The functions of vitamin D are pleiotropic affecting all body organs and systems in some way. Its adequacy de- pends principally on sunshine for UV light to stimulate its synthesis in skin and on foods which contain it, either animal-derived or obtained from fungi or mushrooms, with the UV-responsive substrates dehydrocholesterol for vitamin D-3 or ergosterol for vitamin D-2, respectively. Thus, vitamin D health is very environmentally depend- ent. With ecosytem degradation, whether by atmospheric pollution or food systems which do not derive UV irra- diation, as with fish farming or mushroom processing, then this nutrient input into human biology may falter. Vi- tamin D deficiency is now common and widespread in North-East Asia as elsewhere. When discovered early in the 20th century it was linked to rickets in children and osteomalacia in adults and, for a generation or so, children were given fish, usually cod, liver oil to prevent bone disease. Now cod as a species and many edible fish are threatened. Over-exposure to sun-light increases the risk of skin cancer. We may tackle this problem by vitamin D supplementation with an alternative to fish liver. But the demographic pressures of population size and ageing (when the skin is less UV responsive) make the clinical and public health decisions and strategies demanding. Vi- tamin D health has become indicative of food security whose usual indicator is food diversity; such diversity may allow lesser concentrations to be more effective in organ and system function, but we have little evidence to sup- port this at present.
The effects of total and regional (trunk, arm, and leg) percent fat on total and regional (arm, leg, rib, thoracic spine, lumbar spine, proximal femur, and pelvis) bone mineral density (BMD) in Korean adolescents were exam- ined using the Fourth Korea National Health and Nutrition Examination Survey, 2009. Percent fat and BMD were measured by dual energy X-ray absorptiometry in a population-based sample of 710 Korean adolescents (365 boys and 345 girls), aged 10-19 years. After adjusting for age, height, weight, serum vitamin D, dietary calcium intake, and menarche for girls in complex sampling linear regression analysis, higher total and regional percent fat were associated with low total BMD and BMD in all regions in boys aged 13-16 years, while the associations were inconsistent for early and late adolescent boys. In girls, the inverse associations were more consistent for those aged 17-19 years than for younger girls. While most of total and regional percent fat were negatively asso- ciated with BMD of thoracic and lumbar spine and femur in boys, most of these relationships were not significant in girls. The negative association with total BMD was consistent for trunk percent fat but variable for arm and leg percent fat according to age subgroup and gender. In conclusion, the unfavorable effect of regional percent fat on all regional BMD is more consistent in boys aged 13-16 years and in girls aged 17-19 years, while the relation- ship appears to be gender and age subgroup-specific.
Objective: A population-based survey was conducted to analyze the association of under-weight, blood pressure, glucose and lipid metabolism with cognitive impairment in people, 60 years and over, living in 2 towns of Shanghai. Methods: Face-to-face interviews were carried out to collect relevant information with questionnaires. Anthropo- metric indices of height, weight, waist circumference (WC) and hip circumference were measured. Multivariable logistic regression analyses were performed to evaluate the association of weight status with cognitive impairment. Results: Cognitive impairment were diagnosed in 198 (7.0%) of the 2 809 participants. Compared to the normal BMI category, the under-weight category was significantly associated with the risk of cognitive impairment (OR= 2.47, 95%CI: 1.46-5.23). Subjects with a high WC were 1.5 times (OR= 1.42, 95%CI: 1.10-2.67) more likely and subjects with a high WHR were 1.7 times (OR= 1.68, 95%CI: 1.05-2.84) more likely to be associated with cogni- tive impairment than the subjects in the reference group. This study demonstrates a significant interaction between hypertension, lipid disorder and WC or WHR on the risk of cognitive impairment in a rural population in Shanghai. Conclusions: Central obesity was significantly associated with the risk of cognitive impairment. A low BMI may be a risk factor for cognitive impairment. A significant interaction between hypertension, lipid disorder and WC or WHR on the risk of cognitive impairment in Shanghai rural population was found.
We investigated the characteristics of dietary supplements and their use by 1,076 Japanese pregnant women, the majority of whom were in mid- to late pregnancy. The subjects completed a self-reported survey on their sociodemographic characteristics, supplement use, and attitudes towards diet. The overall prevalence of supple- ment use did not change before and after pregnancy (75%); however, daily use increased by approximately two- fold with pregnancy (20.2% versus 37.2%). After the onset of pregnancy, supplements containing folic acid were taken for fetal health. Daily users were more likely to be older, have a greater awareness of the risk of neural tube defects (NTD), view supplement use as acceptable, have less diet anxiety, and have more advisers regarding diet. Respondents used supplements containing folic acid alone or with other ingredients. Folic acid intake is recom- mended to reduce the risk of NTD. However, supplement use began after pregnancy recognition, suggesting a lack of knowledge on the appropriate timing of folic acid use. Information about supplements was obtained most- ly from newspapers, magazines, flyers, and stores. These results indicate that more accurate information regard- ing the optimal timing of folic acid intake and the safety of dietary supplements must be disseminated.
This study determined factors of preterm delivery in Taiwan. Healthy women (n=520, age 29.1±4.2 y) at 8–12 weeks of pregnancy were recruited from prenatal clinics. Background information, anthropometrics, biochemical parameters, and dietary intake, collected by 24 h-recall were obtained from the first, second, and third trimesters to delivery. Clinical outcomes of neonates were also collected. The results show that 53.7% of women were primiparous and that the incidence of preterm delivery was 6.2%. Body weight gains in the first trimester and throughout pregnancy were significantly lower in mothers with preterm delivery (preterm group) than in mothers with term delivery (term group, p<0.05). Maternal cholesterol intake, circulating white blood cell counts (WBC) and serum albumin were significantly lower and that serum magnesium and ferritin were significantly higher in the preterm group than in the term group. Maternal weight gain was positively correlated with caloric and nutrient intake (p<0.05). Neonatal birth weight was positively correlated with maternal weight gain and intakes of protein and phosphate during pregnancy; with intakes of calories, vitamin B-1 and B-2 in the first trimester; and with intakes of calcium, magnesium, iron and zinc, as well as circulating WBC in the third trimester. However, neonatal birth weight was negatively correlated with serum iron in the third trimester and with serum iron and ferritin at the time of delivery. In conclusion, maternal weight gain in early pregnancy and WBC, mineral intake and iron status in late pregnancy seem to be major factors affecting delivery and neonatal outcomes.
This study was carried out to investigate the nutritional status and feeding practices of young children in the worst-affected areas of China two years after the Wenchuan Earthquake. The sample consisted of 1,254 children 6-23 months of age living in four selected counties from the disaster-affected provinces of Sichuan, Shaanxi and Gansu. Length-for-age, weight-for-age, weight-for-length, and hemoglobin concentration were used to evaluate nutritional status. Interviews with selected children’s caretakers collected basic demographic information, chil- dren’s medical history, and child feeding practices. Stunting, underweight, and wasting prevalence rates in chil- dren 6-23 months of age were 10.8%, 4.9% and 2.8% respectively, and anemia prevalence was 52.2%. Only 12.3% of children had initiated breastfeeding within the first hour after birth. Overall, 90.9% of children had ever been breastfed, and 87% children 6-8 months of age had received solid, semi-solid or soft foods the day before the interview. The diets of 45% of children 6-23 months of age met the definition of minimum dietary diversity, and the diets of 39% of breastfed and 7.6% non- breastfed children 6-23 months of age met the criteria for mini- mum meal frequency. The results highlight that a substantial proportion of young children in the earthquake af- fected disaster areas continue to have various forms of malnutrition, with an especially high prevalence of anemia, and that most feeding practices are suboptimal. Further efforts should be made to enhance the nutritional status of these children. As part of this intervention, it may be necessary to improve child feeding practices.
This study was conducted to investigate the associations between uterine fibroids and lifestyles including diet, physical activity and stress from October 2009 to April 2011 in China. This case-control study composed of 73 women with uterine fibroids and 210 women without fibroids. Uterine fibroid cases were confirmed by ultra- sound diagnosis or hysterectomy surgery. Information on women’s dietary habits, physical activity and stress sta- tus were collected with a validated self-administered questionnaire. A logistic regression model was used to esti- mate the odds ratios (OR) after controlling for age, gravidity and parity. We found that vegetable and fruit intakes and occupational intensity played positive effects on uterine fibroids. For premenopausal women, vegetable and fruit intakes (OR = 0.5; 95% CI: 0.3, 0.9) and occupational intensity (OR = 0.2; 95% CI: 0.1, 0.6) significantly decreased the risk of fibroids; conversely, BMI significantly increased the risk (OR = 1.2; 95% CI: 1.0, 1.4). However, the associations for postmenopausal women were not significant. Our findings suggested protective roles for vegetable and fruit intakes and occupational intensity on uterine fibroids, and supported the hypothesis that high BMI only increased the risk of uterine fibroids in premenopausal women.
Epidemiologic studies that examine whether isoflavone consumption protects against breast cancer have yielded inconsistent results. The controversy focuses on the effects of the menopausal status and exposure dose of isoflavone. We aim to conduct a meta-analysis on the association between isoflavone intake and breast cancer risk by comprehensively assessing isoflavone exposure in the targeted populations. We searched PUBMED and EMBASE databases for case-control and cohort studies that assess the association between isoflavone intake and breast cancer risk. We extracted relative risks (RR) and odds ratios (OR) of different reported categories of isoflavone intake from each study. Fixed- or random-effects models were used to summarize dose-response data. Twenty-two studies were selected for the meta-analysis. Overall, the results showed that isoflavone reduced the breast cancer risk (a combined RR/OR of 0.68, 95% CI: 0.52-0.89) in Asian populations rather than Western populations (a combined RR/OR of 0.98, 95% CI: 0.87, 1.11) for the high-dose category. Further analysis showed that the intake of isoflavone in postmenopausal Asian women 0.46 (95% CI: 0.28-0.78) was better than premenopausal 0.63 (95% CI: 0.50-0.80) but similar in postmenopausal Western women 1.00 (95% CI: 0.98-1.02) and premenopausal 0.99 (95% CI: 0.87-1.12). Exposure to high isoflavone may be associated with a reduced breast cancer risk in Asian populations, especially in postmenopausal women. However, no significant difference in the studies of Western populations may be due to the low intake of isoflavone levels.
The association between tea consumption and bladder cancer has been confirmed in several animal studies, but one epidemiological study in 2001 showed no association between them. In order to provide an accurate assess- ment of this, we conducted a meta-analysis on tea consumption and bladder cancer risk. Studies were identified by a literature search in PubMed from January 1980 to March 2012 and the reference lists of relevant studies. Random effect models were used to calculate summary relative risk estimates (RR) and their corresponding 95% confidence intervals (CI) based on high contrast to low intake values. Twenty-four publications (6 cohort studies and 18 case-control studies) based on consumption of overall tea, black tea, and green tea to bladder cancer risk were included in this analysis. For overall tea, the summary RR indicated no association between tea consump- tion and bladder cancer (RR= 1.09, 95%CI: 0.85-1.40). In subgroup analyses, we found a moderate increase of bladder cancer risk in smoking group (RR= 1.77, 95%CI: 1.04-3.01). In the black tea group, no statistically sig- nificant association was observed (RR= 0.84, 95%CI: 0.70-1.01). Interestingly, in the subgroup of sex, a protec- tive effect was observed between tea consumption and bladder cancer risk in females (RR= 0.61, 95%CI: 0.38- 0.98). For green tea group, there was no relationship associated with bladder cancer risk (RR= 1.03, 95%CI: 0.82- 1.31). In conclusion, our data suggest that high overall tea intake in smokers increased the risk of bladder cancer, and high black tea intake in females may reduce the risk of bladder cancer.
Australians consume substantially more sodium than recommended. Three quarters of dietary sodium derives from processed food and the growing ready meal category is a significant contributor. This study examined changes in sodium levels of Australian ready meal products between 2008 and 2011. Sodium data were systemat- ically collected from all product labels in the same 5 stores each year. Mean sodium levels were calculated overall and compared between ready meal types, and by major brands. The levels of sodium in new, discontinued and es- tablished products were also compared. There were 107 ready meal products in 2008, 313 in 2009, 219 in 2010 and 265 in 2011. Overall mean sodium content was unchanged between 2008 and 2011 (279 vs 277 mg/100g). There were clear differences between sodium levels of different brands (222 vs 310 mg/100g in McCain Healthy Choice and McCain products respectively) and marked variation in similar products (240 mg/100g in one brand of frozen cottage pie product vs 425mg/100g in another). The mean sodium content of recently introduced prod- ucts was lower than discontinued products (289 vs 309 mg/100g), with the sodium level of established products remaining stable. The absence of any overall reduction in sodium levels of Australian ready meal products is dis- couraging. The failure of voluntary industry efforts to reduce the saltiness of these foods suggests a regulated ap- proach will be required to drive product reformulation.
A questionnaire survey was used to determine the status of nutrition education in Japanese medical schools in 2009. A similar survey was conducted in 2004, at which time nutritional education was determined to be inade- quate in Japanese medical schools. The current questionnaire was sent to the directors of Centers for Medical Ed- ucation of 80 medical schools, who represented all medical schools in Japan. Sixty-seven medical schools (83.8%) responded, of which 25 schools (37.3%) offered dedicated nutrition courses and 36 schools (53.7%) did not offer dedicated nutrition courses but offered something related to nutrition in other courses; six schools (9.0%) did not offer any nutrition education. Overall, 61 schools (91.0%) offered at least some nutritional topics in their under- graduate education. Nevertheless, only 11 schools (16.4%) seem to dedicate more than 5 hours to substantial nu- trition education as judged by their syllabi. Although the mean length of the course was 11 hours, substantial nu- trition education accounted for only 4.2 hours. Of the 25 medical schools that offered dedicated nutrition courses, seven schools offered the nutrition course as a stand-alone course and 18 schools offered it as an integrated course. In conclusion, the status of nutrition education in Japan has improved slightly but is still inadequate.
Double burden of malnutrition (DBMN), the coexistence of under- and overnutrition in the same population, is an emerging public health concern in developing countries, including Thailand. This paper aims to review the ma- ternal and child nutrition situation and trends as the country moved from a low-income to a middle-income coun- try, using data from large scale national surveys. Protein-energy malnutrition and micronutrient deficiencies pre- dominantly affected mothers and children prior to the 1980s. The situation greatly improved during the 1980s- 1990s, with the implementation of multi-sectoral policies and programs focusing on poverty alleviation and pri- mary health care. Economic development, improved access to health services and effective community-based nu- trition programs contributed to these positive trends. However, the prevalence of low birth weight remained at 8- 10%, while stunting and underweight declined to about 10% by the 1990s, with small change thereafter. The prevalence of anemia among pregnant women and children decreased by half and vitamin A deficiency is no longer a public health problem. Iodine deficiency, especially during pregnancy is still a major concern. As the country progressed in terms of economic and social development, overnutrition among women and children af- fected all socio-economic levels. Changes in lifestyles, food access and eating patterns are observed both in urban and rural areas. Although efforts have been made to address these challenges, harmonized policy and strategic programs that address DBMN in the complex social and economic environment are urgently needed. Early life undernutrition should be considered along with measures to address obesity and chronic diseases in children.
Objective: Published data concerning associations between IRS1 variants and type 2 diabetes and related traits have been inconsistent. We examined the relationship between common variants in IRS1, type 2 diabetes, and re- lated traits including insulin resistance, hyperglycemia and DNA damage in the Boston Puerto Rican Health Study. Methods: We genotyped six common IRS1 variants in an adult Puerto Rican population (n=1132) and test- ed for association with risk of type 2 diabetes and related traits. Results: SNPs rs934167 and rs1801123 showed significant association with fasting glucose concentrations (p = 0.005 and p = 0.016, respectively) and rs934167 showed significant association with plasma insulin levels (p = 0.005). Carriers of the rs934167 minor allele had significantly higher HOMA-IR and lower QUICKI (p = 0.001 and p = 0.001, respectively), and a 40% and 58% greater likelihood of being hyperglycaemic or hyperinsulinemic (OR = 1.40 and 1.58; p = 0.013 and 0.002, re- spectively). However, they exhibited only a marginally significant trend towards having type 2 diabetes (OR=1.27, p = 0.077). Furthermore, carriers of the haplotype C-T of the rs934167 and rs1801123 minor alleles showed consistent patterns of associations after correction for multiple testing. In addition, the G972R (rs1801278) minor allele was significantly associated with higher urinary 8-OHdG concentrations (p = 0.020) and plasma CRP levels (p = 0.035). Conclusions: Our results support IRS1 variants associated with type 2 diabetes risk in adult Puerto Ricans. Moreover, we report the novel finding that IRS1 variant G972R (rs1801278) may con- tribute to oxidative DNA damage and inflammation.
Introduction: We had demonstrated that single nucleotide polymorphism (787T>C) in the tissue-nonspecific ALP (TNSALP) gene was associated with the bone mineral density (BMD). BMD was the lowest among TNSALP 787T homozygotes (TT-type) and highest among TNSALP 787T>C homozygotes (CC-type) in postmenopausal women. In the present study, we investigated the effects of the TNSALP genotype on associations among serum bone- specific alkaline phosphatase (BAP), serum calcium, and phosphorus in healthy young Japanese subjects. Methods: Young healthy adult subjects (n=193) were genotyped for the polymorphism, and we measured the levels of serum BAP, serum calcium, and phosphorus. Dietary nutrient intakes were calculated based on 3-day food records before the day of blood examinations. Results: Grouped by the TNSALP genotype, a significant negative correlation be- tween serum BAP and phosphorus was observed in 787T>C homozygotes (CC-type), but not in heterozygotes (TC- type), nor in 787T homozygotes (TT-type). Conclusions: In the present study, we revealed that the single nucleotide polymorphism 787T>C in the TNSALP gene had effects on the correlation between serum BAP and phosphorus in young adult subjects. These results suggest that variation in TNSALP may be an important determinant of phos- phate metabolism. Our data may be useful for planning strategies to prevent osteoporosis.
Sound clinical nutrition practice is grounded in evidence and stimulated by research. Yet, there are unanswered questions about food-health relationships. Clinical nutrition involves the identification of nutritional disorders and the motivation to rectify them with all required care. Vitamin D health exemplifies the biomedical, societal and environmental dimensions of clinical nutrition, its science and practice. It depends most of all on access to sun- shine and food and probably represents a paradigm in human health which is still at its beginning. Nevertheless, the problem of its deficiency is much more widespread and common than has been thought since it was first iden- tified as a cause of rickets and osteomalacia. It is now known to spare no body organ or system. The problem in North-East Asia is comparable to much of the rest of the world, but the risk profile for it is exaggerated by at- mospheric pollution, cultures with sun-avoidance on account of skin colour and potentially mitigated by food- stuffs like fish, eggs, organ meats and mushrooms which can partially offset sunshine-deficiency. Diagnosis re- quires a high index of suspicion and confirmation by biochemistry which may not be affordable. Therefore a close working relationship between public health and clinical nutritionist is essential.
A number of prominent people have advocated eating less meat or becoming a vegetarian to reduce global warm- ing, because cattle produce the greenhouse gas methane. This raises a number of questions including: what will happen to the grasslands that much of the world’s cattle currently graze; how will alternate protein be produced, and what will the greenhouse consequences of that production be? It comes down to production systems. About 70 per cent of the world’s agricultural land is grassland, and the only way to produce food from grasslands is to graze ruminants on it. If domesticated animals do not graze the grasslands, native or feral ruminants, which also produce methane, tend to move in. Feeding high quality grain to cattle is much less defensible. Replacing animal protein with plant proteins like soybeans necessitates more cropping land, water, fuel and chemicals being used. A more rational food system would raise cattle on grasslands but not feed them high quality grains. Instead more of the currently grown crop could be devoted to human consumption.
Background: The purpose of this study was to investigate the relationship between salt intake and urinary salt ex- cretion and to examine the validity of a self-monitoring device for estimating 24-h urinary salt excretion from overnight urine samples. Methods: Twelve young, healthy female volunteers consumed test meals from days 1 to 14 and estimated urinary salt excretion on days 2–15 by using a self-monitoring device. The salt content of the test meals was as follows: 10 g (days 1–5), 6 g (days 6–8), 13 g (days 9–11), 6 g (day 12), 13 g (day 13), and 6 g (day 14). Results: The average 24-h urinary salt excretion (the ratio of urinary salt excretion to salt intake of the previous day) estimated from the overnight urine samples was as follows: 8.01±1.15 g (0.73±0.11) on days 2–6, 5.86±0.85 g (1.01±0.15) on days 7–9, 9.69±1.64 g (0.74±0.13) on days 10–12, 6.51±1.56 g (1.03±0.25) on day 13, 8.60±3.25 g (0.71±0.14) on day 14, and 6.28±1.31 (1.05±0.22) on day 15. Thus, the salt excretion/salt intake ratio was approximately 0.8 during the high-salt phase and 1.0 during the low-salt phase. Conclusion: The estimation of 24-h urinary salt excretion from overnight urine samples by using a self-monitoring device is a reasonably val- id method in this young and healthy female population for detecting daily changes in salt intake.
The aim of this study was to evaluate the effect of consuming gilthead sea bream fillets, with different n-6/ n-3 ratios, on atherosclerotic biomarkers. Twenty healthy subjects were included in a randomised single-blinded cross-over trial. Participants were randomized into 2 groups, both of which received approximately 630 g per week of gilthead sea bream fed with either 100% fishmeal (FM) or partial replacement with plant proteins (PP) over two consecutive 10 week periods, respectively. Group A consumed firstly the FM fillets followed by the PP fillets, whereas the reverse order was adopted for group B. Group A reported a significant decrease of 29.3% (∆ = –26 mg/dL) in total cholesterol after the first phase of the intervention, before returning to baseline levels after the dietary intervention with fish fed with PP. Similarly, in group A, both LDL-cholesterol and triglycerides de- creased significantly by 21.6% (∆ = –19 mg/dL) and 11.7% (∆ = –10.7 mg/dL), respectively, before increasing again after the intervention. Improvements in the inflammatory cytokines, interleukin-6 and -8 were also noted. Moreover, whole blood viscosity appeared significantly improved in group A, as seen by a significant increase of 7.59% (∆ = +4.59 mPA) for erythrocyte filtration rate. In conclusion, similar EPA+DHA content with different n- 6/n-3 ratio fish flesh intake was shown to have varied affects on lipid, inflammatory and haemorheological pa- rameters in a group of healthy subjects.
Background: This research was performed to determine the prevalence of iodine deficiency disorder (IDD) and the effects of iodized salt supplementation on thyroid status amongst Orang Asli in Hulu Selangor, Malaysia. Methods: Study respondents were from three target groups, i.e. pre-school children (PSC), primary school-going children (SGC) and adult women. Each household was supplied with iodized salt fortified with iodate fortificant for a period of 12 months and the iodine levels in the salt ranged from 20 to 30 μg/L. Samples collected before and after 6 and 12 months of introduction to iodized salt were urine from all groups, as well as serum samples from adult women. Results: A total of 200 respondents were recruited; 58 (29.0%) PSC, 65 (32.5%) SGC and 77 (38.5%) adult women. The median urine-iodine concentration (mUIC) in all groups were of moderately low be- fore the iodized salt intervention, but increased significantly in all study groups after 6 and 12 months of interven- tion. However, at the end of the study, there was an increase in severe iodine deficiency (mUIC <20 μg/L) from 7.5% to 12% and about 9% of PSC and SGC respondents had mUIC level of more than 300 μg/L while the adult women showed a significant increase in free triiodothyronine (fT3) levels. Conclusion: The study demonstrated that iodized salt supplementation was able to show an improvement in iodine level amongst Orang Asli. However, an increase in severe iodine deficiency and iodine excess indicated that the iodized salt programme needs to be carefully monitored.
Preoperative 12.6% oral carbohydrate loading is an element of the Enhanced Recovery After Surgery (ERAS) protocol aimed at alleviating postoperative insulin resistance; however, in Japan, beverages with 18% carbohy- drate content are generally used for preoperative carbohydrate loading. We investigated the effect of 18% carbo- hydrate loading on alleviating insulin resistance. Six healthy volunteers participated in this crossover-randomized study and were segregated into 2 groups: volunteers in the carbohydrate-loading group (group A) who fasted from after 9 pm and ingested 375 mL of a beverage containing 18% carbohydrate (ArginaidWaterTM; Nestle, To- kyo, Japan) between 9 pm and 12 pm, and 250 mL of the same liquid at 6:30 am. Volunteers in control group (group B) drank only water. At 8:30 am, a hyperinsulinemic normoglycemic clamp was initiated. Glucose infu- sion rate (GIR) and levels of ketone bodies and cytokines (IL-1β, IL-6, and TNF-α) before clamping were evalu- ated. P<0.05 was considered statistically significant. Levels of blood glucose, insulin, and cytokines at the start of the clamp were similar in both the groups. The GIR in group A was significantly higher than that in group B (11.5±2.4 vs 6.2±2.2 mg/kg/min, p=0.005), while blood ketone body levels were significantly lower in group A (22±4 vs 124±119 μmol/L, p=0.04). Preoperative 18% carbohydrate loading could prevent the decrease in insulin sensitivity and suppress catabolism in healthy volunteers. Thus, carbohydrate loading with a beverage with 18% carbohydrate content might contribute to improvements in perioperative management.
Background: To assess nutritional status, the prevalence of nutritional risk, and nutritional support in hospitalized patients in Guangzhou, to determine gender or age associated differences in the prevalence of nutritional risk. Methods: A total of 2550 patients admitted during April to December 2008 from six departments (Gastroenterol- ogy, Pulmonology, Neurology, Nephrology, General Surgery and Thoracic Surgery) of four teaching hospitals were screened using the Nutritional Risk Screening 2002 tool. Results: Overall prevalence of undernutrition and nutritional risk was 17.8% and 41.5%, respectively. The department of Pulmonology had the highest prevalence of undernutrition (28.2%) and nutritional risk (55.9%). The prevalence of nutritional risk was significantly higher in patients ≥70 years of age than patients <70 years (64.2% vs 32.6%, p<0.001). No gender difference in the prevalence of nutritional risk was observed in general. In total, 47.6% of “at risk” and 19.4% of “not at risk” pa- tients received nutritional support. Parenteral nutrition accounted for 88.8% of the nutritional support. Conclu- sions: The present study documented the prevalence of nutritional risk defined by NRS2002 and inappropriate as- signment of nutritional interventions in Guangzhou hospitals.
Objective: The aim of our study was to examine the association between the metabolic syndrome (MS) and serum antioxidant status. Methods: A cross-sectional study was conducted with 221 cases and 329 controls aged 18 to 65 years. Weight, height, body mass index, waist circumference, blood pressure, fasting blood glucose and lipids, as well as serum superoxide dismutase, glutathione peroxidase, malondialdehide, vitamins A, E, β-carotene and lycopene were examined. Intakes of antioxidants were also estimated. Results: Mean serum superoxide dismutase activity, β-carotene concentrations were significantly lower, malondialdehide was higher (p<0.05) in persons with the MS (after adjusting for age, sex) than those without. Superoxide dismutase, glutathione peroxidase, and β- carotene also decreased significantly (p<0.05) with increased number of components of the MS. Low levels of se- rum superoxide dismutase activity and β-carotene concentration appeared to be associated with the MS status. Moreover, dietary energy, carbohydrate, vitamin C, zinc and copper intake in the MS patients were lower, but fat intake were higher. Vitamins E, C and manganese intake decreased with the elevated number of the MS compo- nents. For zinc and manganese, a lower risk was observed for other quartile of intake compared with the first one. Inverse links between dietary fat, energy intake and serum antioxidant status were found in MS patients, mean- while dietary vitamin C was positively related with serum antioxidant level. Conclusions: Serum antioxidant sta- tus was associated with a lower prevalence of the MS, and with lower dietary fat, energy intake and higher vita- min C intake.