Asia Pacific Clinical Nutrition Society Award for 2014
Author:Duo Li
Keywords:
Abstract:
Asia Pac J Clin Nutr. 2014;23(1):i.doi:
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Ecosystem Health Disorders - changing perspectives in clinical medicine and nutrition
Author:Mark L Wahlqvist BMedSc, MD, BS (Adelaide), MD (Up
Keywords:ecohealth and econutrition, geobiology, connectedness, species, food and health systems
Abstract:The inseparability of people from their ecosystem without biological change is increasingly clear. The discrete
species concept is becoming more an approximation as the interconnectedness of all things, animate and inanimate, becomes more apparent. Yet this was evident even to our earliest Homo Sapiens sapiens ancestors as they
hunted and gathered from one locality to another and migrated across the globe. During a rather short 150-200,000 years of ancestral history, we have changed the aeons-old planet and our ecology with dubious sustainability. As we have changed the ecosystems of which we are a part, with their opportunities for shelter, rest, ambulation, discourse, food, recreation and their sensory inputs, we have changed our shared biology and our health
prospects. The rate of ecosystem change has increased quantitatively and qualitatively and so will that of our
health patterns, depending on our resilience and how linear, non-linear or fractal-like the linkage. Our healthassociated ecosystem trajectories are uncertain. The interfaces between us and our environment are blurred, but
comprise time, biorhythms, prokaryotic organisms, sensory (auditory, visual, tactile, taste and smell), movement,
endocrine with various external hormonal inputs through food and contaminants, the reflection of soil and rock
composition in the microbes, plants, insects and animals that we eat (our biogeology) and much more.We have
sought ways to optimise our health through highly anthropocentric means, which have proven inadequate. Accumulated ecosystem change may now overwhelm our health. On these accounts, more integrative approaches and
partnerships for health care practice are required.
Asia Pac J Clin Nutr. 2014;23(1):1-15.doi: 10.6133/apjcn.2014.23.1.20
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Dietetics in China at the crossroads
Author:Lingxia Sun MS, RD, Johanna Dwyer DSc, RD, LDN
Keywords: dietetics, dietitian, China, gaps, nutrition
Abstract:Background: A dietetics profession that conforms to the international standards for dietetics exists in many countries but not in the Peoples’ Republic of China (China). Might China benefit from the presence of the dietetics
profession? Objective: The article reviews the current dietetic situation in China, summarizes the gaps between
current realities in China with respect to meeting needs for nutritional care, and recommends improvements. Results: Gaps and barriers exist between current practice in dietetics and a more optimal system for meeting China’s
nutritional care needs. Recommendations for actions over the near term that would lead to fuller development of
the field of dietetics in China are summarized, following the model suggested by the International Confederation
of Dietetic Associations. Alternative personnel deployment strategies over the next decade are also discussed.
Conclusion: Whether there is a role for the profession of dietetics in China today or in the near future will depend
on the attitudes and political will of Chinese government authorities, health professionals, educators, and consumers.
Asia Pac J Clin Nutr. 2014;23(1):16-26.doi: 10.6133/apjcn.2014.23.1.19
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Nutritional standards for energy-dense low-nutrient density foods for children in Korea
Author:Soon-Kyu Lee PhD, Hye-Kyung Park PhD, Youn-Ju Choi
Keywords:energy-dense low-nutrient density foods, children's preferred foods, obesity, snacks, meal substitutes
Abstract:The increasing rate of child obesity has developed into a serious concern in contemporary society. In Korea, additional concerns over unsanitary environments of food establishments near schools led to the enforcement in 2009 of the Special Act on the Safety Management of Children’s Dietary Life in order to
improve food safety and nutrition. Some of the main policies of the Special Act are the prohibition of Energy-dense Low-Nutrient density Foods (hereinafter referred to as EDLNF) at school canteens and in the
outstanding businesses, along with restrictions on television advertisement for EDLNF products. Confectioneries, candies, sweetened-ice products, breads, chocolates, processed milk, fermented milk, ice cream,
fish-meat sausages, fruit/vegetable beverages, carbonated beverages, mixed beverages, and lactic acid
bacteria beverages are classified as applicable food types of EDLNF . To establish the nutritional standards
for EDLNF , the intake proportions and the pattern of nutrients in children’s preferred foods in Korea were
analyzed, based on the 2005 National Health and Nutrition Survey of Korea. The foods containing more
than 250 kcal, more than 17 g of sugar or more than 4 g of saturated fat and less than 2 g of protein per
serving are considered EDLNF snacks. The Korean government is concentrating its efforts in promoting
healthy environments for children in its research and in food policies. Further studies are necessary to investigate the current state of changes in the children's foods industry .
Asia Pac J Clin Nutr. 2014;23(1):27-33.doi: 10.6133/apjcn.2014.23.1.03
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The effects of intravenous, enteral and combined administration of glutamine on malnutrition in sepsis: a randomized clinical trial
Author:Guniz Meyancı Koksal MD, Emre Erbabacan MD, Yusuf
Keywords:malnutrition, glutamine, sepsis, transferrin, nitrogen balance
Abstract:Our aim was to compare the effects of intravenous, enteral, and enteral plus intravenous supplemented glutamine
on plasma transferrin, nitrogen balance, and creatinine/height index in septic patients with malnutrition. Blood
and urine samples were collected for transferrin, urea and creatinine measurements. Samples, SOFA score and
protein-calorie intake values were repeated on days 7 and 15. Patients (n:120) were randomly divided into 4
groups. Group I received 30 g/day IV glutamine, group II received 30 g/day enteral glutamine, group III received
15 g/day IV and 15 g/day enteral glutamine. Group IV received only enteral feeding as a control group. Transferrin levels decreased in group IV (p<0.01 0-7 days, p<0.01 7-15 days, p<0.01 0-15 days). Nitrogen balance levels
were highest in group IV when compared with group I (p<0.05, p<0.001), group II (p<0.001), and group III
(p<0.05, p<0.001) on days 7-15. Creatinine/height indexes increased in group I (p<0.001), group II (p<0.001),
group III (p<0.001), and group IV (p<0.05) on day 15. In group III the creatinine/height index was higher than in
groups I and II (p<0.05). In group IV, creatinine/height index was lower than in group I (p<0.01) and group II
(p<0.001). Protein-calorie intake in group IV was higher than others on day 7 (p<0.05). SOFA scores of group IV
were higher than the other groups on day 15 (p<0.05). This study demonstrated, that combined route of gln supplementation resulted in the most positive outcome to transferrin, creatine/height index and nitrogen balance (on
days 7 and 15) during the catabolic phase of septic patients with malnutrition.
Asia Pac J Clin Nutr. 2014;23(1):34-40.doi: 10.6133/apjcn.2014.23.1.11
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Fast-track improves post-operative nutrition and outcomes of colorectal surgery: a single-center prospective trial in China
Author:Ka Li BSc, Ji-Ping Li BSc, Nan-hai Peng BSc, Li-l
Keywords:fast-track, nutrition, post-operative, colorectal, prospective
Abstract:Fast- track (FT) has been shown to enhance post-operative recovery. The aim of this study was to compare the effects of FT and traditional nutrition on post-operative rehabilitation, as well as evaluate the feasibility of applying
FT in nutrition management of colorectal surgery. A prospective and randomized controlled trial was performed.
This study included 464 patients who underwent colorectal surgery. The patients were randomly assigned into an
FT group and a traditional group. The nutritional risk screening (NRS 2002) score, post-operative recovery index
and surgical complications were compared between the FT and traditional groups. The NRS 2002 score in the FT
group was better than the traditional group (p<0.05). Serum indicators for nutrition (HGB, ALB, A/G) and immune function (lymphocyte rate [LYMPH%], IgA, and CD4+) in the FT group were superior to those in the traditional group (p<0.05) on post-operative day 5. The first time to aerofluxus, defecation, oral intake and ambulation
in the FT group was shorter when compared to the traditional group (p<0.05). The complication incidence was
significantly lower in the FT group than in the traditional group (p<0.05). In particular, the occurrence rate of
anastomotic leakage was higher in the traditional group than in the FT group (0.5% vs 2.8%, p<0.05). Taken together, these data suggest that FT management can improve the nutritional condition and outcomes of colorectal
surgical patients.
Asia Pac J Clin Nutr. 2014;23(1):41-47.doi: 10.6133/apjcn.2014.23.1.09
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A school-based comprehensive lifestyle intervention among Chinese kids against Obesity (CLICK-Obesity) in Nanjing City, China: the baseline data
Author:Fei Xu MD, PhD, Xiaorong Wang BMed, MPH , Robert S
Keywords:children, intervention trial, lifestyle, obesity, physical activity
Abstract:Background: urgent development of effective interventions to prevent rapidly rising childhood obesity in China is
needed. Methods: Between May 2010 and December 2013, a cluster randomized controlled trial was conducted
among 4
th
graders in eight urban primary schools randomly assigned to intervention or control groups in Nanjing,
China. A multi-component intervention program was implemented within the treatment group, while students in
the control group followed their usual health education curriculum without additional intervention. Results: At
baseline, 638 and 544 students were enrolled in the intervention and control group, respectively. The prevalence
of excess body weight was 26.8%, with 27.4% in the intervention group and 26.1% in the control group(p=0.61).
The mean (SD) BMI and WC was 18.7 (3.0) and 63.0 (9.2) for participants in intervention schools, and 18.5 (2.9)
and 63.6 (8.7) for students in control group, separately (p=0.24 and 0.41, respectively). Compared to those who
were not aware of what lifestyle/behavior factors were unhealthy, students who were aware of the unhealthy lifestyle/behavior factors consumed fewer fried snacks (0.46±0.76 serves/week vs 0.65±0.91 serves/week; p<0.01),
soft drinks (160±194 ml/week vs 199±227 ml/week; p<0.01), but larger amount of meat (502±429 g/week vs
449±344 g/week; p=0.03), and reported less screen time (214±232 minutes/week vs 252±264 minutes/week;
p<0.01). Moreover, there was no difference within physical activity time between these two groups (257±341
minutes/week vs 218±324 minutes/week; p=0.13). Conclusions: Main characteristics of participants were balanced at baseline within intervention and control schools, but a gap existed between healthy lifestyle knowledge
and actual healthy behavior in students. Trial Registration number: ChiCTR-ERC-11001819
Asia Pac J Clin Nutr. 2014;23(1):48-54.doi: 10.6133/apjcn.2014.23.1.04 †
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Association of dietary fatty acids intake with pro-coagulation and inflammation in Saudi Adults
Author:Omar S Al-Attas PhD, Nasser M Al-Daghri PhD, Majed
Keywords:dietary fatty acid, adipokines, plasminogen activator inhibitor -1, proinflammatory molecules, CRP
Abstract:The aim of the study was to understand whether dietary fatty acids such as saturated, polyunsaturated, and monounsaturated fatty acids act as inflammatory mediators or influence pro-coagulation in Saudi adults. The study
sought to examine inflammatory factors such as C-reactive protein, tumor necrosis factor-alpha and activated
plasminogen activator inhibitor 1. A total number of 232 consenting Saudi adults, aged 18–60 years were randomly selected in this cross-sectional study. Independent Student t-test was done to compare means of normally
distributed data. Spearman correlation between the variables was determined. The values of different fatty acids
and adipokines were transformed logarithmically/square root to normalize data before correlations were determined and statistical analyses performed. Statistical significance was set at p<0.05. The results show a significant
positive correlation of dietary intake of poly and monounsaturated fatty acids, but not saturated fatty acids, with
activated plasminogen activator inhibitor 1 (r=0.31, p=0.02, r=0.32 p=0.04). On the other hand, dietary intake of
saturated fatty acids showed a negative correlation with serum C-reactive protein levels (p=0.001) in males. Dietary unsaturated fatty acids is possibly associated with the production of a pro-coagulation factor without enhancing the secretion of pro-inflammatory molecules, while saturated fatty acids have no effect on activated plasminogen activator inhibitor 1, but their level is negatively associated with the inflammatory factor C-reactive protein.
We conclude that dietary intake may exert a gender-specific effect in inflammatory processes among adults. Further studies are warranted to confirm present findings.
Asia Pac J Clin Nutr. 2014;23(1):55-64.doi: 10.6133/apjcn.2014.23.1.12
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Association between body fat and vitamin D status in Korean adults
Author:Seung Seok Han MD, Myounghee Kim PhD, Su Mi Lee MD
Keywords: adiposity, body composition, body fat distribution, Koreans, vitamin D
Abstract:The relationship between body fat mass and vitamin D appears to vary by ethnicity, but our understanding of this
predisposition in Asians is limited due to the scarcity of prior investigations. Data on 1,697 Korean adults were
obtained from the second and third years (2008-2009) of the fourth Korean National Health and Nutritional Examination Survey. Body fat mass was measured using dual-energy X-ray absorptiometry. Both linear regression
analysis for serum 25-hydroxyvitamin D [25(OH)D] and logistic analysis for vitamin D deficiency [25(OH)D
<20 ng/mL] were performed to determine significant predictors among BMI, waist circumference (WC), and
body fat percentage (BF), after adjustment of multiple covariates. To explore a possible non-linear relationship
between them, the fractional polynomials method was used. All analyses were conducted following stratification
by sex. In linear regression analysis, BMI and WC were not associated with 25(OH)D. However, BF was inversely related to 25(OH)D, irrespective of the fat location (both appendicular and truncal fat) in both sexes. In logistic
regression analysis, the highest quartile group of BF had a greater OR for vitamin D deficiency than the lower
quartile groups, irrespective of the fat location and sex. However, the quartiles of BMI and WC werenot associated with vitamin D deficiency. The linear relationships between BF and 25(OH)D (or vitamin D deficiency)
were confirmed despite use of the fractional polynomials method. Body fat mass is inversely associated with serum 25(OH)D in Korean adults. Monitoring of vitamin D deficiency in Korean adults with high fat mass is needed.
Asia Pac J Clin Nutr. 2014;23(1):65-75.doi: 10.6133/apjcn.2014.23.1.10
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Eating behaviors and weight over time in a prospective study: the Healthy Twin Study
Author:Yun-Mi Song MD, PhD, Kayoung Lee MD, PhD, Joohon S
Keywords:eating behavior, body mass index, body weight changes, weight gain, obesity
Abstract:We examined the relationships of combined initial restrained and external/emotional eating with initial BMI and
change in weight and these subscales over time. BMI and the Dutch Eating Behavior Questionnaire were twicemeasured in 1361 Korean twins and families (482 men, 879 women) over a period of 2.7±0.9 years. Subjects
were classified by combination of initial sex-specific restrained and external (or emotional) eating tertiles. Linear
mixed models were performed after adjusting for confounders at baseline (household, sibling relations, sex, age,
education level, smoking, alcohol use, energy intake, physical activity, and medical history). In adjusted models,
initial BMI increased with increasing tertiles of initial restrained eating across initial external/emotional eating
tertiles. Weight was less likely to increase over time with increasing tertiles of initial restrained eating in the lowest external eating tertile and middle tertile of emotional eating at baseline. Subscale scores decreased over time
with increasing tertiles of corresponding subscales at baseline. These findings suggest that high dietary restraint
and external/emotional eating may indicate concurrent high BMI and attenuated weight gain and decreases in corresponding subscales over time.
Asia Pac J Clin Nutr. 2014;23(1):76-83.doi: 10.6133/apjcn.2014.23.1.15
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Sleep deprivation is related to obesity and low intake of energy and carbohydrates among working Iranian adults: a cross sectional study
Author:Kolsoom Parvaneh MSc, Bee Koon Poh PhD, Majid Haji
Keywords: body weight, dietary intake, obesity, physical activity, sleep deprivation
Abstract:Sleep deficiency is becoming widespread in both adults and adolescents and is accompanied by certainbehaviors
that can lead to obesity. This study aims to investigate differences in sleep duration of overweight/obese and
normal weight groups, and the association between sleep deprivation and obesity, dietary intake and physical activity. A cross-sectional study was conducted among 226 Iranian working adults (109 men and 117 women) aged
20 to 55 years old who live in Tehran. Body weight, height, waist and hip circumferences were measured, and
BMI was calculated. Questionnaires, including the Sleep Habit Heart Questionnaire (SHHQ), International Physical Activity Questionnaire (IPAQ) and 24-hour dietary recall, were interview-administered. Subjects were categorized as normal weight (36.3%) or overweight/obese (63.7%) based on WHO standards (2000). Overweight/obese subjects slept significantly (p<0.001) later (00:32±00:62 AM) and had shorter sleep duration
(5.37±1.1 hours) than normal weight subjects (23:30±00:47 PM and 6.54±1.06 hours, respectively). Sleep duration showed significant (p<0.05) direct correlations to energy (r = 0.174), carbohydrate (r = 0.154) and fat intake
(r = 0.141). This study revealed that each hour later in bedtime (going to bed later) increased the odds of being
overweight or obese by 2.59-fold (95% CI: 1.61-4.16). The findings in this study confirm that people with shorter
sleep duration are more likely to be overweight or obese; hence, strategies for the management of obesity should
incorporate a consideration of sleep patterns.
Asia Pac J Clin Nutr. 2014;23(1):84-90.doi: 10.6133/apjcn.2014.23.1.02
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Socio-economic factors and use of maternal health services are associated with delayed initiation and non-exclusive breastfeeding in Indonesia: secondary analysis of Indonesia Demographic and Health Surveys 2002/2003 and 2007
Author:Christiana R Titaley PhD, Philips C Loh MSc, Sabar
Keywords:delayed initiation of breastfeeding, exclusive breastfeeding, Indonesia Demographic and Health Survey, Indonesia
Abstract:This analysis aims to examine factors associated with delayed initiation and non-exclusive breastfeeding in Indonesia. Data were derived from the 2002/2003 and 2007 Indonesia Demographic and Health Survey. Information
from 12,191 singleton live-born infants aged 0-23 months was used to examine factors associated with delayed
initiation of breastfeeding. Furthermore, information from 3,187 singleton live-born infants aged 0-5 months was
used to identify factors associated with non-exclusive breastfeeding. Associations between potential predictors
and study outcomes were examined using logistic regression. Our study found that infants from high household
wealth-index had significantly increased odds of both delayed initiation and non-exclusive breastfeeding. Other
factors associated with an increased odds of delayed initiation of breastfeeding included infants from Sumatera
region (OR=1.64, 95% CI: 1.38-1.95), Caesarean-section deliveries (OR=1.84, 95% CI: 1.39-2.44) and deliveries
in government-owned (OR=1.38, 95% CI: 1.08-1.76) and non-health facility (OR=1.20, 95% CI: 1.00-1.43). Other factors associated with an increased odds for non-exclusive breastfeeding included parents who were in the
workforce (OR=1.37, 95% CI: 1.06-1.78) and mothers with obstetric complication at childbirth (OR=1.35, 95%
CI: 1.05-1.74). However, the odds reduced for infants from Eastern Indonesia (OR=0.64, 95% CI: 0.49-0.85).
Poor breastfeeding practices are associated with environmental, socio-economic, pregnancy-birthing characteristics and maternal health services factors. Efforts to promote breastfeeding practices should be conducted comprehensively to target population at risk for poor breastfeeding practices.
Asia Pac J Clin Nutr. 2014;23(1):91-104.doi: 10.6133/apjcn.2014.23.1.18
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The impact on child wasting of a capacity building project implemented by community and district health staff in rural Lao PDR
Author:Benjamin Coghlan MBBS, Michael J Toole MBBS, Niram
Keywords:wasting, acute malnutrition, Laos, capacity-building, feeding behaviours
Abstract:Laos is a low-income food-deficit country with pockets of high levels of wasting in the highland areas. We implemented a 3-year health/nutrition project in 12 villages in the highlands of Savannakhet province to reduce
acute malnutrition in children. Volunteer nutrition teams in each village monitored child growth and promoted
healthy feeding practices; a multisectoral district committee conducted monthly outreach to assess child growth,
manage acute malnutrition and deliver primary health care services. We conducted a cross-sectional assessment
before project activities began and at the end of the project. The baseline survey randomly sampled 60% of all
households; the endline assessment aimed to survey all eligible registered participants. Anthropometric measures
were taken from children aged 6-59 months; mothers with children aged <12 months were asked about infant
feeding practices, antenatal and post-partum care; and child immunizations were recorded for children aged between 0-23 months. At baseline, 721 households were sampled, while the endline assessment surveyed between
82% and 100% of eligible participants in each age group. Acute malnutrition reduced from 12.4% (95% CI: 10.4-14.3) to 6.1% (4.9-7.3). Unhealthy feeding practices declined: in 2008, 40.0% (34.7-45.3) of mothers breastfed
their newborn within 2 hours of birth and 30.8% (25.7-35.8) threw the colostrum away; in 2011, these figures
were 72% and 8% respectively. Maternal care and child immunisation coverage also improved. Improvingthe
health environment and child feeding practices appears to have markedly reduced the level of wasting. Unsafe
feeding practices were common but readily changed by the community -based nutrition teams.
Asia Pac J Clin Nutr. 2014;23(1):105-111.doi: 10.6133/apjcn.2014.23.1.16
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Disturbed eating tendency and related factors in grade four to six elementary school students in Taiwan
Author:Yueching Wong PhD, RD, Yu-Jhen Chang MS, RD, Shu-W
Keywords:Children’s Eating Attitude Test -26, locus of control, significant others, media, elementary school students
Abstract:OBJECTIVE: This study investigated Taiwanese elementary school students’ status in terms of body size,
body satisfaction and disturbed eating tendencies. METHODS: In a cross-sectional survey, 1,261 elementary school children from grades four to six participated in this study. We used an anonymous selfreported questionnaire, which included: demographics and body satisfaction; Children’s Eating Attitude
Test - 26 (ChEAT- 26); Nowicki-Strickland Locus of Control Scale; and Influence of Significant Others
Scale and Media Impact Scale. RESULTS: W e found that 58.4% of the children were of normal weight,
and 32.7% of the boys and 22.2% of the girls were over-weight or obese. Moreover, 39% of the children
wanted to be thinner. The mean ChEAT -26 score was 8.71±8.35, and 10.5% of the children were at high
risk for disturbed eating tendencies (ChEAT -26≥20), including 8.4% of the boys and 12.6% of the girls.
Scores on the ChEAT -26, Nowicki-Strickland Locus of Control Scale, Influence of Significant Others
Scale and Media Impact Scale were positively correlated. The level of external control and the influence
of significant others and the media were significantly higher in children with disturbed eating attitudes
than in those without them. Multivariable logistic regressions showed that disturbed eating attitudes were
associated with body satisfaction, locus of control, and the level of influence of significant others and the
media. Conclusions: Disturbed eating behaviors exist among elementary school students in Taiwan. This
survey highlights the need for education in acquiring healthy mental attitudes and eating behaviors by elementary school students.
Asia Pac J Clin Nutr. 2014;23(1):112-120.doi: 10.6133/apjcn.2014.23.1.07
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Influence of obesogenic behaviors on health-related quality of life in adolescents
Author:Bamini Gopinath BTech, PhD, Jimmy CY Louie BSc MNu
Keywords:adolescents, quality of life, lifestyle, diet, Sydney Childhood Eye Study
Abstract:We aimed to prospectively examine the association between the combined effects of obesogenic behaviors on
quality of life (QOL) in adolescents. Of 2353 Sydney schoolchildren surveyed (median age 12.7 years), 1,213
were re-examined 5 years later at age 17-18. Children completed activity and food-frequency questionnaires. An
unhealthy behavior score was calculated, allocating 1 point for the following: <60 minutes of total physical activity/ day; ≥2 hours of screen time/ day; consumed salty snack foods and/or confectionery ≥5 times per week; ≥1
serves of soft drinks and/or cordial/ day; and not consuming both ≥2 serves of fruit and ≥3 serves of vegetables/
day. Health-related QOL was assessed by the Pediatric Quality of Life Inventory (PedsQL). The prevalence of 0,
1, 2, 3, 4, and 5 lifestyle risk factors was 4.2%, 17.1%, 30.7%, 30.5%, 13.9% and 3.6%, respectively. After multivariable-adjustment, children engaging in 5 versus 0 unhealthy behaviors had 9.2-units lower PedsQL physical
summary score (p
trend
=0.001), five years later. Boys reporting 4 or 5 lifestyle risk factors compared to their peers
reporting none or one at baseline, had lower total and physical summary scores at follow-up, p
trend
=0.02 and 0.01,
respectively. Girls engaging in 4 or 5 versus 0 or 1 unhealthy behaviors, had 4.6-units lower physical summary
score (p
trend
=0.04), five years later. The number of obesogenic lifestyle risk factors was independently associated
with subsequent poorer QOL, particularly physical health, during adolescence. These findings underscore the importance of targeting lifestyle behaviors to promote general well-being and physical functioning in adolescents.
Asia Pac J Clin Nutr. 2014;23(1):121-127.doi: 10.6133/apjcn.2014.23.1.13
>>Abstract
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Breakfast eating patterns and the metabolic syndrome: the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2009
Author:Ki-Bong Yoo MPH, Hee-Jae Suh PhD, Minjee Lee MPH,
Keywords:breakfast, eating patterns, the metabolic syndrome, Korea, dairy-cereal
Abstract:Objective: The purpose of this study is to find out the association between eating breakfast, breakfast patterns,
and the metabolic syndrome. Methods: We used the fourth Korean National Health and Nutrition Examination
Survey from 2007 to 2009. A total of 16,734 subjects were included. Breakfast dietary patterns were extracted by
factor analysis. Multiple logistic regression was used to assess the relationship between breakfast consumption,
breakfast dietary patterns, and the metabolic syndrome. Results: We found that breakfast consumption itself reduced the risk of the metabolic syndrome (odds ratio=0.82, 95% confidence interval=0.69-0.98). We identified
two breakfast dietary patterns: the traditional Korean pattern and the dairy-cereal pattern. The dairy-cereal pattern
was associated with a reduction in the risk of the metabolic syndrome among breakfast consumers. Compared to
no breakfast consumption, the strongest traditional Korean pattern and the highest quartiles for the dairy -cereal
pattern were associated with a reduced risk of the metabolic syndrome. Conclusions: Breakfast consumption is
associated with the metabolic syndrome. Not all breakfast consumption patterns are associated with a reduced
risk of having the metabolic syndrome. In particular, eating either a dairy-cereal breakfast or high energy and fiber breakfast are associated with a reduced risk of the metabolic syndrome.
Asia Pac J Clin Nutr. 2014;23(1):128-137.doi: 10.6133/apjcn.2014.23.1.08
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Food insecurity and the m etabolic syndrome among women from low income communities in Malaysia
Author:Zalilah Mohd Shariff PhD, Norhasmah Sulaiman PhD,
Keywords:metabolic syndrome, food insecurity, harmonized criteria, low income communities, reproductive age women
Abstract:This cross-sectional study examined the relationship between household food insecurity and the metabolic syndrome (MetS) among reproductive-aged women (n=625) in low income communities. The Radimer/Cornell
Hunger and Food Insecurity instrument was utilized to assess food insecurity. Anthropometry, diet diversity,
blood pressure and fasting venous blood for lipid and glucose profile were also obtained. MetS was defined as
having at least 3 risk factors and is in accordance with the Harmonized criteria. The prevalence of food insecurity
and MetS was 78.4% (household food insecure, 26.7%; individual food insecure, 25.3%; child hunger, 26.4%)
and 25.6%, respectively. While more food secure than food insecure women had elevated glucose (food secure,
54.8% vs food insecure, 37.3-46.1%), total cholesterol (food secure, 54.1% vs food insecure, 32.1-40.7%) and
LDL-cholesterol (food secure, 63.7% vs food insecure, 40.6-48.7%), the percentage of women with overweight/obesity, abdominal obesity, hypertension, high triglyceride, low HDL -cholesterol and MetS did not vary
significantly by food insecurity status. However, after controlling for demographic and socioeconomic covariates,
women in food insecure households were less likely to have MetS (individual food insecure and child hunger)
(p<0.05), abdominal obesity (individual food insecure and child hunger) (p<0.01), elevated glucose (household
food insecure), total cholesterol (child hunger) (p<0.05) and LDL-cholesterol (household food insecure and child
hunger) (p<0.05) compared to food secure women. Efforts to improve food insecurity of low income households
undergoing nutrition transition should address availability and accessibility to healthy food choices and nutrition
education that could reduce the risk of diet-related chronic diseases.
Asia Pac J Clin Nutr. 2014;23(1):138-147.doi: 10.6133/apjcn.2014.23.1.05
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Clustering and determinants of cardiometabolic risk factors among Filipino young adults
Author:Niha Zubair PhD, Chris W Kuzawa PhD, Nanette R Lee
Keywords:young adult, risk factors, cluster analysis, adiposity, cardiovascular diseases
Abstract:BACKGROUND: With modernization, cardiometabolic disease risk has increased in low and middle-income
countries. To better understand cardiometabolic disease etiology, we evaluated the patterning risk factors in a
susceptible young adult population. METHODS AND RESULTS: Participants included 1,621 individuals from
the 2005 Cebu Longitudinal Health and Nutrition Survey. Using cluster analysis, we grouped individuals by the
following biomarkers: triglycerides, HDL and LDL cholesterol, C-reactive protein, blood pressure, homeostasis
model assessment of insulin resistance, and fasting glucose. Using multinomial logistic regression models we assessed how diet, adiposity, and environment predicted cardiometabolic clusters. We identified 5 distinct sexspecific clusters: 1) Healthy/High HDL cholesterol (with the addition of high LDL cholesterol in women); 2)
Healthy/Low blood pressure; 3) High blood pressure; 4) Insulin resistant/High triglycerides; and 5) High Creactive protein. Low HDL cholesterol was the most prevalent risk factor (63%). In men and women, a higher intake of saturated fat increased the likelihood of being in the healthy clusters. In men, poorer environmental hygiene increased the likelihood of being in the High C-reactive protein cluster, compared to the healthy clusters
(OR 0.74 [95% CI 0.60-0.90] and 0.83 [0.70-0.99]). Adiposity most strongly associated with membership to the
Insulin resistant/high triglyceride cluster. CONCLUSIONS: Despite the population’s youth and leanness, cluster
analysis found patterns of cardiometabolic risk. While adiposity measures predicted clustering, diet and environment also independently predicted clustering, emphasizing the importance of screening lean and overweight individuals for cardiometabolic risk. Finding predictors of risk in early adulthood could help inform prevention efforts for future disease.
Asia Pac J Clin Nutr. 2014;23(1):148-158.doi: 10.6133/apjcn.2014.23.1.06
>>Abstract
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What factors were important for dietary improvement in emergency shelters after the Great East Japan Earthquake?
Author:Nobuyo Tsuboyama-Kasaoka PhD, RD, Yuko Hoshi RD, K
Keywords:disaster, emergency shelter, gas, cooking, meals
Abstract:The Great East Japan Earthquake of 2011 left many evacuees with insufficient food and emergency shelter. However, there is no evidence concerning the factors affecting dietary circumstances in emergency shelters after disasters. To clarify the factors that influenced the provision of meals, we reanalyzed a data set from a dietary survey
conducted in emergency shelters one month after the Great East Japan Earthquake (2011). Among the 69shelters
in “city A,” 53 (79.1%) had food shortages. The possibility of cooking in the emergency shelter improved the
provision of meals to evacuees. When comparing emergency shelters with and without cooking equipment, the
shelters with cooking equipment provided more meals, as well as more dishes containing grains and vegetables.
When there was a gas supply, the twice per day provision of “balanced” meals (containing grains, vegetables, and
meat/fish) was more frequent than when there was no gas supply. Interestingly, neither the water supply nor the
electricity supply affected the provision of balanced meals. Further, emergency shelters with larger numbers of
evacuees had a lower possibility of cooking and lower availability of gas supply. Our results demonstrate that early improvements to post-disaster meal provision may maintain the health of evacuees. Such improvements could
be achieved by 1) the speedy restoration of the gas supply to enable cooking, and 2) limiting the number of evacuees per emergency shelter.
Asia Pac J Clin Nutr. 2014;23(1):159-166.doi: 10.6133/apjcn.2014.23.1.17
>>Abstract
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Association of adiponectin gene -11377C>G polymorphism with adiponectin levels and the metabolic syndrome in Thais
Author:Kanjana Suriyaprom PhD, Benjaluck Phonrat MSc, Run
Keywords:metabolic syndrome, visceral obesity, adiponectin, gene polymorphism, Thais
Abstract:The metabolic syndrome is related to increased risk of developing cardiovascular disease and type 2 diabetes. A diponectin is an adipocyte-secreted protein with insulin-sensitizing and anti-atherogenic properties. The aims of
this study were to evaluate adiponectin levels and biochemical parameters in metabolic-syndrome subjects and
healthy controls. The study also sought to identify links between two polymorphisms, -11377C>G (rs266729) and
+45T>G (rs2241766) of the adiponectin gene, in relation to adiponectin levels and the metabolic syndrome.
Three hundres and thirty-two Thai volunteers: 164 metabolic-syndrome subjects and 168 healthy control subjects
were investigated. The adiponectin and HDL-C levels of the metabolic-syndrome group were significantly lower
than the control group (p<0.001). Decreased concentration of adiponectin was associated with -11377C>G polymorphism (p<0.001); this polymorphism was significantly more frequent in the metabolic syndrome group than
in the control group (p<0.001). However, +45T>G polymorphism of the adiponectin gene was found not to be related to adiponectin level or metabolic syndrome. Therefore, -11377C>G polymorphism was related to the metabolic syndrome susceptibility, and this polymorphism impacted on circulating adiponectin concentrations among
Thais.
Asia Pac J Clin Nutr. 2014;23(1):167-173.doi: 10.6133/apjcn.2014.23.1.01
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The effect of HIF-1α on glucose metabolism, growth and apoptosis of pancreatic cancerous cells
Author:Guodong He MD, Yi Jiang MD, Bo Zhang MD, Guohao W
Keywords:HIF-1α, RNA interfering, glycolysis, pancreatic cancer, hypoxia
Abstract:Objectives: The aim of this study is to explore the possible role of HIF-1α in glucose metabolism, proliferation
and apoptosis of pancreatic cancerous cells. Method: The pancreatic cancerous BxPC-3 cells were cultured in
normoxia or hypoxia (3% O2
), respectively. Cell proliferation was determined by MTT assay, apoptosis was determined by Annexin V/PI staining. Expression of Pyruvate dehydrogenase kinase (PDK1), Lactate dehydrogenase (LDHA), pyruvate kinase M2 (PKM2) and citrate synthase (CS) was determined by Western-blot and Realtime PCR. Results: Under hypoxia, the expression of HIF-1α and the lactate production were increased. The expression of glucose metabolic enzymes PDK1, LDHA, PKM2 was also increased compared with that under aerobic condition. Hypoxia treatment had little effect on expression of CS. Under hypoxia, knockdown of HIF-1α inhibited the production of lactate and the expression of PDK1, LDHA and PKM2. Knockdown of HIF-1α repressed the growth of pancreatic cancer BxPC-3 cells and induced apoptosis of the cells under hypoxia. Conclusion: Under hypoxia, the expression of HIF-1α is induced, leading to the increase of glycolysis in BxPC-3 cells
possibly through upregulation of the enzymes related to glycolysis. HIF-1α knockdown can inhibit the prolife ratio and promote apoptosis of pancreatic cancerous BxPC-3 cells in vitro.
Asia Pac J Clin Nutr. 2014;23(1):174-180.doi: 10.6133/apjcn.2014.23.1.14 †
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Erratum
Author:
Keywords:
Abstract:
Asia Pac J Clin Nutr. 2014;23(1):181.doi: 10.6133/apjcn.2014.23.1.21
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