Food components and ocular pathophysiology: a critical appraisal of the role of oxidative mechanisms
controlled trial of formula feeding
diabetes assessed by continuous glucose monitoring
Author:Reinlesh Raman, Ehsan Vaghefi, Andrea J Braakhuis
Keywords:antioxidants, ocular pathology, diet, nutrition, vision
Abstract:Background and Objectives: Three of the major ocular diseases, namely cataracts, age-related macular degener-ation and glaucoma are associated with oxidative damage. Disease risk and progression may be reduced through consumption of dietary components. To critically examine the literature on dietary and supplemental intakes of fruit and vegetables, meat, antioxidants (vitamin C, E and A), calcium, folate, iron, and their association with ocular disease. Methods and Study Design: Google Scholar and key references from texts and publications were searched using search terms (eye disease, antioxidants), (vision, nutrition), no date restriction, only articles in English were included. Results: We found probable evidence that dietary intake of fruits and vegetables, and vit-amin C lowered incidence of cataracts and age-related macular degeneration. In high supplemental doses, vitamin C increases macular degeneration risk. Vitamin A from food was protective for cataracts and glaucoma, but not in supplemental form. Vitamin A was associated with lower incidence of macular degeneration. We also found probable evidence that higher intakes of meat increased the risk of cataracts and macular degeneration. Dietary calcium and iron appeared protective against glaucoma, but not in supplemental form. Conclusions: While a nu-trient rich diet high in fruit and vegetables, and associated antioxidants appeared to be protective, we would cau-tion intake of supplementary antioxidants for those with ocular disease.
Asia Pac J Clin Nutr. 2017;26(4):572-585.doi: 10.6133/apjcn.082016.01
>>Abstract
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Enteral nutritional support in non-ICU hospitalized
patients: current practice in Mexico
Author:Arianne I Lupián-Angulo, Luis A Ortíz-Reyes, Lilia Castillo-Martínez,
Aurora E Serralde-Zúñiga
Keywords:enteral nutrition, malnutrition, nutritional support, energy deficit, complications
Abstract:have better clinical outcomes; unfortunately, there are discrepancies between the amount prescribed and amount
received. The aim of this study was to explore the nutritional clinical practice, determine the adequacy and identify
reasons for underfeeding. Methods and Study Design: A retrospective study was conducted in hospitalized,
non-intensive care unit, adult patients receiving EN for ≥72 h. The following data were recorded: the prescribed
target of energy and protein per day, daily energy intake, and the percentage of adequacy of the energy and protein
requirement up to hospital day seven. Complications during administration or reasons for interruption and the
proportion of patients who received ≥80% of the energy goals on days four and seven were also recorded. Results:
In total, 52 patients were included (61.5% women), with a median age of 57.5 years; 20.4% and 6.1% of the patients
received ≥80% of their energy and protein goals, respectively, on day four, which improved to 28%
(p<0.005) and 19% (p<0.001), respectively, on day seven. During the first seven days, a statistically significant
(p<0.001) difference was observed between the amount of prescribed and administered energy over 24 h. The patients
who received <80% of their total energy requirement remained hospitalized for 29 days (IQR 16.5-45.5),
while those who received ≥80% were hospitalized for 18 days (IQR 13.3-28.8) (p<0.05). Conclusions: Significant
energy and protein deficits were documented. Furthermore, it is necessary to use strategies such as the implementation
of an algorithm to optimize EN.
Asia Pac J Clin Nutr. 2017;26(4):586-590.doi: 10.6133/apjcn.072016.05
>>Abstract
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Prevalence and risk factors for complications in adult
patients with short bowel syndrome receiving long-term
home parenteral nutrition
Author:Guohao Wu, Yi Jiang, Xiaoping Zhu, Dayong Jin,
Yusong Han, Jun Han, Zhaohan Wu, Zhaoguang Wu
Keywords:long-term home parenteral nutrition, short bowel syndrome, adult patients, complications, risk factors
Abstract:ackground and Objectives: Short bowel syndrome (SBS) is a complicated and challenging disease where
home parenteral nutrition (HPN) is widely used. The complications of long-term HPN-dependent in adult patients
with SBS are poorly documented. This study was mainly aimed to assess the prevalence and risk factors of HPNassociated complications in adult patients with SBS, especially the catheter-related sepsis and HPN-associated
liver/biliary disorders. Methods and Study Design: 47 non-malignant adult patients with SBS who received
HPN for more than 2 years in our clinical nutrition center were included. Patients were divided into two groups
according to whether HPN-associated complications were present or not. Student’s t-test and χ2 test were applied
to compare the differences between the two groups. Results: The mean frequency of catheter-related sepsis was
0.31±0.05 per catheter year of HPN. An higher incidence of catheter-related infections (p<0.001) and shorter delay between HPN onset and first infection (p<0.001) were identified as risk factors for catheter-related sepsis. A
total of 25 patients (53.2%) developed HPN-associated liver/biliary diseases. The identified risk factors for HPNassociated liver/biliary disorders were higher rate of catheter-related infections (p=0.009), shorter delay between
HPN onset and first infection (p=0.017), higher energy content of HPN (p=0.014), higher glucose rate of HPN
(p=0.009), and lower lipid rate of HPN (p=0.022). Conclusion: Our study revealed that adult patients with SBS
receiving long-term HPN treatment developed a low prevalence of catheter-related sepsis but a rather high prevalence of HPN-associated liver/biliary disorders. We also identified several risk factors for HPN-associated complications which should be taken notice of in clinical practice.
Asia Pac J Clin Nutr. 2017;26(4):591-597.doi: 10.6133/apjcn.072016.05
>>Abstract
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Dietary fiber intake is associated with chronic kidney disease (CKD) progression and cardiovascular risk, but not protein nutritional status, in adults with CKD
controlled trial of formula feeding
diabetes assessed by continuous glucose monitoring
Author:Lu Lu, Yan-Feng Huang, Ming-Qing Wang, De-Xiu Chen,
Heng Wan, Lian-Bo Wei, Wei Xiao
Keywords:chronic kidney disease, dietary fiber, inflammation, indoxyl sulfate, cardiovascular event
Abstract:Background and Objectives: Evidence suggests that dietary fiber benefits patients with chronic kidney disease (CKD); however, this conclusion requires further validation. In this study, we examined the effects of dietary fi-ber on kidney function, inflammation, indoxyl sulfate, nutritional status, and cardiovascular risk in patients with advanced CKD. Methods and Study Design: We performed linear regressions to assess the association between dietary fiber intake and CKD parameters. The aforementioned parameters were compared over an 18-month fol-low-up period. Kaplan–Meier analysis was used to investigate the association between fiber intake and Cardiac vascular disease (CVD). Results: In total, 157 patients were included in this study. Dietary fiber and inflammato-ry indices were associated (interleukin [IL]-6: β=−0.024, p=0.035). The differential estimated glomerular filtra-tion rate (ΔeGFR) as well as levels of C-reactive protein, IL-6, indoxyl sulfate, and serum cholesterol in the high-er fiber intake (≥25 g/day) group were lower than those in the lower fiber intake (<25 g/day) group (p<0.05). Dif-ferences in IL-6 and indoxyl sulfate levels were more significant in patients in the higher protein intake group (p< 0.05). Dietary fiber intake may be a protective factor associated with CVD (hazard ratio=0.537 and 0.305–0.947). The protein nutritional status was not different between the two groups (p>0.05). Conclusions: Our results sug-gest that increasing fiber intake can retard the decrease in the eGFR; can reduce the levels of proinflammatory factors, indoxyl sulfate, and serum cholesterol; and is negatively associated with cardiovascular risk, but does not disrupt the nutritional status of patients with CKD.
Asia Pac J Clin Nutr. 2017;26(4):598-605.doi: 10.6133/apjcn.072016.08
>>Abstract
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The effect of an Annona muricata leaf extract on nutri-tional status and cytotoxicity in colorectal cancer: a ran-domized controlled trial
controlled trial of formula feeding
diabetes assessed by continuous glucose monitoring
Author:Lili Indrawati, Purwantyastuti Ascobat, Budiman Bela,
Murdani Abdullah, Ingrid S Surono
Keywords:Annona muricata, leaf extract, nutrition status, colorectal cancer, cytotoxicity
Abstract:Background and Objectives: Annona muricata leaf infusion has traditionally been consumed to maintain health, but is now considered for use in treating cancer patients. The objective of this study was to elucidate the effects of A. muricata leaf extract in humans and human cell lines. Methods and Study Design: Thirty outpatients with colorectal cancer who had undergone primary tumor resection were enrolled in a randomized double-blind place-bo-controlled pre–post-trial. They were divided into two groups: those who ingested A. muricata leaf extract (n=14) and those who ingested a placebo (n=14) daily for 8 weeks. Twenty-eight subjects completed the trial; they were equally distributed between the two groups. Serum from patients of both groups was compared for cy-totoxicity against colorectal cancer cell lines. The nutritional status of patients was monitored throughout the study. Results: Ex vivo and clinical studies showed higher cytotoxicity in the supplemented group compared with the placebo group. Further research is required to investigate the long-term effect of A.muricata leaf extract, par-ticularly on parameters directly related to cytotoxic activity toward colorectal cancer cells and nutrition status.
Asia Pac J Clin Nutr. 2017;26(4):606-612.doi: 10.6133/apjcn.062016.02
>>Abstract
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Dietary galactooligosaccharides improve skin health: a randomized double blind clinical trial
Author:Yang Hee Hong, Un Jae Chang, Young Suk Kim, Eun Young Jung,
Hyung Joo Suh
Keywords:galactooligosaccharide, prebiotics, probiotics, skin hydration, wrinkle
Abstract:Background and Objectives: To study the effects of galactooligosaccharides (GOS) on the skin, we investigated
skin-related parameters in healthy adults who received GOS for 12 weeks. Methods and Study Design: This
double-blind, randomized, placebo-controlled study included subjects divided into two groups (control and GOS)
by stratified block randomization. The GOS group received 1.0 g of GOS twice a day, whereas the control group
received only vehicle. Results: The results showed that the increase in corneometer values from baseline to week
12 was significantly greater in the GOS group than in the control group (6.91 vs. 2.88 arbitrary units, p<0.05).
The transepidermal water loss (TEWL) in the GOS group was reduced significantly after 12 weeks of GOS
treatment (20.1 g/h/m2 at baseline vs. 17.5 g/h/m2 at week 12, p<0.05). The differences in total and percentage of
wrinkle areas between the two groups were statistically significant after 12 weeks of GOS treatment (p<0.05).
Conclusion: Our findings support that oral treatment with GOS is beneficial to the skin and present the possibility of new nutritional strategies for skin care.
Asia Pac J Clin Nutr. 2017;26(4):613-618.doi: 10.6133/apjcn.052016.05
>>Abstract
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Lactobacillus intake for 60 days favors antioxidant
status of human breast milk: an RCT
Author:Reza Mahdavi, Leila Nikniaz, Alireza Ostadrahimi, Zeinab Nikniaz, Zhila Khamnian
Keywords:lactobacillus, breast milk, total antioxidant capacity (TAC), malondialdehyde (MDA), trend
Abstract:Background and Objectives: This study aimed to evaluate the effects of lactobacillus supplementation on trends of breast milk antioxidant parameters. Methods and Study Design: In an interventional study, 50 lactating wom-en were randomly allocated to receive a daily supplement of lactobacillus (n=25) or a placebo (n=25) for 60 days. Daily dietary intake, anthropometric measures and breast milk antioxidant parameters were determined at the on-set, and days 30 and 60 of the study. Repeated-measures ANOVA were performed to assess the change over time in the anthropometric and biochemical parameters between the two groups. The main effect of treatment was compared by using Bonferroni’s procedure for CI adjustment. The significance level was set at p<0.05. Results: There was a significant increase in breast milk total antioxidant capacity (TAC) between onset of study and day 30 (p=0.01) and day 60 (p=0.001) after lactobacillus supplementation; however, breast milk TAC level did not change significantly between days 30 and 60 (p=0.7). In the placebo group, breast milk TAC levels decreased significantly after 60 days (p=0.001). Breast milk malondialdehyde (MDA) levels decreased progressively during the study in the lactobacillus group (p=0.001); however, there was a significant increase in MDA with time in breast milk samples in the placebo group (p=0.015). Conclusions: Based on the findings, lactobacillus supple-mentation for 60 days could significantly increase breast milk TAC and decrease breast milk MDA levels, com-pared with baseline; however, further studies are needed to confirm these results.
Asia Pac J Clin Nutr. 2017;26(4):619-623.doi: 10.6133/apjcn.062016.05
>>Abstract
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Snack bar composition and their acute glycaemic and
satiety effects
Author:Mary R Yan, Andrew Parsons, Gillian A Whalley, John Kelleher, Elaine C Rush
Keywords:macronutrient, nutrient profiling, glycaemic response, hunger, satiety
Abstract:Background and Objectives: Maintaining blood glucose within homeostatic limits and eating foods that sup-press hunger and promote satiety have beneficial impacts for health. This study investigated the glycaemic re-sponse and satiety effects of a serving size of a healthier snack bar, branded Nothing Else, that met the required nutrient profiling score criteria for a health claim, in comparison to two top-selling commercial snack bars. Methods and Study Design: In an experimental study, 24 participants aged ≥ 50 years were recruited. On three different days blood glucose concentration was measured twice at baseline and 15, 30, 45, 60, 90 and 120 minutes after consumption of a serving size of each bar. Satiety effects were self-reported hunger, fullness, desire to eat, and amount could eat ratings on visual analogue scales. Results: The incremental area under the blood glucose response curve (iAUC) over two hours for the Nothing Else bar was 30% lower than commercial Bar 2 (p<0.001). At 45 minutes after eating, the Nothing Else bar induced the highest fullness rating and lowest hunger rating among the three snack bars. At two hours, fullness induced by the Nothing Else bar was twice that of Bar 2 (p=0.019), but not different to Bar 1 (p=0.212). Conclusions: The Nothing Else snack bar developed using the nutrient profiling scheme as a guideline, with its high protein and dietary fibre contents, had a lower glycaemic impact and induced a higher subjective satiety than the two commercial snack bars of equal weight.
Asia Pac J Clin Nutr. 2017;26(4):624-629.doi: 10.6133/apjcn.072016.04
>>Abstract
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Symptomatic efficacy of buckwheat products in
Non-Celiac Gluten Sensitivity (NCGS)
Author:Monica Dinu, Donatella Macchia, Giuditta Pagliai, Anna Maria Gori, Francesca Cesari, Rossella Marcucci, Francesco Sofi, Alessandro Casini
Keywords:NCGS, buckwheat, diet, symptoms severity, inflammatory profile
Abstract:Background and Objectives: Buckwheat (Fagopyrum esculentum) is a gluten-free grain with acclaimed benefi-cial effects on human health. Our aim was to assess the effect of buckwheat products on intestinal/extra-intestinal symptoms and biochemical parameters in patients with Non-Celiac Gluten Sensitivity (NCGS). Methods and Study Design: A randomized, crossover trial with two intervention phases was conducted on 19 NCGS patients over a 12 week-period. The participants were assigned to consume products made from buckwheat or to maintain their normal gluten-free diet for 6 weeks in a random order. Symptoms due to NCGS were evaluated using two questionnaires. Results: During the intervention period with buckwheat products, patients experienced a signifi-cant decrease in the severity of abdominal pain and bloating (p=0.03). In contrast, the control group showed a significant worsening trend for the majority of NCGS symptoms such as nausea, headache, joint/muscle pain, and attention disorders. The replacement diet with buckwheat products also resulted in a significant increase of serum magnesium (+4.7%) and a significant reduction in the circulating levels of some pro-inflammatory cytokines such as interferon gamma (-33.3%) and monocyte chemotactic protein-1 (-46.5%). Conclusion: The study supports the positive effects of buckwheat for NCGS patients, showing that this alternative cereal can contribute to the re-duction of both negative gastro-intestinal and related symptoms, and nutritional deficiencies, and lead to an im-provement in inflammatory profile.
Asia Pac J Clin Nutr. 2017;26(4):630-636.doi: 10.6133/apjcn.072016.07
>>Abstract
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Body mass index above 24 is beneficial for the 6-month survival
rate in hepatocellular carcinoma patients with extrahepatic
metastases
Author:Yueh-Shih Chang, Jen-Seng Huang, Cho-Li Yen, Rong-Nan Chien,
Cheng-Hsu Wang, Chien-Hong Lai, Tsung-Han Wu, Yii-Jeng Lan, Kun-Yun Yeh
Keywords:hepatocellular carcinoma, body mass index, 6-month survival, metastasis,
Abstract:Background and Objectives: To investigate the effect of overweight status on the 6-month
survival rate in patients with extrahepatic hepatocellular carcinoma (HCC). Methods and
Study Design: We retrospectively analyzed the records of 51 patients with hepatocellular
carcinoma and extrahepatic metastases between 2007 and 2010 before treatment. The
associations among overweight status (body mass index [BMI] >24 kg/m2), demographic
variables, and survival outcome were analyzed by univariate and multivariate analysis.
Results: BMI >24 kg/m2 was significantly associated with the 6-month survival rate
(p=0.042). Gender (p=0.149), Child Pugh classification (p=0.149), Okuda staging (p=0.093),
and albumin concentration >3.5 mg/dL (p=0.082) showed marginal survival benefits in
univariate analysis. Multivariate analysis confirmed that BMI >24 kg/m2 was an independent
prognostic factor for the 6-month survival rate (p=0.03). Conclusion: BMI >24 kg/m2 was
associated with an improved 6-month survival rate in patients with extrahepatic metastatic
hepatocellular carcinoma.
Asia Pac J Clin Nutr. 2017;26(4):637-641.doi: 10.6133/apjcn.062016.03
>>Abstract
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Dietary choline and folate relationships with serum
hepatic inflammatory injury markers in Taiwanese
adults
Author:Chin-Pao Cheng, Chien-Hung Chen, Chang-Sheng Kuo,
Hsing-Tao Kuo, Kuang-Ta Huang, Yu-Li Shen, Chin-Hao Chang,
Rwei-Fen S Huang
Keywords:choline intake, folate intake, hepatitis injury marker, Taiwanese population, hepatitis
Abstract:Background and Objectives: The relationships of dietary choline and folate intake with hepatic function have
yet to be established in the Taiwanese population. We investigated the associations of choline and folate intake
with hepatic inflammatory injury in Taiwanese adults. Methods and Study Design: Blood samples and data on
dietary choline components and folate intake from 548 Taiwanese adults without pathological liver disease were
collected. Dietary intake was derived using a semiquantitative food-frequency questionnaire. Serum liver injury
markers of alanine transaminase, aspartate transaminase, and hepatitis viral infection were measured. Results:
Elevated serum hepatic injury markers (>40 U/L) were associated with low folate and free choline intake
(p<0.05). Folate intake was the most significant dietary determinant of serum aspartate transaminase concentration (beta=−0.05, p=0.04), followed by free choline intake (beta=−0.249, p=0.055). Folate intake exceeding the
median level (268 µg/d) was correlated with a reduced rate of hepatitis viral infection (p=0.032) and with normalized serum aspartate transaminase (odds ratio [OR]=0.998, 95% confidence interval [CI]=0.996-1, p=0.042) and
alanine transaminase (OR=0.998, 95% CI=0.007-1, p=0.019). Total choline intake exceeding the median level
(233 mg/d) was associated with normalized serum aspartate transaminase (OR=0.518, 95% CI=0.360-0.745,
p=0.018). Conclusions: The newly established relationships of dietary intake of total choline and folate with
normalized hepatic inflammatory markers can guide the development of dietary choline and folate intake recommendations for Taiwanese adults.
Asia Pac J Clin Nutr. 2017;26(4):642-649.doi: 10.6133/apjcn.072016.05
>>Abstract
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Determination of new anthropometric cut-off values for obesity screening in Indonesian adults
Author:Janatin Hastuti, Masaharu Kagawa, Nuala M Byrne, Andrew P Hills
Keywords:anthropometric measures, cut-off values, obesity screening, percentage of body fat, Indonesian adults
Abstract:Background and Objectives: Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) have increasingly been used as screening tools for obesity. However, optimal cut-off values may be different between populations. The current study determined the optimum cut-off values for BMI, WC, WHR, and WSR for obesity screening in Indonesian adults using receiver-operating characteristic (ROC) analysis. Methods and Study Design: Stature, body weight, waist and hip circumferences were measured on 600 Indonesians aged 18-65 years (males, n=292; females, n=308) and BMI, WHR, and WSR calculated. Per-centage of body fat (%BF) was determined using the deuterium isotope (D2O) dilution technique. Some existing cut-off points for obesity determination were evaluated for sensitivity and specificity. Results: The existing cut-off values showed low sensitivity in our sample (between 18.4 and 71.1%) and new proposed cut-offs increased the sensitivity to reach 66.7 to 88.5%. The new cut-offs for BMI, WC, WHR, and WSR for determination of obe-sity were 21.9 (kg/m2), 76.8 (cm), 0.86, and 0.48, respectively, for males and 23.6 (kg/m2), 71.7 (cm), 0.77, and 0.47, respectively, for females. Conclusions: WC and WSR are the most predictive both for males and females, and therefore are considered as better screening tools for obesity in this population.
Asia Pac J Clin Nutr. 2017;26(4):650-656.doi: 10.6133/apjcn.072016.09
>>Abstract
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Dietary behaviours, weight loss attempts and change in waist circumference: 15-year longitudinal study in
Australian adults
Author:Simin Arabshahi, Petra H Lahmann, Maria CB Hughes,
Gail M Williams, Jolieke C van der Pols
Keywords:waist circumference change, dietary behaviours, weight loss attempts, longitudinal studies, abdominal obesity
Abstract:Background and Objectives: Dietary behaviours are suitable as clearly identifiable targets of dietary counsel-ling to prevent weight gain. We therefore investigated associations between dietary behaviours, weight loss at-tempts and waist circumference change. Methods and Study Design: Participants were a community-based sample population residing in Nambour, Australia, including 1,317 adults, aged 25-75 years at baseline. Waist circumference was measured in 1992 and 2007, and dietary behaviours data were derived concurrently from re-peated self-completed short dietary questions. Multivariable models, stratified by sex, were adjusted for potential confounders. Results: In men, consumption of visible fat on meat and in women, weight loss attempts in the last 10 years were the most important predictors of waist circumference gain independent of socio-demographic and lifestyle characteristics and energy intake. Men who consumed most visible fat on meat had a 2.6 times larger yearly increase in waist circumference than men who tended to cut the fat off meat: 0.47 (95% CI 0.23, 0.72) vs 0.18 (95% CI 0.01, 0.34) cm/year, p=0.01. Women who reported that they were always trying to lose weight had a 2.7 times larger yearly increase in waist circumference than women who never tried to lose weight: 0.78 (0.54, 1.02) vs 0.29 (0.06, 0.52) cm/year, p=0.0001. Other dietary behaviours were not associated with change in waist circumference. Conclusions: Consumption of visible fat on meat by men and more frequent attempts to lose weight by women were main dietary behaviours associated with gain in abdominal adiposity in Australian adults.
Asia Pac J Clin Nutr. 2017;26(4):657-664.doi: 10.6133/apjcn.062016.04
>>Abstract
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Nutritional status and dietary diversity of Kamea in Gulf
Province, Papua New Guinea
Author:Janny M Goris, Nienke Zomerdijk, Victor J Temple
Keywords:malnutrition, iodine deficiency, dietary diversity, food security, Papua New Guine
Abstract:Objectives: To assess the nutritional status of infants, children and non-pregnant
women and underlying factors, dietary diversity and community food security, in the
Kamea community in Gulf Province, Papua New Guinea. Methods and Study
Design: Prospective cross sectional study. Study population 69 infants (0-59
months), 151 children (6-12 years) and 79 non-pregnant women from 10 villages in
Kotidanga Local Level Government, Kerema District, Gulf Province, Papua New
Guinea. Results: Among infants prevalence of moderate stunting, wasting and
underweight were 38.9%, 8.3% and 44.4%, respectively; after adjusting Hb
concentration for altitude, the anaemia prevalence was 53.8%. Among children
prevalence of severe stunting was 21.2%; moderate stunting, wasting and underweight
were 57.6%, 12.2% and 48.5%, respectively; anaemia was 30.3%; median urinary
iodine concentration was 32.0 µg/L and iodine deficiency was prevalent among
88.1%. Among women, mean height, weight and BMI were 1.46±0.04 m, 43.9±5.91
kg and 20.4±2.32 kg/m2 , respectively; low BMI (<18.5 kg/m2) and anaemia were
prevalent among 22.8% and 35.4%, respectively; median urinary iodine concentration
was 36.0 µg/L and iodine deficiency was prevalent among 80.3%. Exclusive
breastfeeding was universal for young infants; complementary foods were limited in
variety and frequency. Dietary diversity was limited, implementation of the universal
salt iodisation strategy restricted and community food security was inadequate.
Conclusion: The high prevalence of malnutrition and anaemia among the three age
groups, including moderate status of iodine deficiency among women and children,
are significant public health concerns. Improvements in dietary diversity, adequate
use of iodised salt and community food security are needed.
Asia Pac J Clin Nutr. 2017;26(4):665-670.doi: 10.6133/apjcn.052016.09
>>Abstract
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A comparative study on urinary iodine concentration and
goitre prevalence between coastal and inland areas with low
and high coverage of iodized salt: a cross-sectional study in
Zhejiang province, China
Author:Zhe Mo, Xiao F Wang, Guang M Mao, Wen M Zhu, Pei W Xu,
Yan Zou, Yuan Y Wang, Xiao M Lou
Keywords:urinary iodine concentration, goitre prevalence, children, pregnant women, generalized additive models
Abstract:Background and Objective: WHO recommended that iodized salt are more than 90%
of households in USI programs, which may not be suitable for all regions, especially
in coastal areas. This study intended to find out levels of iodine nutrition and give
advice from the USI programs for areas with different iodized salt coverage. Methods
and Study Design: Coastal and inland areas were selected according to geographical
regions in Zhejiang Province, China. The water iodine concentration
(spectrophotometer analysis), salt iodine concentration (the colorimetric titration
method), salt intake, urinary iodine concentration (spectrophotometer analysis), and
thyroid volume examination (ultrasonography), as well as questionnaire, were
measured in the two areas. Results: Mean Urinary Iodine concentrations (MUIs) of
children in coastal areas was 149 µg/L, which was significantly lower than that in
inland areas (191 µg/L). MUIs of pregnant women in coastal and inland areas
were111 and 138 µg/L, respectively. Pregnant women who consumed
iodine-containing supplements had higher MUIs (207 µg/L) than those did not
(134µg/L) in inland areas. Prevalence of goiter in children reached 7.0% and 6.6% in
coastal and inland areas, respectively. The lowest prevalence of goiter was reached
when the urinary iodine concentration was approximately 120-160 µg/L in coastal
areas. Conclusion: Iodine levels of coastal and inland areas were in the adequate
range. Advice from the USI program should be specialized for different areas to
appropriately reduce the salt iodine concentrations in inland areas and to determine an
appropriate proportion of households using iodized salt in coastal areas. Moreover,
iodine supplement intake during pregnancy should officially be recommended.
Asia Pac J Clin Nutr. 2017;26(4):671-679.doi: 10.6133/apjcn.052016.06
>>Abstract
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The influence of mandatory iodine fortification on the iodine
status of Australian school children residing in an iodine
sufficient region
Author:Anna J Samidurai, Robert S Ware, Peter SW Davies
Keywords:iodine, school children, iodine fortification, bread fortification, urinary iodine concentration
Abstract:Background and Objectives: To counter emerging iodine deficiency mandatory
iodine fortification of bread was introduced throughout Australia in 2009. This study
investigated the impact of iodine fortification on the iodine status of school aged
children living in the iodine replete state of Queensland, and investigated which
foods had greatest influence on overall iodine status. Methods and Study Design: A
convenience sample of 30 children aged 8.0-10.9 years living in south east
Queensland, Australia, provided spot morning and afternoon urine samples on two
consecutive days. Iodine status was categorised by the World Health Organization
criterion. Semi-quantitative food questionnaires (FFQ) completed by carers were
used to investigate which foods were having the greatest influence on UIC. Analysis
of variance was used to reduce the within person variation observed in urinary iodine
concentrations (UIC) and the data were log transformed before statistical analysis.
Results: Adjusted median UIC was 144 ug/L (IQR 120-210 ug/L) indicating iodine
sufficient status. No samples were above the cut off for excessive UIC. Bread was
the only statistically significant contributor to UIC (r=0.37, p=0.02) with 14% of
variation in UIC explained by bread consumption. UIC increased by 8.7% for each
additional serve of bread. Conclusions: Iodine fortification of bread has increased
the iodine status of school aged children in this Queensland cohort. Despite the small
sample size in this study, improvements in methodology allowed its findings to be
comparable to other, larger surveys.
Asia Pac J Clin Nutr. 2017;26(4):680-685.doi: 10.6133/apjcn.052016.04
>>Abstract
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Body mass index is associated with fat mass in normal,
overweight/obese, and stunted preschool children in central
Thailand
Author:Tippawan Pongcharoen, Kunchit Judprasong, Siwaporn Jitngarmkusol,
Wantanee Kriengsinyos, Pattanee Winichagoon
Keywords:preschool children, fat mass, BMI, deuterium, nutritional status
Abstract:Background and Objectives: Body mass index (BMI) is widely used as a surrogate measure
of adiposity. The relationship between BMI and body fatness varies by race, sex, and age and
more variations have been found among children. This study investigated the relationship
between BMI and fat mass among 3-5 year old children having different nutritional status.
Methods and Study Design: A cross-sectional study was conducted in 15 daycare centers in
central Thailand. 137 healthy preschool children were recruited according to their nutritional
status: thin [BMI for age Z scores, (BAZ) < -2 SD], normal BMI (-2 SD ≤ BAZ ≤ +2 SD),
overweight/obese (BAZ > +2 SD), and stunted [height for age Z scores < -2 SD]. Fat-free
mass was determined by deuterium dilution technique. Fat mass (FM) in kilograms (TFM)
and in percentage (FM%), and fat mass index (FMI, FM/ht2) were calculated. Results: FM
and FMI were the highest in the overweight/obese groups. In the thin group, girls had higher
FMI compared to boys (3.2 vs 2.8 kg/m2, p<0.05). The relationship between BMI with FMI
and FM differed by nutritional status. BMI was more strongly associated with FMI, TFM,
and FM% in the overweight/obese (r=0.97, 0.95, 0.80, p<0.05) and the normal (r=0.88, 0.84,
0.68, p<0.05) groups than in the stunted group. There was no association in the thin group.
Conclusions: The inconsistency in the relationship between BMI and body fatness suggests
that BMI is appropriate for reflecting adiposity in normal and overweight/obese children, but
not undernourished preschool children.
Asia Pac J Clin Nutr. 2017;26(4):686-691.doi: 10.6133/apjcn.052016.02
>>Abstract
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Normal-weight central obesity is associated with metabolic
disorders in Chinese postmenopausal women
Author:Peng Ju Liu, Fang Ma, Hui Ping Lou, Yan Ning Zhu
Keywords:normal-weight obesity, waist-to-height ratio, metabolic disorder, metabolic syndrome, body mass index
Abstract:Background and Objectives: This cross-sectional study examined whether
normal-weight central obesity, defined as a high waist-to-height ratio (WHtR), is
associated with metabolic disorders in Chinese postmenopausal women. Methods
and Study Design: We recruited 634 community-dwelling postmenopausal women
with a normal body mass index (BMI) who participated in an annual health checkup.
Normal-weight obesity (NWO) was defined as a normal BMI and WHtR in the
highest tertile of the study population. The updated National Cholesterol Education
Program/Adult Treatment Panel III criteria were used to assess metabolic
abnormalities, and binary logistic regression models were employed to estimate the
associations between NWO and metabolic disorders. Results: The prevalence of each
metabolic disorder showed a graded increase (p<0.05) across the WHtR tertiles in the
study population. NWO was significantly associated with some non-adipose
components of metabolic syndrome (MetS) (p<0.05) after adjusting for age, smoking
status, drinking status, inflammatory markers, total cholesterol (TC), low-density
lipoprotein cholesterol (LDL-c), body fat percentage (BF%), and the remaining
non-adipose MetS components. Participants in the highest WHtR tertile had a higher
odds ratio [2.00 (1.19–3.33), p < 0.01] for the presence of at least two non-adipose
MetS components than those in the lowest tertile after adjusting for age, lifestyle
factors, inflammatory markers, TC, LDL-c, and BF%. Conclusions: NWO is
significantly associated with metabolic disorders, suggesting that a clinical assessment
of abdominal obesity indices should be conducted in postmenopausal women, even in
those with a normal BMI.
Asia Pac J Clin Nutr. 2017;26(4):692-697.doi: 10.6133/apjcn.052016.08
>>Abstract
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High consumption of salt-fermented vegetables and hypertension
risk in adults: a 12-year follow-up study
Author:Hong Ji Song, Seon-Joo Park, Dae Ja Jang, Dae Young Kwon, Hae-Jeung Lee
Keywords:salt, fermentation, vegetable, hypertension, cohort
Abstract:Background: The aim of this study was to investigate the causal relationship between high
consumption of salt-fermented vegetables and hypertension risk in adults. Methods: Data
came from the Korean Genome and Epidemiology Study, an ongoing community-based
cohort study that began in 2001. In the final analysis, a total of 5,932 participants (men=2,822,
women=3,110) was included. Daily energy, nutrient, and major salt-fermented vegetables for
Korean (kimchi) intakes were assessed using a semi-quantitative food frequency
questionnaire. Relative risks and 95% CIs associated with kimchi intake by gender and body
mass index (BMI) were estimated using the multivariate Cox proportional hazards regression
model. Results: Out of the 5,932 participants, 1,798 (905 men, 893 women) developed
hypertension during the 12-year follow-up period. A significant difference in baseline BMI
was shown between the non-hypertension and hypertension groups. There was no significant
difference with regard to the risk of developing hypertension across quintiles for total kimchi
intake and quartile or quartiles for specific kimchi intake in multivariate models by gender
and baseline BMI. The trend for increased risk of hypertension according to increasing
quartile of watery kimchi intake was significant for obese men in the multivariate model
(p<0.05). Conclusion: High consumption of salt-fermented vegetables was not shown to be
associated with increased risk of hypertension. The trend for increased risk of hypertension
according to increasing quartile of watery kimchi intake was significant only in obese men.
Asia Pac J Clin Nutr. 2017;26(4):698-707.doi: 10.6133/apjcn.042016.13
>>Abstract
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Bimodal distribution of fasting plasma glucose in the
Uyghur and Han populations of Xinjiang, China
Author:Haiying Gong, Lize Pa, Ke Wang, Hebuli Mu, Fen Dong,
Shengjiang Ya, Guodong Xu, Ning Tao, Li Pan, Bin Wang,
Shaoping Huang, Guangliang Shan
Keywords:bimodal distribution, fasting plasma glucose, diabetes, Uyghur population, Han population
Abstract:Background and Objectives: Bimodality in fasting plasma glucose (FPG)
distribution has been detected in several populations. However, information regarding
this phenomenon among Chinese ethnic groups is minimal. This study aimed to
describe and update the distribution of FPG in the Uyghur and Han populations of
Xinjiang, China, as well as to estimate the cut points of FPG on the basis of bimodal
distribution. Methods and Study Design: A cross-sectional study was performed
among the Uyghur and Han populations of Xinjiang, China in 2013. Questionnaire
survey and FPG tests were conducted among 5923 participants aged 20-80 years. We
fitted the unimodal and bimodal distributions into the FPG data by ethnicity, age,
gender, and location to test whether the FPG values were consistent with a bimodal
distribution. Results: The FPG distribution could be described as bimodal, except for
the age group of 50 years old and below among the Uyghur and Han populations and
the age group of 70-80 years old among the Uyghur population (p<0.01). However,
most of the cut points estimated using this method did not fall between the
corresponding means of the first and second modes. Conclusions: Although a
bimodal distribution of FPG was observed in the Uyghur and Han populations of
Xinjiang, China, the cut points estimated using this method were not biologically
meaningful, and thus, a bimodal distribution of FPG was not useful for defining cut
points to diagnose diabetes in Xinjiang.
Asia Pac J Clin Nutr. 2017;26(4):708-712.doi: 10.6133/apjcn.052016.07
>>Abstract
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Metabolic syndrome in Korean adolescents and young adult offspring and their parents
Author:Kayoung Lee
Keywords:metabolic syndrome, offspring, parent, sex, age
Abstract:Background and Objectives: Studies have investigated the associations between parental metabolic syndrome
(MetS) and offspring MetS. This study aimed to uncover parental-offspring associations for MetS and its components according to offspring sex and age. Methods and Study Design: A cross-sectional study in 1,403 fathers,
1,451 mothers, and 1,532 offspring (340 male and 404 female offspring aged 10-18 years; 283 male and 505 female offspring aged 19-25 years) using the Korea National Health and Nutrition Examination Survey data between 2010 and 2013. Results: All categorized MetS components in fathers and mothers were significantly associated with the same components in male offspring, while high WC, high TG, and low HDL in fathers and
mothers were associated with the same components in female offspring. The number of categorized MetS components which were significantly associated between parent-offspring pairs was greater in offspring aged 19-25
years than in those aged 10-18 years. All categorized MetS components were significantly associated between father-male offspring aged 19-25 years pairs, but not in other parent-offspring pairs. The MetSper se in fathers and
mothers was significantly associated with that in male offspring aged 10-18 years. Conclusions: There were differential associations according to offspring sex and age group and parent’s sex with respect to parental-offspring
associations for MetS and its individual components. The associations for MetS and its components were stronger
in young adult versus adolescent offspring, in male offspring versus female offspring.
Asia Pac J Clin Nutr. 2017;26(4):713-718.doi: 10.6133/apjcn.082016.02
>>Abstract
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Awareness of coeliac disease among chefs and cooks
depends on the level and place of training
diabetes assessed by continuous glucose monitoring
Author:Michael Schultz, Seong Shin, Kirsten J Coppell
Keywords:coeliac disease, gluten-free diet, quality of life, restaurants, chefs
Abstract:Background and Objectives: Coeliac disease is triggered by gluten. The only treatment is lifelong avoidance of dietary gluten. Dining out and travelling are particular challenges with a huge impact on quality of life. We exam-ined the knowledge about coeliac disease and gluten-free food preparation among chefs and cooks, and culinary students in Dunedin, New Zealand. Methods and Study Design: Outlets serving gluten-free food were identified. The head chefs or cooks were invited to complete a questionnaire regarding demographics, education, qualifica-tion, experience and knowledge of coeliac disease and gluten-free food preparation. Ninety restaurant chefs and cooks, and 35 first-year culinary students participated. Results: Half of participating chefs and cooks had re-ceived no formal training, but all were aware of the term gluten-free diet. Twelve (13%) were unaware of coeliac disease, all of whom were non-European and worked at an ethnic restaurant which did not have gluten-free poli-cies in place. There was no significant difference in awareness of coeliac disease between chefs and students (p=0.36). However, students were significantly more aware of necessary gluten-free food preparation (p=0.007) and scored better in the gluten-free quiz (p=0.01) than chefs and cooks. Conclusions: Awareness of coeliac dis-ease did not necessarily mean that policies were in place to prepare contamination-free gluten-free meals. Chefs and cooks from countries with a low incidence of coeliac disease lacked knowledge about gluten-free food prepa-ration and had difficulties recognising gluten containing foods. Patients with coeliac disease wanting to dine out should be advised to choose a restaurant with care
Asia Pac J Clin Nutr. 2017;26(4):719-724.doi: 10.6133/apjcn.072016.03
>>Abstract
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Associations of self-efficacy, social support, and knowledge with fruit and vegetable consumption in
Japanese workers
Author:Osamu Kushida, Yae Iriyama, Nobuko Murayama,
Toshiko Saito, Katsushi Yoshita
Keywords:fruit, vegetables, self-efficacy, social support, knowledge
Abstract:Background and Objectives: Previous studies have suggested that self-efficacy, social support, and knowledge are primary psychosocial predictors of dietary behavior in adults. The present study aimed to investigate the asso-ciations of self-efficacy, social support, and knowledge with fruit and vegetable consumption in Japanese workers. Methods and Study Design: From September to November 2014, a self-administered questionnaire was com-pleted by Japanese workers at 8 workplaces in Niigata, Japan. Self-efficacy and social support for fruit and vege-table consumption were measured using a 3-item Likert scale across particular situations. Knowledge was meas-ured using a single item about the recommended guidelines for fruit and vegetable consumption in Japan. Fruit and vegetable consumption was assessed using a validated, brief-type self-administered diet history questionnaire. Results: Of the 457 respondents, 395 participants’ data were analyzed. Scores in self-efficacy and social support showed a significant and positive association with fruit (p<0.001, p=0.002) and vegetable consumption (p=0.001, p=0.015). Knowledge was significantly and positively associated with vegetable consumption (p=0.015) but did not statistically differ in fruit consumption (p=0.645). Conclusions: The findings of this study suggest that self-efficacy and social support are positively associated with fruit and vegetable consumption in Japanese workers
Asia Pac J Clin Nutr. 2017;26(4):725-730.doi: 10.6133/apjcn.062016.06
>>Abstract
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Differences in health-related behaviors between middle
school, high school, and college students in Jiangsu
province, China
Author:Weina Liu, Mike Z He, Yunle Wang, Yan Wang, Yonglin Zhou, Ming Wu, Zhen Tang, Yue Dai, Baojun Yuan, Shiqi Zhen,
Lawrence J Cheskin
Keywords:diet, nutrition, pediatric obesity, screen time, China
Abstract:Background and Objectives: Increasing rates of obesity among Chinese adolescents has become a major public
health concern in recent years. Studies have shown that factors such as food choices, physical activity, and screen
time play important roles in fostering obesity. We examined a number of biological and social determinants that
influence these factors. To determine whether dietary behavior, physical activity, and screen time varied among
students in different stages of their education. Methods and Study Design: Students in 13 cities across Jiangsu
Province completed an anonymous survey assessing demographics and various health-related behaviors in a controlled
setting. The survey population ranged from middle school students to undergraduates. 55,361 surveys
were returned, and 46,611 (84.2%) were usable for the analysis. Multiple linear regression models were used to
investigate the relationship between four behavioral factors (dietary behavior, screen time, physical activity, and
moderate exercise) and seven predictors (gender, age, BMI, mother’s education, nearsightedness, allowance, and
geographic region). Results: Baseline characteristics of the survey population analyzed by education level (middle
school, high school, college and beyond) showed moderate differences in demographics among the three
groups. Physical activity, moderate exercise, and dietary behavior decreased with educational level, while screen
time increased. All predictors in the four considered regression models were statistically significant. Conclusions:
This unique, large-scale survey of Chinese students in a region of contrasting economic development revealed
numerous relationships between health-related diet and physical-activity, region, and education level. These findings
can inform the development of measures to counteract the rise of obesity in China.
Asia Pac J Clin Nutr. 2017;26(4):731-737.doi: 10.6133/apjcn.072016.06
>>Abstract
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Rising food accessibility contributed to the increasing dietarydiversity in rural and urban China
Author:Hui Wang, Chao Liu, Hong Fan, Xu Tian
Keywords:dietary diversity, food accessibility, China, urban, rural
Abstract:China has undergone a dramatic transition in food consumption in the past few
decades. Diet composition has changed significantly because of an increase in food
accessibility and lifestyle changes. To investigate dietary changes in China from the
perspective of dietary diversity, we assessed the trend of dietary diversity in China by
using the following 4 indicators: count index, dietary diversity score, entropy, and
Simpson index. Data of 24 542 adults (age ≥18 y) were obtained from the China
Health and Nutrition Survey (CHNS) conducted in 2004, 2006, 2009, and 2011.
Furthermore, the association between dietary diversity and the number of food
facilities was investigated using multivariable regression and local polynomial
regression. Results indicate that dietary diversity increased over time and was
unequally distributed among regions and families. Urban residents had a significantly
more diverse diet compared with their rural counterparts (p<0.01). Moreover, dietary
diversity was positively associated with food accessibility (p<0.01), and it was
affected by socioeconomic factors such as the family income, household size, gender,
age, education, and region. Taken together, these data suggest that the increase in
dietary diversity in China in the past decade can be partially attributed to the increase
in food accessibility.
Asia Pac J Clin Nutr. 2017;26(4):738-747.doi: 10.6133/apjcn.052016.03
>>Abstract
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