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.
The effects of high-fat diet feeding over generations on body fat accumulation were studied in rats. Male and female Sprague-Dawley rats fed a high-fat (HF) diet or a low-fat (LF) diet were mated in the same diet group at age 13 weeks, and the male pups (1st generation) obtained were used in this experiment. The 1st generation rats were nurtured by their own mothers (Experiment 1) or F344 foster mother rats (chow-fed) during pregnancy (Experiment 3) and the suckling period (Experiments 2 and 3). After weaning, rats with HF and LF dietary histories were fed a purified diet for 1217 weeks. Body weights and abdominal adipose tissue weights were greater in rats with HF dietary histories than in those with LF dietary histories, even controlling for environmental backgrounds related to the mother rats during pregnancy and suckling periods. The levels of lipoprotein lipase and leptin mRNA in the perirenal adipose tissue were higher in rats with HF dietary histories. These results suggest that the effects on body fat accumulation of HF diet feeding over generations are not only associated with environmental factors but also with genetic factors. The obesogenous effects of HF diet feeding over generations may be associated with lipoprotein lipase and leptin gene expression on rat adipose tissues.
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.
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.
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.
Gestational diabetes mellitus (GDM) is a new epidemic among Australian women, especially those with Asian backgrounds. The 1998 Australia National Diabetes Strategy and Implementation Plan recognises GDM as an independent glucose metabolic disorder affecting sub-groups of Australians. Gestational diabetes mellitus is an Australian national diabetes priority area, along with insulin dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM). This paper reviews the many issues relating to GDM that continue to be debated by researchers and clinical service providers. These issues include the diagnosis of GDM, the effect of GDM on fetal outcomes, the long-term health effects on the offspring of GDM mothers, the effect of GDM on maternal outcomes and the long-term health effects on women with a history of GDM.
Population variabilities of serum carotenoid and tocopherol levels using reverse-phase HPLC in healthy American (Caucasian), Chinese and Korean adults were determined. Considerable variation in serum nutrient concentrations was found among these groups. The mean serum concentration of lutein/zeaxanthin was significantly higher in the Chinese than in the white Americans (p<0.001), whereas serum α-carotene and lycopene concentrations were significantly higher in white Americans than in Chinese (p<0.001). Serum β-carotene concentrations in Koreans were significantly higher than in either white Americans or in Chinese. The mean serum lycopene concentration in Koreans was lower than in Americans. The mean serum retinol concentration was significantly higher in white Americans than in Chinese or Koreans (p<0.005). American serum γ-tocopherol concentrations were significantly higher (p<0.005) than those of the Chinese, whereas γ-tocopherol values were significantly lower (p<0.001) than those of the Chinese. These differences probably reflect differences in dietary intakes among these population groups.
Because the Maldives is a country of islands it has been assumed, until now, that iodine deficiency disorders (IDD) are not a public health problem. However, no systematic scientific survey has been carried out to assess the status of IDD in the Maldives. This study represents the first IDD survey by the Government of the Republic of Maldives in association with UNICEF Maldives. Undertaken during June and July 1995, the survey adopted the EPI 30 Cluster sampling technique, as recommended by the Joint WHO/UNICEF/ICCIDD Consultation. Based on population proportion to size, a total of 30 clusters were chosen from sampling frames of all 200 islands. A total of 30 schools and 2834 children aged 612 years were surveyed. The total goitre rate was 23.6%, with grade 1 goitre contributing 22.5% of this figure. The prevalence of goitre was greater in girls (26.6%) than in boys (20.7%). The median urinary iodine level was 6.7 µg/dL and 65.5% of children had urinary iodine levels below 10 µg/dL. It is evident from this survey that IDD is a public health problem in the Maldives. Hence, efforts to control IDD should be instituted. The most common method of iodine supplementation is iodised salt. As tested in a non-representative sample of 39 salt samples, only 8% of salt had adequate iodine levels of approximately 15 p.p.m. Because all the atolls are affected there is a need to introduce universal salt iodization in the country.
In order to ascertain the coverage and to identify factors determining the success of an iodine deficiency disorders (IDD) control program in West Sumatra, Indonesia, a cross-sectional study among 495 school children aged 615 years in a subdistrict of an endemic goitre area was conducted. Coverage of iodine capsule distribution was 27%. Forty-eight percent of the households used iodized salt with an appropriate concentration (>= 40 p.p.m.). Factors associated with not taking idodine capsules among children were: mother's lack of knowledge about the iodine capsule (OR 13.3, 95% CI 7.424.1) and mother's education level (OR 1.89, 95% CI 1.053.39). For unsatisfactory use of iodized salt in a household, the only predictor was family monthly income. Odds ratios and 95% CI for moderate and high family income were 2.42 (1.394.21) and 2.22 (1.43.54), respectively. We concluded that for coverage in an IDD control program, supplementation and fortification alone were not enough. Education had an impact on coverage of the supplementation. Furthermore, iodization of salt needs further improvement in relation to quality control. Finally, the program neglected high-income groups. These pitfalls should be corrected.
The nutritional status of patients with chronic pancreatitis was assessed in 76 consecutive patients (63 males, mean age 35 ± 10 years; 13 females, mean age 40 ± 16 years) attending the pancreas clinic of a tertiary care hospital in India. A food frequency questionnaire was used to elicit information regarding dietary intake of food items. Nutrient intake was calculated using the 24 h recall method on a subsample of 20 patients. Anthropometric measurements were taken and haemoglobin and serum albumin were estimated. Thirty patients (45%) had made dietary modifications after they were diagnosed as having chronic pancreatitis. These changes in diet included a decrease in fat, spices and/or quantity of food consumed. Analysis of the qualitative data revealed that the majority of patients were taking wheat, lentils, vegetables, fruits, milk, curd, sugar and oils on a daily basis. The mean energy intake was 1750 ± 375 kcal in males and 1180 ± 246 kcal in females, which turned out to be 37% lower than the Recommended Dietary Allowances (RDA), both in males and females. Alhough most patients (86%) were in the normal range of Body Mass Index (BMI), 67% of the patients reported weight loss after onset of the disease. Biochemical parameters studied were in the normal range: haemoglobin 12.26 ± 1.99 gm% and albumin 4.05 ± 0.89 g/100 mL. We concluded that in patients with chronic pancreatitis, malnutrition occurs mainly due to a low intake of calories and protein as a result of dietary modification for symptomatic relief and pancreatic insufficiency. However, nutritional parameters such as haemoglobin and serum albumin are fairly well maintained.
The proximate composition including mineral and vitamin contents of 16 fruits and 46 vegetables (leaves, fruits, palm hearts and shoots) of indigenous origin in Sarawak are provided. Fruits like dabai (Canarium odontophyllum), kembayau (Dacryodes rostrata f. cuspidata), durian nyekak (Durio kutejensis) and durian kuning (Durio graveolens) are very nutritious with high values for energy, protein and potassium. Among the vegetables, the protein content of letup (Passiflora foetida), kepayang (Pangium edule) and tubu (Pycnarrhena tumetacta) is high, ranging from 6 to 7%. The range of nutrients among foods of indigenous origin are generally comparable with those of many cultivated species except for vitamin C, which is lower. Teh Kampung (Leucosyke capitellata) leaves are particularly high in magnesium (626 mg/100 g). Some of the indigenous vegetables contain antinutritional factors. Kepayang has very high levels of hydrogen cyanide (1834 µg/g on dry basis) but this poison can be completely evaporated by boiling. Indigenous fruits and vegetables which are pesticide residue free are important food sources for rural populations. Nutritious indigenous fruits and vegetables have the potential to be promoted for wider use, domestication and commercialization.
Glycemic indices have been used to predict useful carbohydrate sources of food for patients with non-insulin-dependent diabeties mellitus (NIDDM) on dietary management programs. The present study has revealed that glycemic indices alone are not adequate predictors of useful carbohydrate meal sources. We observed for the first time that glycemic indexes inversely correlate with triglyceride indices. In our test mixed meals varying in five Ghanaian carbohydrate food types for nine non-insulin dependent diabetics, the correlation between glycemic and triglyceride indices was (r = 0.63; P = 0.005). The atherogenic potential of triglyceride makes a critical review of the sole use of glycemic indices as useful carbohydrate predictors necessary. We also observed that unripened big plantains (a staple Ghanaian food) could be a useful carbohydrate source for NIDDM patients.
The iron and vitamin C content of water spinach and rice samples from three sites in Vietnam were chemically analysed. The iron content of home-milled rice from Nghe An was higher than the iron content of machine-milled rice from Thai Binh and Hanoi. In addition, the iron content of cooked rice was lower than that of uncooked rice as iron was removed during the washing and rinsing of the rice prior to cooking. Cooked rice that was washed and rinsed less thoroughly had a higher iron content. The iron content of water spinach from different locations was very similar, although white water spinach had a much higher vitamin C content than red water spinach.