includes the ILSI SEA Regional Forum and Workshop on recommended dietary allowances: Scientific basis and future directions
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.
As part of a prospective, longitudinal study that was carried out in Hanoi, Vietnam (as from 1981), mid-upper-arm circumference (MUAC) measurements, and the weight and height of children were taken from children for the first year of life. These measurements were recorded monthly, 1236 months: 3-monthly, 3672 months: 6-monthly and yearly for children beyond 72 months. The aim of this study was to observe development of MUAC of children on a longitudinal basis. Mid-upper-arm circumference increases by about 1 cm for boys and 1.5 cm for girls between 1 and 5 years. To recognise malnutrition, the cut-off level of MUAC 13.5 cm gave high values for sensitivity and specificity only for children aged 612 months. The cut-off levels of 14.0, 14.5 and 15.0 cm were more appropriate for children aged 1324, 2536 and 3760 months. These results suggest that a single cut-off point of MUAC 13.5 cm cannot be used in screening moderate malnutrition for all children under age 5 but should be elevated with the increasing age of children.
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.
Long chain ω3 and ω6 fatty acids and taurine have been suggested to have structural and/or functional roles in the brain. In this study the levels of fatty acids and taurine in breast milk and their correlations were investigated in 46 lactating women from an area 100 km north-east of Beijing, China. The subjects consisted of two groups: group 1 was 22-47 days postpartum and group 2 was 75-106 days postpartum. Fatty acids and taurine in breast milk were measured by gas-liquid chromatography and high-performance liquid chromatography, respectively. The relative compositions of long chain ω6 and ω3 fatty acids decreased significantly (20:3 ω6, 20:4 ω6, 22:4 ω6, 22:5 ω6 and 22:6 ω3; all P < 0.01) in the course of lactation, while long chain saturated (20:0, 22:0) and monounsaturated (20:1, 22:1) fatty acids tended to increase. The ratio of ω6/ω3 fatty acids in breast milk fat appeared to be higher (12.3 ± 4.3 for group 1, and 16.5 ± 7.4 for group 2) than the desired range of 4-10. Breast milk taurine concentrations from Chinese rural mothers were 186 ± 48 nmol/mL and 157 ± 65 nmol/mL for groups 1 and 2, respectively. A significantly inverse relationship was observed between breast milk taurine concentration and the ratio of arachidonic acid ω6 to docosahexaenoic acid ω3 (r = -0.323, P = 0.028). Further studies on the physiological function(s) of taurine as an antioxidant and as a neurotransmitter are worth pursuing in relation to the balance of long chain ω6 and ω3 fatty acids, especially as regards its role in retina and brain development.
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.
We found that with oral supplementation by a liquid soy-based protein hydrolysate in malnourished COPD patients (BMI ¾ 20), it possible to increase weight over a 6-week period, and body water and an index of muscle mass (MAMC), but not total body nitrogen (TBN judged by Nitrogen Index) which identifies a particular challenge for nutrition support in COPD patients. There was no associated improvement in pulmonary function but we found that better nourished COPD patients (BMI > 20) had some pulmonary function advantage; it is suggested that TBN may need to improve with nutrition support for pulmonary function to improve.
Recommended dietary allowances (RDAs) are widely accepted standards for nutrient (energy, protein and micronutrient) intakes. However, they may differ depending on food culture, age and gender. In times of economic transition, demographic change and cultural diversification, RDAs require review. This has recently been done for the South Eastern countries of Indonesia, Malaysia, Philippines, Singapore, Thailand, Vietnam and Brunei. The complementary concepts of NOAEL (no observed adverse effect level) and LOAEL (lowest observed adverse effect level) were also considered of particular moment as were discussions about micronutrient requirements in the affluent diet which predisposes to CNCD (chronic non-communicable diseases), and the value of harmonization where possible for purposes of regional education and trade.
|In the Western world, the basic staple of nutrition is bread. It evolved, from Neolithic times in Mesopotamia and the Levant, from flour made from natural hybrids of emmer and einkorn. Its form has changed from that of a dark, coarse and heavy loaf, baked in the ashes, to the enriched artistic breads of the late twentieth century. Its variety of forms conferred status on those who ate its refined and whitened form. The wheel of fashion and nutrition has turned full circle to the quality-controlled, vitamin and mineral-enriched wholemeal loaf of the new millennium to come. Bread has changed from a staple not simply of nutrition itself, but to that of a 'functional food' whose fibre confers protection against preventible disease. The bread of the new century thus will be both a food and a medicine. So fundamental to Western life is bread, that its price has long been the last item to remain controlled, when all else is left to the dictates of a free market economy. Bread is the fundamental unit of exchange and forms the last link in a chain of commodities which starts from items of luxury to those of survival itself. The price of bread can thus be used as a currency datum. As such, the price of a loaf of bread, and the minutes of labour needed to produce it, can be used to measure the economy, and to give a measured perspective of its influence on a community's history. Costs, throughout history, can be expressed in 'bread units'. As such, the latter forms an absolute index of the worth of other items, particularly a person's labour. As such, bread and its value forms a partly independent measure of inflationary and other social influences. Bread remains a fundamental part not only of nutrition, but of life itself.|
Three surveys were conducted of 429 supermarket shoppers in Canberra, Australia, in order to examine factors that may influence their concerns about food and health. In each survey, a 28 item food and health concerns inventory was administered along with selected personality trait, personal values or shopping style scales. Principal components analysis of the ratings of the food and health concerns derived eight components. In order to test a number of hypotheses, a series of multiple regression analyses were carried out in which the psychological variables were entered along with demographic variables as predictors of the respondents' scores on the concerns components. Response rates for the surveys averaged 72%. The psychological variables accounted for more variance in the food and health concern scores than the demographic variables. Examples of the observed relationships showed that: (i) safety and quality concerns were positively related to social activism and nature values and to anomy, but were negatively related to age of the respondent and neuroticism; (ii) concerns about hidden additives in foods were directly linked to the quality-seeking shopping style; (iii) concerns about general food system problems were positively linked to the nature value orientation, and negatively to the self-monitoring and neuroticism personality traits; (iv) empathy for vulnerable people was positively linked to the social activism and nature values and negatively to the fashion-seeking shopping style; concern about animal welfare was directly related to the nature value. The findings show that individual difference variables have some utility in predicting responses to food and health issues. They have implications for food communicators, nutrition educators, food label designers as well as consumer and industry groups, all of whom need to recognize consumers' varied orientations.
This paper outlines the importance of information on the composition of foods for a wide range of national and international activities at government, community and industry levels. Particular reference is made to the essential need for nutrient composition data of food supplied for the development of nutrition policy and programmes, for nutrition research and nutritional education to improve health status and reduce risk for disease. The regional activities of the International Network of Food Data Systems (INFOODS) and the Asia Pacific Food Analysis Network (APFAN) to promote the availability and quality of food composition data, are discussed. In particular, reference is made to the role of APFAN in promoting the use of consistent methodologies for food analysis by its member organizations.
In developing countries, data on dietary intake of trace elements, and even major elements, is limited. The dietary intake of 1277 adults of underprivileged communities of rural Rajasthan was studied. Intake was assessed by the 24-h dietary recall method from which the average daily intake of macronutrients, some major elements, and trace elements was computed. The zinc intake was 69.7 and 49.7% of the recommended daily allowance in males and non-pregnant non-lactating females, respectively. The intakes of manganese and molybdenum were adequate when compared with the suggested daily intakes. Element intake during the physiological stress conditions of pregnancy and lactation was 42.4 and 53.0% for zinc, 36.5 and 29.8% for copper, and 21.0 and 23.1% for calcium, respectively. The intake of iron was less than 20 mg/day for all female subjects studied. No significant difference was observed in the trace element intake of subjects with different grades of malnutrition. Assessment of dietary intake may provide a useful indication of the possible status of major and trace elements among adult subjects.
The ranges of sodium and potassium intake and their relationship to blood pressure were studied in 126 healthy Chinese subjects (42 men, 84 women) aged between 20 and 65 years living in Hong Kong. An average of three blood pressure measurements and one to three 24-hour urinary sodium and potassium outputs were used to characterize an individual's blood pressure, and sodium and potassium intake, respectively. The average sodium and potassium intakes were 145 and 40 mmol/day in men and 135 and 41 mmol/day in women. When compared with subjects of similar age in southern China, Chinese in Hong Kong excreted 20% less sodium but 40% more potassium and had a lower systolic blood pressure (113 vs 118 mmHg in men, 106 vs 112 mmHg in women). It should be remembered that the Hong Kong subjects were heavier and were under more urban stress, both of which would be expected to be associated with higher blood pressure. The findings from this pilot study are compatible with a positive association between sodium intake and blood pressure and/or an inverse association between potassium intake and blood pressure.
|The bioavailability of coenzyme Q10 (ubiquinone) formulated as an emulsion in a soft gelatin capsule (Ensorb(TM), NDS Pty Ltd, Sydney, Australia) was compared with a hard gelatin powder-filled capsule. The study design was a randomized cross-over trial with a 3-week wash-out period. The study population comprised 23 apparently healthy adults (12 men and 11 women), aged 2043 years. Each participant took two 50 mg capsules, and blood samples were taken over a period of 36 h. The plasma concentration of coenzyme Q10 peaked between 3 and 4 h after administration of both preparations. The area under the curve (AUC) of Ensorb™ was 927% higher than that observed with the powder-filled capsule (P < 0.0001), suggesting that this emulsion preparation has a higher bioavailability.|
Riboflavin requirements were studied in six non-pregnant, 12 pregnant, 11 lactating women, 20 children aged 46 years and 14 children aged 1012 years. All subjects initially were riboflavin-deficient with erythrocyte glutathione reductase activation coefficient (EGR-AC) of >=1.3, confined in a metabolic ward and repleted with increasing doses of riboflavin during four 10 or 8 day feeding periods. The repletion diet simulated the usual basal diet of the subjects but were modified to contain adequate energy and protein in the pregnant group. Minimum riboflavin requirements determined by regression analysis as intakes required to obtain an EGR-AC value of < 1.3 were: 0.72 ± 0.09 (non-pregnant); 1.36 ± 0.37 (pregnant); 1.31 ± 0.16 (lactating); 0.58 ± 0.10 (children 46 years), and 0.70 ± 0.18 mg/d (children 1012 years). Riboflavin requirements in mg/d, mg/1000 kcal, mg/g protein or mg/kg metabolic body size for the groups varied. Because of the large variability, the use of a single value relating riboflavin requirement to either energy, protein requirements or metabolic body size to calculate requirements for different age groups or gender is deemed inappropriate. It is recommended that riboflavin requirements be expressed in mg/d as determined experimentally for different population groups. Estimated recommended dietary allowances for the groups studied, obtained by adding 30% to the mean minimum riboflavin requirement, are presented.
Body composition was assessed in Indonesian male (n = 18) and female (n = 23) students using densitometry (underwater weighing), deuterium oxide dilution, skinfold thickness measurements, bioelectrical impedance analysis (BIA) and a prediction equation based on the body mass index. From body density and total body water percentage body fat (BF%) was calculated using a three-compartment body composition model. Percentage body fat obtained by this three-compartment model was regarded as the reference value and BF% obtained by the single methods were compared with this value. Mean differences (± SD) in BF% from the three-compartment model minus the single methods were 1.1 ± 2.1 for densitometry, +1.1 ± 1.6 for deuterium oxide dilution, +1.3 ± 2.8 for skinfold thickness measurement, +2.8 ± 4.3 for BIA and +3.4 ± 4.8 for body rated health and activities of daily living among a group of free-living elderly Guatemalan subjects aged >= 60 years. A total of 198 subjects (61 men and 137 women) living in a suburban community participated in the study. Males had higher values for height, weight, and waist-hip ratio, while females had larger skinfolds and higher values for body fat indicators. Most subjects rated themselves in 'good' or 'fair' health and this corresponded well with high scores on a multi-item scale of activities of daily living scores and 'acceptable' weight according to Garrow's classification for BMI. Results presented here may be useful in highlighting diversity in human ageing across cultures while contributing to establishing reference values for anthropometric indicators in similar populations.