The inseparability of people from their ecosystem without biological change is increasingly clear. The discrete species concept is becoming more an approximation as the interconnectedness of all things, animate and inani- mate, becomes more apparent. Yet this was evident even to our earliest Homo Sapiens sapiens ancestors as they hunted and gathered from one locality to another and migrated across the globe. During a rather short 150- 200,000 years of ancestral history, we have changed the aeons-old planet and our ecology with dubious sustaina- bility. As we have changed the ecosystems of which we are a part, with their opportunities for shelter, rest, ambu- lation, discourse, food, recreation and their sensory inputs, we have changed our shared biology and our health prospects. The rate of ecosystem change has increased quantitatively and qualitatively and so will that of our health patterns, depending on our resilience and how linear, non-linear or fractal-like the linkage. Our health- associated ecosystem trajectories are uncertain. The interfaces between us and our environment are blurred, but comprise time, biorhythms, prokaryotic organisms, sensory (auditory, visual, tactile, taste and smell), movement, endocrine with various external hormonal inputs through food and contaminants, the reflection of soil and rock composition in the microbes, plants, insects and animals that we eat (our biogeology) and much more. We have sought ways to optimise our health through highly anthropocentric means, which have proven inadequate. Accu- mulated ecosystem change may now overwhelm our health. On these accounts, more integrative approaches and partnerships for health care practice are required.
Sleep deficiency is becoming widespread in both adults and adolescents and is accompanied by certain behaviors that can lead to obesity. This study aims to investigate differences in sleep duration of overweight/obese and normal weight groups, and the association between sleep deprivation and obesity, dietary intake and physical ac- tivity. A cross-sectional study was conducted among 226 Iranian working adults (109 men and 117 women) aged 20 to 55 years old who live in Tehran. Body weight, height, waist and hip circumferences were measured, and BMI was calculated. Questionnaires, including the Sleep Habit Heart Questionnaire (SHHQ), International Phys- ical Activity Questionnaire (IPAQ) and 24-hour dietary recall, were interview-administered. Subjects were cate- gorized as normal weight (36.3%) or overweight/obese (63.7%) based on WHO standards (2000). Over- weight/obese subjects slept significantly (p<0.001) later (00:32±00:62 AM) and had shorter sleep duration (5.37±1.1 hours) than normal weight subjects (23:30±00:47 PM and 6.54±1.06 hours, respectively). Sleep dura- tion showed significant (p<0.05) direct correlations to energy (r = 0.174), carbohydrate (r = 0.154) and fat intake (r = 0.141). This study revealed that each hour later in bedtime (going to bed later) increased the odds of being overweight or obese by 2.59-fold (95% CI: 1.61-4.16). The findings in this study confirm that people with shorter sleep duration are more likely to be overweight or obese; hence, strategies for the management of obesity should incorporate a consideration of sleep patterns.
This analysis aims to examine factors associated with delayed initiation and non-exclusive breastfeeding in Indo- nesia. Data were derived from the 2002/2003 and 2007 Indonesia Demographic and Health Survey. Information from 12,191 singleton live-born infants aged 0-23 months was used to examine factors associated with delayed initiation of breastfeeding. Furthermore, information from 3,187 singleton live-born infants aged 0-5 months was used to identify factors associated with non-exclusive breastfeeding. Associations between potential predictors and study outcomes were examined using logistic regression. Our study found that infants from high household wealth-index had significantly increased odds of both delayed initiation and non-exclusive breastfeeding. Other factors associated with an increased odds of delayed initiation of breastfeeding included infants from Sumatera region (OR=1.64, 95% CI: 1.38-1.95), Caesarean-section deliveries (OR=1.84, 95% CI: 1.39-2.44) and deliveries in government-owned (OR=1.38, 95% CI: 1.08-1.76) and non-health facility (OR=1.20, 95% CI: 1.00-1.43). Oth- er factors associated with an increased odds for non-exclusive breastfeeding included parents who were in the workforce (OR=1.37, 95% CI: 1.06-1.78) and mothers with obstetric complication at childbirth (OR=1.35, 95% CI: 1.05-1.74). However, the odds reduced for infants from Eastern Indonesia (OR=0.64, 95% CI: 0.49-0.85). Poor breastfeeding practices are associated with environmental, socio-economic, pregnancy-birthing characteris- tics and maternal health services factors. Efforts to promote breastfeeding practices should be conducted compre- hensively to target population at risk for poor breastfeeding practices.
Laos is a low-income food-deficit country with pockets of high levels of wasting in the highland areas. We im- plemented a 3-year health/nutrition project in 12 villages in the highlands of Savannakhet province to reduce acute malnutrition in children. Volunteer nutrition teams in each village monitored child growth and promoted healthy feeding practices; a multisectoral district committee conducted monthly outreach to assess child growth, manage acute malnutrition and deliver primary health care services. We conducted a cross-sectional assessment before project activities began and at the end of the project. The baseline survey randomly sampled 60% of all households; the endline assessment aimed to survey all eligible registered participants. Anthropometric measures were taken from children aged 6-59 months; mothers with children aged <12 months were asked about infant feeding practices, antenatal and post-partum care; and child immunizations were recorded for children aged be- tween 0-23 months. At baseline, 721 households were sampled, while the endline assessment surveyed between 82% and 100% of eligible participants in each age group. Acute malnutrition reduced from 12.4% (95% CI: 10.4- 14.3) to 6.1% (4.9-7.3). Unhealthy feeding practices declined: in 2008, 40.0% (34.7-45.3) of mothers breastfed their newborn within 2 hours of birth and 30.8% (25.7-35.8) threw the colostrum away; in 2011, these figures were 72% and 8% respectively. Maternal care and child immunisation coverage also improved. Improving the health environment and child feeding practices appears to have markedly reduced the level of wasting. Unsafe feeding practices were common but readily changed by the community-based nutrition teams.
OBJECTIVE: This study investigated Taiwanese elementary school students’ status in terms of body size, body satisfaction and disturbed eating tendencies. METHODS: In a cross-sectional survey, 1,261 elemen- tary school children from grades four to six participated in this study. We used an anonymous self- reported questionnaire, which included: demographics and body satisfaction; Children’s Eating Attitude Test -26 (ChEAT-26); Nowicki-Strickland Locus of Control Scale; and Influence of Significant Others Scale and Media Impact Scale. RESULTS: We found that 58.4% of the children were of normal weight, and 32.7% of the boys and 22.2% of the girls were over-weight or obese. Moreover, 39% of the children wanted to be thinner. The mean ChEAT-26 score was 8.71±8.35, and 10.5% of the children were at high risk for disturbed eating tendencies (ChEAT-26≥20), including 8.4% of the boys and 12.6% of the girls. Scores on the ChEAT-26, Nowicki-Strickland Locus of Control Scale, Influence of Significant Others Scale and Media Impact Scale were positively correlated. The level of external control and the influence of significant others and the media were significantly higher in children with disturbed eating attitudes than in those without them. Multivariable logistic regressions showed that disturbed eating attitudes were associated with body satisfaction, locus of control, and the level of influence of significant others and the media. Conclusions: Disturbed eating behaviors exist among elementary school students in Taiwan. This survey highlights the need for education in acquiring healthy mental attitudes and eating behaviors by el- ementary school students.
We aimed to prospectively examine the association between the combined effects of obesogenic behaviors on quality of life (QOL) in adolescents. Of 2353 Sydney schoolchildren surveyed (median age 12.7 years), 1,213 were re-examined 5 years later at age 17-18. Children completed activity and food-frequency questionnaires. An unhealthy behavior score was calculated, allocating 1 point for the following: <60 minutes of total physical ac- tivity/ day; ≥2 hours of screen time/ day; consumed salty snack foods and/or confectionery ≥5 times per week; ≥1 serves of soft drinks and/or cordial/ day; and not consuming both ≥2 serves of fruit and ≥3 serves of vegetables/ day. Health-related QOL was assessed by the Pediatric Quality of Life Inventory (PedsQL). The prevalence of 0, 1, 2, 3, 4, and 5 lifestyle risk factors was 4.2%, 17.1%, 30.7%, 30.5%, 13.9% and 3.6%, respectively. After mul- tivariable-adjustment, children engaging in 5 versus 0 unhealthy behaviors had 9.2-units lower PedsQL physical summary score (ptrend=0.001), five years later. Boys reporting 4 or 5 lifestyle risk factors compared to their peers reporting none or one at baseline, had lower total and physical summary scores at follow-up, ptrend=0.02 and 0.01, respectively. Girls engaging in 4 or 5 versus 0 or 1 unhealthy behaviors, had 4.6-units lower physical summary score (ptrend=0.04), five years later. The number of obesogenic lifestyle risk factors was independently associated with subsequent poorer QOL, particularly physical health, during adolescence. These findings underscore the im- portance of targeting lifestyle behaviors to promote general well-being and physical functioning in adolescents.
Objective: The purpose of this study is to find out the association between eating breakfast, breakfast patterns, and the metabolic syndrome. Methods: We used the fourth Korean National Health and Nutrition Examination Survey from 2007 to 2009. A total of 16,734 subjects were included. Breakfast dietary patterns were extracted by factor analysis. Multiple logistic regression was used to assess the relationship between breakfast consumption, breakfast dietary patterns, and the metabolic syndrome. Results: We found that breakfast consumption itself re- duced the risk of the metabolic syndrome (odds ratio=0.82, 95% confidence interval=0.69-0.98). We identified two breakfast dietary patterns: the traditional Korean pattern and the dairy-cereal pattern. The dairy-cereal pattern was associated with a reduction in the risk of the metabolic syndrome among breakfast consumers. Compared to no breakfast consumption, the strongest traditional Korean pattern and the highest quartiles for the dairy-cereal pattern were associated with a reduced risk of the metabolic syndrome. Conclusions: Breakfast consumption is associated with the metabolic syndrome. Not all breakfast consumption patterns are associated with a reduced risk of having the metabolic syndrome. In particular, eating either a dairy-cereal breakfast or high energy and fi- ber breakfast are associated with a reduced risk of the metabolic syndrome.
This cross-sectional study examined the relationship between household food insecurity and the metabolic syn- drome (MetS) among reproductive-aged women (n=625) in low income communities. The Radimer/Cornell Hunger and Food Insecurity instrument was utilized to assess food insecurity. Anthropometry, diet diversity, blood pressure and fasting venous blood for lipid and glucose profile were also obtained. MetS was defined as having at least 3 risk factors and is in accordance with the Harmonized criteria. The prevalence of food insecurity and MetS was 78.4% (household food insecure, 26.7%; individual food insecure, 25.3%; child hunger, 26.4%) and 25.6%, respectively. While more food secure than food insecure women had elevated glucose (food secure, 54.8% vs food insecure, 37.3-46.1%), total cholesterol (food secure, 54.1% vs food insecure, 32.1-40.7%) and LDL-cholesterol (food secure, 63.7% vs food insecure, 40.6-48.7%), the percentage of women with over- weight/obesity, abdominal obesity, hypertension, high triglyceride, low HDL-cholesterol and MetS did not vary significantly by food insecurity status. However, after controlling for demographic and socioeconomic covariates, women in food insecure households were less likely to have MetS (individual food insecure and child hunger) (p<0.05), abdominal obesity (individual food insecure and child hunger) (p<0.01), elevated glucose (household food insecure), total cholesterol (child hunger) (p<0.05) and LDL-cholesterol (household food insecure and child hunger) (p<0.05) compared to food secure women. Efforts to improve food insecurity of low income households undergoing nutrition transition should address availability and accessibility to healthy food choices and nutrition education that could reduce the risk of diet-related chronic diseases.
BACKGROUND: With modernization, cardiometabolic disease risk has increased in low and middle-income countries. To better understand cardiometabolic disease etiology, we evaluated the patterning risk factors in a susceptible young adult population. METHODS AND RESULTS: Participants included 1,621 individuals from the 2005 Cebu Longitudinal Health and Nutrition Survey. Using cluster analysis, we grouped individuals by the following biomarkers: triglycerides, HDL and LDL cholesterol, C-reactive protein, blood pressure, homeostasis model assessment of insulin resistance, and fasting glucose. Using multinomial logistic regression models we as- sessed how diet, adiposity, and environment predicted cardiometabolic clusters. We identified 5 distinct sex- specific clusters: 1) Healthy/High HDL cholesterol (with the addition of high LDL cholesterol in women); 2) Healthy/Low blood pressure; 3) High blood pressure; 4) Insulin resistant/High triglycerides; and 5) High C- reactive protein. Low HDL cholesterol was the most prevalent risk factor (63%). In men and women, a higher in- take of saturated fat increased the likelihood of being in the healthy clusters. In men, poorer environmental hy- giene increased the likelihood of being in the High C-reactive protein cluster, compared to the healthy clusters (OR 0.74 [95% CI 0.60-0.90] and 0.83 [0.70-0.99]). Adiposity most strongly associated with membership to the Insulin resistant/high triglyceride cluster. CONCLUSIONS: Despite the population’s youth and leanness, cluster analysis found patterns of cardiometabolic risk. While adiposity measures predicted clustering, diet and environ- ment also independently predicted clustering, emphasizing the importance of screening lean and overweight indi- viduals for cardiometabolic risk. Finding predictors of risk in early adulthood could help inform prevention ef- forts for future disease.
The Great East Japan Earthquake of 2011 left many evacuees with insufficient food and emergency shelter. How- ever, there is no evidence concerning the factors affecting dietary circumstances in emergency shelters after dis- asters. To clarify the factors that influenced the provision of meals, we reanalyzed a data set from a dietary survey conducted in emergency shelters one month after the Great East Japan Earthquake (2011). Among the 69 shelters in “city A,” 53 (79.1%) had food shortages. The possibility of cooking in the emergency shelter improved the provision of meals to evacuees. When comparing emergency shelters with and without cooking equipment, the shelters with cooking equipment provided more meals, as well as more dishes containing grains and vegetables. When there was a gas supply, the twice per day provision of “balanced” meals (containing grains, vegetables, and meat/fish) was more frequent than when there was no gas supply. Interestingly, neither the water supply nor the electricity supply affected the provision of balanced meals. Further, emergency shelters with larger numbers of evacuees had a lower possibility of cooking and lower availability of gas supply. Our results demonstrate that ear- ly improvements to post-disaster meal provision may maintain the health of evacuees. Such improvements could be achieved by 1) the speedy restoration of the gas supply to enable cooking, and 2) limiting the number of evac- uees per emergency shelter.
The metabolic syndrome is related to increased risk of developing cardiovascular disease and type 2 diabetes. Ad- iponectin is an adipocyte-secreted protein with insulin-sensitizing and anti-atherogenic properties. The aims of this study were to evaluate adiponectin levels and biochemical parameters in metabolic-syndrome subjects and healthy controls. The study also sought to identify links between two polymorphisms, -11377C>G (rs266729) and +45T>G (rs2241766) of the adiponectin gene, in relation to adiponectin levels and the metabolic syndrome. Three hundres and thirty-two Thai volunteers: 164 metabolic-syndrome subjects and 168 healthy control subjects were investigated. The adiponectin and HDL-C levels of the metabolic-syndrome group were significantly lower than the control group (p<0.001). Decreased concentration of adiponectin was associated with -11377C>G poly- morphism (p<0.001); this polymorphism was significantly more frequent in the metabolic syndrome group than in the control group (p<0.001). However, +45T>G polymorphism of the adiponectin gene was found not to be re- lated to adiponectin level or metabolic syndrome. Therefore, -11377C>G polymorphism was related to the meta- bolic syndrome susceptibility, and this polymorphism impacted on circulating adiponectin concentrations among Thais.
Background: A dietetics profession that conforms to the international standards for dietetics exists in many coun- tries but not in the Peoples’ Republic of China (China). Might China benefit from the presence of the dietetics profession? Objective: The article reviews the current dietetic situation in China, summarizes the gaps between current realities in China with respect to meeting needs for nutritional care, and recommends improvements. Re- sults: Gaps and barriers exist between current practice in dietetics and a more optimal system for meeting China’s nutritional care needs. Recommendations for actions over the near term that would lead to fuller development of the field of dietetics in China are summarized, following the model suggested by the International Confederation of Dietetic Associations. Alternative personnel deployment strategies over the next decade are also discussed. Conclusion: Whether there is a role for the profession of dietetics in China today or in the near future will depend on the attitudes and political will of Chinese government authorities, health professionals, educators, and con- sumers.
Objectives: The aim of this study is to explore the possible role of HIF-1α in glucose metabolism, proliferation and apoptosis of pancreatic cancerous cells. Method: The pancreatic cancerous BxPC-3 cells were cultured in normoxia or hypoxia (3% O2), respectively. Cell proliferation was determined by MTT assay, apoptosis was de- termined by Annexin V/PI staining. Expression of Pyruvate dehydrogenase kinase (PDK1), Lactate dehydrogen- ase (LDHA), pyruvate kinase M2 (PKM2) and citrate synthase (CS) was determined by Western-blot and Real- time PCR. Results: Under hypoxia, the expression of HIF-1α and the lactate production were increased. The ex- pression of glucose metabolic enzymes PDK1, LDHA, PKM2 was also increased compared with that under aero- bic condition. Hypoxia treatment had little effect on expression of CS. Under hypoxia, knockdown of HIF-1α in- hibited the production of lactate and the expression of PDK1, LDHA and PKM2. Knockdown of HIF-1α re- pressed the growth of pancreatic cancer BxPC-3 cells and induced apoptosis of the cells under hypoxia. Conclu- sion: Under hypoxia, the expression of HIF-1α is induced, leading to the increase of glycolysis in BxPC-3 cells possibly through upregulation of the enzymes related to glycolysis. HIF-1α knockdown can inhibit the prolife ra- tio and promote apoptosis of pancreatic cancerous BxPC-3 cells in vitro.
Dr Maitree Suttajit was born in Chiang Mai, Thailand on March 2nd, 1939. His educational background is in chemistry and biochemistry. He graduated in BSc (Chemistry with Honors), Chulalongkorn University, 1960, MSc (Biochemistry), Mahidol University, 1962 and PhD in Biochemistry from the University of New York in Buffalo, USA, 1971. His PhD, under Prof Richard J Winzler, involved the therapeutic structural characteristics of N-acetyl neuraminic acid for glycoproteins. He then joined the Department of Biochemistry, Faculty of Medicine, and Chiang Mai University, Thailand, where he became Head and remained until his retirement in 2000. He was also became Associate Dean for research.
In 1997, he was appointed Professor of toxicology and biochemistry and, on retirement, a Professor Emeritus of Chiang Mai University. He taught across the fields of biochemistry and health sciences in medical science, medicine, pharmacy, nursing, dentistry and public health. He received an outstanding teaching award in 1997 from Chiang Mai University. In 1998, he was awarded the royal honor and insignia of “The Most Noble Order of the Crown of Thailand (Mahawachiramonkut Thai)”. In 2009, he received the Cerebos Award for his findings about health benefits of proanthocyanidins from red and purple rice in diabetes and Alzheimer’s disease.
He became a visiting professor in the Faculty of Science, Mahasarakham University and in the School of Medical Sciences, University of Phayao, 2001-2005. In 2010, he was appointed as the Dean of the School of Medical Sciences, University of Phayao, Phayao where he has introduced undergraduate and graduate studies in nutrition and dietetics. Other appointments have included those at the Cancer Unit, Princess Chulabhorn Research Institute Center, Chiang Mai University, visiting researcher at the Mt Sinai Medical Center, NY, USA and the National Cancer Research Institute, Tokyo, Japan
Dr Suttajit’s nutrition research contributions have ranged across the biochemistry of the dietary prevention and management of certain cancers, cardiovascular disease, diabetes and HIV+/AIDS. He has had a particular interest in aflatoxins in Thai foods and in polycyclic aromatic hydrocarbons as air pollutants, giving an environmental and toxicological orientation to his nutritional interests. Yet again, cancer chemo-prevention has been a theme in his work as has the place and understanding of traditional foods and of medicinal herbs in health maintenance and care in Thailand. He has been author and coauthor of over 67 papers published in peer reviewed journals, and written and edited several Thai textbooks such as Environmetal Toxic Substances, Food for Health and Foods and Cancer.
These various endeavours have been the background to Prof Suttajit’s interest in plant-based diets and to his founding and Presidency of the Chiang Mai Vegetarian Society, the Thai Vegetarian Union, the Asian Vegetarian Union, the Thai Centenarian Society and the Thai Society for Free Radical Research. He is also an Editor of the Phayao Journal and Vegetarian Nutrition Journal (online).
For his pursuit of an appreciation of the scientific basis of traditional food and medicinal usage and toxicology in the Asia Pacific region and for its peoples’ health and well-being, Prof Maitree Suttajit has been bestowed the Award of the Asia Pacific Clinical Nutrition Society for 2014.
Case studies and evidence based nutrition
By Mark L Wahlqvist
Asia Pac J Clin Nutr 2013;22(4):471-473
We report a pagination error of this paper, the page number should be replaced by “664-666”.
Systematic classification of evidence for dietary reference intakes for Japanese 2010 (DRIs-J 2010) in adults and future prospects of DRIs in Asian countries
By Makiko Nakade, Eri Imai, Megumi Tsubota-Utsugi, Nobuyo Tsuboyama-Kasaoka,
Hidemi Takimoto
Asia Pac J Clin Nutr 2013;22(4):474-489
We report a pagination error of this paper, the page number should be replaced by “667-682”.
Salt intakes and salt reduction initiatives in Southeast Asia: a review
By Ada Portia M Batcagan-Abueg, Jeanette JM Lee, Pauline Chan,Salome A Rebello, Maria Sofia V Amarra
Asia Pac J Clin Nutr 2013;22(4):490-504
We report a pagination error of this paper, the page number should be replaced by “683-697”.
Shiftworking, nutrition and obesity: implications for workforce health- a systematic review
By Reza Amani, Tim Gill
Asia Pac J Clin Nutr 2013;22(4):505-515
We report a pagination error of this paper, the page number should be replaced by “698-708”.
The increasing rate of child obesity has developed into a serious concern in contemporary society. In Ko- rea, additional concerns over unsanitary environments of food establishments near schools led to the en- forcement in 2009 of the Special Act on the Safety Management of Children’s Dietary Life in order to improve food safety and nutrition. Some of the main policies of the Special Act are the prohibition of En- ergy-dense Low-Nutrient density Foods (hereinafter referred to as EDLNF) at school canteens and in the outstanding businesses, along with restrictions on television advertisement for EDLNF products. Confec- tioneries, candies, sweetened-ice products, breads, chocolates, processed milk, fermented milk, ice cream, fish-meat sausages, fruit/vegetable beverages, carbonated beverages, mixed beverages, and lactic acid bacteria beverages are classified as applicable food types of EDLNF. To establish the nutritional standards for EDLNF, the intake proportions and the pattern of nutrients in children’s preferred foods in Korea were analyzed, based on the 2005 National Health and Nutrition Survey of Korea. The foods containing more than 250 kcal, more than 17 g of sugar or more than 4 g of saturated fat and less than 2 g of protein per serving are considered EDLNF snacks. The Korean government is concentrating its efforts in promoting healthy environments for children in its research and in food policies. Further studies are necessary to in- vestigate the current state of changes in the children's foods industry.
Our aim was to compare the effects of intravenous, enteral, and enteral plus intravenous supplemented glutamine on plasma transferrin, nitrogen balance, and creatinine/height index in septic patients with malnutrition. Blood and urine samples were collected for transferrin, urea and creatinine measurements. Samples, SOFA score and protein-calorie intake values were repeated on days 7 and 15. Patients (n:120) were randomly divided into 4 groups. Group I received 30 g/day IV glutamine, group II received 30 g/day enteral glutamine, group III received 15 g/day IV and 15 g/day enteral glutamine. Group IV received only enteral feeding as a control group. Transfer- rin levels decreased in group IV (p<0.01 0-7 days, p<0.01 7-15 days, p<0.01 0-15 days). Nitrogen balance levels were highest in group IV when compared with group I (p<0.05, p<0.001), group II (p<0.001), and group III (p<0.05, p<0.001) on days 7-15. Creatinine/height indexes increased in group I (p<0.001), group II (p<0.001), group III (p<0.001), and group IV (p<0.05) on day 15. In group III the creatinine/height index was higher than in groups I and II (p<0.05). In group IV, creatinine/height index was lower than in group I (p<0.01) and group II (p<0.001). Protein-calorie intake in group IV was higher than others on day 7 (p<0.05). SOFA scores of group IV were higher than the other groups on day 15 (p<0.05). This study demonstrated, that combined route of gln sup- plementation resulted in the most positive outcome to transferrin, creatine/height index and nitrogen balance (on days 7 and 15) during the catabolic phase of septic patients with malnutrition.
Fast-track (FT) has been shown to enhance post-operative recovery. The aim of this study was to compare the ef- fects of FT and traditional nutrition on post-operative rehabilitation, as well as evaluate the feasibility of applying FT in nutrition management of colorectal surgery. A prospective and randomized controlled trial was performed. This study included 464 patients who underwent colorectal surgery. The patients were randomly assigned into an FT group and a traditional group. The nutritional risk screening (NRS 2002) score, post-operative recovery index and surgical complications were compared between the FT and traditional groups. The NRS 2002 score in the FT group was better than the traditional group (p<0.05). Serum indicators for nutrition (HGB, ALB, A/G) and im- mune function (lymphocyte rate [LYMPH%], IgA, and CD4+) in the FT group were superior to those in the tradi- tional group (p<0.05) on post-operative day 5. The first time to aerofluxus, defecation, oral intake and ambulation in the FT group was shorter when compared to the traditional group (p<0.05). The complication incidence was significantly lower in the FT group than in the traditional group (p<0.05). In particular, the occurrence rate of anastomotic leakage was higher in the traditional group than in the FT group (0.5% vs 2.8%, p<0.05). Taken to- gether, these data suggest that FT management can improve the nutritional condition and outcomes of colorectal surgical patients.
Background: urgent development of effective interventions to prevent rapidly rising childhood obesity in China is needed. Methods: Between May 2010 and December 2013, a cluster randomized controlled trial was conducted among 4th graders in eight urban primary schools randomly assigned to intervention or control groups in Nanjing, China. A multi-component intervention program was implemented within the treatment group, while students in the control group followed their usual health education curriculum without additional intervention. Results: At baseline, 638 and 544 students were enrolled in the intervention and control group, respectively. The prevalence of excess body weight was 26.8%, with 27.4% in the intervention group and 26.1% in the control group (p=0.61). The mean (SD) BMI and WC was 18.7 (3.0) and 63.0 (9.2) for participants in intervention schools, and 18.5 (2.9) and 63.6 (8.7) for students in control group, separately (p=0.24 and 0.41, respectively). Compared to those who were not aware of what lifestyle/behavior factors were unhealthy, students who were aware of the unhealthy life- style/behavior factors consumed fewer fried snacks (0.46±0.76 serves/week vs 0.65±0.91 serves/week; p<0.01), soft drinks (160±194 ml/week vs 199±227 ml/week; p<0.01), but larger amount of meat (502±429 g/week vs 449±344 g/week; p=0.03), and reported less screen time (214±232 minutes/week vs 252±264 minutes/week; p<0.01). Moreover, there was no difference within physical activity time between these two groups (257±341 minutes/week vs 218±324 minutes/week; p=0.13). Conclusions: Main characteristics of participants were bal- anced at baseline within intervention and control schools, but a gap existed between healthy lifestyle knowledge and actual healthy behavior in students. Trial Registration number: ChiCTR-ERC-11001819
The aim of the study was to understand whether dietary fatty acids such as saturated, polyunsaturated, and mono- unsaturated fatty acids act as inflammatory mediators or influence pro-coagulation in Saudi adults. The study sought to examine inflammatory factors such as C-reactive protein, tumor necrosis factor-alpha and activated plasminogen activator inhibitor 1. A total number of 232 consenting Saudi adults, aged 18–60 years were ran- domly selected in this cross-sectional study. Independent Student t-test was done to compare means of normally distributed data. Spearman correlation between the variables was determined. The values of different fatty acids and adipokines were transformed logarithmically/square root to normalize data before correlations were deter- mined and statistical analyses performed. Statistical significance was set at p<0.05. The results show a significant positive correlation of dietary intake of poly and monounsaturated fatty acids, but not saturated fatty acids, with activated plasminogen activator inhibitor 1 (r=0.31, p=0.02, r=0.32 p=0.04). On the other hand, dietary intake of saturated fatty acids showed a negative correlation with serum C-reactive protein levels (p=0.001) in males. Die- tary unsaturated fatty acids is possibly associated with the production of a pro-coagulation factor without enhanc- ing the secretion of pro-inflammatory molecules, while saturated fatty acids have no effect on activated plasmin- ogen activator inhibitor 1, but their level is negatively associated with the inflammatory factor C-reactive protein. We conclude that dietary intake may exert a gender-specific effect in inflammatory processes among adults. Fur- ther studies are warranted to confirm present findings.
The relationship between body fat mass and vitamin D appears to vary by ethnicity, but our understanding of this predisposition in Asians is limited due to the scarcity of prior investigations. Data on 1,697 Korean adults were obtained from the second and third years (2008-2009) of the fourth Korean National Health and Nutritional Ex- amination Survey. Body fat mass was measured using dual-energy X-ray absorptiometry. Both linear regression analysis for serum 25-hydroxyvitamin D [25(OH)D] and logistic analysis for vitamin D deficiency [25(OH)D <20 ng/mL] were performed to determine significant predictors among BMI, waist circumference (WC), and body fat percentage (BF), after adjustment of multiple covariates. To explore a possible non-linear relationship between them, the fractional polynomials method was used. All analyses were conducted following stratification by sex. In linear regression analysis, BMI and WC were not associated with 25(OH)D. However, BF was inverse- ly related to 25(OH)D, irrespective of the fat location (both appendicular and truncal fat) in both sexes. In logistic regression analysis, the highest quartile group of BF had a greater OR for vitamin D deficiency than the lower quartile groups, irrespective of the fat location and sex. However, the quartiles of BMI and WC were not associ- ated with vitamin D deficiency. The linear relationships between BF and 25(OH)D (or vitamin D deficiency) were confirmed despite use of the fractional polynomials method. Body fat mass is inversely associated with se- rum 25(OH)D in Korean adults. Monitoring of vitamin D deficiency in Korean adults with high fat mass is need- ed.
We examined the relationships of combined initial restrained and external/emotional eating with initial BMI and change in weight and these subscales over time. BMI and the Dutch Eating Behavior Questionnaire were twice- measured in 1361 Korean twins and families (482 men, 879 women) over a period of 2.7±0.9 years. Subjects were classified by combination of initial sex-specific restrained and external (or emotional) eating tertiles. Linear mixed models were performed after adjusting for confounders at baseline (household, sibling relations, sex, age, education level, smoking, alcohol use, energy intake, physical activity, and medical history). In adjusted models, initial BMI increased with increasing tertiles of initial restrained eating across initial external/emotional eating tertiles. Weight was less likely to increase over time with increasing tertiles of initial restrained eating in the low- est external eating tertile and middle tertile of emotional eating at baseline. Subscale scores decreased over time with increasing tertiles of corresponding subscales at baseline. These findings suggest that high dietary restraint and external/emotional eating may indicate concurrent high BMI and attenuated weight gain and decreases in cor- responding subscales over time.