Dr Wen-Harn Pan, PhD graduated from the Department of Agricultural Chemistry, National Taiwan University in 1976 and obtained both her MS degree in Nutritional Biochemistry (1979) and her PhD degree in nutrition epidemiology (1983) from Cornell University. She undertook NHLBI post-doctoral training in the fields of cardiovascular epidemiology, biostatistics, nutrition and preventive cardiology at the Department of Preventive Medicine, Northwestern University from 1983 to1986.
She was appointed an Associate Research Fellow in the Institute of Biomedical Sciences, Academia Sinica, Taiwan, in 1987 and Research Fellow in 1994. She is also an Adjunct Professor of the Institute of Epidemiology and the Department of Biochemical Science and Technology, National Taiwan University. Most recently, she has been appointed to lead the National Health Research Institutes’ Nutrition Program with extensive inter-institutional and multi-disciplinary linkages.
Dr Pan established a community-based cardiovascular cohort study in Chu-Dong and Putze (abbreviated as CVDFAC TS) in 1989. She has led the Nutrition and Health Survey in Taiwan since 1992 and has completed four national surveys. The national data are archived in the Center of Survey Research in Academia Sinica for promoting secondary data analysis. The survey findings have been included in three special journal issues: one published by Nutritional Sciences and the other two by the Asia Pacific Journal of Clinical Nutrition. She has also established the Han Chinese DNA and Genome Bank which is an open-domain facility for gene-mapping of important diseases in Han Chinese. Dr Pan has more than 150 publications in international journals of nutrition, cardiovascular epidemiology, and genetics.
She was awarded the Outstanding Research Award by the Taiwan Society of Nutrition in 2004 and has served on various national and international committees concerned with Nutrition policy, collaborative cardiovascular epidemiology and genomic research, For example: she has been a Taiwan Department of Health Food and Nutrition Council member, chairperson of the nutrition evidence and policy section in the Healthy Taiwan 2020 initiative, and a Board Member of the Asian Pacific cohort study collaboration. She also serves on several editorial boards of international journals and as a grader for the American Heart Association meetings and grant reviewer for various foreign research foundations such as the National Heart Foundation of Australia, Welcome Trust Foundation, and Research Grants Council (RGC) of Hong Kong.
Wen-Harn Pan exceeds the expectations of an Asia Pacific Clinical Nutrition Society awardee in her contributions to the nutritionally-related health and well-being of peoples in the Asia Pacific region. The Society is privileged that she is the 2010 recipient of its annual award. (http://www.apcns.org.cn/Award.html)
In developing countries, access to antiretroviral treatment for persons living with HIV is still in progress. Malnu- trition represents another cause of acquired immunodeficiency and premature death. This evaluation program es- timated the impact of family nutritional support during the first year of antiretroviral treatment in West Africa's sub-Sahara region. Family nutritional support was proposed to patients with CD-4 cell count <200 /mm3 and/or developing a WHO stage III/IV or with body mass index <18.5 kg/m2 and receiving antiretroviral treatment. Fol- low-up of 62 patients receiving support was compared to 118 patients who had only received antiretroviral treatment the year before. Average body mass index, CD-4 cell count were 20.7 and 20.5, 217 and 191/mm3 re- spectively in supported and control groups (NS). Twenty-two (36%) and 56 (48%) were WHO stage III/IV (NS) respectively in supported and control groups. One patient who received support and twelve controls died (Mor- tality Ratio=0.19; p<0.05). Increase in CD-4 cell count was around 1.7 times higher (+ 114 vs. + 68 CD-4 cells/mm3 respectively in supported and control groups; p<0.05) and observance was improved in supported group (p<0.005). The evolutions of WHO stage and body mass index were not different but the study period was short. Family nutritional support for persons living with HIV initiating antiretroviral treatment in a developing country showed a positive impact after six months. This family intervention could be integrated into AIDS inter- ventions as an effective and comprehensive community-based primary care.
This study explored the association between dietary habits and overweight and obesity in adolescents from Xi’an City, China. A cross-sectional sample of 1804 adolescents was recruited in 2004 from 30 junior high schools in six districts of Xi’an City, northwest China. Weight and height was measured and eating habits assessed using a self-administered questionnaire. Logistic regression was used to identify dietary patterns associated with over- weight and obesity and adjusted for socio-demographic factors. Consumption of foods and beverages outside three main meals, and potato chips was more popular in boys than in girls, while girls consumed more fried food and soft drinks than boys. In boys, an increased consumption of soft drinks was associated with increased risk of overweight and obesity (1100 mL/day, OR: 1.9, 95% CI: 1.1-3.8), while consuming preserved fruit was associ- ated with decreased risk (OR: 0.6, 95% CI: 0.5-0.9). In girls, having breakfast outside the home (OR: 1.7, 95% CI: 1.1-2.3) and an increased consumption of energy-dense foods (OR: 1.7, 95% CI: 1.04-2.9), was associated with increased risk of overweight and obesity, while frequently having foods and beverages outside the three main meals (OR: 0.6, 95% CI: 0.4-0.9) was associated with decreased risk. The consumption of breakfast out- side the home, soft drinks and energy-dense fast foods were positively associated with overweight and obesity in adolescents. Future health education programs to prevent excess weight gain should target such unhealthy eating habits.
We investigated in 11 female ultra-runners during a 100 km ultra-run, the association between fluid intake and prevalence of exercise-associated hyponatremia in a cross-sectional study. Athletes drank ad libitum and re- corded their fluid intake. They competed at 8.0 (1.0) km/h and finished within 762 (91) min. Fluid intake was 4.1 (1.3) L during the race, equal to 0.3 (0.1) L/h. Body mass decreased by 1.5 kg (p<0.01); pre race body mass was related to speed in the race (r = -0.78, p<0.05); and change (∆) in body mass was not associated with speed in the race. Change in body mass was positively (r = 0.70; p<0.05), and ∆ urinary specific gravity negatively (r = -0.67; p<0.05), correlated to ∆ percent total body water. Changes in body mass were not related to fluid intake during the race. Fluid intake was not correlated to running speed and showed no association with either ∆ percent total body water nor ∆ [Na] in plasma. Fluid intake showed no relationship with both ∆ haematocrit and ∆ plasma volume. No exercise-associated hyponatremia occurred. Female ultra- runners consuming fluids ad libitum dur- ing the race experienced no fluid overload, and ad libitum drinking protects against exercise-associated hypona- tremia. The reported higher incidence of exercise-associated hyponatremia in women is not really a gender effect but due to women being more prone to overdrink.
We investigated whether male triathletes in an Ironman triathlon lose body mass in the form of fat mass or skele- tal muscle mass in a field study at the Ironman Switzerland in 27 male Caucasian non-professional Ironman tri- athletes. Pre- and post-race body mass, fat mass and skeletal muscle mass were determined. In addition, total body water, hematological and urinary parameters were measured in order to quantify hydration status. Body mass decreased by 1.8 kg (p<0.05), skeletal muscle decreased by 1.0 kg (p<0.05) whereas fat mass showed no changes. Urinary specific gravity, plasma urea and plasma volume increased (p<0.05). Pre- to post-race change (∆) in body mass was not associated with ∆ skeletal muscle mass. Additionally, there was no association be- tween ∆ plasma urea and ∆ skeletal muscle mass; ∆ plasma volume was not associated with ∆ total body water (p>0.05). We concluded that male triathletes in an Ironman triathlon lose 1.8 kg of body mass and 1 kg of skele- tal muscle mass, presumably due to a depletion of intramyocellular stored glycogen and lipids.
This study was performed to investigate the prevalence of the metabolic syndrome using a large representative sample in Beijing. Data from a total of 16442 adults (6489 men and 9953 women) aged ≥18 years from a survey of behavioral risk factors for chronic diseases in Beijing, in 2005, was analyzed. The prevalence of the metabolic syndrome increased with age and the age-standardized prevalence of the metabolic syndrome defined by Interna- tional Diabetes Federation IDF and National Cholesterol Education Program Adult Treatment Panel III ATPIII criteria were 23.2% (24.5% in men and 22.7% in women) and 16.2% (16.1% in men and 16.6% in women), re- spectively. The metabolic syndrome was higher in semi-urban areas and associated with higher rates of hyper- tension, central obesity, salt intake and smoking.
A case-control study was conducted in central Japan to investigate the relationship between dietary intake of folate and lung function, breathlessness and chronic obstructive pulmonary disease (COPD). A total of 278 re- ferred patients (244 men and 34 women) aged 50-75 years with COPD diagnosed within the past four years and 340 community-based controls (272 men and 68 women) were assessed for dyspnoea and undertook spirometric measurements of lung function. A structured questionnaire was administered face-to-face to obtain information on demographics, lifestyle and habitual food consumption. Folate intake was derived from the Japanese food composition tables. The COPD patients had significantly lower habitual intake of folate (mean 231, SD 90 μg/day) than control subjects (mean 261, SD 110 μg/day), p<0.001. Lung function measures were found to be positively associated with dietary folate level. Reductions in prevalence of COPD and especially breathlessness were observed, the respective adjusted odds ratio (OR) being 0.74 (95% confidence interval (CI) 0.35 to 1.58) and 0.43 (95% CI 0.21 to 0.91) for the highest versus lowest quartile of folate intake. The corresponding tests for linear trend were also significant (p<0.05). In conclusion, an inverse association was evident between dietary folate intake and the prevalence of breathlessness for Japanese adults, together with a significant dose-response relationship for the COPD risk. Moreover, increased folate intake might be beneficial to lung function.
The effects of tree nuts on risk factors for coronary heart disease (CHD), in particular blood lipids, have been in- vestigated in a number of studies and the beneficial effects are now recognized. The beneficial effects of nuts on CHD in cohort studies have also been clearly demonstrated. However, while there is also reason to believe the unique micro- and macronutrient profiles of nuts may help to control blood glucose levels, relatively few studies have investigated their role in diabetes control and prevention. Nuts are low in available carbohydrate, have a healthy fatty acid profile, and are high in vegetable protein, fiber and magnesium. Acute feeding studies indicate that when eaten alone nuts have minimal effects on raising postprandial blood glucose levels. In addition, when nuts are consumed with carbohydrate rich foods, they blunt the postprandial glycemic response of the carbohy- drate meal. Despite the success of these acute studies, only a limited number of trials have been conducted with nuts in type 2 diabetes. These studies have either been of insufficient duration to observe changes in HbA1c, as the standard measure of glycemic control, or have been underpowered. Therefore, more long-term clinical trials are required to examine the role of nuts on glycemic control in patients with prediabetes and diabetes. Overall, there are good reasons to justify further exploration of the use of nuts in the prevention of diabetes and its micro- and macrovascular complications.
In addition to being a rich source of several essential vitamins and minerals, mono- and polyunsaturated fatty ac- ids, and fiber, most tree nuts provide an array of phytochemicals that may contribute to the health benefits attrib- uted to this whole food. Although many of these constituents remain to be fully identified and characterized, broad classes include the carotenoids, hydrolyzable tannins, lignans, naphthoquinones, phenolic acids, phytos- terols, polyphenols, and tocopherols. These phytochemicals have been shown to possess a range of bioactivity, including antioxidant, antiproliferative, anti-inflammatory, antiviral, and hypocholesterolemic properties. This review summarizes the current knowledge of the carotenoid, phenolic, and tocopherol content of tree nuts and associated studies of their antioxidant actions in vitro and in human studies. Tree nuts are a rich source of toco- pherols and total phenols and contain a wide variety of flavonoids and proanthocyanidins. In contrast, most tree nuts are not good dietary sources of carotenoids and stilbenes. Phenolic acids are present in tree nuts but a sys- tematic survey of the content and profile of these compounds is lacking. A limited number of human studies in- dicate these nut phytochemicals are bioaccessible and bioavailable and have antioxidant actions in vivo.
The beneficial effects of nut consumption on cardiovascular disease (CVD) have been widely documented. These protective effects are mainly attributed to the role of nuts in the metabolism of lipids and lipoproteins. As chronic inflammation is a key early stage in the atherosclerotic process that predicts future CVD events and is closely related to the pathogenesis of insulin resistance, many recent studies have focused on the potential effect of nut consumption on inflammation and insulin resistance. Through different mechanisms, some components of nuts such as magnesium, fiber, α-linolenic acid, L-arginine, antioxidants and MUFA may protect against in- flammation and insulin resistance. This review evaluates the epidemiologic and experimental evidence in hu- mans demonstrating an association between nut consumption and these two emergent cardio-protective mecha- nisms.
The aim of this paper is to evaluate nut-related epidemiological and human feeding study findings and to discuss the important nutritional attributes of nuts and their link to cardiovascular health. Frequent nut consumption has been found to be protective against coronary heart disease in five large epidemiological studies across two conti- nents. A qualitative summary of the data from four of these studies found an 8.3% reduction in risk of death from coronary heart disease for each weekly serving of nuts. Over 40 dietary intervention studies have been con- ducted evaluating the effect of nut containing diets on blood lipids. These studies have demonstrated that intake of different kinds of nuts lower total and LDL cholesterol and the LDL: HDL ratio in healthy subjects or patients with moderate hypercholesterolaemia, even in the context of healthy diets. Nuts have a unique fatty acid profile and feature a high unsaturated to saturated fatty acid ratio, an important contributing factor to the beneficial health effects of nut consumption. Additional cardioprotective nutrients found in nuts include vegetable protein, fiber, α-tocopherol, folic acid, magnesium, copper, phytosterols and other phytochemicals.
This study extends nutritional intervention results reported by short-term clinical trials of a diabetes-specific nu- tritional meal replacement by assessing the ten-year impact of the interventions on patient outcomes and costs compared to usual care. We developed and validated a computer simulation of type 2 diabetes based on pub- lished data from major clinical trials. The model tracks patients through microvascular and macrovascular health states and reports cumulative costs and quality adjusted life years. We modeled different scenarios that include a diabetes-specific nutritional meal replacement as part of a structured lifestyle intervention, and also as the only difference between the intervention and usual care treatment groups, and compared them to usual care with diet and physical activity recommendations. We used sensitivity analysis to explore the robustness of results. When a diabetes-specific nutritional meal replacement is the only treatment difference and is considered an equal cost meal replacement, the diabetes-specific nutritional meal replacement interventions are less costly and more ef- fective than usual care. As an added cost meal replacement, the diabetes-specific nutritional meal replacement has an incremental cost-effectiveness ratio between $50,414 and $55,036 depending on improvement in percent glycated hemoglobin. A hypothetical lifestyle intervention using a diabetes-specific nutritional meal replacement has an incremental cost-effectiveness ratio of $47,917. The diabetes-specific nutritional meal replacement was found to be cost-effective under the various conditions simulated.
Nuts are rich sources of multiple nutrients and phytochemicals associated with health benefits, including reduced cardiovascular disease risk. This has prompted recommendations to increase their consumption. However, they are also high in fat and are energy dense. The associations between these properties, positive energy balance and body weight raise questions about such recommendations. Numerous epidemiological and clinical studies show that nuts are not associated with weight gain. Mechanistic studies indicate this is largely attributable to the high satiety and low metabolizable energy (poor bioaccessibility leading to inefficient energy absorption) properties of nuts. Compensatory dietary responses account for 55-75% of the energy provided by nuts. Limited data sug- gest that routine nut consumption is associated with elevated resting energy expenditure and the thermogenic ef- fect of feeding, resulting in dissipation of another portion of the energy they provide. Additionally, trials con- trasting weight loss through regimens that include or exclude nuts indicate improved compliance and greater weight loss when nuts are permitted. Nuts may be included in the diet, in moderation, to enhance palatability, nutrient quality, and chronic disease risk reduction without compromising weight loss or maintenance.
Recent epidemiologic studies assessing tree nut (almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pe- cans, pine nuts, pistachios, and walnuts) consumption and the association with nutrient intake and diet quality are lacking. This study determined the association of tree nut consumption and nutrient intake and diet quality using a nationally representative sample of adults. Adults 19+ years (y) (n=13,292) participating in the 1999- 2004 National Health and Nutrition Examination Survey were used. Intake was determined from 24-hour diet re- calls; tree nut consumers were defined as those consuming ≥1⁄4 ounce/day (7.09 g). Means, standard errors, and ANOVA (adjusted for covariates) were determined using appropriate sample weights. Diet quality was measured using the Healthy Eating Index-2005. Among consumers, mean intake of tree nuts/tree nut butters was 1.19 + 0.04 oz/d versus 0.01 + 0.00 oz/d for non-consumers. In this study, 5.5 ± 0.3 % of individuals 19-50 y (n=7,049) and 8.4 ± 0.6 % of individuals 51+ y (n=6,243) consumed tree nuts/tree nut butters. Mean differences (p<0.01) between tree nut consumers and non-consumers of adult shortfall nutrients were: fiber (+5.0 g/d), vitamin E (+3.7 mg AT/d), calcium (+73 mg/d), magnesium (+95 mg/d), and potassium (+260 mg/d). Tree nut consumers had lower sodium intake (-157 mg/d, p<0.01). Diet quality was significantly higher in tree nut consumers (58.0±0.4 vs. 48.5±0.3, p<0.01). Tree nut consumption was associated with a higher overall diet quality score and improved nutrient intakes. Specific dietary recommendations for nut consumption should be provided for consumers.
Concerns are raised that rapid catch up growth during nutrition rehabilitation of severely malnourished children may be associated with disproportionately higher amounts of body fat deposition. This study examined the com- position of weight gain in severely undernourished children who underwent nutrition rehabilitation in a hospital from India. Body composition of 80 severely malnourished children (age 6-60 months) was assessed using skin- fold thickness measurements on admission and after 1 month of supplementary feeding. On admission, children had severe weight and height deficits and were severely wasted. The mean weight for age z score, height for age z score and weight for height z score (WHZ) were -5.0, -4.2 and -4.1 respectively. Children consumed a mixed diet and mean energy intake was 177 kcal/kg/day with a protein energy ratio of 13. Overall, the mean weight gain was 6.1 g/kg/day and fat mass contributed to about 40% of the weight gain. When the composition of weight gain was analysed in tertiles of baseline WHZ score, children in the lowest tertile of WHZ score had sig- nificantly higher weight gain and fat free mass (FFM) gain. Gain in fat mass did not differ in relation to the base- line WHZ score. The study demonstrates that it is possible to achieve rapid weight gain with recovery of lost tis- sue in severely malnourished children with mixed diets. Children with lowest WHZ scores at baseline gained higher FFM during nutrition rehabilitation when compared to the children with relatively higher WHZ score probably in an attempt to recover the lost tissue.
Background: Given an emerging concern for juvenile overweight and obesity, even in populations of developing countries, techniques to assess central obesity, such as abdominal circumference (AC), are of increasing interest. Objective: To compare two procedures for measuring AC in schoolchildren from a convenience sample of mid- dle-class, urban children aged 72 to 131 months in Guatemala City. Methods: We conducted a cross-sectional study (August 2004- April 2005) in 363 schoolchildren; 190 boys and 173 girls. The AC was recorded using both the conventional natural waist circumference (NWC) and the umbilical-level abdominal circumference (UAC) methods; each of which was measured over a thin T-shirt. Height and weight were also measured. The NWC and UAC methods were compared between genders and age groups. In addition, correlation coefficients and Bland-Altman regression were performed. A reproducibility study was performed on a subsample of 50 children. Results: Mean NWC was 63.2±10.0 cm for boys and 60.2±7.7 cm for girls (p=0.001), and mean UAC was 65.9±11.0 cm for boys and 63.2±8.8 cm for girls (p=0.008). Both measures of AC generally increased with age. The UAC - NWC difference increased with abdominal girth. The Pearson correlation coefficient of BMI vs. NWC and BMI vs. UAC was r=0.92, CV=0.46±0.27%. A high test-retest reproducibility (r > 0.98, CV= 0.50±0.24%) of the NWC and UAC measurements was found. Conclusion: Reliable NWC and UAC measure- ments may be obtained by applying a correction term to account for light clothing. Both measurements are appli- cable methodologies for the collection of data in populations with cultural limitations.
Objective: To examine the association between dietary patterns and obesity indices (BMI, WC, WHR) among Tehranian adults in a 6-year follow-up study. Methods: Within frame of a cohort study in Tehran (mean follow up 6.6±0.9 years), 141 adults were recruited with: two 24 hour dietary recalls at the beginning, as well as obesity indices at the beginning and end of the study period. Dietary intakes were converted into grams of intakes of food items and categorized into 16 groups. Reduced rank regression analysis derived five patterns with total and polyunsaturated-to-saturated fat intake, cholesterol, fiber and calcium intake as response variables. Factors (die- tary patterns) were generated retaining a corresponding factor loading ≥ |0.17| on the food groups. Changes in obesity indices were scrutinized within quintiles of factor scores. Results: There were high loadings on refined carbohydrates, whole grain, starchy vegetables, other vegetables, red and refined meat, saturated/trans fat, and egg for the first factor named “traditional”. All obesity indices had increasing trend across quintiles of pattern score. The fifth pattern (namely egg pattern) had high loading for eggs, salty snacks, as well as fruits and dry fruits, and negative loadings for red and processed meat, saturated and trans fat, plant oils, and dairy products. This pattern showed increasing trends for WC and WHR after adjustment for potential confounders. Other pat- terns showed non-significant trends for obesity indices. Conclusions: The results were indicative of a traditional pattern which is dominated in the Tehran region and associated with increase in obesity indices.
This study was conducted to clarify the effect of ingesting soy isoflavone extracts (not soy protein or foods con- taining isoflavones) on bone mineral density (BMD) in menopausal women. PubMed, CENTRAL, ICHUSHI, CNKI, Wanfang Data, CQVIP, and NSTL were searched for randomized controlled trials published in English, Japanese, or Chinese reporting the effects of soy isoflavone extracts on lumbar spine or hip BMD in menopausal women. Trials were identified and reviewed for inclusion and exclusion eligibility. Data on study design, par- ticipants, interventions, and outcomes were extracted. Eleven, seven, five, and five trials were finally selected for estimation of the effects on spine, femoral neck, hip total, and trochanter BMD, respectively. Meta-analysis in- cluding data from1240 menopausal women revealed that daily ingestion of an average of 82 (47–150) mg soy isoflavones (aglycone equivalent) for 6–12 months significantly increased spine BMD by 22.25 mg/cm2 (95% CI: 7.62, 32.89; p=0.002), or by 2.38% (95% CI: 0.93, 3.83; p=0.001) compared with controls (random-effects model). Subgroup analyses indicated that the varying effects of isoflavones on spine BMD across trials might be associated with study characteristics of intervention duration (6 vs. 12 months), region of participant (Asian vs. Western), and basal BMD (normal bone mass vs. osteopenia or osteoporosis). No significant effects on femoral neck, hip total, and trochanter BMD were found. Soy isoflavone extract supplements increased lumbar spine BMD in menopausal women. Further studies are needed to address factors affecting the magnitudes of effect on spine and to verify the effect on hip.
Background: Serum 25-hydroxyvitamin D (25OHD) concentrations are lower in Pacific people compared to Caucasians living in New Zealand. However, there are no data on the 25OHD concentrations of Pacific people living in the Pacific Islands. Aim: To assess the vitamin D status of indigenous and Indian Fijian women living in Fiji by measuring 25OHD concentrations. Methods: 25OHD concentrations in a national sample of 511 Fijian women (15-44 y). Results: The mean 25OHD concentration of Fijian women was 76 nmol/L (95% CI: 73, 78). 25OHD was lower in Fijian Indian [70 (66, 74) nmol/L; n=205] women compared to indigenous Fijians 80 (76, 84) nmol/L; n=306. The mean 25OHD was higher in rural [77 (74, 80) nmol/L; n=392] than urban [70 (65, 76) nmol/L; n=119] women (p<0.0001). Body mass index (BMI) and age were not predictors of 25OHD concentrations. Of Fijian females, 3%, 11%, and 56% had 25OHD concentrations indicative of 25OHD insuffi- ciency using cut-offs of ≤37.5, ≤50 and ≤80 nmol/L, respectively. Conclusion: Mean 25OHD in Fijian women was generally adequate and exceed concentrations reported in Pacific females living in New Zealand.
There have been methodological problems for studying hypovitaminosis D and K in the elderly. First, studies were done either by evaluating food intake or measuring their circulating levels, but rarely by both in Japan. In this paper, vitamin D and K intakes and their circulating levels were simultaneously determined. Second issue is whether hypovitaminosis D and K are independent of general malnutrition, prevalent in the elderly. We tried to statistically discriminate them by principal component analysis (PCA). Fifty institutionalized elderly were evalu- ated for their circulating 25 hydroxy-vitamin D (25OH-D), intact parathyroid hormone (PTH), phylloquinone (PK), menaquinone-7 (MK-7) levels, and their food intake. Although average vitamin D intake (7.0 μg/day) ex- ceeded the Japanese Adequate Intake (AI) of 5.0 μg/day, average serum 25OH-D concentration was in the hy- povitaminosis D range (11.1 ng/mL). Median vitamin K intake was 168 μg/day, approximately 2.5 times as high as AI for vitamin K. Nevertheless, plasma PK and MK-7 concentrations were far lower than those of healthy Japanese elderly over 70 years old. PCA yielded four components; each representing overall nutritional, vitamin K2, vitamin D, and vitamin K1 status, respectively. Since these components are independent of each other, vita- min D- and K-deficiency in these subjects could not be explained by overall malnutrition alone. In summary, in- stitutionalized elderly had a high prevalence of hypovitaminosis D and K, and the simultaneous determination of their circulating level and dietary intake is mandatory in such studies. PCA would yield fruitful results for elimi- nating the interference by confounders in a cross-sectional study.
Cardiovascular disease (CVD) is a leading cause of death in the Philippines, although few studies here have ex- amined the lipid profiles underlying disease risk. The isolated low high density lipoprotein cholesterol (HDL-c) phenotype has been implicated as a CVD risk factor, the prevalence of which exhibits significant variation across populations. To assess population variation in individual lipid components and their associations with diet and anthropometric characteristics, we compare lipid profiles in a population of adult Filipino women (n=1877) to US women participating in the National Health and Nutrition Examination Survey (NHANES, n=477). We conducted multiple regression models to assess the relationship between lipid components, body mass index, and dietary variables in the two populations. We measured the prevalence of lipid phenotypes, and logistic regression models determined the predictors of the isolated low HDL-c phenotype. High density lipoprotein cholesterol was lower in the Philippines (40.8±0.2 mg/dL) than in NHANES (60.7±0.7 mg/dL). The prevalence of the isolated low HDL-c phenotype was 28.8%, compared to 2.10% in NHANES. High prevalence among Filipinos was rela- tively invariant across all levels of BMI, but was strongly inversely related to BMI in NHANES and exhibited only at the BMI>25 kg/m2 threshold. Diet did not consistently predict the low-HDL phenotype in Filipinos. Fili- pino women exhibit a high prevalence of the isolated low HDL-c phenotype, which is largely decoupled from anthropometric factors. The relationship of CVD to population variation in dyslipidemia and body composition needs further study, particularly in populations where the burden of cardiovascular and metabolic disease is rap- idly increasing.