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.
Mark L Wahlqvist
Background: In Rajasthan, an Indian State with significant salt production, the sale of non-iodized salt for hu- man consumption was banned in 1992. This study explored the relationships between the use of iodized salt in Rajasthan and the iodine status of children and pregnant women living in the area. Methods: In a State-wide sur- vey, 30 clusters were selected proportionate-to-population-size and 40 school children, 6 -12 years old, were en- rolled by random house-to-house visits in each cluster. Twelve pregnant women from the same households were also sampled. Salt used for cooking and a casual urine sample from each child and pregnant woman were col- lected. The salt iodine content was measured by titration and the urinary iodine concentration (UIC) by a quality- assured colorimetric method. Results: Salt iodine content was ≥15mg/kg in 41.9% of the households, and 23.0% used non-iodized salt. Median UIC was 139μg/L in children and 127μg/L in pregnant women. In households us- ing non-iodized salt, the median UIC’s were 96μg/L and 100μg/L in children and women, respectively. Disag- gregating the UIC distributions by salt iodine levels revealed a consistent, step-wise pattern of UIC in children with increasing salt iodine content. A similar but less steep pattern was observed in pregnant women. The iodine status of both children and pregnant women attained the optimal range only when the salt iodine content was close to 30mg/kg. Conclusion: For optimum iodine status in the population of Rajasthan, the iodization of house- hold salt should be mandated at a higher level than what is practiced at present.
Objective: A high prevalence of mild to moderate vitamin D deficiency has been observed in women who have recently arrived from the horn of Africa and living in inner Melbourne. Vitamin D status of women with differing age and ethnic distributions residing in other suburbs is unknown. Method: A tertiary referral Women’s hospital- based survey of serum 25(OH)D concentrations in 2,690 women aged 14-78 years residing in Melbourne between 1 July 2004 and 30 June 2005. We computed odds of serum 25(OH)D concentrations < 50 nmol/L and used tests of homogeneity across different suburbs in Melbourne, Victoria. Results: Women with moderate vitamin D defi- ciency from all suburbs were young [29.1 ± 7.2 years (mean ± standard deviation)]. The odds of moderate vita- min D deficiency were highest in inner suburbs and Greenvale, Coburg, Pascoe Vale South, Fawkner, Broad- meadows and Campbellfield from the Hume-Moreland municipality (p value for homogeneity of odds < 0.001). Conclusion: Vitamin D deficiency appears to be a growing health concern in Australia and may be more preva- lent in younger women in Victoria than anticipated.
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.
The prevalence of malnutrition in Cambodia is among the highest in Southeast Asia, and diarrhea and pneumo- nia are the leading causes of death among children. Whether these adverse health outcomes are associated with co-existing micronutrient deficiencies is uncertain. We have determined the prevalence of anaemia, as well as iron, zinc, and vitamin A deficiency and their co-existence among stunted children (77 females; 110 males) aged 6–36 mos. Non-fasting morning venipuncture blood samples were taken and analyzed for haemoglobin (Hb), se- rum ferritin (via IMx system), retinol (via HPLC), and Zn (via AAS), C-reactive protein (CRP) (via turbidimetry) and Hb type (AA, AE, or EE) (via Hb gel electrophoresis). Children with CRP ≥5.0 mg/L (n=34) were excluded. Zinc deficiency defined as serum Zn <9.9 μmol/L had the highest prevalence (73.2%), followed by anaemia (71%) (Hb<110 g/L), and then vitamin A deficiency (28.4%) (serum retinol <0.70 μmol/L). Of the anaemic children, only 21% had iron deficiency anaemia, and 6% had depleted iron stores. Age, log serum ferritin, and Hb type were significant predictors of Hb in the AA and AE children. Serum retinol was unrelated to haemoglo- bin or serum zinc. The prevalence of two or more micronutrient deficiencies (low Hb, serum retinol, and/or se- rum zinc) was 44%. Nearly 10% had low values for all three indices, and 18% had just one low value. In conclu- sion, anaemia, and deficiencies of iron, zinc, and vitamin A are severe public health problems among these stunted Cambodian children. Intervention strategies addressing multiple micronutrient deficiencies are needed.
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.
French Polynesians, like other remote maritime populations are intimately connected to the ocean which nour- ishes their daily life and culture. Their reliance on fish raises the issue of potential exposure to harmful natural and anthropogenic contaminants as well as providing essential nutrients. The purpose of this study was to assess the risks and benefits of fish consumption in French Polynesia. This cross-sectional study included 195 adults aged 18 years old and over from the Tahiti and Moorea islands. Fatty acids, selenium (Se) and mercury (Hg) blood concentrations were measured in participants and were all very high. Blood concentrations indicate that Hg, Se and omega-3 fatty acids have a common origin, i.e. fish consumption. In comparing the Polynesian group with northern populations, we found that the Polynesian group had levels of Hg similar to those observed in Inuit populations (geometric mean (range): 90.3 (15-420) nmol/L vs. Inuit: m(r): 79.6 (4-560) nmol/L). Similar results were observed with Se blood concentrations. The fatty acid concentration was also similar to that of the Inuit population even though the specific profile of fatty acids differed. For the first time, we report very high blood concentrations of mercury, selenium and omega-3 fatty acids in a fishing population from the South Pacific, comparable to those reported among fishing populations from the Northern hemisphere. Further work is ongoing to better substantiate public health nutritional policies.
This study examined dietary patterns of adults on Guam. Four hundred subjects were selected via a multistage procedure to represent the island’s population. A 24-hour dietary recall was administered via telephone in 1995 to 1996. Diets were computer analyzed. There were 4,913 food items reported, representing 1,042 individual foods. Most respondents, 51.3%, had a “more-frequent” eating pattern, 36.9% had “regular” and 11.8% had “less-frequent.” Energy consumption increased (p < 0.05) with eating frequency. Highest levels of all nutrients (p < 0.05) were at the evening meal. The sexes did not differ in nutrient proportions by meal. Grains, meats, and beverages were eaten most frequently. Meat/fish, mixed dishes, and grains supplied 68% of the energy and 47% to 91% of the micronutrients. Twenty five percent of the carbohydrate was from sweetened drinks and desserts. Rice was the most frequently consumed food. More than half of the subjects had no fruit, a third had no vegeta- bles, and only 38.5% had dairy foods. Calcium came from multiple sources: dairy (27.6%), mixed dishes (23.8%), fish (12.6%), desserts (8.5%) and vegetables (6.6%). Most people, 91.8%, had fiesta meals with median consumption at 6 meals per year (range: 0 to 200). Betel nut was used by 12.3% of the sample with median con- sumption 0 whole nuts per day (range: 0 to 25). Ethnic differences (p < 0.01) were observed in both fiesta meal and betel nut consumption. The Guamanian diet includes limited use of traditional foods and dietary patterns as- sociated with increased risk for chronic disease.
Diet is thought to be one of the leading causes of bone mineral loss in aging people. In this study, we explored the potential impact of a vegetarian diet on bone mineral density (BMD) in adult Taiwanese men and women. This was a cross-sectional study of the relationship between diet (vegetarian versus non-vegetarian) and BMD and the incidence of osteoporosis. Bone mineral density was determined in a cohort of 1865 adult male and fe- male patients who underwent routine examination in a regional teaching hospital in Taiwan between February 2003 and February 2004. Subjects with definite vertebral problems, known osteopathy, or poor posture were ex- cluded. Dual-energy X-ray absorptiometry (DEXA) was used to determine BMD, on the right hip in men and on lumbar vertebrae L2 to L4 in women. The subjects were grouped according to sex and diet, and were then strati- fied by age within each of the four groups. The outcome measures were the BMD value and the incidence of os- teopenia or osteoporosis according to defined criteria. Bone mineral density gradually declined with increasing age in Taiwanese men, while Taiwanese women showed a precipitous decrease in BMD after the 5th decade. However, no statistical differences in BMD were observed between vegetarians and non-vegetarians of either sex. The proportion of subjects with osteopenia or osteoporosis also appeared comparable between vegetarians and non-vegetarians of either sex. BMD shows an age-related decline in Taiwanese men and women, and eating a vegetarian diet does not appear to affect this decline.
Childhood obesity is a widespread health problem in Australia. Overweight in childhood can lead to adult over- weight and the development of risk factors for cardiovascular disease (CVD). Effective strategies for reducing childhood obesity are urgently required. A vegetarian diet has been shown to be an effective prophylactic to many lifestyle diseases in the adult population and may therefore be beneficial in children. However the metabolic de- mands of adolescents are different to adults and the impact of a vegetarian diet on CVD markers in this demo- graphic is not certain. We compared key physiological and biochemical markers of health against responses to a modified, Schools Physical Activity and Nutrition Survey (SPANS) using one-way and two-way Analysis of Variance. 215 adolescents (14-15yrs) from 5 Adventist secondary schools in the Sydney and Hunter regions of New South Wales, Australia, participated in this study. Adolescents consuming predominantly vegetarian foods showed significantly better scores on markers of cardiovascular health, including, body mass index (BMI), waist circumference, Cholesterol/High density lipoprotein ratio and low density lipoprotein. Adolescents consuming nuts more than once per week, also showed lower scores for BMI and serum glucose irrespective of their vegetar- ian status. Markers of general health including haemoglobin and average height were not different between groups; however a lower serum level of vitamin B12 was apparent in the vegetarian cohort. Surprisingly, exercise on its own was not statistically associated with any of the risk factors tested suggesting that diet may be the most significant factor in promoting health in this age group.
Parenteral nutrition (PN) solution contains various concentrations of dextrose, amino acids, lipids, vitamins, electrolytes, and trace elements. Incorrect preparation of PN solution could lead to patient death. In this study we used the refractive index as a quality assurance tool to monitor the preparation of PN solution. Refractive indices of single nutrient components and PN solutions consisting of various concentrations of dextrose, amino acids, electrolytes, and lipids were measured. A mathematical equation and its linear plot were generated then used to predict the refractive index of the PN solution. The best-fit refractive index for PN solution (i.e., the predicted re- fractive index) = 0.9798 × (% dextrose) + 1.2889 × (% amino acids) + 1.1017 × (% lipids) + 0.9440 × (% sum of the electrolytes) + 0.5367 (r2 = 0.99). This equation was validated by comparing the measured refractive indices of 500 clinical PN solutions to their predicted refractive indices. We found that 2 of the 500 prepared samples (0.4%) had less than the predicted refractive index (< 95%). Refractive index can be used as a reliable quality as- surance tool for monitoring PN preparation. Such information can be obtained at the bedside and used to confirm the accuracy of the PN solution composition.
Evidence–based nutrition (EBN) has gained currency as part of the growing role of evidence-based medicine (EBM) to increase the validity, utility and cost-effectiveness of both clinical practice and, increasingly, public health endeavours. Nutritionally-related disorders and diseases (NRD) account for a relatively large proportion of the burden of ill-health, disease and mortality, especially as the nexus between them and both infectious disease and so-called chronic disease is understood. As resource allocation is increasingly dependent on the evidence for preventive or therapeutic effect, the case for nutrition interventions also needs to be underpinned by evidence. However, feeding studies are not as amenable to the designs familiar to clinical trialists and dietary interventions in public health may be complex in their conduct and interpretation, making other approaches like cohort studies more attractive even if costly and long in the execution. With a number of food system changes in rapid progress or imminent, especially in the populous Asia Pacific region, along with changing demographics, changing disease patterns and concern about present and future food security, a stock-take and scenario analysis of EBN was un- dertaken by a panel of nutrition scientists, population scientists, agriculturalists, clinicians and policy makers to- gether with consumer and indigenous stake–holders in Taiwan in 2007. They found that clinical practice guide- lines and proposals for health and nutrition policies required greater emphasis and expertise in EBN.
The purpose of the study is to examine the dynamic eating behaviors of the Chinese people, focusing on snacking and the choice of cooking methods, and to identify the influences of socioeconomic factors on these eating behav- iors. Data for this study were from the China Health and Nutrition Survey (CHNS). There were 12808 subjects, older than two years (y), from the 1991 and 11527 from the 2004 surveys respectively. Logistic regressions of pooled data were performed to evaluate how socioeconomic status (SES) was associated with two eating behav- iors: snacking and consuming excessive amounts of fried foods. Simulation techniques were used to clarify the effects of the results that included significant interaction terms. Results showed that the rapid shift in the food and nutrient profile of the Chinese population is accompanied by equally profound changes in meal and cooking pat- terns. Snacking behavior is beginning to emerge and there are shifts away from the steaming and boiling of food to the, less healthy, frying of food. Income is positively associated with the consumption of both snacks and ex- cessive fried food. Urban residents are also more likely to snack and to consume excessive amounts of fried foods than rural residents. These findings indicate that eating behaviors are beginning to change rapidly toward less healthy options in China. SES plays a vital role in the early stages of the eating behavior transition in China. Fu- ture health promotion programs targeting the higher-SES population will exert far-reaching effects on the im- provement of health status in this group.
Purpose of present study is to describe the prevalence and trend of overweight and obesity, as well as its co- existence with stunting, among youngsters in China, from 1982 to 2002. Data from children 7-17 years of age from three cross-sectional national surveys: “1982 China National Nutrition Survey” (5 334 boys and 4 793 girls), “1992 China National Nutrition Survey” (8 048 boys and 7 453 girls) and “2002 China National Nutrition and Health Survey” (23 242 boys and 21 638 girls) were used in this study. Overweight and obesity were defined ac- cording to age, sex specific BMI cut-off points from the International Obesity Task Force, while stunting was de- fined as height-for-age below -2 standard deviation from the NCHS/WHO reference median value. Results: Overweight prevalence of Chinese youngsters was 1.2%, 3.7% and 4.4%, while the obesity prevalence was 0.2%, 0.9% and 0.9% in 1982, 1992 and 2002, respectively. Both the overweight and obesity prevalence and their in- crement were higher among boys in urban areas. In 1982, 28.4% of overweight and 69.6% of obese youngsters were stunted, this decreased to 22.0% and 46.4% in 1992, and then to 5.7% and 7.7% in 2002, respectively. Conclusion: The prevalence of overweight and obesity in Chinese youngsters were low in 1982. There has been a rapid increase since then. If this trend continues, overweight will soon reach epidemic proportions. Stunting among overweight and obese youngsters decreased dramatically at the same time.
Objective: To identify demographic and lifestyle risk factors for excess body fatness in a multiethnic sample of New Zealand children. Design: Cross-sectional study. Participants: A total of 1229 European, Polynesian, Asian, and ‘Other’ children aged 5-11 y (603 male, 626 female) living in New Zealand. Measurements: Percentage body fat (%BF) was measured using hand-to-foot bioelectrical impedance analysis, and overfat participants were defined as those with a %BF greater than 25% (boys) and 30% (girls). A parent proxy questionnaire was devel- oped for assessing demographic and lifestyle factors, and multiday memory pedometers were used to estimate physical activity levels over five days. Results: After controlling for differences in sex, age, and socioeconomic status (SES), Asian children were more likely to have excess body fat than European children. The adjusted odds of overfat also increased with age and decreased with SES. Three lifestyle risk factors related to fat status were identified: low physical activity, skipping breakfast, and insufficient sleep on weekdays. Clustering of these risk factors resulted in a cumulative increase in the prevalence of overfat. Active transport, sports participation, lunch bought at school, fast food consumption, sugary drink consumption, and weekend sleep duration were not associ- ated with fat status after adjustment for the selected demographic variables. Conclusion: The findings from this study enhance our understanding of the risk factors for excess body fatness in New Zealand children, and high- light key demographic and lifestyle priorities for future interventions.
Aim: To examine the kinds of changes parents would like to see in those settings where children spend time (kindergartens and schools, child care centres and after-school care facilities, and the local neighbourhood) in policies and practices that impact on children’s risk of obesity, and to establish whether parents might be willing to advocate for changes in these settings. Materials and Methods: 175 parents from five randomly selected pri- mary schools and five randomly selected kindergartens located in suburbs of metropolitan Melbourne completed a questionnaire in which they rated the importance of a number of potential changes to promote healthy eating and increase physical activity in their children. Results: Parents of children in kindergarten most commonly rated changes to the eating environment as important. In contrast, parents of primary school children believed changes related to both eating and physical activity in school were important. Ninety-five per cent of parents of kinder- garten children and 89% of parents of primary school children believed it was possible for parents to bring about change to provide more opportunities for their child to eat more healthily and be more physically active. One in four parents reported that they had thought about or had tried to bring about changes in their community. Conclu- sions: The findings suggest that mobilising parents to take an active role in advocating for change in those set- tings that have the potential to shape their children’s physical activity and eating behaviours may be feasible.
Objective: To evaluate the association between green tea consumption and the risk of gastric cancer. Methods: Electronic search of the Cochrane Library, MEDLINE, EMBASE and Chinese Bio-medicine Database, which have articles published between (1966 and 2006), was conducted to select studies for this meta-analysis. Results: This meta-analysis included 14 epidemiologic studies, with a total number of 6123 gastric cancer cases and 134006 controls. The combined results based on all studies showed that green tea consumption was not associ- ated with the risk of gastric cancer [odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.77-1.24]. The sum- mary OR from all population-based case–control studies showed a minor inverse association between green tea consumption and risk of gastric cancer (OR = 0.68, 95% CI = 0.49-0.92), while no associations were noted from hospital-based case–control studies (OR = 1.12, 95% CI = 0.70-1.77) and cohort studies (OR = 1.56, 95% CI = 0.93-2.60). No associations were noted both in males (OR = 1.10, 95% CI = 0.76-1.60) and females (OR = 0.99, 95% CI = 0.64-1.51). The summary OR from seven studies suggest that the highest consumption level of green tea was more than 5 cups per day and no associations were noted (OR = 0.99, 95% CI = 0.78-1.27). Conclusions: The results of this meta-analysis indicated that there is no clear epidemiological evidence to support the sugges- tion that green tea plays a role in the prevention of gastric cancer.
A longitudinal study was conducted to validate a 68-item semi-quantitative food-frequency questionnaire (FFQ) for assessing nutrient intake among pregnant women in rural China. The interview administrated FFQs were con- ducted at the start of the third trimester (FFQ1) and repeated three months later prior to delivery (FFQ2), and compared with six repeated 24-hour recalls collected between the FFQs. From June to September 2004, 125 women at 23 to 26 weeks of gestation were recruited into the study in two rural counties in Shaanxi province, China. Pearson correlation coefficients for crude nutrients assessed by FFQ1 and FFQ2 had a mean of 0.46, and ranged from 0.31 for thiamin to 0.61 for fat. Pearson correlation coefficients estimated by FFQ2 and 24-hour re- calls had a mean of 0.62 for all nutrients, and ranged from 0.53 for cholesterol and carotene to 0.70 for α-vitamin E and potassium. De-attenuated coefficients had a mean of 0.69 for all nutrients, and ranged from 0.58 for choles- terol to 0.77 for α- vitamin E. Bland-Altman plots revealed significant relationships between the difference and the average of the two methods with larger differences at higher average intakes. On average, 74% of participants were classified into the same or adjacent nutrient intake quintiles, while 1% were grossly misclassified to oppo- site quintiles. In conclusion, this FFQ has adequate reproducibility and validity for most nutrients but would benefit from the addition of wheat porridge to ensure it is suitable for assessing dietary intake in pregnant women in rural China.
Purpose: To develop Food Frequency Questionnaires (FFQs) and nutrient databases for urban and rural Indian populations with diverse dietary habits for the PURE (Prospective Urban and Rural Epidemiological) pilot study. Procedure: 24 hour dietary recalls were obtained from 84 rural and 60 urban subjects. From a comprehensive food list, separate FFQs were developed for the two groups. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. The FFQs were piloted in 80 urban and 77 rural subjects. Separately for each group, a stepwise regression method was used to identify foods contributing to a cumulative 90 % of variance to total energy intake. Nutrient and food group in- takes were compared using an independent t-test. Main Findings: The urban and the rural FFQs contained 129 and 102 foods respectively, of which 82 foods were common to both. Fourteen urban foods and eight rural foods explained a cumulative 90% of variance for total energy intake. Daily intakes for most nutrients and food groups were two to three fold higher in the urban than in the rural group. Conclusions: In Indian populations with di- verse dietary habits, using standard methods to develop separate FFQs can capture dietary intakes adequately. To develop nutrient databases, substitution of local food composition tables with data from other sources using stan- dard methods to match foods can be adopted.
Increased plasma homocysteine (Hcy) is a significant and independent risk factor for cardiovascular disease. It can cause multi-disease manifestations such as smooth muscle proliferation, premature occlusive vascular dis- ease, progressive arterial stenosis, haemostatic changes, placental vasculopathy, spontaneous early abortion, birth defects, impaired cognitive function and dementia. This review paper summarizes the role of elevated Hcy levels in cardiovascular and other diseases and the molecular mechanisms and pathophysiology involved in the deleterious manifestations of hyperhomocysteinemia. We have collected data from MEDLINE, Current Contents and scientific journals, which included 112 publications from 1932 to 2007. Cardiovascular pathophysiology in hyperhomocysteinemia is a complicated process, possibly due to direct toxicity of Hcy on tissues, low S- adenosylmethionine, high S-adenosylhomocysteine or thrombotic events triggered by stimulation of procoagu- lant factors and suppression of anticoagulant factors and platelet activation, thereby enhancing oxidative stress, smooth muscle cell proliferation, formation of reactive oxygen species, hypomethylation, induction of unfolded protein responses and extracellular matrix modification. The mechanisms involved in the increased risk of car- diovascular disease still remains a mystery in many respects, and more studies are needed to elucidate this asso- ciation.
In addition to modern medicinal therapy, many cancer patients in Taiwan are treated regularly with herbal medi- cines or prescribed a traditional herbal diet. In this paper, the effect of a Taiwanese traditional herbal diet (TTHD) on pain in terminal cancer patients was investigated. A total of 2,466 patients diagnosed with a variety of cancers were included. The most common patient-reported symptoms included troublesome pain (79.2%), weakness (69.0%), anorexia (46.4%), fever (36.5%), dyspnea (31.1%), and leg edema (30.9%). The 2,466 terminal cancer patients included in the study were randomly divided into three groups. The TTHD group (n=1044; 42.3%) were given the TTHD consisting of analgesic herbs (paeony root: licorice root = 1:1) and a Taiwanese tonic vegetable soup (Lilii bulbus, Nelumbo seed, and Jujube fruit). The remaining patients were divided into a reference group, given the regular hospital diet, (n=909, 36.9%) and a control group, given the Taiwanese tonic vegetable soup without analgesic herbs, (n=513, 20.8%). All patients maintained their assigned diets for one week. A verbal numerical scale was used to assess pain. Results revealed that the patients given TTHD reported enhanced pain relief (p < 0.05) compared to the reference and control groups. We found that TTHD could alleviate the pain among terminal cancer patients thereby supporting the supposition that Eastern and Western medicines can be ef- fectively co-administered to enhance terminal patient’s quality of life. Further research is warranted.
The myocardial protective effects of water extracts from Hsian-tsao (Mesona procumbens Hemsl.) on diabetic rats were investigated. Thirty Sprague-Dawley male rats were randomly divided into three groups, “control group” (n=10) with intraperitoneal saline injection, “diabetic group” (n=10) with 60 mg of intraperitoneal strep- tozotocin injection per kg of body weight and “Hsian-tsao group” (n=10) with intragastric administration of Hsian-tsao extracts every day for 4 weeks after intraperitoneal streptozotocin injection. Body weight and blood sugar concentrations were measured before and after model induction in the three groups. Thrombospondin-1 (TSP-1) expressions in the myocardium were monitored by immunohistochemistry and rt-RT-qPCR analysis. Myocardial ultrastructural changes were also analyzed by using transmission electron microscopy. Our results demonstrated that diabetic myocardial ultrastructural changes included myofibrillar disarrangements, mitochon- dria disruption, and an increase in nuclear membrane invaginations. These damages were significantly less se- vere in the Hsian-tsao group compared with the diabetic group. A significant increase of the TSP-1 expression was also observed in the hearts of the diabetic rats (p <0.01), but it was relatively lower in the Hsian-tsao group than in the diabetic group (p <0.01). It suggested that Hsian-tsao treatment in the diabetic rats effectively pre- vented the pathological alterations in the myocardium and decreased TSP-1 expression.
Probiotics have been proposed for the management and prevention of acute diarrhoea in infants. A double-blind, randomised, placebo controlled study was carried out in 224 Chinese infants 6 to 36 months of age with severe acute diarrhoea and free from moderate or severe malnutrition. After oral or parenteral rehydration, they were al- located to one of three groups: a lactose-free formula (Control); the same formula but with viable 108CFU B. lactis Bb12 and 5x107CFU St. thermophilus TH4 per gram of powder and, the same formula with the same mi- croorganisms, but with 109CFU/g and 5x108CFU, respectively. Anthropometric parameters, duration of the di- arrhoea and rotavirus shedding were evaluated. Eighty seven percent of the episodes were associated with rotavi- rus infection. The duration of the diarrhoea was not influenced by the intake of probiotics. However, a decrease of rotavirus shedding was observed in infants fed the formula with 109 Bb12/g, a finding of probable epidemiol- ogical importance in the transmission of this agent.
The objective of the present study was to measure the glycemic index of durian, papaya, pineapple and water- melon grown in Malaysia. Ten (10) healthy volunteers (5 females, 5 males; body mass index 21.18±1.7kg/m2) consumed 50 g of available carbohydrate portions of glucose (reference food) and four test foods (durian, papaya, pineapple and watermelon) in random order after an overnight fast. Glucose was tested on three separate occa- sions, and the test foods were each tested once. Postprandial plasma glucose was measured at intervals for two hours after intake of the test foods. Incremental areas under the curve were calculated, and the glycemic index was determined by expressing the area under the curve after the test foods as a percentage of the mean area un- der the curve after glucose. The results showed that the area under the curve after pineapple, 232±24 mmol×min/L, was significantly greater than those after papaya, 147±14, watermelon, 139±8, and durian, 124±13 mmol×min/ L (p<0.05). Similarly, the glycemic index of pineapple, 82±4, was significantly greater than those of papaya, 58±6, watermelon, 55±3, and durian, 49±5 (p<0.05). The differences in area under the curve and glyce- mic index among papaya, watermelon and durian were not statistically significant. We conclude that pineapple has a high glycemic index, whereas papaya is intermediate and watermelon and durian are low glycemic index foods. The validity of these results depends on the accuracy of the data in the food tables upon which the portion sizes tested were based.
Objectives: To describe the concentrations of serum ferritin among Australian adults by age and sex. Further, the relationships of various social, lifestyle and health factors with serum ferritin concentrations were explored. De- sign: A total of 1634 adults aged >25 years from six randomly selected urban centres in Queensland, Australia participated in the study that was conducted between October and December 2000. Results: Prevalence of de- pleted iron stores, based on low serum ferritin concentration, was 10.6% among females aged <50 years, 2.8% among females aged >50 years and virtually nil among males. In contrast, 16% of the males and 20% of the fe- males aged >50 years had elevated serum ferritin concentrations. Significantly higher serum ferritin concentra- tions were found among females of both age groups who consumed alcohol at a rate of >60 drinks/month, and females aged <50 years who were obese. Lower serum ferritin concentrations were found only among females aged <50 years, with higher education attainment. In multivariable analysis, only the association between higher serum ferritin and obesity was consistent across age-sex groups and statistically significant. Conclusion: Iron deficiency may be a problem among Australian females of reproductive age. Further research is needed to iden- tify the determinants of low iron concentrations in younger females and elevated concentrations of serum ferritin in males and older females in order to develop preventive measures.
The prevalence of trace elements deficiencies, vitamin A deficiency, anemia, and their relationships were inves- tigated in a cross sectional study involving 243 children aged from 12 to 72 months in rural Vietnam. Serum lev- els of copper, zinc, selenium and magnesium were determined by inductively coupled plasma mass spectrometer and that of retinol by high performance liquid chromatography. Hemoglobin concentration in whole blood was measured by the cyanmethemoglobin method. The prevalence of deficiencies in zinc, selenium, magnesium, and copper was 86.9%, 62.3%, 51.9%, and 1.7%, respectively. On the other hand, 55.6% were anemic and 11.3% had vitamin A deficiency. Deficiency in two or more micronutrient was found in 79.4% of the children. Parame- ters associated significantly with anemia were selenium deficiency (OR 2.80 95% CI 1.63-4.80, p = 0.0002) and serum retinol <1.05 μmol/L (OR 1.83, 95% CI 1.10-3.05, p = 0.021). Magnesium deficiency (OR 3.09 95% CI 1.36-7.03) was found to be a risk factor for zinc deficiency and vice versa. The results indicate that micronutrient deficiencies are prevalent among preschool children in Vietnam. In addition, the results also demonstrate a strong relationship between selenium deficiency and anemia. Clearly, sustainable strategies are urgently required to overcome the problems in the country.