Background and Objectives: The present review examined the best available evidence regarding consumption levels and sources of added sugar in different population groups in Thailand. Methods and Study Design: In- formation was extracted from food balance sheets, household expenditure surveys, food consumption surveys, government reports, published and unpublished studies. Results: A total of 24 references were obtained, compris- ing 8 nationally representative reports and 16 individual studies. Results were inconsistent. The National Statis- tical Office reported an available supply of 83 g sugar per capita per day in 2010. The 2009 Food Consumption Survey of Thai Population showed median intake of sugar and sweeteners for all age groups ranging from 2.0 to 20.0 g per day among males and from 2.0 to 15.7 g per day among females (below the Thai recommendation of 40 to 55 g/day). Studies on children suggested intake levels between 25 to 50 g/day, while studies on adults were inconsistent. Frequently consumed sources were table sugar, sweetened beverages, and sweet snacks (traditional desserts, baked products, crispy snacks). Conclusions: Insufficient evidence exists regarding intake levels and sources of added sugar in Thailand. Limitations were the use of food frequency questionnaires or a single 24-h recall to assess intake, and outdated studies with small sample sizes. An updated nationally representative survey using improved methods is needed to determine the levels and sources of sugar intake in different population groups. These include biomarkers to establish levels of consumption and multiple 24-h recalls (at least two) to identify food sources that contribute significantly to excess sugar intake.
Background and Objectives: The aim of this study was to investigate (1) the hydrocolloid properties of grass jelly on reducing glycaemic response, (2) the impact of phenolic compounds in Mesona chinensis L. on glycae- mic response. Methods and Study Design: A total of 15 healthy Chinese men were recruited to this study. On each visit, subjects consumed one of the following three treatments, i.e. glucose solution (T1), grass jelly (Meso- na chinensis L.) solution with glucose (T2) or grass jelly gel with glucose (T3). Capillary blood glucose and ve- nous plasma insulin were analysed over a period of 180 min. Results: The incremental area under the curve for capillary glucose and venous plasma insulin for glucose group, grass jelly solution group and grass jelly gel was found to be statistically not significant (p>0.05). In a previous study the co-ingestion of grass jelly with complex carbohydrate was found to reduce glycaemic response. The key difference between the two studies was the use of monosaccharide glucose in the present study, compared to complex carbohydrates in the other. The present study suggests that the glycaemic lowering effect of grass jelly may be dependent on the inhibition of carbohydrase en- zymes. Conclusions: The co-ingestion of Mesona chinensis L. appears to reduce glycaemic response of only complex carbohydrates through the inhibition of carbohydrase. This conclusion was arrived at by the lack of any effect of Mesona chinensis L. on the monosaccharide glucose.
Background and Objectives: This randomized, placebo-controlled trial was performed for 8 weeks to investi- gate the potential effects of astaxanthin (AST) supplementation on the adiponectin concentration, lipid peroxida- tion, glycemic control, insulin sensitivity, and anthropometric indices in participants with type 2 diabetes mellitus. Methods and Study Design: We enrolled 44 participants with type 2 diabetes who met our inclusion criteria. Eight milligrams of AST supplementation or a placebo were randomly administered once daily for 8 weeks to these participants. Results: The 8-week administration of AST supplementation increased the serum adiponectin concentration and reduced visceral body fat mass (p<0.01), serum triglyceride and very-low-density lipoprotein cholesterol concentrations, and systolic blood pressure (p<0.05). Furthermore, AST significantly reduced the fructosamine concentration (p<0.05) and marginally reduced the plasma glucose concentration (p=0.057). Con- clusions: We demonstrated that because participants with type 2 diabetes often have hypertriglycemia and uncon- trolled glucose metabolism; our findings of dual beneficial effects are clinically valuable. Our results may provide a novel complementary treatment with potential impacts on diabetic complications without adverse effects.
Background and Objectives: Isoflavone (daidzein and genistein) interventions in postmenopausal women have produced inconsistent skeletal benefits, partly due to population heterogeneity in daidzein metabolism to equol by enteric bacteria. This study assessed changes in microflora and bone turnover in response to isoflavone and ki- wifruit supplementation in New Zealand postmenopausal women. Methods and Study Design: Healthy women 1-10 years post-menopause were randomly allocated to group A (n=16) or B (n=17) for a 16-week crossover trial. Two consecutive 6-week treatment periods had a 2-week lead-in period at intervention commencement and a 2- week washout period between treatments. Treatments prescribed either (1) daily isoflavone supplementation (50 mg/day aglycone daidzein and genistein) alone, or (2) with two green kiwifruit. At treatment baseline and end- point (four time points) the serum bone markers C Telopeptide of Type I collagen (CTx), undercarboxylated os- teocalcin (unOC), and serum and urinary daidzein and equol, were measured. Changes in gut microflora were monitored in a subgroup of the women. Results: Equol producers made up 30% of this study population (equol producers n=10; non-equol producers n=23) with serum equol rising significantly in equol producers. Serum ucOC decreased by 15.5% (p<0.05) after the kiwifruit and isoflavone treatment. There were no changes in serum CTx or in the diversity of the gut microflora. Conclusions: 50 mg/day isoflavones did not reduce bone resorption but kiwifruit and isoflavone consumption decreased serum ucOC levels, possibly due to vitamin K1 and/or other bioactive components of green kiwifruit.
Background and Objectives: Eggs, an important source of high-quality protein, contain a variety of key nutri- ents and antioxidants. Here we conducted an intervention study to evaluate whether the additional consumption of one egg per day would affect the daily nutritional intakes and blood antioxidant status in Japanese woman univer- sity students. Methods and Study Design: For 4 weeks, the 14 subjects were provided a nutritious breakfast in- cluding one boiled egg, and they were asked to keep a daily dietary record. Results: The subjects’ daily energy intake during the intervention did not differ compared to the baseline, whereas the protein energy ratio and cho- lesterol intake were significantly increased. The subjects’ consumption of confectionery during the intervention was significantly decreased compared to the pre-trial period. The total score of adherence to the food-based Japa- nese dietary guidelines for a healthy diet during the intervention was higher than that at baseline. The analysis of fasting blood samples showed that the subjects’ serum lipids levels were not altered, whereas their malondialde- hyde modified low-density lipoprotein (MDA-LDL) levels and the oxidative susceptibility of LDL were signifi- cantly reduced after the intervention. More importantly, serum folic acid levels were significantly increased. Conclusions: Our results suggest that regular egg consumption at breakfast can help improve the daily nutritional status and dietary habits and also ameliorate certain indices of antioxidant status in young women.
Background and Objectives: Western dietary patterns have been linked with kidney disease. This study investi- gated the association between Chinese dietary patterns and kidney disease in a Taiwanese population with type 2 diabetes and evaluated dietary fatty acid patterns, a kidney-related dietary biomarker. Methods and Study De- sign: We recruited 838 patients with type 2 diabetes and used their dietary and renal data obtained from three re- peated measures in 2008, 2009 and 2010. Diet was assessed using food-frequency questionnaires, and factor analysis was performed to identify dietary patterns. Albuminuria was defined by having an albumin-to-creatinine ratio 30 mg/g and kidney dysfunction by estimated glomerular filtration rate <60 mL/min/1.73m2. Generalized estimating equation models were used to estimate ORs (95% CIs) of kidney disease adjusted for covariates. Erythrocyte fatty acids were only measured in blood samples collected in 2008. Results: Three dietary patterns were identified: high fat-meat, traditional Chinese food-snack, and fish-vegetable. In the adjusted model, the high fat-meat and traditional Chinese food-snack diets were not associated with any kidney outcomes. The fish- vegetable diet was inversely associated with kidney dysfunction (quartile 4 vs 1, OR: 0.75, 0.58-0.97), but not as- sociated with albuminuria. A higher fish-vegetable diet factor score was associated with higher n-3 fatty acid lev- els. Conclusion: In patients with diabetes, we found greater adherence to a fish-vegetable diet to be associated with better kidney function and greater n-3 fatty acid profiles. The inclusion of repeated dietary assessments and dietary biomarker measurements in future diet-disease research, especially in patient populations, may provide more definitive risk evaluation.
Background and Objectives: Large-scale epidemiological investigations worldwide have shown that dietary glycemic load is associated with metabolic diseases, including diabetes. However, only a few studies have exam- ined the correlations between glycemic load and blood glucose and lipids in Chinese diabetic patients. Therefore, this study aimed to determine these correlations in southeastern China. Methods and Study Design: 201 patients with newly diagnosed type 2 diabetes and 126 participants with normal blood glucose were enrolled at the Sun Yat-sen Memorial Hospital, Guangdong Province. Carbohydrate intake and glycemic load were assessed based on 3-day dietary records. Using glycemic load as the dependent variable, a correlation analysis and multiple re- gression analyses were used to analyze the correlations between glycemic load and blood glucose and lipids. Re- sults: The mean glycemic load in diabetic patients was significantly higher than that in the control group (p<0.05). Correlation analysis showed that glycemic load was positively correlated with body mass index and glycated he- moglobin in diabetic patients (p<0.05) but negatively correlated with high-density lipoprotein cholesterol in all subjects (p<0.05). Multivariable regression analysis indicated that, among participants in southeastern China, a higher glycemic load increased the odds of having diabetes, a low high-density lipoprotein cholesterol, and higher Charlson weighted index of comorbidities score, as well as being overweight. Conclusions: A high-glycemic load diet may be associated with a risk of diabetes, glycemic control, lipid metabolism, prognosis of diseases, and body composition. It is necessary to control dietary glycemic load for both patients with diabetes and healthy people in southeastern China.
Background and Objectives: This study explored the prevalence of gestational diabetes mellitus (GDM) in Chi- nese pregnant women and identified risk factors for GDM after the implementation of the universal two-child policy. Methods and Study Design: On the basis of income and population, we randomly selected three hospi- tals through stratified and cluster sampling. From January 1 to July 31, 2016, 4959 women who had been regis- tered within 12 weeks of gestation received a 75-g 2-h oral glucose tolerance test (OGTT) at 24–28 gestational weeks. International Association of Diabetes and Pregnancy Study Group criteria were used for the diagnosis of GDM. Results: The OGTT was positive in 1080 (21.8%; 1080/4959) women, who were then diagnosed as hav- ing GDM on the basis of their results. GDM was positively associated with the following factors: advanced ma- ternal age (p<0.001; adjusted odds ratio [OR]=4.88; 95% confidence interval [CI]=2.38–10.0, pre-pregnancy body mass index overweight (OR=2.44, 95% CI=1.78–3.34)/obesity (OR=10.9, 95% CI=6–19.6; p<0.001), pa- ternal history of diabetes (p=0.003; OR=2.54, 95% CI=1.38–4.67), and maternal history of diabetes (p<0.001; OR=3.6, 95% CI=2.16–5.98). Conclusions: Qingdao has an exceptionally high estimated prevalence of GDM. Widely recognized risk factors for GDM were advanced age, pre-pregnancy overweight/obesity, and a family his- tory of diabetes in first-degree relatives. More options to prevent and manage GDM must be explored.
Background and Objectives: Maternal iron deficiency in late pregnancy, labor, and the postpartum period has an indirect impact to decrease neurotrophin concentration in the fetal hippocampus, namely brain-derived neu- rotrophic factor (BDNF). It plays an important role in the development of learning, memory, and behavior. The aim of this study was to determine the differences in BDNF between neonates born to mothers with normal and low ferritin. Methods and Study Design: This was an observational study with a cross-sectional design involv- ing 20 term pregnant women with normal ferritin (≥12 ng/mL) and 20 term pregnant women with low ferritin (<12 ng/mL). Samples were taken from Yarsi hospital, BMC hospital, and Hardi clinic located in Padang, from August 2015 to February 2016. Umbilical cord plasma was examined directly after delivery using an enzyme- linked immunosorbent assay (ELISA) employed at the Biomedical Laboratory of Andalas University. Mean dif- ferences were statistically assessed by independent samples t-test. Results: Plasma BDNF concentrations in neo- nates born to mothers with normal and low ferritin were 3.81±1.37 ng/mL and 2.78±1.19 ng/mL, respectively (p=0.015). Conclusions: Plasma BDNF was lower in neonates born to mothers with low serum ferritin.
Background and Objectives: The present study investigated the iodine status of breast milk and breast-fed in- fants during the first 12 weeks postpartum in Tianjin, China. Methods and Study Design: A total of 175 preg- nant women were recruited before delivery. Their breastmilk and 24-h urine samples were collected at 4, 8, and 12 weeks postpartum; spot urine samples were simultaneously collected from their infants. The iodine content of the samples was measured. Results: The mean breast milk iodine concentrations (BMICs) at 4, 8, and 12 weeks were 221.7±103.5 μg/L, 175.2±76.2 μg/L, and 148.1±66.2 μg/L, respectively. Significant differences existed be- tween the mean BMICs of the three sampling times (F=12.449, p<0.001). The BMIC showed a decreasing trend during the first 12 weeks postpartum. The median urinary iodine concentrations (UICs) of the mothers were 152, 112, and 109 μg/L at the different sampling times. The BMIC and UIC were not correlated in the mothers. The median UICs in the infants were 251, 183, and 164 μg/L. The infant UICs were statistically different at the three sampling times (p=0.001). Moreover, the infant UICs correlated with the BMICs (Rs=0.205, p=0.010) but not with the maternal UICs (Rs=0.131, p=0.067). Conclusion: The BMIC in and infant iodine intake from breast milk decreased in the first 12 weeks. Breastfed infants could receive adequate iodine from breast milk in Tianjin City.
Background and Objectives: Childhood obesity is a rising health concern in Vietnam, however, research in this area is not extensive. The aim of this study was to determine the prevalence of childhood overweight and obesity, and to study associations between weight status and selected lifestyle factors, such as diet and physical activity levels, among children aged 6-10 years in Hai Phong City, Vietnam. Methods and Study Design: Two hundred and seventy-six children from an urban and a rural primary school participated in this cross-sectional study. Data on weight, height and waist circumference were used to calculate BMI, and waist-height ratio to determine the proportion of children who were overweight, obese and had high central adiposity. Information on diet, physical activity and socioeconomic status of families was collected using questionnaires. Results: Prevalences of over- weight, obesity and high abdominal adiposity were 11.2%, 10.1% and 19.9%, respectively. Children who com- pleted 60 minutes of physical activity daily were 50% and 80% less likely to be overweight and have high ab- dominal adiposity, respectively. Computer usage increased the odds of overweight and high abdominal adiposity by 4.5 and 3.9 times, respectively. Mothers with higher education and income levels increased the risk of their children being overweight (p<0.05). Conclusions: Physical inactivity and high maternal education and income levels increased the risk of childhood overweight and obesity in this cohort. Future interventions should target parents and their children by providing both with educational modules centred on healthy eating habits, parental feeding practices and strategies for increasing physical activity.
Formula-based animal milk is an alternative source of infant nutrition in many cases when breastfeeding is unac- ceptable or inaccessible; however, these replacements often have low selenium levels. The composition of infant formula milk should be as close as possible to that of human breast milk, both in content and chemical speciation. Selenium is an essential trace element for infants. Generally, human breast milk is the ideal food to ensure ade- quate infant Se intake. However, to date, sodium selenite or sodium selenate has been used as selenium supple- mentation in infant formula milk in most countries. This inorganic Se, which is not a natural component of food, may not be the optimal speciation for Se supplementation in infant formula milk. Advances in speciation in foods, especially in animal milk, suggest that future proposals for selenium speciation in human breast milk can lead to discussions regarding the most favorable methods of selenium supplementation in infant formula milk.
Background and Objectives: Dietary patterns have been linked to the risk of obesity in adults but little is known about such a link in young children. To examine the association between dietary patterns, nutrient intake and obe- sity in a representative population of preschool children in Australia. Methods and Study Design: Dietary intake was assessed using a 3-day weighed food diary. Dietary patterns were identified by factor analysis. Children were classified as overweight or obesity if their BMI z-score was between the 85th–95th percentiles or was above the 95th percentile, respectively. Results: Three dietary patterns were identified. The ‘Traditional’ pattern was char- acterised by grains, fruit, vegetables, and red meat. The ‘Processed’ pattern was characterised by processed meats, snack foods and confectionary. The ‘Health conscious’ pattern was characterised by eggs, fish, polyunsaturated margarines and low fat dairy products. The “Traditional’ pattern was positively associated with protein and zinc intake while the ‘Processed’ pattern was inversely associated. Both patterns were inversely associated with calci- um intake. No associations were found between the ‘Health conscious’ pattern and macronutrients and key mi- cronutrients intakes. The ‘Traditional’ pattern was positively associated with obesity but the association became non-significant after adjustment for energy and protein intake. No association was observed between the other two dietary patterns and weight status. Conclusions: In this cross-sectional study, dietary patterns were not asso- ciated with obesity. Longitudinal follow up will help to better understand the relationship between dietary pat- terns in early childhood and the risk of obesity later in life.
Background and Objectives: Dietary diversity plays a critical role in infants as they need energy and nutrient dense foods for both physical and mental development. This study examines whether three dietary diversity indi- ces validate against Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR) and studies the relation- ship of dietary diversity with nutritional status of preschool children, in two districts of India: Wardha district in Maharashtra state and Koraput district in Odisha state. Methods and Study Design: Dietary diversity was calcu- lated using: individual food scores calculated using 24 hour diet recall (FS24hr) data; household dietary diversity using Berry’s index (DDI) and food scores calculated using food frequency data (FSFFQ). Nutritional status was assessed by anthropometric indices. Results: It was observed that 42.7% of 1 to 5 years children were under- weight, 38% stunted and 27.6% wasted across both locations. The dietary diversity was found to be relatively better in Wardha when compared with Koraput with mean diversity of FS24hr 7, DDI 90 and FSFFQ 63 in both lo- cations. Preschool children in both locations consumed a cereal based diet. Apart from protein in both locations and energy in Koraput, the NAR of all nutrients consumed was <70% of requirement. MAR showed lower con- sumption of nutrients than the recommended levels (50% adequacy). NAR and MAR correlate with FS24hr indi- cating that dietary diversity calculated using 24 hour diet recall ensures nutrient adequacy but showed association only with Height-for-Age scores. Conclusion: Dietary diversity calculated using three methods did not show any correlation with nutritional status of 1 to 5 years children.
Background and Objectives: This study aimed to determine the relationship between breakfast consumption and body weight status among primary and secondary school children in Malaysia. Methods and Study Design: This nationwide cross-sectional study involved 5,332 primary school children aged 6 to 12 years and 3,000 sec- ondary school children aged 13 to 17 years. Height and weight were measured and BMI-for-age was determined. Socio-demographic backgrounds, breakfast habits and physical activity levels were assessed using questionnaires. Breakfast frequency was defined as follows: breakfast skippers (ate breakfast 0-2 days/week), irregular breakfast eaters (ate breakfast 3-4 days/week) and regular breakfast eaters (ate breakfast ≥5 days/week). Results: The over- all prevalence of breakfast skippers and irregular breakfast eaters was 11.7% and 12.7% respectively. Breakfast skipping was related to age, sex, ethnicity, income and physical activity level. Among primary school boys and secondary school girls, the proportion of overweight/obesity was higher among breakfast skippers (boys: 43.9%, girls: 30.5%) than regular breakfast eaters (boys: 31.2%, girls: 22.7%). Among primary school children, only boys who skipped breakfast had a higher mean BMI-for-age z-score than regular breakfast eaters. Among sec- ondary school boys and girls, BMI-for-age z-score was higher among breakfast skippers than regular breakfast eaters. Compared to regular breakfast eaters, primary school boys who skipped breakfast were 1.71 times (95% CI=1.26-2.32, p=0.001) more likely to be overweight/obese, while the risk was lower in primary school girls (OR=1.36, 95% CI=1.02-1.81, p=0.039) and secondary school girls (OR=1.38, 95% CI=1.01-1.90, p=0.044). Conclusion: Regular breakfast consumption was associated with a healthier body weight status and is a dietary behaviour which should be encouraged.
Background and Objectives: In addition to the intake ratio of omega 6 (n-6) to omega 3 (n-3) fatty acids, their intake amount has an effect on health. This study evaluated the n-6:n-3 intake ratio as well as the food sources and association of these fatty acids with demographic characteristics based on sixth Korea National Health and Nutrition Examination Survey data. Methods and Study Design: This study included 13,937 participants from the survey. The weighted mean intake and major food groups of n-3 and n-6 fatty acids were determined. The 10 chief food sources of n-3 and n-6 fatty acid were expressed as percent contribution to total intake. Results: α- Linolenic acid constituted approximately 80% of total n-3 intake, followed by docosahexaenoic acid (10.5%) and eicosapentaenoic acid (6.1%). Linoleic acid constituted 97% of total n-6 intake. After adjustment for cofactors (age, sex, and energy intake), education level (p<0.01), alcohol consumption frequency (p<0.05) and monthly in- come (p<0.01) were significant variables determining n-3 and n-6 FA intake by Korean people. The average n- 6:n-3 intake ratio was 7.49:1. The major source of α-linolenic acid and linoleic acid was soybean oil, whereas that of docosahexaenoic acid and eicosapentaenoic acid was mackerel. Pork (70.0%) and egg (38.7%) were the major food sources of arachidonic acid and dihomo-γ-linolenic acid, respectively. Conclusion: Monthly income, alco- hol consumption frequency, and education level significantly affected n-3 FA intake. The dietary n-6: n-3 intake ratio in Korea is 7.49:1; however, eicosapentaenoic acid and docosahexaenoic acid intake remains inadequate (0.27 g/day).
Background and Objectives: Information on a whole array of characteristics associated with dietary misreport- ing in a representative sample in each country is still limited. Using data from the 2012 National Health and Nu- trition Survey, Japan, we investigated the prevalence and characteristics of under- and over-reporting of energy intake among 19,986 Japanese adults aged ≥20 years. Methods and Study Design: Each individual’s energy in- take was calculated based on a 1-day semi-weighed dietary record. Under-, plausible, and over-reporters were identified based on the 95% confidence limits 1) for agreement between the ratio of energy intake to basal meta- bolic rate and a physical activity level for sedentary lifestyle (1.55), and 2) of the expected ratio of energy intake to estimated energy requirement of 1.0, assuming ‘low active’ level of physical activity. Results: Almost all sub- jects (≥92.8%) were classified as plausible reporters by any of the methods applied, with very low percentages of under- and over-reporters (≤6.3% and ≤2.0%, respectively). Under-reporting was associated with younger age, overweight and obesity (compared with normal weight), current smoking (compared with never smoking), no al- cohol drinking (compared with drinking everyday), and household consisting of a single person (compared with that consisting of two persons). Over-reporting was associated with gender (female), normal weight (compared with overweight), and household consisting of a single person. Conclusions: Overall mean energy intake ob- tained in this sample of Japanese adults appears to be plausible, but caution should be exercised when assessing the plausibility of energy intake in some subgroups.
Background and Objectives: With rapid population ageing and an increasing rate of hypertension in China, this study aims to examine the association between dietary patterns, dietary lead and hypertension among older Chi- nese population. Methods and Study Design: We analysed the 2009 China Health and Nutrition Survey data (2,634 individuals with dietary and hypertension measurement data, aged ≥60 years). Dietary data were obtained using 24 hour-recall over three consecutive days. Dietary lead intake is based on a published systematic review of food lead concentration and dietary lead exposure in China. Factor analysis was used to identify dietary patterns. Poisson regression and multinomial logistic regression models were used to explore the association between die- tary patterns and hypertension. Results: The prevalence of hypertension was 47.0% in men and 48.9% in women. Traditional dietary pattern (high intake of rice, pork and vegetables) was significantly inversely associated with known hypertension. In the fully adjusted model, compared with the lowest quartile of traditional dietary pattern, the highest quartile had a lower risk of known hypertension, with Relative Risk Ratio=0.69 (95% CI: 0.50; 0.95). However, associations between modern dietary pattern and hypertension differed by urbanization; an inverse, positive and null association was seen in low, medium and high urbanization. Additionally, dietary lead showed a significant positive association with hypertension and known hypertension. Conclusions: Policies that facilitate and promote healthy diets, and the availability of healthy foods particularly at the regional and local levels, are important for the prevention of hypertension.
Background and Objectives: Despite the demonstrated protective effects of green tea and coffee intake against several chronic diseases, finding between studies have not been consistent. One potential reason of this discrep- ancy is the imprecision in the measurement of tea or coffee consumption using food frequency questionnaire (FFQ) and food record (FR) in epidemiological studies. Methods and Study Design: In a sample of 57 healthy Japanese women, intake of green tea and coffee was estimated by a validated FFQ and a 3-day FR, while their plasma and urine concentrations of polyphenol biomarkers were measured by HPLC. The polyphenols assessed included (-)-epigallocatechin gallate (EGCG), (-)-epicatechin gallate (ECG), (-)-epigallocatechin (EGC) and (-)- epicatechin (EC), caffeic acid (CA) and chlorogenic acid (CGA). Results: Green tea consumption estimated by FFQ and FR showed moderate association, while strong association was detected for coffee consumption. Uri- nary green tea polyphenol concentrations were moderately-strongly associated with FR-estimated intake, while the associations were weak with FFQ. Similarly, coffee polyphenols in urine were moderately associated with FR-estimated coffee intake, whereas FFQ showed poor correlation. The associations between urinary and plasma polyphenols ranged from moderate to high. Conclusions: The results indicated that firstly, the FFQ tends to overestimate green tea intake. Secondly, the urinary polyphenols are preferred over plasma polyphenols as a po- tential surrogate marker of the short-term green tea and coffee intake, while their use as an indicator of long-term consumption is not reliable.
Background and Objectives: The integration of nutrition knowledge into nutritional behaviour can help children to develop a healthy lifestyle that may be carried forward into adulthood. E-learning enables students to take ownership of recording their dietary intake and modify their diets by making their own decisions regarding food choices and portion sizes through reflective feedback. This study investigated the role of behavioural feedback in nutrition education in modifying students’ nutrition knowledge and behaviour. Methods and Study Design: Ninety-five secondary students studying from Secondary 1 to Secondary 3 were recruited from five schools. Moreover, 50 and 45 students were randomly assigned to experimental and control groups, respectively. Nutrition education delivered through e-learning (NeL) was adopted to record students’ diets. Online reports with behav- ioural feedback were provided for the experimental group but not for the control group. NeL sessions lasted for 12 weeks. The energy and nutrient profiles of the students were recorded as pre–post measurements. Pre–post nu- trition knowledge was assessed using a self-administered questionnaire at the baseline and after intervention. Re- sults: The experimental group had significantly higher scores in the ‘dietary recommendation’ and ‘food choices’ domains of the questionnaire and demonstrated significant dietary improvement in the intake of all studied mac- ronutrients and micronutrients. Conclusions: Nutrition education conducted with behavioural feedback can effec- tively improve adolescents’ nutrition knowledge and nutritional behaviour.
Background and Objectives: This study aimed to investigate the nutritional quality and patterns of lunch menus provided by child care centers in South Korea and Japan. Methods and Study Design: The weekly lunch menus from Monday to Saturday that child care centers provided in November 2014 in South Korea and Japan were ana- lyzed. For Korea, a total of 72 meals provided by 12 centers in Seoul were analyzed by referring to the homepage of the Center for Children’s Foodservice Management, which serviced menus for child care centers. For Japan, a total of 30 meals provided by 5 child care centers in Tokyo were analyzed. Nutrient content and pattern in lunch menus were evaluated. Results: The lunch menus in Korea and Japan provided 359.5 kcal (25.7% of the estimat- ed energy requirement) and 376.3 kcal (29.5% of the estimated energy requirement), respectively. ‘Rice + Soup + Main dish + Side dish I + Side dish II’ were provided in 66.7% of meals in Korea, while various patterns with rice and soup as their bases were provided in Japan. Conclusions: The lunch menus of child care centers in Korea and Japan provide similar amounts of energy, protein, carbohydrate, vitamin A, calcium, and other nutrients. However, there were significant differences in the lunch menu patterns in Korea and Japan. This study provides information about the nutritional content and pattern of lunch menus at child care centers in Asian countries with rice as a staple food.
Background and Objectives: Taste perception plays a key role in consumer acceptance and food choice, which has an important impact on human health. Our aim was to examine the relationship between taste intensities and preferences of sweet (sucrose), salty (sodium chloride and potassium chloride), sour (citric acid), and bitter (qui- nine and phenylthiocarbamide) in relation to dietary intake and dietary patterns in people of Chinese ancestry. Methods and Study Design: This cross-sectional study included 100 adult Singaporean Chinese (50 women). A validated taste methodology was used with taste solutions provided by Monell Chemical Senses Center. Dietary intake and patterns were assessed by dietary recalls. Results: There was little relationship between taste intensity and tastant preference in regard to background dietary intake or pattern. Tastant differentiation was reliable, but there was some confusion in regard to the rating of saltiness as sourness. Conclusions: There was a salty-sour confusion among Singaporean Chinese unlike the bitter-sour confusion reported for Caucasians. Most sodium came from sauces and was added during food preparation. In programs to address sodium: potassium ratio excess among Chinese prone to hypertension and stroke, sour as well as salty taste may need to be considered.
Background and Objectives: To determine whether postprandial lipemia is associated with fat distribution even in young, normal weight women independently of fat mass, adipokines, insulin resistance and systemic inflam- mation. Methods and Study Design: Female college students (ages 21-24, n=35) underwent dual-energy X-ray absorptiometry and a standardized breakfast providing 17 g triglycerides (TG). Serum lipids, lipoproteins, apolipoproteins, adipokines and markers of insulin resistance and inflammation were measured in fasting blood samples. Results: In crude analyses, postprandial lipemia, as assessed by 0-2 h area under the curve of serum TG (TG-AUC), was positively associated with fasting TG, trunk/leg fat ratio, apolipoprotein B, leptin/adiponectin ra- tio and log high-sensitivity CRP. Multiple linear regression analysis with these 5 variables as independent varia- bles revealed that fasting TG (p<0.001) and trunk/ leg fat ratio (p=0.001), were independent positive predictors of TG-AUC (R2=0.923). Women with high compared to low TG-AUC were characterized by higher trunk/leg fat ra- tio, elevated apolipoprotein B and leptin/adiponectin ratio. Conclusion: Trunk/leg fat ratio, a marker of central adiposity, is a significant predictor of postprandial lipemia even in young women who are normal weight and in- sulin-sensitive, suggesting a modifiable pathway to postprandial hypertriglyceridemia, a cardiometabolic risk fac- tor. These findings should be confirmed in studies employing more participants.
The objective is to present the case of a 21-yr-old athlete observed with non-physiological immediate post- prandial insulin response (1162 pmol/l; normal glucose excursion: 6.6 mmol/l), in a warm environment. No sus- picion or evidence of any underlying pathology was found in this well-trained Afro-Caribbean male runner. He never reported any hypoglycemic episode. When performing the same protocol performed in a cooler environ- ment (21.0°C vs 30.3°C), only physiological responses were observed. We conclude that 1) youth, leanness and regular exercise training are not absolutely protective against glucose metabolism impairment in apparently healthy subjects; 2) ambient temperature should be regarded as a potential source of glucose metabolism impair- ment.
Background and Objectives: Malnutrition is an important prognostic factor for patients with liver disease and a novel nutritional assessment tool is required for these patients. The aim of this study was to validate the Mini Nu- tritional Assessment (MNA) as a nutritional screening tool for patients with liver disease, by comparing MNA scores with other nutrition-related parameters. Methods and Study Design: Patients who were hospitalized at the gastroenterology division of Kyushu and Beppu Medical Center were enrolled. The study included 77 patients with liver disease (male/female, 46/31; mean±SD age, 68.5±10.7 years; liver cirrhosis, 64.9%; liver cancer, 61.0%). Correlations of MNA score at hospital admission with anthropometric parameters and blood test data were evaluated. Results: In patients with liver disease, MNA scores demonstrated that 18 (23.4%) had normal nutritional status, 41 (53.2%) were at risk of malnutrition, and 18 (23.4%) were malnourished, indicating that up to 76.6% of the liver disease group were malnourished. Especially, patients with liver cirrhosis had lower scores of nutritional markers and MNA. The MNA score in liver cirrhotic patients correlated with the following parame- ters: % arm circumference, % triceps skinfolds, ratio of % maximum grasp strength and arm circumference, max- imum grasp strength, arm muscle circumference, calf circumference, serum albumin levels, the controlling nutri- tional status score, and Onodera’s prognostic index, while patients without liver cirrhosis did not show such cor- relation. Conclusions: MNA scores correlated with nutrition-related data in patients with liver cirrhosis. The MNA is an appropriate tool for nutritional screening assessment in these cirrhotic patients of any etiology.
Background and Objectives: To investigate the clinical outcomes in septic patients receiving parenteral fish oil. Methods and Study Design: A prospective, non-randomized, observational clinical study was carried out in 112 patients with sepsis from March, 2013 to May, 2015 in the surgical intensive care unit (SICU) of a tertiary- referral hospital. The patients were put into one of two groups; either the control or the study group. Patients re- ceived the standard treatment of sepsis based on guidelines in the control group. In the study group, patients re- ceived parenteral nutrition (PN) containing fish oil. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, the length of ICU and hospital stay, duration of mechanical ventilation, mortality, and re- admission into the ICU were recorded. Tumor necrosis factor (TNF)-α and procalcitonin (PCT) levels were also evaluated. Results: The study group showed a significant reduction for all-cause mortality (20.0% vs 10.0% in study and control groups, p=0.034) and APACHE II score on day 5 (p=0.015), day 7 (p=0.036) and day out of SICU (p= 0.045) compared with the control group. The study group tended to show a shortened length of stay in the ICU compared to the control group. However, TNF-α and PCT level, 28 d mortality, the length of hospital stay and the duration of mechanical ventilation did not show statistical differences between the two groups. There were no drug-related adverse effects shown during the study. Conclusions: PN with fish oil is probably safe and may improve clinical outcome in critical ill patients with sepsis.
Background and Objectives: The stoma of intermediate position enterostomy (IPE) often leads to high output, which is related to electrolyte abnormalities, and prolongs patient recovery post-operatively. The continuous na- sogastric tube feeding method has the advantage of reducing the risk of feeding intolerance, and improves nutri- ent absorption. In the current study, we review our experience with continuous tube feeding and compare the clin- ical outcomes with intermittent oral feeding in patients with an IPE post-operatively. Methods and Study Design: This was a retrospective review of 118 infants with IPEs in our hospital. The infants were categorized into two groups (intermittent oral feeding [OF] group [n=68 infants, 1–14 days of age] and continuous tube feeding [TF] group [n=50 infants, 1–14 days of age]). Differences in stool volume, daily intravenous fluid infusion, weight gain, nutrition indices, and post-operative complications were reviewed. Results: The stool volume and intrave- nous fluid infusion in the TF group were less than the OF group from week 2. The weight gain was higher in the TF group than the OF group from week 3. The pre-albumin and retinol binding protein levels were significantly higher in the TF group than the OF group in weeks 3–4 post-operatively. The incidence of cholestasis and water- electrolyte disturbances in the TF group was significantly lower than the OF group, and the incidence of intestinal obstruction was lower than the control group, but the differences were not significant. Conclusions: Continuous tube feeding had better clinical outcomes than intermittent oral feeding in IPE patients.
Background and Objectives: To investigate the nutritional status of patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and the factors involved. Methods and Study Design: We used the Subjective Glob- al Assessment (SGA) of nutritional status, a general questionnaire, dietary records, and laboratory parameters from 3 consecutive days to develop a NS assessment with it, we assessed 240 patients undergoing CAPD at a di- alysis center in Henan Province. Results: In this setting, the prevalence of malnutrition in patients undergoing CAPD was 11.7%. Univariate analysis showed that patient characteristics related to NS included energy and pro- tein intakes, weight and BMI, dialysis duration, urinary creatinine, and total creatinine clearance rate. Multiple linear regression analysis revealed that dialysis duration (p<0.001) and energy intake (p=0.01) were the principal predictors of nutritional status and allowed 81% of the variance in nutritional status to be explained. Conclusions: Effective collaboration between nutritionists and other health care workers to minimise dialysis duration and op- timize energy intake should improve the nutritionally-related quality of life and well-being among CAPD patients.
Background and Objectives: Respiratory quotient (RQ) is a good marker of substrate oxidation. Low RQ is fre- quently found in patients with liver cirrhosis and is associated with poor outcome. The purpose of this study was to demonstrate the effects of eating frequency on RQ in patients with cirrhosis. Methods and Study Design: We performed a randomized controlled trial to assess the effects of eating frequency on RQ in patients with cirrhosis. Seventy patients and 30 healthy controls were enrolled, and patients were further randomized to receive either normal eating frequency (NEF) meals at 08:00, 12:00 and 18:00 h, or high eating frequency (HEF) meals at 08:00, 10:00, 12:00, 15:00, 18:00 and 20:00 h. The two groups had equivalent energy intake. Fasting RQ was measured at 07:30 h and daytime RQ was measured at 11:30 and 17:30 h. Disease severity was evaluated using the Child– Turcotte–Pugh (CTP) classification. Results: Fasting RQ and daytime RQ were significantly lower in patients with cirrhosis than in healthy controls. Patients in the HEF group had a higher RQ than patients in the NEF group at three time points. In patients with CTP-A, no significant differences in daytime RQ were observed between the two groups. However, in CTP-C patients, daytime RQ was significantly higher in the HEF group than in the NEF group. Serum free fatty acid levels were significantly decreased and albumin was significantly increased after HEF intervention. Conclusions: HEF strategy is effective in improvement of RQ and is beneficial to patients with cirrhosis.
Background and Objectives: Refeeding hypophosphataemia (RH) is characterized by an acute electrolyte de- rangement following nutrition therapy. Complications associated include heart failure, respiratory failure, paraes- thesia, seizure and death. We aim to assess its incidence, risk factors, and outcome in our local intensive care unit (ICU). Methods and Study Design: A prospective observational cohort study was conducted at the mixed medi- cal-surgical of a tertiary ICU in Kuantan, Malaysia. The study was registered under the National Medical Re- search Register (NMRR-14-803-19813) and has received ethical approval. Inclusion criteria include adult admis- sion longer than 48 hours who were started on enteral feeding. Chronic renal failure patients and those receiving dialysis were excluded. RH was defined as plasma phosphate less than 0.65 mmol/L and a drop of more than 0.16 mmol/L following feeding. Results: A total of 109 patients were recruited, of which 44 (42.6%) had RH. Patients with RH had higher SOFA score compared to those without (p=0.04). There were no differences in the APACHE II and NUTRIC scores. Serum albumin was lower in those with RH (p=0.04). After refeeding, patients with RH had lower serum phosphate, magnesium and albumin, and higher supplementation of phosphate, potassium and calcium. There were no differences in mortality, length of hospital or ICU stay. Conclusions: Refeeding hypo- phosphataemia occurs in almost half of ICU admission. Risk factors for refeeding include high organ failure score and low albumin. Refeeding was associated with imbalances in phosphate, magnesium, potassium and cal- cium. Future larger study may further investigate these risk factors and long-term outcomes.