International trends in nutritionally-related health and their implication for health policy
Author:Mark L Wahlqvist MD FRACP FAFPHM, FAIFST, FTSE
Keywords: health and nutrition policy, scenario planning, food systems, well-being, morbidity, mortality
Abstract:To establish health policy which will be relevant and effectual for a decade or more, let alone the much longer
term, is a challenging task for any period of human or planetary history. Presently it is more so than ever because
of major demographic, economic, technological and scientific, climatic and territorial changes and uncertainties.
There are various scenarios which might be envisaged for food-health relationships before global population size
is expected to stabilize by about 2050, dependent on planetary health. These will reflect achieved food intakes
which for many will not be optimal but realizable and food systems with varying degrees of safety, security and
sustainability. Health patterns themselves are bound to continue to change from those associated with different
levels of economic development to those which have more to do with locality, climate, education and equity.
Every aspect of health is in some way intertwined withfood and this will become more explicit. Decisions about
food-health relationships will take into account the United Nations MDGs (Millennium Development Goals), but
be strongly influenced by technology, affordability, sustainability and ethics.
Asia Pac J Clin Nutr. 2008;17(3):360-369.doi:
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How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations
Author:Wen-Harn Pan PhD and Wen-Ting Yeh MS
Keywords:body mass index, evidence-based, metabolic syndrome, obesity definition, waist circumference
Abstract:Metabolic risks are greater in Asians than Caucasians ata given body mass index (BMI). It is generally accepted
that the BMI cut-off points for defining overweight and obesity should be lower for Asians. However, the percent body fat at a given BMI and metabolic responses to fatness vary among the different ethnic groups in Asia.
Therefore, roughly even-spaced multiple action points (i.e., BMIs of 23, 25, 27.5, 30, 32.5, 35 and 37.5) have
been advocated for managing obesity in Asians. We propose here evidence-based ethnicity-specific action points
for public awareness, screening, and treatment that takeinto consideration sensitivity, specificity, and positive/negative predictive values for cardiovascular disease and/or metabolic syndromes, which are the most prevalent adverse consequences of obesity.
Asia Pac J Clin Nutr. 2008;17(3):370-374.doi:
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Sociocultural factors relating to Tongans’ and Indigenous Fijians’ patterns of eating, physical activity and body size
Author:Helen M Mavoa PhDand Marita McCabe PhD
Keywords:food, physical activity, Tonga, indigenous Fijians, obesity
Abstract:This paper reviews literature between 1974 and 2007 that addresses the impact of sociocultural factors on reported patterns of eating, physical activity (activity) and body size of Tongans and indigenous Fijians (Fijians) in
their countries of origin. There have been changes in diet (more imported and fewer traditional foods), activity
(reduced, especially in urban settings),residence (rural-urban shift) and body size (increased obesity and at a
younger age). The prevalence of overweight/obesity in Tongans and Fijians has increased rapidly over the last
two decades and remains among the highestin the world (>80% in Tonga; >40% in Fiji), with more females reported to be obese than males. The few studies that investigated sociocultural influences on patterns of eating,
activity and/or body size in this population have examined the impact of hierarchical organisation, rank and
status (sex, seniority), values (respect, care, co-operation) and/or role expectations. It is important to examine
how sociocultural factors influence eating, activity and body size in order to i) establish factors that promote or
protect against obesity, ii) inform culturally-appropriate interventions to promote healthy lifestyles and body size,
and iii) halt the obesity epidemic, especially in cultural groups with a high prevalence of obesity. There is an urgent need for more systematic investigations of key sociocultural factors, whilst taking into account the complex
interplay between sociocultural factors, behaviours and other influences (historical; socioeconomic; policy; external global influences; physical environment).
Asia Pac J Clin Nutr. 2008;17(3):375-384.doi:
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Levels of Omega 3 fatty acids in Australian seafood
Author:Sahar S A M SoltanPhD and Robert A Gibson PhD
Keywords:omega 3 fatty acids, dietary fats, fish, fish oils, diet
Abstract:The aimof this study was to determine the quantity of omega 3 (n–3) fatty acids in commonly consumed species of South Australian fish. Omega 3 fatty acids ranged from 17.7% to 53.7%of total fat with docosahexaenoic
acid (DHA, 22:6n–3) as the major omega 3 fatty acid in all 26species tested (range 9.5 % to 47.1% of total fat).
The levels of total omega 6 (n–6) fatty acids ranged from 2.3% to 20.2% of total lipids, chiefly as arachidonic
acid (AA, 20:4n–6). Fatty fish such as Gemfish, Atlantic Salmon and Swordfish were found to be good sources
of omega-3 fatty acid (1360, 2252 and 2571 mg/100g fish respectively), while low fat fish such as Ling, Deep
Sea Bream (Blue Warhou) and Blue Grenadier (0.5, 0.7 and 0.7% fat) had low levels of omega 3 fatty acid (222,
257 and 247 mg/100g). Because most white table fish consumedby Australians are so low in fat they are actually a limited source of omega 3 fats. The amount of fishrequired to be consumed to provide 1 g of omega 3
fatty acid per day ranged from 40 to 450 g.
Asia Pac J Clin Nutr. 2008;17(3):385-390.doi:
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Determination of transfatty acid levels by FTIR in processed foods in Australia
Author:Justine McCarthy BSc (Hons), Daniel BarrBSc, Andre
Keywords: transfatty acids, levels in foods, ATR-FTIR analysis, FSANZ, Australian foods
Abstract:Health authorities around the world advise ‘limiting consumption of trans fatty acids’, however in Australia the
trans fatty acid (TFA) content is not required to be listed in the nutrition information panel unless a declaration
or nutrient claim is made about fatty acids or cholesterol. Since there islimited knowledge about trans fatty acid
levels in processed foods available in Australia, this study aimed to determine the levels of TFA in selected food
items known to be sources of TFA from previously published studies. Food items (n=92) that contain vegetable
oil and a total fat content greater than 5% were included. This criterion was used in conjunction with a review of
similar studies where food items werefound to contain high levels of trans fatty acids. Lipids were extracted using solvents. Gravimetric methods were used to determine total fat content and trans fatty acid levels were quantified by Attenuated Total Reflectance Fourier Transform Infrared spectroscopy. High levels of transfatty acids
were found in certain items in the Australian food supply,with a high degree of variability. Of the samples analysed, 13 contained greater than 1 g of trans fatty acids per serving size, the highest value was 8.1 g/serving.
Apart from when the nutrition information panel states that the content is less than a designated low level, food
labels sold in Australia do not indicate trans fatty acid levels. We suggested thathealth authorities seek ways to
assist consumers to limit their intakes of transfatty acids.
Asia Pac J Clin Nutr. 2008;17(3):391-396.doi:
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Vitamin D intake and its food sources in Taiwanese
Author:Meei-Shyuan Lee DrPH, Hsin-Lu Li MPH, Tsui-Hsia Hu
Keywords:vitamin D, dietary intake, determinants, National Nutrition Survey, adults, women, elderly, school children, DRIs
Abstract:In the early 20th Century, vitamin D was discovered and its Recommended Daily Allowance developed. However, average daily dietary intakes have not been reported until recently in the US. There are no food composition and no intake data for vitamin D available in Taiwan. We have taken advantage of several population representative Nutrition and Health Surveys in Taiwan(NAHSIT) conducted from 1993 onwards of various age
groups to examine this possibility systematically. Firstly, we collected and compiled the vitamin D content of
foods from various sources to supplement the Taiwanese Food Composition Tables. Though these vitamin D
data may not be fully representative of local food items, they serve asa reference point. Secondly, we have used
the three NAHSITs databases, which all used the 24-hr recall method to collect dietary intake data and five food
frequency questionnaire type questions tocollect supplement data, to estimate most gender- and age-specific (include: school children, adults and elderly) vitamin D intakes from food source and supplements. Thirdly, we
have defined the sources of vitamin D intake in Taiwanese (gender- and age-specific). Vitamin D intakes of
Taiwanese were adequate except for high school girls and indigenous people. Fish and its products, milk, mushrooms were the major vitamin D food sources. Supplement source vitamin D also varied greatly between age and
gender groups. Elderly women consumedalmost 20% of vitamin D from supplements; 16-18 years old boys
consumed 2.47% vitamin D from supplements only.
Asia Pac J Clin Nutr. 2008;17(3):397-407.doi:
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Consumption of purple sweet potato leaves decreases lipid peroxidation and DNA damage in humans
Author:Chiao-Ming Chen RD MSc, Ya-Ling Lin RD MSc, C-Y Ol
Keywords:purple sweet potato leaves, polyphenols, lipid peroxidation, 8-hydroxydeoxyguanosine, DNA damage
Abstract:Consumption of polyphenols is associated with reduced risk of chronic diseases, possibly via a variety of biomechanisms, including antioxidation and anti-inflammation. Purple sweet potato leaves (PSPL) commonly consumed in Asia possess polyphenols. In this study, we aim to investigate antioxidant effect of 200 g/d PSPL containing 902 mg polyphenols in a clinical trial. This randomized, crossover clinicalstudy included 16 healthy
adults (7 M, 9 F; aged 20-22 y). After a 1-wk run period, subjects were assigned randomly to receive either
PSPL or low polyphenol diet (LPD) for 2 wks, followed by a 2-wk washout period before crossing over to the
alternate diet. Fasting blood and 24-h urine samples were collected from each subject at day 0, 7 and 14 of each
phase. Our data showed PSPL consumption enhanced urinary total phenol excretion by 24.5% at day 14 as compared to day 0, while the LPD decreased total phenol content in plasma and urine by 3.3 and 16.3%, respectively
(p ≤0.05). Low-density lipoprotein lag time and glutathione concentration in erythrocytes at day 14 was significantly enhanced by 15.0 and 33.3% by PSPL as compared today 0, respectively, while their values were not altered by the LPD. Urinary 8-hydoxy-deoxyguanosine (8-OHdG) excretion decreased significantly by PSPL consumptoin by 36.7% at day 7 as compared to day 0, yet unchanged by the LPD (p ≤0.05). In conclusion, our results suggest that polyphenols in 200 g PSPL were bio-available and could enhance antioxidant defense and decrease oxidative stress in young healthy people.
Asia Pac J Clin Nutr. 2008;17(3):408-414.doi:
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Effect of diacylglycerol on body weight: a meta-analysis
Author:Tongcheng Xu PhD, Xia LiPhD, Zhiguo ZhangPhD, Xiao
Keywords:diacylglycerol, triacylglycerol, body weight, reduction, meta-analysis
Abstract:The effects of diacylglycerol (DAG) on body weight are not consistent in clinical trials. This meta-analysis of
randomized controlled trials was conducted to evaluate the efficacy of dietary DAG on body weight. Potential
articles were initially searched from the electronic databases of Medline, Embase and Cochrane library using the
subject keywords as follows: weight, DAG, triacylglycerol(TAG), reduction and obesity. Inclusion criteria required the trial to be randomized placebo controlled with body weight as an endpoint. Two reviewers independently extracted the information and evaluated the methodological quality using the scoring system developed by
Jadad. Meta-analysis was performed with the software of Review Manager 4.2. The robustness of overall analysis was tested by sensitivity analysisand publication bias was visually inspected by funnel plot. Five published
trials were included in the statistical pool. The meta-analysis indicated a significant difference in body weight
reduction between group receiving DAG and group receiving TAG (weighted mean difference -0.75 kg; 95% CI:
-1.11 to -0.39; p< 0.0001). Sensitivity analysis corroborated the result of the overall analysis. Linear regression
analysis showed that there was significant correlation between daily dose and body weight reduction (p= 0.044,
R
2
= 0.889). In conclusion, this meta-analysis suggested that DAG was efficacious for reducing body weight
compared with TAG and this effect was influenced by the daily dose.
Asia Pac J Clin Nutr. 2008;17(3):415-421.doi:
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Waist circumference percentile criteria for the pediatric metabolic syndrome in Korean adolescents
Author:Kayoung LeeMD PhD
Keywords:waist circumference, metabolic syndrome, adolescents, prevalence, Korea
Abstract:This study aimed to determine valid waist circumference (WC) thresholds using receiver operating characteristic
(ROC) curves for pediatric metabolic syndrome (MS) prediction and to compare validities between the thresholds derived from ROC curves and the WC cut-offs defined by International Diabetes Federation (IDF). Four
hundred and sixty four males and 415 females, 10–18 years, who participated in the KNHNES 2005 were included. Subjects were classified as having pediatric MS when a high WC and ≥2 of the risk factors defined by
IDF were present. High WC was defined using either IDF criterion (≥90
th
percentile for age and sex-specific WC
based on Korean reference in adolescents 10-15 years of age, ≥90cm in males and ≥80cm in females 16-18 years
of age) or age-adjusted WC thresholdsderived from the ROC curves predicting ≥2 abnormal risk factors. The
AUCs were 0.71-0.81 (sensitivity 74-100%, specificity 52-65%) among males and 0.63-0.76 (sensitivity 71-90%,
specificity 37-87%) among females for WC thresholds (55
th
and 32
th
percentile for males and females 10-15
years of age, 73cm and 76cm for males and females 16-18 years of age), while the AUCs were 0.65-0.66 (sensitivity 39-45%, specificity 84-93%) among males and 0.53-0.76 (sensitivity 20-57%, specificity 86-96%) among
females for IDF-defined WC cut-offs. The prevalence ofMS using IDF definition for WC was 4% in males and
2% in females, while those using WC thresholds were8% and 5%, respectively. The IDF’s definition of abdominal obesity may be less sensitive in screening adolescents with pediatric MS compared to WC thresholds.
Asia Pac J Clin Nutr. 2008;17(3):422-428.doi:
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Multiple micronutrient deficiencies persist during early childhood in Mongolia
Author:Rebecca L Lander MMedSci, Tserennadmid Enkhjargal
Keywords:Mongolia, children, deficiencies, anaemia, zinc, selenium
Abstract:Data on the prevalence of micronutrient deficiencies in children in Mongolia is limited.We therefore determined
the prevalence of anaemia, iron deficiency anaemia (IDA), and deficiencies of iron, folate, vitamin A, zinc, selenium, and vitamin D among young Mongolian children. Anthropometry and non-fasting morning blood samples
were collected from 243 children aged 6–36 months from 4 districts in Ulaanbaatar and 4 rural capitols for haemoglobin (Hb), serum ferritin, folate, retinol, zinc, selenium, and 25-hydroxyvitamin D (25-OHD) assays. Children with α-1-glycoprotein ≥1.2mg/L (n=27) indicative of chronic infection were excluded, except for folate, selenium, and 25-hydroxyvitamin D assays. Of the children 14.5% were stunted and none were wasted. Zn deficiency (serum Zn<9.9 µmol/L) had the highest prevalence(74%), followed by vitamin D deficiency 61% (serum
25-OHD<25 nmol/L). The prevalence of anaemia (24%) and iron deficiencyanaemia (IDA) (16%) was lower,
with the oldest children (24-36 mos) at lowest risk. Twenty one percent of the children had low iron stores, and
33% had vitamin A deficiencies (serumretinol < 0.70 µmol/L), even though two thirds had received vitamin A
supplements. Serum selenium values were low, perhaps associated with low soil selenium concentrations. In
contrast, no children in Ulaanbaatar and only 4% in the provincial capitols had low serum folate values (<6.8
nmol/L). Regional differences (p<0.05) existed for anaemia, deficiencies of vitamin A, folate, and selenium, but
not for zinc or IDA. Of the children, 78% were at risk of ≥two coexisting micronutrient deficiencies emphasizing the need for multimicronutrient interventions in Mongolia.
Asia Pac J Clin Nutr. 2008;17(3):429-440.doi:
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Calcium, magnesium, potassium and sodium intakes in Japanese children aged 3 to 5 years
Author:Tomiko Shibata DDSc, Taeko Murakami DDSc, Haruo Na
Keywords:duplicate-diet technique, preschool children, seasonal variation, mineral intake, nutrition survey
Abstract:The present study aimed to evaluate in preschool children the intakes of Ca, Mg that possibly affect health and
tooth formation and the intakes of K and Na that may affect lifestyle-related diseases. Information on dietary intake was collected from 90 preschool children (15 boys and 15 girls each in the 3-, 4- and 5-year old groups) on
3 separate days in the school fiscal year 1999 (April 1999 to March 2000) by the duplicate-diet technique. The
Ca, Mg, K, and Na concentrations were determined by atomic absorption spectrometry using wet-ashed samples.
The medians of mean daily intakes of Ca, Mg, K and Na in 3- to 5-year-old children were 432 mg, 110 mg, 1.18
g and 1.60 g, respectively, and no significant differences with regard to gender were observed. Seasonal variation of intake was seen for each mineral. Calcium intake in most preschool children did not meet adequate intake
(AI), probably due to low intakes of milk and dairy products in Japan. Magnesium intake was below the estimated average requirement (EAR) in 13.3% of the subjects,while the K intake met the AI. Sodium intake in a
quarter of preschool children exceeded the tentative dietary goal. We concluded that in Japanese children aged 3-5 years; Ca intake is low, Na intake is high, and K intake is adequate, but some children could be at risk for Mg
deficiency.
Asia Pac J Clin Nutr. 2008;17(3):441-445.doi:
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Vitamin A supplementation in Cambodia: program coverage and association with greater maternal formal education
Author:Davinder S Grover MD, Saskia de Pee PhD, Kai Sun M
Keywords:Cambodia, morbidity, mortality, nutritional blindness, vitamin A
Abstract:Vitamin A supplementation reduces morbidity, mortality, and blindness among children in developing countries.
The objective of this study is to characterize the coverage of the Cambodian national vitamin A program among
preschool children and to identify risk factors for notreceiving vitamin A supplementation. The study subjects
were preschool children and their families who participated in the 2005 CambodianDemographic and Health
Survey (CDHS), a nationally representative survey. Of 1,547 preschool children, aged 12-59 months, 42.8% received a vitamin A capsule within the last six months. There were no significant differences in paternal education, child age, fever within the last 2 weeks, stunting,underweight, or wasting between children who did or did
not receive a vitamin A capsule. Maternal education of ≥10 years (Odds Ratio [OR] 2.09, 95% Confidence Interval [CI] 1.02 – 4.29), 7-9 years (OR 1.46, 95% CI 0.99 – 2.15), 4-6 years (OR 1.71, 95% CI 1.26 – 2.32), and
1-3 years (OR 1.50, 95% CI 1.10 – 2.06) was associated with the child receiving a vitamin A capsule compared
to no formal education in multivariateanalyses adjusting for other potential confounders. The national vitamin A
supplementation program in Cambodia did not reach over one-half of preschool children in 2005. Greater maternal formal education appears to be an important determinant for receipt of a vitamin A capsule by preschool
children.
Asia Pac J Clin Nutr. 2008;17(3):446-450.doi:
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Hepcidin and iron status among pregnant women in Bangladesh
Author:Kerry J Schulze PhD, Parul Christian DrPH, Ingo Ru
Keywords:anemia, hepcidin, inflammation, iron, pregnancy
Abstract:Although hepcidin, a recently discovered peptide hormone, is considered a major regulator of iron metabolism
and anemia in chronic inflammation, its role in anemia during pregnancy has not been characterized. Our objective was to characterize the role of hepcidin in anemiaduring pregnancy. We examined the relationships between urinary hepcidin, iron status indicators, hemoglobin, erythropoietin, alpha-1 acid glycoprotein, and Creactive protein in a cross-sectional study conductedamong 149 pregnant rural Bangladeshi women with biospecimens obtained during home visits. Urinary hepcidin was measured using surface-enhanced laser desorption/
ionization time-of-flight mass spectrometry. Urinary hepcidin, as log(intensity per mmol/L creatinine), was correlated with log ferritin (r= 0.33, p<0.001), the transferrin receptor index (r= -0.22, p= 0.007), and log alpha-1
acid glycoprotein (r = 0.20, p = 0.01), but not hemoglobin (r =0.07,p=0.40), log transferrin receptor (r= -0.07,
p= 0.41), log erythropoietin (r= -0.01, p= 0.88) or log C-reactive protein (r= 0.06, p= 0.48). The strength of
the relationship between hepcidin and ferritin was maintained in multiple linear regression analyses after enhancing the sample with data from women selected for low iron stores (n = 41). Among pregnant women in a community-based study in rural Bangladesh, urinary hepcidin levels were related to iron status and AGP but not hemoglobin, erythropoietin, or C-reactive protein.
Asia Pac J Clin Nutr. 2008;17(3):451-456.doi:
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Body shape dissatisfaction and obesity among Taiwanese adolescents
Author:Li-Jung Chen PhD, Kenneth R Fox PhD, and Anne M Ha
Keywords:body image, body dissatisfaction, obesity, adolescent, Taiwan
Abstract:Purpose: The purpose of this study was to estimate the level of body shape dissatisfaction among a large sample
of adolescent boys and girls withindifferent weight categories. Methods:A total sample of 883 adolescents
aged 12 to 16 was included from junior high schools in Taipei County, Taiwan. The Contour Drawing Rating
Scale was used to assess body shape dissatisfaction. Results: Body shape dissatisfaction is prevalent in Taiwanese adolescents, particularly for girls. This is linked to degree of overweight in both boys and girls but is also
prevalent in girls who are not overweight or obese. Girls and boys clearly aspire to thinness but some boys
would also prefer to be larger. Conclusions:This study extends our understanding of body shape dissatisfaction
and its relationship with weight status in eastern cultures such as Taiwan.
Asia Pac J Clin Nutr. 2008;17(3):457-460.doi:
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High fish consumption in French Polynesia and prenatal exposure to metals and nutrients
Author:Eric Dewailly MD PhD, Édouard Suhas PhD, Yolande M
Keywords:mercury, n–3 fatty acids, iodine, selenium, lead, newborns
Abstract:French Polynesians consume high quantities of fish and are therefore exposed to seafood-related contaminants
such as mercury (Hg) or lead (Pb) and nutrients such as iodine, selenium and longchain polyunsaturated fatty
acids (LC-PUFAs). As the developing foetus is sensitive tocontaminants and nutrients, a cross-sectional study
was conducted in French Polynesia in 2005-2006 to assess prenatal exposure to contaminants and nutrients
through fish consumption. Two hundred and forty one (241) delivering women originating from all islands of
French Polynesia were recruited and agreed to answer questions on fish consumption and gave permission to
collect umbilical cord blood for metalsand nutrients analyses. All parameters were found in high concentrations
in cord blood samples except for lead. Mercury concentrations averaged 64.6 nmol/L(or 13 µg/L) with values
ranging from 0.25 to 240 nmol/L. Of the sample, 82.5% had Hg concentrations above the US-EPA blood guideline of 5.8 µg/L. Tuna was the fish species which contributed the most to Hg exposure. High selenium and LCPUFAs may counterbalance the potential risk of prenatal exposure to Hg in French Polynesia. Due to the high
fish consumption of mothers, Polynesian newborns are prenatally exposed to high doses of mercury. Although
selenium and omega–3 fatty acids may counteract mercury toxicity, informing pregnant women on both the mercury and nutrient content of local fish species is important.
Asia Pac J Clin Nutr. 2008;17(3):461-470.doi:
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A comparison of the prevalence of the metabolic syndrome in the United States (US) and Korea in young adults aged 20 to 39 years
Author:Jinkyung Park PhD RD, Jason A Mendoza MD MPH, Caro
Keywords:National Health and Nutrition Examination Survey, the US, Korea, National Cholesterol Education Program-Adult Treatment Panel III, International Diabetes Federation, metabolic syndrome
Abstract:This study estimated and compared the prevalence of the Metabolic Syndrome and its individual components in
young adults (ages 20-39 years) in the US and Korea using 2003-2004 US and 2005 Korean National Health and
Nutrition Examination Survey data. The mean body mass index and rate of metabolic abnormalities in the US
were significantly higher than in Korea. The prevalenceof the Metabolic Syndrome in the US was nearly three
times higher than in Korea using National Cholesterol Education Program-Adult Treatment Panel III and International Diabetes Federation criteria (21.6% vs. 6.9% and 23.0% vs. 6.9%, p<0.001). The prevalence of abdominal obesity, hyperglycemia, and hypertriglyceridemia was higher in the US while the prevalence of low
high density lipoprotein-cholesterol level was higher in Korea. The rate ofhypertension showed no significant
difference while mean systolic blood pressure and diastolic blood pressure varied between the two countries.
The proportion of subjects having at least one component of Metabolic Syndrome was similar in both countries;
however, multiple abnormalities were more common in the US. These findings indicate the need for the development of race/ethnic-based norms for components of the Metabolic Syndrome and detailed analysis of the risk
factors for the Metabolic Syndrome in the two countries. National health policies designed to prevent the Metabolic Syndrome, its individual abnormalities, and its complications using population-based characteristics of
each nation will generate improved outcomes.
Asia Pac J Clin Nutr. 2008;17(3):471-482.doi:
>>Abstract
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What’s on Malaysian television? - A survey on food advertising targeting children
Author:Tilakavati Karupaiah PhD APD, Karuthan Chinna PhD,
Keywords:television, advertising, children, food groups, content analysis
Abstract:The Malaysian government recently introduced a ban on fast food advertisements targeting children on television. This study reports on data covering 6 months of television food advertising targeting children. Six out of
seven of the Nation’s commercial television networks participated (response rate = 85.7%). Based on reported
timings of children’s programmes, prime time significantly differed (p<0.05) between weekdays (mean = 1.89 ±
0.18 hr) and weekends (mean = 4.61 ± 0.33 hr). The increased trend during weekends, school vacation and
Ramadhan was evident. Over the six-month period, the mean number of food advertisements appearing per
month varied greatly between television stations (C = 1104; D = 643; F = 407; B = 327; A = 59; E = 47). Food
advertising also increased the most in September (n = 3158), followed by July (n = 2770), August (n = 2431),
October (n = 2291), November (n = 2245) and June (n = 2211). Content analysis of advertisements indicated
snacks were the highest (34.5%), followed by dairy products (20.3%), sugars and candies (13.4%), biscuits
(11.2%), fast food (6.7%), breakfast cereal (6.4%), beverages (4.1%), supplements (0.9%), rice (0.6%), noodles
(0.5%), bread (0.3%), miscellaneous and processed foods (0.2%). Paradoxically, we found that the frequency of
snack food advertised during children’s prime time was 5 times more than fast foods. The sodium content (mean
= 620 mg per 100g) of these snack foods was found to be highest.
Asia Pac J Clin Nutr. 2008;17(3):483-491.doi:
>>Abstract
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Association between obesity and medical care expenditure among Taiwanese adults
Author:Hsiao-Yun Hu MHA, Yiing-Jenq Chou MD PhD, Pesus Ch
Keywords: obesity, body mass index, medical care expenditure, socioeconomic status, Taiwan
Abstract:The aim of this study is to evaluate the relationships between obesity and medical care expenditure among Taiwanese adults and to assess the influence of sex, age and socioeconomic status. Our study sample consisted of
12,250 adults aged 18 years or older from the 2001 National Health Interview Survey (NHIS), who had consented to the linking of their survey responses with their NHI claims records. Obesity was defined by Body Mass
Index based on the WHO-Asia Pacific categories. Adjusted expenditure for obese class II and class I men were,
respectively, 44.6% (95%CI: 27.1%-68.7%) and 39.5% (95%CI: 39.4%-41.2%) greater than normal weight men.
For obese class II and class I women, the adjusted expenditure were, respectively, 93.3% (95%CI: 69.9%-114.6%) and 56.1% (95%CI: 50.4%-61.4%) greater than normal weight women. After adjusting for other factors,
higher medical care expenditure was associated with a higher BMI for each age group. The relative magnitude of
the association became more apparent as age increased. Annual medical care expenditure increased as the BMI
increased among women, which was particularly apparent among low socioeconomic status women. On the
other hand, the relationship between BMI and medical care expenditure in men varied by household income. In
conclusion, there is a strong positive relationship between higher BMI and increased medical care expenditure
and this varies according to sex, age and socioeconomic status. Our findings suggest that projections of future
health care costs attributable to obesity will need to take into consideration the demographic make-up of the
obese population.
Asia Pac J Clin Nutr. 2008;17(3):492-504.doi:
>>Abstract
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Coexistence of anaemia and the metabolic syndrome in adults in Jiangsu, China
Author:Zumin Shi PhD, Xiaoshu Hu MD, Baojun Yuan MD, Gang
Keywords:Anaemia, metabolic syndrome, ferritin, adults, China
Abstract:Objective:To determine the prevalenceof anaemia and the metabolic syndrome with special interest in the coexistence of these two problems as well as the possible links. Research design and method:In a cross-sectional
household survey, 1294 men and 1522 women aged 20 years and abovewere interviewed; anthropometric measurements and blood samples were taken. Metabolic syndrome was defined according to IDF 2005 standard.
Anaemia was defined as haemoglobin level below 13 g/dL for men and 12 g/dL for women. Results:The ageadjusted prevalence of metabolic syndrome was 11.2% and of anaemia 24.4%. About 3 percent of the participants had both anaemia and metabolic syndrome. Women had a higher prevalence of both the metabolic syndrome and anaemia than men (14.0 vs 8.4%, 31.5% vs 16.1%). Anaemia coexisted significantly with all the individual components of the metabolic syndrome. Only 7.0% of the sample had anaemia without any individual
component of metabolic syndrome. In women, the prevalence of combined anaemia and metabolic syndrome
peaked in the age group 50-59 years (9.9%). Women in the highest quartile of serum ferritin had a higher risk of
only the metabolic syndrome and coexistence of anaemia and metabolic syndrome. Conclusion:The high prevalence of the metabolic syndrome and anaemia in the area show the urgent need to develop comprehensive strategies aimed at prevention and treatment. In women this coexistence may be related to inflammation but further
research is needed.
Asia Pac J Clin Nutr. 2008;17(3):505-513.doi:
>>Abstract
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An integrated intervention program to control diabetes in overweight Chinese women and men with type 2 diabetes
Author:Jianqin Sun MD MPH, Yanfang Wang MD MHS, Xiafei Ch
Keywords:Type 2 diabetes, Diet therapy, Formulated food, Glycosylated hemoglobin, Metabolic syndrome X
Abstract:This study evaluated a structured and integrated intervention program on diabetes management in individuals
with type 2 diabetes in Shanghai, China. Men and women with type 2 diabetes and body mass index >23 kg/m
2
were randomized into a 24-week, prospective, randomized clinical trial. The Reference Group (n=50) received
diabetes education including diet and physical activity instruction only; the Intervention Group (n=100) received
more intensive intervention, including diabetes education with frequent blood glucose monitoring, nutritional
counseling, meal plans with diabetes-specific nutritional meal replacement, and weekly progress updates with
study staff. Major study assessments were obtained at baseline, and after 12 and/or 24 weeks of intervention. The
Intervention Group improved fasting blood glucose, insulin, systolic and diastolic blood pressures compared to
Reference Group (p<0.05). Importantly, HbA1c was lower (p<0.001) in the Intervention Group at 12 weeks (-0.6 ± 0.1%) and 24 weeks (-0.8 ± 0.1%). Weight loss was modest, but significant differences were observed between groups (p<0.05). Weight change from baseline after 12 and 24 weeks was -2.8 ± 0.2% and -3.7 ± 0.3%,
respectively, in the Intervention Group vs -1.8 ± 0.4% and -2.5 ± 0.4% in the Reference Group. Additionally,
waist and hip circumferences and waist:hip ratio decreased in the Intervention compared to the Reference Group
(p<0.05). In conclusion, this study demonstrates that Chinese men and women with type 2 diabetes following an
integrated intervention program including diabetes education, frequent blood glucose monitoring and daily use
of a diabetes-specific meal replacement, can achieve significant improvements in glycemic control and markers
of cardiovascular health.
Asia Pac J Clin Nutr. 2008;17(3):514-524.doi:
>>Abstract
>> Download PDF
Intraoperative infusion of acetated Ringer solution containing glucose and ionized magnesium reduces ketogenesis and maintains serum magnesium
Author:Takeshi Yokoyama DDS PhD, Kunio Suwa MD PhD, Fumiy
Keywords:perioperative infusion, glucose metabolism, ketogenesis, insulin, magnesium
Abstract:The effect of glucose infusion during surgery on glucose metabolism has not been investigated sufficiently. We,
therefore, examined the effect after the infusion of 1% glucose acetated Ringer solution containing Mg
2+
during
surgery on ketogenesis and serum Mg
2+
concentrations. Patients, classifiedas ASA I-II, age 51-80 years, were
randomly assigned to receive infusion of acetated Ringer solution. The G/Mg group received infusion with 1%
glucose, Na
+
140mEq/L, Mg
2+
2 mEq/L, and the C group received infusion with glucose free solution containing
Na
+
130 mEq/L without Mg
2+
. Both solutions were infused at a rate of 25 mL/kg for the first hour, and maintained at 4 mL/kg/hr thereafter. Blood samples were collected three times: before infusion and at 1 hour and 4
hours after the start of infusion. Electrolytes and glucose metabolism were evaluated at each sampling. After
rapid infusion, blood glucose level significantly increased to 170±19mg/dL in the G/Mg group, but it returned to
close to baseline after 4 hours and serum ketone bodies did not increase during infusion. In the C group, however,
blood glucose never increased beyond 110 mg/dL, but both acetoacetic and hydroxybutyric acids increased significantly at the third measurement.
Asia Pac J Clin Nutr. 2008;17(3):525-529.doi:
>>Abstract
>> Download PDF
Symposium on Understanding and Influencing Consumer Food Behaviours for Health: Executive Summary Report
Author:Ma Sofia V Amarra, Yeong Boon Yee, Adam Drewnowski
Keywords:consumers, Asia, food consumption, consumer behavior, food choice
Abstract:Food consumption patterns in Asia are rapidly changing. Urbanization and changing lifestyles have diminished
the consumption of traditional meals based on cereals, vegetables and root crops. These changes are accompanied by an increasing prevalence of chronic diseasesamong Asian populations. ILSI Southeast Asia and CSIRO,
Australia jointly organized the Symposium on Understanding and Influencing Food Behaviours for Health, focusing on the use of consumer science to improve food behaviour. The goals of the Symposium were to present
an understanding of Asian consumers and their food choices, examine the use of consumer research to modify
food choices towards better health, illustrate how health programs and food regulations can be utilized effectively to promote healthier choices, and identify knowledge gaps regarding the promotion of healthy food behaviour in Asian populations. There is no difference in taste perception among Asians, and Asian preference for certain tastes is determined by exposureand familiarity largely dictated by culture and its underlying values and beliefs. Cross-cultural validity of consumer science theories and tools derived from western populations need to be
tested in Asia. Information on consumption levels and substitution behaviours for foods and food products, obtained using consumer research methods, can guide the development of food regulations and programs that will
enable individuals to make healthier choices. Existing knowledge gaps include consumer research techniques
appropriate for use in Asian settings, diet-health relationships from consumption of traditional Asian diets, and
methods to address the increasing prevalence of over- and undernutrition within the same households in Asia.
Asia Pac J Clin Nutr. 2008;17(3):530-539.doi:
>>Abstract
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The 2 nd International Conference on East-West Perspectives on Functional Foods: Science, Innovations and Claims
Author:Rodolfo F FlorentinoMD PhD
Keywords:functional foods, nutrition and health claims
Abstract:The 2
nd
International Conference on East-West Perspective on Functional Foods held in Kuala Lumpur, Malaysia, on November, 2007, discussed the current work on some traditional Asian foods and new technologies that
offer both challenges and opportunities for functional foods. The highlight of the conference was on the current
regulatory status of nutrition and health claims related tofunctional foods and the experiences in some countries
on the substantiation of claims. Attention was also given to strategies for effective communication of functional
foods to consumers. The conference concluded with recommendations to strengthen R&D efforts and harmonization of protocols and methodologies on functional foods within the region.
Asia Pac J Clin Nutr. 2008;17(3):540-543.doi:
>>Abstract
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