Editorial: Food intake methods in clinical practice
Author:Mark L Wahlqvist, Vichai Tanphaichitr, Akira Okada
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Abstract:see pdf file.
Asia Pac J Clin Nutr. 1993;2(1):1.doi:
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Review article: Nutrition and HIV infection
Author:Lusting JR
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Abstract:Nutritional status may have an impact at all stages of HIV disease. Many of the clinical features of HIV infection cause nutritional problems and may also be exacerbated by the presence of malnutrition. Inadequate food intake, due to a wide variety of aetiologies, malabsorption and altered metabolism, may all contribute to malnutrition. Additionally, factors in food, including micronutrients, can modulate immune function. Reduced micronutrient levels are documented at all stages of HIV infection although the significance of these findings and how they may relate to HIV disease severity and prognosis are still unclear. Body composition changes in adults include loss of weight with proportionately greater loss of lean mass. Paediatric HIV infection has received far less research attention, but growth failure is a significant nutritional complication seen clinically. Clinical experience suggests that e 1000 arly nutritional intervention may improve prognosis as well as quality of life. Nutritional management in HIV disease depends on the clinical state of the patient. Definition of the benefits of particular food factors and diets, as well as the most appropriate nutrition support modalities, would allow rational nutritional counselling. Better definition of the contribution food makes to health through its social role, and the opportunities this provides in patient care, would complement the biomedical research effort.
Asia Pac J Clin Nutr. 1993;2(1):3-14.doi:
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Uses of anthropometry in the elderly in the field setting with notes on screening in developing countries
Author:Solomons NW, Mazariegos M, Mendoza I
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Abstract:A field setting can be defined as any setting outside of a fixed, permanent, and sophisticated health facility or research laboratory. The most important applications of anthropometry at field level include biological anthropology, epidemiology, clinical application, and metabolic research. Data collecting in the field setting requires different levels of accuracy and precision; the standardization should also consider intra- and inter-observer variability due to the possibility of more than one observer participating in a given survey. A field setting, in contrast to the laboratory setting, involves special conditions that challenge the application of anthropometry. The required equipment is different and the conditions of data collection are less rigorous. Issues intrinsic to the target group - of education, culture and sophistication - might be limiting factors for carrying out anthropometric surveys in field settings. Another issue is related to interpretation of the biological, nutritional and health significance of anthropometric findings in relationship to the elderly. Uncertainty regarding the accuracy of chronological age, and geography and differential survival of the elderly should be considered when designing a survey. In addition, because the majority of the elderly now live in developing countries, short stature should be a common finding in the age groups from these regions. It is in these short-stature elderly populations, that there is a problem interpreting and applying anthropometric norms or references for height or weight derived from elderly populations of developed countries. In conclusion, although the application of anthropometry to the field setting is feasible, given its enormous importance to gerontological biology, nutrition and health, researchers should consider a series of factors and paradigms when designing and carrying out anthropometric surveys at the field level.
Asia Pac J Clin Nutr. 1993;2(1):15-23.doi:
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Urinary sodium and potassium in a sample of healthy adults in Sydney, Australia
Author:Notowidjojo L, Truswell AS
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Abstract:Australia has had an official guideline for the last ten years, that people should aim to consume less than 100 mmol sodium per day (equivalent to 6.0 g NaCl). The only practical way of estimating sodium intake is from the 24-h urinary sodium excretion. Between 1970 and 1980 average sodium excretions in different Australian surveys ranged from 130 to 200 mmol/day (middle number 165 mmol/d). These surveys involved small numbers of subjects (n = 11 to 259) . To see how Australians are responding to the guidelines and taking advantage of a range of reduced salt food products now in the supermarkets, we measured urinary sodium and potassium in 117 healthy adult subjects, mostly in the university community. In group N (nutrition personnel) sodium excretion averaged 128 mmol/d in females and 137 mmol/d in males. In group W (eating a western, traditional Australian diet, no special knowledge of nutrition) urinary sodiums averaged 133 mmol/d (female) and 159 mmol/d (male). In group A (eating an Asian diet) sodiums averaged 140 mmol/d (female) and 195 mmol/d (male). Potassium excretions were 73, 81, 72, 76, 53, and 65 mmol/day respectively in the six subgroups. We conclude that these results possibly reflect a small downward trend in Australian sodium intake and that sodium intake is lower in mainline Australian diets than Asian diets. But only a minority of subjects' urinary sodiums were within the recommended 40 to 100 mmol/d. Women excreted consistently smaller amounts of sodium than men; the guidelines for sodium should perhaps be expressed separately by gender. In six subjects who provided seven days' urine collections the coefficient of variation for sodium excretion was between 20 and 35%.
Asia Pac J Clin Nutr. 1993;2(1):25-33.doi:
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Diet does not predict incidence or prevalence of non-insulin-dependent diabetes in Nauruans
Author:Hodge AM, Dowse GK, Zimmet PZ
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Abstract:Cross-sectional and longitudinal relationships between diet and non-insulin-dependent diabetes (NIDDM) were assessed in Nauruan adults to determine if a particular component of the diet contributed to the high prevalence of NIDDM in this population. In 1982, 24-h dietary recall data were collected from 430 Nauruans over the age of 20, who were participating in a noncommunicable disease (NCD) survey. In 1987 a follow-up survey was performed which included 350 of the subjects from whom dietary data was obtained. Neither cross-sectional nor longitudinal analyses showed any statistically significant associations between any of the specific dietary components studied and NIDDM prevalence or incidence. However, when nutrient intakes were adjusted for energy intake it appeared that the age- and body-mass-index (BMI)-corrected mean intakes of total fat, total carbohydrates, alcohol, sugar and monounsaturated fat were slightly higher in the seven incident cases than in those who remained healthy, while intakes of protein, fibre and cholesterol were lower. Despite the inability to demonstrate an association between NIDDM risk and nutrient intake at the individual level, Nauruans as a population have total energy intakes 115-135% greater than recommended for maintenance of healthy weight, protein intakes about 250% of that required, sugar intakes about twic 1000 e the recommended, fibre intakes only about 30% of current recommended levels and in men a mean alcohol intake more than three times the recommended level. This adverse diet undoubtedly contributes to the high prevalence of obesity in the population and hence, even if there are no direct dietary effects, to the risk of NIDDM and other diet-related diseases.
Asia Pac J Clin Nutr. 1993;2(1):35-41.doi:
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Nutrition and health of Victorian Aborigines (Kooris)
Author:Hodgson JM, Wahlqvist ML
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Abstract:Prior to European settlement of Australia, the health of Aboriginal people was probably better than that of the Europeans. In the past 200 years there has been a considerable improvement in the health of non-Aboriginal Australians, and a deterioration in the health of Aborigines. Some improvement in Aboriginal health has occurred in recent times. The Aboriginal people who live in Victoria are known as Kooris. An understanding of traditional Koori diets is important because people were generally healthy eating these diets. The traditional Koori diet was high in dietary fibre, unrefined carbohydrates, and protein, with adequate vitamins and minerals, and low in total fat and saturated fat, sucrose, salt, and without alcohol. Their lifestyle also dictated a high level of physical activity resulting in a reduced likelihood of overweight. The other notable aspect of the traditional diet was the variety of foods consumed. The present health problems of the Koori people stem primarily from their loss of ancestral lands, and social and cultural disruption. Kooris went from a hunter gatherer society to one almost entirely dependent upon mission handouts. There are many factors which may now contribute to the continued poor health and nutrition of Kooris. The relative importance of any of these factors is unknown. Morbidity and mortality data provide valuable information about the overall health of populations and their nutrition status. The Australian population is one of the healthiest in the world. There is however a remarkable difference between the health of Aboriginal and non-Aboriginal Australians. The leading cause of death for both male and female Aborigines is disease of the circulatory system, including ischaemic heart disease and stroke. Deaths due to circulatory system disease is 2.2 and 2.6 times higher than the age adjusted Australian rates for men and women respectively, and between 10 and 20 times higher for young and middle aged adult Aborigines. Rates of hospital admission are 2.5-3 times higher than the rest of the population, with the highest rates being for infants. Although mortality statistics do not show nutrition related disorders such as obesity, non-insulin dependent diabetes mellitus (NIDDM), and hypertension to be significant contributors to mortality, these statistics are not representative of the problem. Across Australia the prevalence of obesity, NIDDM, and hypertension are higher for Aborigines than the general population. Available data on morbidity and mortality for Aborigines in Victoria are limited, but the indication is that the overall situation is similar to the rest of Australia. If the situation for Victoria is similar to the rest of Australia, then this would suggest that the contemporary Koori diet is too high in fat and perhaps alcohol, and too low in fibre and variety. Further evidence is required to veri 644 fy this suggestion. There are several areas where information on Koori nutrition is limited or lacking. These include food intake, nutritional status, and dietary practices, such as cooking methods, salt and sugar use and meal patterns. It is generally agreed that information on Koori nutrition should be made available so that the problems can be identified, and strategies put in place to address the problem areas.
Asia Pac J Clin Nutr. 1993;2(1):43-57.doi:
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