Due to the non-specificity of symptoms and possibly severe consequences of untreated vitamin B-12 deficiency, screening is important for at-risk patients to ensure the prompt delivery of treatment. In this review, studies as- sessing the prevalence of vitamin B-12 deficiency in thyroid dysfunction are evaluated to determine whether reg- ular vitamin B-12 screening is necessary. A literature search was conducted using multiple electronic databases. Only original studies assessing the prevalence of vitamin B-12 deficiency in thyroid dysfunction that reported their findings as percentages of the sample were eligible for inclusion. From a total of 7091 manuscripts generat- ed, 6 were included in this review. The prevalence of vitamin B-12 deficiency in hypothyroidism was reported as 10, 18.6, and 40.5% in three separate studies. The prevalence of deficiency in autoimmune thyroid disease was reported as 6.3, 28, and 55.5% in three studies. The prevalence of vitamin B-12 deficiency in hypothyroidism and autoimmune thyroid disease are reflective of the nutrition status of the population. Autoimmune thyroid disease is also associated with the autoimmune disorders pernicious anemia and atrophic gastritis which may lead to malab- sorption of vitamin B-12. Vitamin B-12 screening is recommended upon initial diagnosis with autoimmune thy- roid disease and then periodically thereafter. There is not enough evidence to recommend regular screening for patients with hypothyroidism unless the underlying cause is autoimmune thyroid disease.
Background and Objectives: Fluid overload and hypermetabolism frequently occur in sepsis patients in the in- tensive care unit (ICU) setting. These abnormalities correlate with inflammatory mediators released under stress- ful conditions. Continuous renal replacement therapy (CRRT) is an extracorporeal life support technology that persistently and stably eliminates overhydration and cytokines. This study investigated the short-term conse- quence of CRRT on body composition and pattern of energy expenditure. Methods and Study Design: We pro- spectively observed 27 sepsis patients in our ICU treated with CRRT. Bioelectrical impedance analysis and indi- rect calorimetry were determined at admission and before and after CRRT. All parameters considered to affect body composition and metabolic state with short-term CRRT were recorded. We used correlation analysis to evaluate the relationship between the change of nutritional state and other parameters. Results: Patients had a de- creased total body water load and an improved metabolic pattern, but the nutritional parameters had no significant change between pre- and post-CRRT. Furthermore, we observed the percentage variation of resting energy ex- penditure (REE) was positively correlated with intracellular water change (r=0.547, p=0.003) and CRRT duration (r=0.515, p=0.006). A negative correlation was found between the percentage variation of REE and dialysate temperature (r=−0.668, p=0.001). Conclusion: These results suggest that short-term CRRT reduces systemic volume in sepsis patients with overhydration and hypermetabolism, but has no significant impact on acute nutri- tional status. Meanwhile, CRRT may exert its optimum efficiency when accompanied by other medical practices and support methods.
Background and Objectives: Drinking is a risk factor of osteoporosis, but controversy surrounds the relation- ship between alcohol consumption and bone mineral density (BMD). We performed an analysis of the association between alcohol consumption and BMD. Methods and Study Design: A cross-sectional study was performed including 2421 men, aged 40-93 years, who participated in the fourth Korea National Health and Nutrition Exam- ination Survey in 2008-2009. Alcohol intake was determined by self-administered questionnaires, and BMD was measured by dual energy x-ray absorptiometry. ANOVA was used to determine the relationship between alcohol intake and BMD, and ANCOVA was performed after adjusting for age, body mass index, education, household income, smoking status, calcium intake, physical activity, and serum 25-hydroxyvitamin D levels. Results: BMD increased significantly in the lumbar spine, total femur, and femoral neck with increased alcohol intake (p for trend=0.028, <0.001, <0.001, respectively). However, after adjusting for age, the relation was no longer statisti- cally significant in any of 3 bone sites (lumbar, p for trend=0.606; total femur, p for trend=0.342; femoral neck, p for trend=0.549). Additionally, after adjusting for all other confounders, no significant relationships were report- ed in the 3 bone sites (lumbar, p for trend=0.451; total femur, p for trend=0.150; femoral neck, p for trend=0.343). In the stratified analysis, there were no significant correlations according to age, smoking status, physical activity or obesity. Conclusions: After adjusting for age and other confounders, no significant relationship was found be- tween alcohol intake and BMD.
Background and Objectives: Coping with stress often leads to unhealthy behaviors that can have an impact on the development of obesity. Therefore, this study is investigate the effect of perceived stress level on alcohol con- sumption habits, as well as the effect of the interaction between alcohol consumption habits and stress level on obesity in Koreans. Methods and Study Design: We analyzed perceived stress, alcohol consumption habits (alcohol consumption status, quantity, and alcohol use disorders identification test) and the anthropometrics of 6,229 subjects from the Korean National Health and Nutrition Examination Survey. The gender-based differences of the effect of the perceived level of stress on alcohol consumption habits and anthropometric measurements, as well as the interaction of the perceived level of stress and alcohol consumption habits on prevalence or ORs of obesity were analyzed. Results: The subjects with high perceived stress showed higher proportions for unhealthy alcohol consumption habits than those with low perceived stress [ORs (95% CIs)=1.35 (1.19-1.54), 1.95 (1.68-2.26), and 1.87 (1.60-2.19) for alcohol consumption status, alcohol consumption quantity, and alcohol use disorders identification test, respectively]. Men showed significant interactions between the perceived stress and all alcohol consumption habits with respect to obesity [ORs (95% CIs)=1.28 (1.06-1.55), 1.81 (1.52-2.16) , and 1.40 (1.17-1.68) for alcohol consumption status, alcohol consumption quantity, and alcohol use disorders identification test, respectively]. Among women, interactions between the perceived stress and alcohol consumption status [ORs (95% CIs)=0.70 (0.60-0.83)] and alcohol consumption quantity [ORs (95% CIs)=0.93 (0.54-1.36)] in relation to obesity were found to be significant. Conclusion: Our study demonstrated that the perceived stress influenced alcohol consumption habits that may have impacted obesity.
Objective: To investigate the relationship of muscle mass and muscle function with age. Methods and Study Design: The study including 415 participants (aged 60-99 years). Upper (UMM) and lower (LMM) limbs muscle mass and whole body fat free mass (FFM) were measured by bioelectrical impedance analysis. The appendicular skeletal muscle mass (ASM) index (ASM/height2) was calculated. Muscle function was assessed by measuring hand grip strength (HGS) and gait speed. Results: Using ASM index cutoff values we found that higher preva- lence of sarcopenia in women than in men (33.5% vs 23.6%, p=0.025). In the upper limb, HGS (β=-0.809) de- clined more rapidly with age than did UMM (β=-0.592) in men, but not in women (β=-0.389 and β=-0.486 re- spectively). In the lower limb, gait speed declined more rapidly than LMM in both men (β=-0.683 vs β=-0.442) and women (β=-1.00 vs β=-0.461). The variance of UMM explained 28-29% of the variance of HGS, and LMM explained 7-8% of the variance of gait speed in women and men respectively. In addition to the common predic- tors (BMI and age), the specific predictors were smoking, exercise and education for FFM and ASM, and smok- ing, drinking and exercise for HGS (p<0.05). Conclusions: Loss of muscle function is greater than the decline of muscle mass particularly in the upper limbs in men. However, women are more prone to have low muscle mass than the men. Exercise programs need to be designed gender specifically.
Background and Objectives: With an increased incidence of obesity in China, this study sought to investigate the correlation between serum 25-hydroxyvitamin D levels and adiposity phenotypes in Chinese adults from ur- ban settings. Methods and Study Design: A total of 1277 subjects aged 20-82 years old were recruited into this cross-sectional study. Anthropometric parameters and blood biochemistry panels were measured. Statistical anal- ysis using partial correlation, multivariable regression and covariance were performed to assess the impact of obesity parameters on serum 25-hydroxyvitamin D levels. Results: After adjustment for age and gender, se- rum25-hydroxyvitamin D levels were found to be inversely related to body mass index, waist circumference, waist/hip ratio, body fat, body fat percentage and waist fat to hip fat ratio. In multivariable regression analysis, se- rum 25-hydroxyvitamin D levels were negatively associated with waist circumference, waist/hip ratio, body fat, body fat percentage and waist fat/hip fat ratio (p<0.05), while there was no correlation with body mass index (p>0.05). After inclusion of body fat, body fat percentage and waist fat to hip fat ratio in one model, only waist fat to hip fat ratio remained significantly associated with serum 25-hydroxyvitamin D levels (p<0.05). The covar- iance analysis results showed that abdominal obesity subjects had lower serum 25-hydroxyvitamin D levels com- pared to the counterpart group, as defined by waist circumference or waist/hip ratio (p<0.05). Conclusion: Our results affirm the relationship between serum 25-hydroxyvitamin D levels and abdominal obesity, suggesting that adiposity phenotypes were strongly linked to serum 25-hydroxyvitamin D levels.
This study investigated the concentration of total mercury (THg) in maternal blood, cord blood, and breast milk, and its association with dietary factors. A total of 127 pregnant women in Busan, Korea were recruited. Maternal blood, cord blood, and breast milk were collected at 36 weeks of gestation, at delivery, and at one week after birth, respectively. Information about dietary habits and other factors were obtained from each subject. The mean THg concentrations in maternal blood, cord blood, and breast milk were 3.12±1.36 μg/L, 5.46±2.41 μg/L, and 0.91 ±2.08 μg/L, respectively. Positive correlations were found between log-transformed THg concentrations in maternal blood and cord blood (r=0.829, p<0.001), and between maternal blood and breast milk (r=0.296, p=0.001). Multiple linear regression analysis showed that the log-transformed concentration of THg in maternal blood was positively correlated with fish consumption (β=0.345, p<0.0001) and negatively correlated with bean consumption (β=−0.055, p=0.048). Fish consumption (β=0.482, p<0.0001) and maternal age (β=0.025, p=0.033) were positively associated with the concentration of THg in cord blood, while negative correlations were found for bean consumption (β=−0.134, p=0.027) and parity (β=−0.172, p=0.015). Beef consumption (β=0.031, p=0.007) was positively associated with log-transformed THg concentrations in breast milk, while negative corre- lations were found for bean consumption (β=−0.019, p=0.003) and maternal age (β=−0.083, p=0.004). Our study found that both the dietary and demographic factors differently affected to THg concentrations among samples of maternal blood, cord blood, and breast milk.
Integrated infant and young child feeding (IYCF)/micronutrient powder (MNP) programs are increasingly used to address poor IYCF practices and micronutrient deficiencies in low-income settings; however, little is known about how MNP use may affect IYCF practices. We describe how MNP use was associated with IYCF practices in a pilot program in select districts of Nepal where free MNP for children 6-23 months were added to an existing IYCF platform. Representative cross-sectional surveys were conducted in pilot districts with mothers of eligible children at 3 months (plains ecozone, n=1054) or 15 months (hill ecozone, rural only, n=654) after implementa- tion of an integrated MNP/IYCF program. We used logistic regression to assess how IYCF practices varied by MNP use (none, 1-30, 30-60 sachets). At both time points, consuming 30-60 MNP sachets vs. none was associat- ed with achieving minimum dietary diversity and minimum acceptable diet. In the 3 month survey consuming 30- 60 MNP sachets vs none was also associated with achieving minimum meal frequency and continued breastfeed- ing at 2 years. In this setting, addition of MNP to an existing platform of IYCF messaging did not appear detri- mental to IYCF practices.
Background and Objectives: To study the associations between nutrient intake, dairy intake and socio- economic variables. Methods and Study Design: Food consumption data using 24 h recall were collected in 3600 children, aged 0.5 to 12 years old in addition to frequency of dairy use and anthropometric and socio- demographic variables. Results: Overall height for age Z-score (HAZ) and body mass index for age Z-score (BAZ) values (mean±SE) were -1.40±0.03 and -0.48±0.03 respectively, associated with a high prevalence of stunting and thinness in the population. The overall percentage of children not using any dairy products was 71%, and this percentage increased steadily with age. The overall energy intake from dairy was 99±3 kcal/capita/day and the overall energy intake from dairy in dairy users was 291±7 kcal/day. Dairy use did not differ between boys and girls, but was higher in urban areas, higher if the education of the mother was higher and higher if the mother had a permanent job and if the wealth status of the family was in the upper levels. Nutrient intake after the age of 3 years was inadequate for energy and all nutrients except for protein. The achievement of Recommended Dietary Allowances (RDA) for all nutrients was higher in dairy users compared to non-dairy users, also after correcting for the confounding effect of the higher energy intake (from dairy) and socio-demographic variables. The contri- bution increased with increasing frequency of dairy use. Conclusion: Adequate dairy intake can substantially add to the achievement of RDA in Indonesian children.
Micronutrient deficiencies continue to be a major public health concern worldwide with many South Asian coun- tries suffering a significant proportion of the global burden. A lack of nationally representative data on micronu- trient deficiencies hampers sustained action to address the problem. Using data on the national food supply pro- duced by the Food and Agriculture Organisation of the United Nations, and international food composition tables, the present study estimated the prevalence of inadequacy of seven micronutrients (vitamin A, thiamine, riboflavin, folate, vitamin B-12, zinc and calcium) in seven South Asian countries - Bangladesh, India, Iran, Maldives, Nepal, Pakistan and Sri Lanka. The estimated average requirement cut-point method was employed to determine the likelihood of inadequate micronutrient intakes. We report multiple micronutrient inadequacies in the food supply in the region, especially in the low and lower-middle income countries. Of the seven micronutrients investigated, calcium had the highest risk levels of inadequacy. Folate, riboflavin, vitamin B-12 and zinc were also deemed to be at high risk of inadequacy, although results differed markedly between countries. Various strategies to combat micronutrient deficiencies are currently underway in these countries. In order to facilitate the implementation of these efforts, the collection of nationally representative nutritional assessment survey data are urgently required to ascertain the true burden of micronutrient malnutrition.
Background and Objectives: We conducted a hospital-based, case–control study to examine the association be- tween Mediterranean diet (MD) and the risk of multiple sclerosis (MS) in Iran. Methods and Study Design: A total of 70 patients with MS and 142 controls underwent face-to-face interviews in the major neurological clinics of Tehran, Iran. Adherence to a MD was assessed using the 9-unit dietary score, to evaluate the level of conformi- ty of the individual’s diet to the Mediterranean dietary pattern. Multivariate logistic regression was used to esti- mate odds ratios (OR) and 95% confidence intervals (CI). Results: Higher consumption of fruits (OR=0.28, 95% CI: 0.12-0.63, p-value: 0.002) and vegetables (OR=0.23, 95% CI: 0.10-0.53, p-value: 0.001) were significantly associated with reduced MS risk. In both age adjusted and multivariate adjusted model, the OR of MS decreased significantly in the third as compared to the first tertile of MD score (age adjusted OR: 0.21, 95% CI: 0.06-0.67; p-trend: 0.01, Multivariate adjusted OR: 0.23, 95% CI: 0.06-0.89, p-trend: 0.04). Conclusions: Our study sug- gests that a high quality diet assessed by MD may decrease the risk of MS.
The term ‘added sugars’ refers to sugars and syrup added to foods during processing or preparation, and sugars and syrups added at the table. Calls to limit the daily intakes of added sugars and its sources arose from evidence analysed by WHO, the American Heart Association and other organizations. The present review examined the best available evidence regarding levels of added sugar consumption among different age and sex groups in Ma- laysia and sources of added sugars. Information was extracted from food balance sheets, household expenditure surveys, nutrition surveys and published studies. Varying results emerged, as nationwide information on intake of sugar and foods with added sugar were obtained at different times and used different assessment methods. Data from the 2003 Malaysian Adult Nutrition Survey (MANS) using food frequency questionnaires suggested that on average, Malaysian adults consumed 30 grams of sweetened condensed milk (equivalent to 16 grams sugar) and 21 grams of table sugar per day, which together are below the WHO recommendation of 50 grams sugar for every 2000 kcal/day to reduce risk of chronic disease. Published studies suggested that, for both adults and the elderly, frequently consumed sweetened foods were beverages (tea or coffee) with sweetened condensed milk and added sugar. More accurate data should be obtained by conducting population-wide studies using biomarkers of sugar intake (e.g. 24-hour urinary sucrose and fructose excretion or serum abundance of the stable isotope 13C) to de- termine intake levels, and multiple 24 hour recalls to identify major food sources of added sugar.
Background and Objectives: A daily mineral supplement is useful for those who are at risk of a deficiency. Some Western reports suggest that mineral supplement users have healthy behaviors and are not mineral-deficient. It is unknown whether the same phenomenon is observed in Japan where there is a different dietary culture. The aim of this study was to examine the characteristics of personal behaviors including food consumption nation- wide among mineral supplement users from the National Health and Nutrition Survey in Japan 2003-2010. Methods and Study Design: Data were obtained from 16,275 adults aged 20-59 years who completed socio- demographic, health status, and 1-day household dietary assessments. Supplement users were compared with non-users. Logistic regression models were utilized to identify the characteristics of food consumption and calci- um and iron supplement use, using the medium intake group as a reference. Results: Overall, 2.1% and 1.4% of adults reported using calcium supplements and iron supplements, respectively. Calcium supplement users were more likely to be physically active, non-smokers, and eat less fat compared with non-users. Furthermore, they were more likely than non-users to consume a higher intake of calcium from foods such as tea, vegetables, sea- weeds, and fruits. Iron supplement users were more likely than non-users to be non-smokers. These individuals tended to have a high intake of seaweeds and fruits. Conclusions: Japanese adults who had healthier behaviors were more likely to use mineral supplements, especially calcium. Mineral supplement users tended to choose healthy foods such as seaweeds and fruits, without considering their overall mineral consumption.
Background and Objectives: Fast-food consumption has greatly increased in Taiwan. Frequent fast food intake is associated with both allergy and obesity. The aim of this study was to describe fast food habit changes, and to assess the relationship between fast food intake and the risk of functional gastrointestinal disorders (FGIDs) among Taiwanese adolescents. Methods and Study Design: This analysis used data from the Nutrition and Health Survey in Taiwan (NAHSIT) of high school students conducted in 2011. A total of 2,042 adolescents (12- 19 years) completed the questionnaire. The survey included the Rome III criteria for FGIDs, translated into Chi- nese for adolescents. Respondents with previously diagnosed chronic organic gastrointestinal diseases were ex- cluded from the study. Results: In total, 2,034 children were enrolled. 545 subjects (26.8%) had history of at least one FGID. 88.1% of the subjects reported fast foods consumption. A significantly higher prevalence of FGIDs was noted in adolescents with a history of fast foods consumption, compared with those reported not to have in- gested fast foods in the past 30 days (27.6% vs 20.6%, p=0.024). An increased risk of FGIDs in children and ado- lescents was associated with fast food intake (OR 1.8, 95% CI: 1.78-1.83). Conclusions: FGIDs were common among Taiwanese adolescents. Fast-food consumption may contribute to a positive association with the develop- ment of functional gastrointestinal disorders. Lower fiber intake and more frozen desserts in the diet may be complicit in FGIDs. The findings have public health relevance in regard to the global increase in fast food con- sumption.
Background and Objectives: The prevalence of hypertension, the greatest contributor to mortality globally, is increasing in low-and-middle income countries (LMICs). In urban regions of LMICs, excessive salt intake is as- sociated with increased risk of hypertension. We aimed to determine whether this is the case in rural regions as well. Methods and Study Design: We performed a meta-analysis of studies in rural and urban areas of LMICs in which the association of salt and hypertension were assessed using multivariable models. Results: We identified 18 studies with a total of 134,916 participants. The prevalence of high salt intake ranged from 21.3% to 89.5% in rural and urban populations. When salt was analysed as a continuous variable, a greater impact of salt on hyper- tension was found in urban (n=4) (pooled effect size (ES) 1.42, 95% CI 1.19, 1.69) than in rural populations (n=4) (pooled ES 1.07, 95% CI 1.04, 1.10, p for difference <0.001). In studies where salt was analysed continuously, a greater impact of salt on hypertension was observed in lean rural populations (BMI <23 kg/m2) than in non-lean rural populations (BMI ≥23 kg/m2, p for difference <0.001). Conclusions: The prevalence of high salt intake is similar in rural and urban regions. Excessive salt intake has a greater impact on the prevalence of hypertension in urban than rural regions. BMI appears to modify the relationship between salt and hypertension in rural popula- tions.
Background and Objective: The increased mortality risk of hyperhomocysteinaemia in diabetes may be miti- gated by dietary quality. Methods and Study Design: The Nutrition and Health Survey in Taiwan of 1999-2000 for elders formed this prospective cohort. Baseline health status, diet and anthropometry were documented and plasma homocysteine and biomarkers for B vitamins measured. Participants without diabetes (n=985) were refer- ent for those who had diabetes or developed diabetes until 2006 (n=427). The effect of homocysteine on mortality risk during 1999-2008 was evaluated. Results: Men, smokers and those with poorer physical function had higher homocysteine, but less so with diabetes. Diabetes incidence was unrelated to homocysteine. In hyperhomocys- teinaemia (≥15 vs <15 mol/L), those with diabetes had an adjusted hazard ratio (HR) (95% CI) for mortality of 1.71 (1.18-2.46); p for interaction between homocysteine and diabetes was 0.005. Without diabetes, but with hy- perhomocysteinaemia and a low dietary diversity score (DDS ≤4 of 6), where the joint mortality hazard for the greater DDS, (>4) and lower homocysteine (<15) was referent, the HR was 1.80 (1.27-2.54) with significant in- teraction (p=0.008); by contrast, there was no joint effect with diabetes. The contribution of DDS to mortality mitigation in hyperhomocysteinaemia could not be explained by B group vitamins, even though plasma folate was low in hyperhomocysteinaemic participants. With hyperhomocysteinaemia, heart failure was a major cause of death. Conclusions: In non-diabetic hyperhomocysteinaemia, a more diverse diet increases survival prospects independent of B group vitamins, but not in hyperhomocysteinaemic diabetes where the cardiomyopathy may be less responsive.
Background and Objectives: In an era where obesity remains an important public health concern, food addiction has emerged as a possible contributor to obesity. The DRD2 gene is the most studied polymorphism. The aim of this study was to investigate a relationship between food addiction questionnaires, body composition measurements, and a dopa- mine-resistant receptor polymorphism (DRD2 A1) among Asian Americans. Methods and Study Design: A total of 84 Asian American college students were recruited. Participants underwent body composition measurement via bioelectri- cal impedance, answered questionnaires (Food Craving Inventory and Power of Food Scale), and had blood drawn for genotyping (PCR). Results: There was no difference in body composition (BMI, percent body fat) between the A1 (A1A1 or A1A2) and A2 (A2A2) groups. There were statistically significant differences in food cravings of carbohy- drates and fast food on the Food Craving Inventory between the A1 and A2 groups (p=0.03), but not for sugar or fat. Among Asian college females, there was also a difference on the Power of Food questionnaire (p=0.04), which was not seen among men. 13 out of 55 women also had >30% body fat at a BMI of 21.4 to 28.5 kg/m2. Conclusion: Greater carbohydrate and fast food craving was associated with the DRD2 A1 versus A2 allele among Asian Americans. Further studies examining the ability of dopamine agonists to affect food craving and to reduce body fat in Asian American are warranted. More studies in food addiction among obese Asian Americans are needed with careful definition of obesity, specifically for Asian women.
Background and Objectives: Certain patients who undergo proximal jejunum resection are unable to undergo primary anastomosis and require exteriorization of the proximal jejunum. These patients usually have major prob- lems with short bowel due to the high output of the stoma. The output of a proximal jejunostomy contains abun- dant amounts of enzymes and electrolytes. Therefore, it is a feasible approach to re-infuse jejunostomy output to regain homeostasis. To evaluate the effects of proximal jejunostomy output reinfusion into the distal small bowel for patients with short bowel syndrome, and to determine whether reinfusion could avoid long-term parenteral nu- trition (PN). Methods and Study Design: PN was initiated immediately after surgery. When patients started en- teral nutrition, we started the proximal jejunostomy output reinfusion protocol. Proximal jejunostomy output rein- fusion was performed by the patients, and continued by them after discharge. When proximal jejunostomy output reinfusion could be performed stably, PN was stopped. Results: The median length of the proximal jejunum was 20 cm and of the distal small bowel was 77.5 cm in patients who could stably receive proximal jejunostomy out- put reinfusion alone. Three patients did not require home PN; they only required PN during hospitalization. Four patients successfully underwent stoma takedown with intestinal anastomosis after 6-7 months without any nutri- tional or metabolic complications. Conclusion: Short bowel syndrome patients with an adequate length of small bowel and functional colon could avoid long-term PN by receiving reinfusion of proximal jejunostomy output in- to the distal small bowel.
African leafy vegetables (ALVs) are known to be high in β-carotene content and are preferred over kales due to this nutritional superiority. Ten different vegetables were collected from farm and market locations and analyzed for β-carotene content. Cooked vegetables (in single or in combination) as well as solar dried samples were pre- pared by the community members in the study area in the usual way and without any instruction or conditions given. β-carotene content was analyzed using a High Performance Liquid Chromatography (HPLC). The results provided new representative β-carotene content of the fresh, marketed, cooked and dried vegetables without con- trolling or simulating the household handling or processing methods in a laboratory. While edible portions of kales are relatively inferior as a β-carotene source as compare to ALVs when in raw form, this is not the case at market place where kales exhibit comparable level of the β-carotene. As much as 280 μRE/100 g (a dietarily sig- nificant amount) can be lost through β-carotene oxidation before farm-fresh ALVs are sold in the market place with the losses severe in some ALVs and only subtle and relatively lower in kales. Post – cooking, kales had sta- tistically comparable β-carotene content to ALVs save for when compared with purple amaranths and blacknight shade. Due to losses experienced in ALVs, kales are not comparatively inferior vegetables in terms of β-carotene content. Measures to prevent β-carotene losses in ALVs between the farm and market, during cooking and drying should be instituted in order to benefit from their high β-carotene content.
Knowledge concerning nutritional status of patients with chronic kidney disease (CKD) is limited. Nutritional Risk Screening-2002 (NRS-2002) has been used to evaluate the nutritional aspects of patients according to the recommendation of European Society for Clinical Nutrition and Metabolism. Here we aim to assess the preva- lence and characteristics of nutritional risk in CKD patients by using NRS-2002. NRS-2002 scores of 292 CDK patients were recorded in first 24 hours subsequent to their admission to hospital. All patients have never been on dialysis. BMI, weight and various biochemical parameters were also characterized for these patients. Possible correlations between these parameters and NRS-2002 score were investigated. The overall prevalence of nutri- tional risk was 44.9% (53.6% in CKD stage 4-5 patients and 38.3% in stage 1-3 patients). Statistically significant differences were found in serum Albumin, Haemoglobin B, and lymphocyte counts between patients with or without increased nutritional risk. Under the situation that attending physicians were completely unaware of NRS-2002 scores, only 35.1% of the patients at risk received nutritional support. The nutritional risk status was associated with CKD stages but independent from primary diagnosis type. More attention should be paid to the nutritional status in CKD patients (including early stage patients). We recommended using NRS-2002 for nutri- tional risk assessment among non-dialysis CKD patients in routine clinical practice.
The Leeds Food Preference Questionnaire (LFPQ) is a computerised procedure that assesses liking, wanting and relative preferences for shared characteristics of food. This study adapted the LFPQ (LFPQ-A) to assess its cross-cultural validi- ty in an Arab sample by examining its performance for food characteristics of fat (high or low) and taste (sweet or non- sweet), under fasted and fed states. Individual differences in eating behaviour were examined by testing for associations between the LFPQ-A outcomes and subscales of the Three Factor Eating Questionnaire (TFEQ). Thirty healthy males (age: 36.3±10.0 years; body mass index: 29.7±5.3 kg/m2) participated in the study. All participants attended the labora- tory in the morning following an overnight fast, and performed the LFPQ-A under fasted and fed conditions (after a standardised test meal). Results showed that implicit wanting and relative preference for non-sweet foods decreased in the fed compared to the fasted state, whereas scores for sweet foods increased. Explicit liking and explicit wanting were also higher for non-sweet foods in the fasted condition, and decreased to a greater extent in the fed condition compared to a lesser decrease for sweet foods. Scores on all LFPQ-A outcomes for high-fat non-sweet foods were positively asso- ciated with TFEQ Disinhibition. Outcome scores for low-fat non-sweet foods were positively associated with TFEQ Restraint. The LFPQ-A showed outcomes that were consistent with studies performed in Western samples, therefore the current study helps to confirm the validity of the LFPQ-A as a measurement of liking and wanting and preference for food among Arabs.
Background and Objectives: This study aimed to explore the effect of functional foods on aphasia related to a previous ischemic stroke. When stroke-related neurological deficits result in physical dependency and poor self- care that persists longer than 6 months, full recovery is almost impossible and the patient often requires long-term care. The functional foods, EASE123 and BioBalance#6, include numerous plant and marine-based nutrient sup- plements that could prove beneficial for such patients. Methods and Study Design: This open-labelled study in- cluded 10 patients diagnosed with prior ischemic stroke and aphasia lasting longer than 6 months. Each patient was administered 6 tablets of EASE123 at 10:30 AM and at 90 minutes before sleeping, and 3 tablets of BioBal- ance#6 at 2:30 PM. After a treatment period of 12 weeks, the patients were followed during a 4-week withdrawal period. Functional improvement was assessed by scores and subscores on the Concise Chinese Aphasia Test (CCAT) at weeks 4, 8, 12, and 16. Results: Average total CCAT scores and matching ability improved signifi- cantly at weeks 4, 8, 12, and 16 (p<0.05). Simple response scores improved significantly at weeks 8 and 12 (p<0.05). Auditory comprehension improved significantly at weeks 4 and 12 (p<0.05), and reading comprehen- sion, at week 12 (p<0.05). Repetition ability improved significantly at weeks 8, 12, and 16 (p<0.05), and sponta- neous writing, at weeks 4, 12, and 16 (p<0.05). Conclusions: Matching, repetition, and average total CCAT scores improved over the course of the study. Therefore, 6 months after ischemic stroke, EASE123 and BioBal- ance#6 administration may improve stroke-related aphasia.
The evolution of nutritional status (the prevalence of nutritional risk, malnutrition, overweight and obesity) and the nutritional support of the hospitalized patients from admission to discharge or over a two-week period in or- thopedics/spinal surgery of a teaching hospital in Hohhot were investigated. 432 patients from two wards of the orthopedics/spinal surgery from Jan to Dec 2013, the traditional spinal surgery and the minimally invasive spinal surgery, were selected and detected in this study. The Nutritional Risk Score 2002 (NRS 2002) was used to de- termine the patients’ nutritional status within 48h after admission and during their hospitalization. The overall prevalence of nutritional risk, malnutrition, overweight and obesity at admission was 11.6%, 12.7%, 35.9% and 7.41%, respectively. Overall, there were 88.0% of the patients who were at nutritional risk received nutritional support, while 14.1% of non-risk patients received a redundant nutritional support. The overall prevalence of nu- tritional risk changed from 11.6% at admission to 19.4% upon discharge (p<0.05), and the prevalence of malnu- trition changed from 12.7% to 20.6% (p<0.05). The prevalence of overweight and obesity, which changed from 35.9% to 31.0% and from 7.41% to 5.79% respectively, didn’t experience statistically significant evolution. NRS 2002 was a feasible nutritional risk screening tool for patients in spinal surgery of orthopedics department. Pa- tients’ prevalence of nutritional risk and malnutrition increased significantly in spinal surgery of this hospital. Some inappropriate uses of nutritional support were observed in orthopedics/spinal surgery, and nutritional sup- port guidelines or protocols should be promoted by a professional committee.
Malnutrition and small intestinal bacterial overgrowth (SIBO) is frequently present in patients with liver cirrhosis (LC). However, the direct relationship between SIBO and nutrition status in the LC patients has not been eluci- dated. The aim of this study was to investigate whether there was an association between nutrition status, evaluat- ed by the subjective global assessment (SGA) and SIBO in patients with Hepatitis B virus (HBV) or hepatitis C virus (HCV) related cirrhosis. A total of 120 patients with HBV or HCV-related cirrhosis and 30 healthy controls were included. Nutritional status was determined according to SGA and anthropometry. All patients and healthy controls underwent a glucose hydrogen breath test for SIBO. The prevalence of malnutrition for the patients with HBV or HCV related cirrhosis ranged 19.4%-60% in China. The highest prevalence of malnutrition was detected by SGA, the lowest by triceps skinfold thickness. The frequency of SIBO was significantly higher in the mal- nourished (SGA-B/C) than in the well-nourished (SGA-A) patients with HBV or HCV related cirrhosis [41/72 (56.9%) vs 12/48 (25.0%) (p=0.001)]. Univariate analysis showed that SIBO, ascites, and Child–Turcotte–Pugh (CTP) class were associated with malnutrition. Multivariate analysis demonstrated that SIBO [odds ratio (OR) 8.10; p=0.002] and ascites (OR 4.56; p=0.022) were independently associated with the occurrence of malnutrition (SGA-B/C) in the same subjects. SIBO is independently related to the occurrence of malnutrition (SGA-B/C) in patients with HBV or HCV cirrhosis. We deduce that SIBO may play an important role in nutrition status in pa- tients with HBV or HCV cirrhosis.
Background and Objectives: The International Society of Renal Nutrition and Metabolism (ISRNM) has recent- ly recommended the use of the term “protein-energy wasting” (PEW). PEW is a state of malnutrition with de- creased body stores of protein and energy fuel in hemodialysis patients and is known as a risk factor for morbidity and mortality. We examined the prevalence of PEW and the characteristics of PEW patients in a hemodialysis center in Japan. Methods and Study Design: Fifty-nine outpatients undergoing maintenance hemodialysis at Iga City General Hospital were evaluated. We observed their biochemical data, body composition, dietary intake, and the number of steps prospectively. PEW was defined according to ISRNM criteria. Results: Nine patients (15% of total) were diagnosed as having PEW. Among indicators of PEW criteria, the relevance ratios of “reduced muscle mass” and “unintentional low dietary energy intake” were significantly higher in PEW than in non-PEW. The number of steps was lower, and serum levels of glucose and C-reactive protein were higher in PEW. Conclu- sion: About 15% of Japanese hemodialysis patients are estimated to have PEW. Our results suggested that major contributing factors to PEW were reduced muscle mass, unintentional low dietary energy intake, lower amount of exercise, insulin resistance, and chronic inflammation.