Objective: to study the effects of different doses of calcium intake on bone health and body composition in Chi- nese adolescents. Methods: a double-blind randomized controlled trial of calcium carbonate supplementation in 257 healthy adolescents aged 12-15 years old for 24 months. Subjects were randomly assigned to four groups re- ceiving chewable calcium carbonate tablets providing elemental calcium at 63 mg/d, 354 mg/d, 660 mg/d, 966 mg/d, respectively. At the end of intervention, we reclassified 197 adolescents into 3 groups who had received actual doses of elemental calcium of 85 mg/d (Low dose), 230 mg/d (Medium dose) and 500 mg/d (High dose). We measured bone mineral content (BMC), bone mineral density (BMD) and body composition by dual-energy X-ray absorptiometry. Results: BMC and BMD of total body and lumbar spine were increased significantly in both males and females after intervention at all doses (p<0.05). In males, after supplementation, total body BMC in the medium and high dose groups (2464 g and 2437 g, respectively) was significantly higher than that in the low dose group (2321 g) after adjusting for age, pubertal development, BMI, physical activity and energy intake; in addition, lean body mass in the medium and high dose groups (49.1 kg and 48.8 kg, respectively) was signifi- cantly higher than that in the low dose group (46.7 kg) (p<0.05). There was no significant effect of calcium sup- plementation on bone mass or body composition in females. Conclusions: calcium supplementation more than 230 mg/d for two years can improve bone mineral accretion and lean body mass in Chinese male adolescents.
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.
Objective: This study was designed to measure the urinary iodine excretion of volunteers who daily consumed iodized salt and to evaluate whether the current iodine content in salt is appropriate. A field trial study was then conducted to determine how the salt iodization content should be adjusted, either to prevent iodine deficiency or to avoid excess consumption. Methods: A total of 1,099 volunteers from 399 households from urban and rural regions were selected. The levels of salt iodine and urinary iodine were measured prior to the field trial. All the households were randomly divided into four groups according to different salt iodine concentrations: group A, 6±2 mg/kg; group B, 15±2 mg/kg, group C, 24±2 mg/kg; and group D, 34±2 mg/kg. The urinary iodine levels of households were determined over five consecutive days, starting on the 27th day after the intervention. Results: Before the intervention, the median urinary iodine excretions for urban and rural residents are 294 μg/L and 509 μg/L, respectively. By contrast, urinary iodine excretion in all groups significantly declined after the intervention. The median excretions of urinary iodine on the 28th day after the intervention for all groups were 97.2 μg/L, 199 μg/L, 249 μg/L and 331 μg/L for urban residents, and 101 μg/L, 193 μg/L, 246 μg/L and 308 μg/L for their rural counterparts, respectively. Conclusions: The trial exhibits a tendency of slightly excessive iodine intake among the households under the currently recommended standard.
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.
Calcium loss after menopause increases the risk of osteoporosis in aging women. Soymilk is often consumed to reduce menopausal symptoms, although in its native form, it contains significantly less calcium than cow’s milk. Moreover, when calcium is added as a fortificant, it may not be absorbed efficiently. This study compares cal- cium absorption from soymilk fortified with a proprietary phosphate of calcium versus absorption from cow’s milk. Preliminary studies compared methods for labelling the calcium fortificant either before or after its addi- tion to soymilk. It was established that fortificant labelled after it was added to soymilk had a tracer distribution pattern very similar to that shown by fortificant labelled before adding to soymilk, provided a heat treatment (90 ̊C for 30 min) was applied. This method was therefore used for further bioavailability studies. Calcium ab- sorption from fortified soy milk compared to cow’s milk was examined using a randomised single-blind acute cross-over design study in 12 osteopenic post-menopausal women aged (mean ± SD) 56.7±5.3 years, with a body mass index of 26.5±5.6 kg/m2. Participants consumed 20 mL of test milk labelled after addition of fortifi- cant with 185 kBq of 45Ca in 44 mg of calcium carrier, allowing the determination of the hourly fractional cal- cium absorption rate (α) using a single isotope radiocalcium test. The mean hourly fractional calcium absorption from fortified soymilk was found to be comparable to that of cows’ milk: α = 0.65±0.19 and α =0.66±0.22, p>0.05, respectively.
Background: Mandatory fortification of bread with iodised salt is proposed to address the re-emergence of iodine deficiency in Australia and New Zealand. The impacts of fortification require baseline data of iodine status among vulnerable sectors of the population. Objective: To assess the iodine status of healthy women and to in- vestigate consumer understanding and attitudes related to the proposed mandatory iodine fortification pro- gramme. Design: Cross-sectional sample of 78 non-pregnant women aged 20-55 y was conveniently sampled in Wollongong, NSW. A single 24-hr urine sample was collected for urinary iodine concentration (UIC). A self- administered questionnaire assessed consumer understanding, perceptions and attitudes related to iodine fortifi- cation. Outcomes: Median UIC = 56 μg/L (IQR = 41-68), indicating mild iodine deficiency. Knowledge about iodine was poor with less than half associating low iodine status with adverse pregnancy outcomes. Health edu- cation and supplementation, particularly at the medical practitioner interface, was considered the best strategy for improving low iodine levels. Conclusions: The iodine status of women in one region of New South Wales was low. These data add support to the need for a national approach to address iodine intake which includes an accompanying consumer education campaign.
Background: Dietary sodium, the major source being salt, is associated with hypertension. Australian adults con- sume more than the recommended amount of salt and approximately 15% of dietary sodium comes from salt added at the table and during cooking. Objective: To determine the frequency of and the demographic character- istics associated with discretionary salt use. Design: A cross sectional survey conducted in shopping centres within Metropolitan Melbourne. Participants completed a questionnaire assessing discretionary salt use and atti- tudes to salt intake. Outcomes: Four hundred and seventy four surveys were collected (65% female, 77% Cauca- sian, 64% holding a university qualification). Eighty nine percent of respondents were classified as salt users and 11% as non-salt users. Of the salt users 52% reported that they always or sometimes add salt during cooking and at the table. Those of Asian descent and younger respondents aged 18-24 years were more likely to be salt users (χ2=12.3, df=2, p<0.001; χ2=19.2, df=5, p<0.01). Conclusion: Discretionary salt use remains high. To success- fully reduce population dietary salt intake public health campaigns are urgently required and need to include consumer advice to reduce discretionary salt use, whilst reducing the salt added to processed foods. Such cam- paigns should include younger age groups and should be appropriate for all ethnic backgrounds to raise the awareness of the risks of a high salt diet on health.
This study estimated prevalence, awareness, treatment, and control rates of cardiovascular risk (CV) defined as hypercholesterolemia, hypertension, and diabetes from 1998 to 2007 among Koreans. Data using self-report or screening examination were obtained from the Korean National Health and Nutrition Examination Survey (KNHANES) conducted in 1998, 2001, 2005, and 2007, for the 30-79 year age range. The age-adjusted preva- lence of hypercholesterolemia slightly increased across the surveys, while those values of hypertension and dia- betes revealed decreasing trends. Awareness and control rates among participants with diabetes and hypertension improved over the period of surveys in both genders, but treatment rate varied among risk factors (24-39% for those with prior diagnosis of hypercholesterolemia, 59-90% for hypertension, and 52-99% for diabetes). In the survey of 2007, participants who achieved target levels made up 67-90% of those who received hypercholes- terolemia treatment, 55-73% of those who received hypertension treatment, and 62-74% of those who received diabetes treatment. Although awareness and control rate of CV risk factors improved across survey periods, strategies for reducing disparity from the assessment and control between CV risk factors will be required.
Yi people are the most primitive society in China. Little information on the metabolic syndrome (MS) is avail- able in Yi people. We explored whether differing lifestyle affected the prevalence of MS among farmers and mi- grants of Yi ethnicity and Han population in one of the Southwestern parts of China. The prevalence of MS among the three populations was described under the same International Diabetes Federation (IDF) criteria. The study populations comprised of 1,535 Yi farmers, 1,306 Yi migrants and 2,130 Han people. The effects of physi- cal activity, obesity and other risk factor on MS were evaluated. Results showed that the age- and sex-adjusted prevalence of MS was 9.9 times higher in Yi migrants (23.8%) and 6.3 times higher in Han people (15.2%) than in Yi farmers (2.4%). In addition, the prevalence of MS increased significantly with age in both sexes, except for a slight increase in Yi farmers. The prevalence of overweight and obesity was much lower in Yi farmers (9.3% in men and 16.5% in women) than that in Yi migrants (46.2% in men and 34.8% in women) and Han people (40.6% in men and 31.9% in women). Levels of physical activity were much greater in Yi farmers than in Yi migrants and Han people. These results indicated that lifestyle had strongly influenced the development of MS in Han and Yi Chinese and our study provided one more piece of evidence imputing that high prevalence of MS might be related to a change in lifestyle associated with urbanization.
Resistant starch (RS) escapes digestion in the small intestine and may ferment in the large intestine. The purpose of this study was to determine the resistant starch content in typical starchy foods and to estimate the daily resis- tant starch intake and identify key sources of dietary resistant starch in the Chinese diets. The resistant starch contents of 121 foods were determined using a method that mimicked gastrointestinal conditions. Tubers and legumes had high resistant starch contents. Rough food processing retained large amounts of resistant starch. In general, the content of RS decreased when foods were cooked. Deep fried and roasted foods had higher levels of resistant starch than braised foods. The average resistant starch intake in the Chinese population was estimated to be 14.9 g per day based on a dietary survey. The main resistant starch sources in the Chinese diet were cereal and tuber products. Based on dietary habits, however, the resistant starch intake varies considerably among indi- viduals.
The Khasi tribal people in India with their distinct ethnic identity have relative geographic isolation from the rest of the country. Although chronic energy deficiency has been documented in this population, their nutritional status has not been re-evaluated following a decade of economic growth in India. In this study, the nutritional status of an ethno-homogenous sample of contemporary Khasi tribal adolescent cohort of age 11+ to 17+ years in the state of Meghalaya, India has been assessed by cross sectional analysis. This was achieved through the use of the following derived anthropometric measurements - total upper arm area (TUA), upper arm muscle area (UMA), upper arm fat area (UFA), and arm fat index (AFI). A total of 670 adolescents (335 boys; 335 girls) par- ticipated in this study. In comparison with North American NHANES 1999-2002 standards, UMA, a measure of upper arm muscle mass, was lower at all age groups in Khasi girls. Conversely, in Khasi boys, AFI, a marker of upper arm fat mass was lower at all age groups, thereby showing a gender dimorphic difference in upper limb muscle and fat proportions. We conclude that in upper arm indirect anthropometry, contemporary Khasi adoles- cent children remain nutritionally deficient with gender dimorphic muscle and fat proportions.
Background: Consumption of low fat dairy foods may decrease the risk of obesity, type 2 diabetes, hypertension, and all cardiovascular risk factors linked with increased probability of cognitive impairment. Aim: To examine associations between dairy intake and self-reported cognitive function and psychological well-being, and to test the novel hypothesis that dairy consumption may benefit cognitive health via its positive effects on cardiome- tabolic health. Methods: Retrospective cross-sectional analyses were undertaken on data from food frequency questionnaires and self-reported health of 432 men and 751 women, aged 39 to 65 years. Health measures in- cluded cardiometabolic health indicators, cognitive and memory functioning, mental health, anxiety, stress, de- pression and self-esteem; assessed by standardised questionnaires. Results: Regression analyses, adjusted for to- tal energy intake and other health confounders, showed that consumption of low fat yogurt was associated with increased quality of memory recall (p=0.029) and greater social functioning (p=0.045) in men. Consumption of low fat cheese was associated with greater social functioning (p=0.021) and decreased stress (p=0.042) in women. Intakes of whole fat dairy products, including ice-cream and cream, were associated with increased de- pression, anxiety, stress, cognitive failures, poorer memory functioning and general health (all p<0.05). There was no association between cardiometabolic health indicators and dairy consumption. Conclusions: Low fat dairy may have beneficial effects on social functioning, stress and memory, while whole fat dairy may be associ- ated with poorer psychological well-being. Dietary intervention trials are needed to establish whether there is a direct effect of dairy consumption on cognitive and psychological health.
Anthropometric assessment is a simple, safe, and cost-efficient method to examine the health status of individu- als. The Japanese obesity classification based on the sum of two skin folds (Σ2SF) was proposed nearly 40 years ago therefore its applicability to Japanese living today is unknown. The current study aimed to determine Σ2SF cut-off values that correspond to percent body fat (%BF) and BMI values using two datasets from young Japa- nese adults (233 males and 139 females). Using regression analysis, Σ2SF and height-corrected Σ2SF (HtΣ2SF) values that correspond to %BF of 20, 25, and 30% for males and 30, 35, and 40% for females were determined. In addition, cut-off values of both Σ2SF and HtΣ2SF that correspond to BMI values of 23 kg/m2, 25 kg/m2 and 30 kg/m2 were determined. In comparison with the original Σ2SF values, the proposed values are smaller by about 10 mm at maximum. The proposed values show an improvement in sensitivity from about 25% to above 90% to identify individuals with ≥20% body fat in males and ≥30% body fat in females with high specificity of about 95% in both genders. The results indicate that the original Σ2SF cut-off values to screen obese individuals cannot be applied to young Japanese adults living today and modification is required. Application of the pro- posed values may assist screening in the clinical setting.
Purpose: This study was designed to explore factors associated with body dissatisfaction among Taiwanese ado- lescents. Methods: Participants were randomly selected from five high schools in Taipei County, Taiwan. A total sample of 883 adolescents aged 12-16 was included. Body mass index (BMI) was calculated using self-reported weight and height. The Contour Drawing Rating Scale was used to assess body dissatisfaction. Other measure- ments included the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation (MBSRQ-AE), the Rosenberg Self-esteem Scale, the Eating Disorder Inventory-Perfectionism, the Socio-cultural Attitudes To- wards Appearance Questionnaire (SATAQ–Internalization and SATAQ–Awareness), and physical activity. Mul- tiple linear regression analyses were performed separately by gender to examine predictors of body dissatisfac- tion. Results: girls reported significantly higher body dissatisfaction, awareness of the socio-cultural ideals (SA- TAQ-Awareness), as well as the internalization of those ideals (SATAQ-Internalization) and lower satisfaction with their physical appearance (MBSRQ-AE). This indicated that girls felt less positive with their overall ap- pearance and had a higher level of recognition and endorsement of the social standards of appearance than boys. Satisfaction with physical appearance (MBSRQ-AE), BMI and internalization of socio-cultural ideals (SATAQ- Internalization) were unique predictors of body dissatisfaction for both genders. Conclusions: this study en- hanced the understanding about body dissatisfaction in Eastern populations. Perceived physical appearance, BMI and internalization of the socio-cultural ideals predicted body dissatisfaction, which are evident in Taiwan, as well as in Western based research. However, these factors only explained a small variance in body dissatisfac- tion for boys, suggesting a need in identifying more factors related to body dissatisfaction among boys.
In many Asian countries, overweight and obese children are sometimes considered healthier than their under- weight or normal weight counterparts. Using Taiwan as an example, this research aims to examine the relation- ship between inappropriate weight and self-rated health (SRH) for adolescents, and inappropriate weight and the parent’s impression of their adolescent’s general health. We analyzed data from 1,879 adolescents (933 boys and 946 girls) from the third year (2003) of a panel survey conducted by the Academia Sinica of Taiwan. Adoles- cents were identified as underweight, normal weight, overweight and obese using body mass index (BMI). Kappa statistic was used to determine agreements between adolescent’s own report and their health as reported by their parent. Logistic regression was used to determine odds of reporting reduced health by adolescents with inappropriate weight. A separate regression was carried out using the parent’s reports for these adolescents. We found that underweight boys were more likely to report reduced health (OR=2.15, p<0.01). Overweight girls had lower odds of reporting reduced health compared with normal weight girls (OR=0.42, p<0.01). Parents were more likely to report reduced health for underweight girls (OR=2.10, p<0.01). For boys, parents were less likely to report reduced health for overweight boys compared with reports for normal weight subjects (OR=0.51, p<0.01). Being underweight is associated with poor perceived health by both the adolescents and their parents. This contrasts with overweight and obesity, which are not. Health educational programs could help in adjusting perceptions concerning the health consequences associated with overweight and obesity.
The aim of this study was to compare the glycaemic index of breads produced using different rising methods and leavening agents. Eleven bread varieties were selected based on method of production, and divided between three groups of ten participants (mean ± SD age 30.0 ± 10.7 years and BMI 22.9 ± 2.8). Standard glycaemic in- dex testing protocol was implemented after an overnight fast, using glucose as the reference food, and collecting blood samples over a two-hour period. Glycemic index was calculated using the usual method. Additionally, in- cremental area under the curve data were log transformed and glycaemic index was calculated using regression analysis. Mean glycaemic index values of the breads in ascending order were as follows: Swiss RyeTM; 60, Long oat; 68, Sourdough+oats; 71, Long rye; 76, Short oat; 77, Short whole meal; 78, Long whole meal; 80, Sour- dough; 82, Short rye; 82, Yeast; 88, and Desem; 92. There were significant differences in mean glycaemic index values between Swiss RyeTM and Yeast (p = 0.010), Swiss RyeTM and Desem (p = 0.007) and Sourdough+oats and Desem (p = 0.043). The rising method and leavening agents used in this study did not impact on the glycae- mic index of the breads tested. Other factors, such as increased bread density, and the addition of whole grains may be required to produce bread with a low glycaemic index.
Low vitamin D status in women of childbearing age may have implications for health. Vitamin D status of New Zealanders (NZ), based on low serum 25-hydroxyvitamin D (25OHD) is suboptimal. Vitamin D status may be improved with supplements and/or fortified foods. Recently an Adequate Intake (AI) for Australia and NZ was set at 5 μg/d vitamin D. We aimed to determine the effect of daily consumption of milk powder fortified with 5 μg vitamin D3 on serum 25OHD concentration over 12 wks. 73 non-pregnant women (18 - 47 y) living in Dune- din, NZ (46°S) were randomised to receive either unfortified (control) or fortified (5 μg vitamin D3) milk for 12 wks from January to April. Mean 25OHD was similar between groups at week 0 (control 74 vs 76 nmol/L) and fell significantly in both groups over the 12 weeks (control 53 nmol/L, fortified 65 nmol/L; p < 0.001). After 12 wks the fortified milk group had a serum 25OHD 19% (95% CI; 7, 32%) higher (10 nmol/L) than the control group after adjusting for baseline levels (p < 0.001). Daily consumption of fortified milk providing the current AI of 5 μg per day vitamin D3 for 12 weeks resulted in higher 25OHD concentrations than control milk. This dose was not sufficient to prevent the seasonal decline in 25OHD. This study suggests an AI of 5 μg may be in- adequate for New Zealanders to allow for seasonal changes in sunlight exposure, and is unlikely sufficient for other populations with low sunlight exposure.
Malnutrition and muscle loss are common in bed-ridden elderly nursing home residents. Supplementation of β- hydroxy-β-methylbutyrate (HMB) has been shown to prevent muscle loss in several catabolic conditions. The aim of this study was to investigate the effect of HMB supplementation on body composition and protein me- tabolism in bed-ridden elderly nursing home residents receiving tube feeding. The subjects were randomly as- signed to HMB (n=39, 2 g/d) or control group (n=40). Anthropometry measurements, blood sampling, and 24-hr urine collection were performed on the day before and 14 days after the start of the study. A subgroup of sub- jects (HMB: n=19, control: n=20) continued the study for another 14 days. Changes in body weight and BMI were not significantly different between the groups after 14 or 28 days after controlling for baseline BMI. Blood urea nitrogen significantly decreased in the HMB group, while it remained unchanged in the control group after 14 days. Urinary urea nitrogen excretion significantly decreased in the HMB group, while it showed a trend of increase in the control group after 14 and 28 days, respectively. Changes in blood urea nitrogen and urinary urea nitrogen excretion were significantly different between the groups after controlling for baseline BMI. This study suggested that HMB supplementation for 2-4 weeks could reduce muscle breakdown in bed-ridden elderly nurs- ing home residents receiving tube feeding.
Background: Rapid changes in dietary patterns and lifestyles in Vietnam warrant monitoring trends of weight, height and body mass index (BMI) among children. Objective: To determine the trends of weight, height and BMI classification of Vietnamese children, 6-15 years of age, from 1992 to 2000 with reference to socioeco- nomic, urban and rural differences. Methods: Data in the Vietnam Living Standard Survey (1992-1993) and the General Nutrition Survey (2000) were collected from representative samples of children. Body mass index clas- sification was determined using the International Obesity Task Force criteria to calculate the prevalence and trends in each survey, and in a pooled survey analysis. Results: Statistically significant increases were seen in children’s mean weight, height and BMI between the two surveys: 2.1 kg for weight, 4 cm for height, and 0.28 kg/m2 for BMI. Increases in height were greater in rural than urban areas, and BMI increases were smaller in ru- ral than urban areas. Conclusions: The rising prevalence of children at risk of overweight in urban Vietnam is a concern that must be monitored to guide policy changes. The unchanging prevalence of rural underweight boys requires attention. A national nutrition program to address under- and overweight for children throughout pri- mary school is needed.
The amino acid citrulline is poorly represented in food, except for the Cucurbitaceae family of fruits (watermel- ons, etc.) and sap from birch trees, which have both been used in the treatment of reproductive disorders for cen- turies. Recently, an interesting observation was published regarding citrulline as a promising candidate bio- marker of abnormal embryogenesis. Our study was undertaken to investigate the involvement of newborn citrul- line concentrations as potential risk factors for orofacial clefting. We performed a retrospective analysis of citrul- line concentrations obtained from the results of a newborn screening program. The study group consists of 52 children with isolated cleft lip with or without cleft palate. One hundred and seven healthy children without con- genital anomalies serve as controls. Whole blood citrulline levels were measured using tandem mass spectrome- try. Two cut-off points of citrulline concentrations were accepted and three groups of participants were analysed: those with (1) low concentrations (<8 μmol/L), (2) medium concentrations (8 - 16 μmol/L), and (3) high concen- trations (>16 μmol/L). Low citrulline levels were significantly more frequent in patients with clefts than in chil- dren without congenital anomalies. In the control group, a high level of citrulline was observed nearly two times more often than in affected children (p=0.03). The presented findings, confirming a possible association between newborn citrulline status and the risk of an orofacial cleft, call for further studies in this area and consideration of increased consumption of foods rich in citrulline (or supplements) by women of childbearing age.