There is conclusive evidence to demonstrate the role of omega-3 polyunsaturated fatty acids (n-3 PUFA) in human development and growth, vision, and cell membrane fluidity (membrane order). N-3 PUFA also contribute to human health maintenance through correction of arrhythmias, inhibition of platelet aggregation and prolongation of clotting time, lowering blood pressure, lowering serum triglycerides and plasma homocysteine, being anti-inflammatory and immunomodulatory, being cardio-protective, increasing insulin sensitivity in Asians, and decreasing the risk of breast and colorectal cancers. This understanding of a wide spectrum of biological effects attributable to n-3 PUFA has been unsettled by a systematic review of randomized clinical intervention trials (RCTs) which has reported that n-3 PUFA have negligible or no effect on all-cause or cardiovascular mortality. Here, possible reasons for the inconsistencies in regard to n-3 PUFA and cardiovascular diseases, along with the implications for their broader biology, are considered.
Background and Objectives: Undernutrition in vascular surgery patients has a significant impact on clinical outcomes. This observational study aimed to investigate the nutritional status of a heterogeneous sample of vas- cular surgery inpatients and to determine the prevalence of nutritional risk, malnutrition (including nutrient defi- ciencies) and sarcopenia. Methods and Study Design: All participants were screened for risk of malnutrition us- ing the Malnutrition Universal Screening Tool (MUST) and assessed using the Patient-Generated Subjective Global Assessment (PG-SGA). Micronutrient status was examined via plasma/serum samples. The presence of sarcopenia was explored using an accepted algorithm incorporating gait speed, muscle mass (DEXA) and grip strength. Results: 322 participants (69% male, mean age 67.6±14.1y) consented to the study. 12.5% were identi- fied as at risk of malnutrition by the MUST while 15.8% were deemed malnourished by the PG-SGA. Only 5% were diagnosed as sarcopenic. Prevalence of malnutrition was much higher when micronutrients were examined with 79% showing low vitamin C, 56% low vitamin D and over 40% having low zinc, vitamin B-12 and folate. A smaller proportion were also low in selenium (19%). Conclusions: Patients with vascular disease are a nutrition- ally vulnerable group. The MUST and PG-SGA did not identify the full extent of nutritional deficiencies. Further investigation is warranted to assess tool validity in this group. A number of micronutrients are crucial in these pa- tients and hence a more comprehensive assessment that encompasses a wider range of parameters, including mi- cronutrient status appears warranted.
Background and Objectives: Limited information is available on how weight loss intervention programs affect skeletal muscle mass especially in trunk. Methods and Study Design: A total of 235 overweight Japanese men and women aged 40-64 years with a body mass index of 28.0 to 44.8 kg/m2 participated in this randomized con- trolled intervention study. They were randomly divided into a lifestyle intervention group and control group. Be- fore and after the one-year lifestyle intervention for weight loss an abdominal transverse image was acquired by computed tomography. The cross-sectional areas (CSAs) of visceral fat, subcutaneous fat, and skeletal muscle of rectus abdominis, abdominal oblique, iliopsoas, and erector spinae muscle were calculated. Results: The body weight changed by approximately -5% in the intervention groups. The corresponding values for subcutaneous fat and visceral fat CSAs were -10.8 to -17.5% in both sexes. The reductions observed in skeletal muscle CSAs were significantly less (-6.0% and -7.2% in the men and women intervention groups respectively) than those in fat tis- sue CSAs. The CSA of each of the four skeletal muscle groups also significantly decreased; however, after ad- justments for body weight at each time point, only reductions in the iliopsoas muscle in both sex and abdominal oblique muscles in men remained significant. Conclusions: The lifestyle weight loss intervention might reduce the relative amount of the abdominal skeletal muscles especially in iliopsoas muscle.
Background and Objectives: The relationship between eating rate (ER) and increased risk of obesity in relation to body mass index (BMI, i.e., total body fat) and waist circumference (WC, i.e., abdominal fat) has not been ful- ly examined. Considering gender differences, we identified unknown confounding factors (CFs) for each risk, and then assessed the two actual obesity risks, adjusting for the CFs. Methods and Study Design: Using a ques- tionnaire, we collected data for ER (slow, normal as “reference,” and fast) and related factors and measured BMI and WC for 3,393 men and 2,495 women. Using multiple logistic regression models, odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated adjusting for both conventional and candidate CFs. Results: The following factors were identified as appropriate CFs, but were differed between the two obesity types: fast food consumption in both genders, sleep duration and restaurants/food service use in men, and family structure and packed lunch in women. In men, actual risks of BMI obesity and WC obesity were negatively associated with slow ER (ORs and 95% CIs; 0.70 and 0.52-0.96, and 0.69 and 0.50-0.96), but positively associated with fast ER (1.48 and 1.25-1.76, and 1.45 and 1.21-1.74). In women, those risks were positively related to fast ER (1.78 and 1.39-2.26, and 1.34 and 1.11-1.61). Conclusions: For both BMI obesity risk and WC obesity risk, we conclude that slow and fast ER were related to decreased and increased risks when adjusted for appropriate CFs, which dif- fered by gender and the obesity type.
Background and Objectives: This cross-sectional study investigated the relationship between eating speed and fat accumulation in Japanese non-obese adults. Methods and Study Design: In total, 381 non-obese participants aged 35–74 years underwent a health checkup including fat distribution. All participants underwent magnetic res- onance imaging to quantify visceral fat area (VFA) and subcutaneous fat area (SFA). Information on eating speed was obtained using a self-administrated questionnaire. Results: The numbers of participants with self-reported behavior of eating slowly, medium, or quickly were 24 (6.3%), 180 (47.2%), and 177 (46.5%), respectively. The prevalence of VFA ≥100 cm2 was higher in the eating quickly group than in the eating slowly (p<0.05) or medi- um groups (p<0.05). On the other hand, no significant differences in SFA ≥100 cm2 were observed between groups. In addition, multiple stepwise regression analysis showed that eating quickly was positively correlated with VFA (standard β=0.068, p<0.05), but not with SFA. Conclusions: Although eating quickly was positively correlated with bigger VFA in Japanese non-obese adults, no associations were found between eating speed and SFA.
Background and Objectives: More than 20% of pregnant Japanese women regularly skip breakfast, thereby re- sulting in a low intake of several nutrients that are required for fetal development and prevention of pregnancy complications. However, whether skipping breakfast affects circulating levels of these nutrients remains unclear. We investigated whether skipping breakfast during pregnancy was associated with decreases in dietary intake and circulating and urinary levels of several nutrients, including fatty acids and vitamins. Methods and Study Design: This cross-sectional study was conducted at a university hospital in Tokyo, Japan, between June and October 2010. Nutrient intakes were assessed using a validated diet history questionnaire. Blood and 24-hour urinary samples were collected for assessing circulating and urinary excretion levels of nutrients. Skipping breakfast was defined as forgoing breakfast including a staple food, such as rice or bread, two or more times per week. Multiple linear regression analyses were used to compare nutrient levels between breakfast skippers and non-skippers after adjusting for confounders. Results: Of 97 healthy pregnant women in the second trimester, 37 (38.1%) skipped breakfast two or more times per week. In multiple linear regression analysis, breakfast skippers had significant lower energy-adjusted intakes of protein than non-skippers (p=0.019). In addition, breakfast skippers had signifi- cantly lower levels of plasma eicosapentaenoic acid (p=0.008), plasma docosahexaenoic acid (p=0.027), serum β- carotene (p=0.013), urinary urea nitrogen (p=0.027), and urinary potassium (p=0.006), compared to non-skippers. Conclusions: Healthcare professionals need to suggest effective strategies for encouraging breakfast skippers to have breakfast regularly and to increase the intake of these nutrients.
Background and Objectives: Lactation is a time of increased nutritional requirements for mothers, and inade- quate nutrient intake may have a detrimental effect on a woman’s nutritional status. To investigate the dietary in- take of two groups of women in Shanghai during the traditional confinement period. Methods and Study Design: Two groups of women (1) a community dwelling sample (n=92); (2) residents in a Maternity Care Centre (MCC) (n=30), kept a prospective dietary record which was complemented by photographing. This data collection was done on a single day on three occasions in the community group, and for three days on five occasions in the MCC one. The mean nutrient intakes of the two groups were compared at common time points to dietary reference in- takes, and the food intake was compared to dietary guidelines. Results: Over half of this population had high body mass indices (BMIs) which reported that an excessive proportion of calories had come from fat intake. The mean intakes of sodium were higher than the recommended. Fruit, vegetable, bean, tuber, and milk intakes were lower than the recommendations. Over 70% of the women failed to meet the Estimated Average Requirement (EAR) for calcium. A notable proportion of all women failed to meet the EAR for vitamin C, thiamin, and ribo- flavin. Dietary fiber intakes were low, with a group mean intake value less than half the Adequate Intake (AI). Conclusions: This study on dietary intakes indicates nutritional intake issues may exist among lactating women in Shanghai, particularly in community-dwelling women.
Background and Objectives: Obesity is a state that results from excessive energy consumption, and obese peo- ple often have micronutrient deficiencies. The objective of this study was to investigate the prevalence of and fac- tors associated with thiamin deficiency in obese Thai children. Methods and Study Design: This cross-sectional study was conducted at Faculty of Medicine Siriraj Hospital, Mahidol University during 2014 to 2017. Children aged 7-15 years old with exogenous obesity were recruited. Symptoms and signs of thiamin deficiency were evaluated. Erythrocyte transketolase activity was measured by thiamin pyrophosphate effect (TPPE), with ≥15% indicating thiamin deficiency. Dietary consumption from a 5-day food diary and food frequency questionnaire was calculated by INMUCAL software. Other medical complications of obesity were also evaluated. Results: One hundred and twenty-four subjects (81 males and 43 females) were enrolled, with a mean age of 10.9 years. Fifty-two subjects had abnormal TPPE for an overall prevalence of thiamin deficiency of 42%. Manifestations of thiamin deficiency included numbness, weakness, and calf muscle cramping. TPPE test results were correlated with at least one symptom or a sign of thiamin deficiency (p<0.01). The thiamin-deficient group tended to have higher proportion of morbid obesity and larger waist circumferences than thiamin-sufficient group. The thiamin- deficient group tended to consume less thiamin in relation to energy intake than the thiamin-sufficient group (p=0.057). Items of foods consumed were statistically indistinguishable between groups. Conclusions: The re- sults of this study revealed a 42% prevalence of thiamin deficiency among obese Thai children, and most of those cases were subclinical.
Background and Objectives: Information on dietary exposure to sulfites as preservative in consumer is needed as a scientific base for food safety policy making. The objective of this research was to conduct dietary exposure assessment to sulfites in consumers by using a deterministic method. Methods and Study Design: The scope of work was identification of food products containing sulfites, determination of food consumption data from the in- dividual food consumption survey report of 2014, determination of sulfite concentration in food, and calculation of sulfite exposure. Results: 3,428 (9%) of 37,613 food products registered in National Agency of Drug and Food Control (2012-2015) may contain sulfite. The most used sulfite in food products was sodium metabisulfite. The mean of food containing sulfite consumption in all age groups was 131.4 g/person/day. The estimation of total exposure for all age groups were 0.27 mg/kgBW/day (38.6% ADI), 0.25 mg/kgBW/day (35.7% ADI) and 0.08 mg/kgBW/day (11.4% ADI) by using concentrations of Maximum Permitted Limit, reported maximum used lev- el and reported maximum product test result, respectively. Food category contributed to the highest exposure in all age groups was spices, condiments, vinegar, powder or mixture for soups and broths, and other soy sauce cat- egory. Conclusions: The highest total exposure to sulfites was found in 0-59 month age group. The highest total exposure for the MPL (0.79 mg/kgBW/day) and the reported maximum used level (0.73 mg/kgBW/day) exceed- ed 112.9% ADI and 104.3% ADI, respectively while the exposure using reported maximum test result was still below ADI (0.25 mg/kgBW/day or 35.7% ADI).
Background and Objectives: Malnutrition is a public health problem especially among the Pacific Small Island developing nations. This study assessed malnutrition with dietary intakes in households of South Tarawa, Kiribati, a West Pacific Island Nation State. Methods and Study Design: A cross-sectional community-based study de- sign was used. One hundred and sixty-one households were selected from Betio, Bikenibeu and Teaorereke towns using a systematic random sampling method. About 35% each of the households was selected from Bikenebue and Besio while 30.4% was selected from Teaoraeke. Family (including children) dietary surveys including 24- hour dietary recall were administered to assess adequacy of nutrient intakes and dietary diversity using House- hold Diet Diversity Scores. A 3-day weighed food record was collected on a sub-sample. Data were analysed us- ing FoodWorks Pro 8 for nutrient intake and Statistical Product for Service Solution (SPSS) version 21 for de- scriptive statistics. Results: Sixty-one percent of the subjects had the lowest dietary diversity, 36.3% had a medi- um dietary diversity and only 2.7% had the highest dietary diversity. Based on the weighed food record results (n=29), male subjects of all age groups had adequate intakes of riboflavin, niacin, vitamin C, magnesium, iron and zinc, but had high intakes of protein and sodium; and low intakes of potassium and calcium. Female subjects had adequate intakes of vitamin C, iron, magnesium and zinc, but had high intakes of protein and sodium; and low intakes of potassium and calcium. Conclusions: Across all groups, 61% of the adult Kiribati population stud- ied showed low dietary diversity, and a high prevalence of multiple micronutrient deficiencies.
Background and Objectives: The importance of diet for the maintenance of health during aging is attracting a growing body of research interest. Given dietary intakes, along with BMI, are substantial contributors to disease burden, this study aimed to investigate prospective changes in dietary patterns and nutrient intakes in a sample of mid to late-life women over 14 years. Methods and Study Design: Participants were from the Women’s Healthy Ageing Project (WHAP); a longitudinal cohort of Australian-born women within the Melbourne metropolitan ar- ea. 173 participants were included in this analysis, their mean age in 1998 was 55 years (range 51-62) and in 2012 was 70 years (range 66-76). Diet was assessed using the Dietary Questionnaire for Epidemiological Studies Ver- sion 2 in 1998 and 2012. Nutritional intakes, Dietary Inflammatory Index (DII®) scores, Mediterranean Diet (MD) scores, sociodemographic and physical measures were calculated for all participants at both time points. Results: Energy intake was found to significantly decrease over time (p<0.005). Energy-adjusted (i.e., energy density) total fat, saturated fat, monounsaturated fat and cholesterol intakes increased over time (all p<0.002), while energy-adjusted and absolute carbohydrate intake decreased (p<0.002). Adherence to the MD decreased over time (p<0.001) whilst DII scores increased slightly over time, although this result was not significant. Con- clusions: This study shows significant changes in the intake of energy and several nutrients in a cohort of aging Australian women in the Melbourne metropolitan area over a period of 14 years. Between 1998 and 2012, chang- es in indices reflecting overall diet were consistently in the direction of a poorer diet.
Background and Objectives: Consumption of salt exceeds dietary guidelines for many countries around the world, despite efforts to increase awareness of the potential cardiovascular health risks. Emerging evidence, pri- marily from rodent models, indicates that high salt intake may also impair aspects of cognitive function. To our knowledge, here we provide the first review of the effects of salt on cognition. To review literature on the effects of high-salt diets on cognitive measures across human and non-human animal research to generate targeted ques- tions for future studies. Methods and Study Design: Non-systematic literature review of studies manipulating (in rodents) or measuring (in humans) salt intake and assessing performance on cognitive measures. Results: Studies in humans have focused on older populations and show mixed associations between salt intake and cogni- tive performance. By contrast, most rodent studies have found impairments in cognition following chronic con- sumption of high-salt (typically 7-8%) diets. Most report impairments in tasks assessing spatial memory with cor- responding increases in hippocampal oxidative stress and inflammatory responses originating in the gut. Notably, several rodent studies reported that high-salt diets impaired cognitive function in the absence of blood pressure changes. Conclusions: Contrasting results from human and animal studies emphasise the need for further studies to clarify whether salt intake affects cognition. Testing cognition in high-salt diet models that induce hypertension will increase the translatability of future studies in rodents. A challenge for research in humans is isolating the ef- fects of salt from those of fat and sugar that tend to co-occur in ‘western’ diets.
Background and Objectives: To examine the association between the frequency of soy products consumption and type 2 diabetes or impaired fasting glucose. Methods and Study Design: A cross-sectional study of 3,314 subjects aged 18-79 years was conducted in Beijing, China in 2016. Consumption of soy products was assessed by a validated food-frequency questionnaire and examined with type 2 diabetes or impaired fasting glucose risk using multiple logistic regression. Results: 509 of the 3,314 participants (15.4%) included in the current analyses had diabetes, and among them 453 were diabetes uncontrolled. The prevalence of impaired fasting glucose was 11.9%. After adjustment for demographic variables, smoke, alcohol, physical activity and BMI, soy products consumption was inversely associated with type 2 diabetes risk and impaired fasting glucose. ORs and 95% CI for diabetes uncontrolled across soy products consumption frequencies (monthly, weekly, daily) were 1 (refer- ence), 0.819 (0.627-1.070), 0.605 (0.387, 0.944) respectively (ptrend=0.033). ORs (95% CI) for impaired fasting glucose across soy products consumption frequencies were 1 (reference), 0.873 (0.661-1.152), 0.616 (0.385, 0.985) respectively (ptrend=0.046). Conclusions: Consuming soy products daily may decrease the risk of diabetes and impaired fasting glucose.
Background and Objectives: Sarcopenia and frailty result in loss of function and independence. Sarcopenia may be a risk factor for frailty; however, risk factors for sarcopenia with frailty, and associated incidence of falls and poor quality of life remain unclear. We investigated the clinical characteristics and relevant factors for sarcopenia with frailty in older community-dwelling Japanese. Methods and Study Design: This cross-sectional study in- cluded 331 Japanese community-dwelling adults aged ≥60 years. We assessed falls history in the past year, health-related quality of life (HRQOL), including physical component summary (PCS) and mental component summary (MCS), age, total energy intake per ideal body weight (TEI/kg IBW), total protein intake/kg IBW, vit- amin D intake, and exercise habits. Sarcopenia was determined using low hand grip strength or slow gait speed and low skeletal muscle mass index. Frailty was determined if ≥3 components, such as unintended weight loss, exhaustion, low muscle strength, slow gait speed, and low physical activity were present. Results: The preva- lence of sarcopenia with frailty was 3.6%; such participants had a higher risk of recurrent falls and lower PCS and MCS scores than robust participants. Age, TEI/kg IBW, total protein intake/kg IBW, and vitamin D intake were significantly associated with risk of sarcopenia with frailty by multivariate logistic regression analysis. Conclu- sions: This study showed that sarcopenia with frailty was had higher incidences of recurrent fall and poor HRQOL than robust older adults. Aging and poor energy, protein, and vitamin D intake, may be relevant factors for sarcopenia with frailty.
Background and Objectives: The need for updated competencies for nutrition scientists in Australia was identi- fied. The aim of this paper is to describe the process of revising of these competencies for undergraduate nutrition science degrees in Australia. Methods and Study Design: An iterative multiple methods approach comprising three stages was undertaken: 1. Scoping study of existing competencies; 2. Exploratory survey; and, 3. Modified Delphi process (2 rounds) involving 128 nutrition experts from industry, community, government and academia. A ≥70% consensus rule was applied to Rounds 1 and 2 of the Delphi process in order to arrive at a final list of competencies. Results: Stage 1: Scoping study resulted in an initial list of 71 competency statements, categorised under six core areas. Stage 2: Exploratory survey-completed by 74 Nutrition Society of Australia (NSA) members; 76% agreed there was a need to update the current competencies. Standards were refined to six core areas and 36 statements. Stage 3: Modified Delphi process-revised competencies comprise five core competency areas, under- pinned by fundamental knowledge, skills, attitudes and values: Nutrition Science; Food and the Food System; Nutrition Governance, Sociocultural and Behavioural Factors; Nutrition Research and Critical Analysis; and Communication and Professional Conduct; and three specialist competency areas: Food Science; Public Health Nutrition; and Animal Nutrition. Conclusions: The revised competencies provide an updated framework of nutri- tion science knowledge for graduates to effectively practice in Australia. They may be used to benchmark current and future nutrition science degrees and lead to improved employability skills of nutrition science graduates.
Background and Objectives: Fat mass and obesity-associated (FTO) and melanocortin 4 receptor (MC4R) genes associated with obesity have been identified through Genome-wide Association Studies. However, no multiple loci interaction studies have been conducted in the Chinese population. This study investigated whether the com- bined effects of FTO and MC4R increase the risk of obesity in children and adolescents living in Northwest China. Methods and Study Design: A total of 370 subjects (170 overweight/obese and 200 normal BMI subjects ac- cording to the Working Group on Obesity in China criteria) were enrolled using the random sampling method. FTO rs9939609 and rs9935401 and MC4R rs12970134 and rs17782313 interactions were analysed through gen- eralized multifactor dimensionality reduction, and logistic regression models were used to calculate the risk of the relationship between genotypes and obesity. Results: Generalized multifactor dimensionality reduction analysis showed a significant gene–gene interaction among FTO rs9939609/MC4R rs12970134/MC4R rs17782313, with a score of 10/10 for the cross-validation consistency and 9 for the sign test (p=0.011). A 2.453-fold increased risk of obesity was observed in individuals carrying the genotypes of FTO rs9939609 TA/AA, MC4R rs12970134 GA/AA, and MC4R rs17782313 TC/CC (adjusted for age, sex, and ethnicity; 95% CI=1.12–5.37, p=0.025). Con- clusions: Our results suggested that FTO rs9939609, MC4R rs12970134, and MC4R rs17782313 are strongly as- sociated with obesity. The combined effects were highly significant on obesity in children and adolescents living in Northwest China.
Background and Objectives: Data suggest that genetic factors are associated with BMI. The fat mass and obesi- ty-associated (FTO) gene modulates adipogenesis through alternative splicing and m6A demethylation. Individu- als with FTO rs9939609 gene polymorphism have a preference for energy-dense foods. This study investigates the relationship between FTO rs9939609 and obesity and preference for dietary fat intake among selected Indone- sian adults. Methods and Study Design: A total of 40 non-obese and 40 obese participants aged 19–59 living in Jakarta were recruited. Body composition measurements included body weight, height, BMI, waist circumference, and body fat mass. Dietary intake was assessed using a semiquantitative food frequency questionnaire and food recall over 2 × 24-h periods. Genetic variation was determined using amplification-refractory mutation system polymerase chain reaction. Results: The genotype distribution of the FTO gene (rs9939609) was at Hardy– Weinberg equilibrium (p=1) with minor allele frequency=0.19. Individuals with AT/AA genotypes had 3.72 times higher risk of obesity (p=0.009) and 5.98 times higher dietary fat intake (p=0.02) than those with TT geno- type. Obese participants with the AT/AA genotypes had 1.40 times higher dietary fat intake than those with the TT genotype (p=0.016). Conclusions: These findings suggest that Indonesian adults with AT/AA genotypes of the FTO rs9939609 have higher obesity risks and preferences for high dietary fat intake than those with TT geno- type.
Background and Objectives: β-Carotene-15,15’-oxygenase (BCO1) is a key enzyme involved in carotenoid metabolism and has been linked with the development of coronary atherosclerosis. This study investigated the association between BCO1 polymorphisms and the risk of coronary atherosclerosis in dyslipidemia participants, and analyzed the influence of personal behaviors on coronary atherosclerosis. Methods and Study Design: A nested case-control study was conducted from 2013 to 2016 in which 1359 dyslipidemia participants were recruited. Personal lifestyle parameters, mainly physical activities and diet, were obtained by questionnaires and the genotypes of rs11641677, rs11646692, rs12934922, rs6564851 and rs7501331 in BCO1 were analyzed by ligase detection reaction. In 2016, 166 participants were diagnosed with coronary atherosclerosis and 498 age-and gendermatched controls were recruited. The association between BCO1 polymorphisms and risk of coronary atherosclerosis were analyzed with logistic regression, and the effect of gene-behaviors interaction on the risk of coronary atherosclerosis were determined with crossover analysis. Results: After adjustment for potential confounders, logistic regression analysis showed that fried food intake (OR=1.637, 95% CI: 1.127~2.378; p=0.010), dessert intake (OR=1.733, 95% CI: 1.158~2.595; p=0.008), and physical activity (OR=0.511, 95% CI: 0.309~0.846; p=0.009) were risk factors for coronary atherosclerosis. Rs12934922 and rs11646692 reflected high susceptibility to coronary atherosclerosis. Crossover analysis indicated that rs12934922 and rs11646692 interacted with physical activity (Inter-OR=8.82; Inter-OR=3.69), fried food intake (Inter-OR=2.95; Inter-OR=2.36) and dessert intake (Inter-OR=3.95; Inter-OR=2.39) to influence the risk of coronary atherosclerosis. Conclusions: In dyslipidemia patients, rs12934922 and rs11646692 may influence the development of coronary atherosclerosis. A combination of BCO1 polymorphisms and several behavioral factors may affect the development of coronary atherosclerosis.
Background and Objectives: In Australia, two public health measures were introduced between 2009 and 2010 to reduce iodine deficiency. However there has been a shortage of information regarding their effectiveness and the ongoing prevalence of iodine deficiency in Australia. The primary aim of this study was to assess the extent to which these public health measures have reduced rates of iodine deficiency among pregnant and lactating women. Methods and Study Design: A review was conducted to identify all studies published since January 2010 that quantitatively measured the iodine status of pregnant and/or lactating women in Australia. Results: We found 25 publications, of which seven were included in this review after our exclusion criteria were applied. Of the seven included publications, three demonstrated the pregnant and lactating women in their studies to be iodine replete (median urinary iodine concentrations (MUIC) greater than 150 μg/L, or a breast milk iodine concentra- tion (BMIC) of greater than 100 μg/L). The remaining four publications found MUIC of pregnant and lactating women to be below the 150 μg/L threshold, in the mild-to-moderate iodine deficiency category. Only two studies, documented iodine sufficiency among pregnant and lactating women in the absence of iodine supplementation. Conclusions: Many pregnant and lactating women in Australia remain at least mildly iodine deficient. Antenatal iodine supplementation was the factor most consistently associated with an adequate iodine status. Larger, more representative studies or sentinel studies with a National coordination are needed to understand the differences in iodine status that exist across the country.
Background and Objectives: To analyze the potential of fatty liver index (FLI) and several obesity indices and to explore which index is best for predicting nonalcoholic fatty liver disease (NAFLD) in Chinese postmenopau- sal women. Methods and Study Design: A cross-sectional study was conducted in 680 Chinese postmenopausal women. NAFLD was defined as a hepatic steatosis observed on liver ultrasonography in the absence of a second cause. Odds ratio and corresponding 95% confidence interval (CI) between hepatic steatosis and FLI as well as different obesity indices were evaluated by Binary Logistic regression model. Receiver operating characteristic curve and area under curve (AUC) were used to compare the ability of predicting hepatic steatosis between FLI and obesity indices. Results: The upper values of all indices were significantly associated with the presence of hepatic steatosis (all p<0.01) after the adjustment for potential confounders. The largest AUC [0.85 (0.82-0.88), 95% CI, p<0.01] was observed for FLI, followed by the frequently used obesity indices. Conclusions: FLI is closely associated with the presence of hepatic steatosis in Chinese postmenopausal women. Compared to the obesity indices frequently used, FLI is a better surrogate marker for predicting the presence of hepatic steatosis in Chinese postmenopausal women.
Background and Objectives: Although appropriate nutrition management could improve rehabilitation out- comes, more than 40 % of patients in a convalescent rehabilitation ward (CRW) suffer from malnutrition. The study was undertaken to investigate whether adequate nutrition for each patient in a CRW could be estimated based on motor scores on the Functional Independence Measure (FIM-M). Methods and Study Design: In 218 patients in our CRW, both basal energy expenditure (BEE) on admission and average energy intake (EI) for 2 weeks were calculated, and EI was divided by BEE to estimate the activity index (e-AI). The patients were classi- fied according to FIM-M to investigate the relationship between the FIM-M and the e-AI. Results: The e-AI tended to increase in proportion to the FIM-M. In the N group, where the increase-decrease rate for body weight was within 2%, the e-AI induced by a FIM-M greater than 60 was significantly higher than that induced by a FIM-M up to 60 (1.3 vs 1.1, p<0.01). Compared to the N group, altering the e-AI caused the same tendency of body weight change in patients with FIM-M greater than 60 and up to 60. Conclusions: The FIM-M could pro- vide a criterial activity index for patients in a CRW when their energy requirement is appropriately estimated, considering the intensity of their physical activity.
Background and Objectives: Accurately assessing energy expenditure (EE) of people with different body weight is essential to facilitate weight management. The aim of this study was to measure basal energy expendi- ture (BEE), resting energy expenditure (REE) and to explore the true 1 MET value for young Chinese adults with different body weight. Methods and Study Design: A total of 251 young Chinese adults were divided into three groups: the normal weight group, the overweight group and the obese group. Their BEE, REE and 1 MET values were measured by Cortex Metamax 3B (MM3B). Multiple linear regressions and correlation analysis were used to examine factors that influence EE in Chinese population. Results: The mean measured BEE and REE of young Chinese adults with normal weight, overweight and obesity was 1429, 1609, 1778 kcal/day and 1522, 1712, 1885 kcal/day, respectively. The EE per kilogram body weight decreased with the increasing body weight. The mean oxygen consumption in the three group was 3.78, 3.47, 3.21 mL/kg/min respectively. There was no significant difference in BEE and REE after adjustment for fat-free mass (FFM). The significant influencing factors were body mass index (BMI) and sex in BEE, FFM and BMI in REE in Chinese population. Conclusions: BEE and REE were significantly different for different body weights while these differences disappeared after adjustment for FFM, and people with different body weights may have different 1 MET values. Further studies should be conducted to obtain more accurate daily energy requirement and 1MET value for specific Chinese populations.
Background and Objectives: Parenteral nutrition (PN) is one of the main nutritional methods used in newborns; however, long-term PN may induce PN-associated cholestasis (PNAC). This study aims to evaluate the effect of cyclic PN in the prevention and improvement of PNAC in newborns requiring long-term PN. Methods and Study Design: A retrospective cohort study was conducted on patients admitted at the Seoul National University Children’s Hospital neonatal intensive care unit between October 2010 and September 2015 and referred to the nutrition support team with total parenteral nutrition for more than 14 days. The primary outcome was the inci- dence of PNAC. The incidence of hypoglycemia, changes in direct bilirubin (DB) concentrations, and length of hospital stay were investigated. Results: A total of 124 patients were observed in this study. Among these, 100 patients received continuous PN, whereas 24 patients received both continuous and cyclic PN. PNAC occurred in 31.5% (39/124) of study population. The incidence rates of PNAC were 27.4% during continuous PN period and 20.8% during cyclic PN period. Cyclic PN was an independent factor that significantly decreased PNAC inci- dence (OR=0.154; 95% CI, 0.045-0.529, p=0.003). DB concentrations significantly decreased (p=0.049) with therapeutic cyclic PN, but remained normal with prophylactic cyclic PN. No significant difference in hypoglyce- mia incidence and length of hospital stay was observed in both continuous PN and continuous to cyclic PN groups. Conclusions: Cyclic PN could be effective in the prevention and improvement of PNAC and also safe in terms of hypoglycemia in newborns.
Background and Objectives: The safety and tolerability of hydrolysed cow’s milk protein-based formulas, par- ticularly partially hydrolysed formulas (pHFs), in children with cow’s milk allergy (CMA) remain poorly under- stood. We evaluated the tolerability of hydrolysed cow’s milk-based formulas in children with CMA. Methods and Study Design: A three-period double-blind crossover evaluation compared the allergic tolerance against three dietary cow’s milk-based formulas: extensively hydrolysed cow’s milk formula (eHF), pHF, and regular cow’s milk formula (rCMF). The primary outcome was the rate of tolerance against a maximum of 20.0 mL of formula. Results: Controlled food challenges were performed in 25 children (18 boys; 7 girls) with a median age of 4.25 years (range: 1–9 years) diagnosed with CMA. The median cow’s milk-specific immunoglobulin E level was 31.9 UA/mL (range: 1.16–735 UA/mL). The tolerance rate ratios for rCMF were lower than those for pHF (2 vs 16; p<0.01) and eHF (2 vs 22; p<0.01). The allergic symptom scores induced by intake of pHF and eHF were significantly lower than those of rCMF (p=0.01 and p<0.01, respectively), and the pHF and eHF scores were not significantly different. Conclusions: Compared to rCMF, the partially and extensively hydrolysed whey and ca- sein formulas evaluated in this study were better tolerated and therefore safer for children with CMA. Although further confirmation from additional centres is needed, our findings suggest the use of pHF in patients with mild CMA. Some children with CMA react to hydrolysed formulas; therefore, food challenge tests in these children should be undertaken with caution.
Background and Objectives: Pectin-containing liquid enteral nutrition (PCLEN) contains pectin, which be- comes solid in the stomach and therefore mitigates vomiting and diarrhea. Its efficacy for use in critical care med- icine was evaluated. Methods and Study Design: We used liquid enteral nutrition (LEN) (traditional LEN (TLEN)) as the primary LEN at the emergency and critical care center. We adopted PCLEN as the primary LEN from 2014. During 2012–2016, 954 patients admitted to intensive care units and emergency wards were given PCLEN or TLEN. We conducted propensity score matching for 693 eligible patients for age, sex, and organ dys- functions for six organs. Results: We included 199 PCLEN patients and 199 TLEN patients. Severity was higher in the PCLEN group. The enteral nutrition failure rate was significantly lower for PCLEN than for TLEN. The diarrhea incidence rates were 28.1% vs 38.2% (p=0.033), and the incidence rates of nosocomial pneumonia were 4.5% and 9.6% (p=0.048). For PCLEN, the enteral nutrition failure rates were not different for patients with gas- tric acid inhibitors and without them. Conclusions: PCLEN can be used effectively for critically ill patients irre- spective of the use of gastric acid inhibitors. It can decrease the incidence of enteral nutrition failure and diarrhea.