APJCN

Objective: To evaluate the association between alcohol consumption and the risk for type 2 diabetes (DM) in Japanese. Methods: We searched the MEDLINE data base with the key words ‘alcohol intake’ (or ‘alcohol con- sumption’) and ‘Japanese’ cross-linked with ‘diabetes mellitus’ (or ‘impaired glucose tolerance’). The reports we sought were restricted to prospective cohort studies, randomized controlled trials, meta-analyses and systematic reviews. Computerized and hand searches were conducted in June 2007. Results: Seven prospective cohort stud- ies were adopted. We previously reported that in lean Japanese men (BMI ≤22.0 kg/m2), moderate to heavy al- cohol intake is a risk factor for diabetes. One study found heavy alcohol intake to be associated with an increased risk in low-BMI men while moderate alcohol intake was associated with a reduced risk in higher-BMI men. An- other study suggested daily alcohol consumption to be a risk factor in low-BMI participants, while being protec- tive in middle-BMI participants. Yet another study demonstrated a U-shaped association between alcohol con- sumption and the risk of diabetes in men. Three other studies, which did not divide the subjects in terms of BMI values, indicated alcohol intake to be an increased risk for diabetes, two being in men and one being in women, respectively. Conclusion: For a large number of Japanese men who have relatively low BMI, alcohol intake is an established risk factor for diabetes.

Nutrition transition is one of the driving forces of the upcoming global epidemic of diabetes mellitus and cardio- vascular diseases. We hypothesized that in previously deprived rapidly changing regions, the progress of the ob- esity epidemic is clustered per community and that screening with anthropometric school surveys can detect the negative effects of the nutrition transition in its early stages. In 16 different rural and urban communities in Binh Thuan Province, southern Vietnam, anthropometric surveys were conducted in local primary schools. Anthro- pometry of 2613 children showed a significant difference of the prevalence of wasting, stunting, and overweight between urban and rural communities. During the transition from high stunting rates to overweight, communities pass through an episode with dual burden of both conditions at different pace. Anthropometry of primary school children can reveal inter-community differences and identify the early stages of the nutrition transition.

Aim: To assess the efficacy of modified World Health Organization (WHO) feeding protocol for severe malnu- trition. Setting: Prospective observational study conducted in the nutritional rehabilitation center of a tertiary care teaching hospital of New Delhi, India over four months period from August to November 2007. Methods: 25 children with severe malnutrition (age 6 months to 5 years) were recruited. All children were treated according to Indian Academy of Pediatrics modified WHO guidelines. Daily weight gain and improvement in the clinical status was assessed. Children were followed up at day 15, day 30 and day 45 after discharge or when a new problem emerged. Results: Weight-for-age z score (WAZ) at admission was -4.82±0.96, weight-for-height z score (WHZ) was –5.0 ±0.7, height-for-age z-score (HAZ) was –2.55 + 1.65. All children had diarrhea on admission, two had pneumonia in addition, and one each had otitis, sepsis and hepatitis in addition to diarrhea. The mean duration of admission was 8.32 + 2.87 days. At discharge the mean WAZ was -4.15 + 0.92 and mean WHZ, -3.91+ 0.61 (p value highly significant). Follow up at day 15, 30 and 45 showed significant improvement in WAZ and WHZ. Conclusions: Following modified WHO guidelines is feasible, efficacious and cost effective in resource-limited settings. Early discharge of patients is possible with no complications or mortality.

Dietary factors may be important in the development of atopic eczema. It remains controversial whether n-3 polyunsaturated fatty acid intake is preventive against allergic disorders and whether n-6 polyunsaturated fatty acid intake increases the risk of allergic disorders. The current cross-sectional study examined the association be- tween intake of fatty acids and foods high in fatty acids and the prevalence of atopic eczema. Study subjects were 1002 pregnant Japanese females. Current atopic eczema and atopic eczema after age 18 were defined as present if subjects had been treated with medications at some time in the previous 12 months and after reaching the age of 18, respectively. Information on dietary factors was collected using a validated self-administered diet history questionnaire. Docosahexaenoic acid intake was statistically significantly related to a decreased preva- lence of atopic eczema after age 18 and current atopic eczema. Inverse dose-response relationships with regard to consumption of n-3 polyunsaturated fatty acids, eicosapentaenoic acid, and fish and the ratio of n-3 to n-6 polyunsaturated fatty acids with atopic eczema were not observed although these dietary variables in the second tertile were inversely significantly associated with atopic eczema after age 18. Intake of total fat, saturated fatty acids, monounsaturated fatty acids, n-6 polyunsaturated fatty acids, cholesterol, meat, eggs, or dairy products was not related to either of the outcomes for atopic eczema. Docosahexaenoic acid intake may be associated with a reduced prevalence of atopic eczema in pregnant Japanese females.

A survey was conducted to monitor the current status of iodine deficiency disorders in children aged 6-12 years and women aged 15-44 years in Bangladesh as measured by goitre prevalence and urinary iodine excretion. Conducted between September 2004 and March 2005, the survey followed a stratified multistage cluster sam- pling design to provide nationally representative data, with self-weighted rural-urban disaggregation. A total of 7233 children and 6408 women were examined for goitre and 4848 urine samples (2447 from children and 2401 from women) were analyzed for iodine. In addition, 5321 household salt samples were analyzed for iodine. In children, the total goitre rate (TGR) was 6.2%, compared to 49.9% in 1993 and the TGR among women was 11.7%, while in 1993 it was 55.6%. Prevalence of iodine deficiency (Urinary Iodine Excretion <100 μg/L) was 33.8% in children and 38.6% in women (compared to 71.0% and 70.2%, respectively in 1993). Iodine nutrition status in urban areas was considerably better than in rural areas. There was a clear inverse relationship between iodine deficiency and the coverage of households using adequately iodized salt (≥15 ppm). The findings of the survey revealed that Bangladesh has achieved a commendable progress in reducing goitre rates and iodine defi- ciency among children and women ever since the universal salt iodization programme was instituted 10 years ago. However, physiological iodine deficiency still persists among more than one-third of children and women, which points to the need for all stakeholders to redouble their efforts in achieving universal salt iodization.

The objective of this study was to evaluate the validity of a Xi’an food frequency questionnaire (FFQ) designed for application in an international case-control colorectal cancer study. The FFQ was administered to 125 par- ticipants twice over 1-year interval. Four 24-hour dietary recalls (24-HDRs) were conducted with the same par- ticipants in each season of the year. Comparative validation was assessed by comparing the nutrient intakes de- rived from the 24-HDRs and the FFQ-2, and reproducibility was estimated by comparing the nutrient intakes from two FFQs. In the validation study, the mean deattenuated correlation coefficients for nutrients between the 24-HDRs and the FFQ-2 ranged from 0.35 to 0.84 in the males. The female results were slightly lower than the male’s. The mean percentage of classification into the same quartile was 38% for the males and 35% for the fe- males. In the reproducibility study, the mean crude correlation coefficients between the two FFQs were from 0.41 to 0.68 in the males and from 0.36 to 0.66 in the females. The newly developed Xi’an FFQ appears to be reasonably valid and reliable for most nutrients but would benefit from the addition of nutritional supplements and seasonings for assessing dietary intake in older persons in Xi’an, China.

Rapid increase in the incidence of type 2 diabetes (DM2) in Papua New Guinea, coupled with compelling epidemiological evidence supporting a diabetogenic association with betel quid (BQ) chewing has lead us to investigate dietary strategies that might offer protection from developing DM2. We investigated the dietary habits of Kalo residents from coastal Central Province who are avid BQ chewers yet have a relatively low incidence of DM2 compared to the ethnically similar and adjacent Wanigelans who abstain from BQ yet have an unusually high incidence of DM2. In Kalo, guava bud (Psidium guajava L) and noni (Morinda citrifolia L) were consumed much more frequently than in Wanigela, whereas the inverse was observed for mangrove bean (Bruguiera gymnorrhiza (L) Lam.). These plants, along with BQ and its component ingredients areca nut (Areca catechu L) and Piper betle L inflorescence, were assessed for their ability to mediate insulin-dependent and insulin- independent glucose transport in cultured 3T3-L1 adipocytes. A dose-dependent inhibition of glucose uptake from methanolic extracts of BQ, areca nut and P. betle inflorescence supports previous reports of pro-diabetic activity. Conversely, guava bud extract displayed significant insulin-mimetic and potentiating activity. Noni fruit, noni leaf, commercial noni juice and mangrove bean all displayed insulin-like activity but had little or no effect on insulin action. Habitual intake of guava and noni is proposed to offer better protection against DM2 development and/or betel quid diabetogenicity than cooked mangrove bean. These findings provide empirical support that DM2 risk reduction can be accomplished using traditional foods and medicines.

Objective: To examine the interaction between salt-intake and helicobacter pylori (H. pylori) infection in the development of stomach cancer in an ecological study of 67 Chinese rural counties. Methods: Stomach cancer mortality data of 67 counties were derived from a national survey conducted in China between 1986 and1988. Information regarding the prevalence of H. pylori infection and urinary sodium excretion were collected from the same individuals during a subsequent dietary survey in 1989. Results: In these 67 counties, H. pylori preva- lence and urinary sodium were correlated with stomach cancer mortality, with r=0.31 (p=0.01) and r=0.28 (p=0.03), respectively. After stratification, the significant correlation between H. pylori prevalence and stomach cancer mortality only existed in counties with high levels (≥5.0 mg/mg creatinine/12-hour) of urinary sodium (r=0.5; p=0.002). Similarly, the significant correlation between urinary sodium and stomach cancer mortality was only presented in counties with high (≥71.6%) H. pylori prevalence (r=0.4; p=0.017). Multivariate regres- sion analysis showed results consistent with the correlation analysis. Conclusion: These findings suggest that there may be an interaction between high salt consumption and H .pylori infection in the development of stom- ach cancer. Corroborating data from epidemiological, clinical, and experimental studies are needed.

C-reactive protein (CRP), a plasma inflammation marker, has been known to play a role in the development of cardiovascular diseases. This study aims to evaluate the association of CRP with anthropometric and plasma lipid parameters in elderly Taiwanese 65 years or older. Data from the Elderly Nutrition and Health Survey in Taiwan (1999-2000), a national probability sampling study conducted to gain an understanding of the dietary pattern, and nutritional and health status of elderly Taiwanese were analyzed. Results showed that in men, CRP was positively correlated with age and waist-to-hip ratio (WHR) (both p<0.05) whereas in women, CRP was positively correlated with waist and WHR but negatively correlated with HDL-C (all p<0.05). Linear regression analysis showed that log CRP was positively associated with WHR in both genders (p<0.05) after adjusting for confounders. The correlation of CRP with WHR was stronger than that with both waist circumference and body mass index (BMI). Log CRP was inversely associated with HDL-C in women, but not men. The study suggests that among the anthropometric parameters examined, WHR is a stronger predictor for elevated CRP in elderly Taiwanese men and women. Whereas low HDL-C is a predictor among the plasma lipid parameters for elevated plasma CRP, at least in women. Gender differences exist in the association of CRP with anthropometric and lipid parameters.

In observational studies, habitual coffee consumption has been linked to a lower risk of type 2 diabetes. We hy- pothesized that the mechanism may be related to delayed effects on postprandial glycemia. The aim of this study is to investigate the glycemic and insulinemic effects of consumption of caffeinated and decaffeinated coffee, sweetened and unsweetened, tea and sucrose, 1 h prior to a high carbohydrate meal. On separate occasions in random order, lean young healthy subjects (n = 8) consumed a potato-based meal 1 hour after consumption of 250 mL of black coffee (COF), black coffee sweetened with 10 g of sucrose (COF+SUC), decaffeinated coffee (DECAF), black tea (TEA), 10 g sucrose (SUC) or hot water (CON). Fingerprick blood samples were taken at regular intervals over 2 h and the glucose and insulin responses quantified as area under the curve. Compared to CON, COF caused a 28% increase in postprandial glycemia (p = 0.022). In contrast, COF+SUC decreased gly- cemia compared with either COF (-38%, p < 0.001) or CON (-20%, p = 0.100) but had no effect on insulin re- sponses. DECAF, TEA and SUC had no significant effects on postprandial responses. SUC and DECAF reduced the absolute glucose concentration at the start of the meal (p < 0.01). In conclusion, only sweetened coffee sig- nificantly reduces postprandial glycemia. This observation may explain the paradoxical findings of observational and clinical studies relating coffee drinking to diabetes risk.

Naturally viscous vegetables and natto, made by fermenting soybeans, are very palatable and considered to be healthy foods in Japan. The objective was to assess whether the consumption of natto and viscous vegetables as part of a traditional Japanese breakfast based on high-glycemic index white rice affects glycemic, insulinemic, lipidemic and satiety responses in healthy subjects. Eleven healthy subjects consumed the reference, control and test meals in a randomized cross-over design. The test meal, comprising 200 g of boiled white rice with viscous meal (50 g natto, 60 g Japanese yams and 40 g okras), and the control meal, comprising 200 g of white rice with non-viscous boiled soybeans, potatoes and broccoli, contained comparable amounts of carbohydrate, fat, protein and fiber. In addition, whiter rice was used as a reference meal. Blood samples over 180 min were analyzed for glucose, insulin, non-esterified free fatty acid and triacylglyceride. Peak glucose and insulin concentrations after the test meal (6.0 mmol/L and 262 pmol/L) were significantly lower than after the control meal (6.8 mmol/L and 360 pmol/L). The incremental areas under the curve for glucose and insulin over 0-120 min after the test meal were also significantly reduced as compared with the control meal (28 and 27%). The consumption of naturally viscous vegetables with white rice reduced acute glycemia and insulinemia. This practical dietary combination would ensure compliance and favorably alter the risk for diabetes and cardiovascular diseases.

Background: The optimal method for conducting omega (n–)3 polyunsaturated fatty acid (PUFA) supplementa- tion trials in children is unknown. Aim: To assess the impact of n–3 and n–6 PUFA intake from the background diet on plasma levels of n–3 and n–6 PUFA in children aged 0-3 years, with and without n–3 supplementation. Methods: Subjects were randomised antenatally to receive either n–3 PUFA supplements and low n–6 PUFA cooking oils and spreads or a control intervention, designed to maintain usual fatty acid intake. Dietary intake was assessed at 18 months by 3–day weighed food record and at 3 years by food frequency questionnaire. Plasma phospholipids were measured at both time points. Associations were tested by regression. Results: N–3 PUFA intake from background diet did not significantly affect plasma n–3 levels. In contrast, n–6 PUFA intake in background diet was positively related to plasma n–6 levels in both study groups. In addition, n–6 PUFA in- take from diet was negatively associated with plasma n–3 levels at 18 months and 3 years (–0.16%/g n–6 intake, 95%CI –0.29 to –0.03 and –0.05%/g n–6 intake, 95%CI –0.09 to –0.01, respectively) in the active group, but not in the control group. Conclusion: Interventions intending to increase plasma n–3 PUFA in children by n–3 sup- plementation should also minimise n–6 PUFA intake in the background diet.

South Asian Indians are at increased risk for cardiovascular disease associated with insulin resistance and a dyslipidemia characterized by high triglyceride and low high-density lipoprotein cholesterol concentrations. The purpose of this study is to determine the effects of a calorie-restricted, relatively low carbohydrate diet on weight loss, insulin sensitivity, and associated cardiovascular disease risk factors in overweight, insulin resistant, but apparently healthy, South Asian Indian women. Twenty-three, overweight, insulin resistant, apparently healthy, South Asian Indian women were advised on a calorie-restricted diet containing 40 percent carbohydrate for 3 months. Change in weight, insulin sensitivity (quantified by the steady state plasma glucose concentration during the insulin suppression test), and associated cardiovascular disease risk factors were measured. Weight fell from 75.5 to 70.5 kg (p < 0.001), associated with significant decreases in diastolic blood pressure, plasma concentra- tions (mg/dL) of steady state plasma glucose (217 to 176, p < 0.001), triglycerides (137 to 101, p = 0.003), and glucose (98 to 92, p = 0.005). A calorie-restricted diet, moderately lower in carbohydrate, can lead to weight loss, decreased insulin resistance, and reduction in several cardiovascular disease risk factors in overweight, insulin resistant, apparently healthy, South Asian Indian women.

Food for humans is one of the most important of all global issues. It is a critical determinant of planetary and in- dividual health, of economic development, of how sustainable energy and water supplies are, and its security a powerful determinant of peace or conflict. Those who assume leadership for the integrity of food and health sys- tems have great responsibility. The IUNS (International Union of Nutritional Sciences), regional and national nutrition science and food technology organizations have concern about the leadership capacity available and re- quired in what are rapidly changing and increasingly demanding circumstances. These include persistent poverty and hunger, climate change which threatens the sustainability of food production and fragile financial systems which are making food less affordable for many. North East Asia (NEA) is a major region for its population size, its economic wealth and disparities, its food production, its life expectancies among the best and its global reach. In 2008, for those of Chinese ancestry and of wider Asian origin, Nutrition Leadership training has been con- ducted in Hangzhou, Shanghai, Seoul and Taiwan (Hsinchu and Zhunan). Ninety prospective young leaders par- ticipated in all. Several successful early career Asian nutrition scientists and professionals served as role models. Senior colleagues acted as mentors for groups of 2 or 3. With mentors, the concept of leadership has been exam- ined, careers and roles explored, knowledge and skills honed for a different future, and plans made to network in mutual support. Early feedback indicates that new opportunities have been created and seized.

Activation of polyol pathway due to increased aldose reductase activity is one of the several mechanisms that have been implicated in the development of various secondary complications of diabetes. Though numerous syn- thetic aldose reductase inhibitors have been tested, these have not been very successful clinically. Therefore, a number of common plant/ natural products used in Indian culinary have been evaluated for their aldose reductase inhibitory potential in the present study. The aqueous extracts of 22 plant-derived materials were prepared and evaluated for the inhibitory property against rat lens and human recombinant aldose reductase. Specificity of these extracts towards aldose reductase was established by testing their ability to inhibit a closely related enzyme viz, aldehyde reductase. The ex vivo incubation of erythrocytes in high glucose containing medium was used to underscore the significance in terms of prevention of intracellular sorbitol accumulation. Among the 22 dietary sources tested, 10 showed considerable inhibitory potential against both rat lens and human recombinant aldose reductase. Prominent inhibitory property was found in spinach, cumin, fennel, lemon, basil and black pepper with an approximate IC50 of 0.2 mg/mL with an excellent selectivity towards aldose reductase. As against this, 10 to 20 times higher concentrations were required for 50% inhibition of aldehyde reductase. Reduction in the accumulation of intracellular sorbitol by the dietary extracts further substantiated their in vivo efficacy. The find- ings reported here indicate the scope of adapting life-style modifications in the form of inclusion of certain common sources in the diet for the management of diabetic complications.

Rice is commonly consumed in the Philippines; however the contribution of other foods to the diet is not well defined. Our aim was to determine the nutrient intake and food group intake of Philippine nuns and compare their intakes to the current estimated average requirements (EAR), and food-based recommendations, respec- tively, and assess any differences in nutrient adequacy and energy intakes between body mass index (BMI) cate- gories. Body weight was assessed at baseline and at nine months; three-day weighed food intakes were recorded once every fortnight (n=187). At baseline, the mean (SD) age and BMI of the women was: 25.0 (4.6) years and 21.8 (17.3) kg/m2, respectively. Over the nine months, women with an underweight (n=46; <18.5 kg/m2) and ac- ceptable BMI (n=132; 18.5-25 kg/m2) lost 5.0 kg (p=0.005) and 1.5 kg (p=0.047), respectively, whereas over- weight women maintained their weight. Irrespective of BMI, 98% of women consumed less than the adequate intake for calcium, and no one met the folate EAR. The intake of all food groups (e.g., rice, vegetables, fruit, meat, dairy) was lower than food-based recommendations. It is evident that the nutrient density of the Philippine diet is poor. In order to meet nutrient requirements, it is recommended that all women increase intake of fruits, vegetables, fish, meat and dairy products, to reduce risk of micronutrient deficiencies. For the overweight women, these nutrient dense foods also are recommended, however it is important that they be substituted for energy dense foods to promote weight loss and prevent weight gain.

The purpose of this study was to compare the accuracy of clinical methods to estimate body fat (%BF) in people who take weight-inducing atypical antipsychotic medications. Forty-seven people (35 males, 12 females) with previously diagnosed psychotic illness who had been taking atypical antipsychotic medications for more than 6 months took part in this study. Percentage body fat was estimated using bioelectrical impedance analysis (BIA) and anthropometry from previously published prediction equations and compared with that measured using the deuterium dilution technique which served as the criterion measure. Bland-Altman analyses were used to assess the agreement between measures. In the males, %BF determined using BIA with the Lukaski equation was the only clinical method with mean differences that were not significant from criterion values. While in the females, %BF determined from BMI was the only method that was significantly different from the criterion values. All of the methods of estimating %BF except Watson equations provided consistent estimates across the weight range. Therefore, this study suggests that in a group of people who predominantly had schizophrenia and were taking atypical antipsychotic medications, BIA using the equation of Lukaski was the best indicator of %BF, although on an individual basis the accuracy was poor. BMI underestimated %BF to a greater significant extent than BIA. The use of BIA rather than BMI may provide a better indicator of adiposity in people who take weight inducing antipsychotic medications.

Objective: To asses the impact of drought on nutritional status of adults of a rural population in desert area. De- sign: Three-stage sampling technique. Setting: 24 villages belonging to 6 tehsils (sub units of district) of Jodh- pur district, a drought affected desert district of Western Rajasthan, in 2003. Subjects: 1540 adults were exam- ined for their anthropometry, dietary intake and nutritional deficiency signs. Results: Overall chronic energy de- ficiency (CED) was found high (42.7 %). Severe CED was 10.7 percent, significantly higher in males than fe- males. Regarding vitamin A deficiency, overall prevalence of Bitot spot and night blindness was 1.8 and 0.2 per- cent respectively, higher in females than males. Regarding vitamin B complex deficiency, angular stomatitis, cheliosis, and glossitis was 1.0, 2.6 and 5.4 percent. Anemia was 35.6 percent. Overall mean calorie and protein intake deficit was very high (38 & 16.4 %). The comparison of present drought results with earlier studies in de- sert normal and desert drought conditions showed higher deficiencies of calories and proteins in their diet. Con- clusions: Severity of malnutrition is critical as CED was more than the cut-off point of 40 percent stated by World Health Organization. Vitamin A and B complex deficiencies, anemia, protein calorie malnutrition along with deficit in calories and proteins in their diet were higher in comparison to non desert areas, which may be due to the harsh environmental conditions in desert areas. Efforts should be made to incorporate intervention measures to ensure the supply of adequate calories and proteins to all age groups.

Bioelectrical impedance analysis (BIA) measures the impedance associated with passage of an alternating cur- rent through the body which is proportional to total body water (TBW) and therefore can provide expedient es- timates of body composition. However, little validity information is available for commercially available bath- room scale type devices which perform whole body estimates from segmental (lower limb) measurements. This study therefore compared body composition estimates between a commercially available segmental BIA device (Tanita BC-532) and four compartment criterion values. Body composition of nine males and nine females (mean ± SD: 37.7 ± 18.7 yr; 170.7 ± 5.3 cm; 68.38 ± 9.7 kg) was determined via BIA and a four compartment model incorporating measures of body density, TBW and bone mineral mass. While the mean %BF and fat free mass (FFM) values for both methods were not significantly different, considerable intra-individual differences were observed. BIA values varied from the four compartment values by -3.0 to 4.4 %BF and -3.3 to 1.9 kg FFM. The BIA estimates of TBW were significantly different from the criterion measures and intra-individual differ- ences displayed a large range (-0.6 to 3.6 kg). Significant underestimations of TBW via BIA are concerning given that this is the parameter initially established by this method. Furthermore, the BIA data resulted in a FFM hydration value of 68.5% which was significantly (p<0.001) lower than the four compartment value of 72.0%. In conclusion, the BIA device tested displayed poor individual accuracy for the estimation of body composition compared with a four compartment criterion method.

Obesity has emerged as an epidemic worldwide. The present study was conducted to assess the prevalence of overweight and obesity amongst children in the age group of 5-18 years belonging to low, middle and high in- come group in National Capital Territory NCT of Delhi. A total of 16,595 children (LIG 5087, MIG 5134 and HIG 6368) were covered in the present study. Overweight and obesity were assessed using Body Mass Index (BMI) and Triceps Skin Fold Thickness (TSFT) utilizing age and sex specific cut off points. Considering the BMI cut off points, the prevalence of obesity and overweight in Low Income Group (LIG) school children was 0.1 and 2.7 percent respectively, amongst Middle Income Group (MIG) school children it was 0.6 and 6.5 per- cent and in High Income Group (HIG) school children was 6.8 and 15.3 percent respectively (p<0001). With re- gard to the TSFT criteria, the prevalence of obesity and overweight in LIG school children was 1.2 and 2.4 per- cent, amongst MIG school children it was 2.5 and 4.9 percent and in children belonging to HIG schools was 9.3 and 13.1 percent respectively (p<0.001). The present study documented that the prevalence of overweight and obesity was higher in the HIG children as compared to the MIG and the LIG for all age groups, highlighting the possible role of change in the dietary pattern and physical activities with increase in income levels.

Background: Worldwide the prevalence of overweight and obesity in children is escalating. Parents’ recognition of overweight or obesity in their own children is very important for a successful intervention in these children. This study examined parental perception of their children’s weight status, and its association with their knowl- edge on nutrition and obesity. Materials and Methods: This was a cross sectional study of parents with children aged 9 to 12 years, in a primary school of Kuala Lumpur. Parents responded to a self-administered questionnaire which contains parental perception of their child weight status as well as knowledge on nutrition and obesity. The parents’ perception of the children’s weight status was then compared with the actual measured weight status. Results: There were 204 parents who participated in the study. Parents were found to underestimate their child weight status and 38.2% were inaccurate in their perception. The mean score of knowledge on nutrition and obesity was 78.5±14.4; and this did not associate with the accuracy of their perception on the child weight status. Parents showed inadequate knowledge in food pyramid and preparation of low fat meals. Conclusion: The Malaysian Health Campaigns had resulted in overall good knowledge on nutrition and obesity in the parents ex- cept in few domains. However, this was insufficient to make the parents recognize the growing overweight and obesity problem in their children.