Asia Pacific Clinical Nutrition Society Award for 2011
Author:
Keywords:
Abstract:
Asia Pac J Clin Nutr. 2011;20(1):i.doi:
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Harmonisation of food labelling regulations in Southeast Asia: benefits, challenges and implications
Author:William Kasapila MSc and Sharifudin MD Shaarani Ph
Keywords:food industry, packaging, consumers, health claims, nutrition
Abstract:In the globalised world of the 21
st
century, issues of food and nutrition labelling are of pre-eminent importance.
Several international bodies, including the World Health Organisation and World Trade Organisation, are encouraging countries to harmonise their food and nutrition regulations with international standards, guidelines and
recommendations such as those for Codex Alimentarius. Through harmonisation, these organisations envisage
fewer barriers to trade and freer movement of food products between countries, which would open doors to new
markets and opportunities for the food industry. In turn, increased food trade would enhance economic development and allow consumers a greater choice of products. Inevitably, however, embracing harmonisation brings
along cost implications and challenges that have to be overcome. Moreover, the harmonisation process is complex
and sporadic in light of the tasks that countries have toundertake; for example, updating legislation, strengthening
administrative capabilities and establishing analytical laboratories. This review discusses the legislation and
regulations that govern food and nutrition labelling in Southeast Asia, and highlights the discrepancies that exist
in this regard, their origin and consequences. It also gives an account of the current status of harmonising labelling
of pre-packaged foodstuffs in the region and explains the subsequent benefits, challenges and implications for
governments, the food industry and consumers.
Asia Pac J Clin Nutr. 2011;20(1):1-8.doi:
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Evaluation of weight loss in the community-dwelling elderly with dementia as assessed by eating behavior and mental status
Author:Keiko Miyamoto MS, Sadanori Higashino PhD, Kazuki
Keywords:eating difficulties, elderly, dementia, nutritional assessment, weight loss
Abstract:Involuntary weight loss is a symptom of protein energymalnutrition often reported among elderly people, especially those with dementia. In this study, we examined whether dementia-related eating difficulties increase the
probability of weight loss in the elderly. This cross-sectional observation study was conducted in 60 communitydwelling elderly people with dementia (84.1±6.7 yr of age). Over 6 months, 26.7% of the subjects lost at least
5% of body weight. Impaired mental status and eating difficulties were closely associated with weight loss as determined by Spearman’s rank correlation coefficient. Assessment of eating difficulties combined with mental
states in the subjects by discriminant analysis enabled us to differentiate subjects with ≥5% weight loss from
those with less than 5% weight loss at a probability of 76.4%. This result suggests that eating difficulties and
impaired mental status among elderly people with dementia are closely associated with weight loss.
Asia Pac J Clin Nutr. 2011;20(1):9-13.doi:
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Associations between combinations of body mass index plus non-alcoholic fatty liver disease and diabetes mellitus among Korean adults
Author:Sang-Hwan Kim MD, Ji-Won Lee MD, Hee-Jin Hwang MD
Keywords:fatty liver, glucose metabolism,diabetes, body mass index, obesity
Abstract:The purpose of this study was to investigate associations between combinations of body mass index (BMI) categories plus non-alcoholic fatty liver disease (NAFLD) and diabetes mellitus (DM) among Korean adults. We
prepared the data of 5665 subjects aged 20 years and over who had visited a health promotion center. We excluded 582 subjects as they had a viral or alcoholic liver disease. According to BMI-NAFLD status, the subjects
were categorized as non-obese (BMI<25 kg/m
2
) without NAFLD (n=2568), obese (BMI≥25 kg/m
2
) without
NAFLD (n=572), non-obese with NAFLD (n=748), or obese with NAFLD (n=1195). The prevalence of NAFLD
was highest in the obese subjects with DM (87.9%). In non-obese and non-DM subjects, the prevalence of
NAFLD was lowest (18.4%). After adjustment of age, gender, waist circumference, smoking status, alcohol
drinking, regular exercise, the odd ratios for DM or DMplus impaired fasting glucose (IFG) of subjects with
mild NAFLD regardless of obesity were almost 2-fold compared to non-obese subjects without NAFLD. Moreover, those of subjects with moderate or severe NAFLD regardless of obesity were about 4- fold. Clinicians and
investigators need to pay attention to non-obese patients with fatty liver.
Asia Pac J Clin Nutr. 2011;20(1):14-20.doi:
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Dieting practices and body image perception among Lebanese university students
Author:Najat Yahia PhD, Hiba El-Ghazale BSc,Alice Achkar
Keywords:dieting, body shape questionnaire, body image, Middle East, university students
Abstract:Dieting is becoming a popular phenomenon among university students to achieve or maintain a healthy weight.
The purpose of this study is to obtain a preliminary understanding of what dieting practices university students
use in order to achieve their desirable body weight and to determine the magnitude of body dissatisfaction in relation to weight status among a sample of students (n=252) from the Lebanese American University in Beirut,
Lebanon. Students filled out a self-reported questionnaire that included questions on their dieting and physical
activity practices in addition to the body shape questionnaire (BSQ). Weight and height were measured to calculate body mass index. Percentagebody fat was measured using Tanitascale body fat analyzer 300A. The outcome of this study showed that smoking and unhealthy dieting practices were not common among students (only
26% reported smoking, 8% reported taking laxatives and 4% taking diet pills). Halfof the students reported
practicing regular physical activity. Multivitamin intake was also not popular among students. BSQ scores indicate that the majority of students were not worried about their body image perception (64% reported not being
worried, 19% were slightly worried, 12%were moderately worried and 5% were extremely worried). A gender
difference was observed in the BSQ scores, as 89% of the “extremely worried” students were females. Collectively, results indicate that unhealthy dieting practices are uncommon among students. However, developing
health promotion awareness’ programs to promote good self image within the concept of a realistic healthy
weight will be beneficial, especially among females.
Asia Pac J Clin Nutr. 2011;20(1):21-28.doi:
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Eating behavior in relation to prevalence of overweight among Japanese men
Author:Yasumi Kimura PhD, Akiko Nanri PhD, Yumi Matsushit
Keywords:overweight, eating behavior, eating quickly, eating until full, epidemiology
Abstract:Obesity is an important risk factor for lifestyle diseases. There has been much interest in the role of eating behavior in the development of obesity, but findings from population-based epidemiologic studies are limited and
inconsistent. The objective of our cross-sectional study was to examine the association between eating behavior
and prevalence of overweight. Subjects were 290 men of two municipal offices in northeastern Kyusyu, Japan. A
positive association was found between overweight and some eating behaviors; multivariate-adjusted odds ratios
(95% confidence intervals) for overweight were 4.33 (2.46-7.64), 2.29 (1.22-4.32), and 2.01 (1.06-3.80) for the
behaviors of eating quickly, eating untilfull and eating fatty foods, respectively. Moreover, the prevalence of
overweight was further increased when these eating behaviors were combined; multivariate odds ratios (95%
confidence intervals) of overweight for men with 1, 2 and ≥3 versus no high-risk eating behaviors were 2.66
(1.27-5.56), 4.32 (1.87-9.97) and 7.32 (3.01-17.84), respectively (p<0.0001 for trend). Our findings suggest that
eating quickly, eating until full and eating fatty foods are related tooverweight in Japanese men.
Asia Pac J Clin Nutr. 2011;20(1):29-34.doi:
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Prevalence of overweight and obesity among adult Malaysians: an update
Author:Wan Nazaimoon Wan Mohamud PhD, Kamarul Imran Musa
Keywords:overweight, obesity, prevalence, oral glucose tolerance test, Malaysia
Abstract:A total of 4428 adults (>18 years old) from 5 different selected regions in Peninsular and East Malaysia participated in this health survey. Using World Health Organization recommendations for body mass index (BMI), the
prevalence of overweight and obesity were found to be 33.6% (95% CI= 32.2, 35.0) and 19.5% (95% CI= 18.3,
20.7) respectively. There were more females who were obese (22.5%, 95% CI=20.9, 24.0) compared to males
(14.1%, 95% CI=12.3, 15.9). Highest prevalence of obesity were among the Indians (24.6%, 95% CI=20.3, 29.3),
followed closely by the Malays (23.2%, 95% CI=21.6,24.8%) and lowest prevalence was among the Chinese
subjects (8.2%, 95% CI=6.2, 10.6). More than 43% of the 531 younger subjects (<30 years old) were either
overweight (20%, 95% CI=16.6, 23.6) or obese (13.9%, 95% CI=11.1, 17.2%). All subjects who claimed to be
non-diabetes were required to undergo 75 g glucose tolerance test. Compared to subjects with normal BMI
(18.5-24.9 kg/m
2
), there was a 3- and 2-folds increase in the prevalence of newly diagnosed diabetes and impaired glucose tolerance respectively, among obese subjects (BMI >30 kg/m
2
) who initially claimed to have no
diabetes. This study highlights a need for more active, inter-sectoral participation advocating a health-promoting
environment in order to combat obesity in this country.
Asia Pac J Clin Nutr. 2011;20(1):35-41.doi:
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The nutritional status of iron, folate, and vitamin B-12 of Buddhist vegetarians
Author:Yujin Lee Dipl oec Trophand Michael Krawinkel PhD
Keywords:iron, folate, vitamin B-12, Buddhist vegetarians, vegetarian diet
Abstract:Nutritional status of iron, folate, and vitamin B-12 in vegetarians were assessed and compared with those of non-
vegetarians in Korea. The vegetariansubjects were 54 Buddhist nuns who ate no animal source food except for
dairy products. The non-vegetarians were divided into two groups: 31 Catholic nuns and 31 female college students. Three-day dietary records were completed, and the blood samples were collected for analyzing a complete
blood count, and serum levels of ferritin, folate, and vitamin B-12. There was no difference in hemoglobin
among the diet groups. The serum ferritin and hematocrit levels of vegetarians did not differ from that of non-
vegetarian students with a high intake of animal source food but low intake of vitamin C, and the levels were
lower than that of non-vegetarian Catholic nuns with a modest consumption of animal source food and a high intake of vitamin C. The serum vitamin B-12 levels of all subjects except one vegetarian and the serum folate levels of all subjects except one non-vegetarian student fell within a normal range. In vegetarians, there was a positive correlation between the vitamin C intake and serum ferritin levels as well as between the laver intake and serum vitamin B-12 levels. In order to achieve an optimal iron status, both an adequate amount of iron intake and
its bioavailability should be considered. Sufficient intake of vegetablesand fruits was reflected in adequate serum folate status. Korean laver can be a good source of vitamin B-12 for vegetarians.
Asia Pac J Clin Nutr. 2011;20(1):42-49.doi:
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Bone is more susceptible to vitamin K deficiency than liver in the institutionalized elderly
Author:Akiko KuwabaraPhD, Minori Fujii RD, Nobuko Kawai C
Keywords:vitamin K, adequate intake, γ-carboxylation, ucOC, PIVKA-II
Abstract:In Japan, γ-carboxylation of blood coagulation factors is the basis for determining adequate intake (AI) for vitamin K in Dietary Reference Intakes (DRIs) issued in 2010. Recently, vitamin K is alsoknown to be essential for
preventing fracture. In this study, relative susceptibility of liver and bone to vitamin K deficiency was studied.
Thirty-seven elderly institutionalized subjects were evaluated for vitamin K statusby measuring serum PIVKA
(protein induced by vitamin K absence) –II and ucOC (undercarboxylated osteocalcin) levels, as sensitive
markers for hepatic and skeletal vitamin K deficiency, respectively. Serum PIVKA-II and ucOC levels, with
their cut-off values in the parentheses, were 20.2±8.9 mAUmL (28 mAU/mL) and 4.7±3.0 ng/mL (4.5 ng/mL),
respectively. Median vitamin K intake was approximately 200 μg/day, which is more than 3 times higher than
the current Japanese AI. Vitamin K intake was significantly correlatedwith serum PIVKA-II and ucOC/OC levels, but not with serum ucOC level. Although serum ucOC level is generally a good indicator for vitamin K
status, multiple regression analysis revealed that elevated bone turnover marker significantly contributed to serum ucOC level. All subjects had vitamin K intakeexceeding AI for vitamin K.Nevertheless, serum PIVKA-II
and ucOC concentrations exceeded the cut-off value in 14% and 43% of subjects, respectively. The present findings suggest that vitamin K intake greater than the current AI is required for the skeletal health in the institutionalized elderly.
Asia Pac J Clin Nutr. 2011;20(1):50-55.doi:
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High prevalence of hypovitaminosis D and K in patients with hip fracture
Author:Tetsuo Nakano MD, Naoko Tsugawa PhD, Akiko Kuwabar
Keywords:hypovitaminosis D, hypovitaminosis K, patients with hip fracture, general malnutrition, principal component analysis
Abstract:Although hip fracture is considered to be associated with hypovitaminosis D and K, few reports have previously
studied both of them. We have studied the vitamin D- and K-status as well as the general nutritional status in ninety-nine patients with hip fracture.Mean serum concentration of 25hydroxy-vitamin D (25OH-D) in female
fractured patients was only approximately 9 ng/mL, suggesting severe vitamin D deficiency. There was no significant difference between the two groups in serum concentration of intact parathyroid hormone in both genders
and serum 25OH-D levels in the male subjects. Plasma concentrations of phylloquinone (vitamin K1; PK) and
menaquinone-7 (MK-7) were significantly lower in the fractured group than in the control group in both genders.
Logistic regression analysis indicated that circulating concentrations of albumin, PK and 25OH-D were the significant and independent determinants of fracture risk, withtheir higher concentrations associated with decreased
fracture risk. Finally, principal component analysis (PCA) was performed tosummarize the clinical parameters
into smaller numbers of independent components. Three components were obtained, each representing the overall nutritional status, the vitamin D status, and the vitamin K status. In conclusion, our study has shown that patients with hip fracture have vitamin D and K deficiency independent ofgeneral malnutrition.
Asia Pac J Clin Nutr. 2011;20(1):56-61.doi:
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Exclusive breastfeeding of low birth weight infants for the first six months: infant morbidity and maternal and infant anthropometry
Author:Grace V Agrasada PhD, Uwe Ewald PhD, Elisabeth Kyl
Keywords: breastfeeding, counseling, diarrhea, anthropometry, growth
Abstract:Background: to report anthropometry and morbidity among term low birth weight infants and anthropometry of
their first time mothers during the first six months in relation to breastfeeding practice. Methods: we examined
data from a randomized controlled trial in Manila, the Philippines. Of the 204 mothers randomized, 68 mothers
received eight postpartum breastfeeding counseling sessions, the rest did not.Maternal and infant anthropometric data at birth, 2, 4 and 6 months were taken. During seven follow-up hospital visits, an independent interviewer recorded feeding data. Results: the 24 infants exclusively breastfed from birth to six months did not have
diarrhea compared to 134 partially breastfed (mean 2.3 days) and 21 non-breastfed infants (mean 2.5 days). Partially breastfed and non-breastfed infants compared to exclusively breastfed infants had more frequent, as well as
more severe episodes of respiratory infections. At six months, neither overall gain in infant weight, length and
head circumferences nor mean maternal weight and body mass index differed significantly between the feeding
groups. Conclusions: exclusive breastfeeding for 6 monthscan be recommended in term low birth weight infants, who were protected from diarrhea, had fewer respiratory infections, required no hospitalization and had
catch up growth. Exclusively breastfeeding mothers did not differ from mothers who breastfed partially or those
who did not breastfeed with regard to weight changes at six months.
Asia Pac J Clin Nutr. 2011;20(1):62-68.doi:
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Improved growth of toddlers fed a milk containing synbiotics
Author:Agus Firmansyah PhD, Pramita G Dwipoerwantoro PhD,
Keywords:lactobacillus, bifidobacterium, fructo-oligosaccharide, long chain polyunsaturated fatty acids, growth
Abstract:Bifidobacterium longum(BL999), Lactobacillus rhamonosus(LPR), prebiotics (inulin and fructo-oligosaccharides),
and long-chain polyunsaturated fatty acids (LCPUFA) are believed to have health benefits. In a randomized,
double-blind, controlled trial we compared growth and development of toddlers fed milk containing synbiotics
(BL999, LPR, and prebiotics) and LCPUFA or a control milk. Three hundred and ninety three healthy, 12
month-old toddlers were fed approximately 400 mL/day for 12 months. Anthropometric measurements were taken at 12, 14, and 16 months. Toddlers’ response to measles and hepatitis A vaccine was measured at 16 months,
and Bayley scale for motor, cognitive, and behavioral functions made at 24 months. The primary outcome was
weight gain between 12 and 16 months. Secondary outcomes were gain in length, head circumference, and body
mass index, gastrointestinal tolerance (stool characteristics), stool bacterial counts, safety, anti-vaccine IgG, and
neurodevelopment. Weight gain was greater in the synbiotics group (mean±SD, 7.57±4.13 g/day) compared with
the control group (6.64±4.08 g/day). The difference of 0.93 g/day (with a 95% confidence interval of 0.12 to
1.75) is significant (p=0.025). The gain in the synbiotics group resulted in a change in z-score weight-for-age
closer to WHO Child Growth Standard. There was a significant increase in lactobacilli and enterococci counts
between 12 months and 16 months in the synbiotic group. We conclude that in healthy toddlers milk containing
synbiotics and LCPUFA provides better growth and promotes favorable gut colonization, as shown by higher
Lactobacilluscounts.
Asia Pac J Clin Nutr. 2011;20(1):69-76.doi:
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Nutrition education guided by Dietary Guidelines for Chinese Residents on metabolicsyndrome characteristics, adipokines and inflammatory markers
Author:Shi-xiu Zhang PhD, Hong-wei Guo MD, Wen-tao Wan MD
Keywords:the metabolic syndrome, nutrition education, adiponectin, leptin, tumor necrosis factor-α
Abstract:Objective: The objective of this study was to test whether “Dietary Guidelines for Chinese Residents” have
beneficial effects on anthropometric and metabolic variables, adipokines and inflammatory markers in metabolic
syndrome patients. Methods & Procedures: A multi-stage sampling method was applied to select metabolic syndrome patients in two districts of Shanghai. Two hundredand seventy-two metabolic syndrome patients were divided into control and intervention groups according to their district. Nutrition education guided by “Dietary
Guidelines for Chinese Residents” was performed in the intervention group for one year. Results: Nutritionrelated knowledge, attitudes and behaviorwere improved in the intervention group. Potassium intake and food to
total energy ratio for grain, vegetable and fruit increased while sodium intake as well as fat to total energy ratio
decreased in the intervention group compared to the control group (p<0.05). Correspondently, the intervention
group significantly improved its waist circumference, waist to hip ratio, high-density lipoprotein cholesterol,
adiponectin, leptin and tumor necrosis factor-αcompared to the control group (p<0.05). Waist circumference
changes from baseline to end of the study in the intervention and the control groups were -3.9±0.3 and -2.3±0.4
cm respectively. There was a significant difference between the two groups (p=0.004). Means of waist circumference, waist to hip ratio, leptin and tumor necrosis factor-αwere lower, and high density lipoproteincholesterol was higher in the intervention group than the control group (p<0.05). Conclusion: This study confirmed “Dietary Guidelines for Chinese Residents” had beneficial effects on anthropometric, lipids, adipokines
and inflammatory markers in metabolic syndrome patients.
Asia Pac J Clin Nutr. 2011;20(1):77-86.doi:
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Nutrition education for adolescents: Principals’ views
Author:Wai Ling Theresa Lai-Yeung PhD
Keywords:adolescent nutrition sciences, diet, education, curriculum, food services
Abstract:This study aimed to examine school principals’ perceptions of the schoolenvironment in Hong Kong as a context for the dissemination of food knowledge and inculcation of healthy eating habits. A questionnaire survey
was administered in secondary schools in Hong Kong to survey Principals’ views of students’ food choices, operation of the school tuck shop, and promotion of healthy eating at school. Questionnaires were disseminated to
all the secondary schools offering Home Economics (300 out of 466), and 188 schools responded, making up a
response rate of 63%. Collected data were analyzed using SPSS. Mostof the schools (82%) claimed to have a
food policy to monitor the operation of the school canteen, and about half (52%) asserted there were insufficient
resources to promote healthy eating atschool. Principals (88%) generally considered it not acceptable for the
school tuck shop to sell junk food; however, 45% thought that banning junk food at school would not help students develop good eating habits. Only 4% of the principals believed nutrition education influenced eating habits; whereas the majority (94%) felt that even with acquisition of food knowledge, students may not be able to
put theory into practice. Cooking skills were considered important but principals (92%) considered transmission
of cooking skills the responsibility of the students’ families. Most of the principals (94%) believed that schoolfamily collaboration is important in promoting healthy eating. Further efforts should be made to enhance the effectiveness of school food policies and to construct healthy school environments in secondary schools.
Asia Pac J Clin Nutr. 2011;20(1):87-94.doi:
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Influence of awareness of the Japanese Food Guide Spinning Top on eating behavior and obesity
Author:Kanae Takaizumi MSc, Kazuhiro Harada MSc, Ai Shiba
Keywords:health promotion, food guide, campaign, nutrition survey, obesity
Abstract:The purpose of the present study was to investigate the influence of awareness of the Japanese Food Guide Spinning Top on eating behavior and obesity in Japan. Participants were 1,558 Japanese male and female adults
(40.2±12.2 years) who had been registered with a social research company. The cross-sectional questionnaire
survey was conducted via the Internet in November 2007.Potential respondents were invited to complete the
survey via e-mail, which contained a link to the survey Uniform Resource Locator(URL). The measures were
awareness of the Japanese Food Guide Spinning Top, eating knowledge scores, eating attitude scores, and eating
behaviors scores, according to the recommendations of the Health Japan 21 and the Food Balance Guide Spinning Top. Obesity was assessed by self-reported body mass index (BMI) and waist circumference. The relationships between awareness of the Japanese Food Guide Spinning Top, eating knowledge scores, eating attitude
scores, eating behavior scores, and obesity were analyzed using path analysis. Path analysis revealed that awareness of the Japanese Food Guide Spinning Top was associated with BMI and waist circumference via eating behavior scores. In addition, eating knowledge scores and eating attitude scoreswere mediators of the association
between awareness of the Japanese Food Guide Spinning Top and eating behavior scores. These results suggest
that promotion of the Japanese Food Guide Spinning Top would be a useful strategy to encourage healthy eating
and prevent obesity in the Japanese population.
Asia Pac J Clin Nutr. 2011;20(1):95-101.doi:
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A comparative study of the culture of thinness and nutrition transition in university females in four countries
Author:Hala N Madanat PhD 1,2,3 , Ryan Lindsay MPH 4 , St
Keywords:Asia, eating behavior, body image, overweight, nutrition
Abstract:The purpose of this study was to examine the nutrition transition in four countries with respect to body dissatisfaction and eating styles. The targetpopulation for this study was college students in China (n=207), Japan
(n=865), Jordan (n=322), and the United States (n=432). A cross-sectional survey was used to assess eating
styles, disordered eating attitudes and behaviors, body esteem and dissatisfaction, and media influence. Results
indicated that the Chinese sample was in an earlier stage of the nutrition transition, followed by Japan, Jordan,
and the US. Interestingly, Jordanian and Chinese students exhibited the lowest level of body dissatisfaction.
However, Jordanian students exhibited high levels of restrained eating similar to those seen in the Japanese and
American students. The Japanese sample demonstrated a complex relationship between the culture of thinness,
body dissatisfaction and eating styles. However the US sample reflected the expected levels of body dissatisfaction, high levels of restrained eating, emotional eating, and disordered eating attitudes and behaviors. Implications and suggestions for further research are discussed.
Asia Pac J Clin Nutr. 2011;20(1):102-108.doi:
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Chronic hemodialysis patients with visceral obesity have a higher risk for cardiovascular events
Author:Yukie Moriyama RD, Rieko Eriguchi MD, Yuzuru SatoM
Keywords:visceral fat area, obesity, cardiovascular disease, ischemic heart disease, abdominal aortic calcification index
Abstract:The risk of cardiovascular disease is substantially high in hemodialysis patients. The risk factors for cardiovascular
disease in dialysis patientsinclude age, malnutrition, duration of dialysis, diabetes mellitus and hyperphosphatemia. However, it is not clear whether cardiovascular disease is associated with abdominal obesity in dialysis
patients. The aim of the present study was to clarify the relationship among visceral fat area and cardiovascular
complications in chronic dialysis patients. Area of visceral fat was measured using computed tomography scan
in 94 patients. The abdominalaortic calcification index (ACI), blood lipid profile and complication of cardiovascular disease were evaluated in these patients. Compared to patients with smaller visceral fat area (<100 cm
2
),
those with larger visceral fat area (≥100 cm
2
) showed significantly higher cardiovascular complication and higher serum levels of triglyceride and significantly lower serum levels of HDL-cholesterol. Patients with larger visceral fat area and longer duration of dialysis showed severer calcification by ACI analysis, and showed higher
incidences of ischemic heart disease. This study suggestedthat chronic dialysis patients with higher visceral fat
area have a higher risk for vascular events, especially ischemic heart disease.
Asia Pac J Clin Nutr. 2011;20(1):109-117.doi:
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The effectiveness of fortified flour on micro-nutrient status in rural female adults in China
Author:Junsheng Huo PhD, Jing Sun BD, Jian Huang BD, Wenx
Keywords:wheat flour, fortification, intervention, micronutrients, anemia
Abstract:This research was designed to evaluate the effectiveness of fortified flour on micronutrient status in poor rural
adult women. A total of 4,700 farmers as the intervention group were supplied with multi-nutrient fortified
wheat flour for three years, while 2750 farmers as the control group were supplied with unfortified wheat flour.
Wheat flour was fortified with vitamins A,B-1, B-2, niacin, folic acid, iron and zinc in mg/kg at 2, 3.5, 3.5, 35, 1,
20 and 25, respectively. Blood samples were taken at baseline and annually from about 300 volunteer adult females aged 20-60 years in each group. Hemoglobin (Hb), serum retinol, serum iron, free erythrocyte protoporphyrin, serum zinc were measured annually and a dietary survey conducted every 6 months. Average intakes of
fortified micronutrients increased to adequate levels with average consumption of fortified flour at 117 g per person per day. Intervention groups showed a significant increase in terms of Hb levels from 24 m to 36 m and
anemia rate decreased from 15.1% at baseline to 10.8% at36 m. Serum iron levels ofthe intervention group significantly increased from 12 m to 36 m and erythrocyte protoporphyrin decreased from 24 m to 36 m respectively. Serum retinol and serum zinc of intervention group improved significantly from 12 m to 36 m compared
with baseline and control group. The results showed that the fortified flour could improve micronutrient status of
adult females in poor rural region.
Asia Pac J Clin Nutr. 2011;20(1):118-124.doi:
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Alcohol consumption and the risk of endometrial cancer: a meta-analysis
Author:Qingmin Sun MD, Linlin Xu MD, Bo Zhou MD, You Wang
Keywords: alcohol consumption, endometrial cancer, risk, association, meta-analysis
Abstract:Epidemiologic findings are inconsistent concerning the association of endometrial cancer risk with alcohol consumption. Therefore, we conduct a meta-analysis of studies that assessed the association of alcohol consumption
and the risk of endometrial cancer. A systematic literature search up to April 2010 was performed in MEDLINE
and EMBASE, and study-specific risk estimates were pooled using a random-effects model. In the present study,
six prospective and 14 case-control studies were included.Alcohol intake was not significantly associated with
the risk of endometrial cancer among prospective studies (relative risk (RR): 1.04; 95% confidence interval (CI):
0.91-1.18) or among case-control studies (odds ratio (OR): 0.89; 95% CI: 0.76-1.05). However evidence from
the results of our stratified analyses revealed that increased risk of endometrial cancer was associated with liquor
consumption (RR: 1.22; 95% CI: 1.03-1.45) but null association with wine and beer consumption. In conclusion,
alcohol consumption is not associated with the risk of endometrial cancer.Future studies should also examine
whether the relation varies according to different type of alcoholic beverages.
Asia Pac J Clin Nutr. 2011;20(1):125-133.doi:
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Validation of a simplified food frequency questionnaire as used in the Nutrition and Health Survey in Taiwan (NAHSIT) for the elderly
Author:Yi-Chen Huang MPH, Meei-Shyuan Lee DrPH, Wen-Harn
Keywords:simple food frequency questionnaire, 24-hour dietary recall, food group, biomarker, NAHSIT Elderly
Abstract:A 28-item simplified food frequency questionnaire (SFFQ) combined with 9 open questions about staples was
designed for the Elderly Nutrient and Health Survey in Taiwan (NAHSIT) to collect information on participants’
usual food intake of the previous month. We have examined the validity of this SFFQvia comparison with data
on multiple 24-hour dietary recall (n=81) and biomarkers(n=1473). All questionnaires were completed by faceto-face interview and fasting blood samples were taken. Thirty seven males and 44 females were randomly selected from NAHSIT participants. Of these, 31 and 50 subjects completed 2 or 3 24-hourdietary recalls within
one month, respectively. Mean daily intake frequencies for each food group were calculated from the SFFQ and
24-hr recalls, respectively. Spearman rank correlation coefficients between frequencies of food group obtained
from the FFQ and from dietary recalls ranged from 0.132 to 0.678 for men; 0.052 to 0.759 for women. Correlation coefficients between frequency and food weight were similar. When validated by nutrient status, the most
correlated was dairy intake frequency judged by 24-hour vitamin B-2 and calcium intakes and by erythrocyte
glutathione reductase (EGRAC) for B-2 functionality, where the correlation coefficients were, respectively,
0.533, 0.518 and -0.205 for men; 0.494, 0.475 and -0.174 for women; fish and fruit frequency followed in overall validity. The SFFQ measured the food patterns of NAHSIT elders withvalidity high for dairy and good for
fish and fruit intakes in both genders.
Asia Pac J Clin Nutr. 2011;20(1):134-140.doi:
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Seminar on Young Child Nutrition: Improving Nutrition and Health Status of Young Children in Indonesia
Author:Mia Isabelle BScand Pauline Chan MSc, RD
Keywords:infant, child, nutrition, health, Indonesia
Abstract:The Seminar on Young Child Nutrition: Improving Nutrition and Health Status of Young Children in Indonesia
held in Jakarta on November 2009 reviewed the current nutritional and health status of young children in Indonesia and identified key nutrient deficiencies affecting their optimal growth. The continuation of child growth
from fetal stage is of paramount importance; and maternal and child health should be a central consideration in
policy and strategy development. Clinical management of nutrient deficiency and malnutrition, as well as strategies and education to improve feeding practices of young Indonesian children were discussed in the seminar.
Relevant experiences, approaches and strategies from France, New Zealand and Malaysia were also shared and
followed with discussion on how regulatory systems cansupport the development ofhealth policy for young
children. This report highlights important information presented at the seminar.
Asia Pac J Clin Nutr. 2011;20(1):141-147.doi:
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