days of a child’s life are increasingly recognized as a critical timeframe for health also into adulthood, whereby nutri- tion plays a key role. There is an ever increasing association between nutrition and gut microbiota composition and development, with life health status of an individual. This review summarizes the latest knowledge in the in- fant gut microbiota from preterms to healthy newborns, as well as in malnourished children in developing coun- tries. The impact of inulin or mixtures thereof on infants, toddlers and young children with respect to intestinal function and immunity in general, is reviewed. Possible benefits of prebiotics to support the gut microbiome of malnourished infants and children, especially those with infections in the developing world, are considered, as well as for the pregnant mothers health. Importantly, novel insights in metabolic programming are covered, which are being increasing recognized for remarkable impact on long term offspring health, and eventual potential bene- ficial role of prebiotic inulins. Overall increasing findings prompt the potential for gut microbiota-based therapy to support health or prevent the development of certain diseases from conception to adulthood where inulin prebiotics may play a role.
Background and Objectives: The present study was conducted to evaluate the effect of cod skin peptide (CSPE) on chemotherapy-induced toxicity in gastric cancer patients. Methods and Study Design: A cohort of 60 gastric cancer patients for chemotherapy was randomly divided into two groups (n=30 per group), who were orally treat- ed with either supplemental CSPE or placebo apart from chemotherapy. The hematologic and gastrointestinal tox- icities experienced by the patients, as well as their Karnofsky Performance Status (KPS) as an index of quality of life was evaluated. Results: Leukocyte counts and haemoglobin levels were significantly reduced in the group treated with peptide (p<0.05), while gastrointestinal toxicity was not affected (p>0.05). KPS consists of 11 cate- gories of quality of life, and the score denoted in deciles ranges from 100 (asymptomatic, normal function) to 0 (death). The KPS score is used to evaluate a cancer patient’s ability to function at work and home, the severity of symptoms, and the patient’s need for personal and medical care. Treatment with CSPE significantly improved the quality of life of patients, as indicated by increased KPS scores (p<0.05). Conclusions: CSPE can potentially be considered as a food supplement that can be used to improve the quality of life of cancer patients.
Background and Objectives: The favourable effects of coffee on liver enzymes have been reported worldwide. This study investigated the association between coffee consumption and serum aminotransferase concentration in Korean adults. Methods and Study Design: Data were obtained from the fourth and fifth Korea National Health and Nutrition Examination Surveys. Elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentration were defined as >30 IU/L for men and >19 IU/L for women. The risk of elevated ALT and AST according to general characteristics and frequency of coffee consumption were tested by chi-square tests and multiple logistic regression analyses. Results: The prevalence of elevated ALT was 27.4%, 27.8%, and 26.9% in subjects who drank <1, 1, and ≥2 times/day, respectively. The proportions of individuals with elevated AST were 32.5%, 33.1%, and 26.7% in subjects who drank <1, 1, and ≥2 times/day, respectively. The aORs for elevated ALT and AST were significantly lower in subjects who drank ≥2 times of coffee/day than in those who drank <1 time/day (ALT: aOR=0.86, 95% CI=0.79-0.94; AST: aOR=0.83, 95% CI=0.76-0.91). In subgroup analysis, con- sumption of ≥2 times/day was associated with lower ORs for elevated ALT in the high-risk group overall and in the viral hepatitis and obesity subgroups, respectively. In sensitivity analysis, reduced frequency of coffee con- sumption was associated with an increased risk for elevated liver enzymes, although an association between cof- fee consumption and elevated ALT was not observed in women or current smokers. Conclusions: Higher coffee consumption was associated with lower risk of elevated aminotransferase concentration in Korean adults.
To investigate the metabolic differences of calcium requirements between Chinese and Westerners, we examined systematically the characteristics of calcium metabolism in Chinese adults with habitual dietary calcium intakes. We searched PubMed, Cochrane Library, SinoMed, and National Index to Chinese Newspapers & Periodicals, from inception to March 17, 2015, as well as the bibliographies of any relevant papers and journals, for trials as- sessing calcium metabolism in healthy Chinese adults within 18-60 years of age on the typical Chinese diet. We extracted a standardized dataset from metabolic studies that reported intake, retention, urinary excretion, faecal excretion and/or fractional absorption of calcium. We pooled data with a random effects meta-analysis. Of 2,046 citations identified by the search strategy, 12 studies (comprising 137 participants, 13 aggregate data deriving from 257 individual data) met the inclusion criteria. Metabolic data with self-chosen or typical Chinese diets were analyzed. Mean daily intakes of calcium ranged between 288 and 948 mg. Mean calcium retentions of each study were between 13 and 294 mg/d. The overall pooled value for dietary intake, urinary excretion, faecal excretion, retention and fractional absorption of calcium were 583 mg/d, 117 mg/d, 381 mg/d, 72 mg/d and 33.3%. Dietary calcium intake and faecal calcium excretion explained almost 85% of the heterogeneity of calcium retention. Chinese adults could maintain a positive calcium balance with plant-based diets at calcium intakes as low as 300 mg/d through increasing fractional calcium absorption and decreasing calcium excretion in urine and faeces.
Background and Objectives: Albuminuria is a risk factor for cardiovascular and renal disease. However, little is known about the association of 24 h urinary sodium and potassium excretion with albuminuria in China. The aim of this study was to examine this association by analyzing the data from 1,975 Chinese adults living in north Chi- na. Methods and Study Design: Excretion of urinary sodium, potassium and albumin was assessed in a single 24-h urine sample for each participant. Height, weight, waist circumference and blood pressure were measured and body mass index was determined as weight divided by square height. Fasting blood sample was collected and fasting glucose was measured. Results: The average 24-h urinary sodium and potassium excretion were 232 mmol and 40.8 mmol, resulting a mean sodium to potassium ratio of 6.7. The median (Q1-Q3) 24-h urinary al- buminuria excretion was 6.1 mg (4.5-8.7 mg). Overall, urinary sodium excretion was positively associated with albumin excretion (β=0.029, p<0.001). This association was independent of major cardiovascular risk factors in- cluding age, gender, systolic blood pressure, body mass index, fasting glucose, waist circumference, hypertensive drug treatment, and smoking. Moreover, the relation of sodium and albumin was similar in the subgroups strati- fied by gender, adiposity and diabetic status. No significant associations of potassium excretion or sodium to po- tassium ratio with urinary albumin excretion were observed. Conclusions: In cross-sectional analyses, high sodi- um intake was shown to be associated with increased urinary albuminuria in the general Chinese adult population, supporting salt restriction for renal and cardiovascular health benefit.
Background and Objectives: To examine the associations of regional body fat distribution with metabolic risk factors among Chinese. Methods and Study Design: Truncal fat (TF) and leg fat (LF) were measured by dual- energy X-ray absorptiometry (DXA) among 947 adults, and abdominal visceral fat (VAT) and subcutaneous fat (SAT), upper leg SAT were measured by magnetic resonance image (MRI) among 103 adults during 2008-2013. Metabolic risk factors included fasting blood glucose, total triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and metabolic syndrome (MetS). Results: TF showed adverse effect while LF showed beneficial effect on metabolic risk factors, and all these effects were independent of body mass index (BMI) (mostly p<0.01). Individuals with higher TF and lower LF experienced the highest risk of MetS compared to other subgroups of combination of TF and LF (all p<0.05). Abdominal VAT was positively associated with risk of MetS (men: odds ratio (OR)=4.45, 95% confidence interval (CI): 1.18, 16.8; women: OR=6.54, 95% CI: 1.08, 39.6) and serum triglyceride (men: beta (β)=0.379, 95% CI: 0.090, 0.667; women: β=0.700, 95% CI: 0.327, 1.07). Upper leg SAT showed an opposite association with most metabolic factors com- pared to abdominal SAT and VAT, however, the association was not statistically significant. Conclusion: TF and LF showed opposite effects on metabolic risk factors among Chinese adults. Abdominal VAT, but not abdominal SAT, was positively associated with serum triglyceride and risk of MetS. Future studies are warranted to examine the potential mechanism of the opposite effects between TF and LF on metabolic risk factors among Chinese.
Background and Objectives: Maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) have been reported to be associated with pregnancy outcomes. Due to the nutrition transition in Thailand, the double burden of malnutrition is increasing and this may have negative consequences on birth outcomes. This study aimed to investigate the relationship between pre-pregnancy BMI and GWG with the risks of low birth weight and macrosomia. Methods and Study Design: We performed a secondary analysis of data obtained from an iodine supplementation trial in mildly iodine-deficient Thai pregnant women. Pre-pregnancy BMI was classi- fied using the WHO classification. GWG was categorized using the IOM recommendation. Binary and multino- mial logistic regressions were performed. Results: Among 378 pregnant women, the prevalence of pre-pregnancy underweight (BMI<18.5 kg/m2) and overweight (BMI≥25 kg/m2) were 17.2% and 14.3%, respectively. Normal weight women had the highest median GWG [15.0 (12.0, 19.0) kg] when compared to overweight women [13.2 (9.0, 16.3) kg]. Forty-one percent of women had excessive GWG, while 23% of women gained weight inade- quately. Women with a high pre-pregnancy BMI had a 7-fold higher risk of having a macrosomic infant. Women who had excessive GWG were 8 times more likely to deliver a newborn with macrosomia. Conclusions: Both high pre-pregnancy maternal weight and excessive weight gain during pregnancy increase risk of infant macro- somia. Therefore, maintaining normal body weight before and throughout pregnancy should be recommended in order to reduce the risk of excessive infant birth weight and its associated complications.
Background and Objectives: Understanding human milk composition is critical for setting nutrient recommend- ed intakes (RNIs) for both infants and lactating women. However, nationwide human milk composition remains unavailable in China. Methods and Study Design: Through cross-sectional study, human milk samples from 11 provinces in China were collected and their compositions were analyzed. Nutritional and health status of the lac- tating women and their infants were evaluated through questionnaire, physical examination and biochemical indi- cators. Results: A total of 6,481 breast milk samples including colostrum (1,859), transitional milk (1,235) and mature milk (3,387) were collected. Contents of protein, fat, lactose, total solid and energy of more than 4,500 samples were analyzed using a human milk analyzer. About 2,000 samples were randomly selected for 24 mineral analyses. Free B-vitamins including thiamin, riboflavin, pyridoxal, pyridomine, pyridoxamine, nicotinamide, nic- otinic acid, flavin adenine dinucleotide (FAD), biotin and pantothenic acid were analyzed in 1,800 samples. Ami- no acids (~800) and proteins (alpha-lactoalbumin, beta-casein, and lactoferrin) were analyzed. In addition, serum retinol and carotenoids, 25(OH)D, vitamin B-12, folic acid, ferritin and biochemical indicators (n=1,200 to 2,000) were analysed in the lactating women who provided the breast milk. Ongoing work: Fatty acids (C4-C24), fat- soluble vitamins and carotenoids, are on-going analysis. Conclusions: A regional breast milk compositional da- tabase is at an advanced stage of development in China with the intention that it be available on-line.
Background and Objectives: China’s nutrition transition is characterized by dramatic increases in overweight and cardiometabolic (CM) risk. The burden of obesity, CM risk factors and dietary intake among Chinese chil- dren were explored. Methods and Study Design: Children 7-12 y old from the 2009 China Health and Nutrition Survey with available dietary intake data, anthropometry, blood pressure, and fasting blood samples were includ- ed (n=663). CM risk prevalence was calculated; logistic regression was used to investigate the association of nu- trient intakes with CM risk, adjusting for age, gender, physical activity, area of residence and income. Results: 14% of Chinese school-aged children and ~20% of those from urban areas and higher income households had overweight/obesity (p<0.05). The prevalence of prehypertension was ~20% while hypertension was 14%. Around 20% of all children and ≥30% of those from urban areas and higher income households had impaired glu- cose/HbA1c (p<0.05). More than half of the studied children had pre-dyslipidemia (i.e. at least one lipid meas- urement above borderline levels) and 21% of children had dyslipidemia. Approximately 30% of all children had energy intakes above requirements and 38% of them had excessive proportions of dietary fat and saturated fat. Children with higher intakes of total daily energy and total and added sugars had a greater likelihood of having impaired blood pressure and glucose/HbA1c. Conclusions: Childhood overweight and CM risk is prevalent in urban and rural areas of China and across different socioeconomic groups although disparities between classes still pervade. Several dietary factors such as sugars were significant correlates of CM risk.
Background and Objectives: National dietary surveys are needed and difficult to conduct in China. The current study aims to develop and validate an internet-based diet questionnaire for Chinese (IDQC) to assess intakes in Northern China. Methods and Study Design: We recruited 292 city residents by email and telephone in Harbin to obtain the IDQC and 3-day diet diaries. The food group and nutrient intakes from the IDQC were validated against those from the 3-day diet diaries. Paired sample t-tests were used to compare the methodological differ- ences, and repeatability was estimated using Pearson’s correlations. Cross-classification was used to calculate the percentage agreement in quartiles for all food groups and nutrients. Results: Positive correlations were found be- tween the IDQC and 3-day diet diaries for all food groups after energy adjustment (from 0.28 for seeds and nuts to 0.63 for dairy products). Positive correlations were observed for all nutrients between the IDQC and 3-day diet diaries, with correlations ranging from 0.37 for folic acid to 0.98 for iodine. The overall agreements for food groups and nutrients were above 69.2%, indicating satisfactory consistency between the IDQC and 3-day diet dia- ries. Conclusions: The IDQC can be used to estimate the food and nutrient intakes in a Northern China popula- tion for both clinical nutrition epidemiological and public health nutritional purposes. The questionnaire system IDQC (v1.0) is freely available at http://www.yyjy365.org/diet/.
Background and Objectives: The sudden occurrence of the 2008 Wenchuan Earthquake not only devastated people’s health, but also may have impacted on the psychological and dietary attitudes and behaviours of the sur- vivors. Although the influence of natural disaster on people’s health has been extensively investigated, there is a lack of information about the effects on people’s dietary attitudes and behaviours. Our aim was to evaluate the in- fluence of the Wenchuan earthquake on the dietary attitudes and behaviours of adult women from different zones of China in July 2008. Methods and Study Design: 736 women, aged 18-55 years old, were randomly selected and interviewed after the earthquake. Women were selected from three zones: the earthquake zone (n=206), the shaking zone (n=326), and the non-seismic zone (n=204). Results: Although nutrition knowledge mean scores of women in the three zones were relatively low, the women in the earthquake zone became more vigilant about the nutritional value and acceptability of food than women in the other two zones. Nevertheless, women in the earth- quake zone also developed some arguably untoward, if understandable, behaviour after the disaster. They in- creased their consumption and tendency to stock instant food and snack items. That said, these findings were modulated by other factors such as age, residence, Body Mass Index (BMI), and nutrition knowledge itself, as were post-earthquake eating behaviours, as judged by the ordinal logistic regression analyses performed. Conclu- sions: The major Wenchuan earthquake was associated with differentials in dietary attitudes and behaviours among women by seismic zone.
Background and Objectives: Current practices and available resources for nutrition therapy in paediatric inten- sive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Ex- isting guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment. Challenges and recommendations unique to the region are described. Methods and Study Design: Following a systematic literature search from 2004-2014, consensus statements were developed for key areas of nutrient delivery in the PICU. This review focused on evi- dence applicable to the Asia Pacific-Middle East region. Quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation approach. Results: Enteral nutrition (EN) is the preferred mode of nutritional support. Feeding algorithms that optimize EN should be encouraged and must include: assessment and monitoring of nutritional status, selection of feeding route, time to initiate and advance EN, management strategies for EN intolerance and indications for using paren- teral nutrition (PN). Despite heterogeneity in nutritional status of patients, availability of resources and diversity of cultures, PICUs in the region should consider involvement of dieticians and/or nutritional support teams. Conclusions: Robust evidence for several aspects of optimal nutrition therapy in PICUs is lacking. Nutritional assessment must be implemented to document prevalence and impact of malnutrition. Nutritional support must be given greater priority in PICUs, with particular emphasis in optimizing EN delivery.
Background and Objectives: Although food hypersensitivity is a public health concern, its documentation among the elderly is limited. The current study aims to compare the prevalence and characteristics of food hyper- sensitivity among adolescent women between aged 18-24 with among older women >50 years of age. Methods and Study Design: 660 female university students between the ages of 18 and 24 who volunteered were enrolled as adolescent subjects. 470 women >50 years old who visited the Health Care Centre of Kyoto Katsura Hospital for health check-ups were enrolled as the older subjects. A questionnaire created by ourselves asking the presence of food hypersensitivity, symptoms, causative food, personal or family history of other allergic disorders was dis- tributed. Results: The prevalence of food hypersensitivity was statistically similar between adolescent (8.2%) and older women (8.9%). Among them, only 24.1% of the adolescent women and 26.2% of the older women had been diagnosed by physicians as having food allergy. The main causative foods (fruits, shellfish and fish) and the manifestations relating to food hypersensitivity were almost identical between adolescent and older women. In both adolescent and older women, food hypersensitivity positive group showed significantly higher prevalence of personal or family history of allergic disorders than that in food hypersensitivity negative group. Conclusions: These data indicate that food hypersensitivity in older women should be given more attention because the preva- lence of this condition was as common as that in adolescent women.
Background and Objectives: Food marketing has been identified as a target for intervention in the prevention of childhood overweight and obesity within countries and globally, and promotion of healthy diets has been classi- fied as a key strategy to reduce the burden of non-communicable diseases and health inequalities. The present study aims to investigate how Vietnamese middle-class household food providers are impacted by food advertis- ing communications, their views of food marketing and the ways they think the government can control food marketing to assist people to consume healthier diets. Methods and Study Design: 810 household food providers participated in the online survey. Frequency counts were calculated using IBM SPSS version 21. Results: Many respondents had been exposed to food marketing; 82.8% had seen food advertising in magazines at least once a month, 65.1% had received free food samples in public places, 68.0% had received food advertising information via email. Many household food providers appeared to support food marketing; 73.3% approved of nutrition edu- cation in schools or on television being provided by soft drink or fast food companies, 63.7% supported the mar- keting of infant formula milk. There were mixed views about what actions the government could implement to control food marketing; 88.2% supported clearer food content on food labels, 84.1% believed that children should learn how to purchase and cook foods at school. Conclusions: A substantial majority of Vietnamese middle-class household food providers appeared unaware of the adverse effects of food marketing. Education and policy lead- ership in food and nutrition are urgently required.
Background and Objectives: The main purpose of this study was to evaluate the associations between salty food preference and osteoporosis (OP) in general Chinese men. Methods and Study Design: We conducted a large- scale, community-based, cross-sectional study to estimate the associations by using self-report questionnaire to evaluate the salty food preference. The total of 1,092 men was available to data analysis in this study. Multiple regression models controlling for confounding factors to include salty food preference variables were employed to explore the relationships for OP. Results: We found negative correlations between preference for salty food and T-score (p=0.006). Multiple regression analysis showed that the preference for salty food was significantly positively associated with OP (p<0.05 for all). The men with preference for salty food habits had a higher preva- lence of OP. Conclusion: The findings indicated that salty food preference was independently and significantly associated with OP. The prevalence of OP was more frequent in Chinese men preferring salty food habits.
Background and Objectives: Excessive oral salt intake can induce hypertension. According to previous studies, the prevalence of hypertension is higher in Myanmar than in Korea. We postulated that Myanmar adults had higher salt taste thresholds and eat much saltier food. This study aimed to compare salt taste thresholds and salt usage behaviour scores between adults in Myanmar and Korea. Methods and Study Design: This cross-sectional study enrolled patients who visited volunteer medical service clinics at Ansung in Korea and Hlegu and Bago in Myanmar in August 2014. We measured the vital signs, heights, and weights of each patient and evaluated detec- tion thresholds, recognition thresholds, and salt preferences. All patients underwent urinalysis and spot urine Na tests. Additionally, they each completed a salt usage behaviour questionnaire. Results: A total of 131 patients were enrolled, including 64 Myanmarese patients and 67 Korean patients. Blood pressure was significantly higher in the Myanmarese than in the Koreans. Detection and recognition thresholds, salt preferences, and spot urine so- dium and salt usage behaviour scores were also higher in the Myanmarese than in the Korean subjects. We calcu- lated correlation coefficients between systolic blood pressure and parameters that were related to salt intake. The detection and recognition thresholds were significantly correlated with systolic blood pressure. Conclusion: All parameters related to salt intake, including detection and recognition thresholds, salt preference, salt usage behav- iour scores and spot urine sodium concentrations, are significantly higher in Myanmarese than in Korean individ- uals.
Background and Objectives: This study assessed vitamin D status and its determinants in a cohort of octogenar- ians living within New Zealand’s Bay of Plenty and Lakes Districts. Methods and Study Design: Serum 25- hydroxyvitamin D [25(OH)D] concentration was measured in 209 Māori (aged 80-90 years) and 357 non-Māori (85 years), along with demographic, lifestyle, supplement use and other health data. Results: Mean [95% CI] 25(OH)D concentration was 69 [67 to 72] nmol/L, with 15% >100 nmol/L and 6 individuals >150 nmol/L. Con- centrations in Māori (59 [55 to 62] 4 nmol/L) were lower than in non-Māori (75 [72 to 78] nmol/L; p<0.001), a difference maintained when adjusted for day-of-year measured. Vitamin D supplementation was reported by 98 participants (18%): including a greater proportion of women (24%) than men (11%; p<0.001) and of non-Māori (24%) than Māori (7%; p<0.001). Of those taking vitamin D, 49% took high oral doses (≥25 μg/day or equiva- lent) and five individuals took >50 μg/day. Vitamin D supplement use strongly and independently predicted sea- sonally-adjusted 25(OH)D concentration and was associated with 28 nmol/L higher levels than non-use. Other predictors included Māori ethnicity (10 nmol/L lower concentration than for non-Māori), and female gender (11 nmol/L lower). Conclusions: Vitamin D status in New Zealand octogenarians appears higher than previously re- ported, particularly in non-Māori compared to Māori. Prescribed and non-prescribed oral vitamin D supplementa- tion is prevalent in this group and a strong indicator of vitamin D status.
Background and Objectives: Survey items of the Japan National Nutrition Survey (J-NNS) have changed over time. Several papers on dietary surveys have been published; however, to date, there are no in-depth papers re- garding physical examinations. Therefore, we investigated changes in the survey items in the physical examina- tions performed in the J-NNS and the National Health and Nutrition Survey (NHNS), with the aim of incorporat- ing useful data for future policy decisions. Methods and Study Design: We summarized the description of phys- ical examinations and marshalled the changes of survey items from the J-NNS and NHNS from 1946 to 2012. The physical examination is roughly classified into the following six components: some are relevant to anthro- pometric measurements, clinical measurements, physical symptoms, blood tests, lifestyle and medication by in- terview, and others. Results: Items related to nutritional deficiency, such as anaemia and tendon reflex disappear- ance, and body weight measurements were collected during the early period, according to the instructions of the General Headquarters. From 1989, blood tests and measurement of physical activity were added, and serum total protein, total cholesterol, triglycerides, HDL-cholesterol, blood glucose, red blood corpuscles and haemoglobin measurements have been performed continuously for more than 20 years. Conclusions: This is the first report on the items of physical examination in the J-NNS and NHNS. Our research results provide basic information for the utilization of the J-NNS and NHNS, to researchers, clinicians or policy makers. Monitoring the current state cor- rectly is essential for national health promotion, and also for improvement of the investigation methods to apply country-by-country comparisons.
Background and Objectives: The aim of this study was to explore the influence of fluoride exposure and ERα gene polymorphisms on reproductive hormone concentrations of women in accordance with endemic fluorosis residence. Methods and Study Design: A cross sectional study was conducted in Tongxu county, Henan Prov- ince, China. A total of 679 women were recruited using cluster sampling and each subject provided fasting blood and an associated urine sample. We measured the concentrations of serum gonadotropin releasing hormone (GnRH), follicle-stimulating hormone, luteinizing hormone, and estradiol and urinary fluoride. Results: In the defluoridation project group (DFPG), serum GnRH was lower in women carrying C/C genotype compared to in those carrying C/T and T/T genotypes of ERα gene rs3798577 (p<0.05). In the endemic fluorosis group (EFG), serum GnRH was lower in women carrying Pp genotype compared to in those carrying PP and pp genotypes of ERα PvuII (p<0.05). Serum GnRH in women from EFG who carried Pp, pp, Xx and xx genotypes in ERα gene PvuII and XbaI was lower than in those in the control group (CG) who carried same genotypes (p<0.05). Fur- thermore, serum GnRH in women from EFG was significantly lower than in those in CG, regardless of whether the women were carrying C/C, C/T or T/T genotypes of ERα rs3798577 (p<0.05). Serum estradiol concentrations in EFG were significantly lower than in CG when the women were carrying the Pp, Xx and T/T genotypes in ERα gene (p<0.05). Conclusion: Interaction of ERα gene and fluoride exposure may influence women’s serum repro- ductive hormone concentrations.
A 13-year-old, obese girl presented with acute abdominal pain with abdominal distension for a year. The physical examination revealed marked abdominal distension with a large well-circumscribed mass sized 13×20 cm. Her body mass index (BMI) was 37.8 kg/m2. An abdominal CT scan revealed a huge multiloculated cystic mass and a left adnexal mass. She had an abnormal fasting plasma glucose and low HDL-C. Laparotomy, right salpingo- oophorectomy, left cystectomy, lymph node biopsies and partial omentectomy were performed. The left ovary demonstrated multiple cystic follicles over the cortex. The histologic diagnosis was a mucinous cystadenoma of the right ovary and a matured cystic teratoma of the left ovary. Both obesity and polycystic ovary syndrome (PCOS) are associated with a greater risk of ovarian tumours, where PCOS could be either the cause or as a con- sequence of an ovarian tumour. We report an obese, perimenarchal girl with bilateral ovarian tumours coexistent with a polycystic ovary and the metabolic syndrome.
The melamine contaminated milk powder contamination scandal occurred in China in 2008. Its main conse- quences so far have been urinary stone formation in children with associated renal damage and increased child mortality. Eight years have passed, but food safety issues still remain of concern in the daily lives of millions of Chinese. Vigilance is required to ensure no recurrence of such food safety problems. Ongoing studies focus on the early detection of food industry malpractice, mechanisms whereby these toxic substances induce disease and how its advent may be prevented and better managed. Melamine undergoes renal excretion, but is metabolized slowly and excreted largely unchanged in the urine. Urinary melamine measurement may provide a rapid and in- expensive way to identify exposure to melamine adulterated food items. Although most patients with melamine- related urinary stones (MUS) have been responsive to conservative treatment, longer time follow-up is needed to assess chronic effects. Aside from MUS, melamine is a recognized carcinogen and can induce urinary tract tu- mours. Very little is known about the effects of excessive exposure to melamine contaminated milk powder in in- fants on growth, adolescent and adult health, although short-term effects have become apparent during the scan- dal.
Food systems have changed markedly with human settlement and agriculture, industrialisation, trade, migration and now the digital age. Throughout these transitions, there has been a progressive population explosion and net ecosystem loss and degradation. Climate change now gathers pace, exacerbated by ecological dysfunction. Our health status has been challenged by a developing people-environment mismatch. We have regarded ecological conquest and innovative technology as solutions, but have not understood how ecologically dependent and inte- grated we are. We are ecological creatures interfaced by our sensoriness, microbiomes, shared regulatory (endo- crine) mechanisms, immune system, biorhythms and nutritional pathways. Many of us are ‘nature-deprived’. We now suffer what might be termed ecological health disorders (EHD). If there were less of us, nature’s resilience might cope, but more than 9 billion people by 2050 is probably an intolerable demand on the planet. Future food must increasingly take into account the pressures on ecosystem-dependent food systems, with foods probably less biodiverse, although eating in this way allows optimal health; energy dysequilibrium with less physical activity and foods inappropriately energy dense; and less socially-conducive food habits. ‘Personalised Nutrition’, with extensive and resource-demanding nutrigenomic, metabolomic and microbiomic data may provide partial health solutions in clinical settings, but not be justified for ethical, risk management or sustainability reasons in public health. The globally prevalent multidimensional malnutritional problems of food insecurity, quality and equity require local, regional and global action to prevent further ecosystem degradation as well as to educate, provide sustainable livelihoods and encourage respectful social discourse and practice about the role of food.
Background and Objectives: Atopic dermatitis is one of the most common pediatric chronic inflammatory skin diseases, and certain food allergens and nutrients are closely related to the development and severity of atopic dermatitis. While avoidance of the causative foods is considered the mainstay of treatment, unverified excessive restriction might induce unnecessary limitations in the food intake, consequently leading to nutritional deficien- cies and poor growth. This study aimed to identify the characteristics and nutrient intake status in children with atopic dermatitis and to investigate the effects of individualized nutrition intervention. Methods and Study De- sign: We retrospectively reviewed electronic medical records of 77 pediatric patients with atopic dermatitis who received 4 months of individualized nutrition intervention combined with an elimination diet. The patient charac- teristics, nutrient intake status, and clinical status were examined before and after the intervention. Results: Be- fore the intervention, 5 children had a weight for height z-score below -2.0, and 48.1% had experienced food re- striction; these children showed a significantly higher SCORing of Atopic Dermatitis index than those without experiences, with the number of restricted foods before the intervention positively correlating with the disease se- verity. The intakes of n-6 and n-3 fatty acids, calcium, folate, and vitamin D were lower than the recommended nutrient intakes for Koreans. After the intervention, the weight for height z-score of 35 children was significantly increased and their SCORing of Atopic Dermatitis index was significantly reduced (p<0.05). Conclusions: Indi- vidualized nutrition intervention appears useful for alleviating the severity of atopic dermatitis and improving the growth status by improving the nutrient intake.
Background and Objectives: Sleep deprivation and coffee caffeine consumption have been shown to affect glu- cose homeostasis separately, but the combined effects of these two variables are unknown. Methods and Study Design: Forty-two healthy Iranian men, aged 20-40 years old, were assigned to three groups in a randomised crossover trial involving three treatments with two-week washout periods. Subjects were moderate coffee con- sumers (≤3 cups/day), and had a Pittsburgh Sleep Quality Index ≤5. Each treatment involved three nights of de- prived sleep (4 hrs. in bed) plus 3×150 cc/cup of boiled water (BW treatment), decaffeinated coffee (DC treat- ment, without sugar, 99.9% caffeine-free), and caffeinated coffee (CC treatment, without sugar, 65 mg caf- feine/cup). DC and CC treatments were blinded. At the end of each treatment, fasting serum glucose (using en- zyme assays) and insulin (using electrochemiluminescence immunoassay) were measured and, again, two hours after an oral glucose tolerance test (OGTT). Insulin resistance was quantified with the homeostasis model. Re- sults: Repeated measures ANOVA indicated no significant difference between the treatments in fasting serum glucose (p=0.248) or insulin resistance (p=0.079). However, ANOVA demonstrated differences between treat- ments in fasting serum insulin (p=0.004) and glucose, as well as insulin after OGTT (p<0.001). Pairwise compar- isons test (within subjects) showed that the CC treatment yielded higher serum glucose and insulin after OGTT (p<0.001), higher fasting serum insulin (p=0.001), and increased insulin resistance (p=0.039) as compared to the DC treatment. Conclusions: Thus caffeinated coffee was more adverse for glucose homeostasis compared to de- caffeinated coffee in individuals who were simultaneously sleep deprived.
Background and Objectives: This study’s main aim was to observe the effects of a fibre-enriched nutrition solu- tion on requisite feeding volume, which is directly proportional to energy intake in mechanically ventilated pa- tients with enteral nutrition. Methods and Study Design: Some 120 patients who required mechanical ventila- tion and enteral nutrition with a nasogastric tube were studied. Upon ICU admission, the patient’s age, gender, weight, height, comorbidities, diagnosis and APACHE II score were recorded. We assigned two diets to the pa- tients randomly. The control group received the fibre-free nutrition solution. The study group, received the fibre- enriched nutrition solution. Prescribed feeding volume and administered feeding volume, gastric residual volume (GRV), volume ratio (VR), diarrhoea score and gastrointestinal complications (GIC) were recorded, along with daily biochemistry. Results: The two groups did not differ with respect to age, sex, weight, BMI, APACHE II score, target caloric intake or GRV (p>0.05). On days four and five, the study group had higher VR values (p<0.05). Seventy-one (59%) patients had at least one gastrointestinal complication; 44 (73%) of them were con- trols and 27 (45%) of them study patients. The most commonly observed GIC was diarrhoea. Thirty-eight pa- tients had diarrhoea in control group, and twenty-two patients had diarrhoea in study group, and this difference was statistically significant (p<0.001). There were no significant differences between the groups about vomiting and regurgitation. Conclusions: We suggest that ICU staff initiate enteral nutrition with fibre-enriched formulas rather than fibre-free formulas to avoid frequent feeding interruptions that cause protein energy malnutrition in ICU patients.
Background and Objectives: Peroral supplementation with trivalent-chromium (Cr) or magnesium (Mg) has been shown to improve insulin resistance (IR). The objective of this study was to determine whether combined peroral supplementation with Cr and Mg improves IR more effectively than Cr or Mg alone. Methods and Study Design: Subjects (n=120, age range 45-59 years old) and diagnosed with IR were randomly divided into four groups and monitored for a period of 3 months: group 1 (the placebo control group), group 2 (160 μg/d Cr), group 3 (200 mg/d Mg), and group 4 (160 μg/d Cr plus 200 mg/d Mg). Fasting blood glucose (FBG), fasting insulin (FIns), erythrocyte Cr and Mg content, and glucose-transporter-4 (GLUT4) and glycogen-synthase-kinase-3β (GSK3β) mRNA levels in activated T-lymphocytes were measured, and insulin resistant index (IRI) was calculat- ed. Results: Significant decreases between the baseline and study conclusion values of FBG (0.37 mmol/L, p<0.01), FIns (2.91 μIU/mL, p<0.01) and IRI (0.60, p<0.01) were observed in group 4, but not groups 1-3. Simi- larly, compared with baseline, significant changes in GLUT4 (2.9-fold increase, p<0.05) and GSK3β (2.2-fold de- crease, p<0.05) mRNA levels in activated T-lymphocyte were observed at the study’s conclusion in group 4, but not in groups 1-3. Conclusions: Our results indicate that combining peroral supplementation with Cr and Mg im- proves IR more effectively than Cr or Mg alone, and this may be attributable to increased induction and repres- sion, respectively, of GLUT4 and GSK3β expression.
Background and Objectives: Seventy six hemodialysis (HD) patients were used in a prospective randomized and clinical trial to determine if a multivitamin with vitamin D (cholecalciferol 12,000 IU/week) given during di- alysis would improve the vitamin D status of hemodialysis subjects. Methods and Study Design: Subjects were randomly assigned to two groups: 37 subjects were in the renal multivitamin without vitamin D (MV) group and 39 subjects were in a multivitamin route with vitamin D (MVD) group (12,000 IU of cholecalciferol per week). All subjects were given 2 multivitamin tablets at their 3 HD sessions each week for 20 weeks. Serum 25(OH)D, calcium (Ca), and phosphorus (P) levels were evaluated. Results: At baseline, mean serum 25(OH)D were below adequate (<30 ng/mL) in the MV group (23.5±12.2 ng/mL) and in the MVD group (20.8±10.3 ng/mL). A signifi- cant increase was seen in serum 25(OH)D levels (37.7±11.4 ng/mL; p<0.001) in the MVD group after vitamin D supplementation with no rise in the MV group value (21.7±11.4 ng/mL; p=0.06). Prior to supplementation, 17.9% of patients in the MVD group had adequate serum 25(OH)D level and post supplementation 76.9% in the MVD group had adequate serum 25(OH)D. In the MV group, 18.9% subjects had adequate serum 25(OH)D levels at baseline with 18.9% having 25(OH)D >30 ng/mL at the end of the study. There were no significant differences in group values for serum Ca and P. Conclusion: The majority of HD subjects given a multivitamin with cholecal- ciferol at dialysis had improvement in their vitamin D status.