Existing food insecurity instruments are focused largely on the financial constraints associated with acquiring sufficient amounts of food. This narrow focus has resulted in underestimating the true prevalence of food poverty, particularly in high-income countries. Food poverty needs to be defined as capability deprivation, extending from the nutritional to the temporal, spatial, qualitative and affective aspects of eating. In this article, the Alkire-Foster counting approach is evaluated and an alternative method for measuring such multidimensional food poverty is proposed. The method is demonstrated by using evidence from interviews with 53 single mothers, the most high-risk social group in Japan. On the basis of an operational definition of food deprivation and poverty cut-offs, 16 mothers (30%) were identified as living in food poverty, followed by a qualitative analysis of their deprivation profiles. The results show that the economically-poor were highly likely to fall into food poverty, but that food poverty also occurred without economic deprivation, notably among the mental or physical illness carriers and long-hour workers. This multidimensional and decomposable measurement tool is effective for identifying food-poor populations not reflected in traditional food insecurity measurement instruments.
Background and Objectives: Epidemiological studies often use the food frequency questionnaire (FFQ) to predict the food consumption habits of a target group and subsequently promote healthy eating in the group. In the present study, a version of the FFQ for Malaysian young adults aged 18–24 years was designed and validated. Methods and Study Design: This study comprised development and validation phases. In the development phase, 129 young adults from a public university in Klang Valley completed a 3-day food record (3DFR), and the data were used to create a food list for the FFQ. Two weeks later, in the validation phase, another 100 participants recruited from the same university completed the 3DFR and a newly developed FFQ for assessing consumption of 38 food items. Finally, the data obtained from the FFQ and 3DFR were used to analyze the nutrient intake of each participant, and the developed FFQ was validated using Spearman correlation coefficients (r) and Bland–Altman methods. Results: For the development phase, 38 food items were determined to contribute to 90% of the participants’ total energy and macronutrient intake, and these items were included on the FFQ. For the validation phase, the average Spearman correlation coefficient for energy and all nutrients was 0.43, which indicated good agreement between the 3DFR and FFQ. Cross-classification analysis of the 3DFR and FFQ results revealed that 79% of the young adults were classified into similar or neighboring quartiles when each set of results was used. The Bland–Altman plots revealed that the results obtained using the two methods were parallel. Conclusions: The FFQ is a simple and validated tool that can be self-administered to young adults to assess their energy and nutrient consumption.
Background and Objectives: To investigate the relationship between sodium (Na) and potassium (K) nutritional condition and body compositions in youth aiming to give target population reasonable diet recommendations. Methods and Study Design: The cross-sectional study was conducted involving 512 healthy youth aged 18 to 31 years from universities in Beijing. Food frequency questionnaire (FFQ) and bioelectrical impedance analyzer (BIA) were used to collect dietary intake information and body compositions. Results: There was an increasing tendency in fat-related indicators and muscle-related indicators of the dietary Na tertile group (p <0.05). Additionally, Weight, body mass index (BMI), waist circumference (WC), and muscle-related indicators increased with the dietary K tertile group (p <0.05). Across increasing tertiles of dietary Na intake, the odds ratio (OR) was increased significantly (p < 0.05) in fat-related indicators. On the contrary, with the increased dietary Na intake, the OR decreased (p < 0.05) in appendicular skeletal muscle mass index (ASMI) and body lean mass. As tertiles of dietary K intake increased, the OR in both skeletal muscle mass index (SMMI) and lean mass index (LMI) decreased. Conclusions: High dietary Na is a risk factor for abnormal lipid distribution in college students. High dietary K can maintain skeletal muscle mass and reduce the risk of obesity. Na in the diet has a greater impact on the body composition of young people than K. Low dietary Na and high dietary K still need to be strengthened in science popularization and practice among more college students.
Background and Objectives: Sichuan cuisine is characterized by high salt and oil content. We aimed to evaluate the effects of the Sichuan cuisine version of Chinese heart-healthy diet (CHH diet-SC) on blood pressure reduction among hypertensive adults. Methods and Study Design: The Chinese heart-healthy diet (CHH) trial was a multicenter randomized controlled feeding trial among Chinese hypertensive people. We conducted a secondary analysis of the CHH trial using data from the Sichuan center in Southwest China. Fifty-three people aged 25 to 75 years with a mean systolic blood pressure (SBP) between 130 and 159 mmHg were enrolled. Eligible participants underwent a 1-week run-in period with the typical local diet and were randomized 1:1 to consume the CHH diet-SC (n=27) or typical local diet (n=26) for the next 4-week. The primary outcome was the net change in SBP, the secondary outcomes included diastolic blood pressure (DBP), mean arterial pressure (MAP), and the rate of BP control. Results: Compared with the control group, the CHH diet-SC decreased cooking salt, oil, and red meat content and increased inclusion of whole grains, fruits, seafood, low-fat dairy, soybean, and nuts; the SBP experienced reductions of 7.54, 8.60, 9.14, and 10.1 mmHg at the end of weeks 1 through 4; the DBP was reduced 4.01 mmHg at week 4; the MAP was significantly reduced 6.02 mmHg finally; and rate of BP control significantly increased (p˂0.05). Conclusions: Adoption of the CHH diet-SC for 4 weeks can significantly reduce BP and increase the rate of BP control in hypertensive adults.
Background and Objectives: Fermented foods play an important role in establishing intestinal bacterial flora, and the composition of the intestinal bacterial flora might be associated with neurodevelopment. This study investigated the association between maternal intake of fermented foods during pregnancy and early neurodevelopment in offspring. Methods and Study Design: Data were analyzed for 73,522 pregnant women participating in the Japan Environment and Children’s Study. Their intake of four common fermented foods during pregnancy was assessed using a semi-quantitative FFQ. Neurodevelopment in their infants at 1 year of age was estimated using the Ages and Stages Questionnaires. Results: Multivariable logistic regression analysis showed that maternal intake of miso soup and fermented soybeans was each associated with a significantly reduced risk of delay in infant communication skills. Maternal intake of fermented soybeans and cheese was each associated with a significantly reduced risk of delay in fine motor skills in the third and fourth quartiles. For problem-solving, preventive associations were observed with maternal intake of fermented soybeans in the second and third quartiles and with maternal intake of cheese in the third and fourth quartiles. Maternal intake of yogurt was associated with a significantly reduced risk of delay in personal-social skills in the third and fourth quartiles, while that of cheese was associated with a reduced risk in the third quartile. No reductions in risk were observed for gross motor skills. Conclusions: Our results suggest that fermented food intake during pregnancy may have beneficial associations with several areas of psychomotor development in children.
Background and Objectives: This study investigated the influence of dietary intake on the relationship between serum uric acid (SUA) levels and the risk of hypertension. Methods and Study Design: Data from the 7th and 8th Korean National Health and Nutrition Examination Survey, a nationally representative survey, were analyzed. A total of 19,140 adults aged 19–64 years were included. Dietary intake was assessed using a 24–hour recall method. SUA levels were measured using a Hitachi Automatic Analyzer 7600–210. Hypertension was defined as a systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or the use of antihypertensive medication. Statistical analyses included generalized linear regression, Cochran–Mantel–Haenszel analysis, and multivariate logistic regression. Results: The highest SUA quartile (Q4) had an odds ratio (OR) of 1.68 (95% CI: 1.41–1.99) for hypertension compared to the lowest quartile (Q1). Additionally, the association between elevated SUA levels and increased hypertension risk was stronger in participants who consumed fewer fruits (OR: 1.79, 95% CI: 1.44–2.21), vegetables (1.80, 1.43–2.25), nuts (1.87, 1.51–2.33), and milk (2.20, 1.73–2.79). The ORs (95 % CI) for the highest SUA quartile on hypertension were 1.68 (1.39–2.04), 1.35 (1.13–1.62), and 1.89 (1.57–2.27) in those consuming more seafood, meat, and alcohol, respectively. Conclusions: Reduced intake of fruits, vegetables, nuts, and milk, and increased consumption of seafood and alcohol, exacerbates the positive association between SUA levels and the risk of hypertension. These findings suggest dietary modifications as a potential strategy for hypertension prevention and management.
Background and Objectives: Prioritizing key preventive and therapeutic interventions are the one of the actions to accelerate the reduction of anemia. This study aimed to examine interventions intended for preventing anemia. Methods and Study Design: The systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library. Analysis of publication bias was done using The Joanna-Briggs Institute critical appraisal tool. Data collected from articles included author, year of publication, setting and location of the study, study type, participant of the study, intervention and control given, main outcome, main findings, and risk of bias. Results: Three nutrition-specific interventions aimed at preventing iron deficiency anemia in low- and middle-income countries utilized diverse types and dosages of iron. While most studies showed success, some indicated a worsening trend in anemia, even with standard dosages and the same form of iron. Determining effective interventions requires consideration of factors such as other micronutrient composition, compliance rate, availability of educational intervention, and dietary backgrounds in those countries. Conclusions: Supplementation, fortification, and food-based interventions generally result in higher hemoglobin levels and lower prevalence of anemia. It is important to consider several factors before deciding on an approach.
Background and Objectives: This study aimed to examine whether eating alone, folate intake, and n-3 PUFA intake are independently associated with psychological distress in older adults. Methods and Study Design: We analyzed cross-sectional data from 1011 study participants aged ≥65 years in Japan. We assessed psychological distress using the Kessler 6 scale, whether the participants ate alone or with others, and folate and n-3 PUFA intake using a short food frequency questionnaire. Results: Of 1011 study participants, 465 (46.0%) were male and the mean (SD) age was 71.6 (4.8) years. In a multivariable logistic regression analysis, the odds ratio (OR) for psychological distress in participants eating alone compared to those eating with others was 1.32 (95% confidence interval [CI], 0.76–2.31). The ORs in the second and third tertiles compared to the first tertile, which had the lowest folate intake, were 0.92 (95% CI, 0.62–1.37) and 1.12 (95% CI, 0.73–1.73), respectively. The ORs in the second and third tertiles compared to the first tertile, which had the lowest n-3 PUFA intake, were 0.83 (95% CI, 0.56–1.24) and 0.95 (95% CI, 0.62–1.45), respectively. In an additional analysis, the OR in those eating alone combined with the first tertile of n-3 PUFA intake compared to those eating with others combined with the third tertile was 2.18 (95%CI, 1.05–4.55). Conclusions: Eating alone, folate intake, and n-3 PUFA intake were not independently associated with psychological distress in older adults, although eating alone combined with low n-3 PUFA intake was associated with psychological distress.
Background and Objectives: This cross-sectional study aimed to examine associations between diet quality scores and adverse cardiometabolic status in young Japanese women. Methods and Study Design: In total, 1084 female dietetics students aged 18–22 years completed a validated self-administered diet history questionnaire. Diet quality was assessed using the Diet Quality Score for Japanese (DQSJ), Healthy Eating Index-2015 (HEI-2015), Alternate Healthy Eating Index-2010 (AHEI-2010), Alternate Mediterranean Diet score (AMED), Dietary Approaches to Stop Hypertension score (DASH), and Japanese Food Guide Spinning Top score (JFGST). Adverse cardiometabolic status was defined as the highest quartile of the sum of z scores for waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol (multiplied by –1), triacylglycerol, glucose, and insulin. Results: After adjustment for potential confounding factors, adverse cardiometabolic status was significantly associated with all the diet quality scores except for AMED, with adjusted odds ratios (95% confidence interval) in the highest quartile compared with the lowest of 0.39 (0.25–0.61) for DQSJ, 0.40 (0.26–0.61) for DASH, 0.44 (0.30–0.66) for AHEI-2010, 0.59 (0.39–0.88) for HEI-2015, 0.67 (0.45–0.99) for JFGST, and 0.80 (0.54–1.18) for AMED. Associations with each of the cardiometabolic risk factors were most prominent for AHEI-2010 (significant associations with all factors except triacylglycerol), followed by DQSJ (significant associations with all factors except triacylglycerol and glucose). Conclusions: This cross-sectional study of young Japanese women showed associations between several diet quality scores and cardiometabolic status. These should be confirmed in other populations, prospectively where possible.
Background and Objectives: Postprandial hyperglycemia is a risk factor not only for diabetes mellitus, but also arteriosclerosis. Therefore, controlling the rapid postprandial increase in blood glucose levels is necessary. This study aimed to develop a mulberry leaf and water chestnut husk tea and investigate its effect on postprandial blood glucose levels. Methods and Study Design: We measured the polyphenols and 1-deoxynojirimycin contents as well as antioxidant activity of mulberry leaf and water chestnut husk tea in an in vitro experiment. The effect of the tea on postprandial blood glucose levels in 30 participants with borderline diabetes was investigated in a randomized, double-blind, placebo-controlled crossover comparison study. Results: The 1-deoxynojirimycin and total polyphenol contents in the tea (test food, 3g) were 10.2±0.8 and 61.3±1.4 mg, respectively. The test food showed higher antioxidant activity than the placebo food. Compared with those in the placebo group, blood glucose levels in the test group significantly decreased 30 and 60 min after eating rice. Additionally, insulin was significantly lower at all time points (30, 60, 90, and 120 min after rice consumption). Conclusions: The mulberry leaves and water chestnut mix tea may be an effective beverage to reduce insulin secretion and prevent rapid increases in blood glucose levels in patients with borderline diabetes.
Background and Objectives: Nutrient Reference Values play an important role in nutrition labeling and nutrition and health claims based on scientific data. This study, with a global perspective, reviewed recent trends in Nutrient Reference Values for adults and their establishment for infants and toddlers. Methods and Study Design: We searched for laws and regulations on official government websites for nutrition labeling in the United States, Canada, Australia, New Zealand, China, South Korea, Japan, the Codex Committee, and the European Union. Results: Nutrient Reference Value revisions have been made in the United States, Canada, and South Korea. In the United States and Canada, Nutrient Reference Values for most nutrients, including macronutrients, vitamins, and minerals, were revised in 2016, reflecting updated Dietary Reference Intakes and new scientific findings. Nutrient Reference Values for infants and toddlers have already been formulated in the United States, Canada, Australia, New Zealand, and South Korea and are used for nutrition labeling. However, concerns have been raised regarding the labeling of all foods with Nutrient Reference Values for infants and toddlers, which may result in challenges in distinguishing foods formulated under different standards as appropriate for infants and toddlers. Conclusions: This study highlights recent general Nutrient Reference Value revisions and formulation status for infants and toddlers. This provides useful information for determining the basis for future updates and the development of Nutrient Reference Values in various countries.
Nutrition science has been represented as biomedical, environmental, societal and economic field, but quantum biology is sidestepped, thereby obscuring cognate problems and solutions. We are generally nourished for health, optimal well-being, longevity and personal security through sustainable livelihoods. Our nourishments include not only food and energy but also light from the sun, the firmament and the earth itself, along with information transmitted in subatomic particles and electromagnetic wave forms. We propose ‘quantum nutrition’ as an approach to reconcile quantum phenomena with nutritional biology. Appreciating quantum nutrition and recognizing its potential applications will provide opportunities for future health and well-being and for planetary habitability.
Background and Objectives: The proportion of noodles in the Korean diet is increasing, but the effect of noodle intake on metabolic syndrome has not been sufficiently investigated. Therefore, we investigated noodle consumption and its relation to metabolic syndrome in Korean adults. Methods and Study Design: This study was conducted on 10,505 adults using the combined data of the 2012–2016 Korea National Health and Nutrition Examination Survey (KNHANES). Noodle intake was evaluated with a food frequency questionnaire (FFQ) based on 112 food items. To compute odds ratios (ORs) and their 95% confidence intervals (CIs) controlled for confounders, multivariable logistic regression models were used. Results: Compared to people in the lowest levels of noodle intake, the OR of the metabolic syndrome of those in the highest levels was 1.48 (95% CI, 1.16-1.90; p-trend = 0.002). This positive association was also found for hypertriglyceridemia and abdominal obesity, which were metabolic syndrome components. Specifically, the odds of having hypertriglyceridemia were 38% (OR, 1.38; 95% CI, 1.14-1.66; p-trend < 0.001) higher for people with high noodle consumption compared to those with low noodle consumption in the overall population. The tendency for people who consume a lot of noodles to have raised odds of metabolic syndrome was observed when analyzed by the type of noodles. Conclusions: This study suggested noodle intake was positively related to metabolic syndrome and its components in Korean adults. Further clinical trials and prospective cohort studies are required to identify a causal relationship between noodle intake and metabolic syndrome in Koreans.
Background and Objectives: Consuming a diet that ensures adequate nutrient intake is essential to address all forms of malnutrition. In Japan, a meal combining staple food, main dish, and side dish is considered a balanced diet. This study was conducted to investigate the frequency of meals combining staple food, main dish, and side dish associated with nutrient adequacy. Methods and Study Design: This cross-sectional study included 6,264 adults. All data were obtained from the 2015 Health and Nutrition Survey in Shiga prefecture. Staple food, main dish, and side dish were each defined as a dish with primary ingredients of ≥50 g. Regarding the frequency, participants were divided into ≥2 and <2 times/d groups. The nutrient adequacy evaluated using the Dietary Reference Intakes for Japanese 2020 (DRIs–J) score is based on the reference values provided in the DRIs–J. The t-test was used to evaluate nutrient adequacy between the 2 groups. Results: Of the total participants, only 1,423 (22.7%) were classified into the ≥2 times/d group, and they had significantly higher DRIs–J scores than participants in the <2 times/d group (p < 0.001). The adequacy percentage of all nutrients except saturated fatty acid, particularly dietary fiber and most micronutrients, was >1.5-fold higher in the ≥2 times/d group than in the <2 times/d group (p < 0.001). Conclusions: This study provides important information that meals combining staple food, main dish, and side dish at least twice a day is effective in maintaining a diet with high nutrient adequacy.
Background and Objectives: To explore the nutritional challenges and its influencing factors of adults aged 40-69 living in Chinese cities. Methods and Study Design: This cross-sectional study involved 300 subjects from 29 cities in China. Questionnaires were used to collect demographic information, presence of chronic disease, and the use of nutritional supplements and fortified foods. 24-hour food intake was recorded using the Eat-Right Assistant, a validated digital service. Results: Fiber (56.7%), calcium (66.3%) and selenium (67.0%) were the nutrients with the highest insufficient intake. The foods with the highest inadequate consumption were dairy products (91%), fruits (84.3%), tubers (76.3%), soybeans and nuts (70%), and whole grains (65%). Even though 95.7% of the study population showed medium-high level of dietary diversity, dietary imbalance was present among 99% of the subjects. Higher socioeconomic status, passive health awareness, or the use of nutritional supplements or fortified foods, showed positive influence on nutrient intake and dietary quality. Conclusions: This research provided insights into the dietary intake status and its influencing factors of 300 urban residents aged 40-69. The adult population still face a challenge of inadequate nutrient intake and imbalanced diet. In addition, this study supported the feasibility of using a digital service in research. Further studies with a larger sample size are needed to confirm current findings. This will help to clarify the unmet nutritional needs of adults in China and thus help to achieve healthy aging.
Cow’s milk protein allergy is an adverse immune reaction to proteins found in cow’s milk, primarily casein and whey, affecting artificially fed, breastfed and mixed-fed infants. The immunological mechanisms involved lead to diverse clinical presentations, most commonly impacting the digestive and respiratory systems, as well as the skin. Diagnosis relies primarily on clinical evaluation due to the absence of specific diagnostic tests, making accurate identification crucial to prevent misdiagnosis or underdiagnosis. Treatment requires strict avoidance of cow’s milk proteins in both children’s and breastfeeding mothers’ diets, with close monitoring of nutritional status during long-term management. Recent advancements in treatment, including the use of probiotics, provide new options for improving clinical outcomes. This narrative review aims to provide clinicians with evidence to standardise diagnosis and treatment, improve food allergy management by non-allergy specialists and develop accurate feeding recommendations.
Erratum for Bellisle F. Experimental studies of food choice and palatability responses in European subjects exposed to the Umami taste. Asia Pac J Clin Nutr 2008;17(S1):376-379.
The name of the author – France Bellisle – was reversed as Bellisle France. In the list of authors, the surname should have been Bellisle and have appeared as France Bellisle in the text and Bellisle F in MedLine.
The online version of this article has been corrected. We regret the error.
Background and Objectives: Patients with gastrointestinal (GI) malignancies are at high risk for malnutrition because of reduced food intake, poor digestion, and altered absorption. Methods and Study Design: In a retrospective review of medical records for patients admitted to urban hospitals in an Asian nation for GI tumor surgery (gastric, colon, or anorectal cancers), we found that malnutrition was common yet often overlooked. Our review identified records for 349 adult GI-tumor surgery patients. The Nutrition Risk Screening-2002 (NRS-2002) was the most frequently used screening instrument. In further review, we compared outcomes for malnourished GI tumor surgery patients given daily oral nutritional supplements (ONS) to outcomes for patients who were not given ONS. Results: Review of results revealed that only 20% of patients in our sample underwent nutritional screening or assessment on admission. Of those who did, nearly 60% were malnourished. Although due to small sample sizes, no statistically significant differences were observed, malnourished patients who received ONS had fewer complications and shorter lengths of stay by 1-day. Such findings reveal many missed opportunities to improve patient outcomes and to avert excess healthcare costs for treatment of complications, slowed recovery, longer hospital stays, and readmissions. Conclusions: Based on our findings, nutritional training for professionals is necessary to address the serious problems of under-recognition and inadequate treatment of malnutrition in hospitalized patients.
Creationists and evolutionists acknowledge that the human diet has passed through at least four phases. The original plant food-based diet; a second phase of increasing meat consumption; a third phase of agricultural dependence on starchy foods; and, finally, the supermarket high-saturated fat, low-fibre phase with minimal energy expenditure. Our aim is to define the value of the original or 'Garden of Eden' diet and to speculate on which components should be retained in the modern supermarket diet. The original plant-based diet would have been high in vegetable proteins, plant sterols, dietary fibre and antioxidants, and low in saturated fats with no trans fatty acids. This diet would increase fecal cholesterol losses from the body as bile acids and neutral sterols, while providing little stimulus to cholesterol synthesis. To replace the bile acid losses we would have adapted to a relatively high capacity for cholesterol synthesis. Now, in the high-saturated fat, low-fibre supermarket age, this may be a disadvantage and predisposes consumers to high serum cholesterol and increased risk of cardiovascular disease. We believe part of the solution is a return to the plant-based 'Garden of Eden' diet combined with physical activity. A lipid-lowering portfolio containing vegetable proteins, especially soy, plant sterols and high fibre intakes combined with low saturated and trans fatty acids and cholesterol, would go a long way to reducing serum lipids and coronary heart disease risk seen in the modern Western diet.
The contributors to and consequences of disordered health are increasingly complex with sociodemographic, eco- logical, economic and food system change. But there are opportunities for any adversity to be mitigated by ad- vances in the understanding of human, especially nutritional, ecobiology and in its more accessible and affordable evaluation and monitoring. Viral pandemics are on the rise with climate change and loss of ecosystems. They threaten human civilisation and planetary habitability. Human security is dependent on sustainable livelihoods of which food and water systems are a vital part. We are socioecological beings and depend for our health on biodi- versity and the food diversity that ensures; and on connectedness and communication, made more difficult in pandemics. Rapid and accessible point-of-care (POC) tools are now becoming available to compliment other self- monitoring network approaches, whether checklist or questionnaire, physical, chemical, or biological, for healthcare and nutritional health. They can provide information as several complimentary and interdependent health indices to facilitate personal, group and community action and management plans. This applies to indices of both communicable and non-communicable disease which problems separately and together are compromising health prospects. These indices include ones of physical and mental activities, dietary patterns, metabolites, blood pressure and now the presence and severity of viruses like Covid-19.Of imminent relevance and promise are opti- cally-readable biosensor based strips for nasal, pharyngeal or salivary samples to check viral presence or finger prick blood for immunoglobulins and interleukins. These should allow less socially prohibitive measures to curb viral transmission and promote personal and societal wellbeing.
Benchmarking has been adopted by educational institutions as a potentially sensitive tool for improving learning and teaching. To date there has been limited application of benchmarking methodology in the Discipline of Nutritional Science. The aim of this survey was to define core elements and outstanding practice in Nutritional Science through collaborative benchmarking. Questionnaires that aimed to establish proposed core elements for Nutritional Science, and inquired about definitions of "good" and "outstanding" practice were posted to named representatives at eight Australian universities. Seven respondents identified core elements that included knowledge of nutrient metabolism and requirement, food production and processing, modern biomedical techniques that could be applied to understanding nutrition, and social and environmental issues as related to Nutritional Science. Four of the eight institutions who agreed to participate in the present survey identified the integration of teaching with research as an indicator of outstanding practice. Nutritional Science is a rapidly evolving discipline. Further and more comprehensive surveys are required to consolidate and update the definition of the discipline, and to identify the optimal way of teaching it. Global ideas and specific regional requirements also need to be considered.
Nutrition was invented in the early 19th century as a biochemical science that reduces foods into significant chemical constituents. Ever since then, the teaching and practice of nutrition has been based on this conceptual framework, or paradigm. The examples given here are dietary guidelines and other food guides. The first guides issued up to the middle of the last century were designed to help prevent nutrient deficiencies, promote growth, and ensure plentiful diets. These recommended foods then thought to contain adequate proteins, fats, carbohydrates, vitamins, minerals and trace elements, as well as dietary energy. At a time of accelerating industrial production of food, they were generally effective. Within the second half of the century, guides were developed and changed to counter the rapid rise in heart disease in the USA, the UK, and other high-income countries. These recommended less foods of all types high in fat, saturated fat, cholesterol and sodium, more ‘complex carbohydrates’, and fruit and vegetables rich in microconstituents. They probably had some limited effect. In this century and now, dominant guides have been changed again in attempts to counter what has become pandemic obesity and diabetes. These recommend less food high in saturated fat, sugar and sodium, with less emphasis on total fat and more on sugar. They are not effective. All these guides are derived from and governed by the biochemical paradigm of nutrition science. This was once useful, but now should be discarded as obsolete except for addressing deficiencies. Here, a new paradigm is proposed.
In order to sustain life during the occurrence of a natural disaster, it is vital to ensure that people’s intake of water and food is adequate (prioritizing first energy, then protein and water-soluble vitamins). Infants, pregnant women, patients, and the elderly are particularly vulnerable to insufficiencies in food intake, even if they are provided with the same quantity of food as others, and providing them with dietary and nutritional support becomes a high priority as their insufficient intake of energy and protein becomes long term. It is necessary to have a system in place for identifying those who are vulnerable and in need of support and providing them with the items (food) and nutritional care that they require. Eating is equivalent to living, and if the vulnerable themselves recognize the importance of food and nutrition, this will help improve the nutritional situation of the entire population. It is recommended that measures be taken in non-emergency periods such as stockpiling food for special dietary uses.
Hee Young Paik, ScD is a Professor in the Department of Food and Nutrition, College of Human Ecology, at the Seoul National University in Seoul, Korea. Dr Paik was born on September 30, 1950 in Seoul, Korea. She received the BS in food and nutrition from Mississippi University for Women in Columbus, Mississippi, the MS in food science from the University of California at Berkeley, and her ScD in nutrition from the Harvard School of Public Health in Boston, Massachusetts, U.S.A. Dr Paik’s research interests have focused on dietary intake and the health and development of the Korean population. She developed computer software programs and questionnaires in the 1980s, which were utilized in large-scale surveys in Korea, including the first community-based health and nutrition survey which took place from 1993-1995. She continues to collect and analyze dietary data to understand the dietary and nutritional status of Koreans and related trends in Korea. Dr Paik also has a strong interest in the effects of long-term diet on bioavailability and metabolism of nutrients. She has investigated the effects of soy protein, phytate, high salt, and isoflavone—all of which are specific to the traditional Korean diet—on protein and mineral metabolism. She recently expanded her research interests, with studies of the dietary intake and nutritional status of Korean descendants living in China and the U.S., and in the cultural as well as health implications of changing dietary patterns which occur due to acculturation. Dr Paik was the President of the Korean Nutrition Society in 2005, and the Chair of the Committee for Dietary Reference Intakes of Koreans, 2002-2005, Chair of the Dietary Guidelines Committee in 2007 and 2009. She has served as President of the Korean Home Economics Association in 2003, and on various organizing committees of international meetings in nutrition and home economics held in Korea. She has also served on the editorial boards of the Korean Journal of Nutrition and the Korean Journal of Home Economics, and is currently on the editorial boards of Nutrition Today, Asia Pacific Journal of Clinical Nutrition and Annals of Nutrition and Metabolism. Dr Paik is a four-time recipient of the Excellence in Research award granted by the Korean Nutrition Society, and received the Outstanding Research Award of the Korea Federation of Science and Technology Association in April, 2005. She was selected for the Humboldt Fellowship from 1990-1991 to visit the Institute of Social Medicine at the Free University of Berlin in Germany. She was among the Twenty Leaders of Science in Korea in 2005 and received the National Medal for Promotion of Science and Technology by Ministry of Science, Korea in 2008. Dr Paik was selected to be a member of the National Academy of Medicine of Korea in 2009. She currently serves as a Councillor of the International Union of Nutritional Sciences and plays a major role in nutrition leadership training in the Asia Pacific Region.
The Asia Pacific Clinical Nutrition Society makes an annual Award to persons who have made exceptional contributions to the health, wellbeing and nutritional status of peoples in the Asia Pacific region. In 2009, Professor Hee Young Paik joins an illustrious line of Awardees since the first recipient in 1993, Profesor Tu Giay of Vietnam.
Citation By
Mark L Wahlqvist Editor-in-Chief APJCN
The present research investigated the enrichment of fenugreek (Trigonella foenum graceum) seed substrate with phenolic antioxidants and L-DOPA via fungal-based solid-state bioconversion (SSB) system. This approach us- ing food grade fungus Rhizopus oligosporus, was chosen because it has been demonstrated to be effective in other seed and food substrates for improving health-relevant functionality and has long history of use for food processing in Asia. The protein content and β-glucosidase activity of the substrate which reflects fungal growth, increased with incubation time in conjunction with enhanced phenolic content and also suggested its possible in- volvement in phenolic mobilization. The antioxidant activity assayed by β-carotene bleaching and DPPH free radical scavenging methods both indicated high activity during early growth stage (days 4-6) followed by re- duced activity during later growth stage (days 8-20). A direct association between higher phenolic contents dur- ing early growth stage (days 4-6) and antioxidant activity suggested a link to mobilization of polymeric and hy- drophobic phenolic forms. The L-DOPA content of the fenugreek extract fluctuated during the course of biocon- version with higher levels during days 6-10 (1.5-1.7 mg/g DW). The SSB process substantially improved the in vitro porcine α-amylase inhibition activity by 75 % on day 4 which correlated to higher levels of total phenolics and related antioxidant activity of the extracts. The high α-amylase inhibitory activity also coincided with high L-DOPA content on day 6. These results have implications for diet-based diabetes management. The same bio- conversion stage had Helicobacter pylori inhibitory activity, which has implications for ulcer management.
Background and Objectives: In Indonesia, stunting is one of the most public health concerns. This study aims to systematically review and meta-analyze childhood stunting risk factors in the country. Methods and Study Design: We did a systematic review and meta-analysis of observational (cross-sectional and longitudinal) studies on stunting risk factors published between 2010 and 2021 based on available publications in online databases of PubMed, ProQuest, EBSCO, and google scholar. The quality of the publications was evaluated using the Newcastle-Ottawa Quality Assessment Scale and organized according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Publication bias was examined using Egger’s and Begg’s tests. Results: A total of 17 studies from the literature search satisfied the inclusion criteria, with 642,596 subjects. The pooled stunting prevalence was 30.9% (95% CI 25.0%-36.8%). Children born with low birth weight (POR 2.39, 2.07–2.76), female (POR 1.05, 1.03-1.08), and did not get the deworming program (1.10, 1.07-1.12) are the primary child characteristics that contributed to stunting. Meanwhile, maternal age ≥ 30 years (POR 2.33, 2.23-2.44), preterm birth (POR 2.12, 2.15-2.19), and antenatal care < 4 times (POR 1.25, 1.11-1.41) were among mother characteristics consistently associated with stunting. The primary household and community risk factors for stunting were food insecurity (POR 2.00, 1.37-2.92), unimproved drinking water (POR 1.42, 1.26-1.60), rural residence (POR 1.31, 1.20-1.42), and unimproved sanitation (POR 1.27, 1.12-1.44). Conclusions: A diverse range of risk factors associated with childhood stunting in Indonesia demonstrates the need to emphasize nutrition programs by scaling up to more on these determinants.
Background and Objectives: As breast milk is considered nature’s best food for infant growth and development, understanding its nutritional composition is crucial for optimising the components of infant formula milk. In this study, we aimed to summarise the available evidence on the nutritional composition of breast milk from Chinese women, in particular, the macronutrients, fatty acids and minerals. Methods and Study Design: We searched PubMed, Embase, and Chinese databases for articles about human breast milk from Chinese women published in English or Chinese between 1999 and 2015. We classified the data in 35 articles from the literature search into three lactation stages: colostral, transitional and mature milk. Results: The content of each component varied greatly during the three lactation stages. Protein content decreased from colostral milk to mature milk (mean±SD, 1.64±0.32 g/dL vs 1.22±0.12 g/dL). In contrast, lipid content increased from colostral milk (2.36±1.17 g/dL) to mature milk (3.39±1.24 g/dL). Colostrum contained more linoleic acid (LA) than transitional and mature milk, while colostrum contained less α-linolenic acid (ALA) than transitional and mature milk. As lactation progressed, the ratios of docosahexaenoic acid (DHA) and arachidonic acid (AA) to total fatty acids decreased while the po- tassium (K), zinc (Zn), and copper (Cu) concentrations decreased significantly, but their standard deviations were large. Magnesium (Mg) and manganese (Mn) concentrations showed significant differences across the three lac- tation stages. Conclusions: The stage of lactation was an important factor affecting the nutritional composition of breast milk from Chinese women.
Childhood obesity, a significant global public health problem, affects an increasing number of low- and middle- income countries, including in Asia. The obesity epidemic has been fuelled by the rapid nutrition and physical ac- tivity transition with the availability of more energy-dense nutrient-poor foods and lifestyles of many children dominated by physical inactivity. During the growing years the pace and quality of grow this best quantified by a combination of anthropometric and body composition measures. However, where normative data are available, this has typically been collected on Caucasian children. To better define and characterise overweight and obesity in Asian children, and to monitor nutrition and physical activity interventions, there is a need to increase the use of standardized anthropometric and body composition methodologies. The current paper reports on initiatives fa- cilitated by the International Atomic Energy Agency (IAEA) and outlines future research needs for the prevention and management of childhood obesity in Asia.
Indonesia, as a major population in the Asia Pacific region, threatened with food and health insecurity through climate change and rapid economic development, faces the challenge to build capacity among its science-based food and health professionals and institutions. The nutrition research agenda is now being more actively set with- in the region, rather than by external imposition. A series of papers emanating from a new generation of public health and clinical nutrition scientists is reported in this issue of APJCN. It draws attention to the importance of food patterns and background culture as contributors to the failure of the nutrient rather than a food, food system and socio-ecological approach to solve the region’s intransigent nutritionally-related health problems. New un- derstandings of human eco-social biology are providing opportunities to accelerate the resolution of these prob- lems. The challenge is to transform the food-health construct from one which is not sufficiently concerned about the precarious state of ecologically dysfunctional health and its nutrient market drivers to one which strives for more sustainable and affordable solutions. The present reports address a range of options to these ends.
Soyfoods have long been a part of traditional Asian diets; they provide plentiful amounts of high-quality protein and have a favourable fatty acid profile. In addition, provocative research suggests soyfoods offer health benefits independent of the nutrients they provide. However, there is a widely-held belief among Asian health profes- sionals and the public that soyfoods increase risk of gout and potentially precipitate acute attacks in patients with this disease. To examine the veracity of this belief, this review critically evaluated the relevant clinical and epi- demiologic data. In addition, background information on the etiology and prevalence of hyperuricemia and gout in Asia is provided along with the results of a small survey of Asian healthcare professionals about their attitudes toward soyfoods. Among the healthcare professionals who responded to the survey, 95% considered soyfoods to be somewhat or very healthy and nutritious. In contrast, 48% expressed the view that soyfoods are likely to cause gout. However, none of the six epidemiologic studies identified provided any evidence that soy intake was associated with circulating uric acid levels, hyperuricemia or gout. Data from the five human intervention studies evaluated indicate soy protein does elevate serum uric levels, but in response to amounts comparable to Asian in- take, the expected rise would almost certainly be clinically irrelevant. Although there is a need for long-term re- search, on the basis of the existing data there is no reason for individuals with gout or at risk of developing gout to avoid soyfoods.
Pandemics have shaped humanity over and over again, but the coronavirus outbreak of 2019-2020 is in a world at the tipping point of catastrophic climate change. Its origins and distinction derive from over-population with in- equity and an industrial revolution since the 17th century which has exploited fossil fuels as a globalised energy source, a period now described as the anthropocene. Asymptotic ecosystem loss and dysfunction, for people whose being is socioecological, makes ultimate survival tenuous. Microbial forms of life jump species when habitats are destroyed, or their host misused. Our innate immunity depends on our general health and fitness- so- cial, mental, physical, and nutritional, in step with nature and its rhythms through walking in it, enjoying sunlight and sleep. Biodiversity and the associated benefit of food variety, after being breast-fed, is the key descriptor of a healthful, sustainable, accessible, and acceptable way of eating. How this pattern might contribute to our resili- ence in the face of a highly transmissible and biologically evasive virus is becoming clear. It may also be possible to compliment usefully preventive vaccination and therapeutic healthcare and rehabilitation through a greater un- derstanding of our nutritional biology.
Anemia in Indonesia has been of concerning persistence in all age groups for some 75 years since independence.
The relationships between anemia and nutrition are complex being evident with compromised general health and
nutrition. Increased micronutrient intakes, especially iron and folic acid, has alleviated the problem, but encouraged
nutrient-specific micronutrient interventions as attractive policy directions as if anemia were a stand-alone
disease irrespective of associated disorder. Concerted action to deal with the fundamental causality has been
missing. Much of the pathogenetic pathway may be nutritional, but its multifactoriality is ultimately socioecological.
Given the intransigence and progression of societal and ecosystem dysfunction, it can be expected that failure
to recognize their causal importance will further entrench endemic anemia. This review deliberates the practical
measures taken to recognize anemia by symptomatology, food and nutrition surveys, screening (fingerpick
blood), nutrition assessment, and blood loss (menstrual and faecal). It identifies vulnerable groups including
premenopausal and pregnant women, children and adolescents, unwell adults, and the dependent aged. Risk settings
include food insecurity, infectious disease, non-communicable disease, inheritance and epigenetics, and socioeconomic
disadvantage. Underlying socio-ecological problems are livelihood, food systems, cultural habits,
belief systems, and social networks and activities. With this framework, policy directions could deal more comprehensively
and effectively with the socioecological complexity which underpins and limits progress towards
anemia eradication at a time of intense global food and health insecurity. It will require co-operative intersectoral
and eco-nutritional approaches which take into account the need for universal, sustainable livelihoods.
Recommendations have been made accordingly.
The importance of micronutrient deficiencies to child survival and to the health and development of nations is universally recognized. Over two billion people, or more than one in three individuals, are at risk of iron, vitamin A and iodine deficiencies. More than 13 million people suffer night blindness or total blindness due to vitamin A deficiency; severe iron deficiency accounts for one in five maternal deaths and one-third of all young children are anaemic; iodine deficiency affects 50 million children and is the greatest single preventable cause of intellectual impairment, as well as a major cause of lost potential and productivity. The World Summit for Children acknowledged that the elimination of the various forms of micronutrient malnutrition would constitute a significant contribution to social, economic and public health development. At the FAO/WHO International Conference on Nutrition held in Rome in 1992, the governments and the non-Governmental Organizations from virtually all nations, together with the international development community, made the elimination of iodine deficiency disorders and vitamin A deficiency important goals to be achieved by the end of the decade, along with a substantial reduction in the levels of iron deficiency anaemia. The United States Agency for International Development established the Opportunities for Micronutrient Interventions in 1993 to help countries achieve these goals by institutionalizing micronutrient activities into other sectoral policies, projects and strategies internationally. An important factor in the recent perceived higher priority for multisectoral micronutrient interventions is the cost-effectiveness of such interventions. The World Bank estimates that a deficiency of vitamin A, iron and iodine could waste up to 5% of the gross domestic product (GDP) of a country, while addressing them effectively would cost only 0.3% of GDP. The three main complementary approaches to controlling and preventing micronutrient malnutrition include food-based strategies such as fortification and diet-based approaches including gardening; supplementation; and related public health interventions.
Background and Objectives: The present review examined the best available evidence regarding consumption levels and sources of added sugar in different population groups in Thailand. Methods and Study Design: In- formation was extracted from food balance sheets, household expenditure surveys, food consumption surveys, government reports, published and unpublished studies. Results: A total of 24 references were obtained, compris- ing 8 nationally representative reports and 16 individual studies. Results were inconsistent. The National Statis- tical Office reported an available supply of 83 g sugar per capita per day in 2010. The 2009 Food Consumption Survey of Thai Population showed median intake of sugar and sweeteners for all age groups ranging from 2.0 to 20.0 g per day among males and from 2.0 to 15.7 g per day among females (below the Thai recommendation of 40 to 55 g/day). Studies on children suggested intake levels between 25 to 50 g/day, while studies on adults were inconsistent. Frequently consumed sources were table sugar, sweetened beverages, and sweet snacks (traditional desserts, baked products, crispy snacks). Conclusions: Insufficient evidence exists regarding intake levels and sources of added sugar in Thailand. Limitations were the use of food frequency questionnaires or a single 24-h recall to assess intake, and outdated studies with small sample sizes. An updated nationally representative survey using improved methods is needed to determine the levels and sources of sugar intake in different population groups. These include biomarkers to establish levels of consumption and multiple 24-h recalls (at least two) to identify food sources that contribute significantly to excess sugar intake.
It has been estimated that over 700 million people still do not have enough food to eat on a daily basis and that more than 2 billion are subsisting on diets that lack the essential vitamins and minerals required for normal growth and development and to prevent premature death and disabilites such as blindness and mental retardation. At the same time, millions more suffer from chronic diseases caused by excessive and unbalanced diets. At the International Conference on Nutrition (ICN), held in Rome in 1992 and sponsored by the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) of the United Nations system, 159 nations endorsed a World Declaration that included recognition of the need for national plans of action for nutrition/national food and nutrition policies. Specific objectives that the delegates agreed should be achieved were a reinforcement of earlier goals agreed to at the World Summit for Children 1990. Political will is an essential prerequisite for successful national food and nutrition policies and plans. These must also be realistic, well-conceived and effective at all levels, especially where devolution is taking place. Over the last two decades there has been an evolution in the issues that policies address, as well as changes in the expectations of them. Virtually all countries have agreed to 'establish appropriate national mechanisms to prioritize, develop, implement and monitor policies and plans to improve nutrition within designated time-frames, based on national and local needs, and to provide appropriate funds for their functioning'. Worldwide, over 120 member states of the United Nations (UN) have finalized, strengthened or have under way, national plans of action for nutrition. The policy decisions being made in order to implement more of these plans over the remainder of the decade and beyond, are already providing invaluable experience and data. Evaluation should provide even more in the future.
There is benefit, risk and cost in all that we do, but when it comes to food, we expect that it will benefit our health, be available, safe to eat and affordable. But as climate change and demographic shifts through displacement and ageing gather momentum, the emphases on each of benefit, risk and cost will alter. That we are ecological beings whose health and wellbeing are ecosystem-dependent, must now be the underpinning framework for risk man- agement. Loss of natural environment and biodiversity represents reduced nutritional and health resilience, which will need to be factored in to risk assessment and management with climate change. This is proving a problematic risk communication challenge. Previously desirable food and food pattern recommendations will be tempered by substantial sustainability, availability, safety, affordability, equity and ethical considerations. Future workforces will need to ensure basic livelihoods (food, water, shelter, clothing, healthcare, education, communication, essen- tial transport, resource management and effective governance) and with risk minimisation. Cost appraisal will have less to do with monetisation and more to do with resource management in accordance with equity and ethi- cal principles. Communities could adopt Liveability Units (LU) for traceability and community-based transac- tions, as a currency for a more sustainable future, encouraging and enabling food and health system viability. Open source food and health systems, supported by LU matrix (bar code or QR) scanning with smartphones could be widely available for individual, household and community benefit, risk and cost management. The risk is remoteness from food’s origins and megadata commercialisation.
The achievement of nutrition security at the household level involves adequacy of food supply at the national level and equitable distribution of food among the population in accordance with their physiological needs. The emergence of globalization and market liberalization and the increasing power of some transnational corporations that are advocating pharmaceutical shortcuts have raised concerns in many developing countries. In order to achieve adequacy of food production, earlier mistakes (such as a reliance on unsustainable new technologies) need to be corrected and the resultant imbalances with respect to food production need to be reversed. Emerging new technologies, including genetic modifications, need to be effectively harnessed and adapted with due consideration to safety and sustainability. There is a need to collect convincing evidence of the efficacy and safety of genetically modified foods before they can gain general public acceptance. Information technology will play an important role in future programmes of food production and developing countries must strive to achieve access to this technology. There is considerable scope and need for the expansion of agro-based industries in villages and townships. This could create job opportunities and could also lead to better production and more effective utilization of local food resources by the community and reduce the present considerable loss of perishable food items. Household nutrition security means more than avoidance of chronic starvation. Policy makers of developing countries should set, as their target in the next century, the achievement of adequate nutrition rather than mere survival.
Effective clinical nutrition practice depends on a sound knowledge of biomedical, societal and environmental sci- ence and the skills to diagnose, prevent and manage the health problems related to food patterns, energy equilib- rium (mostly to do with physical activity) and nutrient metabolism. Its delivery needs to be accessible, equitable, affordable and sustainable. Ordinarily, this will require both local and widely distributed health services. In North-East (NE) Asia, these requisites are being met to an ever increasing extent. The roots of this progress are steeped in cultures which acknowledge the food-health connections and support education which pays regard to these connections. As elsewhere, however, the food and health systems, their safety and security are threatened by exploitative operatives. In China, a concerted effort was made in the mid-1980s to foster clinical nutrition in major hospitals throughout the country by programs directed at medical graduates, nursing and kitchen staff; die- tetics has appeared much more recently. By contrast, Japan has had an extensive and well-trained dietetic work- force for much longer, alongside a vibrant basic nutrition science constituency in its universities and food- nutraceutical industry. South Korea and Taiwan have traversed a similar course to that in Japan. Now, all of these NE Asian economies have gathered rapid momentum in the publication of innovative approaches to public health and clinical nutrition which have the prospect of not only improving health outcomes, but also reducing the socie- tal and financial burden of health care. This is particularly important in rapidly ageing societies, which they are. It is also a growing challenge where climate change threatens to engulf the lives and destinies of hundreds of mil- lions of Asians on account of natural disasters, water and food insecurity.
The inseparability of people from their ecosystem without biological change is increasingly clear. The discrete species concept is becoming more an approximation as the interconnectedness of all things, animate and inani- mate, becomes more apparent. Yet this was evident even to our earliest Homo Sapiens sapiens ancestors as they hunted and gathered from one locality to another and migrated across the globe. During a rather short 150- 200,000 years of ancestral history, we have changed the aeons-old planet and our ecology with dubious sustaina- bility. As we have changed the ecosystems of which we are a part, with their opportunities for shelter, rest, ambu- lation, discourse, food, recreation and their sensory inputs, we have changed our shared biology and our health prospects. The rate of ecosystem change has increased quantitatively and qualitatively and so will that of our health patterns, depending on our resilience and how linear, non-linear or fractal-like the linkage. Our health- associated ecosystem trajectories are uncertain. The interfaces between us and our environment are blurred, but comprise time, biorhythms, prokaryotic organisms, sensory (auditory, visual, tactile, taste and smell), movement, endocrine with various external hormonal inputs through food and contaminants, the reflection of soil and rock composition in the microbes, plants, insects and animals that we eat (our biogeology) and much more. We have sought ways to optimise our health through highly anthropocentric means, which have proven inadequate. Accu- mulated ecosystem change may now overwhelm our health. On these accounts, more integrative approaches and partnerships for health care practice are required.
Dr Junshi Chen was graduated from the Beijing Medical College in 1956 and engaged in nutrition and food safety resea rch for more than 50 years at the Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Preventi on (the former Chinese Academy of Preventive Medicine), Beijing, People Republic of China.
Because of his outstanding research in the selenium and Keshan disease during period 1968-1976, he received the Schwartz International Award in 1984. He has also conducted large epidemiologic studies on diet, nutrition and chronic diseases, in collaboration with Dr T Colin Campbell, Cornell University and Prof Richard Peto, University of Oxford since 1983. From late 1980's, he conducted a series of studies on the protective effects of tea on cancer, including laboratory study and human intervention trials. He is the member of the expert panel who wrote the WCRF/AICR report “Food, Nutrition and the Prevention of Cancer: a Global Perspective” (1997). Recently, he was appointed as the Chair of the Chinese National Expert Committee for Food Safety Risk Assessment and the Vice-Chair of the National Food Safety Standard Reviewing Committee. Internationally, he serves as the chairperson of the Codex Committee on Food Additives (CCFA) , member of the WHO Food Safety Expert Panel and Director of ILSI (International Life Sciences Institute) Focal Point in China.
Dr Chen's research interests focus on nutrition epidemiology as well as food safety surveillance and risk assessment in the following areas:
(1) Relationship between diet, nutrition and non-communicable diseases in different geographical areas and population
groups in China.
(2) Food fortification.
(3) Studies on the protective effect of edible plant (tea, vegetables, fruits, etc.) components on cancer formation with
special emphasis on biomarkers and human intervention trial.
(4) Total Diet Study in China.
His commitment to nutrition scholarship and capacity building in the Asia Pacific region make him a most worthy
recipient of the Asia Pacific Clinical Nutrition Society Award for 2011.
Collecting dietary data in the clinical research setting is labour intensive and can be burdensome for study participants. The aim of this study was to assess the agreement between data obtained from 2 different dietary assessment methods, a 74-item semi-quantitative food frequency questionnaire (FFQ) and 3-day weighed food records (WFR) used to estimate dietary intake over the preceding month. One hundred and fifty nine subjects, aged between 31 and 74 years (53 males, 65 females), enrolled in a clinical trial at the Commonwealth Scientific and Industrial Research Organisation, Division of Health Sciences and Nutrition, (CSIRO HSN) Adelaide, Australia. Group mean intakes and individual mean intakes estimated by the two measures were compared. One hundred and eighteen (91%) three-day WFR and their corresponding FFQ were analysed. Pearson correlation coefficients ranged from 0.22 for cholesterol to 0.78 for alcohol (median 0.41). Mean energy and nutrient intakes were within ± 20% difference. The FFQ gave lower carbohydrate intake estimates, percentage energy from carbohydrate (P <0.001) and dietary fibre (P <0.05) and gave higher percentage energy from saturated fat estimates, poly-unsaturated fatty acids (P <0.001) and mono-unsaturated fatty acids (P <0.05). Subjects were also ranked into quintiles and the quintiles cross-tabulated. The FFQ classified more than two thirds of the subjects within ±1 quintile difference for all nutrients. We conclude that this FFQ can capture similar information as WFR and may be used for estimation of dietary intakes over a relatively short time in clinical intervention trials.
Background and Objectives: Undernutrition remains a significant cause of childhood illness, poor growth, de- velopment, and death in Papua New Guinea (PNG). Studies on child nutritional outcomes in PNG vary by design, measurement protocols and quality. We conducted a systematic review to assess the evidence for the prevalence of child undernutrition across different study populations, geographical locations and time periods. Methods and Study Design: Six electronic databases and additional grey literature were searched for articles describing the nutritional status by wasting, stunting and underweight, of PNG children under five years of age, published be- tween 1990 and April 2015. Prevalence data using different scales of measurement and reference populations were standardized according to WHO protocols. Results: The search yielded 566 articles, of which, 31 studies met the inclusion criteria. The prevalence of child undernutrition varied from 1% to 76% for wasting (median 11%), 5% to 92% for stunting (median 51%), and 14% to 59% for underweight (median 32%). Wide variations exist according to the index used for measurement, the population characteristics and the geographical region in which they live. Prevalence estimates increase significantly when data using different scales of measurement and population references are standardized to the WHO protocols. Conclusions: Child undernutrition in PNG is re- gionally variable due to a complex interplay of poverty, disease, food-security, cultural, environmental and socio- political issues requiring a complex mix of solutions by governments, health systems and local communities. Ar- ea-specific surveys using multiple measures are necessary to inform local solutions for this important problem.
| Asia Pacific Clinical Nutrition Society 1995 AwardPROFESSOR GU JING-FANBy: Dr CS Lo MD PhD JP |
Professor Gu Jing-Fan was born in Wuxi, Jiangsu province, China on November 3, 1927. He is one of the most outstanding nutritionists in China and in the Asia Pacific Area. He has been engaged in scientific research on nutritional requirements, nutritional assessment and nutritional biochemistry and metabolism for more than 40 years. He is Research Professor of Nutrition in the Institute of Hygiene and Environmental Medicine, Tianjin, China and was Director of the Institute. He graduated from Yenching University in 1948 and from Peking Union Medical University in 1952. He was the immediate past President and now is Vice-President of the Chinese Nutrition Society, Vice-President of the Chinese Society of Food Science and Technology, member of the State Consultative Committee of Food and Nutrition, Member of the Executive Committee of the Federation of Asian Nutrition Societies, the Chief Editor of Acta Nutrimenta Sinica and a member of the Editorial Advisory Board of the Asia Pacific Journal of Clinical Nutrition. He and his colleagues in China developed a crystalline amino-acid solution for intravenous infusion, for which they won the National Scientific and Technological Award. Recently he has furthered the understanding of metabolic changes after trauma and the consequential nutrient requirements during management. Studies of the antiarteriosclerotic action of the mono-unsaturated fatty acid source, teaseed oil, have indicated that atheroma may be decreased through blood lipid lowering, reduced blood coagulation, and anti-lipid peroxidation. He has edited 8 books including: "Clinical Nutrition", "Intravenous Nutrition", "Specialised Nutrition" and the Chinese edition of "Patient Problems in Clinical Nutrition". Through his active support for the discipline of Clinical Nutrition, he played a key role in the mid to late 1980s in its development in hospitals throughout China.
Food systems and their health and economic outcomes are changing rapidly, whether locally, regionally or internationally.1,2,3
This poses particular challenges to clinicians and public health personnel, the two not necessarily or even desirably separate.3,4
The recent International Conference on Clinical Nutrition in Hangzhou, Zhejiang Province, China, endeavoured to canvass these issues. It did so in the midst of unprecedented economic growth amongst Chinese speaking peoples. The fact that many of the papers came from these same people signals a new era in Food and Nutrition Science, especially amongst an evolving younger generation of young scientists, clinicians and public health workers.
At the time of the meeting, there was often a lack of appreciation of how the new ideas and lines of enquiry were converging or diverging, being reductionist or integrative, being socially or medically relevant or counter-productive. As it turns out, in these proceedings, relevance and direction, as well as inspiration for the future have emerged and crystallised. The proceedings will stand as a statement and reference point for this shift in the affairs of nutrition science.
There were many papers which set a new direction, amongst them that of Yun-Hwa Peggy Hsieh4 which looked critically at emerging technologies which would affect the food supply with greater or lesser risk. It was inescapable that questions of affordability and sustainability will increasingly influence clinical and public health nutrition.
The conference assembled a relatively young, enthusiastic and participatory audience of food technologists, nutrition scientists, clinicians and public health workers who will form new alliances and change the shape of regional and international nutrition and health.2
Almost a thousand years ago, in the Southern Sung Dynasty, Hangzhou was an innovator in textiles, food and trade, with a reputation for scholarship and leadership.1 We experienced a resurgence of this during October 15-18th 2006 at Zhejiang University and in the City of Hangzhou.
Corresponding Author: Mark L Wahlqvist
Reference
India is often thought of as a development paradox with relatively high economic growth rates in the past few years, but with lower progress in areas of life expectancy, education and standard of living. While serious ine- qualities in growth, development and opportunity explain the illusion of the paradox at the country level, still, a significant proportion of the world's poor live in India, as do a significant proportion of the world's malnourished children. Poverty and undernutrition coexist, and poor dietary quality is associated with poor childhood growth, as well as significant micronutrient deficiencies. Food security is particularly vulnerable to changes in the eco- nomic scenario and to inequities in wealth distribution. Migration from rural to urban settings with a large infor- mal employment sector also ensures that migrants continue to live in food insecure situations. While food produc- tion has for the most part kept pace with the increasing population, it has been with regard to cereal rather than of pulses and millet production. Oil seeds, sugar cane and horticultural crops, along with non-food crops are also be- ing promoted, which do not address nutrition security, and, coupled with the increase in the consumption of pre- prepared food, may indeed predispose towards the double burden of malnutrition. Access to food is also particu- larly susceptible to poverty and inequality. Many strategies and policies have been proposed to counter undernu- trition in India, but their implementation has not been uniform, and it is still too early to assess their lasting im- pact at scale.
Low protein rice can be part of a nutritionally adequate dietary pattern in the prevention of chronic kidney disease. We developed a low protein fermented genmai (brown rice) LPFG) to improve chronic kidney disease (CKD) management. The principal functional features of brown rice are retained in LPFG, lessening the negative spiral of gut-kidney associative spiral attributable to uremic dysbiosis and a leaky gut. LPFG is characterized by (1) an energy value the same as white rice, (2) a protein content less than 0.2 g/ 100 g, (3) a potassium content almost zero, (4) phosphorus less than a quarter that of conventional rice, (5) the presence of dietary fiber, (6) having γ-oryzanol, and (7) antioxidant activity. Dietary therapy for CKD patients is challenged by the joint needs to provide enough energy and to restrict protein. Patients replaced staple foods with LPFG without side dish restriction. Preliminary study of intervention with 3 months of LPFG reduced constipation probably by increased Blautia wexlerae, Bifidobacteria, acetic acid, and a decrease in potentially harmful bacteria. Protein intake decreased from 60 to 50 g per day. Urinary protein excretion decreased from 510 to 300 mg per day, and β2-microglobulin from 926 to 250 μg/L. Adherence to the LPFG diet enabled improvement in glomerular and tubular function.
Background and Objectives: The 68th United Nations General Assembly declared 2016 the International Year of Pulses. Therefore it is timely to review the current evidence of the benefits of legumes for human health with a focus on Australian sweet lupins. Methods and Study Design: Medline, Pubmed, Cochrane library were searched to identify cross-sectional/epidemiological studies, randomised controlled trials (RCTs) and systematic reviews. Results: The strongest evidence appears to be for links between eating legumes and reduced risk of col- orectal cancer as well as eating soy foods and reduced LDL cholesterol. However, epidemiological studies and RCTs suggest that replacing several meat-based meals a week with legumes can have a positive impact on lon- gevity, diabetes, cardiovascular disease and weight management, potentially via favourable effects on the gut mi- crobiome. Sweet lupins are unique among legumes with one of the highest combined amounts of digestible plant protein (38%) and dietary fibre (30%). Unlike other legumes, their low amount of anti-nutritional factors negates the need for soaking/cooking and they can therefore be eaten uncooked. Sweet lupins may lower blood pressure, improve blood lipids and insulin sensitivity and favourably alter the gut microbiome. There is growing interest in pulses, especially sweet lupins, as ingredients to improve the nutritional value of baked goods (particularly gluten free) and to create novel products to replace meat. Conclusion: Legumes form part of most traditional diets. They, including sweet lupins, can play a useful role in health maintenance.
Human ecology requires both oxygen and water with the generation from food of an immediate energy source, ATP, by oxidative phosphorylation. A continuing balance between oxidation and antioxidation is necessary for longer less-disabled lives, taking account of oxidative stresses and the critical roles of oxidants in defence against infection, tissue repair and signalling. Antioxidant capacity is derived both exogenously (from food, beverage and sunlight) and endogenously (from enzymatic and non-enzymatic pathways). A number of oxidant food factors service antioxidant metallo-enzymes. The capacity operates extra- or intracellularly. Uric acid is the major antiox- idant in primate blood. Uric acid synthesis is increased by dietary fructose from fruit, sugary foods and drinks. This indirect antioxidant effect of fruit is separate from that attributable to its flavonoids. Alcohol also increases serum uric acid. Urate excess and retention is associated with disease. The high prevalence of hyperuricaemia in NE Asia presents a major public health dilemma in regard to putative benefits and risks. Foods with high antioxi- dant activity include berries, nuts and legumes, tomatoes and sweet potato leaves. Each of the antioxidants in the- se foods is pleiotropic being inter-alia anti-inflammatory, anti-angiogenic or anti-neoplastic. Moreover, food ma- trices and patterns contribute to the safety of antioxidant consumption. There is no evidence to date that isolated antioxidants as food supplements improve health outcomes or survival; and some that indicate unacceptable risk. Their use as biomarkers of food cannot justify their isolated use. Nevertheless, a spectrum of dietary pluripotential antioxidants for tissues, metabolic and immune systems is advantageous.
The recognition that nutritional status plays a role in altering susceptibility to lead absorption and toxicity has triggered the development of this review. There has been a significant increase worldwide in awareness and concern about the effects of lead on human health and the environment over the last two decades. Both occupational and environmental exposures to lead remain a serious problem in many developing and industrialising countries, as well as in some developed countries. Port Pirie (South Australia) has the world's largest lead smelter and the surrounding population continues to be exposed to environmental lead. The increased awareness of the detrimental impacts of 100 years of smelting at Port Pirie led in 1984 to the development of the Lead Implementation Program, run by the Environmental Health Centre (EHC), Department of Human Services (DHS). The major focus of the program is to reduce household lead exposure for pregnant women and children below the age of five years. Despite intervention efforts by all stakeholders in Port Pirie, 55% of children less than 4 years old have blood lead levels above the National Health and Medical Research Council (NH&MRC) goal of 10µg/dl. The Port Pirie Lead Implementation Program includes components on nutrition education aimed at reducing lead absorption and toxicity. However, nutritional intake and nutritional status of Port Pirie residents, in particular children under five years, has not been evaluated. This review focuses on nutrition as a component of intervention in lead toxicity and it discusses the nutritional concerns in relation to lead exposure. Fortunately most food patterns that reduce susceptibility to lead toxicity are consistent with recommendations for a healthy diet. The relationship between nutritional status and lead uptake and toxicity is most clearly established for irregular food intake (i.e. periods of fasting), marginal calcium ingestion and (subtle) iron deficiency.
Background and Objectives: The Mediterranean diet has been demonstrated to provide a range of health bene- fits in observational and clinical trials and adopted by various dietary guidelines. However, a broad range of defi- nitions exist impeding synthesis across trials. This review aims to provide a historical description of Mediterrane- an diets, from the ancient to the modern, to inform future educational and diet index tool development represent- ing the ‘traditional’ Mediterranean diet. Methods and Study Design: Nine databases were searched from incep- tion to July 2015 to identify papers defining the Mediterranean diet. The definition accepted by the United Na- tions Educational, Scientific and Cultural Organization (UNESCO) was also reviewed. Results: The ‘traditional’ Mediterranean diet is described as high in unprocessed plant foods (grains, vegetables, fruits, legumes, nuts/seeds and extra virgin olive oil), moderate in fish/shellfish and wine and low in meat, dairy, eggs, animal fats and dis- cretionary foods. Additional elements relating to cuisine and eating habits identified in this review include fre- quent intake of home cooked meals; use of moist, lower temperature, cooking methods; eating main meals in company; reduced snacking occasions; fasting practice; ownership of a vegetable garden; use of traditional foods and combinations; and napping after the midday meal. Conclusions: Scope exists for future tools to incorporate additional elements of the ‘traditional’ Mediterranean diet to improve the quality, consistency, and synthesis of ongoing research on the Mediterranean diet.
The aim of the present paper is to understand the relationship between malnutrition and poverty, and how to generate ideas and concepts for developing studies leading to policy and programme implementation in the context of establishing collaborating networks among South-East Asian Ministers of Education Organization (SEAMEO) centres. Malnutrition is found at all stages of life, from the fetus to older people, in what is considered to be 'nutrition throughout the life cycle'. Low birthweight could become an important indicator of fetal/intrauterine nutrition. The consequences of being born undernourished extend into adulthood. Stunting is an indicator for poverty, it demonstrates early poor nutrition. Malnourished children face terrifying long-term results when they grow to adults, deprived of their full mental and intellectual capacity. The way to break the poverty cycle is to focus on children. Seventy per cent of the world's poor are women, which is considered as a feminization of poverty. Women play an important role in giving birth to the next generation, in food security, and as caregivers for the family. It is therefore important to increase the physical, mental, and intellectual well-being of every woman as a good investment for the well-being of future society and a human right. However, the gender issues are rarely openly acknowledged in national antipoverty strategies. Adequate nutrition, healthy ageing, and the ability to function independently are thus essential components of a good quality of life. Food security refers to access at all times to sufficient, nutritionally adequate, and safe food. It is important for healthy and peaceful development. Nutrition policy must be an integral part of health policy, from the national to the grass-roots level. The strategy is to focus government, NGOs and community activities on the reduction of poverty, hunger, and malnutrition in developing countries; determine who the poor people are, where they live, why they are poor and how our research could contribute and reduce both poverty and malnutrition.
The concept of lactose intolerance has become embedded in Western medicine and developing economy medi- cine. It is based on evidence that intestinal lactase activity persists into later childhood and throughout life in only a minority of the world’s population, notably northern European–derived populations. These people have the T single nucleotide polymorphism (SNP) of the rs49882359 allele (C/T), also known as C/T-13910, the MCM6 gene which positively influences the lactase LCT gene. Other lactase persistent (LP) populations are found in Af- rica and the Middle East with different genetic variants. These SNPs represent co-evolution with dairying since the agricultural revolution and nutrient-dependent ecological adaptation. That said, gastrointestinal symptoms considered due to small intestinal lactose malabsorption are poorly correlated with lactase non-persistence (LNP), the situation for most people. With LNP, colonic microbiome lactase enables lactose fermentation to occur so that none is found in faeces. Whether the short chain fatty acids (SCFAs) and gases (hydrogen, carbon dioxide and methane) produced cause symptoms is dose-dependent. Up to 25 g of lactose at any one time can usually be con- sumed by a LNP person, but its food and meal pattern context, the microbiomic characteristics, age and other fac- tors may alter tolerance. Thus, the notion that lactose intolerance is a disorder or disease of LNP people is mis- placed and has been one of cultural perspective. What actually matters is whether a particular dairy product as normally consumed give rise to symptoms. It is, therefore, proposed that lactose tolerance tests be replaced with dairy food tolerance tests.
For most of its history, China has supported a growing population through food systems which have been mutually inclusive of people and their locality. This trajectory has required adequate ecosystem maintenance or human- ised reformulation and a high degree of recyclable nutrient flow. The ‘tipping point’ in habitat sustainability has come with the size and demographic structure of China’s population to one that is ageing, with modernisation of its infrastructure and increased expectations of better livelihoods, standards of living and health. In order to meet these expectations, China has embarked on rapid urbanisation for upwards of 300 million people over the next 15-20 years and to do so taking account of the environmental limitations. The process will radically change rural as well as urban China and the systems which connect them. Chief among these will be ecosystems in number and type along with the food and health systems integral to them. To minimise ecological damage and optimise the benefits to people and place, describing, monitoring and managing the process will be paramount. The present paper is a situational analysis of health as it may be ecologically favoured or disordered (Ecosystem Health Disorders) and of the food systems on which the environment and health depend. An effort is made to enumerate the current situation in China in a way that might enable the optimisation of humanised ecosystems.
In 1987, the International Union of Nutritional Sciences (IUNS) subcommittee on Nutrition and Ageing, in conjunction with the World Health Organization (WHO) global program for the elderly, embarked on the 'Food Habits in Later Life' (FHILL): a cross-cultural study to determine to what extent health, social and lifestyle variables, especially food intake, collectively predict survival amongst long-lived cultures. A total of 818 participants aged 70 years and over, were recruited from five IUNS centres. Mortality data were collected after five to seven years. The cohorts included Swedes in Sweden (SWD), Greeks in Greece (GRS) and in Melbourne, Australia (GRM), Anglo-Celts in Australia (ACS) and Japanese in Japan (JPN). Information was obtained on health, lifestyle and diet at baseline. A Cox Proportional Hazard model containing ten potential predictors of survival, adjusted to age at enrolment and ethnicity/locality, was developed to analyse the survival data. Based on up to seven years survival data, it was found that being an elderly Greek in Australia conferred the lowest mortality risk and being an elderly Greek in Greece conferred the highest mortality risk. When the ten potential predictors of survival were entered into the Cox model, the memory score, the Mediterranean diet score, Activities of Daily Living (ADL) and general health status scores showed the greatest effects in significantly reducing mortality hazard ratios by 22%, 13%, 4% and 4%, respectively. For diet score, a one-unit change predicted a significant 13% difference in survival. Of the lifestyle (modifiable) variables entered in the multivariate model, exercise and social activity were not significant predictors of survival suggesting that diet is a more important predictor of survival than these variables. Another lifestyle variable, smoking, significantly increased mortality hazard ratios by 67%, making it a more important predictor of survival than diet. Being male (non-modifiable) also increased risk of death by 63%. Diet, particularly the Mediterranean Diet, operates irrespective and together with other factors as an appreciable contributor to survival, with a strength comparable to or greater than all other measured variables. The independence and strength of the predictiveness of food pattern for survival, and for this to be cross-cultural from Europe to Asia is a novel and important observation for food and health policy.
The functions of vitamin D are pleiotropic affecting all body organs and systems in some way. Its adequacy de- pends principally on sunshine for UV light to stimulate its synthesis in skin and on foods which contain it, either animal-derived or obtained from fungi or mushrooms, with the UV-responsive substrates dehydrocholesterol for vitamin D-3 or ergosterol for vitamin D-2, respectively. Thus, vitamin D health is very environmentally depend- ent. With ecosytem degradation, whether by atmospheric pollution or food systems which do not derive UV irra- diation, as with fish farming or mushroom processing, then this nutrient input into human biology may falter. Vi- tamin D deficiency is now common and widespread in North-East Asia as elsewhere. When discovered early in the 20th century it was linked to rickets in children and osteomalacia in adults and, for a generation or so, children were given fish, usually cod, liver oil to prevent bone disease. Now cod as a species and many edible fish are threatened. Over-exposure to sun-light increases the risk of skin cancer. We may tackle this problem by vitamin D supplementation with an alternative to fish liver. But the demographic pressures of population size and ageing (when the skin is less UV responsive) make the clinical and public health decisions and strategies demanding. Vi- tamin D health has become indicative of food security whose usual indicator is food diversity; such diversity may allow lesser concentrations to be more effective in organ and system function, but we have little evidence to sup- port this at present.
To establish health policy which will be relevant and effectual for a decade or more, let alone the much longer term, is a challenging task for any period of human or planetary history. Presently it is more so than ever because of major demographic, economic, technological and scientific, climatic and territorial changes and uncertainties. There are various scenarios which might be envisaged for food-health relationships before global population size is expected to stabilize by about 2050, dependent on planetary health. These will reflect achieved food intakes which for many will not be optimal but realizable and food systems with varying degrees of safety, security and sustainability. Health patterns themselves are bound to continue to change from those associated with different levels of economic development to those which have more to do with locality, climate, education and equity. Every aspect of health is in some way intertwined with food and this will become more explicit. Decisions about food-health relationships will take into account the United Nations MDGs (Millennium Development Goals), but be strongly influenced by technology, affordability, sustainability and ethics.
Despite progress with the food-associated health agenda in the public health and clinical domains, much remains to be done in Indonesia. There are reasons to be optimistic which include economic development, increasing literacy, progress towards universal health coverage and community organizational arrangements across the archipelago which focus on health through some 10,000 puskesmas. These community health centres are variably staffed with voluntary cadres from the community, bidans (nurses) and general medical practitioners. For more effective prevention and management of nutritionally-related health problems, innovative community and clinical nutrition research and expertise is required. With rapid urbanisation, the growth of the digital economy, increasing socio-economic inequity and climate change, there are imperatives for ecologically sustainable, non-employment dependent livelihoods which provide energy, food, water, education and health care security. A relevant health care workforce will include those who research and practice clinical nutrition. Here we gather together an account of an extensive body of published and emerging literature which makes a case collectively for a more ecological approach to nutrition and health and how it might revitalise the Indonesian and other health care systems.
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)
Background and Objectives: Wasting among under-five years old (U-5) children is a significant global public-health-nutrition burden. To effectively address this problem in Bangladesh, knowing its prevalence, causes and associated-factors are essential. This review aimed to identify evidences available in the existing-accessible literature/documents that describe the individual, socioeconomic, demographic, and contextual risk-factors associated with wasting among U-5 children in Bangladesh. Methods and Study Design: Electronic-databases included were MEDLINE, EMBASE, CINAHL, WoS, and Cochrane-Library written in English and published until 29 February 2024. Results: The search from the five databases yielded 167 publications. Of these, 50 papers/articles were duplicates and 108 were irrelevant, and nine have met the inclusion criteria. Additionally, 22 articles/documents were identified from other sources. Finally, a total of 31 articles/documents have been included in this review. The odds of childhood wasting observed were high for smaller birth-size, higher birth-order, male child, 12-24 months age-group, improper breastfeeding- and complementary-feeding practices, not-receiving DPT1 and/or measles vaccine, ≥1 sibling(s), maternal-undernutrition, less food-consumption during pregnancy, lack of maternal-education, lack of hand-washing practices by the mother/caregiver, paternal tobacco use, lower socioeconomic-status, food-insecurity, lack of access to hygienic-latrine and/or improved-water, Monsoon season (May-August), flood exposure, living especially in Barishal, Rajshahi Chittagong and Rangpur-division and/or Eastern part of Bangladesh, and urban-slum. Conclusions: The risk/associated factors of wasting among U-5 children in Bangladesh were found at various multilevel. Rarely caused by any one factor alone, wasting in U-5 children results from an interplay between pregnant-mother’s health and nutrition, child-caring practices, diets, poverty, and disease, which vary by context.
| Asia Pacific Clinical Nutrition Society1996 AwardTAKEHIKO TANAKA |
Professor Takehiko Tanaka who holds the chair of Nutrition and Physiological Chemistry, Osaka University Medical School, has devoted his life to attracting international professionals to a career in nutrition. Dr Tanaka obtained his medical degree from Osaka University Medical School in 1953. Then he entered the institute for Protein Research of Osaka University and spent his younger days in the basic research of protein metabolism and enzymology. In 1967, he became a professor and chairman of the Department of Nutrition and Physiological Chemistry of Osaka University Medical School. He has devoted himself to nutritional research and the organisation of those few departments responsible for human nutrition in medical schools in Japan.
In 30 years, he has developed and made significant contributions to several nutritional research areas: (1) the isozymes of glycolytic enzymes in higher animals, (2) the regulatory mechanisms for glycolytic enzyme genes, (3) regulation of polyamine synthesis, (4) metabolic approaches to cancer cachexia, (5) energy metabolism and whole body calorimetry. He helped establish the concept of "molecular nutrition". Using molecular biology, he demonstrated the regulation of L-type pyruvate kinase gene expression in various nutritional conditions. With these studies, he developed the new concept of "Nutrients and gene expression". His work in the field of energy metabolism was based on the fact that indirect calorimetry in small animals shows immediate heat production on the intake of several nutrients; he clearly showed that this was initiated by hormonal and autonomic nervous system signals.
Besides his research interests, he has been a Council Member of IUNS (the International Union of Nutritional Sciences), a member of the Japanese National Committee of Nutrition and Food Sciences, a member of the US-Japan Cooperative Medical Science Program, Secretary General of the Fifth Asian Society of Nutritional Sciences Council and, most recently, the president of the International Symposium on "Nutritional Support in Organ Failure".
Originally a basic scientist, he showed great understanding of clinical medicine, especially with his interest in the modern nutrition support systems of parenteral and enteral nutrition. Likewise, he promoted the need for nutrition assessment in clinical practice. His lectures have always been informative. He has contributed significantly to the education of nutritionists, dietitians and doctors and served as Dean of Medicine at Osaka University. Thus, his contribution to the development of nutritional sciences is international and considerable.
The nomination of Professor Tanaka for the annual award of the Asia Pacific Clinical Nutrition Society reflects his great services to the international development of nutrition science and clinical nutrition.
Akira Okada
President, Asia Pacific Clinical Nutrition Society
Background and Objectives: Three of the major ocular diseases, namely cataracts, age-related macular degener- ation and glaucoma are associated with oxidative damage. Disease risk and progression may be reduced through consumption of dietary components. To critically examine the literature on dietary and supplemental intakes of fruit and vegetables, meat, antioxidants (vitamins C, E and A), calcium, folate, iron, and their association with ocular disease. Methods and Study Design: Google Scholar and key references from texts and publications were searched using search terms (eye disease, antioxidants), (vision, nutrition), no date restriction, only articles in English were included. Results: We found probable evidence that dietary intake of fruits and vegetables, and vit- amin C lowered incidence of cataracts and age-related macular degeneration. In high supplemental doses, vitamin C increases macular degeneration risk. Vitamin A from food was protective for cataracts and glaucoma, but not in supplemental form. Vitamin A was associated with lower incidence of macular degeneration. We also found probable evidence that higher intakes of meat increased the risk of cataracts and macular degeneration. Dietary calcium and iron appeared protective against glaucoma, but not in supplemental form. Conclusions: While a nu- trient rich diet high in fruit and vegetables, and associated antioxidants appeared to be protective, we would cau- tion intake of supplementary antioxidants for those with ocular disease.
The general health message to the public about meat consumption is both confusing and misleading. It is stated that meat is not good for health because meat is rich in fat and cholesterol and high intakes are associated with increased blood cholesterol levels and coronary heart disease (CHD). This paper reviewed 54 studies from the literature in relation to red meat consumption and CHD risk factors. Substantial evidence from recent studies shows that lean red meat trimmed of visible fat does not raise total blood cholesterol and LDL-cholesterol levels. Dietary intake of total and saturated fat mainly comes from fast foods, snack foods, oils, spreads, other processed foods and the visible fat of meat, rather than lean meat. In fact, lean red meat is low in saturated fat, and if consumed in a diet low in SFA is associated with reductions in LDL-cholesterol in both healthy and hypercholesterolemia subjects. Lean red meat consumption has no effect on in vivo and ex vivo production of thromboxane and prostacyclin or the activity of haemostatic factors. Lean red meat is also a good source of protein, omega-3 fatty acids, vitamin B12, niacin, zinc and iron. In conclusion, lean red meat, trimmed of visible fat, which is consumed in a diet low in saturated fat does not increase cardiovascular risk factors (plasma cholesterol levels or thrombotic risk factors).
There are growing concerns about the health impacts of climate change with ecosystem degradation and global warming, finite reserves of non-renewable energy, water shortages in food-producing regions, limits to contem- porary agriculture with its dependence on exhaustible petrochemical nitrogen and rock phosphate fertilizers, and failure of the global financial system. To date, health security has meant attention to safe environments espe- cially water, sanitation and waste disposal; and access to health care and its affordability. Its dependency on food security (safety, sufficiency, sustainability, and satisfactoriness which requires diversity and quality) has been under-estimated because the current and imminent risks have increased and extended to more populations, be- cause these may be less tractable and because the nature, extent and dynamics of nutritionally-related health are better appreciated. As a step towards more collaborative food and health systems, the National Health Research Institutes in Taiwan has created an interdisciplinary Nutrition Consortium (NC) with research and policy agen- das. The NC held a food in Health Security (FIHS) in the Asia Pacific region roundtable in conjunction with the World Vegetable Center based in Tainan, supported by the National Science Council and Academia Sinica in Taiwan and the Australian Academies of Science and of Science Technology and Engineering, August 2-5th 2009 in Taiwan. A FIHS Network is being established to further the initiative. It should form part of the broader Human Security agenda.
Being home to 31% of the world’s children who are stunted and 42% of those who are underweight, and with many children and adults affected by micronutrient deficiencies, India is facing huge challenges in the field of nutrition. Even though the Indian Government is investing vast amounts of money into programs that aim to enhance food security, health and nutrition (the Integrated Child Development Services program alone costs 3 billion USD per year), overall impact has been rather disappointing. However, there are some bright spots on the horizon. The recent District Level Health Surveys (DLHS-4) do show significant progress, ie a reduction in stunting of around 15% over the past 6 years in a few states for which preliminary results are available. The reasons for this reduction are not unambiguous and appear to include state government commitment, focus on the ‘window of opportunity’, improved status and education of women, a lowered fertility rate, and combinations of nutrition-specific and nutrition-sensitive interventions. Apart from the government many other agencies play a role in driving improvements in nutrition. Since 2006 the Global Alliance for Improved Nutrition (GAIN) has worked with a range of partners to improve access to nutritious foods for large parts of the population, through public and private delivery channels. This supplement presents a selection of these activities, ranging from a capacity assessment of frontline workers in the ICDS system, large scale staple food fortification, salt iodization, fortification of mid-day meals for school children and decentralized complementary food production.
The subject of the future regarding nutritional status and food security, and of their ramifications in terms of nutrition-related disorders/diseases in Sub-Saharan African (SSA) populations, is a complex one. As well as social unrest, a country's socioeconomic situation may affect food availability and, crucially, influence the generally low proportions of the Gross National Product devoted to health services. Additional determinants include changes in the roles of non-dietary adverse factors (i.e. smoking practice, alcohol consumption, physical inactivity) and of infections (i.e. gastroenteritis, malaria, tuberculosis and, particularly, HIV). As to future health in 2020, major increases in socioeconomic status are very unlikely; in fact, there has been a deterioration in some countries with food shortages affecting nutrition status and food security. However, with some measures of prosperity there are likely to be decreases in family size and falls in the proportions of children born with low birthweights or with protein-energy-malnutrition (PEM), and of children lying under the 5th percentile of growth reference standards. Simultaneously, though. there will be variable rises, especially in urban dwellers, in the occurrence of hypertension, diabetes, cardiovascular disease and certain cancers. Improvements in the health status of both children and adults are likely to be strongly affected by whether HIV infection can be controlled or whether it becomes rampant.
The purpose of the Elderly Nutrition and Health Survey in Taiwan (1999-2000) was to assess the diet, nutrition and health of persons aged 65 and above in Taiwan. A multi-staged, stratified, clustered probability sampling scheme was used in the survey. The survey population was stratified into a total of 13 strata. The four strata of "Hakka areas", "Mountain areas", "Eastern areas", and "PengHu islands" were unique in their ethnicity or geographic locations. The remaining areas of Taiwan were stratified into "Northern", "Central", and "Southern" parts with these 3 strata, then each subdivided into a further 3 strata based on population density. The household interview of the survey was arranged such that effect of seasonal variation was taken into account. A total of 1,937 persons completed the interview and 2,432 persons completed the health exam. The following data were collected: (1) Interview data : household information, basic demographics, 24 hour dietary recall, food frequency and habit, knowledge, attitudes and practice medical history, 36-item Short Form for generic health status, and physical activity. (2) Health exam data: blood sample for measurement of nutritional biochemical indicators and complete clinical chemistry profile, urine sample for urinary electrolytes, anthropometric measurements, ECG, blood pressure, body temperature, pulmonary function, and an osteoporosis assessment. Data from the survey were analyzed using SUDAAN to adjust for the design effect and to obtain unbiased estimates of the mean, standard error and confidence intervals. Survey respondents were slightly younger compared to non-respondents; however, after weighting and adjustment with SUDAAN, the education levels and ethnicity of respondents and non-respondents were similar indicating lack of bias. We anticipate that the results of this survey will be of benefit in understanding the nutritional status of the elderly, the relationship between nutrition and health, and factors influencing elderly persons' nutritional status. Furthermore, this information could be used in the development of public health nutrition policy aimed at improving the nutrition and health of the elderly in Taiwan..
Overweight and obesity have started to emerge as a significant public health arisen from the changing dietary pattern towards energy-dense and high fat diets, together with a more sedentarylifestyle arising from increasing urbanization. Obesity's threat to the health and economy of the population gives urgency to meeting the problem headlong before it gets any worse. Fundamental knowledge gaps, however, constrain the institution prevent and manage this growing problem. Foremost the region, coupled with a lack of uniformity in reference standards and cut-off points. While the principles of dietary management, physical activity and behaviour modification are well known, integrating these strategies into a national policy and program in the face of competing priorities is the greatest challenge of all. This requires the collaboration of government, academia, the food industry, the private sector, NGOs and the community, with the assistance of international and bilateral aid agencies, to develop and implement such policies and programs.
This study was conducted to investigate the concentrations of serum fatty acids, lipoprotein(a) and apolipoprotein of three populations in North Vietnam: rural area with low income (n = 101), suburban with average income (n = 97), and urban with high income (n = 95). The results showed the suburban and urban populations had higher fat intake than the rural. The fat intake in quality was different in these three populations. The suburban had the highest consumption of fatty foods rich in n-6 polyunsaturated fatty acid (PUFA). The rural consumed more fatty foods rich in monounsaturated fatty acid (MUFA), but less fatty foods rich in n-3 PUFA than the two other populations. The high index of thrombogenicity (IT) of the Vietnamese diet may result from their low intake of fish and vegetable oils. Risk factors for premature cardiovascular disease (CVD) assessed by serum lipoprotein(a) and apolipoprotein levels were not observed in all three populations. However, coronary heart disease (CHD) and stroke are problems that should be monitored because the increase of CVD morbidity has been reported in Vietnamese people. From a nutritional point of view, the increase of fish and vegetable oils consumption is necessary for the prevention of CVD and CHD in these Vietnamese populations.
Widjaja Lukito was born in Surabaya, Indonesia on August 29th 1958. He undertook his medical training at Airlangga University in Surabaya and his PhD work in nutritional immunology at Monash Univesity, Melbourne, Australia in conjunction with internal medicine specialist training in Clinical Nutrition and Metabolism at the Monash Medical Centre, Melbourne. He became a Clinical Associate Professor of Medicine at Monash University, a role he continued on his return to Indonesia to facilitate clinical academic and public health co-operation between Indonesia and Australia. He joined the SEAMEO-TROPMED (South East Asian Ministries of Education Tropical Medicine) Regional Centre for Community Nutrition, based at the University of Indonesia and ultimately became the director of the Center. At the same time he has taught in the Clinical Nutrition Specialty of the Postgraduate Program in Nutrition, at the Faculty of Medicine, University of Indonesia. This combined professional approach and responsibility has enabled Widjaja Lukito to build Clinical and Public Health Nutrition not only in Indonesia, but in the region.
He has fostered a vigorous research program amongst young South-East Asians who have participated in the various graduate programs co-ordinated through the regional community nutrition program and this capacity-building role will be enduring. His research interests have spanned those of childhood and the aged, the spectrum of nutritionally-related diseases referred to as the Double Burden of Nutrition, the community and the hospitalized, in nutrition assessment and body composition, of food systems and food choice.
He has contributed to various organizations which have benefited from his leadership. In particular, he was foundation Treasurer of the Asia Pacific Clinical Nutrition Society in 1993, then Vice-President and served as its President from 2000 to 2004. He chaired the IUNS (International Union of Nutritional Sciences) Task Force on “Nutrition and Resistance to Infectious Disease” and was a member of its Nutrition and Ageing Committee. He has been a member of the UNU (United Nations University)/IUNS Task Force on Capacity-Building in Nutrition in Asia. He is a Scientific Advisory Panel member of the International Life Science Institute in South East Asia, is currently President of the Indonesian Clinical Nutrition Society and a committee member of the Indonesian Society of Atherosclerosis and Vascular Diseases. He is also a member of various Expert Panels of the Indonesian Medical Nutrition Society.
He is on several Editorial Advisory Boards, the Southeast Asian Journal of Tropical Medicine and Public Health, the Malaysian Nutrition Journal and the Asia Pacific Journal of Clinical Nutrition.
He has had a long-standing interest and involvement in critical health and nutrition situations through World Vision. Since 2006, he has been a Special Advisor to the Indonesian Minister of Health on Health Policy. In his current position, he has taken an increasing role in Health Policy, especially in relation to Avian Influenza and Health and Development. He is a member of the Expert Group on Global Health and Foreign Policy (an initiative of the Foreign Ministers of Brazil, France, Indonesia, Norway, Senegal, South Africa and Thailand).
The annual Asia Pacific Clinical Nutrition Society Award is made to persons who have made exceptional contributions to the health, well-being and nutritional status of peoples in the Asia Pacific Region. Dr Lukito meets and represents these criteria admirably.
Citation By
Mark L Wahlqvist
The replacement in the diet of refined carbohydrate and fat with fibre and protein has been shown to promote satiety and improve glucose and insulin profiles. It is less clear whether the macronutrient composition of individual foods such as snacks have any meaningful impact on metabolic parameters and satiety. We examined if the consumption of higher protein higher fibre snack bars would result in reducing outcome measures such as food intake and glucose and insulin patterns compared to a conventional isocaloric high fat high refined carbohydrate snack bar. Twenty three women were randomized in a single blind cross over study with 2 interventions, a high fat high sugar snack bar and a comparatively higher protein, higher fibre snack bar intervention. Snack bars were eaten at mid morning and mid afternoon, and a standard breakfast and ad libitum buffet lunch. The glucose and insulin responses over 9 hours were significantly lower (P = 0.014 and P = 0.012 respectively) during the high protein snack bar intervention. Peak glucose levels were also 16% lower after the morning HP bar (P <0.001). The morning high protein bar reduced the energy intake at the buffet lunch meal by 5% (4657 ± 1025KJ vs 4901 ± 1186KJ, P < 0.05). Altering the macronutrient composition of a snack bar can assist in reducing the energy intake at a subsequent meal and improve short term glucose and insulin profiles.
Excess dietary salt is a well established cause of high blood pressure and vascular disease. National and interna- tional bodies recommend a significant reduction in population salt intakes on the basis of strong evidence for health gains that population salt reduction strategies could achieve. The Australian Division of World Action on Salt and Health (AWASH) coordinates the Drop the Salt! campaign in Australia. This aims to reduce the average amount of salt consumed by Australians to six grams per day over five years through three main implementation strategies targeting the food industry, the media and government. This strategy has the potential to achieve a rapid and significant reduction in dietary salt consumption in Australia. With industry and government engage- ment, this promises to be a highly effective, low cost option for preventing chronic disease.
Iodine deficiency is the most common preventable cause of brain damage with more than 2 billion people from 130 countries at risk. The global problem of iodine deficiency has been redefined by a readily transmitted popula- tion concept, with an easy acronym – the concept of the iodine deficiency disorders (IDD) – referring to all the ef- fects of iodine deficiency in a population, that can be totally prevented by correction of iodine deficiency with special emphasis on brain damage and not just to goitre and cretinism (1983). This was followed by the creation of the International Council for Control of Iodine Deficiency Disorders (ICCIDD) supported by WHO and UNI- CEF with 700 multidisciplinary professionals from more than 100 countries, committed to providing technical as- sistance to national programs for the elimination of IDD (1986). The WHO policy of Universal Salt Iodization (USI) has been widely adopted which requires iodization of all food for human and animal consumption by the use of iodized salt (25-40 mg I/kilo). Simple practical methods for monitoring – by the measurement of salt io- dine and urine iodine were developed and promoted on a large scale with the technical assistance of the ICCIDD.
In terms of the ancestral genome of Homo sapiens, 90% of our genetic adaptation has come in the context of various hunter-gatherer settings, in which food variety was diverse and balanced between the Animal and Plant Kingdoms, and life-expectancy was short. Only recently, during the past century, when the human life-span began to elongate, have "long-term" health concerns truly been important. Reproductive health and child-rearing skills were the primary primeval concerns of evolutionary humans. With the number of persons over 60 years of age increasing at a rapid rate, chronic diseases threaten to cause suffering and disability for an increasing segment of the population while bankrupting health-care systems with the costs of therapeutic and custodial care for the elderly. How a society eats from birth and throughout the lifespan has a major determining effect for either more or less health and function. The meat-based fare of the caveman is probably not the recommended food pattern for healthy aging and compression of mortality, but neither is heavy exposure to the newer foods (dairy foods; cereals; refined sugars; vegetable oils; alcohol; salt; and fatty meats) which the agricultural and technological revolutions have made abundantly available. Taken in a lifespan perspective with an assumption of median survival through seven decades, a micronutrient-dense, but primarily plant-based intake reduces the risk of non-transmissible diseases. A concern going forward is how governmental policies and food-industry practices can contribute to making the most healthful diets and physical activity patterns accessible, available and appealing to persons throughout both the affluent and developed and the low-income and developing societies of the world.
Soybean isoflavone (SIF) is a type of polyphenol present extensively in legumes. Because of its unique chemical construction and the physiological activity of the phenolic hydroxyl group, SIF exhibits strong antioxidant activi- ty in antioxidant and nonantioxidant enzyme systems. Genistein is the major isoflavone in soy foods, accounting for more than 50% of the isoflavone content. The health effects of soybean dietary isoflavones on humans have gained increased attention. Recent studies have suggested that SIF may alleviate neurodegenerative diseases such as Alzheimer’s disease (AD). Despite the comprehensive research on AD, effective treatments for AD are yet to be established. The early diagnosis and prevention of mild cognitive impairment (MCI) have become crucial for delaying AD development. Several dietary polyphenols have exerted cognitive effects on AD, and the appropriate intake of dietary SIF helps reduce the risk of AD. This study reviews the possible mechanisms of AD pathogene- sis and their relationships with SIF intake; the results provide useful insights for AD prevention in the future.
Background and Objectives: Consumption of foods made with wheat flour, particularly instant noodles, is increasing in Asia. Given this trend, fortifying wheat flour with vitamins and minerals may improve micronutrient intake in the region. The objective of this review was to understand what is known about fortifying wheat flour used to make instant noodles. Methods and Study Design: A literature review of seven databases was performed using the search terms “noodle” and (“Asian” or “instant”). Grey literature was requested through a food fortification listserv. Articles were title screened first for relevance and duplicity, with exclusion criteria applied during the second round of abstract-level screening. This review considered studies examining simulation, retention,
sensory, bioavailability, efficacy, and effectiveness of instant noodles made with fortified wheat flour. Results: Fourteen relevant documents were reviewed for simulation (n=1), retention (n=11), and sensory studies (n=3).
The documents revealed that instant noodles produced from fortified wheat flour have potential to improve nutrient intakes, have high retention of most nutrients, and provoke no or minimal changes in sensory characteristics. Conclusions: The available literature indicates that using fortified wheat flour for instant noodle production results in retention of the added nutrients, except thiamin, with no significant sensory change to the final product. Given the rising consumption of instant noodles, production of this item with fortified wheat flour has potential to improve nutrient intakes in Asia. This review provides a resource for the design of a wheat flour fortification program in countries where a large proportion of wheat flour is consumed as instant noodles.
Anaemia in pregnancy is a major public health problem in China. Anaemia in pregnant women may be related to dietary intake of nutrients. To examine the relationship between iron status and dietary nutrients, a cross-sectional study in pregnant women was carried out. The intake of foods and food ingredients were surveyed by using 24-h dietary recall. Blood haemoglobin, haematocrit, serum iron, serum ferritin, transferrin and soluble transferrin receptor were measured in 1189 clinically normal pregnant women in the third trimester of pregnancy. The results showed that the average daily intake of rice and wheat was 504.2 g in the anaemia group and 468.6 g in the normal group. Carbohydrates accounted for 63.69% and 63.09% of energy in the anaemia and normal groups, respectively. Intake of fat was very low; 18.38% of energy in anaemia group and 19.23% of energy in normal group. Soybean intake was 109.4 g/day and 63.6 g/day in the anaemia and normal groups, respectively (P < 0.001). There were lower intakes of green vegetables (172.1 g/day) and fruits (154.9 g/day) in the anaemia group than in the normal group (246.2 g/day green vegetables (P < 0.001) and 196.4 g/day fruit (P < 0.001)). Intakes of retinol and ascorbic acid were much lower in the anaemia than in the normal group (P < 0.001). In the anaemia group, vitamin A intake was only 54.76% of the Chinese recommended daily allowance (RDA) and ascorbic acid intake was 53.35% of the Chinese RDA. Intake of total vitamin E was 14.55 mg/day in the anaemia group compared with 17.35 mg/day in the normal group (P < 0.016). Moreover, intake of iron in pregnant women with anaemia was slightly lower than that in the normal group. Comparison of iron status between the anaemia and normal groups found serum iron in women with anaemia at 0.89 µg/L, which was significantly lower than 1.09 µg/L in the normal group (P < 0.001). There were lower average values of ferritin (14.70 µg/L) and transferrin (3.34 g/L) in the anaemia group than in the normal group (20.40 µg/L ferritin (P < 0.001) and 3.44 g/L transferrin (P < 0.001)). Soluble transferrin receptor was significantly higher (32.90 nmol/L) in the anaemia than in the normal group (23.58 nmol/L; P < 0.001). The results of this study indicate that anaemia might be attributed to a low iron intake, a low intake of enhancers of iron absorption and a high intake of inhibitors of iron absorption from a traditional Chinese diet rich in grains.
Some reflections from work in the Asia Pacific Region, mostly with WHO, in the past 25 years, and the changes in nutrition seen in this time are shared. In 1988-89 I helped to start a Centre for Child Nutrition in Chengdu, Si- chuan, through the Italian Development Cooperation. The nutritional problems in urban and rural China, 25 yearsago,weresimilartothoseelsewhereintheRegion. LikeChina,thesecountriesunderwentrapideconomic development and changes in health patterns, within two decades. The main problems for child nutrition had to do with infant feeding practices and less breastfeeding: anaemia, protein energy malnutrition and rickets were fre- quent. How did China and other countries tackle these and other nutrition problems? In the 1990s the global nu- trition community started working on a problem-solving framework. In 1992, at the 1st FAO/WHO International Conference on Nutrition, 159 countries agreed to develop national nutrition plans. In 2014, 22 years later, FAO and WHO invited countries to review their national nutrition situation and plans. The epidemiological picture to- day is profoundly different. Many Asia-Pacific countries have achieved remarkable progress in socio-economic development, including malnutrition reduction. To reach the MDGs and the post-MDG goals being formulated, the remaining under-nutrition problems need to be alleviated, inequalities between sectors of society reduced, and also the growing threat of overweight/obesity and NCDs prevented and controlled. Assessing, monitoring and evaluating programmes to improve progress, now requires focusing not only on biological outcomes, but al- so on food security, programme process, and the policy environment.
The World Health Organization reported that inappropriate feeding in children is responsible for one-third of the cases of malnutrition. This cross-sectional study aimed to determine the prevalence of malnutrition and identify the relationship between feeding practices and malnutrition in children below 5 years, in 7 remote and poor coun- ties of China. A sample of 2201 children and 1978 caregivers were obtained with multistage cluster random sam- pling. A survey about feeding practices among the caregivers was implemented using a structured questionnaire, and the health status of children was evaluated using anthropometric measurements. We found 5 problems: first, high prevalence of stunting, underweight and wasting in children below 5 years old (19.3%, 13.1% and 5.5%); second, short duration of breastfeeding for children below 36 months; third, low prevalence of exclusive breast- feeding among children below 6 months of age and continued breastfeeding to 1 year (17.5% and 32.2%). Fourth, although most of the infants (81.1%) between 6 and 8 months of age were given complementary foods, some of the 6- to 8-month-old infants did not receive any complementary foods. Last, a higher prevalence of stunting among Chinese children who had never been breastfed, who had been breastfed for less than 1 year, or had been fed with semi-solid foods of poor quality. Therefore, we suggest that more programs to increase caregivers' feed- ing knowledge and practices be conducted, to improve the health of children in remote and poor areas in China.
Little is known about the dietary patterns of Asian populations aged ≥85 years and their associated factors. Thus, we aimed to (1) identify these dietary patterns and (2) clarify the relationships between the dietary pattern and health outcomes in a community-dwelling very old population. The Tokyo Oldest Old Survey on Total Health study is an observational cohort study comprising 512 Japanese subjects (women, n=288; men, n=224; age, 87.8±2.2 years). Dietary patterns were assessed by principal component analysis using a brief self-administered diet history questionnaire. Barthel index, Mini-Mental State Examination, and oral health status [maximum oc- clusal force (MOF), denture use, and dentulous / edentulous state] were also measured. Two dietary patterns were identified. The first factor component “traditional Japanese” was characterized by a high consumption of vegeta- bles, seaweed, legumes, and fish. The second factor component “noodles and confectioneries” was characterized by a high consumption of noodles, confectioneries, and non-alcoholic beverages. Multivariable analysis showed that the “traditional Japanese” dietary pattern was inversely associated with dentulous state (OR: 0.53; 95% CI: 0.34–0.82), the lowest tertile of MOF (OR: 0.64; 95% CI: 0.42–0.99), and denture use (OR: 2.42; 95% CI: 1.26– 4.63) even after adjustment for potential confounders. Furthermore, the “noodles and confectioneries” dietary pat- tern was inversely associated with the lowest tertile of MOF (OR: 0.62; 95% CI: 0.40–0.94). However, there were no significant associations between these dietary patterns and disability or cognitive function. We identified two dietary patterns in the very old population, which were associated with oral health status.
Any attempt to optimize a plant-based diet necessitates an identification of the features of the diet which confer benefit as well as any which may be associated with detrimental effects. The former task is more difficult than might be assumed as there is no doubt that some of the apparent health benefits observed amongst vegetarians are a consequence of environmental determinants of health which characterize groups of people who choose vegetarian diets, rather than dietary practices. This review will consider the major health benefits of plant-based diets, the specific foods or nutrients which confer the benefits as far as can be ascertained from present knowledge, potential nutrient deficiencies associated with a plant-based diet and nutritional strategies that can be employed to prevent any such deficiencies.
Background and Objectives: The association between diet and macrocytic and hypochromic anemia in young Chinese men and women remains unclear. The present study aimed to investigate the relationship between dietary pattern and macrocytic and hypochromic microcytic anemia in young Chinese men and women. Methods and Study Design: Some 4,840 first-year students (2,385 men and 2,455 women) were recruited for this study from Qingdao University, China. Biochemical and hematological parameters, and food frequency questionnaires were obtained from the subjects. Based on dietary intake, participants were divided into three dietary patterns: seafood dietary pattern (SDP), vegan dietary pattern (VDP) and omnivorous dietary pattern (ODP). The risks for macro- cytic and microcytic hypochromic anemia in three dietary patterns were assessed. Results: Macrocytic and hypo- chromic anemia were less common in participants who adhered to the omnivorous dietary pattern than to the ve- gan or seafood dietary patterns (p<0.05). Adhering to an omnivorous dietary pattern was negatively associated with macrocytic anemia in men [odds ratio (95% CI): 0.74 (0.62, 0.89), p<0.001] and microcytic, hypochromic anemia in both genders [men: odds ratio (95% CI): 0.64 (0.45, 0.92), p=0.01; women: odds ratio (95% CI): 0.71 (0.51, 0.99), p=0.04]. Conclusions: Adhering to an omnivorous dietary pattern was associated with less common macrocytic anemia in young men and microcytic, hypochromic anemia. Dietary diversity is important in prevent- ing macrocytic anemia in men and also microcytic, hypochromic anemia in young men and women. Excessive al- cohol intake is the most plausible explanation for macrocytosis in the young men.
This study examined the trends in snacking behaviours and eating food-prepared-outside- the-home (FPOH) by Chinese children and adolescents using data from the China Health and Nutrition Survey. The sample consisted of 3223 subjects aged 6-18 in 1991 and 2836 in 1997. Three days of 24hr recall dietary data and per capita income (deflated to 1989) was used. The percentage of Chinese children having snacking behaviours was significantly differentiated according to the income level while percentage of eating FPOH increased in middle and high income groups. Snacking contributed about 8% of the energy intake (EI) for snackers, compared with over 15% from FPOH for those who ate FPOH. Fruit was a major component of snacking: snacks based on fruit intake almost doubled over the study period as did snacks based on soft drink consumption. Animal source food consumption was a key component of FPOH and its intake also increased.
Background and Objectives: Overconsumption of drinks containing fructose increases the risk for hyperuricemia and gout. Comparative analysis evaluating the indicators of serum uric acid (SUA) load caused by natural food-derived fructose and pure fructose in sweeteners is lacking. We aimed to uncover the effect of fructose from apple and honey and pure fructose powder on the SUA concentration of healthy young Chinese individuals. Methods and Study Design: Two randomized crossover trials were performed. The participants were randomly assigned to consume apple or honey (test food) or pure fructose powder (reference food); one week later, the groups’ dietary intervention was switched. Blood samples were collected at 0, 30, 60, and 120 min after meal to measure the SUA and blood glucose concentrations. Results: At 30 and 60 min, the SUA concentration in participants consuming apple or honey was lower than in those consuming fructose powder. At 120 min, the SUA concentration of participants consuming apple returned to baseline. The areas under the curve (AUC) within 2 h (2h-AUCs) of SUA exhibited the trend of fructose >honey >apple. The 2h-AUC ratio between test food and reference food was determined using the uric acid index to assess the efficiency of food-derived fructose in increasing the SUA concentration. The uric acid index of honey was higher than that of apple. Men had higher postprandial SUA concentration than women. Conclusions: Food-derived fructose caused a lighter load on uric acid metabolism than pure fructose. Uric acid index can be useful for distinguishing fructose-containing foods.
Background and Objectives: This study aimed to investigate the effects of tomato juice consumption on semi- nal plasma lycopene levels and sperm parameters in infertile men. Methods and Study Design: Subjects were male infertility patients with poor sperm concentration (<20×106/mL) and/or motility (<50%). Following a four- week observation period, subjects were randomly assigned among three groups: a tomato juice group, an antioxi- dant group, and a control group. The subjects in the tomato juice group and the antioxidant group daily consumed one can of tomato juice (containing 30 mg of lycopene) or one antioxidant capsule (containing vitamin C 600 mg, vitamin E 200 mg, and glutathione 300 mg), respectively, for 12 weeks (feeding period). Seminal plasma lyco- pene levels and sperm parameters were measured every 6 weeks during the feeding period. Results: Forty-four patients completed the study (control group: 12, antioxidant group: 15, tomato juice group: 17). In the tomato juice group, plasma lycopene level was significantly increased at the 12th week of the feeding period. Moreover, a decrease in seminal plasma white blood cells and an increase in sperm motility in the tomato juice group were statistically significant at the 12th and 6th weeks, respectively, compared to the control group. In the antioxidant capsule group, no significant improvement was observed in semen parameters. Conclusions: In conclusion, regu- lar consumption of tomato juice seems to improve sperm motility in infertile patients. This is the first report to show that commercially available food, such as tomato juice, might be beneficial for male infertility.
Background and Objectives: People with dental problems and dysphagia frequently consume foods in paste form. A strategy is required to mitigate the glycemic responses of these foods. Methods and Study Design: The effect of yam paste ingestion on postprandial glycemic responses was assessed using a two-arm study design for yam paste ingestion: (1) as low– and medium–glycemic index food and (2) as preload and coingested food in a rice meal. In a randomized crossover trial, 18 healthy volunteers consumed (1) low-intensity-cooked yam paste; (2) medium-intensity-cooked yam paste; (3) cooked white rice; (4) coingested low-intensity-cooked yam paste with rice; (5) coingested medium-intensity-cooked yam paste with rice; (6) a preload of low-intensity-cooked yam paste before rice; (7) a preload of medium-intensity-cooked yam paste before rice. Postprandial glycemic responses and satiety assessments were conducted for each food approach. The glycemic characteristics of yam paste were manipulated with the preparatory treatment. Results: Ingesting a preload of 10 g of yam paste before a rice meal resulted in better glycemic responses for 0–60 min in terms of peak glucose value and positive increments under the curve than co-ingesting yam paste with rice, with no adverse effect on satiety, irrespective of the glycemic index of the yam paste. Conclusions: Regarding isocarbohydrates, both low- and medium-glycemic index yam paste preloads curbed the glucose peak value of a rice meal and lowered the glycemic index value of mixed meals in young healthy people.
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.
Data on the overall dietary folate intakes among high-risk groups in poor countries is very limited. Vegetables are considered good sources but the evaluation of their contribution is hampered by the lack of data on folate concentrations in many traditional foods. Data on the analysis of folate concentrations in 16 wild vegetables used in the Mekong Delta and the Central Highlands in Vietnam and an evaluation of the relative importance of different foods in folate intakes of women is presented. Vegetable samples were collected in four study villages, blanched and frozen samples were transported to Sweden for analysis. Freeze-dried samples were analysed for total folate quantification using a commercial radio protein binding assay. Daily folate intakes among women were estimated from 7-day food frequency interviews with 213 women. The folate concentration in the vegetable samples ranged from 10 to 96 g/100 g. The mean estimated daily folate intake among the 213 women in the study areas was 251 g. Vegetables contributed approximately one-third of the daily folate intake, of which 72% and 42%, respectively, in the two regions was from wild vegetables. A majority of the women (87%) got some dietary folate from wild vegetables and nearly one-third had mean daily folate intakes of > 50 g from such hidden food sources. The evaluation of dietary folate is complicated by data gaps in food composition tables, the unreliability of existing food data, variations between methods used for folate analysis and limited understanding of the bioavailability of food folate.
OBJECTIVE: The purpose of this study was to investigate body weight satisfaction, eating attitudes and dietary intake related to eating disorders of female junior high school students in Taiwan. METHODS: In a cross- sectional survey, 835 female junior high school students participated in this study. The questionnaire items in- cluded respondents’ demographic information as well as weight and body image concerns. Developmental and attitudinal scales such as the body shape-related teasing scale, Pubertal Development Scale, Eating Attitudes Test-26 (EAT-26) and 24-hour dietary recall were also used to collect data. Data were analyzed using a Stu- dent’s t test, chi-square test and logistic regression. RESULTS: Disturbed eating attitudes and behaviors were found in 10.4 % of participants (measured by EAT-26≥20). The multivariate logistic regressions showed that disturbed eating attitudes and behaviors were associated with weight/shape-related teasing experiences and dis- satisfaction with body weight. The reported intakes of energy, protein, fat, carbohydrate, cholesterol, zinc and vi- tamins B-6, B-12, were significantly lower in participants with disturbed eating patterns than in participants without disturbed eating. Conversely, participants with disturbed eating patterns had higher dietary and crude fi- ber intake than participates without disturbed eating. CONCLUSION: Disturbed eating behaviors exist among female adolescents in Taiwan, and these behaviors jeopardize their necessary dietary intake requirements. More research using the EAT-26 as a measure to predict the quality and quantity of food intake among female adoles- cents warrants further study.
Nationwide surveys of food and nutrient intake in China have revealed geographical variation between urban and rural areas. This study developed a semi-quantitative food frequency questionnaire (SQFFQ) for cancer risk assessment suitable for both urban and rural populations by conducting a survey of food intake in Chongqing, China. We recruited 100 urban and 104 rural healthy residents aged from 35 to 55 years in Chongqing, and collected dietary data with 3-day weighed records to assist in the development of the SQFFQ. The intake of 35 nutrients was calculated according to Standard Food Composition Tables for China and Japan. For each nutrient estimated by percentage contribution analysis (CA) and multiple regression analysis (MRA), foods with up to a 90% contribution or a 0.90 cumulative R2 were selected as items for SQFFQs. The food items of the combined SQFFQ were selected from all items listed in either urban or rural SQFFQs. Mean intake of energy, protein and carbohydrate did not differ between the urban and rural residents. The latter consumed more fat than their urban counterparts. We selected 119 food items for the combined SQFFQ, comprising 22 specific items for the urban SQFFQ, 6 for the rural, and 78 common and 13 additional items. The combined SQFFQ covered 33 nutrients with up to a 90% contribution in each area. We were able to develop a data-based SQFFQ that can estimate nutrient intake of both urban and rural populations, with suitable coverage rates. Further reliability and reproducibility tests are now needed to assess its applicability..
Over two billion people, or more than one out of three individuals throughout the world, are at risk of iron, vitamin A and iodine deficiencies. Although countries of the Asia Pacific region have generally shown a remarkable decline in the proportion of malnourished children, micronutrient deficiencies remain significant public health problems. The World Summit for Children in 1990, and the FAO/WHO International Conference on Nutrition held in Rome in 1992, affirmed that the elimination of the various forms of micronutrient malnutrition would constitute a significant contribution to social, economic and public health development. Governments and non-governmental organisations from virtually all nations, together with the international development community, have made the elimination of iodine deficiency disorders and vitamin A deficiency important goals to be achieved by the end of the decade, along with a substantial reduction in the levels of iron deficiency anaemia. A further important factor in implementing multisectoral micronutrient interventions is the cost-effectiveness of such interventions. The three main complementary intervention strategies to controlling and preventing micronutrient deficiencies are: (i) food-based approaches such as fortification and dietary diversification; (ii) supplementation when appropriate; and (iii) public health measures to control infection, including incorporating micronutrients into other child survival activities such as immunisation. Much of the global experience in these strategies comes from countries of the Asia Pacific region, with some significant examples of success.
Background and Objectives: The counts of cariogenic bacteria lactobacilli and mutans streptococci have been studied and correlated with sugar intake. This study was to investigate the association between salivary lactoba- cilli and mutans streptococci counts with sweet food eating behavior and sweet sensitivity among 120 Malaysian women (101 ethnic Chinese, 19 ethnic Indians), while taking into account anthropometric and menstruation vari- ables. Methods and Study Design: Demographics, anthropometric measurements and menstrual history were taken. Hedonic preference, intake frequency of a list of sweet foods, intensity perception and pleasantness ratings of sweet stimuli were assessed. Saliva was collected for lactobacilli and mutans streptococci culture. Results: We found that centrally obese subjects (high waist circumference and waist-hip ratio) had significantly higher sali- vary lactobacilli and mutans streptococci counts (all p<0.05), while overweight and high total body fat subjects had significantly higher salivary mutans streptococci counts (p<0.001). The sweetness intensity perception of chocolate malt drinks was significantly lower in women who were in their pre-menstrual (post-ovulation) phase. However, menstruation variables (menstrual phases, regularity and pre-menstrual syndromes) did not play a role in determining compulsive eating, sweets/chocolate craving and salivary lactobacilli and mutans streptococci counts. Conclusions: Taken together, salivary lactobacilli and mutans streptococci counts of the Malaysian women are associated with central obesity, but not sweet food eating behaviour, sweet sensitivity and menstrua- tion variables. Salivary microbiome analysis could be useful as a potential diagnostic indicator of diseases such as obesity.
It has been postulated that changes in lifestyle follow five 'stages of change', which reflect a 'decisional balance' between the advantages and disadvantages of making such a change. We have assessed this model among Pacific Islands people in New Zealand. We questioned 105 Pacific Islands volunteers to identify their decisional balance for their reduction in dietary fat intake (DFI), weight control (WC) and the adoption of regular exercise habits (REH). Answers were used to develop a closed questionnaire, which was completed by a second group of 195 Pacific Islands volunteers. The major reported advantages were good health (45%) and increased physical attractiveness (41%) for WC; disease prevention (70%) for DFI; and increased fitness (71%) for REH. The major reported disadvantages were losing too much weight (40%) for WC; eating fatty foods was enjoyable (50%) for DFI; and the time required (47%) for REH. Major differences in responses were found by age, sex, Islands group and educational status. The derived decisional balance questions related to the stage of change with advantages outweighing disadvantages for those in the maintenance/action phases and the converse for those in the precontemplative phase. The use of this model will be helpful in evaluating long-term programs aimed at the primary prevention of non-insulin-dependent diabetes through lifestyle change.
Background and Objectives: Obesity has become a public health problem and is a cause of some preventable illnesses. Among several methods for treating obesity, the use of food supplements is highly common. A com- monly used food supplement is green coffee bean extract. The objective of this study was to evaluate the efficacy of green coffee bean extract combined with an energy-restricted diet on the body composition and serum adipo- cytokines in obese women. Methods and Study Design: In this randomised clinical trial, 64 obese women aged 20–45 years were selected and divided into two groups: an intervention group (receiving 400 mg green coffee bean extract for 8 weeks) and control group (receiving placebo). All participants were on an energy-restricted diet. The body composition, leptin, adiponectin, lipid profile, free fatty acids (FFAs), and fasting blood sugar were compared between the two groups. Results: We observed significant reductions in the body weight, body mass and fat mass indices, and waist-to-hip circumference ratio in both groups; however, the decrease was higher in the intervention group. Moreover, serum total cholesterol, low-density lipoprotein, leptin, and plasma free fatty acids significantly decreased in the intervention group (p<0.05) after adjustment for energy and fibre intake. The serum adiponectin concentration significantly increased in the intervention group (p<0.05). Conclusions: Green coffee bean extract combined with an energy-restricted diet affects fat accumulation and lipid metabolism and is thus an inexpensive method for weight control in obese people.
The primary objective of this study was to determine the variables associated with intention to consume soy products and identify key variables that could be used as targets in soy nutrition education and consumption promotion. A pre/post-test survey was used during a three session class focused on diabetes that discussed and introduced soy foods. The Theory of Planned Behavior framed the questions and variables examined. Subjective norms and behavioral control were most important in predicting intention to consume soy foods. Specifically, health experts and providers were important subjective norms; accessibility and ability to prepare were key be- havioural control determinants. While most participants tried soy during the program, taste and texture percep- tions did not impact intention to buy soy in adults concerned about diabetes.
Background and Objectives: This study investigated major dietary patterns and their relationship to obesity among urbanized Tibetan pastoralists. Methods and Study Design: Using a cross-sectional design, this study as- sessed 782 urbanized Tibetan pastoralists aged 18-84 y. A food frequency questionnaire and anthropometric measurements were conducted in 2018. Principal component analysis was used to identify dietary patterns. Lo- gistic regression was applied to compare the risks for overweight (BMI ≥24 kg/m2), obesity (BMI ≥28 kg/m2), and central obesity (waist circumference ≥80 cm for women and ≥85 cm for men) across quintiles of dietary pat- tern scores after controlling for gender, age, education, medical insurance, smoking status, alcohol consumption and physical activity. Results: This study identified three major dietary patterns: an urban pattern characterized by high intake of vegetables, tubers/roots, and refined carbohydrates; a western pattern characterized by sugary drinks, snacks, and desserts; and a pastoral pattern characterized by tsamba (roasted Tibetan barley), Tibetan cheese, and buttered/milk tea. Subjects in the highest quintile of urban pattern scores were more likely to be overweight (OR=2.58, 95% CI 1.48-4.49) (p-for-trend=0.001), obese (2.94, 1.57-5.49) (p-for-trend=0.001), and centrally obese (1.94, 1.12-3.36) (p-for-trend=0.019) compared to those in the lowest quintile with confounders controlled. The western dietary pattern was positively associated with overweight (p-for-trend=0.037). No clear association was observed for the pastoral dietary pattern. Conclusions: Urban and western dietary patterns inde- pendently predict the likelihood of being overweight. Improved nutrition education may contribute to healthier eating behaviors, thus reducing or preventing obesity.
Background and Objectives: To determine the effect of a low carbohydrate diet and standard carbohydrate counting on glycaemic control, glucose excursions and daily insulin use compared with standard carbohydrate counting in participants with type 1 diabetes. Methods and Study Design: Participants (n=10) with type 1 diabe- tes using a basal; bolus insulin regimen, who attended a secondary care clinic, were randomly allocated (1:1) to either a standard carbohydrate counting course or the same course with added information on following a carbo- hydrate restricted diet (75 g per day). Participants attended visits at baseline and 12 weeks for measurements of weight, height, blood pressure, HbA1c, lipid profile and creatinine. They also completed a 3-day food diary and had 3 days of continuous subcutaneous glucose monitoring. Results: The carbohydrate restricted group had sig- nificant reductions in HbA1c (63 to 55 mmol/mol (8.9-8.2%), p<0.05) and daily insulin use (64.4 to 44.2 units/day, p<0.05) and non-significant reductions in body weight (83.2 to 78.0 kg). There were no changes in blood pressure, creatinine or lipid profile and all outcomes in the carbohydrate counting group were unchanged. There was no change in glycaemic variability as measured by the mean amplitude of glycaemic excursion in ei- ther group. Conclusions: A low carbohydrate diet is a feasible option for people with type 1 diabetes, and may be of benefit in reducing insulin doses and improving glycaemic control, particularly for those wishing to lose weight.
Recent estimates of human requirement for indispensable amino acids have shown that the requirement for key amino acids such as lysine is twofoldthreefold higher than previously thought. As a consequence
recommended intakes for protein, particularly for vulnerable groups such as the elderly, need to be revised. Indispensable amino acids can also be used directly to improve amino acid supply in diets. A range of nitrogen compounds such as creatine and branched chain amino acids are currently used by groups such as athletes, although their efficacy is open to question. Peptides are natural components of the diet and some of these have been shown to have beneficial effects. The emergence of methods for genetic modification of food proteins raises possibilities of the development of novel foods for a variety of benefits including improved supply of indispensable amino acids, reduced allergenicity, or preformed antibodies to reduce risk of disease.
The purpose of this study was to determine the accuracy of a quantitative food frequency questionnaire for measuring the usual dietary intake of Samoans living in New Zealand. We compared a self-administered 89 item quantitative food frequency questionnaire (FFQ) with a 7 day diet record (DR) in a sample of 55 Samoan adults aged 20 years and over. The FFQ asked people to report their dietary intake in frequency and amount and included photos of standard serving sizes. The DR was collected over non-consecutive three and four day periods, including two weekend days. Food weighing scales and measuring cups and spoons were provided to measure food portions. Correlations between the two methods were poor for both crude (range -0.03-0.48) and energy-adjusted (range -0.12-0.54) nutrient intakes. Approximately 29-53% of people fell into the same tertile when classified by the two methods and 9-22% of subjects were grossly misclassified into opposite tertiles. Agreement was also poor when the differences in energy, fat, protein and carbohydrate intake between the methods were plotted against mean intake. Relative to an estimate of energy expenditure, both methods underestimated usual energy intake; however, underestimation occurred to a greater extent with the DR. We conclude that agreement between the two dietary assessment methods was poor and we were unable to use the DR to calibrate the FFQ. In terms of total energy, the FFQ gave a better assessment of usual dietary intake than did the DR.
Background and Objectives: Research has produced inconsistent findings on the association between dietary patterns and cognitive function. In the present study, we examined the association between dietary patterns and cognitive function among rural China’s older adults and aimed to identify major dietary patterns. Methods and Study Design: This cross-sectional study included 1176 individuals aged 65–85 years. Dietary intake was assessed using a food frequency questionnaire. Factor analysis and the Chinese Dietary Balance Index were respectively employed to determine dietary patterns and assess dietary quality. Cognitive function was evaluated using the Mini-Mental State Examination, and logistic regression analysis was performed to examine the relationship between dietary patterns and cognitive decline. Results: Three main dietary patterns were identified and named on the basis of foods with high content: a “healthy dietary pattern,” a “multigrain dietary pattern,” and a “snack dietary pattern.” With the increase in the score of the healthy dietary pattern, the Mini-Mental State Examination total score exhibited a significant downward trend (p<0.001). Moreover, we observed a prominent negative association between the healthy dietary pattern and mild cognitive impairment (4th to 1st quartile, OR=0.36; 95%CI, 0.24–0.54; p<0.001). After we adjusted for potential covariates, the negative correlation remained (4th to 1st quartile, OR=0.48; 95%CI, 0.28–0.81; p=0.006). However, no relation was observed between mild cognitive impairment and either the multigrain or snack dietary patterns. Conclusions: The healthy dietary pattern, which is based on the consumption of rice and flour, red meat, chicken, vegetables, seafood, and fruits, protects against cognitive dysfunction.
Adiponectin, an adipocyte-derived hormone has been implicated in the control of blood glucose and chronic in- flammation in type 2 diabetes. However, limited studies have evaluated dietary factors on plasma adiponectin levels, especially among type 2 diabetic patients in Malaysia. The aim of this study was to investigate the influence of dietary glycemic index on plasma adiponectin concentrations in patients with type 2 diabetes. A cross- sectional study was conducted in 305 type 2 diabetic patients aged 19-75 years from the Penang General Hospital, Malaysia. Socio-demographic information was collected using a standard questionnaire while dietary details were determined by using a pre-validated semi-quantitative food frequency questionnaire. Anthropometry measurement included weight, height, BMI and waist circumference. Plasma adiponectin concentrations were measured using a commercial ELISA kit. Data were analyzed using multiple linear regression. After multivariate adjust- ment, dietary glycemic index was inversely associated with plasma adiponectin concentrations (β =-0.272, 95% CI -0.262, -0.094; p<0.001). It was found that in individuals who consumed 1 unit of foods containing high die- tary glycemic index that plasma adiponectin level reduced by 0.3 μg/mL. Thirty two percent (31.9%) of the varia- tion in adiponectin concentrations was explained by age, sex, race, smoking status, BMI, waist circumference, HDL-C, triglycerides, magnesium, fiber and dietary glycemic index according to the multiple linear regression model (R2=0.319). These results support the hypothesis that dietary glycemic index influences plasma adiponectin concentrations in patients with type 2 diabetes. Controlled clinical trials are required to confirm our findings and to elucidate the underlying mechanism.
A micro level study on the haemoglobin status of 127 Munda (a tribe) and 174 Poundrakshatriya (Pod) (caste) women were conducted in the peri-urban area of Kolkata City, India. The two ethnic groups were selected in order to find out whether populations residing in the same habitat, with similar medical and health care facilities have similar haemoglobin status. Results indicate that there exists very high percentage of anaemia in both the ethnic groups and 100 percent anaemia was observed among the Munda. Mean haemoglobin level was higher among the women of both the ethnic groups, consuming calorie, protein, iron and folic acid, above the recommended value (Indian Council of Medical Research, 2000).25 Women below the age of 30 years were found to be more anaemic. Education (P <0.001), height (P <0.001) and weight (P <0.005) were significantly associated with the haemoglobin status of the Pod women. Haemoglobin level of both ethnic groups was found to increase with increase in Body Mass Index. Low socioeconomic condition, very low literacy rates, poverty and higher live births may have lowered the haemoglobin level of the women of the Munda population. However, women of both the ethnic groups were found to be anaemic in higher percentage than the state of West Bengal and all India (NFHS, 2000).26 Linear regression analysis indicated that expenditure on food had positive effect on the haemoglobin level (P <0.05) of the Munda adult women, possibly due to better buying capacity. However, negative effect of food expenditure on the haemoglobin level was noticed among the Pod women (P <0.05), which may be due to disparity in food sharing within the households. Thus populations residing with similar medical and health care facilities revealed differences in the haemoglobin level. Differential expenditure pattern and food sharing practice seems to be the major factors responsible for the differences in haemoglobin status among the adult women in this present study. Very low intake of iron and heavy workload may be the reasons for this high percentage of anaemia. Moreover, hookworm infections need to be analyzed, as its prevalence is very high in India and South Asia. One hundred percent anaemia among Munda women is also very alarming. The results suggest that government policies should be intensified further at problem specific areas for the more vulnerable populations and literacy and antenatal care (especially iron supplementation) at various growing periods among the women should be intensified to eradicate anaemia.
Background: Malnutrition can potentially prone a disabled child to further morbidities thus imposing further suf- fering to the affected child and his/her family. This is the first report on the nutritional status of physically dis- abled children from Iran. Methods: A total of 290 physically disabled children aged 6-12 yeas old, of both sexes, and from all specialized schools in Tehran, Meshed and Rasht were enrolled in a descriptive cross-sectional study. Dietary assessment was performed for disabled children using 24hr and food-frequency questionnaires. Weight and height were assessed and body mass index (BMI) was calculated for all subjects. Results: In disabled children, while the mean energy intake was more than 90% of the amount required, mean calcium and iron in- takes were 75.8% and 58.7% of the corresponding required amounts. Despite absence of significant difference in energy and fat intake, the intakes of protein, calcium and riboflavin were significantly lower in girls than in boys. Z score of weight showed that over 40% of disabled girls and boys were underweight. Comparison with anthro- pometric data from other studies showed that low weight was more prevalent in disabled than in non-disabled children (p<0.001). Moreover, both disabled boys and girls had significantly shorter statures than their non- disabled counterparts. Conclusions: Malnutrition (low weight and stunting) is quite prevalent among Iranian children with motor disabilities and it is more prevalent in girls than in boys. It seems that poor food composition is a more important contributing factor than total low calorie intake. These data warrants further studies.
Trials of nutritional intervention in a wide range of health and disease states, preventive and therapeutic, are required. Not only has the emergence of chronic non-communicable disease (CNCD) with acknowledged nutritional pathogenesis created this imperative need, but so also have other conditions which, previously, had not been regarded as nutritionally based. Among the latter are health problems associated with ageing: the menopause, a decline in immune function, and a decline in cognitive function. At the same time, there is a new set of materno-foetal and infant nutrition issues for investigation which relate to new food exposures and the long-term effects of nutritionally mediated gene expression. The emergence of the new food science of phytochemicals with human biological importance also sets the scene for their evaluation in traditional diets and novel foods. Such trials are more complex than comparable pharmacotherapeutic studies because of the complexity of food chemistry, as well as the food behavioural changes which may accompany a nutritional intervention, and the general problem of there not being a 'gold standard' for food intake methodology. Choice of study population is also a key issue in relation to the extrapolation of findings from a particular trial, with population representativeness being an advantage. In order to obtain useful information on manageable sample sizes, either intermediate end-points (short of morbidity and mortality) need to be studied or high-risk groups (such as the aged) need to be recruited. There are some unique ethical issues which must inform clinical nutrition trials. These include certain preventive imperatives like the right to be fed, the risks in disruption of food cultures and the need for food security and sustainability. Rapid changes in the food supply do, however, make such trials more important, while the value of food-health knowledge that cannot be obtained by trial must still be appreciated.
Background and Objectives: Information about an association between animal food intakes and risk of anemia is still limited. This study aimed to investigate the association between fish and meat intake and anemia risk in the Japanese elderly. Methods and Study Design: A nationally representative sample of 6,469 aged 65 years and over was obtained from pooled data of annual National Health and Nutritional Survey in Japan during 2002–2011. Anemia was defined as hemoglobin concentrations <13.0 g/dL in males and <12.0 g/dL in females. Logistic re- gression analysis, with the lowest intake tertile as the reference, was applied to estimate anemia risk for each nu- trient and food group. Results: After adjustment for putative confounding factors, males in the highest tertile of animal protein intake had significantly lower risk of anemia than those in the lowest tertile (odds ratio (OR): 0.77; 95% confidence interval (CI): 0.63, 0.95; p for trend=0.017). These associations were not seen in females (OR: 0.72, 95% CI: 0.49, 1.06; p for trend=0.100). Multivariate analyses revealed that anemia risk (OR: 0.80; 95% CI: 0.65, 0.97; p for trend =0.002) was lower for males in the highest tertile of fish intake than in the lowest tertile; this effect was also observed for females (OR: 0.64; 95% CI: 0.45, 0.92; p for trend =0.014). In both sexes, the highest tertile of meat intake was not associated with lower anemia risk in the multivariate-adjusted models. Conclusions: The current cross-sectional study in Japanese elderly males suggests that higher animal protein, specifically the high protein content of fish may be associated with a lower prevalence of anemia.
Background and Objectives: Overweight and obesity increase the risk of hypertension, type 2 diabetes, and other metabolic disorders and are increasing in Japan, particularly among men. Several prospective studies have suggested that high vegetable intake is inversely associated with weight gain. Here, the association between vege- table consumption and weight gain in a group of food manufacturing workers over the course of one year was in- vestigated. Methods and Study Design: The study was a one-year cohort study of the nutrition and lifestyle sur- vey. The study population consisted of 900 and 910 Japanese employees (aged 19-60 years) from a manufactur- ing company located in Musashino City, Tokyo, Japan, that were administered the same validated brief self- administered diet history and dietary lifestyle questionnaire in 2006 and 2007, respectively. Clinical examinations of body weight were also performed to assess changes in weight. We analyzed participants who responded in both 2006 and 2007 (n=478). Results: Risk of weight gain of more than 3 kg was significantly lower in the group consuming the most vegetables than in the group consuming the least, and this difference remained significant af- ter adjustment for baseline age, sex, and consumption of other foods (p for trend=0.028). Conclusions: Weight gain was inversely associated with high consumption of vegetables. Encouraging Japanese employees to consume more vegetables may be an important strategy in controlling weight gain and preventing metabolic syndrome.
Vitamin E is composed of various subfamilies that include tocopherols and tocotrienols. These compounds have antioxidant properties but differ in structure, dietary source and potency. In this study we evaluated the efficacy of -tocopherol as an antioxidant and its role in wound closure in normal and streptozotocin-induced diabetic rats. The healing of 6 cm linear incisions created on the back of each male SpragueDawley rat (250300 g) was monitored by measuring the length of the wounds daily. The rats were divided into two categories; normal and streptozotocin-induced diabetic rats. For each category, the animals were further divided into two groups; those untreated and those receiving 200 mg/kg bodyweight -tocopherols daily by oral gavage. All rats were fed standard food and water ad libitum. Blood samples were taken at 0, 5 and 10 days after the wounds were created for the determination of malondialdehyde levels and red cell superoxide dismutase, catalase and glutathione peroxidase activities. The results showed that -tocopherol reduced plasma malondialdehyde levels, increased glutathione peroxidase activity and accelerated the rate of wound closure in treated rats.
Background and Objectives: Maternal diet during pregnancy may impact infant respiratory morbidity. The aim was to determine the association between antenatal maternal diet and respiratory morbidity of their infants during their first 6 months of life. Methods and Study Design: This prospective cohort study included healthy mother-infant pairs. Maternal diet during the last trimester was determined with a validated food frequency questionnaire. Infant respiratory morbidity was solicited at 1, 3 and 6 months. Results: Three hundred mother-baby pairs were recruited. Maternal consumption of milk and dairy products was associated with reduced respiratory symptoms at 1 month (aOR 0.29 [95% CI: 0.10, 0.86], p=0.03) and 3 months old (aOR 0.43 [95% CI: 0.20, 0.93], p=0.03), while intake of confectionery items was associated with increased unscheduled doctor visits at 3 months (aOR 2.01 [95% CI 1.33, 3.06], p=0.001) and increased nebuliser treatment at both 3 months (aOR 1.88 [95% CI 1.12, 3.17], p=0.02) and 6 months (aOR 1.64 [95% CI 1.05, 2.54], p=0.03). Finally, at 6 months, hypertensive disorders during pregnancy was associated with increased nebuliser treatment (aOR 17.3 [95% CI 1.50, 199], p=0.02) while exclusive breastfeeding was associated with reduced incidence of respiratory symptoms (OR 0.47 [95% CI 0.26, 0.83], p=0.01). Conclusions: Increased antenatal maternal consumption of milk and dairy products may reduce respiratory morbidity while increased consumption of confectionery items may increase respiratory morbidity in their infants during the first 6 months of life.
Daily consumption of 400 µg folic acid prior to conception and during early pregnancy is recommended for the prevention of neural tube defects (NTD). Strategies to increase folic acid consumption include supplements and fortified foods. Milk is consumed by women and can be fortified with folic acid but little is known about the effect of fortified milk on blood folate concentration in women of childbearing age. The objective of this study was to determine whether daily consumption of milk fortified with 375µg folic acid increases blood folate and lowers homocysteine concentrations in women of childbearing age. Seventy-three non-pregnant women (aged 18-47 y) were randomized to receive either 75 g/d of a fortified or unfortified (control) milk powder for 12 weeks. Women who consumed the folic acid fortified milk had mean (95% CI) red blood cell and plasma folate concentrations that were 539 nmol/L (436, 641) and 35 nmol/L (30, 41) higher, respectively, than in the control group. Women drinking fortified milk had a 14% lower mean plasma homocysteine concentration at week 12 than women consuming the control milk. Daily consumption of fortified milk powder providing 375µg folic acid increases blood folate and lowers homocysteine concentrations over 12 weeks in women of childbearing age. Daily consumption of fortified milk would be expected to reduce NTD risk.
Choline and betaine are involved in several similar health-relevant metabolic pathways, but the foods sources are different. We have assessed their intakes (individual, sums and ratios) from a dominantly Chinese food cultural point of view. A representative free-living Taiwanese population aged 13-64 years was drawn from the Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996. Food intake was derived from interviews as 24-hour recalls. The USDA database, with adaptations for Taiwan, provided choline and betaine food compositions. Major food contributors of these nutrients were identified and compared with data from the US Framingham offspring study. Mean and variance reduced median nutrient intakes were calculated. Top ten major food contributors of choline in Taiwan were eggs, pork, chicken, fish, soybean and its products, dark leafy vegetables, dairy, fruit, wheat products and light leafy vegetables in sequence. For betaine, the top ten were dark leafy vegetables, wheat prod- ucts, fish, pork, bread, chicken, cake/cookies, grain-based alcoholic beverages, rice and its products and sauces. The main contributors of choline in Taiwan and the USA were, respectively, eggs and red meat; and for betaine, greens were similarly best contributor. The rankings of the main food contributors of choline and betaine differed substantially between Taiwan and the USA. The total daily intakes (mean±SE, mg) in Taiwan for choline were 372±19 (median=348) in men and 265±9 (median 261) for women; for betaine, values were 101±3 (median 93) in men and 78±8 (median 76) for women. These allow for health outcome considerations.
Marine fish is one of the most important sources of animal protein for human use, especially in developing coun- tries with coastlines. Marine fishery is also an important industry in many countries. Fifty years ago, many peo- ple believed that the ocean was so vast and so resilient that there was no way the marine environment could be changed, nor could marine fishery resources be depleted. Half a century later, we all agree that the depletion of fishery resources is happening mainly due to anthropogenic factors such as overfishing, habitat destruction, pol- lution, invasive species introduction, and climate change. Since overfishing can cause chain reactions that de- crease marine biodiversity drastically, there will be no seafood left after 40 years if we take no action. The most effective ways to reverse this downward trend and restore fishery resources are to promote fishery conservation, establish marine-protected areas, adopt ecosystem-based management, and implement a “precautionary princi- ple.” Additionally, enhancing public awareness of marine conservation, which includes eco-labeling, fishery ban or enclosure, slow fishing, and MPA (marine protected areas) enforcement is important and effective. In this pa- per, we use Taiwan as an example to discuss the problems facing marine biodiversity and sustainable fisheries.
Background: Inhabitants of agrarian villages of rural Cambodia suffer from high prevalences of iron deficiency and anemia in the context of a monotonous diet. Objective: To compare the efficacy and safety of placebo Khmer fish sauce to that of 10 mL of fish sauce containing 10 mg of iron, added to daily school meals either as NaFe-EDTA or as FeSO4+ citrate. Methods: 140 students aged 6-21 years were enrolled in a double-blinded, placebo-controlled inter- vention trial. They were randomly allocated to one of three treatment groups, and followed for 21 weeks during which 114 school meals seasoned with 10 mL of fish sauce were consumed by each participant. Changes in the con- centrations of hemoglobin (hb), serum ferritin (SF), and C-reactive protein (CRP) and in body weight and standing height were determined. Prevalences of vomiting, diarrhea, and acute respiratory infections were monitored weekly. Results: Both iron-fortified fish sauces increased hb and SF concentrations significantly as compared to placebo. No significant differences were observed between FeSO4+citrate and NaFe-EDTA fortification, regarding mitigation of iron-deficiency anemia (IDA) or regarding CRP, growth, infections, or side-effects. Conclusions: Iron-fortified Khmer fish sauce added to Khmer food is a suitable vehicle for iron fortification in children and adolescents. FeSO4+citrate and NaFe-EDTA show equivalent efficacy and safety.
Background and Objectives: Soy products are essential to the daily life of the Chinese population. However, the association between soy products and serum uric acid remains unclear. Better understanding of their relationship could provide food choice information for patients with gout. This study assessed the acute effects of soy and soy products on serum uric acid. Methods and Study Design: Sixty healthy adult male volunteers were recruited and randomly assigned to six groups. Ten participants in each group randomly ingested one of six foods: water, soy, and four different soy products. A blood test was conducted after 3 h to examine uric acid concentration. Results: The serum uric acid concentration significantly increased by 21.4±23.4 μmol/L at 1 h and 16.3±19.4 μmol/L at 2 h following ingestion of whole soybeans. These changes also applied to the soy powder group. The serum uric ac- id concentration rapidly increased by 38.1±20.5 μmol/L at 1 h, 34.4±18.2 μmol/L at 2 h, and 24.1±24.2 μmol/L at 3 h after the ingestion of soybean milk. The maximum concentration of serum uric acid was observed at 1 h after intake of soybeans and soy products, and then gradually decreased during the subsequent 2-h period. No signifi- cant uric acid changes from ingesting bean curd cake and dried bean curd stick were detected. Conclusions: In- gesting different soy products resulted in different concentrations of serum uric acid, with soybeans, soybean milk, and soy powder considerably increasing serum uric acid.
A cross-sectional nutritional survey was carried out on 350 elderly Malays aged 60 and above from 11 randomly selected villages in a rural area on the east coast of Malaysia. The findings indicated that the mean intakes of energy and of all of the nutrients investigated were below the Malaysian Recommended Dietary Allowances, except for protein and vitamin C. With respect to dietary habits, almost all of the subjects reported that they had breakfast (99.3%), lunch (97.9%) and dinner (90.4%) daily or almost daily (5-6 times/week). However, approximately half of the subjects, especially women, had particular beliefs and prohibitions about specific foods. Most of the subjects usually ate their meals at home, particularly dinner, with 99.3% always having dinner in their own home. Thus, although the rural elderly Malays studied had regular meal intakes, the dietary intake was inadequate. There is a need to plan community-based intervention programmes in order to prevent the subsequent consequences of malnutrition that lead to increased morbidity and mortality.
Background – Poor nutrition can adversely affect health and quality of life in the elderly population. Whilst several studies have used diagnostic screening questionnaires as a tool for nutritional risk assessment, few studies have investigated the relationships of score results derived from the questionnaires with the nutritional status indicated by anthropometric measurements and biochemical markers.
Objectives – To determine the nutritional status among a group of Australian aged care residents utilising three available diagnostic screening questionnaires: Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), and Katz Activities of Daily Living (ADL). The associations of the questionnaire results with the nutritional (anthropometry and serum concentrations of 25(OH)D, folate and vitamin B12) and mobility (using the timed up and go, TUG, walking test) status of the study population were examined.
Subjects and Methods – Of 115 participants, 66 were able and willing to complete all three questionnaires, 113 provided a blood sample for biochemical tests and underwent anthropometric measurements, and 46 were able and willing to complete the TUG test.
Results – According to the participants’ responses to the questionnaires, 16% were malnourished (MNA score <17), and 39% were depressed (GDS score ≥ 6). GDS score was inversely associated with MNA score (greater the depression the lower the MNA score) (r=-.353, P=.015), and serum zinc concentrations (r = -0.343, P = 0.001), and GDS was positively associated with the TUG (r = 0.30, P = 0.030) and ADL score (r = 0.37, P = 0.001). Conclusions – Nutritional risk assessment using questionnaires indicated that nearly 20% of the study population were classified as malnourished, and more than one-third were depressed. Those who were depressed were at greater risk of malnutrition, and had reduced serum zinc concentrations and reduced mobility. Results from this study indicate that depression is a key factor affecting dietary intake and mobility in elderly populations. Minimising or alleviating depression may therefore assist in increasing food intake, improving mobility, and consequently enhancing the quality of life for aged care residents.
Background – Lipid oxidation is on of the most important chemical reactions, which lead to food spoilage. In vivo oxidation reactions have been associated with several important diseases, including cancer and cardiovascular diseases. Both in foods and in vivo oxidation reactions are complex. Therefore, comprehensive understanding of roles of various antioxidants and their activities is challenging. Natural plant-derived antioxidants continue to be one of the most popular research topics in food science. One of the trends is to search for simple measurements to characterize foods and their potential for providing antioxidants and thus supporting our health.
Review – In foods antioxidants are needed to inhibit lipid oxidation, which may proceed by autoxidation, photo- oxidation or enzymatic oxidation. Antioxidants act by several mechanisms, e.g. by donating phenolic hydrogen to radicals, chelating metals, and quenching singlet oxygen. In addition, food antioxidants are often multifunctional, i.e. each antioxidant may inhibit oxidation by several mechanisms. The dominant mechanism depends on conditions. For example, composition of foods and experimental systems (oxidizing substrates, initiators, and other components present), physical structure of foods, and temperature are among factors, which may influence the dominant mechanism and antioxidant activities. Partitioning of oxidizing substrates, antioxidants, and pro-oxidants in the studied food is critical. Antioxidant activity may thus be distinctly different in bulk oils and multiphase foods, such as emulsions. In addition, the method used to measure and calculate antioxidant activities has a major impact on the results. For all these reasons, use of several test conditions and methods simultaneously is generally highly recommended. Antioxidant activity in a given food is reliably shown by measuring decrease in the formation of a number oxidation products from different steps of the oxidation chain reactions. Antioxidant activities measured using radical scavenging tests do not take into account the effect of the substrate and its structure and other properties.
In vivo, imbalance between antioxidant defense and initiative factors may lead to oxidation reactions, which cause undesirable changes not only in lipids but also in DNA, enzymes and other proteins. In vivo the role of enzymatic defense is emphasized as compared with food systems. Liberation of antioxidants from foods in digestion may differ from liberation in extraction for antioxidant tests. Further, dietary antioxidants have to be absorbed and localized in active forms in the oxidation site to enable the antioxidant effect. Recently, there has growing interest in measuring total antioxidant activities or total antioxidant capacities of foods by simple radical trapping methods, with the aim of providing data on the nutritional quality of the studied foods. Because of the high number and diversity of individual antioxidants in our foods, efforts to look for simplified procedures is understandable. However, the current approaches still leave many open questions.
Conclusions – When antioxidant activities are considered we need to distinguish the role of antioxidants in foods and in vivo. Factors affecting oxidation reactions and antioxidant activities in foods and in vivo differ. In addition, multifunctionality of many antioxidants complicates further possibilities to find simple approaches for antioxidant activities.
References
Background – Antioxidants have been a rapidly growing area of scientific research over the last decade. The term “antioxidant” is now widely recognised, and to some extent understood, by the general public as media coverage increases and the food industry promotes their health benefits. However, there is still considerable confusion over what compounds are antioxidants, the levels present in different foods, which foods have the highest antioxidant capacity and their particular health benefits. Accurate data on the antioxidant composition of foods is important for a number of reasons, including for the food industry to be able to promote their products and for health professionals to compare different foods in order to make the best recommendations for their clients. It is also an essential tool for population studies and intervention trials in order to translate the promise surrounding the health benefits of antioxidants into validated reality.
Review– Participants at the First International Congress on Antioxidant Methods agreed that antioxidant methods must be standardized but disagreed on the best methods to use (1). Analysis of antioxidants is a complex issue because of the number of compounds involved, the variety of ways in which they act and the different food matrices they are present in. There are several different approaches to quantifying antioxidants:
1) Measure individual antioxidant compounds: Some antioxidants such as vitamin C, vitamin E and selenium are relatively simple to quantify. However, the challenges lie in identifying and quantifying the carotenoids and flavonoids as these groups are made up hundreds and thousands of different compounds respectively. The U.S. Department of Agriculture, Agricultural Research Service (2) is building up food composition databases for selected carotenoids, flavonoids, proanthocyanidins and isoflavonoids. These databases provide useful information but have their limitations and because of the number of compounds present in some foods it may make food labels complex if antioxidants were to be shown.
2) Quantify antioxidants by class (e.g. total phenolics, total carotenoids): This is perhaps the simplest way is to measure some antioxidants. There is consensus that the Folin-Ciocalteu method is an appropriate assay for quantification of total phenolics (3) and simple spectrophotometric methods are available for total carotenoids. There are limitations to these general assays and they do not always provide enough information to be meaningful.
3) Determine antioxidant capacity: This approach has benefits over simply quantifying antioxidant components as it provides a measure of their effectiveness. The difficulty is that no one assay can capture the different modes of action of antioxidants. Current commonly used and accepted methods include the oxygen radical absorbance capacity (ORAC) assay and the Trolox equivalent antioxidant capacity (TEAC) assay (3). These assays are useful measures of in vitro activity but it may be more important to learn how the compounds affect cell activity and if any of the beneficial antioxidants are absorbed. Hence, there is a need to develop better processes for cell model screening of biological activity, and subsequent absorption.
Conclusions – With the growing research and consumer awareness of antioxidants it is important to have accurate antioxidant composition and antioxidant capacity data for consumer education, food labelling and promotion. However, there is still some way to go before a consensus is reached on the best measures to use.
References
Background – Antioxidants are compounds that help prevent oxidation. Information on their presence in foods and their uses as neutralizers of oxidants or free radical compounds in the prevention of chronic non-communicable diseases has attracted scientists in various fields. Hence information related to their analytical determination is crucial.
Objectives – To discuss the major analytical methods in the determination of antioxidants in foods.
Discussion – The choice of analytical methods in the determination of antioxidants depends on the types of antioxidants of interest. Antioxidants in foods could be analysed either as a functional group, antioxidant groups or as individual antioxidants. Functional group could be measured by the total antioxidant capacity (TAC) in the use of any of the following major assays; trolox equivalent antioxidant capacity (TEAC) decolourization (1), ferric reducing antioxidant power (FRAP) (2) and oxygen radical absorbance capacity (ORAC) (3). The major antioxidant group assays include the determination of total polyphenol (TPP) performed by the Folin-Ciocalteu method, total carotenoids, total anthocyanins and total flavonoids (4). The determinations of individual antioxidants such as carotenoid and flavonoid profiles include the use of HPLC and LC-MS and other complex assays (5).
Conclusion – Attempts are made to validate the antioxidant assays in the Pacific region for use as a routine analysis in regional laboratories.
References
1 Re R, Pellegrini N, Proteggente A, Pannala A, Yang M and Rice-Evans C. Antioxidant activity applying an improved abts radical cation decolorization assay. Free Radic. Biol. Med, 1999; 26, 1231-1237.
2 Pulido R, Bravo L and Saura-Calixto F. Antioxidant activity of dietary polyphenols as determined by a modified ferric reducing/antioxidant power assay. J. Agric. Food Chem, 2000; 48, 3396-3402.
3 Cao G and Prior RL. Measurements of oxygen radical absorbance capacity in biological samples. In Methods in Enzymology: Oxygen radicals in biological systems. New York, Academic press, pp. 51-62.
4 Sellappan S, Akoh CC. Flavonoids and antioxidant capacity of Georgia-grown Vidalia onions. J. of Agric. and Food Chemistry, 2002a; 50: 5338-5342.
5 Lako J, Trennery VC, Wahlqvist M, Wattanapenpaibbon T, Sotheeswaran S, and Premier R. Phytochemical flavonols, carotenoids and the antioxidant properties of a wide selection of Fijian fruit, vegetables and other readily available foods. Food Chemistry 2006; in press.
Background – Challenges in the analysis of food include new residues that need monitoring, and ever lower concentrations of target compounds. New methods of analysis have provided clever approaches but now quantitative methods need adequate validation and laboratories using those methods need proper quality control. Food analysis has traditionally relied on mutually agreed standard methodology, eschewing approaches such as the Guide to Uncertainty in Measurement (GUM)1 , and thereby foregoing metrological traceability. This paper will explore aspects of quality assurance and will argue that food analysis can be brought into the orbit of normal chemical analysis. Quality Assurance – Australia has led the world in aspects of metrology ever since minister Dedman stated in 2
Parliament “Measurements must be what they purport to be” . The National Association of Testing Authorities (NATA) was the first such accreditation body in the world. A proper quality assurance program will have the following elements: 1. Accreditation of the laboratory, 2. Participation in proficiency testing schemes, 3. Use of certified reference materials (CRMs) for calibration and quality control, 4. Estimation of measurement uncertainty,
People are living longer. Australia now has the second longest life expectancy (at birth) in the world: about 71 years for males and 74 for females. At 60 years our average health-adjusted life expectancy (HALE) is another 16.9 in men and 19.5 in women (mortality is longer). Around 20% of Australians are now over 65 years old. Many occupations are no longer obliged to retire people at a fixed date and a number continue working past 65. “70 is the new 60!” So we have to adjust the cut offs for “older” people and “elderly”.
Nutrition research in older people is handicapped by (i) great heterogeneity of the people’s health and conditions, (ii) special problems with access, (iii) confounding by medications, (iv) the varied, often indirect criteria used for nutritional status.
Nutrition science’s concerns with this age group can seem to be looking in two opposite directions. “Don’t eat too much, so you’ll stay healthy for longer” (and there’s the calorie restriction hypothesis) OR “We’ll help you get more to eat to keep you healthy for longer”. Which direction depends partly on interpretation of the limited research. It depends more on the stage an individual is at: third age or fourth. Chronological timing of aging is more variable than the timing of growth in teenagers.
For the third age there is much good advice in the NHMRCs ‘Dietary Guidelines for Older Australians’ (1999) (1). Among the messages to be found in it:- “Anyone refusing to give a sprightly 66 year old dietary advice to prevent cardiovascular disease could be accused of age discrimination’ (p 85). ‘We know that salt sensitivity (of blood pressure) increases with age’ (p 110). ‘Keep active to maintain muscle strength and a healthy body weight’ (p 29). ‘Older people may become infected with food borne pathogens at low doses that might not produce a reaction in (younger) people’ (p 48). As people age ….. a lowered energy output leads to a lowered energy intake: we eat less food. ‘Because of this older people need foods that are rich in nutrients – nutrient-dense foods – if they are to maintain their intake of essential nutrients’ (p xxi).
The National Nutrition Survey (1995) confirmed lower energy intakes over age 65 y. As to requirements of essential nutrients, the NH&MRC (2005) sets RDIs higher for protein, calcium, riboflavin and (especially) vitamin D for the 70+ year line (than for younger adults).
In the fourth age old people are no longer healthy and under – or malnutrition is likely to be associated. SENECA Study participants who lost 5 kg body weight had a significantly shorter survival. Undernutrition in old people has many, often combined causes. Broadly these are (a) serious disease or advanced aging, and (b) socio-economic and management problems. The first group are for medical care, AUSPEN and high tech nutrition support. The latter group are the main challenge for this society: older people who are not eating what they need because they are socially isolated, have chronic disabilities, were nutritionally depleted by major illness in hospital, are housebound or don’t eat enough in nursing homes.
Different agencies and professionals are theoretically in a position to help nourish and re-nourish people in some of these situations. Nutritionists/dietitians are likely to be advisers rather than at the front line. For most jobs there’s a manual telling the best way to do the job. In nursing homes this has been lacking for nutrition. Bartl and Bunney asked 100 people for practical ways of looking after nutrition and food in nursing homes. This is embodied in their manual (2), which a book reviewer considers “ideal for aged care staff who want a single source of information in plain English, which will assist them, or prompt them, to address all the food and nutrition related standards and guidelines for aged care”.
Housebound elderly are scattered, isolated, out of sight and more difficult for nutritional advice to access. This was discussed – with no major answers – at a conference at Sydney University last year. We heard stories about individuals with food insecurity, about the adverse effects of bad teeth, early Alzheimer’s, depression, social isolation and other disadvantages. In Lipski’s experience at least 30% of independent community living elderly are undernourished, most unrecognised. Meals on Wheels cost more than they used to. Community nurses and care services help some people. An increasing number of commercial companies will deliver meals for those who can pay. It is estimated there will be a large increase of frail older Australians living in the community and not enough people to care for them - ? us. This important exception to the obesity epidemic deserves much more of our attention.
References
Background – Childhood diet may have important implications for health in old age for two reasons. First, diet in childhood may influence diet in later life. Second, diet in childhood may have direct effects on the pathogenesis of chronic disease processes independent of subsequent adult diet. Few studies have examined the associations of diet in childhood with later diet and mortality in old age prospectively. I will attempt to summarise findings from the Boyd Orr cohort that have examined the association between diet in childhood and later diet and health outcome. Methods – The Boyd Orr cohort is based on the long- term follow up of 4,999 children who were surveyed in the Carnegie survey of Family Diet and Health in Pre-World War II Britain (1). Socio-economic data, anthropometric data and a seven-day household dietary inventory were collected on 1,352 families living in 16 areas of England and Scotland between 1937 and 1939 and repeat dietary data was collected on over 300 families (1). The name, age and address of the children of the families surveyed were used to trace the children and 88% have been successfully traced (1). In 1997-1998 a self-completion questionnaire that included a 113- item food frequency questionnaire was sent to all 3,182 surviving traced study members (2).
Results – A childhood diet rich in vegetables was associated with a healthy diet in early old age. In multivariable models the healthy diet score (a 12 item score) for those in the upper quartile of childhood vegetable intake was 0.30 (95% CI –0.01 to 0.61, p for trend 0.04) higher compared to those in the lowest quartile. (2) Higher childhood energy intake was associated with increased cancer mortality - in multivariable proportional hazard models that adjusted for social variables the relative hazard for all cancer mortality was 1.15 (95% CI 1.06 to 1.24, p 0.001 for every MJ increase in adult equivalent daily intake) (3). Higher fruit intake was associated with reduced risk of incident cancer. In fully adjusted logistic regression models odds ratios (95% CI) across increasing quartiles of fruit consumption were 1.0 (reference), 0.66 (0.48 to 0.90), 0.70 (0.51 to 0.97) and 0.62 (0.43 to 0.90), p for linear trend =0.02. (4) Higher childhood intake of vegetables was associated with lower risk of stroke. After controlling for age, sex, energy intake and range of socio-economic and other confounders the rate ratio between the highest and lowest quartiles of intake was 0.40, 95% CI 0.19 to 0.83, p for trend = 0.01) (5) Higher intake of fish was associated with higher risk of stroke. The fully adjusted rate ratio between the highest and lowest quartile of fish intake was 2.01, 95% CI 1.09 to 3.69, P for trend = 0.01) (5). There was no association between intake of any of the foods and constituents considered and deaths attributed to coronary heart disease or all cause mortality (5). The reported childhood diet-cancer associations were robust to adjustment for measurement error (6).
Conclusions – Though these results are based on household measures on children across a range of ages measured in the 1930s they do suggest that diet in childhood influences diet in old age and cancer risk. These findings require replication but suggest that childhood diets rich in vegetables and fruit may be beneficial.
References
Background – Healthy aging depends, in part, on good nutrition, to compress morbidity, or, in other words, to minimize the time spent in states of ill-health in the later years of life. Little information is available in Australia about trends in food and nutrient intakes of any age group, including older people. The Blue Mountains Eye Study, a population based cohort study, provided an excellent opportunity to study trends in intakes of foods and nutrients, measured three times over a 10-year period on a large cohort of older people. Such data enable the exploration in patterns of dietary change among the same people as they age over time, which is not possible with population cross sectional surveys. We have also begun to analyse the dietary trend data in relation to health outcomes, to see whether particular patterns of intake predict better health status and longevity.
Review – The Blue Mountains Eye Study is a population-based cohort of older people living in two postcode areas
west of Sydney. At baseline (1992-1994) 3654 people aged 49 years and over (82% of those eligible) were
examined (mean age at baseline 62 years). Five years later (1997-1999) 2334 people were re-examined, and ten
years after the baseline data collection (2002-2004) 1952 people were re-examined (75% of survivors). A validated
145 item food frequency questionnaire (FFQ) was used to assess food and nutrient intake at each of the three assessments.
During the ten year period, 1166 people completed the FFQ satisfactorily on all three occasions.
Mean intakes of foods and nutrients were examined. In addition, food and nutrient intakes at baseline were
examined in relation to various health outcomes, including weight gain, eye disease, and mortality. Mean intakes of
energy and sugars significantly increased among women over the 10 year period (7920kJ vs 8272kJ, p<0.05; 118g
vs 127g sugar, p<0.05). Mean intakes of n-3 polyunsaturated fatty acid (PUFA) and fish significantly increased
among women and men over the ten year period (n-3 PUFA: women 0.9g vs 1.1g, p<0.05; men 1.0g vs 1.1g,
p<0.05) (fish: women 27g vs 38g, p<0.0001; men 26g vs 36g p<0.0001). Mean dietary folate intake increased in
women and men, reflecting changes to food supply during the study period (folate (μg): women 323 vs 376,
p<0.001; men 346 vs 393, p<0.001). Study participants consumed significantly lower quantities of cuts of red meat
(red meat cuts: women 42g vs 36g, p<0.0001; men 49g vs 40g, p<0.0001), but more mixed dishes containing red
meat over the ten year period (red meat dishes: women 54g vs 62g, p<0.001; men 69g vs 73g, p=0.23 not sig).
Whole milk consumption decreased and low fat yoghurt increased (whole milk: women 98g vs 78g, p=0.002; men
131g vs 102g, p=0.002; yoghurt: women and men 18g vs 30g, p<0.0001). There were no significant changes in total
fruit and vegetable intake, though some sub-types of fruits and vegetables increased, notably canned fruit and
avocado (p<0.05). Mean intakes of wholemeal bread decreased over the 10 year period (52g vs 40g, p<0.05).
Amongst men, mean intake of beer decreased but wine increased (210g vs 166g for beer, p<0.01, 68g vs 78g for
wine, p=0.051). People who consumed the highest tertile of fruit and vegetables were more likely to consume lean
red meat and fish (p<0.0001). At baseline 57.9% of participants were overweight or obese and ten years later 65.9%
were overweight or obese. During the 10 years of follow-up median weight gain was 2.4kg and 31% of people had
weight gain greater than 5kg. Participants with the highest vs lowest quintile of n-3 PUFA at baseline had a lower
risk for incident early age-related macular degeneration (ARM) at five years (OR 0.41, 0.22-0.75), and there was a
40% reduction of incident early ARM associated with fish consumption of at least once a week (OR 0.58, 0.37-
3
0.9).
Conclusions – Many of the observed changes in diet over a 10-year period among older Australians were in line with current population dietary recommendations, including, an increase in intakes of fish, n-3 fatty acids, folate and low fat dairy products. However, some changes resulted in poorer dietary choices, such as decreasing use of wholemeal bread. A full analysis of the dietary trends will inform nutrition policy and programs targeted to older Australians.
References
Background and Objectives: The elderly population is increasing rapidly worldwide, and frailty is a common geriatric syndrome. Comprehensive dietary management strategies may have beneficial effects on frailty preven- tion and reversal. This 3-month single-blind, paralleled, randomized controlled trial compared the effects of mi- cronutrients and/or protein supplements, and a personalised diet on frailty status in elderly individuals. Methods and Study Design: Between 2014 and 2015, 40 prefrail or frail subjects aged ≥65 years were recruited at Miaoli General Hospital, Taiwan. Of these, 37 completed the study, and 36 were included in the analysis. Participants were randomly assigned to one of four treatment groups: (1) the control (2) multiple micronutrient supplements, (3) multiple micronutrients plus isolated soy protein supplement, and (4) individualised nutrition education with customised dishware and food supplements (mixed nuts and skimmed milk powder). Dietary intake, protein bi- omarkers, frailty score, and geriatric depression score were assessed. Results: Individualised nutrition education with customised dishware and food supplements significantly increased the participants’ intake of vegetables, dairy, and nuts, in addition to increasing the concentration of urinary urea nitrogen. It yielded a significant reduc- tion in frailty score (p<0.05) and a borderline reduction (p=0.063) in geriatric depression score. No significant beneficial changes were observed for the other two intervention groups. Conclusions: Our study indicated that a dietary approach with easy-to-comprehend dishware and food supplements to optimize the distribution of the consumption of six food groups improved frailty status and, potentially, psychological well-being in elderly peo- ple.
Selective feeding programs are centres for the treatment of persons suffering from acute malnutrition. Unlike chronic malnutrition, acute malnutrition reflects recent problems. In a crisis situation, wasting is preferred above other indicators because it is sensitive to rapid change, indicates present change, can be used to monitor the impact of interventions and is a good predictor of immediate mortality risk. This paper reviews the current approach being used in the field to evaluate the effectiveness of feeding programs. There is no comprehensive evaluation framework in place to assess the impact of feeding programs on mortality due to malnutrition. Some loose outcome measures, such as the number of children enrolled in a feeding centre, are being used to determine if a feeding centre should continue. In addition, malnutrition prevalence and crude mortality rates determined through nutritional and mortality surveys are used to assess the impact of feeding programs. This procedure does not take into account potential confounding factors that impact on malnutrition prevalence, including access to non-relief foods and the general food ration. Therefore, one could not confidently say that the reduction of malnutrition prevalence is a result of feeding programs. This paper presents an alternative approach to evaluating feeding centres.
In Australia, diet-related disease ranks alongside tobacco-related disease as the most important preventable health area, accounting for at least 10% of the total burden of disease. A population approach to improve the nutrition of all Australians is a vital contribution to the nation's overall health and well-being, yet action has often been ineffective, uncoordinated and poorly resourced. Through the National Public Health Partnership's nutrition group, SIGNAL, an ambitious work program has been commenced to address this situation. This includes the development of a national framework for action in public health nutrition 2000-2010. Following extensive consultation with health groups and the food industry, the strategy, Eat Well Australia, is now in a late stage of development. Key priorities have been agreed and focus on: (i) Aboriginal and Torres Strait Islander people; (ii) vulnerable groups; (iii) maternal and child health; (iv) overweight and obesity; and (v) fruit, vegetables and legumes. Eat Well Australia should provide a new pathway for more concerted and integrated action from a wide range of organizations and interest groups. As a core component, SIGNAL has also developed an action plan to promote comsumption of fruits, vegetables and legumes, which should mobilize responses at local, regional and national levels. Close cooperation between the food industry and the governmental and non-governmental sectors will be vital for success. A partnership platform is needed with clearly defined directions, operating principles and roles and responsibilities. Encouragingly, new and energetic alliances are now developing, which will be supported by Eat Well Australia.
This study examined the effects of a tocotrienol-rich fraction (TRF) obtained from palm oil on the healing of aspirin-induced gastric mucosal lesions. Thirty-six male SpragueDawley rats (200250 g) were randomly divided into three groups. Group I was fed a vitamin E-deficient diet (control), Group II was fed a vitamin E deficient diet supplemented with tocopherol (300 mg/kg food) and Group III was fed a vitamin E-deficient diet supplemented with TRF (300 mg/kg food). After eight weeks, the control and treated groups received a single intragastric dose of 400 mg/kg body weight aspirin. The rats were killed 24 h after exposure to aspirin. Assessment of gastric lesions showed a lower gastric lesion index in the TRF (P = 0.0005) and tocopherol groups (P = 0.0008) compared to the control. The gastric malondialdehyde (MDA) content was also lower in the TRF (P = 0.025) and tocopherol groups (P = 0.025) compared to control. There were, however, no significant differences in the gastric lesion index and gastric MDA content between the TRF and tocopherol-fed groups. There were no significant differences in the adherent gastric mucous concentration and gastric acid concentration among all groups. We conclude that the TRF and tocopherol are equally effective in preventing aspirin-induced gastric lesions. The most probable mechanism is through their ability to limit lipid peroxidation, which is involved in aspirin-induced gastric lesions.
Background and Objectives: The present study aimed to investigate the hypothesis that dietary amino acid intakes are associated with the risk of sarcopenia through a community-based observational study. Methods and Study Design: A total of 1,140 participants (72.7±6.3 y) were recruited from an annual health check-up program in Qingdao, China. Skeletal muscle mass, muscle mass functions and biochemical parameters were measured by standard methods. Dietary intake was assessed by 3-day, 24-hour food records. The odds ratios (ORs) and 95% confidence intervals (CIs) of sarcopenic risk across quartiles of amino acid intakes were calculated using a multivariable-adjusted logistic regression model. Generalized linear models were used to assess the associations between dietary amino acid intakes and muscle mass functions. Results: The prevalence of sarcopenia was 4.1%. Compared with the lowest category intake, the highest category of branched chain amino acids (BCAAs) (OR=0.11; 95% CI: 0.01, 0.90; p for trend=0.119), isoleucine (OR=0.11; 95% CI: 0.01, 0.89; p for trend=0.122) and tryptophan (OR=0.10; 95% CI: 0.01, 0.87; p for trend=0.176) was negatively correlated with sarcopenic risk with adjustment for potential confounding factors. Generalized linear model analysis showed that gait speed was positively correlated with dietary intakes of lysine, threonine, leucine, valine, tryptophan, BCAAs and aromatic amino acids (p<0.05). Conclusions: Higher intakes of BCAAs were associated with a lower risk of sarcopenia, which might beneficially protect against sarcopenia and improve physical function of the elderly.
Complementary foods (CF) are introduced earlier or later than appropriate in developing societies. They often contribute poorly to overall adequate micronutrient intake during the critical period for growth and development, which constitutes the period from 6 to 12 months of life. The objective of this study was to determine the contri- bution of the CF nutrients to the total estimated nutrient intake in infants in the second semester of life. Three non-consecutive 24-hour recalls interviews were conducted with mothers of 64 infants, aged 6-12 months on en- rolment, from a convenience sample in a marginal urban settlement in Guatemala City. Retrospective recording of early introduction of pre- and post-lacteal feeding and introduction of first foods and beverages was included. Human milk intakes were estimated by a model based on assumptions that human milk plus CF exactly satisfied the infant’s daily energy needs. The WHO/FAO Recommended Nutrient Intakes (RNI) were the standards for adequate nutrient consumption. Instances of exclusive breast feeding to 6 months were rare, with the introduc- tion of CF earlier than recommended. Baby food in jars was mentioned most frequently as the first food offered. The contribution of CF increased with age through the second semester of life. CF contributed more of a nutrient than human milk in all instances. However,CF nutrient density for Ca, Fe, and Zn fell below international stan- dard. Fortified sugar contributed excessive amounts of Vitamin A to the diets. We conclude that for most nutri- ents, intakes reached or exceeded recommendation levels, unusual within the CF experience in scientific litera- ture.
The aim of this study was to compare mean blood pressure (BP), anthropometric and body compositional measurements in three Chinese communities and to examine relationships between BP and body composition in these communities. A total of 935 adult (aged >= 25 years) men and women were randomly sampled from three communities (Chauzhou County speaking Teochew, Meixian County speaking Hakka, and Xinhui speaking Cantonese) in Guangdong Province, China. Self-administered questionnaires about food habits, lifestyle and health status were completed. Body weight, stature, waist and hip circumferences and systolic and diastolic blood pressures were measured. Body mass index, waist to hip ratio, fat free mass, total body fat mass and the percentage body fat were calculated to assess body composition. No significant differences were found in stature, body mass index, umbilical circumference, hip circumference, fat free mass, percentage body fat and defined hypertension between the three communities. However, the waist to hip ratio was lower in Chauzhou men than Meixian women. The mean BPs were different between the communities and mean blood pressure was the highest in the Chauzhou community. Intra-community non-parametric relations between BP and body composition were found mostly in men with increased total and abdominal fatness positively related to BP. The relationships of the aggregate communities with blood pressure were found consistent with those for intra-community analyses, although the body fatnessblood pressure relationship was then evident without exception. Anthropometrically assessed body composition predicts BP in Chinese men, but to a lesser extent, in Chinese women in Guangdong Province, China.
In Cambodia, both anaemia and vitamin A deficiency are serious health problems. Despite this, few comprehensive nutritional surveys have been completed to date. This study evaluates the adequacy of iron and vitamin A intakes, as well as women’s nutritional knowledge in rural Kandal province. Twenty-four hour recalls, pile sort activities, socioeconomic surveys, focus groups, and market surveys were carried out with 67 women from 5 villages in rural Kandal Province. Ninety seven percent of women did not meet their daily-recommended intake of iron, while 70% did not meet their daily-recommended intake of vitamin A. Although many women consume vitamin A-rich and iron rich-foods daily, they do not consume large enough quantities of these foods. Results suggest that both the cost of foods as well as the extent of health knowledge is linked to nutritional practice. Most animal-source iron and vitamin A-rich foods are considered expensive; however, small fish, and several plant-source vitamin A-rich foods are inexpensive and easy to access. Despite health education, food restrictions lead some healthy foods to be considered to be harmful to women. Ultimately, this study demonstrates the importance of developing comprehensive nutritional interventions in Cambodia. Health programming must provide women with not only suggestions to include low-cost nutrient-rich foods, but also ad- vise them about the quantities that are likely to have an impact on nutritional status. Programs should take a community-based, inter-sectoral approach that simultaneously combines culturally informed health education with initiatives that combat poverty and increase access to nutrient rich foods.
The aim of the present study was to obtain the nutritive and bioactive compounds of mucuna tempe and the consumer preference of its formulated snack. The tempe was made traditionally from mucuna prurience seeds using 'ragi tempe' as inoculants. Proximate, vitamin, mineral and dietary fibre analysis was done using the methods of the Association of Official Analytical Chemists, isoflavone was analysed using high performance liquid chromatography (HPLC) with an RP-18 column and a UV detector. The preference test was done using scoring methods by trained panelists. The study demonstrates that compared with soybean tempe, mucuna tempe had a higher dietary fibre level, but lower vitamin E content. The mucuna tempe contains 31.5% protein, 7.3% fat, 3.0% ash, 58.1% carbohydrate and 9.1% fibre. It contains 0.551 mg/L isoflavone aglucone; daidzin is the highest, followed by Factor II (6,7,4 trihydroxy isoflavone) that is much higher than that of soybeans tempe. These are much higher isoflavone aglucone contents than found in soybeans tempe. The preference score for a 20%mucuna tempe-based snack was not significantly different compared with control or with the preference score for a 10% soybean tempe-based snack. This preliminary study needs to be followed by both in vitro and in vivo studies.
The cobalt content of Australian foods is unknown, and as this content is, at least in part, related to the respective concentrations in the Australian soil, data collected previously in other countries may not reflect the levels in Australian produce. To compare reported food cobalt levels to that found in Australian foods, one hundred and fifty different food and beverage items from each of the major food groups were selected for analysis, based on annual sales figures in Australia. Food digests were analysed for cobalt content using a Finnigan High Resolution Inductively Coupled Plasma Mass Spectrometer. While some variation in cobalt content was seen in a small selection of foods from different States, in general terms, the cobalt content of Australian foods is similar to that seen in data from other countries.
Intakes of energy, protein, iron and vitamin A in India are usually reported as inadequate. Recognizing that tra- ditional food systems are sustainable, high in species variety, and have rich nutrient sources, we compared die- tary intakes and nutrient sources of Dalit mothers and their children living in villages with and without an inter- vention based on improved access to the traditional Dalit food system. 24-hour recalls were conducted with Dalit mothers and their children aged 6-39 months during summer and rainy seasons in 2003. We found that mothers from intervention villages had significantly higher intakes of energy (mean ± SD: 12,197 ± 3,515 kJ vs. 11,172 ± 3,352 kJ; p= 0.02) and protein (77.5 ± 25.1 g vs. 71.1 ± 25.2 g; p= 0.05) in summer, and higher in- takes of energy (11,168 ± 3,335 kJ vs. 10,168 ± 3,730 kJ; p= 0.04), protein (68.9 ± 22.6 g vs. 60.4 ± 23.8 g; p<0.01) and iron (15.8 ± 6.6 mg vs. 13.7 ± 9.1 mg; p<0.01) during rainy season. There were no differences in children’s intakes between intervention and control villages. In mothers, sorghum contributed 29% of energy, 33% of protein and 53% of iron, and green leafy vegetables contributed 21% of vitamin C and 38% of vitamin A. Our results indicate that traditional food such as sorghum, pulses and green leafy vegetables are major sources of energy, protein, iron, vitamin C and vitamin A, and that mothers from villages with the traditional food intervention had higher intakes of energy, protein and iron.
Several nutrition and non-nutritional pathways are recognised in the development and occurrence of cardiovascular disease. In many populations, high intakes of saturated fat are associated with elevated serum cholesterol concentrations and increased coronary heart disease (CHD) mortality. However, several studies report that hyperlipidaemia and heart diseases are not common among populations who consume coconut, a source of saturated fat. A case-control study was conducted among the Minangkabau known to be high coconut consumers to examine the difference in food patterns and risk of coronary heart disease (CHD) between the coronary cases and their gender- and age-matched apparently healthy counterparts serving as controls. Eligible subjects with CHD were identified through the co-operation of five participating hospitals located in Padang and Bukittinggi in West Sumatra, Indonesia. A total of 93 eligible cases (62 men and 31 women) in the Case group and 189 subjects (113 men and 76 women) in the Control group were recruited. Information on the intakes of individual foods and dishes over the preceding 12 months was obtained using a semi-quantitative food frequency questionnaire. The Case group had significantly higher intakes of meats, eggs, sugar, tea, coffee and fruits, but lower intakes of soy products, rice and cereals compared to the controls. Coconut consumption as flesh or milk was not different between cases and controls. The cases had significantly higher intakes of protein and cholesterol, but lower intake of carbohydrate. Similar intakes of saturated and unsaturated fatty acids between the cases and controls indicated that the consumption of total fat or saturated fat, including that from coconut, was not a predictor for CHD in this food culture. However, the intakes of animal foods, total protein, dietary cholesterol and less plant derived carbohydrates were predictors of CHD.
Background and Objectives: Although there are many studies on the umami receptor and its signaling pathway, literature on the effect of umami taste acuity on dietary choices in healthy subjects is limited. The current study aims to clarify the relationship between umami taste acuity with sweet or bitter taste acuity, food preference and intake. Methods and Study Design: Forty-two healthy Japanese female university students were enrolled. The acuity for umami, sweet, and bitter tastes was evaluated using the filter-paper disc method. The study population was divided into 32 umami normal tasters and 10 hypo-tasters based on the taste acuity at the posterior part of the tongue using monosodium glutamate. Results: Umami hypo-tasters exhibited a significantly lower sensitivity to sweet tastes than normal tasters. However, the sensitivity to bitter taste was comparable between the two groups. Food preference was examined by the food preference checklist consisted of 81 food items. Among them, umami tasters preferred shellfish, tomato, carrot, milk, low fat milk, cheese, dried shiitake, and kombu significantly more than umami hypo-tasters did. A self-reported food frequency questionnaire revealed no significant differences in the intake of calories and three macronutrients between the two groups; however, umami tasters were found to eat more seaweeds and less sugar than umami hypo-tasters. Conclusions: These data together may indicate the pos- sibility that umami taste acuity has an effect on a dietary life. Therefore, training umami taste acuity from early childhood is important for a healthy diet later in life.
Background: It has been reported that adequate calcium intake decreases body fat and appropriate intakes of magnesium suppress the development of the metabolic syndrome. Furthermore, lactulose increases the absorption of calcium and magnesium. An optimal combination of calcium, magnesium and lactulose may therefore reduce body fat mass. Methods: An open-label randomized controlled trial was conducted to investigate the body fat- reducing effects of a test food containing 300 mg calcium, 150 mg magnesium, and 4.0 g lactulose. Body compo- sition parameters and blood hormone and urine mineral concentrations were measured at baseline and at 6 and 12 months thereafter. Whole-body fat mass was measured with dual-energy x-ray absorptiometry. Results: Sev- enty-six middle-aged Japanese women (47.5±4.7 years) were randomized to the intake group (n=48) or the non- intake control group (n=28). At 12 months the difference in body fat mass change between the two groups (intake group – control group) was -0.8 kg (95% CI: -1.5 - 0.0 kg, p=0.046), although there were no differences in an- thropometric data between the two groups. Body fat percentage at 12 months tended to be lower in the intake group, but the difference was not significant (p=0.09). Conclusions: These findings may suggest that calcium in combination with magnesium and lactulose can reduce body fat mass in middle-aged Japanese women. However, the contribution of magnesium and lactulose are unclear in this study. Further studies are needed to clarify these contributions.
This study investigated the nutrient composition of ready cooked foods commonly consumed in southern Thai- land. Four samples of fourteen types; eight curry dishes, one sweet and sour curry, a soup dish, one stir-fried curry, one stir-fried dish and two single plate dishes were each purchased from 4 different shops around Hat Yai district. The edible part was blended and analysed for its nutrients content per 100 g edible portion. Cassia curry, Thai noodle salad, Ark shell curry and Fermented fish gut dish were a good source of vitamin B1 (145 μg), vitamin C (2.20 mg), calcium (0.23 g) and iron (6.07 mg), respectively. Moisture, ash, fat, protein and carbohy- drate were high in Mungbean noodle soup (92.6 g), Fermented fish gut dish (4.1 g), Cassia curry (9.9 g), Stingray stir-fried curry (16.7 g) and Thai noodle salad (24.2 g). Results also showed that the main ingredients and cooking process determined the nutritional values of the foods. A new set of 4 samples of Round noodle in southern curry was purchased, each separated into its edible components and nutrient values estimated using the Thai single ingredient databases. Their nutrient content was also calculated using the data of similar food ob- tained from this study. Considerable differences amongst the values from the 2 sets of calculation were ob- served. Problems inherent in using the single ingredient databases were highlighted. This work demonstrates a need to create a food composition database of whole cooked meals ready for serving that reflects real life con- sumption.
The aim of this paper is to examine the factors associated with the belief that vegetarian diets provide health benefits. A random population mail survey about food choice was conducted among a sample of 1000 South Australians. An additional (non-random) survey of 106 vegetarians and semi-vegetarians was also conducted, giving a total of 707 participants from both samples. The main predictors of the belief that vegetarian diets provide health benefits for all respondents were found to be the belief that meat is neither healthy nor necessary and frequent searching for information on healthy eating. However, there were differences between vegetarians, non-vegetarians and semi-vegetarians. In particular, health issues were relatively more important for semi-vegetarians and vegetarians, while knowledge and convenience issues were most important for non-vegetarians. The results have important implications for public health. Many South Australians perceive that health benefits are associated with eating a vegetarian diet, which may also apply to plant-based diets in general. However, if non-vegetarians are to obtain some of the health benefits associated with the consumption of a plant-based diet, they require information on the preparation of quick and easy plant- based meals.
Background and Objectives: We examined how food choice motives and dietary habits changed during the COVID-19 pandemic. Methods and Study Design: Four hundred elderly Japanese completed an online questionnaire in early May in 2021. Participants were retrospectively asked about their intake of food groups and food choice motives before and during the COVID-19 pandemic. Dietary diversity was determined using the dietary variety score calculated from the food frequency questionnaire with 10 food groups. The importance of each of the nine food choice motives for elderly people was assessed. Each scores ranged from 1 to 5. Changes in food choice motives and dietary behaviors during the COVID-19 pandemic were assessed using the paired t-test and a general linear model. Results: Among the food choice motives, scores for the importance of weight control, physical well-being and economical efficiency significantly increased in both sexes (all p<0.05). Dietary diversity score was lower during the COVID-19 pandemic than that before the pandemic in women (p=0.019), but there was no difference in men. In the multivariate adjustment model, physical well-being and economical efficiency were shown to have significant positive associations with the COVID-19 pandemic in women (p=0.034 and 0.009, respectively). In contrast, eating out was shown to have a significant inverse association with the COVID-19 pandemic in women (p=0.009). Conclusions: The findings suggest that the COVID-19 pandemic was associated with an increase in some food choice motives and a decrease in the frequency of eating out among elderly female Japanese.
In this study, we investigated the association between food form (mixed vs separated) and eating rate. The exper- iment used a within-subjects design (n=29, young healthy women with normal weight). Test meals (white rice and side dishes) with the same content and volume were served at lunch in a mixed or separated form. The form in which the food was served had significant effects on consumption volume and eating rate; subjects ate signifi- cantly more (p<0.05) when a test meal was served as a mixed form (285 g, 575 kcal) compared to a separated form (244 g, 492 kcal). Moreover, subjects also ate significantly faster (p<0.05) when the test meal was served as a mixed form (22.4 g/min) as compared to a separated form (16.2 g/min). Despite consuming more when the test meal was served as a mixed form than when served as a separated form, the subjects did not feel significantly fuller. In conclusion, we confirmed that meals served in a separated form might lower the eating rate and, moreo- ver, slower eating might be associated with less energy intake, without compromising satiety.
Food fortification has played a significant role in the current nutritional health and well-being of populations in industrialized countries for over 70 years. A relative lack of a concentrated food processing chain, less developed commercial markets, and relatively low consumer awareness and demand have hindered the same application of the intervention in the transitional, and even more, in the least developed countries until quite recently. The present paper reviews fortification of foods with micronutrients in advantaged (industrialized), transitional (developing) and least developed countries briefly, including reference to bio-fortification, examining some of the public health issues involved. There are different needs and challenges in getting this technology accepted and making it sustainable. Primary constraints in reaching poor target populations are adequate availability, accessibility, and quality assurance/quality control. The paper then examines some issues of risk and benefit and the communication of these, and finally looks towards the future and draws some conclusions. Despite these issues there has been an enormous increase in fortification programmes over the last couple of decades in developing countries. Along with dietary diversification, supplementation and related public health and private sector intervent ions, this has resulted in considerable progress in reducing the prevalence of vitamin A and iodine deficiencies, but much less so with iron, even as zinc and folic acid deficiencies have emerged as significant public health problems. Food fortification based on sound principles and supported by clear policies and regulations will play an increasingly large role in the progress towards the prevention and control of micronutrient malnutrition. Success and sustainability require clear communication of the small risks involved and the substantial benefits, particularly to populations with significant levels of micronutrient malnutrition, as a complementary approach with other public health measures, in reducing the prevalence of deficiencies and their health consequences.
Background and Objectives: This study evaluated the association of physical prefrailty with the prevalence of inadequate nutrients among community-dwelling Japanese elderly women. Methods and Study Design: This cross-sectional study included 120 older women (age range, 65–79 years) at an elders college. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study (J-CHS). Participants were classified as either prefrailty (1–2 deficits) or nonfrailty (0 deficits) based on set criteria. Both groups were compared in terms of physical function, exercise time, nutrient intake, and food group intake estimated by Food Frequency Questionnaire Based on Food Groups (FFQg), and estimated prevalence of inadequate nutrient intake, which was evaluated using each dietary reference value, set as the estimated average requirement (EAR) and dietary goal (DG), based on the Dietary Reference Intakes (DRIs) for Japanese, 2020. Results: Of the participants, 45.0% exhibited physical prefrailty. Binary logistic regression analysis identified that vitamin C intake below EAR (OR, 7.12; 95% CI, 1.47-34.41, p=0.014) was the only factor associated with physical prefrailty. Conclusions: In addition to measuring physical function, dietary surveys and evaluation of nutritional adequacy by DRIs are expected to be useful for the early prevention of physical prefrailty by linking to nutrition education among community-dwelling Japanese elderly adults.
This cross-sectional study investigated the prevalence of anaemia and vitamin A deficiency (VAD) among pregnant women in a poor urban population of Bangladesh. It also examined the association of various socio-economic and dietary factors with anaemia and vitamin A status. A maternal and child health clinic in Dhaka city, Bangladesh was used to obtain the sample. Three hundred and eighty three pregnant women, aged 20-30 years, of 20-30 weeks gestation were randomly selected from women on their first presentation for antenatal care. Socio-economic, pregnancy related information, usual dietary pattern and anthropometric data were collected. Blood haemoglobin and serum retinol (vitamin A) concentrations were determined. About 40% of the pregnant women were anaemic (haemoglobin <11.0 g/dl) and 45% had low serum vitamin A levels (<30 mg/dl); with 8.6% having sub-clinical VAD (serum retinol <20 mg/dl). The women with low serum vitamin A levels had 1.8 times greater risk of being anaemic than did the women with normal vitamin A status. Food frequency data revealed that a large proportion of these women did not consume egg (49%), milk (25%), meat (31%), liver (83%), large fish (32%), small fish (39%) and sweet pumpkin (52%) at all; while about 25% of the women reported consuming dark green leafy vegetables (DGLV) and 64% reported an intake of fruit at least four servings a week. The pregnant women who were either illiterate or received only informal education (up to grade ten) had significantly lower haemoglobin and serum vitamin A levels compared to those who completed at least a secondary school certificate. The women whose husbands were illiterate or received only informal education had significantly (P=0.01) lower serum vitamin A levels than those whose husbands had received at least a secondary school certificate. The women who came from families with a per-capita income below the poverty line had significantly lower haemoglobin and serum vitamin A levels compared to those who came from families with a per-capita income above the poverty line. The women who consumed three servings or less of DGLV and fruit per week had significantly lower haemoglobin and serum vitamin A levels than those who consumed four or more servings a week. The women who never consumed large fish had significantly lower haemoglobin compared to those who reported at least one serving a week. Furthermore, the women who never consumed sweet pumpkin had significantly lower serum vitamin A than the women who ate at least one serving a week. By multiple regression analysis, intake of meat, DGLV and fruit, and serum vitamin A levels were found to have a significant independent relationship with haemoglobin. The overall F-ratio (9.9) was highly significant (P=0.000), the adjusted R-square was 0.086 (multiple R =0.309). Multiple regression analysis for serum vitamin A also revealed a significant independent relationship with per capita income, haemoglobin levels, intakes of DGLV and sweet pumpkin. The overall F-ratio (10.2) was highly significant (P=0.000), the adjusted R-square was 0.10 (multiple R =0.312). In conclusion, anaemia and vitamin A deficiency were highly prevalent among poor urban pregnant women in Bangladesh. Various socio-economic and dietary factors may influence the anaemia and vitamin A status of these women. The present study emphasizes the need for a comprehensive intervention strategy, which include both nutritional and environmental factors, to improve the nutritional status of this population.
This brief keynote speech provides an annotated check list for topics to be covered during the meeting. The topics presented include specific indicators of nutrition, new regional information and communication technologies, empowerment of communities, effective nutrition and health interventions, advances in agricultural research, progress in food technology and the potential of biotechnology and genomics to benefit the region. Other issues to be considered are land decentralization, south-south and south-north cooperation, program monitoring and evaluation, human rights and ethics.
Background and Objectives: The objective was to compare the dietary intakes of individuals with type 1 diabe- tes (T1D) to individuals without diabetes in China. Methods and Study Design: Data are from 1) the 3C Nutri- tion Ancillary Study, a cross-sectional study of individuals with T1D in China, and 2) the China Health and Nu- trition Survey. Dietary intake in both samples was assessed using three 24-hour recalls. ANCOVA and multivari- able logistic regression, adjusted for sex, age, and urban-rural residence, were used to assess differences in nutri- ent and food group intake between participants without diabetes (n=1059) and participants with T1D (n=97), who were stratified by insulin regimen (basal-bolus, n=49, versus fixed, n=48). Results: Participants with T1D had a lower percentage of energy from carbohydrates, higher vegetable intake, and were more likely to consume low- fat cakes and fungi/sea weed compared to participants without diabetes (all p<0.05). Distinguishing characteris- tics of insulin regimen groups also emerged. Participants on fixed regimens had higher intakes of wheat and were less likely to consume fruit and more likely to consume high-fat cakes and dairy compared to participants without diabetes (all p<0.05). Participants on basal-bolus regimens were less likely to consume fried foods and more like- ly to consume fish/shellfish compared to participants without diabetes (all p<0.05). Conclusions: Differences in dietary intake between participants with and without T1D in China suggest that dietary modifications are com- mon and reflect carbohydrate-conscious nutrition recommendations for individuals with T1D. Future research should focus on the health effects of these modifications.
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.
Background and Objectives: An adequate iodine status during pregnancy is very important for maternal and infant health. The aim of this study was to characterize the iodine nutritional status of healthy pregnant women in Chengdu by measuring urinary iodine (UI) and analyzing dietary iodine intake. Methods and Study Design: Pregnant women who underwent regular antenatal examinations were invited to participate in this study. Each woman underwent UI determination and urinary creatinine (Cr) measurement and recorded the details of her diet and salt intake at the beginning and end of one week. Results: In total, 139 healthy pregnant women underwent UI determination in this study; among them, 116 participants completed the diet survey. The median urine iodine/creatinine (UI/Cr) of the 139 patients was 216 µg/g, and the median dietary iodine level of 104 patients who completed the 7-day dietary record was 230 µg/d. The dietary iodine sources of the pregnant women were mainly seafood (11%), iodized salt (51%), iodized multivitamins (17%) and daily food (21%). Conclusions: We concluded that healthy pregnant women in Chengdu showed appropriate iodine nutritional status. The 7-day dietary record can be a nice way to evaluate dietary iodine nutritional status, and there is a strong correlation between dietary iodine intake and UI concentration.
Background and Objectives: The relationships of dietary choline and folate intake with hepatic function have yet to be established in the Taiwanese population. We investigated the associations of choline and folate intake with hepatic inflammatory injury in Taiwanese adults. Methods and Study Design: Blood samples and data on dietary choline components and folate intake from 548 Taiwanese adults without pathological liver disease were collected. Dietary intake was derived using a semiquantitative food-frequency questionnaire. Serum liver injury markers of alanine transaminase, aspartate transaminase, and hepatitis viral infection were measured. Results: Elevated serum hepatic injury markers (>40 U/L) were associated with low folate and free choline intake (p<0.05). Folate intake was the most significant dietary determinant of serum aspartate transaminase concentra- tion (beta=−0.05, p=0.04), followed by free choline intake (beta=−0.249, p=0.055). Folate intake exceeding the median level (268 μg/d) was correlated with a reduced rate of hepatitis viral infection (p=0.032) and with normal- ized serum aspartate transaminase (odds ratio [OR]=0.998, 95% confidence interval [CI]=0.996-1, p=0.042) and alanine transaminase (OR=0.998, 95% CI=0.007-1, p=0.019). Total choline intake exceeding the median level (233 mg/d) was associated with normalized serum aspartate transaminase (OR=0.518, 95% CI=0.360-0.745, p=0.018). Conclusions: The newly established relationships of dietary intake of total choline and folate with normalized hepatic inflammatory markers can guide the development of dietary choline and folate intake recom- mendations for Taiwanese adults.
Dietary habits of children, including snack foods consumption, in developing countries have seldom been investi- gated in relation to their nutrition and health. To assess the effects of snack foods consumption of 154 children aged 1-12 years in a rural village of West Java, Indonesia, a 3-hour-interval food recall survey for all meals and snack foods consumed in seven consecutive days for each subject, anthropometry, and interviews for socio- demographic indicators were conducted. Their overall prevalence of stunting and underweight was 69.5% and 35.7%. There were 221 foods consumed by the subjects, among which 68 foods were categorized as snack foods. Though the children of both <7 year and ≥7 year age groups consumed snack foods similarly throughout the day, the latter group only consumed larger amounts of energy from snack foods at school recess-times. The mean per- cent contribution of snack foods was 59.6% for fat, 40.0% for energy, 20.6% for calcium, and <10% for vitamins A and C. Half number of the subjects who snacked more than the median amount consumed less carbohydrate and vitamin C than the remaining half. Furthermore, the more snack-consuming group the lower z score for height-for-age (HAZ) among schoolchildren. To improve this nutritionally vulnerable situation, consumption of snack foods should be replaced by the non-snack foods which contain much higher nutrient density, i.e., 15 times for calcium and 32 times for vitamin A. Moreover, considering high snack foods consumption of ≥7 y age group at school, appropriate school nutrition programs should be promoted.
Distrust of food safety has grown among the Japanese people after the occurrence of bovine spongiform en- cephalitis (BSE) in 2001. The Food Safety Commission was formed under the Cabinet Office and made a net- work among the ministries. The newly-established Consumer Agency may strengthen the quick response to emergencies. Shoku-iku (food and dietary education) Law is being implemented by the Cabinet Office with co- operation from relevant ministries and NGOs. Food Sanitation Law and Health Promotion Law are briefly ex- plained, and the necessity of functional nutriology for non-nutrient biologically active substances is described. With regard to public health nutrition, a new food label showing energy balance and antioxidant unit (AOU) as a surrogate marker of fruit and vegetables has been developed for tailor-made nutrition which makes it easy to for individuals to control energy intake.
The main objective of this study was to assess the iodine nutritional status among school children (6-12 yrs) of Sundarban delta in North 24- Parganas district of West Bengal in eastern India. A total of 2050 children were clinically examined for goiter and 240 urine samples were analyzed for iodine and thiocyanate respectively; iodine content in 48 water samples and 210 salt samples were also measured. Results indicate that the studied region is clinically severely goiter endemic having goiter prevalence 33.1 % (grade 1: 30.4 %; grade 2: 2.7%), median urinary iodine level 200 μg/l indicating no biochemical iodine deficiency, 65.2 % salt samples contain recommended level of iodine and the iodine content in drinking water is sufficient while mean urinary thiocyanate level was 0.708±0.38 mg/dl. In spite of the consumption of adequate iodine, the existing goiter prevalence may be for the consumption of dietary goitrogens/antithyroid substances that possibly come through food and water.
There is considerable interest in the potentially protective effects of high fish consumption on many chronic diseases. Many epidemiological studies use food frequency questionnaires (FFQ) to quantify usual dietary fish intake, so it is important to validate this assessment against objective markers. The objective of this study was to determine the relationship between plasma percentage fatty acids and dietary fish intake as assessed by a FFQ. A semiquantitative FFQ was completed by 174 adults from the community (aged 26-49 years) who also had venous blood analysed for plasma percentage fatty acids. Following linear regression modelling, total non-fried fish intake was a significant predictor of n-3 (regression coefficient, B = 0.94; 95% CI = 0.60-1.28), docosahexaenoic acid (DHA; B = 0.73; 95% CI = 0.47-0.99) and the ratio of n-6 : n-3 fatty acids (B = -1.0; 95% CI = - 1.35-- 0.65). Steamed, grilled or baked fish was a small but significant predictor of eicosapentaenoic acid (EPA) levels (B = 0.13; 95% CI = 0.05-0.21) while total fish intake was a predictor of n-6 fatty acids (B = - 0.88; 95% CI = - 1.41-- 0.36). This semiquantitative FFQ could be useful for ranking subjects according to their likely plasma n-3, DHA, and n-6 fatty acid intake and the ratio of n-6 : n-3 fatty acids, when the available resources may simply not permit biological markers to be used.
ACTIVATE was initiated in 1999 by the International Food Information Council (IFIC) Foundation and the International Life Sciences Institute Center for Health Promotion. Extensive qualitative research was conducted to help understand consumer beliefs, attitudes, and perceptions about preventing overweight, specifically overweight in childhood. ACTIVATE then used the research findings to develop potential avenues for communicating obesity prevention messages. The research, conducted with children and their parents, consisted of three progressive phases of focus groups, with each building on information obtained from the previous phase. The findings suggest the need for parents and children to work together to address the obesity prevention issue, as well as the need for effective tools to facilitate this conversation. Parents need to learn how to talk about eating and exercise habits with their children in positive and encouraging ways and how to help sustain their child's involvement in eating healthily and staying physically active. Children themselves need direct messages to motivate them to change their exercise and eating habits, as well as tips on partnering with their parents to achieve fitness goals. Children and parents both stated that positive and realistic approaches to getting fit that seem achievable and accessible would be of great help in their efforts. Both groups considered ongoing encouragement and 'small victories' to sustain involvement in getting fitter to be critical factors to success. Children and parents are also looking for support and customized information to help them in their efforts. ACTIVATE responds to the critical need for comprehensive obesity prevention initiatives. It is a communications program designed to help children and their families achieve healthy lifestyles through regular physical activity and good nutrition. ACTIVATE promotes sound nutrition advice by emphasizing that healthy eating is based on the overall diet, not any one food or any one meal. The message that all foods can fit into a healthy diet when consumed in moderation is an integral piece of ACTIVATE. Being physically active is equally as important as eating well, and various ways to incorporate activity into children's lives are emphasized. Particular attention is placed on making physical activities fun, enjoyable, and sustainable. ACTIVATE is also a unique partnership. The IFIC Foundation is working closely with several organizations to develop ACTIVATE's program elements and to extend ACTIVATE's reach. These partner organizations are the American Academy of Family Physicians (AAPP); the American College of Sports Medicine (ACSM); the American Dietetic Association (ADA); the International Life Sciences Institute Center for Health Promotion (ILSI CHP); and the National Recreation and Park Association (NRPA). In addition, ACTIVATE is advised by individual experts in physical activity, nutrition, family medicine, and child psychology. Currently, the IFIC Foundation and its partners are using the research findings to develop ACTIVATE's customized program elements program elements that will deliver positive, balanced information on physical activity and nutrition to help families achieve healthy lifestyles.
Background and Objectives: There is very limited published data on Tibetan dietary patterns and its association with nutrient intakes and socioeconomic factors. The aim of this study was to identify and describe the dietary patterns and the associations with nutrient intakes in rural Tibetan pregnant, lactating mothers. Methods and Study Design: Dietary patterns and nutrient intakes were identified via a food frequency questionnaire (FFQ). We identified dietary patterns using principle component analysis (PCA) of intakes of 17 food groups and specif- ic Tibetan foods. Quartile categories of each dietary pattern were used, and non-dietary lifestyle factors and total energy intake were adjusted for the analysis. We identified two dietary patterns: “Varied pattern” and “Staple pat- tern”. Result: The “Varied pattern” was characterized by a high intake of vegetables, fruits and soy foods which showed significant positive associations with vitamins. Vitamin C (Ptrend<0.01) and vitamin E (Ptrend<0.01) were strongly associated with “Varied pattern” among mothers with children younger or older than 12 months. The “Staple pattern” was characterized by Tibetan staple foods, Tibetan beverages and Tibetan snacks and showed significant negative associations with protein (Ptrend<0.01) among mothers with children younger than 12 months or older than 12 months. Carbohydrate intakes significantly increased with “Staple pattern” among mother with children younger than 12 months only. Conclusions: The results presented here suggested our dietary patterns to great extent characterize the dietary behavior of Tibetan lactating mothers. There is, therefore, potential for die- tary patterns to be used as a valid tool in assessing Tibetan diet.
Probiotic organism Bifidobacteria was isolated from the faeces of breast-fed infants at Universiti Putra Malaysia. Trypticase phytone peptone yeast extract agar (TPY) was used as a selective media for the isolation. Morphological examination of the isolates indicated that Bifidobacteria was Gram-positive rods in nature, curved with characteristics of V and Y shapes. The organisms were non-catalase producing, non-nitrate reducing, non-motile, had an absence of indole and were unable to liquify gelatin. The ratios of acetic and lactic acids were determined using high performance liquid chromatography (HPLC). Using carbohydrate fermentation profile test API-CH-50 kits, 20 Bifidobacteria strains had been identified: they were the species of Bifidobacteria infantis and two different sub-species, mainly infantis and lacentis. Based on a wide zone of inhibition, three suitable strains of B. infantis, Bifi-11, Bifi-19 and Bifi-20, were tested in weaning foods for antimicrobial activity towards two human pathogens: E. coli-0157 (World Health Organization) and Salmonella typhimurium S-285. The pH, titratable acidity of weaning foods and total colony count for Bifidobacteria, enteropathogenic Escherichia coli and S. typhimurium were recorded at 3-h intervals for 30 h. It was found that after 9 h of incubation of weaning foods, the pH declined to < 3.6 from pH 6.0, whereas titratable acidity increased from 0.026 to 0.08%. It was indicated that Bifidobacteria inhibited E. coli better than did S typhimurium due to low pH. After 24 h of incubation, approximately 98% of E. coli was inhibited by Bifidobacteria. It is suggested that the inhibitory effect of Bifidobacteria strains in weaning foods towards the growth of enteropathogenic E. coli and S. typhimurium was solely due to low pH and the production of volatile acid components by the organism.
The objective of this study was to compare the dietary calcium intakes assessed by a quantitative food frequency questionnaire (FFQ) and the three-day food record method in 230 Chinese postmenopausal women aged 50-65 years in Kuala Lumpur. The results showed that the mean calcium intake from the dietary records was 447 ± 168 mg/day and 499 ± 211 mg/day from the FFQ. The mean difference in intake by the two methods was 51.3 mg (95% CI = - 30.8 - 77.9; SD = 181.2, P> 0.05), which did not differ significantly from zero. Pearson's correlation coefficient of 0.56 was obtained between the two methods. Ninety-five percent of the individuals classified by food records fell into the same or within-one-quartile category when classified by FFQ. Forty-eight percent were classified into the same quartile by both methods. No subjects were grossly misclassified by the FFQ. The FFQ correctly identified subjects with calcium intakes below the Malaysian recommended daily allowance (450 mg/day) with 60% specificity and with 92% specificity for women consuming less than 800 mg calcium/day. In conclusion, the FFQ developed was a useful, rapid clinical tool for assessing calcium intake and identifying postmenopausal Chinese women with low calcium intakes in Malaysia.
Evaluating the nutritional status of individuals and population groups is an important tool in public health and a
feasible indicator of standards of living. The objective of this study was to determine the frequency of obesity
and present nutritional status of university students of Iran University of Medical Sciences in Tehran. The
survey was conducted between Oct 2004 and June 2005. The statistical population included all students from
School of medicine, nursing and midwifery, health services, management, science, and rehabilitation. The
method of sampling was multistage random. The sample size for the survey was 1150 students. We used a self-
administered 24h food recall questionnaire. We categorized BMI to two groups in bivariate analysis (BMI ≥ 25 -2-2 -2
kg m as obese and less than 25 kg m as non-obese). Mean BMI for all subjects was 21.7 ± 2.9 kg m-2 . Almost 88% of the subjects were classified into a non-obese group (BMI <25 kg m ). About 10% were underweight and 12.4% of the students had a BMI more than 25 kg m-2 . A significant difference was observed for BMI between males and females; 7.9% of males versus 22.5% of females had BMIs over 25. About 18% of students aged 23 years and over had BMIs over 25 versus 7.7% of students aged under 18. Intakes of fiber, pre-vitamin A, folacin and iron were significantly different between BMI groups. Intakes of these nutrients were higher in the obese students than the students with BMIs less than 25 kg m-2 . Our results indicate that about 12.4% of the students had a BMI more than 25 kg m-2. There was a significant association between BMI, and smoking habits, age, sex, place of resident and having specific dietary regimen.
Background – Current treatments and outcomes for Ulcerative Colitis (UC), a form of inflammatory bowel disease (IBD), are generally disappointing hence new forms of therapy are urgently required. It has been proposed that manipulation of the gut microbiota with a diet containing wheat bran plus resistant starch (WBRS) may have the ability to modulate the colonic microflora towards a more remedial community and thus potentially act as a novel therapeutic approach in the management of UC.
Objective – To examine the effect of a diet containing high (~32 g/day) levels of WBRS compared to a diet containing low (~10 g/day) levels of WBRS, on the composition of the colonic microflora in individuals with UC. Design – Single blind randomised 48-day crossover dietary intervention, where a total of five subjects (two women, three men) between the age of 18 and 54 years with UC in remission, consumed dietary supplements containing low and high levels of WBRS.
Outcomes – Compared to the low WBRS diet, the high WBRS diet significantly reduced the numbers of the Bacteroides-Prevotella spp. group (P = 0.043) and increased the numbers of the Bifidobacterium spp. group (P = 0.04). No effects on the total number of bacteria, Enterobacteriaceae including Escherichia coli, Clostridium spp. group, Eubacterium spp. group and Lactobacillus spp. group were observed.
Conclusions – Addition of high level WBRS supplements to the diet of UC subjects provided favourable changes to specific groups of bacteria, in particular the Bacteroides-Prevotella spp. group and the potentially beneficial Bifidobacterium spp. group, which suggest this novel combination of dietary fibres may be useful in the management of UC.
Background – Food fortification and/or multivitamin supplementation may improve nutritional status in aged care residents who are at risk of malnutrition and related diseases.
Objective – To assess the effectiveness of a multivitamin tablet, and calcium-vitamin D3 fortified milk supplementation for six months, on serum indices of nutritional status and bone quality (quantitative heel ultrasound, QUS) in a group of Australian aged care residents.
Design – With a 2x2 factorial design, subjects were randomized to receive either a placebo (P) or multivitamin (MV) tablet containing various vitamins including 5 μg cholecalciferol, 250 mg calcium carbonate, 20 μg cyanocobalamin and 200 μg folic acid (1 tablet/day), and, matched on mobility levels, to receive fortified milk (7 g protein, 200 mg calcium and 5 μg cholecalciferol), or usual milk for six months. Measurements of body weight, QUS, and serum concentrations of nutrients were performed at baseline and at six months.
Outcomes – Low compliance in consuming the fortified milk caused by the difficulties in delivering the milk to the participants led to the cessation of milk after 16 weeks of the study. Therefore only the effect of multivitamin supplementation was examined. Of 115 participants entering the study, 92 (49 MV and 43 P) completed the study. Following supplementation after six months, compared to the P group, the MV group had a greater rise in serum 25(OH)D (33.4 ± 2.6 nmol/l), folate (13.4 ± 2.8 nmol/l), and vitamin B12 (163.5 ± 40.3 pmol/l). The number of participants with adequate 25(OH)D concentrations (>50 nmol/l) increased from 23% to 77% for the MV group, and was reduced from 17% to 10% for the P group. After adjustment for baseline levels, the MV group had an improvement in QUS by 2.7 dB/MHz, compared to -2.5 dB/MHz for the P group (P=0.041).
Conclusions – Daily multivitamin supplementation improved nutritional status with respect to serum 25(OH)D, and raised vitamin B12 and folate concentrations. Additionally, there was an indication of a positive effect on bone density; this could in the long term contribute to a reduction in falls and fractures.
Background – Increases in the prevalence of asthma may be explained by changes in the dietary intake of long chain omega-3 polyunsaturated fatty acids (LCn-3 PUFA’s), which are shown to have anti-inflammatory properties. Objective – To evaluate the dietary intake of LCn-3 PUFA’s in adult women with and without asthma and to examine the effect of inhaled corticosteroid use (ICS) on dietary intake.
Design – We recruited asthmatic women (n=34) and non-asthmatic controls (n=26). Participants completed a food frequency questionnaire and dietary analysis was determined using Foodworks software, Xyris, QLD.
Outcomes – There were no significant differences in age and BMI between the asthmatic and non-asthmatic control groups. Asthmatic women had lower lung function compared to controls (Mean ± SEM) (FEV1%; 96 ± 2% vs. 100 ± 1%, P=0.51). The median (Q1-Q3) inhaled corticosteroid dose for asthmatic women was 625 (287.5-1000) μg/day. A significant difference in the dietary intake of LCn-3 PUFA’s between asthmatic and non-asthmatic controls was observed (Mean (g/day) ± SEM) (Asthma: 0.16 ± 0.42, Control: 0.05 ± 0.005, P=0.02). The control group had a lower LCn-3 PUFA intake compared to the Australian average (0.159 g/day) (1). Further subgroup analysis showed that there was no significant difference in dietary intake of asthmatic women using ICS compared to asthmatic women who were steroid naïve.
Conclusions – An unexpected elevation in the LCn-3 PUFA intake was seen in these asthmatic women. This may be likely to represent an increased awareness of the health benefits associated with LCn-3 PUFA consumption in asthma, leading to an increased dietary intake. These results also indicate that the non-asthmatic control group are failing to meet Australian intake recommendations for LCn-3 PUFA’s.
References
Background – LCn-3PUFA are known to have beneficial effects on human health. However, changes to the human diet in the past 150 years appear to have resulted in reduced intakes of LCn-3PUFA which now fall well short of an adequate intake for optimal health.
Objective – To examine awareness of and intake of LCn-3PUFA major food sources by young adult consumers. Design – Questionnaires about knowledge and consumption of omega-3 fats were completed by 78 tertiary students (28 male and 50 female). Demographic variables were considered as influences on behaviour.
Outcomes – Intake of LCn-3PUFA (ALA, EPA and DHA) was considerably lower in females (60 mg/day) than in males (100 mg/day). These intakes were both lower than the average Australian adult intakes (females 159 mg/day and males 222 mg/day), and much lower than the recommended 430 mg/day for females and 610 mg/day for males. Seventy four percent of participants did not know about the best food sources of n-3 PUFA or the potential health benefits of consuming these fatty acids.Conclusions – The low intake of LCn-3PUFA by young adults is a concern. It is possible that awareness and consumption increases with age, as reflected in the Australian adult population. Consideration should be given to promotions targeting young adults to ensure an adequate consumption to maximise the health benefits in later years.
Background – Pro-inflammatory cytokines are released in response to conditions of stress such as trauma, surgery, burns, sepsis and exercise. Exercise has been suggested to affect the immune system in a J curve, where moderate exercise improves immune function and chronic exercise impairs the immune system and increases the risk of upper respiratory tract infection [1, 2].
Objective – The objective of the study was to determine the effect of acute maximal exercise on plasma markers of inflammation, carotenoids and fatty acids in healthy endurance athletes and untrained adults.
Design – Twenty endurance trained athletes and 15 sedentary adults completed an overnight fasting treadmill VO2max test, a 7-day physical activity record and a 4-day weighed food record. Blood was collected at baseline and post-exercise for the analysis of inflammatory markers, fatty acids and carotenoids in plasma.
6
Outcomes–Plasmamonocyteconcentration(x10 cells/ml)significantlyincreased(P<0.001)inallparticipants
from baseline (1.35 + 0.33) to post-exercise (2.65 + 1.10). Athlete monocyte concentration was significantly higher (P < 0.05) at baseline (1.44 + 0.37) and post-exercise (3.00 + 0.80) compared to sedentary adults (1.25 + 0.24, 2.23 + 1.29). There was no difference in the plasma inflammatory markers IL-6, TNF-alpha and LTB4 at baseline and post-exercise. Acute maximal exercise significantly increased plasma lutein/zeaxanthin (P < 0.001), beta- cryptoxanthin (P < 0.001) and lycopene (P < 0.01) concentrations. Plasma non-esterified fatty acid (NEFA) significantly increased but total fatty acids remained unchanged in response to exercise.
Conclusion – In healthy human adults acute maximal exercise can increase plasma monocyte, carotenoid and NEFA concentration without a change in inflammatory mediators.
References
Background – The in vivo glycaemic index (GI) testing of foods can give a broad range of results between laboratories and even within laboratories for the same food item. Demographic factors such as gender, ethnicity and age of participants may influence the glycaemic responses in the individuals to a standard Oral Glucose tolerance test (OGTT), hence may affect the determination of the GI value of foods.
Objective – To determine effect of age, gender and ethnicity of the subjects attending the GI testing site on their glycaemic response (GR) to a standard OGTT.
Design – Glucose response data was collected on 204 subjects of varying age, ethnicity and gender from multiple OGTT (minimum =3, maximum=11). The individuals were grouped based on their ethnicity into: Western European (n = 105), Asian (n = 83) and Indian and Middle Eastern (n = 16), as well as age groups: 18 - 26, 27 – 35 and 36- 45 years, and male and female gender.
Outcomes – There was no significant difference in the area under the curve (AUC) for the 50g glucose solution in Asian, Western European and Indian and Middle Eastern F (2, 201) = 10.3, P= 5.2. The blood glucose level in Indian and Middle Eastern subjects tended to return to the fasting level very slowly compared to other ethnicities. The effect of age on glucose responses was not significant. Statistical analysis also showed no significant differences in the AUC based on gender (57.3% female; 42.6% male), F (1, 202) = 0.42, P= 0.5.
Conclusion – Ethnicity, gender and age do not have significant influence on the GR and thus may have no impact on GI determination of foods.
Several studies show that intrauterine nutrition restriction is associated with vascular disease. Animal studies have shown that atherosclerosis can be affected by a constrained intrauterine diet, but this relationship in humans is controversial. The purpose of this study was to investigate the relationship between maternal intake during pregnancy and carotid intimal media thickness (CIMT). We measured CIMT in 565 twenty year old young adults whose mothers, while pregnant, participated in a nutritional study during 1989-1990 at two hospitals in Chiang Mai, Thailand. Maternal diet during pregnancy was assessed by two methods in each trimester, namely, the 24 hours food recall method and the food frequency method. Carotid intimal media thickness was greater in males and participants who showed higher blood glucose, higher body mass index and higher systolic blood pressure. Maternal protein intake during the first trimester was negative correlated with thickness of CIMT (p=0.02). The mean CIMT of participants whose mothers were in the lowest quarter of the distribution of protein intake in the first trimester was 0.45 mm (95% confidence interval (CI): 0.44-0.46) more than that of those whose mothers were in the highest quarter of the distribution (0.43 mm 95% CI: 0.42-0.44). In conclusion, lower maternal pro- tein intake during early pregnancy may increase CIMT in adolescents.
The aim of this project was to improve clinical nutrition practice amongst Australian general practitioners by offering of web-based learning as a medium for integrating clinical nutrition into general practice. Eleven nutrition units were developed in conjunction with nutritionists at www.healthyeatingclub.org and offered as part of an existing comprehensive online continuing professional development program comprising 400 educational units and offered free to Australian General Practitioners. Pre- and post-assessment questionnaires and eva-luations were collected over a 19 month period and the results collated. The experience of providing online continuing professional development to general practitioners within an integrated comprehensive primary care curriculum demonstrates that they are both interested and able to integrate clinical nutrition into practice. Since 2002, 1437 (28% of participating general practitioners) have voluntarily selected and completed clinical nutrition units as part of their learning programs. Effective educational modalities are case-based learning and peer group discussion supported by resource material and clinical tools to take learnings into practice. Educational outcomes include increased confidence to undertake counselling for weight management, increased used of anthropometric measurements, increased understanding of and use of dietary intake evaluation tools, especially the food variety score. Sustained change in clinical practice was measured by the use of clinical nutrition tools with 59% of participants making modifications to practice. A further 34% indicated an intention to review their practice and/or take up the clinical nutrition practice tool kit. Web-based nutrition education programs can be designed to be both modular and flexible, and are able to adapt to the different learning needs and styles of the different practitioners within Australia. They are an effective way of increasing knowledge, skills and confidence of general practitioners in nutrition counselling.
Background – Increasingly, measures of dietary patterns have been used to capture the complex nature of dietary intake and investigate their association with health. Healthy dietary patterns may be important in the prevention of chronic disease however there are few investigations in adolescents.
Objective – The objective of this study was to describe the dietary patterns of adolescents and their associations with socio-demographic factors and health outcomes.
Design – Analysis was conducted of data collected in the 1995 National Nutrition Survey on participants aged 12-18 years who completed a 108 item food frequency questionnaire (n=764). Dietary patterns were identified using factor analysis and pattern scores were calculated from the consumption of the food items in each dietary pattern. Outcomes – Factor analysis revealed three dietary patterns labeled on the basis of the food items that loaded highly, that is, a fruit, salad, fish and cereals pattern, a vegetables pattern and a high fat and sugar pattern which explained 11.9%, 5.9% and 3.9% of the variation in food intakes, respectively. High consumers of the high fat and sugar pattern were more likely to be male (p<0.001), while high consumers of the vegetable pattern were more likely to be living in rural areas compared to metropolitan areas (p=0.004). There were no significant associations with age or area-level index of relative socio-economic disadvantage. The fruit, salad, fish and cereals pattern was significantly associated with diastolic blood pressure (p=0.019) with high consumers having lower blood pressure. In contrast, high consumers of the high fat and sugar pattern had significantly higher systolic blood pressure (p=0.026). Conclusion – Diets characterised by healthier food items were associated with lower blood pressure while consumption of foods high in fat and sugar were associated with higher blood pressure. Specific dietary patterns are already evident in adolescence and may be associated with health.
Background and Objectives: As the incidence and prevalence of Alzheimer’s disease increases, so does the body of epidemiological and clinical research that suggests a relationship between dietary fatty acids, in particular saturates, and cognitive decline. In this study, we investigated the association between serum apolipoprotein B48 (apoB48), saturated fatty acid intake and consumption behaviour, and cognitive performance, in healthy, older aged Australians. Methods and Study Design: We retrospectively analysed fasted serum apoB48 concentrations, food frequency questionnaire, and cognitive performance data collected from 147 participants (98F|49M) over the age of 50. We used Spearman’s correlations and a nested domain model to evaluate the relationship between se- rum apoB48, dietary behaviour and measures of cognitive performance. Results: Overall, we found that higher fasted apoB48 concentrations, and/or dietary behaviours which led to increased dietary consumption of diets high in saturated fatty acids, were inversely associated with cognition. Interestingly however, dietary behaviour pat- terns of saturated fatty acid consumption and serum apoB48 were linked with better secondary memory and per- ceptual speed, respectively. Conclusions: This is the first time that fasted apoB48 has been implicated as a bi- omarker for cognitive decline and Alzheimer’s disease risk.
Background: Food frequency questionnaire (FFQ) must be tailored to the target populations because dietary hab- its vary within the populations due to differences in cultural and lifestyles practices. Limited information is avail- able to assess the validity of FFQ used among Malaysian adolescents. Objective: To construct the validity and re- producibility of a newly developed FFQ in assessing habitual nutrients intake over the past year of 170 Malay ad- olescent boys and girls in Kelantan, Malaysia. Methods: The FFQ that consisted of 124 food items was assessed, whereas three days of 24-hours dietary recalls (DR) was administered as the standard criteria method. Results: Estimated mean intake for most nutrients assessed by the FFQ were higher as compared to the three DRs (p<0.05). Pearson correlation coefficients for energy-adjusted nutrients intake between both methods were ranged from 0.22 (zinc) to 0.68 (calcium) with a median r-value of 0.43. The cross classification of quartile analysis showed that most nutrients were classified into the same or adjacent quartiles (median=52.7%). For the repro- ducibility of FFQ, the correlation of nutrients ranged from 0.43 for carotene to 0.86 for total fat intake (me- dian=0.67), after adjusting for total energy intake. Conclusion: The newly developed dietary FFQ is a relatively good and valid tool in assessing habitual nutrients intake for the past year among Malay adolescents in Malaysia.
Clinical trials investigating the effects of soy food intake require high compliance with a dietary protocol. Measuring soy isoflavonoids in bodily fluids is the most objective method currently available in determining compliance to a soy diet. In the present study, we investigated how frequently the urinary isoflavonoid excretion rate (UIER) should be analyzed to provide a reasonably accurate measurement of dietary compliance without being a burden on the participants. Nineteen premenopausal women who were on a daily soy diet protocol collected first-morning urine samples over one menstrual cycle. Spearman rank order correlation coefficients (r) between the UIERs of total isoflavonoids for a single day, for a week, and for all weeks combined with the monthly UIER were high for all samples (single day: r = 0.89; Week 1: r = 0.89; Week 2: r = 0.85; Week 3: r = 0.75; all weeks combined UIER: r = 0.94) and remained high after stratification by ethnicity, body mass index, and equol-excretor status. According to these results, the analysis of UIERs from a single or weekly first-morning sample provides a highly accurate and more feasible method of determining dietary compliance among women with regular soy consumption than that from urine samples collected every morning during one month.
The main substrates fuelling ion absorption in the mucosa of the small intestine and large intestine are respectively glutamine and short-chain fatty acids, . Measurements now reported showed that derivation of both glutamine and fibre for short-chain fatty acid production can be achieved from a single foodstuff - macerated groundnuts. Macerated groundnuts may be more suitable as an additive in oral rehydration solutions for promoting ion absorption than other agents that are low either in glutamine or fibre, such as rice water or resistant starch.
Background and Objectives: Uterine fibroids (UFs) are the most common neoplasm affecting reproductive-age
women. The purpose of the present study is to explore the association between dietary diversity and risk of UFs in
a cross-sectional study of urban premenopausal women. Methods and Study Design: A total of 248 urban premenopausal
women with age of 20-45 were recruited in 3 randomly chosen hospitals in Shijiazhuang, China. Dietary
diversity was assessed from food frequency intake data using dietary diversity score (DDS), Prime Diet Quality
Score (PDQS) and food variety score (FVS). UFs were diagnosed by the methods of ultrasound, pelvic exam, or
surgery. Binary logistic regression was used to estimate the relationship between dietary diversity and risk of UFs.
Results: 37 of the study subjects (14.9%) had UFs. Participants with a low education level and single marital status
participants had a lower DDS and PDQS, respectively. After adjustment for confounding factors, a higher DDS 24
was associated with decreased UF risk (OR=0.22, 95% CI=0.05–1.01). Similar trends were observed for the plantbased
FVS (ptrend=0.025). Carrot (OR=0.04, 95% CI=0.00–0.48) and kiwi fruit (OR=0.03, 95% CI=0.00–0.47)
were also inversely associated with risk of UFs after adjustment for confounding factors. Conclusions: Multifarious
food groups and the increase of variety of plant-based food, especially carrot and kiwi fruit, may be associated with
the lower risk of UFs; they may play an important role in inhibiting the formation of UFs.
Dietary guidelines for the general population and for the management of obesity, diabetes and heart disease suggest a reduction in dietary fat, and in particular dietary saturated fatty acids (SFA). In order to achieve the recommended levels, changes in food choice patterns are required. Foods are consumed in combination with other foods, and these combinations are often recognizable as cuisine patterns. In this study we examined the food choice patterns of a group of 63 adults with existing type 2 diabetes mellitus who completed a 12 month dietary intervention trial aimed at changing dietary fat under 'free living' conditions. In both lower fat (LF, 27%E) and modified fat (MF, 37%E) groups, a reduction in dietary SFA and an increase in polyunsaturated fat were required, with an additional requirement to increase dietary monounsaturated fat in the MF group. The usual diets of the study sample were on average low in total fat (27%E), but high in saturated fat (12%E). Those already consuming total fat at the level concordant with their allocation (LF or MF) achieved targets faster than those with a discordant allocation, but there was no significant effect of usual diet on time of target achievement at 12 months. At 6 months, those achieving dietary fat targets had changed to low fat dairy products and leaner meats, were having more spreads, oils, and nuts and were consuming takeaway meals less than twice a week. Contributions to dietary fat shifted from takeaway foods, meat, dairy products and cakes to spreads, oils and nuts. The modified fat and low fat groups chose more Mediterranean and South East Asian cuisines respectively. In this study sample, usual dietary patterns had an initial impact on change in the diet, but identifiable changes in food choice patterns and the adoption of certain cuisines that combined foods indicative of the dietary guidelines resulted in successful achievement of dietary fat targets.
The Danone Institutes are not-for-profit organizations, independent of the Danone business, and whose programs are independent and contain no commercial information. The mission of the Danone Institutes is to develop knowl- edge about the links between nutrition, diet and health, and to disseminate that knowledge to the general public. To date, there are 18 Danone Institutes worldwide.
In supporting the above mission, the Danone Institutes of Indonesia, Japan and China organized jointly a half- day pre-congress seminar in conjunction with the XI Asian Congress of Nutrition (ACN) and held in Singa- pore on July 12, 2011, with the theme “Progress of Die- tary Guidelines in Asia”. Facing a double burden of nutri- tion, the countries in economic transition in Asia need regularly to re-visit their dietary/nutrition guidelines so that they can be implemented and beneficial for the popu- lation at large. Learning from the experiences of other countries may help to make the messages more effective. The seminar was attended by 211 delegates from at least 139 institutions and 18 countries (Asia: China, Korea, Indonesia, Philippines, Malaysia, Sri Lanka, Japan, Sin- gapore, Vietnam; and other countries from South and North America, Europe, and Australia). About one-third (35%) of the participants were from Indonesia, followed by Singapore (16%) and China (11%).
Eight experts were invited to present the experiences of their respective countries. They were:
Dietary Reference Intakes (DRIs) are nutrient standards that may be used to plan nutrient intakes. Thus, they are useful as the basis for formulating dietary guidelines. The guidelines are often presented to the public as a food guide that will promote nutrient adequacy without risk of excessive intake. Such guides typically use the Recommended Dietary Allowances (RDAs) as intake targets because intake at the RDA is associated with a high probability of nutrient adequacy for healthy persons. During the development of the MyPyramid food guide for the United States, several questions were addressed: (1) What energy levels will be covered by the specific food patterns within the food guide? Each pattern should promote nutrient adequacy for the targeted energy intake level, which may include different age and gender groups. (2) What nutrients will be targeted by the food patterns? They should promote nutrient adequacy while also ensuring that intakes are not excessive for food components such as sodium, saturated fat, and cholesterol. (3) What food groups will be included in the food patterns, and how will their nutrient profiles be determined? After these decisions have been made, then the recommended amounts of each food group can be determined. A unique approach has been used to develop Canada’s Food Guide, which included a simulation of the effect of differing food choices within each food group. Dietary guidelines and food guides which are based on the DRIs have the potential to improve nutrient intakes for consumers who follow them.
The world's scientific community has recognized that isotopic techniques play a vital role in monitoring the effectiveness of nutrition intervention by providing precise data on absorption, bioavailablity and interaction of various micronutrients in a cost effective manner. The International Atomic Energy Agency (IAEA) has been supporting many such health related studies in Member States from developing countries using nuclear and isotopic methods for over 20 years. This report documents the Agency's support for a variety of projects in East Asia and Pacific countries to assess body composition, total energy expenditure, nutrient intake, osteoporosis, infection, vitamin and mineral bioavailability as well as food composition. The IAEA spent a total of 10,302,356 US dollars through Coordinated Research Projects (CRP) and Technical Cooperation Projects (TCP) over the past 20 years. Out of this only 2,732,802, US dollars or 26.5% was used by the East Asia and Pacific countries. While the participation of East Asia and Pacific countries was strong in CRPs and moderate in regional TCPs, they did not participate in national TCPs at all. The non-participation under national TCPs is a serious deficiency when compared with Latin American and African regions and therefore, more participation from the East Asia and Pacific countries in national TCPs is strongly encouraged in the future.
Differences in the dietary intake of cobalt were assessed for vegans, lacto-ovo-vegetarian and non-vegetarian Australians using food intake logs, and daily or average trend recall over three months. A significant decrease in cobalt intake was observed for the lacto-ovo-vegetarian population compared with the intake in vegans and omnivores. There is no RDI for cobalt, however, the cobalt intake of Australians was similar to that reported in other countries. Microflora above the terminal ileum have been shown to produce significant amounts of biologically available vitamin B12. This study was unable to demonstrate a correlation between elemental cobalt intake and serum vitamin B12 concentrations in humans, as has been shown in vitro.
Laos is a low-income food-deficit country with pockets of high levels of wasting in the highland areas. We im- plemented a 3-year health/nutrition project in 12 villages in the highlands of Savannakhet province to reduce acute malnutrition in children. Volunteer nutrition teams in each village monitored child growth and promoted healthy feeding practices; a multisectoral district committee conducted monthly outreach to assess child growth, manage acute malnutrition and deliver primary health care services. We conducted a cross-sectional assessment before project activities began and at the end of the project. The baseline survey randomly sampled 60% of all households; the endline assessment aimed to survey all eligible registered participants. Anthropometric measures were taken from children aged 6-59 months; mothers with children aged <12 months were asked about infant feeding practices, antenatal and post-partum care; and child immunizations were recorded for children aged be- tween 0-23 months. At baseline, 721 households were sampled, while the endline assessment surveyed between 82% and 100% of eligible participants in each age group. Acute malnutrition reduced from 12.4% (95% CI: 10.4- 14.3) to 6.1% (4.9-7.3). Unhealthy feeding practices declined: in 2008, 40.0% (34.7-45.3) of mothers breastfed their newborn within 2 hours of birth and 30.8% (25.7-35.8) threw the colostrum away; in 2011, these figures were 72% and 8% respectively. Maternal care and child immunisation coverage also improved. Improving the health environment and child feeding practices appears to have markedly reduced the level of wasting. Unsafe feeding practices were common but readily changed by the community-based nutrition teams.
Background and Objectives: The prevalence and potential health effects of common food antimicrobials in pro- cessed foods and beverages are relatively unknown in Singapore. The occurrence of chemical antimicrobials in processed foods and beverages and their effects on inflammation and oxidative stress in vitro were examined. Methods and Study Design: The occurrence of antimicrobials in 1605 processed food and 359 beverage items were examined by surveying the ingredients on the product labels. Human neutrophils were exposed to physio- logically relevant concentrations of common antimicrobials. Established markers of inflammation, l Leukotriene B4 and oxidative stress, F2-isoprostanes were measured using stable-isotope dilution gas chromatography-mass spectrometry. Results: Antimicrobials were added to 23.2% of the processed foods and beverages. Sorbic, benzoic, lactic, propionic and acetic acids accounted for 84.8% of the added antimicrobials in the processed foods and beverages. 92.5% of the bread contained propionic acid. Lactic acid was the most common antimicrobial (44.4%) in cheeses. Sorbic acid was added to 63.2% of the margarines selected. Sauces (31.5%), energy drinks (50.0%), soft drinks (70.7%) and fruit cordials (66.6%) contained added benzoic acid. Benzoic and propionic acids at physiologically relevant concentrations augmented leukotriene B4formation (benzoicacid, EC50 = ~100 μg L-1and propionic acid, >200 μg L-1). Lactic and sorbic acids dose-dependently inhibited the F2-isoprostanes production (IC50 values ~100 μg L-1) and myeloperoxidase activity (IC50values ~100 μg L-1). Conclusions: Our results demon- strate that Singapore consumers are significantly exposed to food antimicrobials, and these molecules, in physiologically relevant concentrations, exert significant and differential effects in vitro.
Background: Poverty persists at an alarming level in Bangladesh. To reduce extreme poverty and create the foundation for a sustainable livelihood change, BRAC undertook a targeted programme since 2002 named, Challenging the Frontiers of Poverty Reduction/Targeting the Ultra Poor (CFPR/TUP).
Objective: To investigate the impact of the CFPR/TUP programme on food and energy consumption. Design: Two cross sectional surveys on food consumption were conducted, a pre-intervention survey in 2002 and a post-intervention survey in 2004 covering 180 intervention and 193 non-intervention households. Three days’ recall method was administrated in both the survey rounds.
Results: The baseline food consumption survey showed an inadequate food intake in all households, which did not differ between the two groups. At post-intervention, the quality and quantity of food intake improved significantly in the intervention households as compared to baseline. In this group, the consumption of vari- ous food items such as rice, pulse, vegetables, fish, fruit, milk and egg showed significant improvement (p<0.001), particularly, the level of fish consumption doubled in intervention households while in control households it remained almost unchanged (14 g/day to 27 g/day for intervention vs. 11 g/day to 13 g/day for control). Energy intake increased from 1750±650 Kcal/day to 2138±704 Kcal/day in intervention households (p<0.001), whereas no significant change was observed in control households. Percentages of energy from cereals decreased from 85% to 78% in intervention households (p<0.001) while it remained unchanged in control households.
Conclusion: CFPR/TUP programme seems to have direct impact on ultra poor family’s ability to signifi- cantly increase consumption of food and energy.
Background and Objectives: To elucidate the role of dietary fats on the relationship between mild cognitive impairment and sarcopenia and help identifying and preventing the decline of cognitive and muscle function in elderly individuals. Methods and Study Design: The study conducted involving a group of 1812 individuals between the ages of 61 and 92. Body composition and BMR were assessed by bioelectrical impedance analysis. Cognitive function and dietary nutrition were evaluated by neuropsychological assessments and questionnaire of food intake frequency. Lipidomics analysis was performed using UHPLC-Qtrap-MS/MS. Results: MCI and SA are mutual influencing factors, lower intake of MUFA, PUFA and higher intake of fat was associated with cognitive dysfunction and/or SA (p < 0.05). PUFA was important for MCI combined with SA (Compared with Q1, Q4 OR: 0.176, 95%CI: 0.058,0.533). Lipidomics analysis revealed that triacylglycerol (TAG) contain more carbon chains with saturated double bonds may be closely related to cognitive impairment and the progression of SA (p < 0.05). While, DAG with carbon chains of unsaturated double bonds is opposite. Conclusions: Insufficient intake of unsaturated fatty acids was associated with the development of cognitive decline and the progression of SA. MUFA affecting muscle health, fats and PUFA has a greater impact on MCI combined with SA. Less MUFA intake and increasing saturated double-bonded fatty acid intake might be the key factors on promoting cognitive impairment and SA in the elderly. They have the potential to serve as prospective biomarkers indicating a higher risk of cognitive decline and/or SA in the elderly population.
The oxidative degradation of polyunsaturated fatty acids is the primary factor in limiting the shelf-life of most manufactured foods. Free radical mechanisms are implicated in the pathogenesis of human diseases and in the process of ageing. This has led to the suggestion that antioxidants, and plant diet-derived antioxidants in particular, might have health benefits as prophylactic agents. Delineating the in vivo contribution of plant extracts and/or plant-derived antioxidants (the pure active principles in plant extracts with antioxidant indications) to the modulation of the pathological consequences of oxidative stress in the human body is complicated by the fact that antioxidant actions may be achieved through more than one mechanism. The interest in the health promoting qualities of plant foods may be ascribed to the observation that various compounds present in these foods possess antioxidant properties in vitro. From a food stability perspective, one would be interested in the integrity of the food and the effects of storage on the molecular components of the food. For humans, the emphasis is on the importance of nutritional antioxidants in health and disease management.
Regions are significant for the way we understand and strategize food for health and economic development. They generally represent various food cultures and opportunities for food exchange based on proximity, historical linkages and complementarities. The example of North and West Africa represents an intersection of some of the most original of human eating experiences out of Africa and the enrichment of these by Arab traders, through the exchange of products, ideas, observations, beliefs and technologies. All of these will have encouraged diversity in food intake. However food diversity and, with it, biodiversity may not always have been recognized as important, and, therefore, secured and protected. Ultimately, food diversity cannot be sustained unless the food chain and the technologies to support it are environmentally appropriate. Cooking, without renewable energy sources, is a critical example. Additionally, human settlement has always required an adequate, a dependable and a safe water supply, although this same settlement tends to compromise these water characteristics. Water is a major factor in food diversity, whether as a source of aquatic food, or the basis of food production and preparation. The extent to which food diversity for human health is required will depend on the food component (essential nutrient and phytochemical) density of the foods represented. For example, fish, fresh lean meat, eggs and seed foods (grains, pulses, nuts) will reduce the requirement. Regional food diversity can support food diversity at the community level - where otherwise it might be fragile - by shared learning experiences, and by trade. Diversity can also be captured and enshrined in recipes with composite ingredients and by traditional emblematic foods - like soups and pies; and it provides the basis for food culture and cuisine. The evidence for food diversity (or variety) as a major factor in health has grown substantially over the last few years - as integrative indices of health like "maternal nutrition" and "successful pregnancy" (for example, through the inclusion of a variety of food sources of folate, increasing the bioavailability of iron, and the sustainable intakes of quality food protein and essential fatty acids); "adult mortality rates"; other "specific disease incidences" (like cancer, cardiovascular disease, diabetes and bone health) for "risk factors for disease" (like hypertension and abdominal fatness); and for "wellbeing" (palatable, enjoying and neurologically relevant food stuffs). Thus, there is an ongoing need to promote and maintain food diversity at the regional level and between communities.
Background and Objectives: Oligosaccharide or oligopeptide supplementation may have a significant impact on endurance performance. This study evaluated the effects of adding maltooligosaccharides (MO) or soy oligopep- tides (SO) to compressed food (CF) on the physical response of soldiers to daily military training. Methods and Study Design: Twelve soldiers were randomized to four diet groups: regular meals, CF, CFMO, and CFSO (crossover design). They participated in exercise tests including 90 minutes running at 55-65% VO2max and ex- haustive running. Heart rates, rating of perceived exertion (RPE), and blood and urine samples were collected during exercise and recovery. Results: The recovery heart rates were significantly lower with the CFMO diet compared with the other diets. Compared with all other diets, blood glucose levels were higher, post-exercise blood lactate levels were lower, and lactate clearance during recovery was higher with the CFMO diet, followed by the CFSO diet. Post-exercise levels of erythrocytes and hematocrit were significantly higher with the CFSO diet. Post-exercise urine specific gravity was lower with the CFMO diet and urine pH was decreased with the CFSO diet. Blood urea nitrogen (BUN) and uric acid (UA) were significantly higher with the CFSO diet than with the other diets. There was no significant difference in skeletal and cardiac muscle injury indices and RPE among diets. Conclusions: CFMO led to better heart rate recovery, improved and maintained blood glucose and increased removal of blood lactate. CFSO accelerated removal of blood lactate during recovery, maintained oxy- gen supply, and increased fluid retention.
Foods derived from plants, such as fruits and vegetables, have been the backbone of human nutrition since the beginning of time. Hunting and fishing supplemented diets with protein-rich foods but nutrition was predominantly based on the availability of plant foods. The importance of various plant foods in the development of some civilizations and economies has been well documented: maize in the Americas, potatoes in parts of Europe after their introduction from the Americas, and wheat in Australia. Plant industries are still the backbone of cultures and economies in almost every corner of the world and production figures support the fact that plant industries are still regarded as the most important source of nutrition. Nutrition parameters found in plant foods vary between crops but there is a consensus that plant foods can supply most, if not all, of the essential components for human nutrition. These components were discovered slowly by trial and error during human history, a classic example was the prevention of scurvy in seafarers. When fresh fruit and vegetables were missing from their diet, they learned that products such as pickled cabbages and citrus, rich in vitamin C, could prevent the manifestation of this dehabilitating dietary disease. As early as the turn of the century scientists learned that diet not only affected nutrition but also had an effect on health and well-being. But it was not until 1933 that a direct relationship between consumption of fruit and vegetables and diseases such as cancer was shown. Fruit and vegetables not only have become the backbone of local agricultural markets but also play a major role in international trade. Competition for local and international markets is driving extensive research and development to produce new cultivars. Until recent times research has concentrated on producing new varieties that store longer, yield better, look better, taste better, suit local climates, display disease and pest resistance and suit processing technologies. A new wave of research is addressing the newly developing interest in heath-based foods. Molecular biologists, biochemists, botanists and medical researchers are linking in with plant breeding programmes to develop new varieties of fruit and vegetables that are tailor-made to produce higher levels of health-related phytochemicals. New phytochemical-enhanced products such as broccoli, tomato, oranges and berries are currently being evaluated for commercial exploitation. The present paper will discuss some of the products that are being produced, the driving forces behind their production, the phytochemicals targeted and the problems that must be addressed if this new approach in human nutrition and health is to be of benefit to consumers.
Background and Objectives: Sleep disturbance is a common health problem in the elderly population. We examined the association between dietary variety and subjective sleep quality in community-dwelling elderly Japanese women. Methods and Study Design: This cross-sectional study recruited 160 community-dwelling elderly women aged ≥65 years. Subjective sleep quality and dietary variety were assessed by Pittsburgh Sleep Quality Index (PSQI) and dietary variety score (DVS), respectively. DVS was calculated from the eating frequency of 10 food groups. Sleep disturbance was defined as PSQI score of ≥6. Results: The DVS in subjects with sleep disturbance was significantly lower than that of those without the disturbance (4.1±2.1 vs 5.3±2.1, p<0.01). In the multivariable regression model, the PSQI score was negatively correlated with the DVS score in age-adjusted model (standardized coefficient; −0.234, p<0.01). In the further adjusted model that included depression levels, the negative association between PSQI score and DVS score was retained (standardized coefficient; −0.211, p<0.05). Among 10 food groups comprising DVS, the eating frequency of soybean and soybean products was the determinant of sleep disturbance in the stepwise liner regression analysis. In the further model that contained DVS, DVS was the independent determinant of sleep disturbance, while the eating frequency of soybean and soybean products was excluded. Conclusions: A worse sleep quality was associated with lower DVS in elderly Japanese women. Diet comprising various food groups was better for sleep quality than consuming only a particular food in the elderly.
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.
The aim of our study was to describe and compare nutritional status and food related behaviours in rural preg- nant women of Li ethnicity as they had been divided into mountainous and costal groups by residential area. One hundred and ninety-six randomly selected healthy rural pregnant women of Li ethnicity for the mountainous group (MG), and eighty-two for the coastal group (CG) were recruited. Data were collected via demographic questionnaires, anthropometric measurements, food related behaviour questionnaires, five day dietary diaries and plasma folate tests. The mean (SD) age, years of education, and height of all participants were respectively 25.7 (3.99) years, 7.57 (2.45) years and 155 (5.04) cm, without significant group differences (p>0.05). Significant dif- ferences were shown in dietary intakes of protein, fat, carbohydrate, dietary fibre, thiamine, vitamin C, folate, potassium, sodium and magnesium between MG and CG (p<0.05). The prevalence of plasma folate deficiency differed significantly between groups (3.08% in MG vs 37.8% in CG, p<0.001). High prevalence of active or passive smoking (65.1% in MG vs 68.4% in CG), alcohol consumption (13.8% in MG vs 2.6% in CG), and betel quid chewing (19.6% in MG vs 53.9% in CG) were found in all participants. Differences in alcohol consumption and betel quid chewing rates between groups were also significant (p<0.05). In general, coastal Li pregnant women have a poorer plane of nutrition than their mountainous counterparts. Therefore, healthy diet and lifestyle education are urgently required and should be emphasised during routine prenatal care.
The present paper describes the development of a food safety course that was initially given as part of the Master of Science programme in community nutrition at the South-East Asian Ministers of Education Organization, Tropical Medicine Regional Centre for Community Nutrition at the University of Indonesia. This course is an example of intersectorial collaboration between industry, government and academia. Several years later the course was rolled out to other countries.
Background and Objectives: Total fat intake is linked to the intake of other nutrients. Little data are available on the extent to which total fat affects diet quality in Japanese people. We investigated the relationship between total fat intake and other nutrient intake using INTERLIPID/ INTERMAP data on Japanese people living in Japan. Methods and Study Design: The participants included 371 men and 401 women with a healthy body mass in- dex and between the ages of 40 and 59 from 4 population samples in Japan. Nutrient intake data were based on four in-depth 24-hour dietary recalls per person. Results: Analysis of covariance adjusted for age revealed that total fat intake was positively related to intakes of calcium, thiamine, riboflavin, meat, eggs, and milks and dairy products for both sexes. Total fat intake was inversely associated with carbohydrate and cereals intake for both sexes. On average, men with total fat intake between 25.0 and 27.4% of total energy had saturated fatty acids above 7%, which is the upper limit recommended for preventing lifestyle-related diseases. Men with total fat in- take less than 20% of total energy had a higher risk of not meeting the Dietary Reference Intakes for Japanese (2015) for some nutrients. Conclusions: Total fat intake was positively associated with calcium, thiamine, and ri- boflavin intakes and inversely associated with carbohydrate intake. Our results suggest that in 40–59-year-old men with a healthy body mass index, total fat intake between 20 and 27% of total energy may best support ade- quate intake of other nutrients.
Background and Objectives: Types and amounts of nutrients may influence the volume of subcutaneous adi- pose tissue (SAT) and visceral adipose tissue (VAT). This study targeted to investigate the relationship between SAT and VAT volumes and macro- and micronutrients intake among adults. Methods and Study Design: Data were collected via a private face-to-face interview, in which diet history was obtained using validated quantitative food frequency questionnaire. The different fat volumes were assessed using magnetic resonance imaging (MRI) scanning. Results: Participants with the lowest VAT volume had the highest intake of saturated fats, monoun- saturated fatty acids and omega-3 and omega-6 fatty acids (p<0.05). VAT volume was significantly associated with the highest level of total energy and energy from carbohydrate consumption among participants while signif- icantly associated with the lowest energy intake from fat among participants (p=0.013). There was a significant relationship with the highest consumption of total carbohydrate, soluble fiber, and insoluble fiber and VAT vol- ume (p<0.05). Participants in the highest VAT volume had significantly the highest intake of vitamin A, β- carotene, and copper. Conclusions: This study underscores the importance of quantifying depot-specific body fat and highlights the unique responsiveness of various fat depots to dietary intake.
Background and Objectives: Although large-scale natural disasters and the resultant changes in living environments worsen dietary habits among adults immediately after the disasters, whether this association remains for a long period is unclear. This is particularly important for recent mothers because lactating women require additional nutrition for milk production. Thus, we investigated the association of living environments with dietary habits and nutritional intake of recent mothers between four and seven years after the Great East Japan Earthquake (11th March, 2011). Methods and Study Design: We analyzed 8,551 mothers who participated to the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Living environments were characterized into four categories: “same home before the earthquake”, “rental housing”, “reconstructed home”, and “acquaintance’s home”. Dietary habits and nutritional intake were evaluated using a food frequency questionnaire answered 12 months after their deliveries (the questionnaire was answered between March 2015 and July 2018). Results: Multiple linear regression analyses demonstrated that mothers in ‘rental housing’ or ‘reconstructed home’ had a significantly lower intake of almost all nutrients or certain nutrients, respectively, compared with those residing in ‘same home before the earthquake’. However, fewer significant differences were detected between the nutritional intake of the mothers lodging in an ‘acquaintance’s home’ and that of those living in ‘same home before the earthquake’. Conclusions: Our findings indicate that living environments long-term after large-scale disasters are associated with dietary habits and nutritional intake among recent mothers.
Supplementary files https://apjcn.nhri.org.tw/server/APJCN/30/4/651_Supp.pdf
Background and Objectives: The relationship between eating rate (ER) and increased risk of obesity in relation to body mass index (BMI, i.e., total body fat) and waist circumference (WC, i.e., abdominal fat) has not been ful- ly examined. Considering gender differences, we identified unknown confounding factors (CFs) for each risk, and then assessed the two actual obesity risks, adjusting for the CFs. Methods and Study Design: Using a ques- tionnaire, we collected data for ER (slow, normal as “reference,” and fast) and related factors and measured BMI and WC for 3,393 men and 2,495 women. Using multiple logistic regression models, odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated adjusting for both conventional and candidate CFs. Results: The following factors were identified as appropriate CFs, but were differed between the two obesity types: fast food consumption in both genders, sleep duration and restaurants/food service use in men, and family structure and packed lunch in women. In men, actual risks of BMI obesity and WC obesity were negatively associated with slow ER (ORs and 95% CIs; 0.70 and 0.52-0.96, and 0.69 and 0.50-0.96), but positively associated with fast ER (1.48 and 1.25-1.76, and 1.45 and 1.21-1.74). In women, those risks were positively related to fast ER (1.78 and 1.39-2.26, and 1.34 and 1.11-1.61). Conclusions: For both BMI obesity risk and WC obesity risk, we conclude that slow and fast ER were related to decreased and increased risks when adjusted for appropriate CFs, which dif- fered by gender and the obesity type.
Undernutrition among children under five year is a significant public health problem in India. The present study was carried out to assess trends in nutritional status, nutrient and food intake among children under five year over two time periods. It was a community-based cross-sectional study, carried out in tribal areas of India. A total of 14,587 children, 0-5 years old were covered for nutritional assessment in terms of underweight, stunting and wasting. A 24 hour diet survey was carried out in a sub-sample of households surveyed. Wealth index was con- structed using principle component analysis. The prevalence of underweight and stunting had declined signifi- cantly over the periods (49% vs 57%, 51% vs 58%, respectively), while the prevalence of wasting remained simi- lar (22% vs 23%). There was marginal decrease in the intake of foods and nutrients over the periods, and was be- low recommended levels. Stepwise regression showed that the risk of underweight and stunting was significantly (p<0.01) higher among children of illiterate mothers and children from lowest and middle households wealth in- dex. Morbidities during preceding fortnight had 1.3 times higher risk of underweight and wasting. In conclusion, undernutrition is a significant health problem among tribal children and is associated with literacy status of moth- ers, household wealth index and morbidities. Therefore implementation of appropriate nutritional intervention strategies and improvement in households food security through public distribution systems, food intakes, socio- economic condition, literacy of parents and personal hygiene may help in improving the nutritional status of tribal children.
Economic growth inevitably influences the food chain. Growing demand with changes in lifestyle and health consciousness encourage use of packaged and pre-prepared foods. The needs of environmental protection from waste generated are largely overlooked, and a lack of knowledge about the impact on the environment and its health effects constitute food security/safety problems. Food production and waste generation directly affect re- source (i.e., energy and water) consumption and often contaminate the environment. More pressure on food pro- duction has inculcated the use of pesticides, herbicides, antibiotics and chemical fertilizers which add to current global pollution. At least half of food grown is discarded before and after it reaches consumers. It is estimated that one third to half of landfill waste comes from the food sector. This landfill releases green house gases (GHG) as well as leachate which worsen soil and water quality and safety. Pharmaceutical and chemical contaminations from residential, industrial and agricultural sources make their way into nearby water and soil and can eventually affect our food systems. Phthalates, PFOA, BPA, commonly used in plastics and personal care products, are found in unacceptable concentrations in Taiwanese waters. They, too, contribute to food contamination and long-term health risk. Existing waste management strategies warrant more stringent norms for waste reduction at source. Awareness through education could reduce food waste and its consequences. This review encompasses impacts of food production systems on the environment, pollution which results from food waste, costs and eco- nomic advantages in food waste management, and health consequences of waste.
The aim of this study was to determine the iron status of infants who consumed porridge cooked in water with added ferrous sulphate. A total of 234 infants, aged 6~12 months, were recruited from 36 nurseries in the De- mocratic Peoples Republic of Korea (DPRK North Korea) and randomly divided into iron (Fe) and placebo groups. At baseline, almost half the children had Hb<110 g/L and no significant differences between the two groups were found with regard to hemoglobin concentration and anemia prevalence. The Fe group received rice porridge fortified with 10 mg of iron (as ferrous sulfate) per day, added to the water in which the rice was cooked and the placebo group non-fortified cereal for 6 months. After which, the hemoglobin (Hb), serum fer- ritin (SF) and packed cell volume (PCV) were measured and it was found that the proportion of children with anemia (Hb<110 g/L) was lower (24.3% v 48.1% p< 0.01), the Hb levels (117.6 g/L v 109.8 g/L p<0.001) and serum ferritin were higher (40.7 v 26.8 mcg/L p<0.001); and iron deficiency anemia (Hb<110 g/L, SF<12 mcg/L) was lower in the Fe group (3% v 22% p<0.001) when compared to the placebo group. Ferrous sulphate, added to the water in which rice was cooked, lowered the prevalence of iron deficiency anemia of infants in the DPRK with no adverse reactions. This simple fortification would be suitable as a nationwide program in the DPRK and other countries with large infant nurseries.
The purpose of this study was to assess the agreement between the 24 h diet recall and a short 17-item 24 h food intake recall in assessing calcium intake. The calcium intakes of 21 women over the age of 50 were assessed by both methods on four occasions. The mean calcium intakes were similar using both methods, being 1034 ± 398 mg/day by 24 h diet recall and 822 ± 412 mg/day (SD) by 17-item 24 h food intake recall. The 17-item 24 h food intake recall tended to underestimate calcium intake compared with the 24 h diet recall, with the limits of agreement being between -1197 and -727 below and 370 and 682 mg/day above 24 h diet recall values over the four assessments. The 17-item 24 h food intake recall identified 8% more women with inadequate calcium intakes than the 24 h diet recall method did. Although there is poor agreement in calcium intake between the 24 h diet recall method and the 17-item 24 h food intake recall, the latter provides a quick and simple means for assessing extremes of calcium intake and whether day to day calcium intake is adequate.
An overview from the perspective of one manufacturer is provided on products that utilise either palm oil or palm kernel oil. The manufacturer is Macphie of Glenbervie while the products are of a wide-ranging nature for use in bakery, food service and food-manufacturing. Much of the discussion concerns cream alternatives on the grounds that this product-category places great demand on the type of fat needed and, to Macphie of Glenbervie, is responsible for most of the oil from oil palm used. However, other products are also touched on. The overview considers key product attributes the function that fat has within these products, together with research requirements and future opportunity.
Mongolians are at high risk for vitamin D deficiency because of their residence at northern latitude, reduced ex- posure to UV-B rays during the winter months, and a low availability of vitamin-D fortified foods. We per- formed a pilot study in May 2005 to estimate the prevalence of hypovitaminosis D in Mongolian school age chil- dren and to determine the feasibility of conducting a longer and larger trial with fortified milk and vitamin D sup- plements. In a group of 46 Mongolian children (22 girls and 24 boys) aged 9-11 years, 76% (35) had levels of 25-hydroxyvitamin D (25(OH)D) below 50nmol/L (20ng/mL) and 32% had levels below 37nmol/L (15ng/mL). After a month of consuming 710 ml of vitamin D-fortified (total 300IU or 7.5μg) milk daily, only 3 of the chil- dren were below 50nmol/L (20ng/mL) and none below 37nmol/L (15ng/mL). These results reveal prevalent and serious 25(OH)D deficiency among Mongolian prepubertal school age children that appears to be ameliorated by a month of consuming approximately 7.5μg of vitamin D3 in fortified milk.
Background – Glycemic Response (GR) is the extent to which any food raises the blood glucose level and is controlled by the structure of the carbohydrate and its rate of digestion and absorption by the small intestine. Glycaemic index (GI) is a measure used to rank carbohydrates based on their effect on the blood glucose level relative to a standard such as pure glucose. One of the factors which may change the rate of gastrointestinal emptying, digestion and absorption and hence influence the GR and GI value is ethnicity.
Objective – To ascertain the effect of racial differences on glycaemic response and glycaemic index of white bread: comparing Western European vs. South East Asian cohorts.
Design – The standard Oral Glucose Tolerance Test (OGTT) was performed for both the standard food (glucose solution) and the test food (white bread) on 40 healthy individuals, age 18 to 45 years from Western European and South East Asian backgrounds. The “Homebrand” white bread was selected as the test food and was consumed on one occasion. A 50g glucose solution was used as the standard food and consumed on 3 occasions by the subjects. Finger prick blood samples in duplicates were obtained and instant blood glucose concentration was measured using automatic analyzers (HemoCue® glucose 201) over a two hour period. The area under the curve (AUC) for each 2h blood glucose response to the glucose solutions and the white bread was calculated and used to determine the GI value of the test food.
Outcomes – There were 55% females and 45% males in each ethnic group. The AUC for both the glucose standard (M = 234, SD = 8.1) and the test food (M = 174, SD = 13.4) were greater in Asian subjects compared with Caucasians (M = 214, SD = 12.6) and (M = 153, SD= 4.2). An ANOVA test showed no significant differences in the GI value of white bread F (2, 37) = 0.29, P =0.6 between Asian (M= 78, SEM= 5.4) and Caucasians (M= 73, SEM= 8.6).
Conclusion – The in vivo determination of the GI value of foods can not be influenced by ethnicity of the participants.
Background – The origins of children’s food preferences remain largely unexplored. However, experimental research suggests they are affected by parents’ feeding behaviours. Outside of the laboratory context, in daily life, there is little indication of how parents attempt to influence their children’s food likes and dislikes, and associations between feeding behaviours and children’s food preferences. Furthermore, parents’ use of feeding behaviours may be partly determined by characteristics of the child, especially their food neophobia.
Objective – To explore parents’ use of strategies for influencing their preschool-aged children’s food preferences, and associations with children’s food preferences and food neophobia.
Design – Semi-structured interviews were conducted with three groups of parents: those of (a) children with healthy food preferences (N=20), (b) children with unhealthy food preferences (N=18), and (c) food neophobic children (N=19). Parents were asked to describe how they tried to influence their children’s food preferences in general, as well as a specific time when they attempted to promote liking or disliking of a food. Interviews were transcribed verbatim and entered into a qualitative software package (N6) for thematic analysis and extraction of quotes.
Outcomes – Several themes concerning parents’ feeding behaviours emerged, some of which differed by group. Themes that arose from parents of children with healthy food preferences included use of exposure, repeated exposure, encouragement, parental modelling, manipulating peer influence and involving children in food preparation and selection. Conversely, themes emerging from parents of unhealthy or food neophobic children included forcing, fighting, restricting and controlling, rewarding or bribing and indulging children’s desires. Conclusions – The results support the hypothesis that parents’ feeding behaviours may be a source of variation in children’s food preferences. Parents’ use of feeding behaviours promoting unhealthy food preferences may be partially in response to children’s food neophobia. Education of parents about effective strategies for promoting healthy food preferences in children, and especially food neophobic children, is needed.
Background – Dietary intervention for obese populations is vital in light of the growing incidence of obesity within Australia. The Healthy Eating Lifestyle Program (HELP) and Healthy Eating for the Reduction of Obesity (HERO) are randomized controlled dietary intervention studies that target this condition. Both studies aim to assist overweight volunteers with weight loss through structured dietary prescriptions.
Objective – This study aimed to identify differences in nutrient intakes and food patterns between obese subjects with and without type 2 diabetes mellitus (T2DM).
Design – HELP study included adult healthy obese subjects while HERO study included adult obese subjects with T2DM. Participants were recruited through the local media and internet mailing lists. Dietary macronutrient intakes were assessed at baseline using diet history interviews and analysed using FoodWorks Professional (version 4.00.1178). Gram amounts of macronutrient intake were obtained and compared using independent sample t-test. Reported foods were grouped for each study based on the Australian Guide to Healthy Eating food groups and fatty acid content.
Outcomes – Thirty-eight (15 males, 23 females) healthy obese subjects without T2DM and 50 (22 males, 28 females) obese subjects with T2DM were recruited. Weight (89.6 ± 13.2; 92.8 ± 15.4) and BMI (31.8 ± 3.5; 33.2 ± 4.2) of subjects, were not significantly different between studies. Reported intakes were significantly lower among obese volunteers with T2DM for energy (P<0.001), total fat (P=0.011), saturated fat (P<0.001), protein (P=0.018) and carbohydrate (P<0.001). Meat-based dishes, dairy foods and ‘extra’ foods were the major food groups contributing to saturated fat in both groups. No differences were found in reported intakes of monounsaturated fat, polyunsaturated fat and fibre between obese subjects with or without T2DM.
Conclusion – Presence of a disease state in obese subjects appear to have a significant impact on dietary intake and subjects appear to follow a lower-energy and lower-fat dietary pattern when they are diagnosed with T2DM. Funding Source – HELP Study: National Health and Medical Research Council, HERO Study: California Walnut Commission.
Background – Osteoporosis is a disease which places considerable burden on the health budget, and brings pain, disability and possibly death to those in whom it develops. As it is essentially incurable, a preventative public health approach is required. Perceptions of personal susceptibility, belief in the seriousness of the disease and in the efficacy of recommended risk reducing behaviours have been shown to be critical in bringing about behavioural change.
Objective – To investigate the attitudes and knowledge of New Zealand women towards osteoporosis risk factors and risk reduction.
Design – A descriptive, web-based survey was completed by 622 Auckland women between the ages of 20 and 49 years. Two validated questionnaires measured levels of knowledge about osteoporosis and preventative behaviours, and perceptions of personal susceptibility and seriousness of the disease. Subjects were recruited by email and the sample was opportunistic.
Outcomes – The subjects reported higher than average educational attainment, and were well motivated to take care of their health. However, over 60% of the women denied feeling any susceptibility to osteoporosis, and 78% did not believe the disease to be crippling. Although most women (90%) agreed that a diet low in calcium increased the risk, 77% thought that calcium-rich foods contained too much cholesterol and 87% did not feel good about eating calcium-containing foods.
Conclusion – The findings of this study suggest that public health strategies aimed at increasing osteoporosis- preventing behaviours in pre-menopausal women should address attitudes about personal susceptibility and the seriousness of the disease. Further research into the opinions of women about the cholesterol content of calcium-rich foods would be valuable.
Background – Ready access to a safe and affordable food was identified as an important element for food security at the 1996 World Food Summit in Rome (1). In 1994, 30% of Indigenous adults worried at least occasionally about going without food (2). The health status of Indigenous people remains the worst of any subgroup within the population, with little evidence of significant improvement over the past two decades (3). The causes of health
3 disadvantage are complex, however, improved diet, access to food and health care play a role in improving health .
Objectives – Examine the literature for evidence of food security in the Indigenous population and examine the amount and type of materials published over the last 20 years.
Design - Biomedical databases were interrogated to determine the amount and type of materials published over the last two decades. Other resources, including departmental reports, were also examined.
Outcomes – Of the materials collected, 84% were published in the second decade. Most of those published in the first decade were descriptive and focused on Indigenous health, nutrition, diet and factors affecting food access. During the second decade, the focus was more on the development of policy and intervention programs. Most related to the Northern Territory.
Conclusion – Lack of food security in many communities is a major concern contributing to poor health status in Indigenous communities. Over the last decade this issue has received more attention in the literature. Policies have been developed to address food insecurity in some jurisdictions; however few report implementation of these policies. Little work, if any, was reported levels of food insecurity in the urban environment nor interventions undertaken to address it.
References
Background – In Australia, the concept of the Glycemic Index (GI) was introduced to the general public through dietitians, other health professionals and the popular press in the mid 1990s, with the recommendation to consume more low-GI foods.
Objective – To determine whether general advice to consume more low GI foods has impacted the mean dietary GI of a representative sample of older Australians over the last 10 years.
Design – Prospective cohort study of 3,654 people aged 49 years or older in the Blue Mountains region of NSW. A total of 2,868 people completed a 145-item semi-quantitative food frequency questionnaire satisfactorily in 1992-94 (BMES 1), and were followed up in 1997-1999 (BMES 2), and 2002-4 (BMES 3). This data analysis includes those people who satisfactorily completed the FFQ on all three occasions (n=1166). Nutrient intake data were analysed in a custom-built database using the NUTTAB (1-2) databases and Australian GI values (3). One-way analysis of variance was used to determine differences between mean dietary GI.
Outcomes – Mean dietary GI was 56.5±4.2 in BMES 1, 56.4±4.3 in BMES 2 and 56.2±4.3 in BMES 3 (P=0.037). Post-hoc comparisons using the Tukey HSD test indicated that mean dietary GI for BMES 3 was significantly lower than BMES 1, but BMES 2 did not differ significantly from either BMES 1 or 3.
Conclusion – Mean dietary GI values of older Australians have dropped by a small but significant amount since the mid 1990’s. Recommendations to consume more low-GI foods may be having a positive effect on older Australians’ diets.
References
1 Department of Community Services and Health. NUTTAB 90 Nutrient Data Table for Use in Australia. Canberra: Australian Government Publishing Service, 1990.
2 Department of Community Services and Health. NUTTAB 95 Nutrient Data Table for Use in Australia. Canberra: Australian Government Publishing Service, 1995.
3 Foster-Powell K, Holt SH, & Brand-Miller JC. International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr 2002; 76: 5-56.
Background and Objectives: Malnutrition is a major public health concern that increases morbidity and mortality in hospitalized patients, particularly those in developing countries. This study aimed to investigate its prevalence, risk factors, and impact on clinical outcomes in hospitalized children and adolescents. Methods and Study Design: We conducted a prospective cohort study in patients aged 1 month to 18 years who were admitted to four tertiary care hospitals between December 2018 and May 2019. We collected demographic data, clinical information, and nutritional assessment within 48 hours of admission. Results: A total of 816 patients with 883 admissions were included. Their median age was 5.3 years (interquartile range 9.3). Most patients (88.9%) were admitted with mild medical conditions (e.g., minor infection) or noninvasive procedures. The prevalence of overall malnutrition was 44.5%, while that of acute and chronic malnutrition was 14.3% and 23.6%, respectively. Malnutrition was significantly associated with age ≤2 years, preexisting diseases (cerebral palsy, chronic cardiac diseases, and bronchopulmonary dysplasia), and muscle wasting. Additional risk factors for chronic malnutrition included biliary atresia, intestinal malabsorption, chronic kidney disease, as well as inability to eat and decreased food intake for >7 days. Malnourished patients had a significantly longer hospitalization duration, higher hospital cost, and nosocomial infection rates than did well-nourished patients. Conclusions: Patients with chronic medical conditions on admission are at risk for malnutrition. Therefore, determination of admission nutritional status must be assessed, and its management are requisites for improved inpatient outcomes.
Background – There is little recent data on the dietary intake of sodium (Na) and potassium (K) in the Australian population. The best method for assessing dietary Na is 24-hour urine collections, which require a high level of subject co-operation. Dietary assessment can provide an estimate of Na intake but the association between dietary assessment and urinary measurement in Australian community dwelling adults is not known.
Objective – To determine the dietary intake of Na and K measured by 24-hr urinary excretion (UNa and UK) and 24-hr dietary recall (Diet Na and Diet K).
Design – Adults recruited to dietary intervention studies had dietary intake measured using a 24-hr recall (analysed with FoodWorks) and provided a single 24-hr urine collection, whilst on their usual diets.
Outcomes – Of the 144 participants, 85% (54 females (F), 69 males (M)) had UNa over the suggested dietary target (SDT) of 70mmol/day and 62% (32 F, 57 M) were over the upper limit (UL) of 100mmol/day.
Only 19% of participants (5 F, 23 M) met the SDT for K (120mmol/d). Those with two 24hr recalls at baseline (n=88), Diet Na and Diet K were significantly correlated with UNa and UK (r=0.391; B(se)=0.018(0.005); P=0.0001 and r=0.579; B(se)=0.500(0.076); P=0.0001, respectively). BMI was also significantly correlated with UNa (r=0.397; B(se)=5.293(1.318); P =0.0001).
Conclusions – Most participants exceeded the UL for Na and few met the SDT for K. Dietary assessment was correlated with urinary output. Body size was a predictor of UNa and with the increasing BMI of the population, meeting the SDT for Na and K presents a great challenge.
Objective: To evaluate the validity and reproducibility of a food frequency questionnaire (FFQ) developed for assessing the association between dietary factors and breast cancer risk among Chinese women in Guangdong. Methods: 61 women (24-64 years) were recruited from the community in Guangzhou city. An 81-item FFQ was administered twice, one year apart (FFQ1, FFQ2). In the mean time, six 3-day dietary records (DRs) were col- lected at two month intervals within the year. Daily consumption of nutrients and foods from the FFQs and DRs, correlation coefficients between the two FFQs and the FFQ with DRs were calculated. Results: Median intakes of nutrients and food group items are higher in FFQ1 than FFQ2. The energy-adjusted Pearson correlation coef- ficients between the FFQ1 and FFQ2 ranged from 0.46 to 0.71 for nutrients and 0.36 to 0.66 for food group items, respectively. In the validation study, energy-adjusted correlation coefficients were 0.25 to 0.65 for nutri- ents and 0.30 to 0.68 for food groups. Mean proportion of subjects being classified into the same quartile of nu- trients and foods intake from the FFQ and DRs was 36% and 43%, respectively. Mean misclassification of sub- jects into opposite quartiles was 5% for nutrients and 3% for foods. Bland-Altman analysis showed that no linear trend existed between the differences and means for nutrients. Conclusions: The 81-item FFQ has satisfactory reproducibility and reasonable validity, and is useful in assessing the usual consumption of major nutrients and food groups among Chinese women in Guangdong.
Background and Objectives: Indonesia’s community health delivery system offers services such as prenatal care and supplementation. Despite accessibility to these services, compliance with supplementation is low, and childhood stunting rates remain high. To address undernutrition, a National Nutrition Communication Campaign (NNCC) – using interpersonal communication (IPC) strategies – was implemented to promote consumption of iron-folic acid (IFA) supplements and iron-rich foods (ATIKA). The purpose of this study was to understand how participation in IPC activities influenced knowledge, attitude/intention, and consumption of IFA supplements and ATIKA among pregnant Indonesian women. Methods and Study Design: Cross-sectional data came from 766 pregnant women that participated in a survey that was based on the constructs from the Theory of Planned Behav- ior and Health Belief Model. Adjusted linear and logistic regression models were conducted to analyze the differ- ences between self-reported IPC participants and non-IPC participants. Approximately 20% of women were ex- posed to the IFA portion of the IPC campaign, and 18% were exposed to the ATIKA portion. Results: Women that were exposed to the campaign reported significantly higher knowledge of IFA tablets and ATIKA, and im- proved attitudes/intentions towards IFA, compared to non-exposed women. Exposure was not associated with ac- tual consumption behaviors. Conclusions: These findings suggest that exposure to a low-intensity intervention can increase knowledge but may not be sufficient to impact behavior. As such, future efforts to reduce stunting through improved maternal nutrition should seek to increase exposure, address barriers, understand perceived susceptibility, and improve self-efficacy in order to expand intervention reach in Indonesia.
Dietary lifestyle is relevant for prevention and treatment of various colorectal conditions. Colorectal disorders have significant morbidity and mortality in a western-style community, particularly irritable bowel syndrome (IBS), colorectal cancer, haemorrhoids, constipation and diverticular disease. This review addresses how bowel health can be maintained, what foods and dietary lifestyles are associated with risk for disease and what foods are of real value in management. Bowel health is that state where the individual is satisfied with defaecation, the diet does not create undue risk for disease and lumenal contents maintain an intact and functional mucosa. Bowel health depends on a healthy dietary lifestyle, but in particular on an adequate intake of non-digestable dietary polysaccharide. Diet influences biology in part by altering the lumenal environment. Effects such as high butyrate levels, lowered pH, a predominance of 'healthy'over 'unhealthy' bacteria, rapid intestinal transit, high faecal bulk, a non-leaky epithelial barrier, adsorption of dietary carcinogens by fibre, low bile salt concentrations, reduced generation of toxic bile salts or protein derivatives and provision of certain bioactive substances are seen as beneficial. Diet influences future risk for colorectal cancer (vegetables, animal fats, polysaccharides amongst others) and for diverticular disease (fibre). Adequate fibre and resistant starch can improve constipation and anorectal conditions such as fissure and haemorrhoids. The role of diet in managing patients with IBS is complex. Fibre may worsen symptoms in severe cases of IBS, diverticular disease and inflammatory bowel disease. Certain carbohydrates of limited digestibility/absorbability, such as lactose, fructose and sorbitol, can precipitate IBS symptoms. Low fat, high fibre diets may reduce recurrence of colorectal adenomas. Diet has a significant role to play in colorectal disorders.
Three hundred and five Nigerian elderly from the Yoruba tribe of both rural and urban areas in the south Western zone of Nigeria were studied. The objective was to assess their nutritional status and identify indicators of nutritional vulnerability. Using a structured household questionnaire, anthropometric measurement and checklist of nutritional vulnerability, nutritional status was assessed and classified into various levels of vulnerability. The demographic characteristics showed that half of the population studied were between 60-69 years, 53% male, 61% married and 58% had no formal education. Based on Body Mass Index (BMI), more than half of the respondents had an acceptable nutritional status with a BMI between 18-25 (63% male; 58% female) whilst 15% of the males and 14% of the females were underweight with BMIs below 18 and 3% of the males had severe malnutrition (BMI below 15). According to the nutritional vulnerability checklist, only 10% of the males and 4% of the females were not nutritionally vulnerable. The majority were either moderately vulnerable or (50% male; 50% female) or highly vulnerable (39% male and 46% female). Stepwise regression analysis identified ten factors contributing to nutritional vulnerability in the elderly: environmental health; food intale, food security; family life; psychological situation; functional capacity; health status; economic situation; alcoholism; and bereave-ment, with the coefficient of multiple determination of 0.94 at P<0.05 (R=0.94 P<0.05). In conclusion, under nutrition was common among the Yoruba elders and women were more vulnerable than men.
Background and Objectives: Energy provided by macronutrients plays a key role in healthy aging. This study therefore explored the association between macronutrients and cognitive function in elderly populations in rural areas of Qingdao, China. Methods and Study Design: This study included 1,504 participants over the age of 65 recruited from Licha Town, Qingdao City, China. Dietary intake was measured using the Food Frequency Questionnaire, and cognitive function was assessed using the Mini-Mental State Examination. Logistic regression models were used to evaluate the association between dietary macronutrient intake and cognitive function. In addition, restricted cubic bars were applied to determine the dose–response relationship between macronutrient ratios and cognitive performance. Results: A total of 877 adults over the age of 65 were included. After adjusting the weighted multiple variables, significant positive associations were revealed between protein and moderate carbohydrate intake and cognitive ability, but a negative association between fat intake and cognitive performance was identified. After calculating the daily energy supply ratio, similar associations were revealed between fat and protein intake and cognitive function. Furthermore, the ratio of proteins to carbohydrates had a U-shaped relationship with cognitive function (pnonlinearity=0.674), whereas the ratio of proteins to fats was L-shaped with lower cognitive function (pnonlinearity<0.001). Compared with the lowest quartile of the ratio of protein to fat intake, the weighted adjusted OR (95% CI) of the highest quartile was 0.509 (0.314, 0.827) for low cognitive performance. Conclusions: With an adequate carbohydrate supply, appropriately increasing dietary protein intake and reducing fat intake might benefit the cognitive function of elders in rural areas.
Background and Objectives: Dietary patterns are undergoing a major shift worldwide. This study analysed the consumption of processed and ultraprocessed foods in Jakarta and its contribution to the energy and nutrient in- take based on the Individual Food Consumption Survey 2014. Methods and Study Design: Food consumption data were based on 24-hour dietary recall. Foods were grouped into four food groups: nonprocessed foods, pro- cessed ingredients, processed foods, and ultraprocessed foods and subsequently categorised according to the In- donesian Food Category System. Energy and nutrient intake were calculated using Nutrisurvey 2007 software. Results: Nonprocessed food, processed ingredient, processed food, and ultraprocessed food consumption con- tributed to 57.2%, 21.6%, 1.7%, and 19.5% of total weight consumption, respectively. Ultraprocessed foods con- tributed to 15.7%, 16.7%, 14.2%, 12.6%, 18.4%, and 31.3% of daily energy, carbohydrate, protein, fat, sodium, and sucrose intake, respectively, and the respective contributions of nonprocessed foods were 52.2%, 58.7%, 65.8%, 32.6%, 7.9%, and 11.1%; of processed ingredients were 30.0%, 22.7%, 16.4%, 53.6%, 68.9%, and 57.6%; and of processed foods were 2.1%, 2.0%, 3.6%, 1.2%, 4.8%, and 0%. Linear regression analysis between the amount of food consumption and nutrient intake showed that at the same weight consumption, processed ingredi- ents provided a higher intake of energy, fat, sodium, and sucrose than the other food groups. Conclusions: Pro- cessed and ultraprocessed foods still have a lower contribution to energy and nutrient intake in Jakarta than nonprocessed foods and processed ingredients.
We aimed to prospectively assess dairy intake among adolescents, and determine the predictors of adequate dairy consumption during adolescence. 634 Sydney schoolchildren (351 girls and 283 boys) who had dietary data at both age 12 and 17 were included for analyses. Dairy consumption was assessed from validated semi-quantitative food frequency questionnaires. At age 12, mean total dairy intake was 1.62 serves/day which decreased to 1.40 by age 17 (p<0.0001). Mean serves/day of milk decreased from 1.11 to 0.92 during adolescence. Moreover, 90% of the decrease in serves/day of total dairy was due to reduced milk consumption. At age 12, 8.5% of children con- sumed ≥3.5 serves/day of total dairy and this decreased to 6.2%, 5 years later at age 17 (p=0.001). A lower pro- portion of girls compared with boys consumed ≥3 serves/day of total dairy at both ages 12 (p=0.005) and 17 (p=0.01). Participants with tertiary qualified parents at baseline were 85% more likely to have intakes of the dairy food group above the median during the 5 years, OR 1.85 (95% CI 1.18-2.91). Frequent flavored milk consump- tion (≥2 serves/week) at baseline was associated with ~5-fold greater likelihood of maintaining intakes of dairy foods above the median during adolescence. Dairy food consumption decreased significantly during adolescence, driven primarily by a decrease in milk consumption. Most adolescents did not meet national recommended guide- lines for the dairy food group intake. These findings highlight the need for further research into intervention strat- egies aimed at sustaining dairy consumption.
The objective of this study was to validate a food frequency questionnaire (FFQ) used to estimate energy and se- lected nutrient intake in a Brazilian population with various ethnic backgrounds. Validity of intake estimated us- ing the FFQ was tested among 55 Brazilian women, namely 26 Caucasians, 15 of Japanese descent, and 14 oth- ers. The FFQ was originally developed for use in a case-control study of breast cancer conducted in São Paulo. Dietary records (DRs) recorded in two seasons were used as references. Intake of energy and 24 nutrients were calculated using the USDA and Japanese food composition tables. Validity and reproducibility were evaluated using Spearman’s correlation coefficients. Results showed that intake of chicken/poultry, eggs and legumes were overestimated by the FFQ compared to the DR, whereas that of pork and fat was underestimated. Further, intake of folate, fiber and isoflavones was overestimated by the FFQ whereas that of energy, fat, carbohydrate alpha- carotene and lycopene was underestimated. Energy-adjusted correlation coefficients between nutrient intakes es- timated with the FFQ and DR were high for isoflavones (0.76), calcium (0.50), and vitamin C (0.49). In contrast, validity varied from moderately high to low for energy and other nutrients. In conclusion, validity of the FFQ for estimation of the intake of selected nutrients among Brazilian women with varied ethnic background was moder- ately high.
A case-control study was conducted to investigate the association between the consumption of local common foods that are rich in vitamin A and the risk of lung cancer in Taiwan. A total of 301 incident lung cancer cases, 602 hospital controls, and 602 neighborhood controls were recruited. The consumption of 13 food items and vi- tamin supplements was estimated by use of a food frequency questionnaire. The conditional logistic regression models were used to estimate the adjusted odds ratios (AOR) and 95% confidence intervals (CI) for lung cancer risk with each control group as reference by adjustment of covariates. A reduced risk for lung cancer was found to be associated with increased intakes of vitamin A, α-carotene, and β-carotene from 13 food items. More serv- ings of vegetables (AOR for the highest versus the lowest quartile = 0.67-0.70, 95% CI = 0.42-1.08, plinear trend = 0.04), garland chrysanthemum (AOR for the highest versus the lowest tertile = 0.58-0.74, 95% CI = 0.37-1.14, plinear trend ≤ 0.04) and sweet potato leaves (AOR for the highest versus the lowest tertile = 0.43-0.65, 95% CI = 0.28-0.96, plinear trend ≤ 0.03) were associated with the reduced risk for lung cancer. In conclusion, higher con- sumption of vitamin A-rich vegetables, especially garland chrysanthemum and sweet potato leaves might provide potential protection from lung cancer.
The aim of the study was to feed convenience baby food brown rice (BC) and white rice (WC) congee diets compared to egg custard (EC) and baked bean (BB) diets to newborn guinea pig pups. Diets were isocaloric and formulated to contain equal macronutrient content of carbohydrate, protein, fat and fibre. Diets were supplemented with essential nutrients, fruit and vegetables and decrementally with standard chow for palatability. We investigated the acceptability of the diets and specifically whether the different natural fibre content of these diets could influence whole animal and small intestinal growth, caecal digesta properties and specifically in vitro ileal contractility. After 8 weeks of feeding, the mean body weight of WC group was significantly lower than the BB group. WC group had lower small intestine weight than both BC group and BB group resulting in lower small intestine density compared to BB group. Caecal digesta pH and total short chain fatty acid (SCFA) concentration were similar. However, butyrate was higher in the BB group compared to the other diets. Contractility studies revealed a small but significantly higher voltage was required to initiate ileal contraction of BC group compared to both the EC and BB groups. All dietary groups responded similarly to acetylcholine, histamine, serotonin, PGE2, PGF2a, and 8-iso-PGE2. There were no differences on inhibition of electrically-driven contraction by morphine or epinephrine. The newborn guinea pig model was an effective system for testing, with limitations, supplemented convenience baby foods with variable natural fibre content that demonstrated significant effects on animal growth, caecal digesta SCFA and intestinal contractility.
China promulgated her first food based dietary guidelines (FBDGs) in 1989. It was proposed by the standing board of Chinese Nutrition Society. The guidelines consisted of 8 items, each followed by a paragraph of expla- nation words. The second FBDGs came out in 1997, was expanded to include 3 parts i.e. guide lines for general population, for 7 particular population groups (infants, toddlers and preschool children, school-age children, ado- lescents, pregnant women, lactating mothers and the aged) and a newly formed food guide pagoda (FGP). The last version of the Chinese FBDGs was compelled by Chinese Nutrition Society in 2007, and proclaimed by the Ministry of Health in early 2008. The new guidelines kept the skeleton of three parts, but expanded remarkably in volume and coverage. The guidelines for the general population consisted of 10 items, each containing: core information, a discussion and reference materials. The guidelines for particular groups contained more subgroups, and more detailed recommendations. The revised pagoda kept the previous food grouping and placement but al- tered the amount of some food groups. An image of a walker and a cup of water were added to the side of the pagoda. Guidelines-2007 called for more coarse grains and less cooking oil consumption. Physical activity is al- so strongly recommended.
This study was undertaken to determine the effect of medium-chain triglyceride (MCT) oil supplementation on the duration and episodes of diarrhea attacks, and specifically its effect on the clinical manifestations of patients. Seventeen children aged 6 months to 47 months old with a mean age of 19.6 months, suffering from acute diar- rhea at the Pediatric Ward of the Philippine General Hospital Medical Center and other neighboring health cen- ters were studied. A double-blind randomized design was employed. Physical and clinical assessment was per- formed by a physician prior to enrolment in the study. Dietary, anthropometric, and biochemical assessment were undertaken by clinical investigators before and after the supplementation. The subjects were randomly as- signed to either the MCT oil- supplemented diet or the non-MCT oil diet. Daily monitoring of food intake and the frequency or episodes of diarrhea attacks was done. Subjects were closely monitored for any possible ad- verse reactions. The baseline characteristics of the subjects were not significantly different for any of age, height, weight, cholesterol or triglyceride concentrations between the two groups. Nutrient intakes at baseline and dur- ing intervention were also not significantly different. There were no differences in cholesterol and triglyceride between the two groups after supplementation. Stool frequencies of the MCT group and the non-MCT group at baseline, after the 6th hr, and at 12th hour, were not different. No subject developed fat malabsorption during the intervention, as assessed with Sudan Black stain. There was statistical significant difference in the rate of weight gain among subjects in the MCT group compared to subjects in the non-MCT group (0.22 ± 0.22 kg/day vs. -
.048 ± .26 kg/day, (p= .042). MCT oil may promote weight gain (although what this constitutes in body com- positional terms is uncertain) and shows a trend towards shorter duration of intervention among children with acute diarrhea. Limited sample size precludes conclusions on these possibilities. MCT oil did not cause vomit- ing, dehydration, or fat intolerance. MCT oil did not cause an elevation in cholesterol and triglyceride levels. More studies, with larger sample size, and longer duration will be worthwhile to assess the effect of MCT oil on childhood diarrhea.
The aim of the study was to explore the association between dietary patterns and lipid levels in Henan rural area. Methods and Study Design: Fasting blood samples, information on dietary intakes (with food frequency questionnaires) and other data were collected from the Henan Rural Cohort Study. Principal component analysis was used to identify the dietary patterns. Binary logistic regression and restricted cubic spline regression models were performed to obtain odds ratios (ORs) and 95% confidence intervals (95%CI). The study recruited 38,983 available participants aged from 18 to 79 from rural areas in Henan province. Results: The study showed that, three patterns were identified by higher factor loadings: namely the “meat” (high intakes of red meat, white meat and fish), “grain-egg-nut complex” (high intakes of nuts, milk, eggs, grains and beans), and “vegetables- staple food-fruits” pattern (high intakes of vegetables, staple food and fruits). “Grain-egg-nut complex” pattern was significantly positively related to the risk of dyslipidemia (OR: 1.10; 95% CI: 1.05–1.16, p<0.05). The multivaria- ble-adjusted ORs across tertiles of each dietary pattern were significantly associated with each component of dyslipidemia indexes. Conclusions: Grain-egg-nut complex dietary pattern was positively associated with dyslipidemia. All three dietary patterns were associated with blood lipid profiles aberrations.
With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary ac- tion guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a pub- lic hearing for general and professional comments. Lastly, the language was clarified in terms of public under- standing and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your ac- tivity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; pre- pare foods properly, and order sensible amounts; enjoy our rice-based diet.
| Current models of the nutrition transition focus on demographic changes and economic development. A further influence may be the adoption of western-based perceptions of beauty that lead to potentially harmful eating behaviours which contribute to overweight, obesity, and eating disorders. This paper proposes a comprehensive model of the nutrition transition that includes western influences on perceived attractiveness and subsequent eating styles. An exploratory test of this model for Asian countries explores differences in intuitive eating as a function of economic development and the adoption of western standards of beauty. The intuitive eating scale (IES), a measure of food consumption that is primarily characterized by the satisfaction of physical hunger, was used to evaluate agreement with intuitive eating principles in the US and four Asian countries (Japan, Thailand, the Philippines, and China). Although intuitive eating scores in the US and Thailand failed to follow predicted patterns on two of the four IES subscales, scores for the other two IES subscales and the total IES score followed predicted patterns for Asian countries. Intuitive eating appears to be a valid, measurable concept that is correlated with economic development and levels of western influence in Asian countries. The tentative findings of this exploratory study support further evaluation of cultural influences as an important component of the nutrition transition. |
The alkaline extracts from pine seed shells (Pinus koraiensis) suppressed the human immunodeficiency virus (HIV)-induced cytopathicity using HIV (HTLV-III) infected MT-4 cells in vitro, and showed extremely low cytotoxicity. The active substances were acid polysaccharides containing uronic acids. No animal died and no harmful effect was observed at a concentration of 1.05 g per kg body weight. We also studied the clinical effects of alkaline extracts on the protection of feline immunodeficiency virus (FIV) infection. Protection against infection by FIV was achieved by oral administration of the alkaline extracts with usual food.
Background and Objectives: Eggs, an important source of high-quality protein, contain a variety of key nutri- ents and antioxidants. Here we conducted an intervention study to evaluate whether the additional consumption of one egg per day would affect the daily nutritional intakes and blood antioxidant status in Japanese woman univer- sity students. Methods and Study Design: For 4 weeks, the 14 subjects were provided a nutritious breakfast in- cluding one boiled egg, and they were asked to keep a daily dietary record. Results: The subjects’ daily energy intake during the intervention did not differ compared to the baseline, whereas the protein energy ratio and cho- lesterol intake were significantly increased. The subjects’ consumption of confectionery during the intervention was significantly decreased compared to the pre-trial period. The total score of adherence to the food-based Japa- nese dietary guidelines for a healthy diet during the intervention was higher than that at baseline. The analysis of fasting blood samples showed that the subjects’ serum lipids levels were not altered, whereas their malondialde- hyde modified low-density lipoprotein (MDA-LDL) levels and the oxidative susceptibility of LDL were signifi- cantly reduced after the intervention. More importantly, serum folic acid levels were significantly increased. Conclusions: Our results suggest that regular egg consumption at breakfast can help improve the daily nutritional status and dietary habits and also ameliorate certain indices of antioxidant status in young women.
Saffron is a well-known spice and food colorant commonly consumed in different parts of the world. Recently, much attention has been focused on the biological and medicinal properties of saffron. In the present study the interactive effects of saffron with two commonly consumed dietary agents, garlic and curcumin was evaluated for anti-genotoxic effects against cyclophosphamide (CPH) in the mouse bone marrow micronucleus test. Experimental animals were orally pretreated with saffron (100 mg/kg body weight), garlic (250 mg/kg body weight) and curcumin (10 mg/kg body weight), either alone or in combination for five consecutive days, 2h prior to the administration of CPH. Maximum reduction in the frequencies of micronucleated polychromatic erythrocytes (Mn PCEs) induced by CPH was observed when all the three test compounds were administered together. Furthermore, the protective effects were more pronounced in the garlic-administered groups compared to curcumin and/or saffron administered groups.
Background and Objectives: Food intolerance is believed to be a source of frequent medical problems in ulcera- tive colitis (UC), which closely correlate with patients’ dietary pattern. Living in an underdeveloped area of Chi- na, residents in southwestern region have diverse dietary habits. The objective of this study is to determine the prevalence of food intolerance in the UC patients in this area and to discuss some of the possible risk factors lead- ing to the condition. Methods and Study Design: Food antibodies in serum of 80 patients with active UC were determined by standard enzyme-linked immuno sorbent assay (ELISA). This study examined the risk factors con- tributing to high titers of food antibodies and the dietary patterns correlating with food intolerance in these de- mographics. Results: 83.8% of patients (67/80) were found to be seropositive for food intolerance. Patients of female, aged between 20 to 40 and the one who tended to have a high fat diet were tested to be highly seroposi- tive (p<0.05). Neither spicy food intake nor the course the disease manifested any relationship with the presence of food intolerance (p>0.05). Conclusion: Active UC patients in southwestern region of China have showed to be high seropositive in food intolerance, particularly in female and young patients. Dietary patterns with high in fat intake seem to have caused high prevalence of seropositivity in food intolerance. Although rice has been taken as staple food and the spicy food has been popular among citizen in this region, these foods have indicated to no ef- fect on food intolerance in this study.
Objective: The objective of this study was to test whether “Dietary Guidelines for Chinese Residents” have beneficial effects on anthropometric and metabolic variables, adipokines and inflammatory markers in metabolic syndrome patients. Methods & Procedures: A multi-stage sampling method was applied to select metabolic syn- drome patients in two districts of Shanghai. Two hundred and seventy-two metabolic syndrome patients were di- vided into control and intervention groups according to their district. Nutrition education guided by “Dietary Guidelines for Chinese Residents” was performed in the intervention group for one year. Results: Nutrition- related knowledge, attitudes and behavior were improved in the intervention group. Potassium intake and food to total energy ratio for grain, vegetable and fruit increased while sodium intake as well as fat to total energy ratio decreased in the intervention group compared to the control group (p<0.05). Correspondently, the intervention group significantly improved its waist circumference, waist to hip ratio, high-density lipoprotein cholesterol, adiponectin, leptin and tumor necrosis factor-α compared to the control group (p<0.05). Waist circumference changes from baseline to end of the study in the intervention and the control groups were -3.9±0.3 and -2.3±0.4 cm respectively. There was a significant difference between the two groups (p=0.004). Means of waist circum- ference, waist to hip ratio, leptin and tumor necrosis factor-α were lower, and high density lipoprotein- cholesterol was higher in the intervention group than the control group (p<0.05). Conclusion: This study con- firmed “Dietary Guidelines for Chinese Residents” had beneficial effects on anthropometric, lipids, adipokines and inflammatory markers in metabolic syndrome patients.
Infectious diseases transmitted by food have become a major public health concern in recent years. In the USA alone, there are an estimated 633 million cases each year. The list of responsible agents continues to grow. In the past 20 years some dozen new pathogens that are primarily food-borne have been identified. Fruits and vegetables, often from the global food market, have been added to the traditional vehicles of food-borne illness; that is, undercooked meat, poultry, seafood, or unpasteurized milk. Such products are minimally processed and have fewer barriers to microbial growth such as salt, sugar or preservatives. The evolution of the epidemiology of food-borne illness requires a rethinking of traditional, though still valid, solutions for their prevention. Among various strategies to prevent food-borne pathogens, use of dietary phytochemicals is promising. The major obstacle in the use of dietary phytochemical is the consistency of phytochemicals in different foods due to their natural genetic variation. We have developed a novel tissue-culture-based selection strategy to isolate elite phenolic phytochemical-producing clonal lines of species belonging to the family Lamiaceae. Among several species we have targeted elite clonal lines of thyme (Thymus vulgaris) and oregano (Origanum vulgare) against Escherichia coli and Clostridium perfrigens in fresh and processed meats. We are also evaluating high phenolic profile-containing clonal lines of basil (Ocimum basilicum) to inhibit gastric ulcer-causing Helicobacter pylori. Other elite lines of the members of the family Lamiaceae, rosemary (Rosmarinus officinalis) and salvia (Salvia officinalis) also hold promise against a wide range of food pathogens such as Salmonella species in poultry products and Vibrio species in seafood.
Modern nutritional science is providing ever more information on the functions and mechanisms of specific food components in health promotion and/or disease prevention. In response to demands from increasingly health con- scious consumers, the global trend is for food industries to translate nutritional information into consumer reality by developing food products that provide not only superior sensory appeal but also nutritional and health benefits. To- day’s busy life styles are also driving the development of healthy convenience foods. Recent innovations in food technologies have led to the use of many traditional technologies, such as fermentation, extraction, encapsulation, fat replacement, and enzyme technology, to produce new health food ingredients, reduce or remove undesirable food components, add specific nutrient or functional ingredients, modify food compositions, mask undesirable flavors or stabilize ingredients. Modern biotechnology has even revolutionized the way foods are created. Recent discoveries in gene science are making it possible to manipulate the components in natural foods. In combination with biofermenta- tion, desirable natural compounds can now be produced in large amounts at a low cost and with little environmental impact. Nanotechnology is also beginning to find potential applications in the area of food and agriculture. Although the use of new technologies in the production of health foods is often a cause for concern, the possibility that innova- tive food technology will allow us to produce a wide variety of food with enhanced flavor and texture, while at the same time conferring multiple health benefits on the consumer, is very exciting.
Algal polysaccharides such as carrageenan are good sources of dietary fibre. Previous studies have shown that carrageenan has hypoglycemic effects, but its cholesterol and lipid-lowering effects have yet to be demonstrated. In this study, carrageenan was incorporated into 4 food items, then fed to 20 human volunteers to determine its effects on blood cholesterol and lipid levels. The study followed a randomized crossover design. Each phase of the study - control and experimental - lasted for 8 weeks separated by a 2-week washout. At control, the subjects consumed their usual food intake; at experimental, they were given test foods with carrageenan partly substituting similar items in their usual diet. Fasting venous blood samples were collected immediately before and after each phase to assay serum cholesterol and triglyceride. The mean serum cholesterol was significantly lower (P < 0.0014) after the experimental phase at 3.64 mmol/L compared with the mean level after the control phase, 5.44 mmol/L. The mean triglyceride level after the experimental phase, 0.87 mmol/L, was significantly lower (P < 0.0006) in comparison to the level after the control phase, 1.28 mmol/L. The mean HDL cholesterol level significantly increased (P < 0.0071) after the experimental phase at 1.65 mmol/L compared to the mean value after the control phase, 1.25 mmol/L. No significant differences were observed between the LDL cholesterol levels after the experimental and the control phases. This study indicates that regular inclusion of carrageenan in the diet may result in reduced blood cholesterol and lipid levels in human subjects.
The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and to investi- gate associated lifestyle factors. Subjects were an age-stratified sample of 511 women aged 40-80 y, randomly selected from the electoral roll and participating in the Longitudinal Assessment of Ageing in Women at the Royal Brisbane and Women’s Hospital. A cross-sectional study was conducted to assess isoflavone and lignan intake over the past month from food and supplements using a 112-item phytoestrogen frequency questionnaire. Data were also collected on nutrient intakes, physical activity, smoking, alcohol, non-prescription supplements, hormone therapy, education and occupation. Logistic regression was used to evaluate associations between demographic and lifestyle variables and soy/linseed consumption while controlling for age. Isoflavone intakes were significantly higher in the younger compared to older age groups (p<0.001); there were no age-related dif- ferences in lignan intake. Forty-five percent of women consumed at least one serve of a soy and/or linseed item and were defined as a soy/linseed consumer. Median (range) intakes by consumers for isoflavones and lignans (3.9 (0-172) mg/d and 2.4 (0.1-33) mg/d) were higher than intakes by non-consumers (0.004 (0-2.6) mg/d and 1.57 (0.44-4.7) mg/d), respectively (p<0.001). Consumers had higher intakes of dietary fibre (p=0.003), energy (p=0.04) and polyunsaturated fat (p=0.004), and higher levels of physical activity (p=0.006), socio-economic po- sition (p<0.001), education (p<0.001) and supplement use (p<0.001). Women who consumed soy or linseed foods differed in lifestyle and demographic characteristics suggesting these factors should be considered when investigating associations with chronic disease outcomes.
Excessive intake of trans fatty acids (TFA) could reduce the fat density of human milk and impair the desatura- tion of essential fatty acids. Because the mammary glands are unable to synthesize TFA, it is likely that the TFA in human milk come from dietary intake. Thus, the aim of this study was to investigate the sources of TFA intake for lactating mothers in one of the urban areas in Selangor. In this cross-sectional study, anthropometric meas- urements, FFQ including 7 food groups and dietary consumption data were collected from 101 lactating mothers. Five major TFA isomers (palmitoelaidic acid (16:1t9), petroselaidic acid (18:1t6), elaidic acid (18:1t9), vaccenic acid (18:1t11) and linoelaidic acid (18:2t9,12) in human milk were measured by gas chromatography (GC). The relationship between food consumption and TFA levels was assessed using the non-parametric Spearman’s rho test. The TFA content in human milk was 2.94±0.96 (SEM) % fatty acid; this is considered low, as it is lower than 4%. The most abundant TFA isomer was linoelaidic acid (1.44±0.60% fatty acid). A sub-experiment (ana- lyzing 3 days of composite food consumption) was conducted with 18 lactating mothers, and the results showed that linoelaidic acid was the most common TFA consumed (0.07±0.01 g/100 g food). Only 10 food items had an effect on the total TFA level and the isomers found in human milk. No association was found between TFA con- sumption and the TFA level in human milk.
Oxalic acid and its salts occur as end products of metabolism in a number of plant tissues. When these plants are eaten they may have an adverse effect because oxalates bind calcium and other minerals. While oxalic acid is a normal end product of mammalian metabolism, the consumption of additional oxalic acid may cause stone formation in the urinary tract when the acid is excreted in the urine. Soaking and cooking of foodstuffs high in oxalate will reduce the oxalate content by leaching. The mean daily intake of oxalate in English diets has been calculated to be 70150 mg, with tea appearing to contribute the greatest proportion of oxalate in these diets; rhubarb, spinach and beet are other common high oxalate-content foods. Vegetarians who consume greater amounts of vegetables will have a higher intake of oxalates, which may reduce calcium availability. This may be an increased risk factor for women, who require greater amounts of calcium in the diet. In humans, diets low in calcium and high in oxalates are not recommended but the occasional consumption of high oxalate foods as part of a nuritious diet does not pose any particular problem.
Among the countries that can be classified as Near East Africa, North West Africa, and Western Africa, there is a great diversity of foods and dietary patterns. Prevalence of undernourishment as defined by FAO using dietary energy supply data, varies dramatically among these countries, with Tunisia in the lowest prevalence category (<2.5%), and Sierra Leone in the highest prevalence category (>35%). Throughout the 1960's, the dietary energy supply of North West African and Western African countries was similar. However, since the 1970s a great and consistent improvement has been seen in North and North West African countries. Both the proportion and number of undernourished in North Africa is now very similar to that of North America. Oil use, energy from fat, and protein from plant versus animal sources account for a large part of the food pattern differences between countries in these regions. Using Tunisia and Sierra Leone as examples again, dietary diversity as measured by the percentage of energy from foods other than starchy staples, is about 50% in the former, while in the latter, it is only 36%. Fatty fruits such as olives, cocoa and palm fruit have a special role in both the diet and the economies of the region.
Background and Objectives: In Crohn’s disease (CD), belonging to inflammatory bowel disease, the small in- testine is involved in most cases. Most frequently affected is the distal ileum, where vitamin B-12 is specifically absorbed. Therefore, malabsorption of vitamin B-12 is quite likely to occur in patients with CD. In this study, we have studied the vitamin B-12 status in CD patients. Methods and Study Design: Forty eight patients with CD were evaluated for their food intake, and circulating concentrations of vitamin B-12, folic acid, and homocysteine (Hcy) as a sensitive marker for the insufficiency of these vitamins and a risk factor of atherosclerosis. Results: Plasma Hcy concentration was significantly correlated with serum vitamin B-12 concentration alone, and 60.4 % of the subjects had hyperhomocysteinemia. Receiver Operating Characteristics (ROC) analysis showed that se- rum concentration of vitamin B-12, but not folic acid, predicted hyperhomocysteinemia. Their intake of vitamin B-12 was much higher than the Japanese RDA, but not correlated with blood concentrations of vitamin B-12 or Hcy, probably due to malabsorption. Conclusions: Vitamin B-12 insufficiency and hyperhomocysteinemia were highly prevalent in CD patients. Recently, the significance of extra-intestinal complications of CD has been in- creasingly recognized, and our finding is likely to be of clinical importance.
Despite carbohydrate hypothesis related to breast cancer development, the inter-relationships of carbohydrate measures with risk of breast cancer are unclear. We evaluated the association between the risk of breast cancer and total carbohydrate intake, glycemic load, and glycemic index, and types of rice in a hospital-based case- control study. Cases were 362 women aged 30-65 years old who were histologically confirmed to have breast cancer. Controls visiting the same hospital were matched to cases according to their age (±2 years) and meno- pausal status. Food intake was estimated by a quantitative food frequency questionnaire (FFQ) with 121 items. Conditional and unconditional logistic regression analysis was used to obtain the odds ratios (ORs) and corre- sponding 95% confidence intervals. There were no associations between risk of breast cancer and carbohydrate intake and glycemic load. A positive association with white rice (OR=1.19 per 100 g/d increment, 95% confi- dence interval (CI)=1.01-1.40), no association with mixed white rice (OR=0.95 per 100 g/d increment, 95% CI=0.80-1.13), and an inverse association with mixed brown rice (OR=0.76 per 100 g/d increment of mixed brown rice, 95% CI=0.61-0.95) was found. Additional analysis showed a positive association for white rice and an inverse association for mixed brown rice with breast cancer risk among overweight, postmenopausal women. These results do not support an association between breast cancer and diets high in carbohydrate, glycemic index, or glycemic load. However, a higher consumption of mixed brown rice may be associated with a decreased risk of breast cancer, especially in overweight, postmenopausal women.
Obesity has become a global “epidemic”. At this stage, overweight / obesity has become a major public health problem that seriously affects not only adults but also children and adolescents worldwide. Medical nutritional therapy is the basic treatment for obesity and an indispensable measure for prevention and control at any stage in the course of obesity. Management of co-morbidities and improving the quality of life of obese patients are also included in treatment aims. In recent years, there have been some guidelines on the nutrition management of overweight/obesity. However, the management of nutrition and lifestyle interventions must be compatible with specific regional dietary habits and social culture. To provide a clinical reference for the standardized treatment and management of overweight / obesity, guidelines for medical nutrition treatment of overweight/obesity in China (2021) were published, which cover the relationship of weight loss with different dietary patterns, meal replacement foods, biorhythms, intestinal microecology, metabolic surgery, and medical nutritional intervention, as well as weight loss in special populations. We hope the guidelines will improve the awareness of the importance of nutrition intervention in the treatment of metabolic disease, further regulate the principle and approach of medical nutrition therapy, and establish a workflow of standardized medical nutrition therapy for weight loss management so that more clinical nutrition professionals and medical staff can use it to provide better services for obese people.
The present paper will discuss the nature of nutrition communication and knowledge in relation to novel foods. The paper starts with an introduction to trends in present-day society, then focuses on the concepts of knowledge and information in relation to human needs and motivation. Next, the relevance of food and nutrition communication to consumer lifestyles is discussed. This is followed by consideration of consumer issues related to novel foods. The key conclusions are that nutrition communication is a minor part of most consumers' lifestyles and that the promotion of novel foods must be based on the dissemination of sound nutrition principles throughout the various values and lifestyles segments of the population.
India is an agricultural country and the majority of India's population live in rural areas. This is so in Karnataka, a state in southern India. The present report consists of a detailed nutrition situation analysis. Karnataka has a population of 45 million, which is approximately 3-5% of India's population. One in every two women are agricultural labourers, reflecting women's predominance in the field of agriculture. The state has a literacy rate of 56%. The food consumption patterns reveal that cereals and millets are the main food items. However, protective foods (i.e. foods that are rich in proteins, vitamins and minerals) are consumed in lesser amounts. When compared with the average Indian recommended dietary intake (RDI), the intake of energy in adults was found to be higher, as was protein. The average intake of vitamins, however, was 50% less than the RDI. Unlike adults, energy deficiency is a problem in the diets of preschool children. Growth retardation has been observed in a vast majority of children in Karnataka. An improvement in the nutritional status of rural adults has been observed in recent years. Protein energy malnutrition, vitamin A deficiency and B-complex deficiencies are the major nutritional deficiencies among preschool children, while anaemia remains a major health problem in women. Improvement in the healthcare system has brought a decline in the infant mortality rate in Karnataka and the state attained universal immunization coverage in 1990. The National Nutrition Programme - Integrated Child Development Scheme provides an integrated package of services to residents of Karnataka
Background and Objectives: We aimed to explore the relationship between dietary patterns and gestational diabetes mellitus (GDM) during pre-pregnancy six months using principal component analysis (PCA) and the geometric framework for nutrition (GFN). Methods and Study Design: We conducted a case-control study that included 210 GDM pregnant women and 210 controls. The dietary intake of all participants was assessed by a validated semi-quantitative food frequency questionnaire (FFQ). Major dietary patterns were extracted by PCA. A conditional logistic regression model was used to determine whether specific dietary patterns are associated with the risk of GDM. Meanwhile, the relationship between dietary patterns and GDM was visualized using GFN. Results: Four major dietary patterns were identified: “protein-rich pattern,” “plant-based pattern,” “oil-pickles-desserts pattern,” and “cereals-nuts pattern.” After adjustment for confounders, the “plant-based pattern” was associated with decreased risk of GDM (Q4 vs. Q1: OR = 0.01, 95% CI: 0.00~0.08), whereas no significant association was found in other dietary patterns. Moreover, there was no dietary intake of ice cream cones and deep-fried dough sticks for the population, which would produce fewer patients with GDM. Deep-fried dough sticks had statistically significant differences in the case and control groups (p < 0.001), while ice cream cones had the opposite result. Conclusions: The “plant-based pattern” may reduce the risk of GDM. Besides, although the “cereals-nuts pattern” had no association with GDM risk, avoiding the intake of deep-fried dough sticks could decrease GDM risk.
Background and Objectives: Considering the impact of unfavorable dietary practices on inadequate nutrient in- take, this cross-sectional study aimed to explore dietary practices, including problem nutrients, and develop local food-based recommendations (FBRs) to improve the intake of problem nutrients among women of reproductive age (WoRA) with dyslipidemia in Minangkabau, Indonesia. Methods and Study Design: The study was con- ducted in the Padang township inhabited mostly by the Minangkabau tribe. Accordingly, 74 WoRA with dyslipidemia completed the study. Two replicate 24-h recalls and a 5-day food record were used to assess food consumption patterns. Then, linear programming (LP) analysis using three modules of the WHO Optifood soft- ware was employed to identify problem nutrients and develop FBRs. Results: Median (5th and 95th percentiles) weekly consumption frequencies for grain; meat, fish, and eggs; and added fat were 18 (14–27), 11 (6–16), and 15 (7–30), while those for fruits and vegetables were 2 (0–11) and 7 (2–16), respectively. Based on the aforemen- tioned food pattern, PUFA (both n-3 and n-6 fatty acids), dietary fiber, iron, and zinc were identified as typical problem nutrients. The final FBR emphasized on incorporating locally available nutrient-dense foods, as well as food groups and sub-groups, which would improve the intake of problem nutrients. Conclusions: Minangkabau WoRA have dietary practices that predispose them to dyslipidemia. Moreover, the LP approach is a sensitive tool for identifying nutrient-dense foods that could potentially improve problem nutrient intake, as well as those that need to be limited in the final FBR.
Background and Objectives: To explore the diet characteristics of anaemic infants and young children of China, blood tests and diets surveys were conducted in five cities. Methods and Study Design: About 150 children aged 6-36 mo were selected in a typical community health center of each city, and the total sample was 750. Nutrition- al status was measured through 24h dietary recall method and HEMO Cue was used for Haemoglobin concentra- tion testing. Results: The average prevalence of anaemia was 17.2% in 6-12 mo children, which was higher than in other age groups. Median intakes of 8 nutrients (protein, vitamin A, B-1 and C, calcium, iron, zinc and copper) in anaemic children were less than non-anaemic children (p<0.05) in 6-12 mo olds; at age 12-24 mo the intake of vitamin A in anaemic children was less than in non-anaemic children (p<0.05). Market complementary food was the main source of iron in both anaemic and non-anaemic children (6-12 mo olds: 2.28 and 3.69 mg; 12-24 mo olds: 2.06 and 2.09 mg, respectively). Iron intake from formula was lower in anaemic children than in non- anaemic children (6-12 mo olds: 0.88 vs 2.54 mg; 12-24 mo olds: 1.59 vs 2.87 mg). The proportion of children obtaining continued breastfeeding in anaemic children was significantly higher than in non-anaemic children aged 6-12 mo (65% vs 37%, p<0.05). Conclusions: Appropriate practices around continuing breastfeeding and complementary feeding particularly targeted to breast fed older infants and young children are needed to reduce anaemia in infants and young children.
The addition of some legume ingredients to bread has been associated with effects on glycaemic, insulinaemic and satiety responses that may be beneficial in controlling type 2 diabetes, cardiovascular disease and obesity. However, the effect of Australian sweet lupin (Lupinus angustifolius) flour (ASLF) is unknown. This investigation examined the effect of adding ASLF to standard white bread on post-meal glycaemic, insulin-aemic and satiety responses and palatability in healthy subjects. Using a randomised, single-blind, cross-over design, 11 subjects consumed one breakfast of ASLF bread and two of standard white bread ³ 7 days apart after fasting overnight. Each breakfast also included margarine, jam, and tea with milk and contained 50g available carbohydrate. On each test day, blood samples were taken after fasting, then several times over 2 hours post-prandially, and analysed for plasma glucose and serum insulin. Subjects rated breakfast palatability and perception of satiety, in the fasting state and over 3 hours post-prandially, after which food intake from an ad libitum buffet and for the rest of the day was recorded. Incremental areas under the curves for glucose, insulin and satiety, glycaemic index, insulinaemic index and satiety index were calculated. ASLF addition to the breakfast reduced its glycaemic index (mean ± SEM; ASLF bread breakfast = 74.0 ± 9.6. Standard white bread breakfast = 100, P=0.022), raised its insulinaemic index (ASLF bread breakfast = 127.7 ± 12.0. Standard white bread breakfast = 100, P=0.046), but did not affect palatability, satiety or food intake. ASLF addition resulted in a palatable breakfast; however, the potential benefits of the lowered glycaemic index may be eclipsed by the increased insulinaemic index.
In addition to product trade, technology trade has become one of the alternatives for globalization action around the world. Although not all technologies employed on the technology trade platform are innovative technologies, the data base of international technology trade still is a good indicator for observing innovative technologies around world. The technology trade data base from Sinew Consulting Group (SCG) Ltd. was employed as an example to lead the discussion on security or safety issues that may be caused by these innovative technologies. More technologies related to processing, functional ingredients and quality control technology of food were found in the data base of international technology trade platform. The review was conducted by categorizing technologies into the following subcategories in terms of safety and security issues: (1) agricultural materi- als/ingredients, (2) processing/engineering, (3) additives, (4) packaging/logistics, (5) functional ingredients, (6) miscellaneous (include detection technology). The author discusses examples listed for each subcategory, includ- ing GMO technology, nano technology, Chinese medicine based functional ingredients, as well as several inno- vative technologies. Currently, generation of innovative technology advance at a greater pace due to cross-area research and development activities. At the same time, more attention needs to be placed on the employment of these innovative technologies.
With an effort to investigate possible relationship between flavonoids and health, an accurate estimation of flavo- noid intake is valuable. We estimated dietary flavonoid intake and identified the major food sources. Subjects were healthy adults aged ≥19 y (n=11,474) who completed the 24-h dietary recall of the Korean National Health and Nutritional Examination Survey (2010-2012). The US Department of Agriculture and newly estimated or published values for typical Korean foods were combined into a Korean-targeted flavonoid database. The mean intake of total flavonoid was 107±1.47 mg/d, with a higher intake in women than in men after energy-adjustment. Quercetin, cyanidin, genistein, daidzein, epigallocatechin 3-gallate, epicatechin, hesperetin, and luteolin were identified as major flavonoid compounds. Across the age range studied, flavonols and flavones showed a reversed U-shape curve; flavan-3-ol and flavanones showed a decreasing pattern; and anthocyanidins and isoflavones showed an increasing pattern. Forty-five food items were identified as contributing >2% of at least one flavonoid compound’s intake. Kimchi was the major food source of total flavonoids, followed by green tea, persimmons, and soybeans. Single food items accounting for more than 50% of the intake of a specific flavonoid included per- simmons (cyanidin), green tea (epigallocatechin, epicatechin-3-gallate, and epigallocatechin 3-gallate), black tea (thearubigin), tangerines (hesperetin and naringenin), and onions (isorhamnetin). This study provides information on Korean flavonoid intake to enable international comparisons, along with insight into how the sources and in- take of various flavonoids vary according to age and gender. This work should facilitate future investigations of the association between flavonoid intake and health.
Background and Objectives: Regular breakfast consumption is widely considered an important component of healthy dietary habits. In this study, we assessed differences in nutrient/food intake between breakfast consumers and skippers. We also investigated behavioural factors related with breakfast skipping utilizing data collected from both children and their guardians. Methods and Study Design: This cross-sectional study was conducted in 14 public primary schools in Japan. Two questionnaires were distributed: a behavioural questionnaire and a brief-type, self-administered diet history questionnaire. In total, 1816 child (10-12 y/o)-guardian dyads were included in the analysis. Intakes of nutrients and foods were compared between breakfast consumers and skippers by the t-test. The relationship between breakfast skipping and behavioural factors was investigated by logistic regression analysis by child sex. Results: The proportion of breakfast skippers in the children was 9.8%. Daily intakes of nutrients/foods were better in the breakfast consumers. Later bedtime, lower nutrition knowledge level, and frequent incomplete consumption of home meals was significantly or marginally associated with breakfast skipping. Guardians’ breakfast skipping was also associated with children’s breakfast skipping. Some relationships between behavioural factors and breakfast skipping differed between boys and girls. Conclusions: Breakfast consumers had a more nutritious meal quality. To increase breakfast consumption, morning time schedules may need to be rearranged to avoid time pressure. Nutritional knowledge and dietary behaviour appear relevant. Guardians played a major role in coping with breakfast avoidance, in part as role models.
Objective: To study the dietary intake and level of physical activity (PA) of patients with diabetes mellitus and the association with non-alcoholic fatty liver disease (NAFLD). Methods: Consecutive adult patients with type 2 diabetes mellitus seen in our hospital diabetes clinic were enrolled. The Global Physical Activity Questionnaire and a semi-quantitative food-frequency questionnaire were used to assess PA and dietary intake, respectively. Di- agnosis of NAFLD was ultrasound-based and following exclusion of significant alcohol intake and other causes of chronic liver disease. Results: Data for 299 patients were analyzed (mean age 63.3±10.5 years old, 41.1% male). Prevalence of NAFLD was 49.2%. Patients with low PA were more likely to have NAFLD (OR=1.75, 95% CI=1.03-2.99, p=0.029). There was no significant difference in energy intake, intake of macronutrients and percentage energy intake from each macronutrient, high sugar food, high cholesterol food and high SFA food be- tween patients with and without NAFLD. Among centrally obese patients, patients with low PA and in the high- est quartile of percentage energy intake from fat (OR=4.03, 95% CI=1.12-15.0, p=0.015), high cholesterol food (OR=3.61, 95% CI=1.37-9.72, p=0.004) and high SFA food (OR=2.67, 95% CI=1.08-6.67, p=0.019) were most likely to have NAFLD. Among those who were not centrally obese, PA and percentage energy intake from fat, high cholesterol food and high SFA food was not associated with NAFLD. Conclusion: Low PA and high per- centage energy intake from fat, high cholesterol food and high SFA food is associated with NAFLD in centrally obese but not in non-centrally obese patients with diabetes mellitus.
Background – In recent years, there has been a focus on using the general practice setting for health promotion including improving dietary and exercise practices among patients.
Objectives – To determine the extent to which Australian-based GPs advise overweight and obese patients to make lifestyle changes for weight loss and advise hypertensive patients to reduce intake of salt and/or salty foods.
Design – A face to face survey was conducted on a representative sample of South Australian residents. Respondents provided information on height and weight (self-report), whether they had received lifestyle advice from their GP for weight loss, whether their GP had recorded their weight in the past 12 months, if they had ever been told that they had high blood pressure, their current use of anti-hypertensive medication and if they have ever received advice to reduce their intake of salt and/or salty foods.
Outcomes – The sample included 2947 people aged 18 years or older (47% female; BMI (mean (SD)), 26.6 (5.3) kg/m2; age, 50.7 (18.0) years). Ninety-six percent of respondents had visited their GP in the past 12 months. Forty- one percent of males and 25% of females were overweight and 19% of males and 20% of females were obese. Forty-five percent of overweight or obese respondents were weighed and 27% received lifestyle advice for weight loss purposes from their GP (5.5% received only dietary advice, 6.5% received only exercise advice and 15% received both dietary and exercise advice). Thirty-three per cent of all respondents had been told in the past by their doctor that they had high blood pressure. Of these, 66.7% were taking medication for blood pressure control and 33.7% had been advised to reduce salt intake.
Conclusion – Although almost 1/2 of overweight and obese patients had been weighed, less than 1/3 of these had received lifestyle advice that could assist with weight loss. Additionally just over 1/3 of those who had been told they have high blood pressure by a doctor received advice to reduce salt intake. There are potentially missed opportunities in which GPs could provide re-enforcement of benefits of lifestyle changes with respect to weight and blood pressure control. Strategies should be investigated to encourage GPs to assess risk of overweight, obesity and that would support GPs in providing simple advice to assist patients in making positive lifestyle changes that could at least assist in the prevention of weight gain and reduce blood pressure.
Background – There is a growing concern over the increasing prevalence of obesity, diabetes and dental erosion amongst Australian children. Association of the effect of marketing such as television advertising of low nutrient, high energy dense foods with childhood obesity is becoming an issue of concern for public health (1).
Objectives – The purpose of this study was to determine the nutrient content, particularly fat and sugar content, of food products marketed to children in Australia.
Design – Packaged food products (408) were purchased from supermarkets in different Brisbane regions on random days in April, June and July in 2005. A further 23 products were purchased from fast food outlets. Food products were chosen based on the marketing techniques directed at children. The food products were categorized into 17 food types. A Microsoft Access database was created to consolidate information on nutrients, labels and marketing techniques of the products evaluated. The RED category criteria tables from the Smart Choices food and drink selector (2) and the Nutrition Australia Selection Guidelines (3) were used as the benchmarks for mean energy, total fat, saturated fat, sugar and sodium levels. Statistical analyses were performed using MINITAB 14.
Outcomes – Important marketing strategies included ease-of-use packaging that is well-designed for children (88.9%), use of popular personality (63.3%) and television advertising (37.4%). Mean total fat, saturated fat and/or mean sugar content of most food types were found to be significantly higher (p <0.05) than the comparable benchmark values. The majority of the 431 food products were classified into the RED category of the Smart Choices food and drink selector ie foods that are high in energy, saturated fat, and/or added sugar and/or sodium. Conclusion – Manufacturers use a variety of techniques to market food products to children. Most of the food products especially marketed to children used in this study are not the most appropriate and healthiest food choices. References
1 Zuppa JA, Morton H, Mehta K. TV food advertising: Counterproductive to children’s health? Nutr Diet 2003;60:78–84.
2 Department of Education and the Arts & Queensland Health. Smart Choices: Healthy food and drink supply strategy for Queensland Schools. Queensland Government, 2005.
3 Nutrition Australia. Food selection guidelines for children and adolescents. Nutrition Australia, 2004.
Background – Obesity is a major concern for westernised populations and one of the leading contributors is the prevalence of foods that are high in fats and sugars. Honey is a ready source of sugar that offers nutritional benefits over the use of sucrose.
Objectives – To assess whether replacing sucrose in a standard western diet with honey would have any impact on weight, food intake or blood sugar and cholesterol levels.
Design – Forty rats, aged 6 weeks were fed one of four experimental diets that contained either no sugar, 8% w/w sucrose, 8% w/w mixed sugars as in honey or 10% w/w high peroxide/high antioxidant rewarewa honey (honey is 20% w/w water). The diets were fed ad libitum for 6 weeks. The carbohydrate/fat/protein ratio of each diet was formulated to be equivalent to a typical New Zealand diet based upon data from the 1997 NZ National Nutrition Survey. During the experiment, the rats were housed in standard rat cages (2 animals per cage) that had a raised mesh floor. Animals’ weights and food intakes were assessed weekly. On day 42, all rats were anaesthetised using CO2 gas. Blood samples were taken via cardiac puncture, and analysed for glycated haemoglobin (HbA1c) and fasting lipid profiles. After euthanisation, each rat was minced using a Sunmile SM-G50 mincer (Vantage) and total body fat and protein levels determined using soxtec fat extraction and LECO total combustion method, respectively. Outcomes – Overall percent weight gain in honey-fed rats was significantly reduced by 16.7% compared with sucrose-fed rats (p < 0.01), and similar to that observed in rats fed a sugar-free diet after 6 weeks. Total food and calorie intake was significantly higher in all sugar treatments compared with the sugar-free treatment group (P<0.01); however, no statistically significant differences in total food intake were observed between the three sugar treatments. No differences in HbA1c, total-, LDL- and HDL-cholesterol or triglyceride levels were observed between the three sugar treatments. Body fat measurements were inconclusive due to large data variability, but no significant differences in total body protein levels were observed.
Conclusion – The replacement of sucrose with honey in the diet can lead to lower weight gains in young animals despite a similar food intake. Mixed sugars (as in honey) did not show decreased weight gains suggesting the effect with honey may be due to other components of the honey.
Background – Epidemiological studies suggest that adhering more closely to National Dietary Guidelines is
associated with improved diet-related health outcomes, with a reduction in morbidity and mortality. A number of methods have been used to generate dietary scores to measure diet quality and variety.
Objectives – To evaluate whether an association exists between diet quality and indices of quality of life, health service use and Medicare costs in the Australian Longitudinal Study of Women’s Health (ALSWH).
Design – Cross-sectional measurement of association between an Australian Recommended Food Score (ARFS), self-reported variables and Medicare costs in women (n = 11,194, 50-55 yr) participating in the 2001 survey of the mid-aged cohort of ALSWH. ARFS was derived from responses to the Dietary Questionnaire for Epidemiological Studies FFQ and increases as the number of foods consistent with Australian Dietary Guidelines consumed at least once a week, increases. ARFS was divided into quintiles with higher scores having more favourable macro and micronutrient profiles. Data linkage allowed examination of associations with Medicare costs.
Outcomes – More women in the lowest quintile of the Australian Recommended Food Score reported their general health as fair or poor compared to those in the highest quintile (18 vs 10%, P<0.0001). The mean SF36 general health perception domain score was higher for those in the top ARFS quintile compared to the bottom (mean (95%CI): 75.3 (74.3, 76.2) vs 67.1 (66.2, 68.0) P<0.0001). Fewer women in the highest ARFS quintile reported four or more GP consultations in the previous year compared to the lowest (13% vs 17%, P=0.0024) but there was no difference in Medicare costs across the quintiles, P>0.05.
Conclusion – Higher ARFS is associated with improved self-reported indices of quality of life, but not reduced Medicare costs. Longitudinal evaluation will determine whether a higher ARFS is protective in terms of predicting health outcomes or reducing long-term health costs.
Background – Following ingestion of a meal, postprandial hyperglycaemia in cats persists for 20-24 hrs, and the reasons for this are unknown.
Objectives – To describe the patterns of postprandial plasma glucose, D-lactate, and L-lactate concentrations, and gastric emptying time in meal-fed cats, and to assess the effects of meal volume on gastric emptying time.
Design – Eleven healthy cats were fed a commercially available, high carbohydrate (54% metabolisable energy) diet for 2 weeks. In the third week, on two separate occasions, fasted cats were fed a meal of 50 kcal/kg and consumed at least 90% within 30 mins. On the first occasion, the cats underwent repeated ultrasound examinations over 26 hrs to determine gastric emptying time. On the second occasion, plasma glucose, D-lactate and L-lactate concentrations were measured over 24 hrs. To assess the effect of volume of food eaten on gastric emptying time, 2 weeks later, five of the same cats were fed a meal of the same composition but half the volume (25 kcal/kg) and a second series of ultrasound examinations was performed.
Outcomes – Glucose concentrations were significantly higher than baseline from 1 to 18 hrs after feeding (P<0.001), reaching a peak at 10.7 ± 5.3 hrs (mean ± SD) after the meal. Median time to gastric emptying when cats were fed their total daily energy intake in a single meal was 24 hrs (range 16-26 hrs). In contrast, times to gastric emptying were substantially shorter when cats were fed 50% of their daily intake in a single meal (median 14 hrs; range 12-14 hrs). D- and L-lactate concentrations did not change substantially after feeding.
Conclusion – These results suggest that prolonged gastric emptying time contributes to the prolonged postprandial hyperglycaemia observed in meal-fed cats. They also show that gastric emptying is faster if the meal size is reduced.
Background – Most plant foods, especially green vegetables, wholegrain breads and cereals and peas and dried beans contain folates. There is a critical need to estimate dietary folate intakes for nutrition monitoring and food safety evaluations in the South Pacific.
Objectives – One objective of this survey was to ascertain the knowledge of the people of the Central and Eastern parts of Viti Levu in the Fiji Islands about the importance of folates in their diet. Another objective was to collect information on the types of food consumed by the population in order to select folate containing foods and to analyse their folate content. A third objective was to assess whether the people surveyed were getting sufficient folates in their daily diet.
Design – A short qualitative food frequency questionnaire (FFQ) to assess folate intake was developed. A random sample of 200 males and females was interviewed in the year 2005. The average age for the study sample was 35 years old. 50% were from rural areas and 50% from urban.
Outcomes – The FFQ showed that most of the foods high in folic acid/ folate were being consumed only once a week in both the male and female population. In the research study of folate levels in Fiji leafy vegetables, Chinese cabbage (Brassica chinensis) and Bele (Abelmoschus manihot) were found to have high levels of folates (1). However, it was noted that of the female population surveyed, none consumed these vegetables on a daily basis. Conclusion – There is a need to explore ways to improve folate intakes in the overall population in Fiji Islands and the South Pacific to prevent folate deficiency diseases, especially neural tube defect in females of child bearing age. Reference
1 Sotheeswaran S, Riteshma Devi, Jayashree Arcot, Sadaquat Ali. Folate concentration of selected Fijian Foods using Tri-enzyme Extraction method, J. Food Composition and Analysis, 2006, submitted.
Background – In-vitro models of the human digestive system are useful for identifying factors that may influence the molecular behaviour of nutritional ingredients during digestion and passage into the circulatory system. It is important that models faithfully represent important digestive processes with the minimum of operational complexity. Current models (a) usually use mechanical size reduction to mimic chewing and (b) sometimes use a Caco-2 epithelial cell monolayer to estimate uptake into cells, but not to evaluate metabolism across the cell layer. Objectives – To investigate (a) whether chewing can be substituted by mechanical size reduction and (b) whether passage across Caco-2 cells can be used to assess the potential for metabolism of food components during uptake. Design – (a) Using fresh and processed fruit as example foods, the size profile and microstructure of chewed (ready to be swallowed) pieces was examined. Subsequent release of fruit sugars during simulated gastric and intestinal processing was monitored. (b) The passage of beta-carotene and catechin across a Caco-2 epithelial cell monolayer was studied.
Outcomes – (a) Physiologically, chewing cannot be simulated with simple size reduction methods because of the heterogeneity of chewed particle sizes (75 μm – 7 cm) and shapes, and the effects of oral processing on bolus characteristics. The large size (> 0.5 cm) of chewed fresh or dried fruit results in incomplete release of sugars after simulated gastric and small intestinal digestion (up to 47% lower compared with juice). (b) After 2 h assay, beta- carotene is metabolized by the Caco-2 cell monolayer more extensively (in total, approximately 8.03% conversions to retinol) than catechin (about 1.43E-5% conversion to catechin metabolites).
Conclusion – (a) Chewed particle characteristics are a likely determinant of subsequent nutrient release from solid foods and should not be overlooked in the development of in-vitro digestion models. (b) the Caco-2 cell monolayer can be used to monitor metabolic transformation of nutrients that may be relevant to first pass metabolism in-vivo.
The evidence for a relationship between dietary patterns and uric acid concentrations is scanty. Here, we used a validated food frequency questionnaire for an ethnic Chinese population in Taiwan to investigate the relationship between dietary patterns and uric acid concentrations. A cross-sectional study on 266 adults, who were inter- viewed with a 38-item food frequency questionnaire, was conducted and serum uric acid levels were measured. Three dietary patterns were derived from the questionnaire by exploratory factor analysis. Participants in the higher vegetable and fruit pattern quartiles were more likely to have a lower uric acid concentration (6.5 for the first, 5.7 for the second, 6.0 for the third, and 6.0 mg/dL for the fourth quartile, p = 0.030). For uric acid-prone patterns, as the quartiles increased, the adjusted mean uric acid concentrations increased significantly (5.88, 5.93, 5.99 and 6.38 mg/dL for each quartile, respectively, p = 0.04). However, the significance level was attenuated af- ter adjusting for additional confounding factors. In conclusion, three dietary patterns were identified for ethnic Chinese in Taiwan, and the relationship between these dietary patterns and uric acid was not significant after ad- justment.
Background – Current scientific literature has yet to provide strong support for the role of nutrition knowledge in influencing food intake behaviours. This relationship may have been prematurely rejected, as previous measures of nutrition knowledge used have lacked validity and reliability; and measuring dietary intake is notoriously difficult. Objective – Test a valid and reliable measure of nutrition knowledge to assess the relationship between knowledge and dietary intake in two South Australian communities of differing socio-economic status (SES).
Design – Nutrition knowledge was measured in two community groups in South Australia: a lower SES sample (Low-SES, n = 118) and a higher SES sample (High-SES, n = 96). Dietary intake was measured within a smaller sub-sample of the two groups by validated food frequency questionnaire (FFQ) and assessed using a diet quality index and food group analysis.
Outcomes – Low-SES scored significantly lower on three of the four knowledge areas: specifically, knowledge of the sources of nutrients, choosing everyday foods and knowledge of diet-disease relationships (p<0.001). Overall, the total nutrition knowledge score (out of a possible 113) was almost 13 points lower for Low-SES compared to High-SES (a notably significant difference; p<0.001). Preliminary analysis of reported dietary intake (FFQ) suggests that individuals from the lower SES community were consuming less fruit and vegetables, more high sugar, low fibre carbohydrates foods and less variety in their food choices.
Conclusions – Nutrition knowledge levels differed significantly between community samples of differing SES. Differences in diet quality appear to be present. Further analysis will be conducted on the strength of the relationship between nutrition knowledge and dietary intake and located within the context of other factors that impact upon dietary behaviour.
The Diabetes Control and Complications Trial and United Kingdom Prospective Diabetes Study (UKPDS) trials have provided evidence for the pivotal importance of optimizing glycaemic control to prevent complications in type 1 and 2 diabetes mellitus. Both patients and diabetes professionals consider lifestyle change and appropriate medication as cornerstones for achieving good glycaemic control. The frequent reversals in the recommended diabetic diet in the past century warn that in the nutritional area the hypotheses are many, but the proofs are few. In type 1 diabetes, the patient is still advised to spread out carbohyrate foods during the day with three short-acting insulin injections at meal times to minimize postprandial hyperglycaemia. In type 2 diabetes, weight loss is the major target, because 80% of patients are overweight or obese. However, it is salutory to note that in the UKPDS trial, no modality of treatment delayed the relentless deterioration of glycaemic control in type 2 diabetes, the extent of which was predicted by the insulin secretion. Controversy still exists regarding whether lowering the dietary fat enhances weight loss of itself and whether dietary carbohydrate, fat and fibre influence insulin sensitivity and glycaemia. The American Diabetes Association's evidence-based recommendations currently offer a choice between a high carbohyrate and modified fat diet, with monounsaturated fat replacing the saturated fat instead of carbohydrate. The role of omega-3 fatty acids in man is not resolved. The reason for the surprising lack of definitive evidence lies in the limitations of nutritional research. Under-reporting of diet is common and dietary assessment tools are often inaccurate. Sustained weight loss is unattainable by the majority of patients, perhaps because of the strongly genetic nature of obesity and the sedentary lifestyle. Compliance may be improved by suggesting small, sustained dietary changes, setting small weight loss targets and encouraging a permanent increase in total activity.
The publication of the proceedings of the 4th Asian Network Symposium on Nutrition “The Nutrition Education Program for National Health Promotion in Asian Countries: a Focus on School-based Programs”, held at the National Institute of Health and Nutrition (NIHN), Japan on September 8, 2010 is a significant step for regional and international nutrition. The symposium was joint with the “IUNS Workshop on Capacity and Leadership Development in Nutrition Sciences” from September 7-9, 2010, organized by the International Union of Nutritional Sciences (IUNS) in Japan, and was supported by the Ministry of Health, Labour and Welfare, Japan, the Japan Dietetics Association, the Japanese Society of Nutrition and Dietetics, and the Japanese Society of Nutrition and Food Sciences. It was also collaborative with the 57th Annual Assembly of the Japanese Society of Nutrition and Dietetics held from September 10-12.
The symposium was co-chaired by Prof Shigeru Yamamoto and Dr Nobuo Nishi and includes a plenary presentation, country reports and discussion. The plenary presentation “School Lunch for Health Promotion among Children” was made by Ms Nobuko Tanaka, Ministry of Education, Sports, Science, and Technology, Japan. Country reports were given by Dr Jihyun Yoon from Korea, Dr Yueching Wong from Taiwan, Dr Duc Son NT Le from Vietnam, and Ms Letty Shiu from Singapore..The general discussion was led by Dr LT Cavalli-Sforza from WHO/WPRO, Dr Takanori Noguchi from the Ministry of Health, Labour and Welfare, Japan, Ms Mitsuko Otome from the Japan Dietetics Association, Dr Alka M Chutani from All India Institute of Medical Sciences (who also made a brief country report), Ms Tebogo TO Leepile from Ochanomizu University Graduate School, and ourselves.
In Japan, the school lunch system has functioned well under the School Lunch Law enacted in 1954, and the nutritional and growth status of Japanese children has greatly improved. In addition, for nutrition education in Japan, a Basic Law on Shokuiku and the Diet and Nutrition Teacher System were introduced in 2005 and 2007 respectively, and have probably been important contributors to the present nutritional status of people in Japan. The importance of school-based nutrition program towards improving nutrition status and establishing healthy behavior and lifestyle among children is increasingly acknowledged in Japan and worldwide. The symposium has enabled past experience, the current situation and future prospects for nutrition education policies and programs, especially for children, to be shared and directed towards a changing environment for the prevention of nutritionally-related disease, health promotion and the enhancement of the quality of life in Asia and beyond.
Background and Objectives: Malnutrition is potentially preventable in older people, but with varied reported prevalence. We assessed its prevalence, assessment methods, and risk factors in older Thai people. Methods and Study Design: Studies published from January 1, 2000, to September 30, 2020 were searched in Medline, EMBASE, Google Scholar, and local databases. A random-effects model was used to calculate pooled prevalence with subgroups analysis (setting of the patient, region). Forest plots displayed sensitivity and specificity for all nutritional screening tools validated against Mini Nutritional Assessment (MNA) with tests for heterogeneity. Publication bias was tested by funnel plot and Egger’s test. Results: 71 studies (total 23,788 subjects) were included where mean age was 65.5 to 78.3 years. The pooled prevalences of malnutrition were 10.4%, 6.1%, and 5.7% by body mass index (BMI), MNA, and MNA-Short Form (MNA-SF), respectively. At-risk of malnutrition prevalence was 42.6% using the MNA and 37.8% using the MNA-SF. The pooled prevalence of malnutrition by BMI <18.5 kg/m2 was 10.4% (95% CI 8.7-12.4). The pooled prevalence of malnutrition based on MNA was 6.1% (95% CI 3.8-9.4). It was highest among hospitalized patients and lowest in community-dwelling elders by both measures. Factors associated with malnutrition were female sex, advanced age, low education, living alone, living in rural areas, comorbidities, eating problems, and geriatric conditions. Conclusions: The pooled prevalence of elder malnutrition was 6-10%, depending on assessment method and study setting. Hospitalized older people were at increased risk of malnutrition. It might be ameliorated through community directed food systems.
Asian populations have changed from traditional to Westernized diets, with increased red meat intake. They are suggested to be particularly susceptible to the adverse effects of red meat on the development of colorectal can- cers, however, few prospective studies of this putative link have been conducted. We examined associations be- tween the consumption of red and processed meat and the risk of subsite-specific colorectal cancer by gender in a large Japanese cohort. During 1995-1998, a validated food frequency questionnaire was administered to 80,658 men and women aged 45-74 years. During 758,116 person-years of follow-up until the end of 2006, 1,145 cases of colorectal cancer were identified. Higher consumption of red meat was significantly associated with a higher risk of colon cancer among women [multivariate hazard ratios (95%CIs) for the highest versus lowest quintiles (HR): 1.48 (1.01, 2.17; trend p=0.03)], as was higher consumption of total meat among men [HR=1.44 (1.06, 1.98; trend p=0.07)]. By site, these positive associations were found for the risk of proximal colon cancer among women and for distal colon cancer among men. No association was found between the consumption of processed meat and risk of either colon or rectal cancer. In conclusion, red meat intake may modestly increase the risk of colon cancer in middle-aged Japanese, although the highest quintile of red meat consumption could be consid- ered moderate by Western standards.
Porcine pancreatic alpha-amylase (PPA) was allowed to react with herbal extracts containing rosmarinic acid (RA) and purified RA. The derivatized enzyme-phytochemical mixtures obtained were characterized for residual amylase activity. These in vitro experiments showed that the amylase activity was inhibited in the presence of these phytochemicals. The extent of amylase inhibition correlated with increased concentration of RA. RA-containing oregano extracts yielded higher than expected amylase inhibition than similar amount of purified RA, suggesting that other phenolic compounds or phenolic synergies may contribute to additional amylase inhibitory activity. The significance of food-grade, plant-based amylase inhibitors for modulation of diabetes mellitus and other oxidation-linked diseases is hypothesized and discussed.
Background and Objectives: The effect of fiber, especially the effect of specific fiber in different food groups, on gestational diabetes mellitus (GDM) has seldomly been investigated. This study aimed to examine the association between GDM risk and consumption of total fiber, fiber in specific food groups, and glycemic load (GL) in the second trimester in Chinese women. Methods and Study Design: A total 162 GDM cases were matched to 324 controls on women’s age and pre-pregnancy BMI. Dietary survey was conducted twice to evaluate dietary factors between 13-16 gestational weeks (GW) and 21-24 GW respectively. Multivariable logistic regression analysis was used to compute the odds ratios (ORs) and 95% confidence intervals (CIs). Results: Intake of total fiber and fruit fiber in both 13-16 GW and in 21-24 GW were significantly correlated with decreased risk of GDM, with adjusted ORs (95% CIs): 0.06 (0.03-0.13) and 0.03 (0.01-0.08) for total fiber in the highest quartile, 0.003 (0.0002-0.02) and 0.01 (0.001-0.02) for fruit fiber in the highest quartile, respectively. In contrast, consumption of cereal fiber in 21-24 GW and daily average GL in 13-16 GW were positively associated with GDM risk, with adjusted ORs (95% CIs) of the highest quartile: 3.34 (1.45-7.92) and 3.88 (1.43-10.89) respectively. Conclusions: Our findings suggested consumption of dietary fiber in various food groups in the second trimester might be associated with GDM risk. Particularly, diet rich in total fiber and fruit fiber may play a protective role.
Nutrition history in Indonesia began in 1887, when Christiann Eijkman discovered the relationship between vi- tamin B-1 deficiency and beri-beri. In the 1950’s, the socialization of nutrition messages started with the intro- duction of “Healthy Four Perfect Five” (Empat Sehat Lima Sempurna-ESLS). For the next 25 years after that, ESLS became a favorite in nutrition education and was nationally known. Although the ESLS was never eva- luated, food consumption pattern of Indonesians are never balanced. Undernutrition is rampant and overnutrition emerged. In 1995 the Indonesian food-based dietary guidelines was launched by the Ministry of Health, and formally incorporated into the nutrition policy. The Guide has 13 messages. Again, the guidelines were never evaluated; in 2010 undernutrition persists and the prevalence of degenerative diseases increased. Thus, it is ur- gent for Indonesia to have concrete Nutrition Guidelines (Gizi Seimbang) covering messages like: (1) consume a variety of foods; (2) keep clean; (3) be active, exercise regularly; and (4) monitor body weight. The guidelines shall be developed for all age groups. The guidelines were tested to over 300 audiences and the responses were promising. Dissemination of the messages widely within the formal channels is compulsory. The new Nutrition Guideline messages are an open concept ready to be revised accordingly. It is evident that nutrition sciences and its application had undergone rapid changes over time and Indonesia need to adopt accordingly and timely. Al- though, outcomes may not be seen in a short time, longer term output will benefit future generations.
In early 1980’s, the first edition of dietary guidelines for Taiwanese was established by the Department of Health (DOH), Executive Yuan. The main purposes of the guidelines were to guide nutritional professionals and dieti- cians to plan diet for preventing general population from diseases. Besides the amount of daily cholesterol intake, the percentages of calories from carbohydrate, protein, and fat was recommended. Dietary guidelines were re- vised concurrently as the results of national nutrition survey showed dietary or nutrient deficits of Taiwanese population. The recent dietary guidelines were then revised for general publics and consist of 8 items, including: maintain ideal body weight, eat well-balanced meals from all food groups, eat whole grains as staples for main meals, eat more high-fiber foods, eat less fat, less salt, and less sugar, consume plenty of high calcium content foods, drink plenty of water, if you drink alcohol, do so in moderation. In addition to these qualitative guidelines, a daily food guide was also established to instruct the general public to consume portions from six food groups. The suggested portions for food groups were calculated and based on basic balanced meal principles and the recommended energy, protein for different age groups from DRIs. The pictorial representation of the daily food guide was plum blossom which is the national flower. Leaflets, posters, and slides were developed for nutrition education. As the eating behavior and disease patterns may change, the governments and nutrition societies should keep revising dietary guidelines and daily food guides to encourage population health.
This study evaluated the intake of soy foods and soy isoflavones by rural adult women and potential determinant factors. Soy food consumption and information on age, education and medical history were collected on 1,188 subjects in Gansu Province and Hebei Province, China using a food frequency questionnaire to gather data on food intake over the past year. Weight and height were simultaneously measured. The results showed that 1139 (95.9%) rural women consumed soy foods in the past year. The average intake of soy foods and isoflavones was 38.7 +/- 58.2 (median = 23.5) g/d and 17.7 +/- 26.6 (median= 8.9) mg/d, respectively. Tofu accounted for the most contribution to their intake. The soy isoflavone intake ranged between 0-35 mg/day in 89.2% of subjects. Gansu women had higher intakes of soy foods and isoflavones than Henbei women (P< 0.05). Women aged 41-50 years consumed less soy foods and isoflavones than the 20-30-year olds and 31-40 year olds(P < 0.05). The intake of soy foods (P< 0.01) and isoflavones (P< 0.01) by women who experienced secondary education or above was significantly higher than illiterate women. Women without a medical history had a higher soy isoflavone intake than women with a medical history, but the difference was not statistically significant. These results suggest that the intake of soy isoflavones by Chinese rural adult women was much higher than women in Western countries. The distribution of intake was skewed to the right and varied among women in regard to region, age group and education level.
This study aimed to assess the nutritional status of infants aged 0 to 5 months by different feeding approaches. A cross-sectional study on infant nutrition was performed in eight cities in China. A total of 622 infants from birth to 2 months of age and 456 infants from 3 months to 5 months of age were included in this study. Mix-fed infants received breast milk and complementary foods from birth to 2 months of age. Approximately 38.2% of mix-fed infants received excessive vitamin A, and 15.6% of infants exceeded the tolerable upper intake levels (ULs) of zinc. For artificially fed infants who received only complementary foods, approximately 20% and 12.5% infants received inadequate dietary vitamin A and zinc intakes, respectively. The vitamin A and zinc intakes of half of the infants exceeded the ULs. Results showed that the usual intake distribution of the infants from 3 months to 5 months of age were similar to that of the infants from birth to 2 months of age. The common vitamin A and zinc intakes were also severely imbalanced. In addition, higher disease prevalence and lower Z scores of length-for- age, weight-for-age, and weight-for-length were found in artificially fed infants and mix-fed infants compared with those in breast-fed infants. In conclusion, the usual nutrient intakes were adequate for the majority of Chi- nese infants, except for an important number of infants at risk for imbalance of vitamin A and zinc intakes.
The Nutrition and Health Survey in Taiwan (NAHSIT) 2005-2008 was funded by the Department of Health to provide continued assessment of health and nutrition of the people in Taiwan. This household survey collected data from children aged less than 6 years and adults aged 19 years and above, and adopted a three-stage stratified, clustered sampling scheme similar to that used in the NAHSIT 1993-1996. Four samples were produced. One sample with five geographical strata was selected for inference to the whole of Taiwan, while the other three samples, including Hakka, Penghu and mountainous areas were produced for inference to each cultural stratum. A total of 6,189 household interviews and 3,670 health examinations were completed. Interview data included household information, socio-demographics, 24-hour dietary recall, food frequency and habits, dietary and nutri- tional knowledge, attitudes and behaviors, physical activity, medical history and bone health. Health exam data included anthropometry, blood pressure, physical fitness, bone density, as well as blood and urine collection. Re- sponse rate for the household interview was 65%. Of these household interviews, 59% participated in the health exam. Only in a few age subgroups were there significant differences in sex, age, education, or ethnicity distri- bution between respondents and non-respondents. For the health exam, certain significant differences between participants and non-participants were mostly observed in those aged 19-64 years. The results of this survey will be of benefit to researchers, policy makers and the public to understand and improve the nutrition and health status of pre-school children and adults in Taiwan.
Background and Objectives: Western dietary patterns have been linked with kidney disease. This study investi- gated the association between Chinese dietary patterns and kidney disease in a Taiwanese population with type 2 diabetes and evaluated dietary fatty acid patterns, a kidney-related dietary biomarker. Methods and Study De- sign: We recruited 838 patients with type 2 diabetes and used their dietary and renal data obtained from three re- peated measures in 2008, 2009 and 2010. Diet was assessed using food-frequency questionnaires, and factor analysis was performed to identify dietary patterns. Albuminuria was defined by having an albumin-to-creatinine ratio 30 mg/g and kidney dysfunction by estimated glomerular filtration rate <60 mL/min/1.73m2. Generalized estimating equation models were used to estimate ORs (95% CIs) of kidney disease adjusted for covariates. Erythrocyte fatty acids were only measured in blood samples collected in 2008. Results: Three dietary patterns were identified: high fat-meat, traditional Chinese food-snack, and fish-vegetable. In the adjusted model, the high fat-meat and traditional Chinese food-snack diets were not associated with any kidney outcomes. The fish- vegetable diet was inversely associated with kidney dysfunction (quartile 4 vs 1, OR: 0.75, 0.58-0.97), but not as- sociated with albuminuria. A higher fish-vegetable diet factor score was associated with higher n-3 fatty acid lev- els. Conclusion: In patients with diabetes, we found greater adherence to a fish-vegetable diet to be associated with better kidney function and greater n-3 fatty acid profiles. The inclusion of repeated dietary assessments and dietary biomarker measurements in future diet-disease research, especially in patient populations, may provide more definitive risk evaluation.
Background and Objectives: Childhood obesity is rapidly rising in China and effective diet interventions are needed. Here, we determine whether the Chinese government-recommended diet (GRD) or a modified diet of further restriction of sugar and ultra-processed food but without energy restriction, minimally processed diet (MPD) is effective on weight loss in children and adolescents with obesity/overweight. Methods and Study Design: This open-label, randomized study included 60 children and adolescents between 5-18 years old with overweight/obesity. Participants were randomized 1:1 to the GRD or MPD and self-managed at home for 12 weeks. Both groups received general recommendations in physical activities. The changes were evaluated in body weight, fasting glucose and insulin, lipid metabolism and serum uric acid between baseline and week 12. Results: The results indicated great reductions by time for BMI, BMI z-score, fat mass percentage and fat mass index in both groups. An obvious decrease by time for weight was found in the MPD group (p<0.001) as well as fasting glucose (p=0.005), fasting insulin (p=0.001), total cholesterol (p=0.007) and serum uric acid (p=0.006). As for the amount of visceral fat, greater reduction by time was observed in MPD group compared with GRD group. Conclusions: A 12-week self-intervention combining the Chinese government-recommended diet with physical activities was effective on weight loss in children and adolescents with overweight/obesity. The minimally processed diet was more effective on decreasing visceral fat mass and may be beneficial to improving insulin resistance. Further studies are required to assess long-term outcomes of the general public.
We aimed to prospectively examine the association between the combined effects of obesogenic behaviors on quality of life (QOL) in adolescents. Of 2353 Sydney schoolchildren surveyed (median age 12.7 years), 1,213 were re-examined 5 years later at age 17-18. Children completed activity and food-frequency questionnaires. An unhealthy behavior score was calculated, allocating 1 point for the following: <60 minutes of total physical ac- tivity/ day; ≥2 hours of screen time/ day; consumed salty snack foods and/or confectionery ≥5 times per week; ≥1 serves of soft drinks and/or cordial/ day; and not consuming both ≥2 serves of fruit and ≥3 serves of vegetables/ day. Health-related QOL was assessed by the Pediatric Quality of Life Inventory (PedsQL). The prevalence of 0, 1, 2, 3, 4, and 5 lifestyle risk factors was 4.2%, 17.1%, 30.7%, 30.5%, 13.9% and 3.6%, respectively. After mul- tivariable-adjustment, children engaging in 5 versus 0 unhealthy behaviors had 9.2-units lower PedsQL physical summary score (ptrend=0.001), five years later. Boys reporting 4 or 5 lifestyle risk factors compared to their peers reporting none or one at baseline, had lower total and physical summary scores at follow-up, ptrend=0.02 and 0.01, respectively. Girls engaging in 4 or 5 versus 0 or 1 unhealthy behaviors, had 4.6-units lower physical summary score (ptrend=0.04), five years later. The number of obesogenic lifestyle risk factors was independently associated with subsequent poorer QOL, particularly physical health, during adolescence. These findings underscore the im- portance of targeting lifestyle behaviors to promote general well-being and physical functioning in adolescents.
This study aimed to examine school principals’ perceptions of the school environment in Hong Kong as a con- text for the dissemination of food knowledge and inculcation of healthy eating habits. A questionnaire survey was administered in secondary schools in Hong Kong to survey Principals’ views of students’ food choices, op- eration of the school tuck shop, and promotion of healthy eating at school. Questionnaires were disseminated to all the secondary schools offering Home Economics (300 out of 466), and 188 schools responded, making up a response rate of 63%. Collected data were analyzed using SPSS. Most of the schools (82%) claimed to have a food policy to monitor the operation of the school canteen, and about half (52%) asserted there were insufficient resources to promote healthy eating at school. Principals (88%) generally considered it not acceptable for the school tuck shop to sell junk food; however, 45% thought that banning junk food at school would not help stu- dents develop good eating habits. Only 4% of the principals believed nutrition education influenced eating hab- its; whereas the majority (94%) felt that even with acquisition of food knowledge, students may not be able to put theory into practice. Cooking skills were considered important but principals (92%) considered transmission of cooking skills the responsibility of the students’ families. Most of the principals (94%) believed that school- family collaboration is important in promoting healthy eating. Further efforts should be made to enhance the ef- fectiveness of school food policies and to construct healthy school environments in secondary schools.
Background: Food systems are rapidly changing as world population grows, increasing urbanization occurs, consumer tastes and preferences change and differ in various countries and cultures, large scale food production increases, and food imports and exports grow in volume and value. Consumers in all countries have become more insistent that foods available in the marketplace are of good quality and safe, and do not poise risks to them and their families. Publicity about food risk problems and related risks, including chemical and microbiological contamination of foods, mad-cow disease, avian flu, industrial chemical contamination all have made consumers and policy makers more aware of the need of the control of food safety risk factors in all countries.
Objective: To discuss changes in food systems, and in consumer expectations, that have placed additional stress on the need for better control of food safety risks.
Outcomes: Food producers, processors, and marketers have additional food law and regulations to meet; gov- ernment agencies must increase monitoring and enforcement of adequate food quality and safety legislation and coordinate efforts between agriculture, health, trade, justice and customs agencies; and academia must take ac- tion to strengthen the education of competent food legislation administrators, inspectorate, and laboratory per- sonnel for work in government and industry, including related food and food safety research .
Conclusions: Both Government and the food industry must assure that adequate control programs are in place to control the quality and safety of all foods, raw or processed, throughout the food chain from production to final consumption. This includes appropriate laboratory facilities to perform necessary analysis of foods for risk and quality factors, and to carry out a wide range of food science, toxicological and related research.
Australians are eating far more salt than is good for health. In May 2007, the Australian Division of World Ac- tion on Salt and Health (AWASH) launched a campaign to reduce population salt intake. A consumer survey was commissioned to quantify baseline aspects of awareness and behaviour related to salt and health amongst Australians. A total of 1084 individuals aged 14 years or over were surveyed by ACA Research using an estab- lished consumer panel. Participants were selected to include people of each sex, within different age bands, from major metropolitan and other areas of all Australian states and territories. Participants were invited via email to complete a brief questionnaire online. Two-thirds knew that salt was bad for health but only 14% knew the rec- ommended maximum daily intake. Seventy percent correctly identified that most dietary salt comes from proc- essed foods but only a quarter regularly checked food labels for salt content. Even fewer reported their food pur- chases were influenced by the salt level indicated (21%). The survey showed a moderate understanding of how salt effects health but there was little evidence of action to reduce salt intake. Consumer education will be one part of the effort necessary to reduce salt intake in Australia and will require government investment in a tar- geted campaign to achieve improvements in knowledge and behaviours.
Obesity is at last being recognized as a major public health problem of global significance. More quality national obesity prevalence data are urgently needed but it is clear that rates are already high and increasing in most parts of the world. Current estimates of the global prevalence exceed 250 million. The first formal World Health Organization Consultation on obesity concluded that the global epidemic is an unintended consequence of modernization, economic development, urbanization and other societal changes. These have led to widespread reductions in spontaneous and work-related physical activity and to excessive consumption of energy dense foods. Links between reduced growth in utero and increased risk of ill health in later life may partly explain why populations in many developing countries are especially susceptible to obesity, diabetes and heart disease when exposed to modern sedentary living. The International Obesity TaskForce has launched a global initiative for coherent action to tackle the epidemic.
The life-stage approach, which views the behaviours and exposures of an individual from the preconceptual situation of the parent through pregnancy, infancy, childhood and adolescence, and into the advancing years through adulthood, is the basis of analysis of strategies to improve long-term health. Among the behaviours of note is the dietary selection pattern, conditioning our exposure to nutrients and dietary constituents that influences growth, nutriture, cognitive and physical performance, and disease resistance and susceptibility. The African Diaspora created a population displaced from Africa to the Western Hemisphere as part of the African slave trade from the 16th to 18th centuries. It continues to manifest distinct dietary and lifestyle practices in the context of a health experience that is different both from the population in their African countries of origin and from the other ethnicities in their countries of displacement and current residence. Afro-Americans are more susceptible to a series of diseases and conditions including low birth weight, violence, and HIV/AIDS, as well as the non-communicable diseases: obesity, diabetes mellitus, cardiovascular disease, hypertension, stroke, renal failure, breast cancer, prostate cancer and lead poisoning. The differential nature of dietary practices are conditioned at times by the poverty and marginalisation of the populace, resulting in either disadvantageous or beneficial outcomes relative to others' eating habits. Serious consideration must be given to the possibility that ethnic difference give rise to different requirements and tolerances for essential nutrients and distinct protective or adverse responses to foods and dietary substances. The major challenges to health improvement for the African Diaspora is coming to grips with the policy and programmatic nuances of differential treatment and the effecting the behavioural changes that would be needed in a population skeptical of the motives of media and of the power elites of their societies.
The imbalance of oxidant/antioxidant plays an important role in the development of chronic obstructive pulmo- nary disease (COPD). There is increasing evidence that individuals with high antioxidative nutrient levels in the diet or in blood tend to maintain better lung function. This study was conducted to determine whether COPD pa- tients in Taiwan have lower plasma concentrations of antioxidative nutrients than do healthy people, and whether the dietary habits of COPD patients in Taiwan affect their intake of vitamin C and carotenoids. Thirty-four COPD patients and 43 healthy persons (with normal lung function) aged 50 years or older were recruited. Fast- ing venous blood was collected to measure concentrations of vitamins A, C, and E and carotenoids. Endogenous and H2O2-induced additional DNA damage (markers of oxidative stress) in white blood cells were assayed. Die- tary intakes of vitamin C and carotenoids were assessed by a food-frequency questionnaire. Compare to the healthy controls, COPD patients had significantly lower plasma concentrations of vitamins A, C, and E; α- and β-carotene; and total carotenoids but significantly higher endogenous and H2O2-induced white blood cell DNA damage. Intakes of vitamin C and several carotenoids were lower in the COPD group, and COPD patients con- sumed significantly fewer vegetables and fruits than did the healthy controls. In conclusion, COPD patients in Taiwan have lower levels of antioxidative nutrients in their plasma and diet than do healthy people. Intakes of vitamin C and carotenoids are correlated with dietary habits.
Background and Objectives: Cow milk allergy is the most common food allergic disease in young infants and vitamin D has a critical role in regulating intestinal inflammation. Methods and Study Design: To determine roles of vitamin D in cow milk allergy, fifty-six young infants with cow milk allergy were enrolled. The serum 25-hydroxyvitamin D (25OHD), total and specific IgE, circulating regulatory T lymphocytes, and blood eosino- phil counts were determined. Results: The serum 25OHD in cow milk allergy and age-matched infants were sim- ilar (68.3±38.9 nmol/L versus 72.9±33.1 nmol/L, p>0.05), 71% Cow milk allergy infants (40/56) had serum 25OHD lower than 75 nmol/L compared to 66% (37/56) in the controls. The cow milk allergy infants with 25OHD lower than 75 nmol/L had persistent blood eosinophilia and delayed resolution of symptoms after cow milk elimination compared to those with 25OHD above 75 nmol/L (odd ratio 3.7, 95% CI 1.1-12.6, p<0.05). The serum 25OHD inversely correlated with blood eosinophil counts after cow milk elimination (r=-0.37, p<0.01). Cow milk allergy infants with 25OHD lower than 50 nmol/L (vitamin D deficiency, n = 22) were in general at younger age (1.6±0.6 months) compared to infants with insufficient (50-75 nmol/L) or normal (≥75 nmol/L) group (4.3±1.2 and 4.6±0.9 months, respectively, p<0.001). Conclusions: Low serum vitamin D associates with persistent blood eosinophilia and symptoms in young cow milk allergy infants.
Children and adolescents tend to lose weight, which may be associated with misperceptions of weight. Previous studies have emphasized establishing correlations between eating disorders and an overestimated perception of body weight, but few studies have focused on an underestimated perception of body weight. The objective of this study was to explore the relationship between misperceptions of body weight and weight-related risk factors, such as eating disorders, inactivity, and unhealthy behaviors, among overweight children who underestimated their body weight. We conducted a cross-sectional, descriptive study between December 1, 2006 and February 15, 2007. A total of 29,313 children and adolescents studying in grades 4-12 were enrolled in this nationwide, cross- sectional survey, and they were asked to complete questionnaires. A multivariate logistic regression using maxi- mum likelihood estimates was used. The prevalence of body weight misperception was 43.2% (26.4% overesti- mation and 16.8% underestimation). Factors associated with the underestimated perception of weight among overweight children were parental obesity, dietary control for weight loss, breakfast consumption, self-induced vomiting as a weight control strategy, fried food consumption, engaging in vigorous physical activities, and sleeping for >8 hours per day (odds ratios=0.86, 0.42, 0.88, 1.37, 1.13, 1.11, and 1.17, respectively). In conclu- sion, the early establishment of an accurate perception of body weight may mitigate unhealthy behaviors.
The history of food is a history of thousands of years of human choice set in the context of an almost Darwinian process of natural selection. Around the world, food is eaten to fill stomachs and to keep bodies strong and healthy. In Asia there is, frequently, a shift in emphasis. The Asian people, like everyone else, eat to survive, but they also eat to keep their bodies finely tuned, physically and spiritually. No food is a nutritious food if it is not safe. Food safety is of paramount importance for food trade, both domestically and internationally. Developed Asian nations such as Japan, Singapore, and South Korea have been paying more attention to healthy eating. Fearful of health problems, they are returning to traditional foods. On average, life expectancy has more than doubled from 34 years at the turn of the 19th century to 76 years in developed countries today. With the advance of medical science and technology, the figure is set to rise. There is growing scientific evidence that these major diseases are closely associated with lifestyle, dietary habits in particular. There are many well-accepted observations that show that protective immune responses are impaired in old age, that immune deficiency causes an increased risk of more frequent and more severe infections, and that nutritional deficiencies occur frequently and are a detrime determinant of the immunocompetence of aging. The relationships of nutrition, aging and immune competence are attracting more and more attention. The world trend in foods will be focused into four food groups, which are characterized for their positive effect on human life in the future: (i) foods that will improve cardiovascular disease; (ii) foods that enhance the immune system; (iii) foods that increase women's health, fitness and beauty; and (iv) foods that could improve the nutritional status of children. To communicate better, there is an urgent need for easily available local-based textbooks that successfully discuss applications of food science and nutrition to people of the particular developing countries, and at the same time discuss in simple national language all the basic principles of foods and nutrition. If developing countries are to give their children the heritage of health as well as freedom, the people must change their attitude toward food. They must learn from each other and from the world about the kind of foodstuffs that make a person healthy.
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.
We set out to compare the effect of diets containing intact seeds as food ingredients on colon function and fermentation-dependent events. Using a randomized cross over design, twelve healthy adults were recruited and required to consume an experimental diet containing intact or ground seeds for 7-days then after returning to their usual diet for 21-days to consume the second experimental diet for 7-days. All foods consumed during the experimental dietary periods were supplied by the researchers. Stools passed on three consecutive days on the usual diet prior to commencement and on days 5, 6 and 7 during each experimental diet, were collected. Outcome measures were whole gut transit time, 24 h stool output, faecal pH, particle size, and short chain fatty acid content. Seeds recovered from stools were examined by scanning electron microscopy. Nine of the twelve subjects completed all aspects of the study. Consumption of intact seeds compared to ground seeds increased 24 h faecal wet weight (mean 258g ± 123g and 170g ± 63g, respectively; P=0.005) and dry weight (78g ± 34g and 46g ± 28g, respectively; P=0.003). Whole gut transit times and moisture content of stools were not different. There was a trend for stools from the whole seed diet to be more acidic than those from the ground seed diet (pH 6.2 ± 0.3 and pH 6.6 ± 0.3, respectively; P = 0.06) and they contained more short chain fatty acids (35 ± 5.2 and 30 ± 10.5 mmol/kg, respectively; P=0.05). Large amounts of apparently whole seeds were recovered from stools, but internally the endosperm was often eroded and coated with bacteria. Intact seeds as food ingredients bring about changes to the colonic environment and to faecal composition that may reduce the risk of colon cancer.
Background and Objectives: Differences in anthropometry and food acceptance among tasters and non-tasters of 6-n-propylthiouracil has been well studied in Western countries. However, reports on this issue from Asian countries are still limited. Methods and Study Design: Healthy Japanese students attending Nara Women’s University (n=153) were recruited and classified into 3 groups based on taste sensitivity to a 0.32 mM 6-n- propylthiouracil solution as scored on a labeled magnitude scale. Accordingly, the study population consisted of 34 non-tasters, 78 medium-tasters, and 41 super-tasters. Self-reported food intake was assessed using a food fre- quency questionnaire. Self-reported food preferences were established using a food checklist listing 63 food items. Results: Although subjects in the 6-n-propylthiouracil non-taster group showed a significantly higher body height and weight than subjects in the taster groups, body mass index was comparable among three groups. In- takes of calories, 3 macronutrients, β-carotene and vitamin C did not differ significantly between groups, but the intake of green and yellow vegetables was significantly lower in the taster groups. Among the 5 factors defined by a factor analysis performed with 277 age- and BMI-matched Japanese female students, the taster groups showed a significantly reduced preference for green and cruciferous vegetables alone. Conclusions: To the best of our knowledge, this is the first comprehensive report investigating associations between anthropometry, food intake, and food preference in relation to 6-n-propylthiouracil sensitivity in Asian countries. The effect of this tendency towards an aversion to vegetables including cruciferous ones among females on living a healthy life re- mains to be investigated.
Background and Objectives:More than 30 years of socioeconomic development in China has improved living conditions which contributed to a steep decline in malnutrition prevalence of children under 5 years. To elucidate the role of socioeconomic development in improving nutritional status and to identify appropriate policy priorities for intervention in nutrition improvement for younger children. Methods and Study Design: We collected data on socioeconomic development, education, cultural and recreational services, food consumption, average family size and malnutrition prevalence from national surveys. Results: From 1990 to 2010, Gross Domestic Product (GDP) per capita increased from 1644 Chinese Yuan (CNY) to 30,015 CNY; average disposable income and food expenditure per capita significantly increased in urban and rural areas; per capita consumption for education increased from 112 CNY to 1628 CNY and from 15.3 CNY to 367 CNY for other cultural services; illiteracy rate decreased from 15.9% to 4.1%; average family size from 3.97 to 3.10; and prevalence of stunting and under- weight decreased from 33.1% to 9.9% and 13.7% to 3.6%, respectively. However, anaemia prevalence did not obviously decline between 1992 and 2000. After adjusting confounding effects of variables, negative relation- ships were observed between GDP per capita, average family size and stunting or underweight prevalence. How- ever, no association was observed between illiteracy rate and prevalence of stunting and underweight, and there was no correlation between GDP per capita, illiteracy rate, average family size and anaemia prevalence. Conclu- sions: Our results indicated that economic development cannot solve all nutritional problems and comprehensive national developmental strategies should be considered to combat malnutrition.
This study was carried out to investigate the nutritional status and feeding practices of young children in the worst-affected areas of China two years after the Wenchuan Earthquake. The sample consisted of 1,254 children 6-23 months of age living in four selected counties from the disaster-affected provinces of Sichuan, Shaanxi and Gansu. Length-for-age, weight-for-age, weight-for-length, and hemoglobin concentration were used to evaluate nutritional status. Interviews with selected children’s caretakers collected basic demographic information, chil- dren’s medical history, and child feeding practices. Stunting, underweight, and wasting prevalence rates in chil- dren 6-23 months of age were 10.8%, 4.9% and 2.8% respectively, and anemia prevalence was 52.2%. Only 12.3% of children had initiated breastfeeding within the first hour after birth. Overall, 90.9% of children had ever been breastfed, and 87% children 6-8 months of age had received solid, semi-solid or soft foods the day before the interview. The diets of 45% of children 6-23 months of age met the definition of minimum dietary diversity, and the diets of 39% of breastfed and 7.6% non- breastfed children 6-23 months of age met the criteria for mini- mum meal frequency. The results highlight that a substantial proportion of young children in the earthquake af- fected disaster areas continue to have various forms of malnutrition, with an especially high prevalence of anemia, and that most feeding practices are suboptimal. Further efforts should be made to enhance the nutritional status of these children. As part of this intervention, it may be necessary to improve child feeding practices.
Background and Objectives: More than 20% of pregnant Japanese women regularly skip breakfast, thereby re- sulting in a low intake of several nutrients that are required for fetal development and prevention of pregnancy complications. However, whether skipping breakfast affects circulating levels of these nutrients remains unclear. We investigated whether skipping breakfast during pregnancy was associated with decreases in dietary intake and circulating and urinary levels of several nutrients, including fatty acids and vitamins. Methods and Study Design: This cross-sectional study was conducted at a university hospital in Tokyo, Japan, between June and October 2010. Nutrient intakes were assessed using a validated diet history questionnaire. Blood and 24-hour urinary samples were collected for assessing circulating and urinary excretion levels of nutrients. Skipping breakfast was defined as forgoing breakfast including a staple food, such as rice or bread, two or more times per week. Multiple linear regression analyses were used to compare nutrient levels between breakfast skippers and non-skippers after adjusting for confounders. Results: Of 97 healthy pregnant women in the second trimester, 37 (38.1%) skipped breakfast two or more times per week. In multiple linear regression analysis, breakfast skippers had significant lower energy-adjusted intakes of protein than non-skippers (p=0.019). In addition, breakfast skippers had signifi- cantly lower levels of plasma eicosapentaenoic acid (p=0.008), plasma docosahexaenoic acid (p=0.027), serum β- carotene (p=0.013), urinary urea nitrogen (p=0.027), and urinary potassium (p=0.006), compared to non-skippers. Conclusions: Healthcare professionals need to suggest effective strategies for encouraging breakfast skippers to have breakfast regularly and to increase the intake of these nutrients.
Background and Objectives: To assess the nutritional status of infants, children and non-pregnant women and underlying factors, dietary diversity and community food security, in the Kamea community in Gulf Province, Papua New Guinea. Methods and Study Design: Prospective cross sectional study. Study population 69 infants (0-59 months), 151 children (6-12 years) and 79 non-pregnant women from 10 villages in Kotidanga Local Level Government, Kerema District, Gulf Province, Papua New Guinea. Results: Among infants prevalence of moder- ate stunting, wasting and underweight were 38.9%, 8.3% and 44.4%, respectively; after adjusting Hb concentra- tion for altitude, the anaemia prevalence was 53.8%. Among children prevalence of severe stunting was 21.2%; moderate stunting, wasting and underweight were 57.6%, 12.2% and 48.5%, respectively; anaemia was 30.3%; median urinary iodine concentration was 32.0 μg/L and iodine deficiency was prevalent among 88.1%. Among women, mean height, weight and BMI were 1.46±0.04 m, 43.9±5.91 kg and 20.4±2.32 kg/m2, respectively; low BMI (<18.5 kg/m2) and anaemia were prevalent among 22.8% and 35.4%, respectively; median urinary iodine concentration was 36.0 μg/L and iodine deficiency was prevalent among 80.3%. Exclusive breastfeeding was universal for young infants; complementary foods were limited in variety and frequency. Dietary diversity was limited, implementation of the universal salt iodisation strategy restricted and community food security was inad- equate. Conclusions: The high prevalence of malnutrition and anaemia among the three age groups, including moderate status of iodine deficiency among women and children, are significant public health concerns. Im- provements in dietary diversity, adequate use of iodised salt and community food security are needed.
This paper discussed the threats from farm animals to food and human security. In response to these threats, a radical reform plan was adapted by several countries and the plan includes restructure of the organization of governing agencies, implementation of a traceability system from the farm sector to end users, application of hazard control measures, as well as tightening the food import control system.
Objectives: To assess the potential dietary supply of vitamin D to Australian adults by application of new data for Australian primary foods of animal origin. Methods: New published analytical data on the vitamin D contents of Australian primary foods from animal products were obtained and assessed for reliability. Using food con- sumption data from Australian population dietary surveys for 1995 and 2011-2013, estimates were made of the likely average daily intakes of vitamin D equivalents from these sources by Australian adults. Results: Meats, chicken, fish, eggs and dairy produce may alone have contributed about 4.2 μg vitamin D equivalents per day to average Australian diets of adults >18 years in 1995 and 4.3 μg in 2011-2013. Conclusions: Dietary vitamin D intake in Australia is likely to be higher than previously estimated because new data from improved analytical methods reveal the contributions to vitamin D supply from foods of animal origin. Absence of reliable vitamin D data for milk and milk products, and the gaps in vitamin D data for many commonly consumed seafood, poultry, eggs and processed animal products greatly limit estimation of dietary vitamin D intakes by Australians.
Introduction: Zinc deficiency is wide spread in developing countries. Its deficiency during pregnancy has been documented to be associated with growth retardation, congenital abnormalities, and low birth weight. Limited community based data is available on the serum zinc levels during pregnancy from Haryana State, India. Hence the present study was undertaken. Methods: A community based cross sectional study was conducted amongst 283 pregnant women with gestational age of 28 weeks or more. Each pregnant woman was inquired about her age, obstetric profile, socio-economic status, and other demographic parameters by utilizing a pre-tested semi- structured questionnaire. Blood from the antecubital vein was drawn to assess the serum zinc levels utilizing the atomic absorption spectrophotometer. Nutrient intake was assessed by the standard 24-hr dietary recall method. Statistical tests were applied to the data collected. Results: Mean serum zinc level was 61.1 ± 16.6 μg/dL. Almost 64.6% of the women had zinc deficiency. The dietary data revealed that 58.9 % of the women were consuming calories less that 75% of the recommended, indicating an overall poor food intake. Dietary zinc intake revealed that 86.2 % of the women were consuming less than 50% of the recommended (15 mg). A high prevalence of zinc deficiency (64.6%) was found amongst the pregnant women possibly due to the low dietary intake of zinc. There is a need to undertake multi-centric studies in various parts of the country to assess the serum zinc levels, magnitude of zinc deficiency and factors leading to zinc deficiency amongst pregnant women in India.
The prevalence of breastfeeding for the first 6 months in infants has been low in Hong Kong since the 1970s. In order to develop effective breastfeeding policies and promotion programs, an appraisal of feeding practices and factors related to initiation and early cessation of breastfeeding is necessary. A survey with a population- based representative sample was conducted to determine social-demographic, personal and cultural factors that influenced decision, duration and practice of infant feeding among infants 0-24 months old. This paper focuses on infants below 6 months old to study factors related to decision, duration and practice of breastfeeding. In 1993, 7,298 healthy infants were recruited from 46 Maternal-and-Child-Health-Clinics (MCHC) throughout Hong Kong, of whom 3161 were below 6 months old. The mother reported her feeding decision, duration and practice in a questionnaire. Breastfeeding rate was found to be very low (8.4%) for infants below 6 months old. Only 50.9% infants were breastfed. Infant formulae were widely given among partially breastfed infants. 45% mothers were full-time employed. Most mothers were aware of the benefits of breastfeeding to the infants and themselves. Husbands (43.3%) were regarded the most influential on initiation and duration on breastfeeding. Restricted food varieties (54%), sore nipple and breast engorgement (67%), perceived home confinement (41.5%) and perceived inadequate milk supply (31.7%) were major concerns upon breastfeeding. Furthermore, 76.9% mothers turned to MCHC staff for advice when they encountered difficulties during breastfeeding. In conclusion, the survey collected population-based representative data on factors determining initiation and early cessation of breastfeeding in Hong Kong in 1993. The findings will serve as a cornerstone in understanding the evolution of breastfeeding practice in Hong Kong. It merits further study to investigate how the confounders interplay to modulate initiation, duration and patterns of breastfeeding.
Eight cholesterol oxides are commonly found in foods with high cholesterol content, such as meat, egg yolk and full fat dairy products. Factors known to increase the production of cholesterol oxides in foods are heat, light, radiation, oxygen, moisture, low pH, certain pro-oxidising agents and the storage of food at room temperature. Processes, such as pre-cooking, freeze-drying, dehydration and irradiation, have all been reported to result in increased production of cholesterol oxides in meats. As prepared consumer foods are becoming increasingly popular, the consumption of higher levels of cholesterol oxides in foods is inevitable. An understanding of the mechanisms involved in the generation of cholesterol oxides may assist in their reduction in foods and possibly reduce the impact of these compounds on human health.
In December 2001, the World Health Organization launched the Mega Country Health Promotion Network. This network includes the countries with populations of 100 million or more. The 11 countries that are part of this network account for more than 60% of the world's population. The overall goal of this network is to promote healthy lifestyles; much of the focus of activities will be on promoting a healthy diet, based on food-based dietary guidelines and increased physical activity. Data will be presented that illustrate the 'double burden' of disease in the low income populations in these 11 countries. The network is attempting to identify new paradigms for health promotion, including the innovative use of public/private partnerships. Examples of these innovations will be presented.
Objectives: This study investigated the distribution density of fast food outlets around schools, and the relation- ship between dietary health of children and adolescents and the density of fast food outlets in Korea. Methods: A distribution map of fast food outlets was drawn by collecting information on 401 locations of 16 brands within a 15-minute walk (800 meter) of 342 elementary and secondary schools in Suwon, Hwaseong and Osan. A ques- tionnaire was used to gather data on the dietary life of 243 sixth and eighth grade students at eight schools. Schools in the upper 20% and lower 20% of the fast food outlet distribution were classified as high-density and low-density groups, respectively. The practice rate of dietary guidelines published by the Health and Welfare Ministry and the fast food consumption pattern of children and adolescents from low and high density groups were determined. Results: The number of schools with a fast food outlet within 200 meters or in the Green Food Zone around its location was 48 of 189 (25.4%) in Suwon and 14 of 153 (9.2%) in Hwaseong and Osan. Students in the low-density group visited fast food outlets less often than those in the high-density group (p<0.01). Dietary guideline practice scores for children did not show a significant difference between the two groups. Conclusion: The distribution map of fast food outlets within 200 meters of schools was useful for identifying the effectiveness of the Green Food Zone Act and nutrition education programs.
The aim of this study was to compare blood fatty acid profiles of two population groups: Italian and Tibetan, dif- fering with regard to ethnic, life style and environmental aspects. Additionally the collection of two staple foods provided the opportunity to analyze typical Tibetan dishes. A new, simple, rapid, and substantially non invasive method for fatty acid (FA) analysis of blood lipids was applied to healthy Italian (n= 14) and Tibetan (n= 13) sub- jects. Blood drops obtained from the ear lobe of Tibetans or the fingertip of Italians were adsorbed by a special strip of paper and processed for fatty acid analysis. The fatty acid profiles of the two groups are different, and en- vironmental factors, such as dietary fats and altitudes of Milan, Italy (a low altitude site), and Lhasa, Tibet (a high altitude site) appear to contribute to these differences. More specifically, in Tibetans higher levels of monounsatu- rated fatty acids, including the 22 and 24 carbon molecules, were found. This appears to be derived mainly from locally consumed fats (mustard seed oil), and are associated with lower levels of total polyunsaturated fatty acids and higher levels of selected omega 3 fatty acids, when compared to the Italians. These relatively higher levels of monounsaturated fatty acids may also indicate means of adaptation to local prooxidant conditions. The observed differences in blood fatty acid profiles in Tibetans vs Italians appear to result both from dietary factors and adap- tation to local environmental conditions such as the high altitude of the Tibetan location.
This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people) communi- ties and its associated factors. A total of 182 OA households in two districts in Selangor with the required criteria (182 non-pregnant women of child bearing age and 284 children aged 2-9 years old) participated in the study. Height and weight of both women and children were measured. Energy intake and food variety score (FVS) were determined using three 24-hour diet recalls. While 58% were underweight and 64% of the children were stunted, the prevalence of overweight and obesity in women were 31% and 20% respectively. The percentage of dual burden households (overweight mother/underweight child) was 25.8% while 14.8% households had normal weight mother/normal weight child. The mean food variety score (FVS) was similar for women (7.0+2.1) and children (6.9+1.9). Dual burden households were associated with women’s employment status (OR: 3.18, 95% CI: 2.65-5.66), FVS of children (OR: 0.71, 95% CI: 0.51-0.95) and FVS of women (OR: 1.39, 95% CI: 1.02- 1.89). The FVS of children (OR: 0.49, 95% CI: 0.25-0.89) and women (OR: 1.92, 95% CI: 1.64-2.77) remained significant even when dual burden households were compared to only households with normal weight mother/normal weight child. In these OA communities, food variety may predict a healthier diet in children, but may increase the risk of overweight and obesity in adults. Efforts to address households with dual burden malnu- trition should consider promotion of healthy diets and lifestyle for all members.
Background – Selenium deficiency may be associated with increased risk of viral virulence, cancer, negative mood states and immunological dysfunction, and Se intakes above the minimum requirements appear to have a positive effect on the later three. There is relatively little detailed information on selenium intake in Australian adults. Objective – This study aimed to estimate selenium intake of a randomly selected population of Victorian women enrolled in the Geelong Osteoporosis Study; to ascertain the main food groups contributing to daily selenium intake and to investigate the effect of the age group differences in food choices on Se intake and Se sufficiency.
Design – A detailed-history semi-quantitative food frequency questionnaire (FFQ) was administered to randomly selected women (n=556), aged 20–88 y, from the Barwon Statistical Division, representative of Australia in several demographic factors. Se values for Australian foods were used where available (Australian NZ Food Authority). Outcomes and conclusion – The FFQ captured responses on 359 foods. Se intake (mean±SD) was 77±29 μg/day; median 73 μg/day – which is higher than NZ and most European countries, but lower than US and Canadian mean Se intakes. Mean intake was 1.1±0.4 μg/kg body weight (range (0.2 – 3 μg/kg). 43% of women consumed less Se compared to the Australian NHMRC recommended intake (70 μg/day) for women. Wheat products, fish, vegetables, beef, fruit (Australian canned fruit has relatively high Se), dairy and poultry provided 20%, 10%, 10%, 10%, 9%, 9% and 7% respectively of the total Se intake. Significant age group differences were also found. Women 40-49y were those mostly at risk of Se insufficiency and older women consumed more Se from fruits, lamb, peas and beans. Younger women consumed more Se from mixed dishes (includes many “take away” food), chocolate foods and non-wheat grains.
Background – Australian fresh pork composition was last analysed in 1994; since then rearing and butchering practices have improved considerably with potential to affect composition of pork as available at the present time. Objective – To assess the folate composition of nationally representative retail fresh pork cuts in 2005/6
Design – Fresh pork cuts were purchased anonymously in three capital cities in 2005/2006 according to a sampling design that generates representative independent duplicate samples per state. Pork loin chop was studied as independent state duplicates, and other cuts were analysed as national homogenates. Gross composition was measured at Food Science Australia and lean and fat homogenates, raw and cooked, were formed for freight as fresh chilled samples for folate measurement in triplicate by the tri-enzyme method (1), modified with a fourth lipase enzyme treatment.
Outcomes – Folate levels varied from 0–83μ g/100 g in raw lean, and from 0-37 μg/100 g in raw fat. The nationwide average folate levels for all cuts in μ g/100 g (mean + SD) were: raw lean, 39.8 + 24.8, cooked lean, 28.6 + 23.2, raw fat, 17.8 + 12.3, cooked fat, 25.9 + 21.5.
Conclusions – Australian raw fresh pork contains highly variable levels of folate. The average levels of folate in Australian pork were higher than expected, and were much higher than reported for British or American fresh pork. Reference
Background – Since mandatory fortification of folic acid of flour has contributed to the reduction of neural tube defects (NTDs) in the U.S., Canada and Chile (1), mandatory folic acid fortification in bread-making flour has been proposed for Australia and New Zealand (2).
Objectives – To determine patterns of eating behaviour of women of childbearing age, and evaluate the appropriateness of bread-making flour as the selected food vehicle of folic acid fortification.
Design – A population sample of 197 women aged 19-45 years were recruited to complete a food frequency questionnaire (FFQ). Data on women’s dietary preferences and intakes were collected and analysed.
Outcomes – For all subgroups, average intakes of bread and cereal products did not meet recommendations set in the Dietary Guidelines for Australian Adults (3). Bread consumption averaged three to four slices per day. With fortification of bread, dietary folate intake would increase by 117-156 μg/day, achieving the proposed target. However, the survey revealed that one third of women did not eat sufficient bread to benefit from fortification. Conclusion – Although potentially beneficial, folic acid fortification warrants an educational campaign, particularly for women with low bread consumption.
References
Background – The majority of epidemiological studies examining associations between glycemic load (GL) and risk of chronic diseases have used validated food frequency questionnaires with carbohydrate correlation coefficients ranging from 0.4 to 0.8. Few have reported the degree of agreement between the questionnaire and reference intake.
Objectives – To test the validity of a GL questionnaire (GLQ) by comparison with a detailed diet history.
Design –54 women aged 42 to 82 years were recruited from a cohort of 511 participants in the Longitudinal Assessment of Ageing in Women (LAW). Carbohydrate intake was assessed by a specially-designed GLQ; GL [carbohydrate (g) x glycemic index (%)] values were summed to provide the average daily GL. Data were validated against a diet history.
Outcomes – Mean + SEM intakes from the diet history were 6% higher than those from the GLQ for carbohydrate (216 + 6 versus 203 + 8 g/day, P<0.05) and the GL (110 + 4 versus 103 + 4, P=0.1), respectively. There were significant correlations between methods for carbohydrate (r=0.54, P<0.01) and GL (r=0.57, P<0.01). 95% limits of agreement determined by Bland Altman plots ranged from -111 to 83.7 g for carbohydrate, with almost half the subjects recording a difference of + 40 g; and -60.0 to 46.6 for GL, with a third of subjects recording a difference of + 25 units or more.
Conclusion – Our GLQ had acceptable validity in terms of correlation with the dietary history. From a clinical perspective however, substantial error existed in estimation of individual carbohydrate and GL intakes. We suggest that studies using food frequency questionnaires to estimate GL state limits of agreement instead of or as well as correlations when discussing validity. Failure to accurately assess carbohydrate intake could explain some of the discrepancies in results of dietary studies investigating associations between GL and the development of chronic diseases in individuals.
Background and Objectives: Falls are common among older females. This study investigated the relationships among falls and dietary patterns, nutritional inadequacy and prefrailty in community-dwelling older Japanese females. Methods and Study Design: This cross-sectional study involved 271 females aged 65 and over. Prefrailty was defined as exhibiting one or two of the five Japanese version of the Cardiovascular Health Study criteria. Frailty was excluded (n=4). Energy, nutrient and food intakes were estimated using a validated FFQ. Dietary patterns were determined from intakes of 20 food groups assessed with FFQ, by cluster analysis. Nutritional inadequacy for the selected 23 nutrients in each dietary pattern was examined based on DRIs. Binomial logistic regression was applied to examine the relationships among falls and dietary patterns, prefrailty, and inadequate nutrients. Results: Data from 267 participants were included. The incidence of falls was 27.3%, and 37.4% of participants were classified as prefrailty. Three dietary patterns identified were namely; ‘rice and fish and shellfish’ (n=100); ‘vegetables and dairy products’ (n=113); and ‘bread and beverages’ (n=54). A binomial logistic regression analysis revealed that dietary patterns of ‘rice and fish and shellfish’ (OR, 0.41; 95% CI, 0.16–0.95), and ‘vegetables and dairy products’ (OR, 0.30; 95% CI, 0.12–0.78) were negatively correlated with falls, and falls was positively associated with prefrailty. Conclusions: Dietary patterns characterized by ‘rice and fish and shellfish’, and ‘vegetables and dairy products’ were associated with a reduced incidence of falls in community-dwelling older Japanese females. Larger prospective studies are needed to validate these results.
The single major cause of death throughout the world is coronary heart disease. Prevalence is stable or decreasing in North America, Australasia and most of Europe, while rapidly increasing in eastern Europe, Asia and Africa. Atherosclerosis is the underlying pathology. This is one of the classic lifestyle diseases on the background of genetic susceptibility. Diet plays a key role in the initiation and progression of coronary heart disease. A low total fat diet is almost universally recommended throughout the world. However, the most successful secondary prevention diet trials have used modification of fat, rather than decrease in total fat per se. Successful diet trials suggest that diet modification is as effective as accepted drug therapy to prevent recurrent coronary events, and importantly is very cost effective. Marine lipid supplementation has been demonstrated beyond reasonable doubt to decrease total mortality and in particular sudden death in patients who have survived their first myocardial infarction. Large-scale diet intervention trials are indicated to improve the scientific basis for dietary recommendations to prevent initial and recurrrent coronary heart disease.
School nutrition programs are essential for children’s long-term nutrition and health promotion. The last decade has been the most dramatic years in the history of school nutrition programs in Korea. The percentage of schools serving school lunches reached almost 100% in 2003. In 2006, School Meals Act was significantly revised after serial outbreaks of food-borne illness among students having eaten school lunches. The safety and nutritional quality of school meals had remained as the biggest issue until the middle of 2000s, and then eco-friendly and universal free school lunches have become the main issues related to school meal service and are still under de- bate. Implementation of the Nutrition Teacher System in 2006 was the turning point of school-based nutrition ed- ucation in Korea. In addition, two new laws, Special Act on Children’s Dietary Life Safety Management of 2008 and Dietary Life Education Support Act of 2009, started to make meaningful changes in school nutrition envi- ronment and practices. The next decade is expected to be very critical in the development of school nutrition pro- grams in Korea as the new systems and laws are to be settled. Significant effort is needed from both the academia and the field to make the related issues to be debated and answered to progressive direction for the school nutri- tion programs in Korea.