Iodine excess or not: analysis on the necessity of reducing the iodine content in edible salt based on the national monitoring results
Author:Sumei Li , Qingsi Zheng, Jing Xu, Jonathan Gorstei
Keywords:iodine deficiency disorders, monitoring, salt iodization, iodine excess, iodine nutrition
Abstract:Using national monitoring datacollected between 1995 and 2009, this paper describes the change in trend with
regard to the coverage of qualified iodized household saltand iodine status of the population in China since the
implementation of universal salt iodization. The review indicates that the iodine content in edible salt increased
from 16.2 mg/kg in 1995 to 42.3 mg/kg in 1999, then declinedto 30.8 mg/kg in 2005 and has retained this level
through the most recent data collection cycle, which is considered sufficient to achieve optimal iodine status.
However, the median urinary iodine excretion level for children aged 8-10 at the national level has been consistently classified as “excessive iodine intake” since 1997, suggesting that although three adjustments on the standard of iodine content in edible salt have been made, the current content of salt iodization is still on the high side.
The iodine content in edible salt could be lowered, and possibly adapted to local specific conditions such as water iodine content and the average daily intake of salt among the population in order to achieve a balance between preventing deficiency and reducing the risk of excessive intake.
Asia Pac J Clin Nutr. 2011;20(4):501-506.doi:
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Association between 24 hour urinary α-tocopherol catabolite, 2,5,7,8-tetramethyl-2(2'-carboxyethyl)-6-hydroxychroman (α-CEHC) and α-tocopherol intake in intervention and cross-sectional studies
Author:Eri Imai MSc, Tomiko Tsuji PhD, Mitsue Sano PhD, T
Keywords:α-tocopherol, catabolism, CEHC, urine, biomarker
Abstract:The objective is to determine the association between the 24 hour urinary α-tocopherol catabolite, 2,5,7,8-tetramethyl-2(2'-carboxyethyl)-6-hydroxychroman (α-CEHC) and α-tocopherol intake in an intervention and a
cross-sectional studies. In the 4-weeks intervention study, Japanese men (n = 10) consumed the test diet in week
1, and the test diet plus varying amounts of α-tocopherol in the three subsequent weeks: 21 μmol/d α-tocopherol
in week 2, 63 μmol/d in week 3, and 125 μmol/d in week 4. A significant association between α-tocopherol intake and urinary α-CEHC was observed in this strictly controlled experiment (r = 0.99, p<0.001). In the crosssectional study, all foods consumed over 4 consecutive days were recorded in 76 free-living young subjects (18-33 years). The association was weak, but a significant relationship was observed (r = 0.29, p<0.05) even in the
cross-sectional study. In the cross-sectional study adults, mean estimated α-tocopherol intake calculated by urinary α-CEHC and the excretory ratio was 91% of their mean intake over the 4 days. The results show that urinary α-CEHC level reflected recent α-tocopherol intake in free-living young Japanese adults, and could be used
as a measure of intake during the previous few days, both for group means and for individual rankings within a
group.
Asia Pac J Clin Nutr. 2011;20(4):507-513.doi:
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Moderate NaFeEDTA and ferrous sulfate supplementation can improve both hematologic status and oxidative stress in anemic pregnant women
Author:Xiu X Han MD, Yong Y Sun MD, Ai G Ma MD, Fang Yang
Keywords:anemia, pregnant women, NaFeEDTA, ferrous sulfate, oxidative stress
Abstract:Iron is important general well being, to prevent or treat anemia, and is a cofactor of many enzymes in the antioxidant process. Effect of sodium iron ethylenediaminetetraacetate (NaFeEDTA) and ferrous sulfate on iron bioavailability and oxidative stress in anemic pregnant women was evaluated. A 2-month randomized controlled
trial was conducted on 153 anemic pregnant women, with 80≤Hb <110g/L. They wererandomly allocated to
three groups: group C (n=51) was the placebo control group, group I (n=51) was supplemented daily with 60 mg
iron as ferrous sulfate, and group IE (n=51) with 60 mg iron as NaFeEDTA. Blood samples were collected before and at the end of the intervention for measurementsof hematological indices and oxidative stress parameters.
Considerable increases of hematologic indicators were observed: 20.5 and 21.8 g/L for Hb (both pvalues
<0.001); 4.81 and 7.19 μmol/L for plasma iron (both pvalues <0.001), 2.63 and 8.99 μg /L for ferritin (both p
values <0.05) in I and IE groups, respectively, comparedwith the control group. Glutathione peroxidase (GSHPx) activities increased by 32.6 and 75.3 IU/ml, and malondialdehyde (MDA) levels decreased by 0.70 and 1.12
μmol/L in I and IE groups, compared withthe C group (pvalues <0.05). Moreover, differences of plasma iron,
ferritin and GSH-Px activity were 2.38 μmol/L, 6.36 μg /L and 42.7 IU/ml were also significantly greater in the
IE group than in the I group. Moderate iron supplementation may be beneficial to improving iron deficiency and
oxidative stress, and NaFeEDTA is better than ferrous sulfate.
Asia Pac J Clin Nutr. 2011;20(4):514-520.doi:
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Impact of treatment with oral calcitriol on glucose indices in type 2 diabetes mellitus patients
Author:Mohammad Hassan Eftekhari PhD, Marzieh Akbarzadeh
Keywords:diabetes mellitus, calcitriol, glucose, insulin resistance, hemoglobin A1C
Abstract:Introduction: Type 2 diabetes is a major public health problem. Recent epidemiological evidence also points to a
potential association of vitamin D insufficiency with adverse metabolic risks, including that for type 2 diabetes.
Subjects and method: A double-blind randomized placebo-controlled trial was carried out. Seventy subjects with
type 2 diabetes, age 30-75 years old, were randomlyassigned in a double-blind fashion to two groups. One
group received two capsules of calcitriol(0.25 µg 1,25-dihydroxy cholecalciferol per each capsule) per day. The
second group received placebo tablets. At the beginning, middle and the end of the 12 week supplementation
trial, serum glucose, insulin, calcium and phosphorous, HbA1c and 25(OH) vitamin D were measured. Results:
There was no significant difference between two groups at baseline. At the end of the study, fasting plasma glucose increased in the control group (p=0.038), while it remained unchanged incalcitriol group. Level of insulin
and HbA1c increased significantly in both groups (p=0.013 and 0.0004 in treatment and control group). Regarding insulin resistance indices, there was a significant change in HOMA-IR and QUICKI in both groups (p=0.023
and 0.002 in treatment and 0.001 and <0.001 in control group respectively). Insulin secretion as assessed by
HOMA-%β, remained relatively unchanged in the control group, while it increased significantly in the treatment
group at the end of study (p=0.009). Conclusion: Vitamin D supplementation attenuated the increase in glycemia,
and increased insulin secretion, but had no effect on insulin resistance.
Asia Pac J Clin Nutr. 2011;20(4):521-526.doi:
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Acute effect of a soy protein-rich meal-replacement application on renal parameters in patients with the metabolic syndrome
Author:Peter Deibert MD, Lisa Lutz MD, Daniel König MD, S
Keywords:renal function, metabolic syndrome, glomerular filtration rate, renal plasma flow, soy protein
Abstract:Background: Soy protein is used for meal replacement therapy in obesity, however the influence on renal function parameters is not adequately investigated. This study evaluates glomerular filtration rate (GFR) and renal
plasma flow (RPF) in patients with the metabolic syndrome and healthy controls after ingestion of different
amounts of soy protein. Methods: 10 patients with the metabolic syndrome butno signs of kidney disease and 10
healthy controls ingested 1 g protein/kg body weight of a commercial soy-yoghurt-honeypreparation. The patient
group was also given a protein challenge of 0.3 g/kgbody weight. Results: Baseline GFR and RPF both were
significantly higher in the patientgroup (147±34.8 vs. 116±21.1 ml/min, p=0.01 and 848±217 vs. 637±121
ml/min, p=0.02) and were strongly correlated with body weight. Use of differentalgorithms to estimate GFR resulted in underestimation of GFR, particularly in the patients with the metabolic syndrome. The challenge with
an acute protein load of 1g protein per kilogram body weight induced a significant increase in GFR and RPF in
healthy controls (GFR: +12.6±11.0 % (p=0.01), RPF: +13.6±15.6 % (p=0.04)) and even more in patients with
the metabolic syndrome (GFR: +31.5±32.2 % (p=0.01); RPF: +19.4±22.7 % (p=0.02)). The ingestion of 0.3 g
protein/ kg body weight did not induce significant changes. Conclusions: Basic renal function is changed in patients with the metabolic syndrome, even without microalbuminuria. In addition, there is an elevated susceptibility for protein load. However, the protein amount recommended for use in soy-protein based meal replacement
therapy induced no significant changes.
Asia Pac J Clin Nutr. 2011;20(4):527-534.doi:
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Fortified juice drink improved iron and zinc status of schoolchildren
Author:Imelda Angeles-Agdeppa PhD, Clarita R Magsadia MPS
Keywords: anemia, hemoglobin, plasma ferritin, zinc status, fortified juice drink
Abstract:Energy and micronutrient deficiency remain prevalent among Filipino children. Juice drinks are commonly consumed and could be a viable vehicle for fortification to supplement the nutrient gap. This study determined the
effects of a newly developed non-carbonated fortified juice drink on the iron, zinc and nutritional status of
schoolchildren. One hundred randomly selected anemic children were randomlyallocated into two groups in a
doubly-masked placebo controlled manner: Group 1 received the fortified juice, Group 2 received the nonfortified juice for 100 days, five days a week under strictsupervision. The juice drink was fortified with vitamin
A, zinc, iron, vitamin C and lysine. The non-fortified juice was fortified only with vitamin C. All children were
dewormed prior to the intervention. Hemoglobin, plasma ferritin and plasma zinc, weight and height were assessed using standard methodsbefore and after intervention. A two-day 24-hour food recall was also collected.
The basal prevalence of anemia was significantly reduced in both the fortified group (100% to 13%) and the
non-fortified group (100% to 40%) at endline. The mean plasma ferritin levels weresimilar in both groups at
baseline and endline. At endline, mean plasma zinc in the fortified group has significantly increased by 20 μg/dL
from a baseline value of 83.9 µg/dL to 103.9 µg/dL, while the non-fortified group remained at similar levels
with baseline. Basal weight and heightsignificantly increased among all children at endline. The fortified juice
drink was effective in reducing the prevalence of anemia and improved the zinc status of children.
Asia Pac J Clin Nutr. 2011;20(4):535-543.doi:
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Malnutrition in hospitalized people living with HIV/AIDS: evidence from a cross-sectional study from Chengdu, China
Author:Wen Hu MD , Hua Jiang PhD, Wei Chen MD, Sheng-Hua
Keywords:HIV/AIDS, malnutrition, nutrition screening tool, hospitalized, China
Abstract:Objectives: Nutrition support has long been ignored in China’s HIV/AIDS treatment and care. The objectives of
this project were to evaluate the prevalence of malnutrition among Chengduurban HIV positive patients, and to
provide evidence for further nutritional intervention. Materials and Methods: HIV-infected adults admitted to an
infectious diseases inpatient unit were eligible for this study. Nutritional status was evaluated using Subject
Global Assessment (SGA), Malnutrition Universal Screening Tool (MUST), body mass index (BMI), food frequency questionnaire and dietary records. Results: 94 hospitalized HIV positive patients were enrolled from
April 2009 to May 2010. The median CD4 T cell count was 44.0/mm
3
. The prevalence of malnutrition is measured by three tools and ranged from 37.2% (by BMI) to 77.2% (by SGA class B/C or MUST scores≥2). Chisquare test showed significant relationship between opportunistic infections and MUST score (OR=5.67,
p<0.005, 95% CI=1.96-16.4). Of patients, 59.6% had insufficient total energy intake; while 54.3% had insufficient protein intake. Conclusions:Malnutrition is highly prevalent among Chengdu urban HIV/AIDS patients
who underwent inpatient treatment. Calorie and protein deficiency should be given more attention in HIV/AIDS
care programs. Nutrition evaluation and support should be considered an integral parts of national and community HIV/AIDS treatment and care guidelines.
Asia Pac J Clin Nutr. 2011;20(4):544-550.doi:
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Anthropometric equation for estimation of appendicular skeletal muscle mass in Chinese adults
Author:Xu Wen PhD, Mei WangMEd, Chong-Min Jiang PhD, Yi-M
Keywords:skeletal muscle mass, prediction model, body composition, anthropometry, skinfold
Abstract:The purpose of this study was to develop and cross-validate anthropometric equations for the estimation of appendicular skeletal muscle mass (ASM) in Chinese adults. A total of 763 adults aged 18-69 years (345 men and
418 women) were recruited from residents living in four regions (Jinan, Guangzhou, Xi’an and Chengdu) in
China. ASM were measured by fan-beam dual energy x-ray absorptiometry. Participants’ body weight, height,
limb circumferences (upper arm, thigh, and calf), waist circumference, and skinfold thicknesses (triceps, thigh,
and calf) were measured by trained testers. The participants were randomly assigned to two groups: a modeldevelopment group (MD group) and a cross-validation group (CV group). Prediction models were established
using the data from the MD group, and cross-validated with the data of the CV group. The results suggested that
the developed equations had satisfactory prediction qualities, and could be applied as a practical method of quantifying ASM in Chinese adults.
Asia Pac J Clin Nutr. 2011;20(4):551-556.doi:
>>Abstract
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Waist circumference as an indicator of high blood pressure in preschool obese children
Author:Bin Chen MD, Hai-fei Li MD
Keywords:preschool children, obesity, waist circumference, blood pressure, body mass index
Abstract:Objective:To investigate the relationship between waist circumference and blood pressure (BP) to determine if
waist circumference was an indicator of BP in preschool children. Methods: Body weight, height, waist circumference (WC), hip circumference, and blood pressure of 939 3-6-year-old preschool children were collected. Results: Systolic blood pressure (SBP) and diastolic blood pressure (DBP) in obese children were significantly
higher than that in normal weight children in both sexes (p<0.001). Overweight children had significantly higher
SBP and DBP than normal weight boys (p<0.01). Age- and sex-adjusted Body mass index (BMI) correlated significantly with SBP and DBP. In children aged 3-6 years, age-, sex-and BMI-adjusted waist circumference correlated significantly with SBP, but not with DBP. Receiver operating characteristic (ROC) curves showed a significant ability of BMI, WC and waist-to-height ratio (WtHr) to discriminate high blood pressure in children of
both sexes. Multiple linear stepwise regression analysis using SBP as the dependent variable showed that BMI
and WC were significant independent factors that influence high blood pressure adjusted for age, WtHr and
waist-to-hip circumference ratio (WHr) in boys. When using DBP as the dependent variable, BMI was the only
significant independent factor that influenced high blood pressure adjusted for age, WtHr and WHr, in both sexes. Conclusion: Waist circumference was independently associated with high blood pressure in boys aged 3-6
years. In addition to BMI, increased waist circumference was found to be an indicator of high blood pressure in
the preschool children, especially in boys.
Asia Pac J Clin Nutr. 2011;20(4):557-562.doi:
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Interactive effects of main genotype, caloric intakes, and smoking status on risk of obesity
Author:Sangyeoup Lee MD, Cheol Min Kim MD, Hyun Jun Kim P
Keywords:obesity, adrenergic beta-2 receptors, interaction, nutrition, smoking
Abstract:The aim of this study was to determine the strong candidate genes increasing susceptibility to obesity among
previously reported obesity-related genes in Korean subjects and evaluate gene-environmental interactions in
susceptibility to obesity. The study population comprised of163 adolescents (95 boys and 68 girls) and their
parents (97 men and 96 women).We used multivariable-adjusted logistic regression analysis, and classification
and regression tree (CART) analysis incorporating both the genetic (ADRB2 R16G genotype) and environmental (overeating, smoking status, and parent’s obese status) variables. The polymorphisms were genotyped
with SNP-ITTM assays using the SNPstream 25KTM System (Orchid Biosciences, New Jersey, USA). Arg16
allele of ADRB2 R16G, smoking and overeating were linked to an increased risk of obesity in adults. CART
analysis showed that smoking parents who overate and carried the Arg allele, ADRB2 R16G, had an odds ratio
(OR) of 11.7 (95% confidence interval (CI), 2.13-64.04) for obesity compared to non-smoking parents who had
none of these factors. Among children, the highest risk group for obesity was the overeater with obese parents
(OR, 5.20; 95% CI, 1.86-14.53). The results of the study indicate that beta2-adrenoceptor polymorphism may
contribute to the development of obesity through gene-environmental interactions. Further replication studies
with larger sample size would be needed to confirm our study results.
Asia Pac J Clin Nutr. 2011;20(4):563-571.doi:
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Contribution of complementary food nutrients to estimated total nutrient intakes for urban Guatemalan infants in the second semester of life
Author:Liza Hernández BS, Raquel Campos BS, Anke Enneman
Keywords:human milk, complementary foods, infant feeding, micronutrient intake, Guatemala
Abstract:Complementary foods (CF) are introduced earlier or later than appropriate in developing societies. They often
contribute poorly to overall adequate micronutrient intake during the critical period for growth and development,
which constitutes the period from 6 to 12 months of life. The objective of this study was to determine the contribution of the CF nutrients to the total estimated nutrient intake in infants in the second semester of life. Three
non-consecutive 24-hour recalls interviewswere conducted with mothers of 64 infants, aged 6-12 months on enrolment, from a convenience sample in a marginal urban settlement in Guatemala City. Retrospective recording
of early introduction of pre- and post-lacteal feeding and introduction of first foods and beverages was included.
Human milk intakes were estimated by a model based on assumptions that human milk plus CF exactly satisfied
the infant’s daily energy needs. The WHO/FAO Recommended Nutrient Intakes (RNI) were the standards for
adequate nutrient consumption.Instances of exclusive breast feeding to6 months were rare, with the introduction of CF earlier than recommended. Baby food in jars was mentioned most frequently as the first food offered.
The contribution of CF increased with age through the second semester oflife. CF contributed more of a nutrient
than human milk in all instances. However,CF nutrient density for Ca, Fe, and Zn fell below international standard. Fortified sugar contributed excessive amounts of Vitamin A to the diets.We conclude that for most nutrients, intakes reached or exceeded recommendation levels, unusual within the CFexperience in scientific literature.
Asia Pac J Clin Nutr. 2011;20(4):572-583.doi:
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Undernutrition status of children under 5 years in Chinese rural areas - data from the National Rural Children Growth Standard Survey, 2006
Author:Jing Zhang MD, Junxin Shi PhD, John H Himes PhD, Y
Keywords: undernutrition, children under five years, China, rural area, WHO Child Growth Standard
Abstract:Purpose: To assess the nutritional status among rural children under five years in China relative to
WHO Child Growth Standards 2006, and to explore risk factors for undernutrition. Design: Crosssectional study of rural areas in 10 provinces of China. A total of 84,009 children under five recruited
through multi-level sampling. Main findings: A total of 17.92% of children have at least one form of
undernutrition. The prevalence of stunting, underweight and wasting, were 14.59%, 7.19% and
3.07%, respectively. The corresponding mean z-score in height-for-age, weight-for-age, and weightfor-height were -0.732, -0.410 and -0.001. An upward trend with age in stunting and underweight
was observed, and higher risks noticed among older children in contrast with children under 6 months
in terms of stunning and underweight. The inter-provincial variation of undernutrition remains very
large. Low birth weight, multi parity, preterm birth, multiple birth, maternal illiteracy, low provincial
GDP, and low household income are identified as significant factors associatedwith stunting. Parity
shows no corresponding significant relationship with underweight, and wasting was not found to be
associated with either preterm or multiple births. Conclusion: The nutritional status among children
under five in rural areas of China, although greatly improved in the past decades, still lags behind the
WHO Child Growth Standards. Stunting and underweight occur mostly before two years of age. Intervention strategies and programs should be developed to target the preventable risk factors.
Asia Pac J Clin Nutr. 2011;20(4):584-592.doi:
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Systematic review and meta-analysis of soy products consumption in patients with type 2 diabetes mellitus
Author:Bin Yang MSc, Ying Chen MSc, Tongchen XuPhD, Yingh
Keywords:soy products, type 2 diabetes mellitus, lipids, fasting glucose, meta-analysis
Abstract:Clinical trials have reported the lipid-lowering effect of consuming soy products, and epidemiological studies
have shown that soy intake is associated with decreased risk of type 2 diabetes mellitus (T2DM). The aim of this
meta-analysis was to systematically review the effects of soy products consumption on serum lipid profiles and
glycaemic control in T2DM patients. Potential papers were initially searched from PubMed (1966 to 2010) and
Cochrane Library (1984 to 2010) without language limitations. All randomized controlled trials were included in
which soy products supplementation was the only intervention in subjects with type 2 diabetes. Weighted mean
effect size was calculated for net changes in serum lipids and fasting glucose concentrations using fixed-effect or
random-effect models. Previously defined subgroup analyses were performed toidentify the source of heterogeneity. Eight studies were included according to the criteria. The intake of soy products was associated with a significant reduction in serum total cholesterol (by 0.42 mmol/L; 95% confidence interval (CI): -0.70, -0.14;
p<0.001), triacylglycerol (by 0.22 mmol/L; 95% CI: -0.38, -0.07; p<0.001) and low-density lipoproteincholesterol (by 0.30 mmol/L; 95% CI: -0.60, -0.00; p<0.001), and a significant increase in high-density lipoprotein-cholesterol (0.05 mmol/L; 95% CI: 0.04, 0.06; p=0.89). There were no significant effects on fasting glucose, insulin and glycated hemoglobin. It can be concluded that intake of soy and soy products has beneficial effects in T2DM patients in relation to serum lipids.
Asia Pac J Clin Nutr. 2011;20(4):593-602.doi:
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Red meat intake may increase the risk of colon cancer in Japanese, a population with relatively low red meat consumption
Author:Ribeka Takachi PhD, Yoshitaka Tsubono PhD, Keisuke
Keywords:meat, colon cancer, rectal cancer, prospective studies, Japan
Abstract:Asian populations have changed from traditional to Westernized diets, with increased red meat intake. They are
suggested to be particularly susceptible to the adverse effects of red meat on the development of colorectal cancers, however, few prospective studies of this putative link have been conducted. We examined associations between the consumption of red and processed meat and the risk of subsite-specific colorectal cancer by gender in
a large Japanese cohort. During 1995-1998, a validated food frequency questionnaire was administered to 80,658
men and women aged 45-74 years. During 758,116 person-years of follow-up until the end of 2006, 1,145 cases
of colorectal cancer were identified. Higher consumption of red meat was significantly associated with a higher
risk of colon cancer among women [multivariate hazard ratios (95%CIs) for the highest versus lowest quintiles
(HR): 1.48 (1.01, 2.17; trend p=0.03)], as was higher consumption oftotal meat among men [HR=1.44 (1.06,
1.98; trend p=0.07)]. By site, these positive associations werefound for the risk of proximal colon cancer among
women and for distal colon cancer among men. No association was found between the consumption of processed
meat and risk of either colon or rectal cancer. In conclusion, red meat intake may modestly increase the risk of
colon cancer in middle-aged Japanese, although the highestquintile of red meat consumption could be considered moderate by Western standards.
Asia Pac J Clin Nutr. 2011;20(4):603-612.doi:
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Prevalence, influencing factors and control of food insecurity: a model in the northwest of Iran
Author:Saeed Dastgiri PhD, Rahim Sharafkhani MSc, Rasool
Keywords:food insecurity, prevalence, causes, control, epidemiology
Abstract:Food insecurity is frequent in both developed and developing countries, affecting from 5% to 25% of the general
population. The aim of this study was to assess food insecurity, its influencing factors and control measures in
the northwest of Iran. A total population of 15,070 (2,911 households) were studied.A short questionnaire was
used for the screening of food insecurity and energy intake in this study. After the screening programme, those
families identified as having food insecurity were recruited for the second part of the study which was a community trial. We organized small training campaigns (through peer education)for target households. Six months
later, the same techniques were applied again to assess the impact of educational intervention in reducing the rate
of food insecurity. Total prevalence of food insecurityin the study population was 59.3 percent (95% confidence
interval: 57.4-61.3). Logisticregression showed that apart from the mother’s age and smoking status of the head
of the family, there was a significant association between household food insecurity and other variables in the
model (mainly economic factors). The prevalence of food insecurity reduced by 7.3 percent after the intervention
(p>0.10). The high prevalence of food insecurity in this study indicates that there is an urgent need for a close
collaboration between governmental, international and local leadership to identify and implement the key interventional programmes to overcome this ever increasing health problem. According to our findings, a special attention should be paid on the economic improvement in the region.
Asia Pac J Clin Nutr. 2011;20(4):613-617.doi:
>>Abstract
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Paternal smoking is associated with greater food insecurity among poor families in rural Indonesia
Author:Richard D Semba MD, Ashley A Campbell BS, Kai Sun
Keywords:food insecurity, Indonesia, poverty, smoking, tobacco
Abstract:Food insecurity is common in developing countries and related to the physical well being of families. Household
food insecurity is intended to reflect a household’s access, availability, and utilization of food. The relationship
between paternal smoking and household food insecurity has not been well characterized. The objective of this
study was to examine the relationship of paternal smoking with household food insecurity among poor families
in rural Indonesia. In a cross-sectional study of 26,380 rural households in the Indonesian Nutrition Surveillance
System in 2003, we examined the relationship between paternal smoking and household food insecurity score, as
measured using a 9-item food security questionnaire. The prevalence of paternal smoking was 72.9%. In families
with and without a father who smoked, the mean (standard error) household food insecurity score was 1.83 (0.01)
and 1.48 (0.02), respectively (p<0.0001). Paternal smoking was associatedwith greater household food insecurity score (p<0.0001) in a multivariable linear regression model, adjusting for maternal age, maternal education,
weekly household expenditure per capita, and province. Among poor families in rural Indonesia, households
with a father who smokes are at greaterrisk of household food insecurity.
Asia Pac J Clin Nutr. 2011;20(4):618-623.doi:
>>Abstract
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Comparison of dietary habits between migrant and local adolescents in Shenzhen, China
Author:Lijun Wang MD, Zhenzhen Zhang MPH, Ying ChangMD, X
Keywords:migrant adolescents, dietary habits, nutrition, sociodempgraphic factors, China
Abstract:Background: It is estimated that the number of migrant adolescents inChinese cities may have reached 25 million. However, little research has been conducted on their dietary habits. The objective of this study was to compare dietary habits between migrant and local adolescents in Shenzhen, China. Methods: A school based crosssectional study was conducted in 3368 adolescents (aged 11-18 years; 52.5% boys). A self-administered questionnaire completed by adolescents was designed to gather information on socio-demographic characteristics,
meal location, food pattern and intake. Results: Of the 3368 adolescents, 58.2% were migrants. Compared with
locals, migrant adolescents showed significantly higher percentage ofhaving three meals away-from home.
Nearly half of the subjects (45.6 %) skipped breakfast, with a higher proportion among migrant students (48.5 vs
41.5%). Migrant students consumed street food more frequently (12.2 vs8.5%), while the difference was opposite in Western fast food intake (27.3 vs 32.5%). No significant difference was found in snacks intake between
these two groups. Migrant students exhibited lower percentage of vegetables (57.3 vs 63.7%), fruits (27.7 vs
38.3%), meats (37.0 vs 44.3%), soybean (11.6 vs 17.5%) and dairy products (28.4 vs 42.5%) intake daily. After
adjusted for socio-demographic confounders, the difference mentioned above still remained except Western fast
food. Conclusion: Dietary habits among adolescents showed pronounced household variation. Migrant adolescents are more likely to exhibit unhealthy dietary behavior. Schools and families should collaborate to improve
the dietary environment for adolescents, especially those from migrant families.
Asia Pac J Clin Nutr. 2011;20(4):624-631.doi:
>>Abstract
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Nutrition risk: cultural aspects of assessment
Author:Carol A Wham PhD, Lorna Dyall PhD, Ruth OY Teh PhD
Keywords:nutrition assessment, malnutrition, aged, culture, New Zealand
Abstract:Aim: To assess a nutrition risk screening tool amongst Māori and non-Māori of advanced age. Method: A cross
sectional feasibility study was conducted in three North Islandlocations. One hundred and eight communityliving residents aged 75- 85 years wereassessed for nutrition risk using ‘thevalidated questionnaire ‘Seniors in
the Community: Risk Evaluation for Eating and Nutrition’, Version II (SCREENII) and level of physical activity
using the ‘Physical Activity Scale for the Elderly’ (PASE). Physical assessments included height and weight.
Results: Fifty-two percent of participants were assessed to be at high nutrition risk (SCREENII score <50; range
29-58; out of maximum score 64). Nutrition risk factors amongst Māori and non-Māori respectively differed for
weight change in the previous six months (45.2% and 18.7%, p=0.005), skipping meals (54.8% and 13.3%,
p<0.001), fruit and vegetable intake (77.4% and 18.7%, p<0.001) and the use of mealreplacements (28.1% and
9.3%, p=0.013). Process evaluation showed that Māori took different meaning from the individual question
items in SCREENII. Level of physical activity (PASE score) was higher for Māori, median (IQR): 125 (74) than
non-Māori, 72 (74) (p<0.001) especially for leisure-time and household related activity. BMI was higher for
Māori median (IQR): 31.5 kg/m
2
(6.8) compared to non-Māori 24.7 kg/m
2
(5.4) (p<0.001). Conclusions: The nutrition risk tool suggested that Māori were at high risk for malnutrition despite higher BMI and higher levels of
activity. Several items of the screening tool were interpreted differently among Māori compared to non-Māori.
Further development is needed to ensure accurate assessment.
Asia Pac J Clin Nutr. 2011;20(4):632-638.doi:
>>Abstract
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Validation of a food frequency questionnaire to assess dietary cholesterol, total fat and different types of fat intakes among Malay adults
Author:Jui Yee Eng MMedSc, Foong Ming Moy PhD
Keywords:food frequency questionnaire, validation, fat, cholesterol, Malay adults
Abstract:Background: Cardiovascular diseases are the major cause of death in Malaysia. Evidence shows that dietary fat
intake is one of the important risk factors for cardiovascular disease. However, studies assessing the association
of fatty acids and risk of cardiovascular diseases in Malaysia are scarce. Therefore, this study aimed to develop
and validate a food frequency questionnaire (FFQ) assessing total fat and different types of fat among Malay
adults in Malaysia. Methods: A 100 food item FFQ focused on dietary cholesterol, total fat, saturated fat, monounsaturated fat and polyunsaturated fat intake for the past one month was developed and validated against 3-day
dietary record (DR) among 151 Malay participants. Validity was assessed through the reliability and agreement
of two methods. Intra-class correlation (ICC) coefficients were used to assess reliability; while regression analysis and classification into categories were used to assess agreement of the two methods. Results: The mean nutrient intakes tended to be higher in FFQ compared to DR. The developed FFQ showed excellent reliability with
ICC coefficients ranging from 0.92-0.98. Regression analysis demonstrated an acceptable agreement between
FFQ and DR for total fat and different types of fat intakes. There were a relatively high proportion of subjects
being correctly classified (into same or adjacent category) and only a small number of grossly misclassification
for total energy, fat, dietary cholesterol, saturated fat and unsaturated fat occurred. Conclusion: This FFQ is valid
in assessing absolute total energy, total fat and types of fat intakes among Malay adults.
Asia Pac J Clin Nutr. 2011;20(4):639-645.doi:
>>Abstract
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Validity of predictive equations for resting energy expenditure among Iranian women
Author:Mahboubeh Shaneshin MSc, Arezoo Rezazadeh MSc, Mah
Keywords:resting metabolic rate, predictive equations, validity, women, energy metabolism
Abstract:Objectives: To determine the resting metabolic rate (RMR) in a sample of Iranian women, and to evaluate the
validity of predictive equations for estimating RMR in normal and obese subjects. Methods: This cross-sectional
study was conducted on a total of 187 healthy women aged18-45 years. Anthropometricdata were collected and
subjects’ RMR was measured by indirect calorimetry for 15 minutes following an overnight fast. RMR was also
predicted using various types of formulas based on subjects’ height, age, weight or fat-free mass. Body composition was estimated by bioelectric impedance analysis (BIA). Results: Measured RMR (mean ± SD) was found to
be 1473 ± 296 kcal/day. The abbreviation formula overestimated RMR, while other formulas underestimated it.
Harris-Benedict formula was valid among all BMI categories (normal weight, overweight, obese and morbidly
obese). Two Schofield formulas werevalid in normal weight, overweight and morbidly obese subjects; and
Cunningham formula was valid only among overweight and obese women. Overweight and obese Iranian
women had higher RMR in comparison with normal weight subjects (p<0.01); although after age and weight adjustment, the differences were not significant in any of the BMI categories. Conclusions: The Harris-Benedict
for mula provides a valid estimation of RMR at the group level in a range of normal-weight to morbidly obese
Iranians. However, at the individual level, errors might be so high that using a measured value has to be preferred over an estimated value.
Asia Pac J Clin Nutr. 2011;20(4):646-653.doi:
>>Abstract
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