Nutrition of elderly people in China
Author:Jodi Dunmeyer Stookey MS, Fengying Zhai PhD, Namv
Keywords:body mass index, elderly Chinese, nutrition
Abstract:Cross-sectional data from the 1991 (n= 1657) and 1993 (n= 1773) China Health and Nutrition Surveys were
used to describe patterns in the diets, activity levels and body mass index (BMI) of elderly Chinese (aged 60 or
older). In 1991 and 1993, the prevalence of low BMI (BMI < 18.5 or BMI < 22.0) exceeded 15%, while the
prevalence of high BMI (BMI > 25.0 or BMI > 27.0) ranged between 4% and 24%. The BMI was consistently,
positively and significantly associated with urban residence. Urban residence and income were consistently and
positively associated with energy from fat and protein intakes, and decreasing physical activity levels. The
results suggest that under- and overnutrition coexist among Chinese elders and are differentially distributed
across income and urban/rural strata.
Asia Pac J Clin Nutr. 2000;9(4):243-251.doi:
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Predicting stature from knee height in Chinese elderly subjects
Author:Edmund TS Li MSc, PhD, Emily KY Tang BSc, Cora YM
Keywords:Chinese elders, gender, Hong Kong, knee height, stature, validation
Abstract:The main aim of this study was to validate the use of the Caucasian-based knee height equations for predicting
stature of Chinese elderly subjects and to compare the predicted height to those estimated by equations derived
from elderly subjects of Chinese origin. The study was performed by a survey by measurement of convenience
samples. Twenty-one women and 26 men were recruited to validate the use of the Caucasian-based equations.
The Chinese-based predictive equations were derived from 164 women and 89 men. The sample included
ambulatory elderly subjects of Chinese origin, 60 years of age or older. These subjects were without spinal
curvature and able to stand erect. Measurements were taken for height by a standard hospital scale. Calipers was
used to measure knee height while the subject was in the sitting position. The measured stature and that
predicted by the Caucasian-based equations were significantly different in Chinese elderly women but not in
men. New regression models are being developed for the elderly Chinese population in Hong Kong. The
relationship between stature, knee height and age appears to be ethnicity- and gender-dependent. While stature
of elderly Chinese men can be estimated by either the Caucasian-based or Chinese-based equation, the
regression model developed in the present study will better estimate the stature in elderly Chinese women.
Asia Pac J Clin Nutr. 2000;9(4):252-255.doi:
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Body fat distribution and lipids profile of elderly in southern Jakarta
Author:I Wayan Weta MD, PhD, MSc, Savitri Sayogo MD, Wid
Keywords:BMI, body fat distribution, elderly, Jakarta, Indonesia, LDL cholesterol, serum total cholesterol, triglycerides
Abstract:A cross-sectional study on 222 elderly subjects was carried out at Health Centers in 10 subdistricts in south
Jakarta, Indonesia. The anthropometric data (body mass index (BMI), body fat distribution), fasting blood
glucose, serum total cholesterol, low density lipoprotein (LDL) cholesterol and triglycerides were assessed.
There was a positive correlation between body fat distribution and serum lipid concentration (total cholesterol,
LDL cholesterol and triglycerides). Body fat distribution appears to be a stronger determinant of serum lipids
than BMI.
Asia Pac J Clin Nutr. 2000;9(4):256-263.doi:
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Nutrition and educational achievement of urban primary schoolchildren in Malaysia
Author:Zalilah Mohd Shariff PhD, Jenny T Bond PhD, RD and
Keywords: educational achievement, height-for-age, Kuala Lumpur, Malaysia, nutrition, primary schoolchildren
Abstract:The relationship between nutrition, health and educational achievement of school-age population in less
developed countries has been of interest to many researchers due to the frequent observation that many children
did not complete primary school and those who completed, did not do as well as children in the developed
countries. Nevertheless, nutritional and health status by itself is not the only variable affecting educational
achievement, since biological, psychological, socioeconomic and cultural factors could directly or indirectly
affect both nutrition, health status and educational achievement. The mechanism by which health and nutrition
influence educational achievement is not well established, but poor health and malnutrition in early childhood
may affect cognitive abilities, necessary for learning process and consequently educational achievement. A
study was conducted in Kuala Lumpur, Malaysia, to investigate the relationship between nutritional status and
educational achievement among primary schoolchildren from low income households (n= 399). A high
percentage of them were mild-significantly underweight (52%), stunted (47%) and wasted (36%) and
increasingly overweight (6%). In general, more boys than girls were found to experience some form of
malnutrition. While weight-for-height did not differ significantly according to family, child and school factors,
weight-for-age and height-for-age differed significantly by gender. Also, height-for-age was significantly related
to household income. This indicates that stunting may be a consequence of prolonged socioeconomic
deprivation. Educational achievement was measured based on test scores for Malay language (ML), English
language (EL) and mathematics (MT). While a majority of the schoolchildren obtained optimum scores (>75)
for ML and MT, the majority of them had insufficient scores (<50) for EL. Children’s total score (TS) for the
three subjects was significantly associated with household socioeconomic status, gender, birth order and heightfor-age. Even after controlling for household socioeconomic status, significant association between TS and
height-for-age persisted. In this sample of schoolchildren, household income, gender, birth order and height-forage were significant predictors of TS. The finding that height-for-age is related to educational achievement
agrees with other studies, which have reported that height-for-age, compared to weight-for-height or weight-forage is linked to educational achievement. Height-for-age reflects the accumulation of nutritional deprivation
throughout the years, which may consequently affect the cognitive development of the children.
Asia Pac J Clin Nutr. 2000;9(4):264-273.doi:
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Effect of iodized oil supplementation on thyroid hormone levels and mental performance among Orang Asli schoolchildren and pregnant mothers in an endemic goitre area in Peninsular Malaysia
Author:Zaleha Md. Isa PhD, Iskandar Zulkarnain Alias MSc
Keywords:goitre, iodized oil, Malaysia, mental performance, Orang Asli, pregnant women, schoolchildren, thyroid hormones.
Abstract:Although endemic goitre is no longer a major public health problem in Malaysia, iodine deficiency still remains
a significant problem in a few remote settlements. The aim of this study was to determine the effectiveness of
iodized oil intervention in the prevention of endemic goitre among the indigenous people in Malaysia. A pretest
and post-test controlled trial was conducted among primary schoolchildren and pregnant mothers in Lasah,
Sungai Siput and Perak. Legap Post and Yum Post were selected as the intervention areas, while Perwor Post
and Poi Post were taken as controls. The variables studied included thyroid hormone concentrations, thyroid
volume, urinary iodine excretions and mental performance. A baseline and two follow-up visits were conducted
in both intervention and control areas. Intervention subjects were given iodized oil in the form of capsules
which were taken orally (Laboratoire Guerbet, Paris, France). There was a significant increase in serum
thyroxine hormone (T4) concentrations (P< 0.0001) and a significant decrease in thyroid stimulating hormone
(TSH) concentrations (P< 0.05) in the schoolchildren following the intervention, however, pregnant mothers
did not show any significant changes in T4 and TSH concentrations. Thyroid size was significantly reduced in
both groups (P< 0.05). Urinary iodine excretions showed a significant increase in both groups following the
intervention (P< 0.01). However, mental performance in schoolchildren was not affected. In conclusion,
iodized oil (oral) is effective in reducing thyroid size, as well as improving the supply of iodine among
schoolchildren and pregnant mothers in endemic goitre areas; however, its long-term effects need to be
monitored closely. This method can be considered as an alternative while awaiting national coverage for the salt
iodization program.
Asia Pac J Clin Nutr. 2000;9(4):274-281.doi:
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Validation of a semiquantitative food frequency questionnaire for estimation of intakes of energy, fats and cholesterol among Singaporeans
Author:Mabel Deurenberg-Yap, Teresa Li, Wei Ling Tan, Wij
Keywords:multiple 24-h recalls, semiquantitative food frequency questionnaire, Singaporeans, urinary biomarker, validation study
Abstract:The aim of this study was to assess the relative validity of a 159-item semiquantitative food frequency
questionnaire (FFQ) for use among adult Singaporeans. This FFQ should be able to classify intakes of energy,
total fat, saturated fat, polyunsaturated fat, monounsaturated fat and cholesterol into quintiles of intakes for
purposes of epidemiological studies. A total of 126 subjects (84 women and 42 men) took part in the study
which included an interview using the newly developed FFQ (assess past month’s intake) and three 24-h (24 h)
recalls (reference method, collected over a period of 1 month). Subjects also collected two 24 h urinary samples
for urea from which total nitrogen excretion was assessed to validate protein intake. When compared to the
reference method, the FFQ slighty overestimated the intakes of energy, total fat and types of fat as reflected by
the difference in means and the ratio of FFQ to 24 h intakes. The overestimation ranged from 1 to 11% of the
reference method. Dietary cholesterol was underestimated by 17% by the FFQ. These differences were
however, not statistically significant. Pearson’s correlation coefficients (95% confidence intervals (CI)) between
intakes assessed by FFQ and reference method varied from 0.58 (0.45, 0.69) for total fat to 0.39 (0.23, 0.53) for
polyunsaturated fat. Cross-classification into quintiles resulted in correct classification into the same or adjacent
quintiles in 70% of subjects, with only one or two subjects being grossly misclassified. Nitrogen (N) intake
from the 24 h recalls did not differ significantly from that estimated from the urinary nitrogen excretion. The
mean (± SD) difference was 0.0 ± 0.4 g and the Pearson correlation coefficient (95% CI) was 0.55 (0.31, 0.72).
It is concluded that the newly developed FFQ is an adequate tool for classifying individuals’ intakes into
quintiles for epidemiological studies among Singaporean adults.
Asia Pac J Clin Nutr. 2000;9(4):282-288.doi:
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Key role of dietary fats in coronary heart disease under progressive urbanization and nutritional transition
Author:Gandham Bulliyya PhD
Keywords: coronary heart disease, developmental transitions, dietary fats, dietary fish/fish oils, essential fatty acids, India, Orissa.
Abstract:The increased vulnerability to non-communicable diseases (NCD) of developing populations experiencing a
demographic and epidemiological transitions to increased risk of NCD at a time when the battle against
infectious diseases, is ongoing. Apart from population growth, the major attributes of developmental transition
are confined to changes in occupational pattern in family structure, lifestyle, dietary practices and progressive
ageing of population. The emergence of the NCD is significantly associated with changes in dietary pattern, in
most of the countries. Coronary heart disease (CHD) is the leading cause of death in developed countries and
the incidence is increasing in developing countries, including India. The disease needs awareness of the risk
factors responsible for prevention. The purpose of this review is to present an overview of the role of dietary
fats in growth and development and in health and disease. Although the causation of CHD is multifaceted and
the risk factors associated in general are several, there are specific and important elements, such as dietary fats
and lifestyle. Dietary fats are an important component as they serve a number of functions in the body. The
minimum desirable and upper limits of fat intake have been given, based on recommendations of expert groups.
Sources of different fats are made available worldwide and the production, consumption, storage, oxidation and
nomenclature are being discussed in the light of health and disease. The relative essentiality of the omega-6 and
omega-3 fatty acids is recognized in terms of pharmacologically active eicosanoid metabolism. Nevertheless,
epidemiological, physiological and clinical studies have demonstrated that long-chain omega-3 fatty acids
present in fish oils have quite diverse health benefits. Appropriate guidelines need to be recommended at a
national level consistent with dietary habits. The ratios of balanced fatty acids, namely omega-11, omega-9,
omega-6 and omega-3, should be worked out appropriately in ameliorating nutrition-related disease states. Any
simple dietary modification that can lead to a substantial reduction in morbidity and mortality from CHD would
be of great medical, social and economic benefit.
Asia Pac J Clin Nutr. 2000;9(4):289-297.doi:
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Association of dietary factors and other coronary risk factors with social class in women in five Indian cities
Author:Ram B Singh,MD, Raheena Beegom PhD, Satya P Verma
Keywords:body mass index, Bombay, Calcutta, central obesity, fruit, India, legume, Morababad, Mumbai, Nagpur, obesity, Tirvadrum, total visible fat, vegetable
Abstract:The association between social classes, food intake and coronary risk factors was determined. Cross-sectional
surveys were conducted in 6–12 urban streets in each of five cities, each one from five different regions of India
using similar methods of dietary intakes and criteria of diagnosis. We randomly selected 3257 women aged
25–64 years inclusive, from Moradabad (n= 902), Trivandrum (n= 760), Calcutta (n= 410), Nagpur (n= 405)
and Bombay (n= 780). All subjects, after pooling of data, were divided into social class 1 (n= 985), class 2 (n=
790), class 3 (n= 774), class 4 (n= 602) and class 5 (n= 206) based on various attributes of socioeconomic
status. Social class 1 was the highest and 5 was the lowest social class. Social classes 1–3 had greater intake of
pro-atherogenic foods; total visible fat, milk and milk products, meat and eggs, as well as sugar and
confectionery, compared to social classes 4 and 5. The consumption of wheat, rice, millets, fruits, vegetables
and legume/total visible fat ratio were inversely associated with social class. Mean body mass index (BMI),
obesity, overweight, central obesity and sedentary lifestyle were also significantly more common among
subjects from higher social classes. Spearman’s rank correlation showed that bodyweight, BMI, wheat, rice,
millets, total visible fat, milk and milk products, meat, eggs, sugar and jaggery intakes were significantly
correlated with social class. Social class 5 subjects had a lower intake of all foods and a lower BMI, suggestive
of a higher rate of undernutrition among them. The findings indicate that the consumption of pro-atherogenic
foods and other coronary risk factors are more common in higher social classes compared to lower social
classes.
Asia Pac J Clin Nutr. 2000;9(4):298-302.doi:
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Blood glucose responses of diabetes mellitus type II patients to some local fruits
Author:Maria Teresa B Guevarra RND MSNand Leonora N Panla
Keywords:blood glucose response, fruit, glycemic index, Philippines, type II diabetes
Abstract:To determine the glucose responses of diabetes mellitus type II subjects to fruits, four locally available fruits
(containing 25 g of available carbohydrates per serving portion) of chico, mango, pineapple, and papaya were
tested among ten type II diabetic subjects, using wheat bread as the control. Results of the in vivo test indicated
that chico and mango had significantly lower (P≤0.05) blood glucose areas compared to wheat bread. Chico
and mango also had a much lower glycemic index (GI), 57 and 59, respectively, compared to pineapple, 73 and
papaya, 86. Differences in glucose responses to fruits and their varying GI are attributed to the amount of fiber,
type and amount of sugars found, presence of antinutrients, acidity and physical characteristics of the fruits
when chewed. The high fiber content of chico (7.9%), its fructose content (5.3%), its grainy texture when
chewed and the presence of antinutrients (saponin, sapotin and achrasaponin) may contribute to its slow
digestion and absorption. The low GI and blood glucose response of mango may be because of its fructose
content (3.0%), acidity content (malic, citric and tartaric) and its phytic acid content (0.03%). Furthermore,
starch, which is a possible factor contributing to low GI, is present in chico (0.8%) and mango (0.3%).
Pineapple and papaya, the test fruits that elicited higher blood glucose responses and GI, have much lower fiber
contents, less acids and contain glucose and sucrose sugars.
Asia Pac J Clin Nutr. 2000;9(4):303-308.doi:
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Green vegetable juice increases polyunsaturated fatty acid of erythrocyte membrane phospholipid in hypercholesterolaemic patients
Author:Misako Okita PhD, Takayo Sasagawa PhD, Mayumi Kota
Keywords:hypercholesterolaemia, erythrocyte membrane, green vegetable juice, phospholipid, polyunsaturated fatty acid
Abstract:Treatment with green vegetable juice rich in dark-green leafy and cruciferous vegetables, such as cabbage, was
tested in 31 hypercholesterolaemic patients for three weeks. Green vegetable juice supplementation significantly
increased the content of polyunsaturated fatty acids (PUFA; P); 18:2n-6, 20:3n-6, 20:4n-6, 20:5n-3, 22:4n-6,
22:5n-3 and 22:6n-3 of erythrocyte membrane phospholipid and decreased saturated fatty acids (SFA; S): 14:0
and 18:0, and therefore increased the polyunsaturated fatty acids/saturated fatty acids (P/S) ratio markedly from
0.26 ± 0.01 to 0.49 ± 0.01 (P< 0.001). Green vegetable juice supplementation increased both n-6 and n-3
PUFA, but the increase of n-3 PUFA was greater than that of n-6 PUFA. Therefore, the n-6/n-3 ratio decreased
significantly from 4.29 ± 0.42 to 3.00 ± 0.16 (P< 0.05). Plasma thiobarbituric acid reactive substance
production decreased, following the green vegetable juice supplementation. These results suggest that green
vegetable juice may protect the erythrocyte membrane from oxidative stress, and the decrease in n-6/n-3 and
increase in P/S ratio in the erythrocyte membrane phospholipid may be accompanied by rheological and
functional changes in erythrocytes in hypercholesterolaemic patients.
Asia Pac J Clin Nutr. 2000;9(4):309-313.doi:
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Protective effects of quercetin during influenza virus-induced oxidative stress
Author:Telugu Akula Narasa Raju MSc, Ayyagari Naga Vijaya
Keywords:anti-oxidants, influenza virus, oxidative stress, quercetin
Abstract:Oxidative stress was found to have a role in many viral diseases including AIDS, hepatitis and influenza. In the
present study the pathology of influenza viral infection in the lungs, which may lead to oxidative stress, was
investigated and an attempt was made to study the efficacy of anti-oxidants as therapeutic agents. Adult male
mice of Swiss albino type were infected with influenza virus (A/Hong Kong/8/68) and studied for the antioxidant status in the lungs by evaluating the lung enzymatic anti-oxidant system including superoxide dismutase
and catalase. Superoxide radical generation, which might increase by the activated alveolar macrophages, was
estimated by nitroblue-tetrazolium reduction assay. We have also estimated lipid peroxidation levels in lung
through thiobarbutiric acid reactive substances assay. We also examined the ability of flavonoid quercetin in
protecting from influenza virus-induced oxidative stress. The influenza-infected group showed decreased levels
of superoxide dismutase and catalase; however, anti-oxidant supplemented groups showed these activities to be
the same as in the control group. The lipid peroxide levels were increased in virus-infected mice. Administration
of quercetin lowered the lipid peroxide levels significantly. Formazan positive cells were increased by 80% in
the virus-infected group and supplementation with quercetin reduced their number to 44%.
Asia Pac J Clin Nutr. 2000;9(4):314-317.doi:
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Risk science and communication issues and challenges for food: an Australian perspective
Author:Martha I Sinclair PhD, Gayle S Savige PhD, Grad D
Keywords:food quality and safety, risk assessment
Abstract:From any perspective, whether it be Australia or other countries, the issue of risk and food is one that includes
all sectors of the community. The expansion of information technology and globalisation is making society as a
whole more knowledgeable and expectant of safer foods with minimal risk. There is risk in everything and the
basis of risk science is one that involves a number of established steps such as risk assessment, management and
communication. The evolution of food technology, production and dietary habits, together with changes in
trade, will no doubt raise new safety issues and governments need to be abreast of risk science to assess such
changes.
Asia Pac J Clin Nutr. 2000;9(4):318-321.doi:
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Tempe, a nutritious and healthy food from Indonesia
Author:Mary Astuti1Bachelor Eng, MSc, PhD, Andreanyta Mel
Keywords:bone health, bowel health, cancer, cardiovascular disease, Central Java, Indonesia, isoflavones, oligosaccharides, phytic acid, tempe
Abstract:Tempe is a fermented soy bean product originally made by Central Javanese people through fermentation with
Rhizopus species. Although there is evidence of earlier fermentation of soy, tempe had appeared in the Central
Javanese food pattern in the 1700s. Through its extensive use in main meals and snacks, it has led to people in
the Jakarta prectinct having the highest known soy intake in the world and accordingly of the isoflavones
contained. This provides an unique opportunity to consider the health effects of tempe (and soy), both beneficial
and potentially toxic. Apparent health benefits are bowel health, protection against cardiovascular disease,
certain cancers (e.g. breast and prostate) and menopausal health (including bone health). The long use of tempe
at all stages of life, without recognised adverse effects, suggests it is relatively safe at the levels of intake seen in
Central Java. However, further research on soy, both fermented and non-fermented, in Central Java should yield
more insight into the mechanisms of action and the safe ranges of intake.
Asia Pac J Clin Nutr. 2000;9(4):322-325.doi:
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