Dietary soybean isoflavones in Alzheimer’s disease prevention
Author:Yanhui Lu, Yu An, Chenyan Lv, Weiwei Ma, Yuandi Xi, Rong Xiao
Keywords:Alzheimer’s disease, soybean isoflavone, dietary, cognitive impairment, prevention
Abstract:Soybean isoflavone (SIF) is a type of polyphenol present extensively in legumes. Because of its unique chemical construction and the physiological activity of the phenolic hydroxyl group, SIF exhibits strong antioxidant activity in antioxidant and nonantioxidant enzyme systems. Genistein is the major isoflavone in soy foods, accounting for more than 50% of the isoflavone content. The health effects of soybean dietary isoflavones on humans have gained increased attention. Recent studies have suggested that SIF may alleviate neurodegenerative diseases such as Alzheimer’s disease (AD). Despite the comprehensive research on AD, effective treatments for AD are yet to be established. The early diagnosis and prevention of mild cognitive impairment (MCI) have become crucial for delaying AD development. Several dietary polyphenols have exerted cognitive effects on AD, and the appropriate intake of dietary SIF helps reduce the risk of AD. This study reviews the possible mechanisms of AD pathogenesis and their relationships with SIF intake; the results provide useful insights for AD prevention in the future
Asia Pac J Clin Nutr. 2018;27(5):946-954.doi: 10.6133/apjcn.052018.01
>>Abstract
>> Download PDF
Nutritional outcomes with radiotherapy for head and neck cancer: a before and after comparison of ‘best practice guidelines’ implementation
Author:Emily Jeffery, Pascale Young, Jill Sherriff
Keywords:head and neck cancer, dietetic counselling, malnutrition, nutrition support, radiotherapy
Abstract:Background and Objectives: Malnutrition is prevalent amongst people with head and neck cancer treated with radiotherapy and can result in reduced tolerance to treatment and increased hospital admissions. Current best-practice guidelines recommend weekly dietetic review during radiotherapy and fortnightly review for six weeks following radiotherapy to minimize weight loss. The primary aim of this study was to compare percent weight loss during radiotherapy before and after the implementation of weekly dietetic review. In the post-guideline implementation group we aimed to investigate factors associated with greater weight loss and describe weight changes 4-8 weeks post radiotherapy. Methods and Study Design: Adults with head and neck cancer who received dietetic input and curative intent radiotherapy were included. Data were collected via retrospective chart audit of records from the Nutrition and Dietetics department. Results: The analysis involved 142 people, 66% (n=94) of whom received dietetic input in the post-guideline implementation period. Mean weight loss was not different between the pre- and post-guideline implementation groups (5.9±6.34% vs -6.6±5.29%; p=0.477). In the post-guideline implementation group, advanced tumor stage and concurrent chemoradiation were associated with greater percent weight loss (p=0.006 and p<0.001, respectively). Mean weight loss increased by 1.9±4.96%, 4-8 weeks after radiotherapy (p=0.004). Conclusions: Percent weight loss during radiotherapy was not reduced following the implementation of weekly dietetic review. In the 4-8 weeks following radiotherapy, weight loss increased significantly over that between baseline and end of radiotherapy. Future research should explore and address the reasons why critical weight loss occurs despite improved access to dietetic care.
Asia Pac J Clin Nutr. 2018;27(5):955-961.doi: 10.6133/apjcn.122017.05
>>Abstract
>> Download PDF
Serum vitamin D decreases during chemotherapy: an Australian prospective cohort study
Author:Elizabeth A Isenring, Laisa Teleni, Richard J Woodman, Michael G Kimlin, Euan Walpole, Christos S Karapetis, Shawgi Shawgi, Ganessan Kichenadasse, Skye Marshall, Bogda Koczwara
Keywords:vitamin D, 25(OH) D, cancer, chemotherapy, breast cancer
Abstract:Background and Objectives: Vitamin D plays an important role in bone and muscle function, and cell proliferation. The impact of chemotherapy and associated behavioural changes such as fatigue and sun avoidance on vitamin D (25(OH) D) is unknown. This study aims to evaluate variations in serum vitamin D during chemotherapy and the predictive value of latitude, season and pre-existing vitamin D deficiency. Methods and Study Design: A 12-week prospective cohort study was conducted in chemotherapy-naïve patients in two Australian locations with different sun exposure. Vitamin D deficiency was defined as ≤25 nmol/L and insufficiency 26-50 nmol/L 25(OH) D. Demographics, chemotherapy regimen, nutritional status, sun exposure, geographic location, and season were collected at baseline, 6 and 12 weeks after commencing chemotherapy. Results: Eighty-five patients (μ55.3±13.4 years of age; 49% female) were recruited, 96% Caucasian. Fifty-four patients were treated with curative intent (mostly for breast [n=29] or colorectal [n=12] cancers). At baseline, 10 patients were vitamin D deficient and 33 were insufficient. Mean serum 25(OH) D (nmol/L) was higher at latitude -27.5o (Brisbane) than latitude -34.9o (Adelaide) (μ61.9±22.1 vs. μ42.2±19.2, p<0.001) and varied according to season (spring: μ46.9±20.3, summer: μ50.8±18.2, autumn: μ76.4±25.2, winter: μ36.5±15.7, p<0.001). Serum 25(OH) D decreased with chemotherapy (baseline: μ49.2±22.3, 6-weeks: μ40.9±19.0, 12-weeks: μ45.9±19.7, p=0.05), with a significant and more rapid decline in winter and autumn (p=0.03). Conclusions: Chemotherapy is associated with a decrease in serum vitamin D, particularly during winter and autumn. Investigations into the underlying mechanism and associated potential outcomes with this decrease requires further investigation.
Asia Pac J Clin Nutr. 2018;27(5):962-967.doi: 10.6133/apjcn.042018.01
>>Abstract
>> Download PDF
Fasting leads to fasting: examining the relationships between perioperative fasting times and fasting for symptoms in patients undergoing elective abdominal surgery
Author:Erica Tsang, Eva Lambert, Sharon Carey
Keywords:fasting, perioperative care, elective surgical procedures, malnutrition, enhanced recovery
Abstract:Background and Objectives: A growing body of evidence indicates traditional perioperative care practices of extended fasting and delayed feeding are outdated and detrimental to patient prognosis. This study aimed to explore associations between perioperative fasting, progression to solids and fasting for symptoms; assessing whether excessive pre-operative fasting results in further fasting post-operatively. Methods and Study Design: Two hundred patients who underwent elective surgery from March 2015 to June 2015 in upper gastrointestinal, colorectal and urological departments of a major teaching hospital were included in the study. A retrospective medical record audit was conducted to determine patient demographics, clinical data, perioperative fasting times and diet progression. Results: Preoperative fasting significantly correlated with time taken to progress to solids (rs(198)=0.180, p=0.011), but not with postoperative fasting. Patients who experienced subsequent fasting episodes for symptom management had a significantly longer postoperative fasting time (Med=25.5 hours +/- 19.7) than those who did not (Med=6.2 hours +/- 38.7, p=0.025). Significant differences in fasting times and diet progression were found based on Enhanced Recovery After Surgery (ERAS) status, magnitude of surgery, surgical department, and morning versus afternoon operating lists. Conclusions: Associations between extended perioperative fasting times, diet progression, and fasting for symptoms exist, such that the adverse effects of suboptimal nutritional status on recovery may be traced back to before the patient even arrives for surgery. Challenges of reducing fasting times may be overcome with repeated training of clinicians with best practice guidelines, and improving postoperative adherence to ERAS protocols.
Asia Pac J Clin Nutr. 2018;27(5):968-974.doi: 10.6133/apjcn.042018.04
>>Abstract
>> Download PDF
Safety and benefit of pre-operative oral carbohydrate in infants: A multi-center study in China
Author:Weiwei Jiang, Xiang Liu, Fengli Liu, Shungen Huang, Jie Yuan, Yingzuo Shi, Huan Chen, Jie Zhang, Changgui Lu, Wei Li, Qiming Geng, Xiaoqun Xu, Weibing Tang
Keywords:enhanced recovery after surgery, preoperative oral carbohydrate, infants, blood glucose, gastric residual
Abstract:Background and Objectives: Pre-operative oral carbohydrate administration (POCA) is an important aspect of enhanced recovery after surgery and has many advantages. The objective of this study was to explore the safety and effect of pre-operative oral carbohydrate administration in infants. Methods and Study Design: This was a prospective, multi-center, randomized study that randomly assigned 1200 infants into four groups. In the control group (group A), the infants were strictly restricted to 6-h preoperative fasting before anesthesia. In the enhanced recovery after surgery (ERAS) groups (groups B, C, and D), the infants were orally administered a 10% carbohydrate solution (10% glucose water; 5, 10, and 15 mL/kg, respectively) 2 h before anesthesia. Blood glucose, gastric residual volumes, crying ratios, and the length of hospital stay were observed. Results: The blood glucose was significantly higher in groups B, C, and D than group A at the time of anesthesia. The gastric residual volume revealed virtually no residue in groups A, B, and C, but 15 infants in group D had a gastric residual volume. The crying ratio was significantly higher in group A. The length of hospital stay was not significantly different between the groups. Conclusions: POCA is welltolerated in infants at a dose of 10 mL/kg.
Asia Pac J Clin Nutr. 2018;27(5):975-979.doi: 10.6133/apjcn.052018.08
>>Abstract
>> Download PDF
Prevalence of undernutrition in Japanese pediatric patients on admission: Comparison of tertiary, acute-care, and rehabilitation hospitals
Author:Yukiko Maegawa, Yuma Konishi, Masaru Kubota, Yuka Kawate, Yoshihiro Wakazono, Katsutsugu Umeda, Chiharu Kawaguchi
Keywords:undernutrition, hospitalized children, BMI, Waterflow classification, albumin
Abstract:Background and Objectives: There exist many studies in Western countries dealing with pediatric nutritional assessment on admission, but those in Asian countries are comparatively limited. This study aimed at clarifying the prevalence of undernutrition in 3 Japanese pediatric hospitals, especially focusing on their different characteristics. Methods and Study Design: Study participants included 313 patients aged 1–17 years admitted to a tertiary hospital (175 patients), an acute-care hospital (99 patients), or a rehabilitation hospital (39 patients). On admission, body height, weight, and serum albumin were measured. BMI was calculated by dividing the weight (kg) by the square of height (m). Patients exhibited undernutrition on account of BMI z-score <−2, weight-for-height (W/H) <90%, height-for-age (H/A) <95%, or albumin <3.5 g/dL. Results: The overall prevalence of undernutrition was 53.0%. Among 4 nutritional measures, the prevalence was highest in H/A (33.9%), followed by W/H (26.8%), BMI z-score (17.6%) and albumin (12.8%). A rehabilitation hospital exhibited significantly higher prevalence than that in a tertiary- or acute-care hospital. By the classification of International Statistical Classification of Diseases and Related Health Problems-10, neurological diseases and congenital anomalies showed higher prevalence among the disease categories which had the number of enrolled patients more than twenty. Conclusions: This study indicates that hospital characteristics and inpatient disease categories are important in the admission evaluation of the likelihood of undernutrition. These observations require consideration by hospital physicians in paediatric nutritional diagnosis and management.
Asia Pac J Clin Nutr. 2018;27(5):980-985.doi: 10.6133/apjcn.042018.03
>>Abstract
>> Download PDF
Prevalence and associated risk factors of malnutrition among hospitalized adults in a multisite study in Ho Chi Minh city Viet Nam
Author:Tran Quoc Cuong MSc1,2, Merrilyn Banks PhD1,3, Mary Hannan-Jones, Do Thi Ngoc Diep, Danielle Gallegos
Keywords:malnutrition, hospital, SGA, Viet Nam, prevalence
Abstract:Background and Objectives: This study aims to assess the prevalence and associated risk factors of malnutrition in adults in acute care settings. Methods and Study Design: A crosssectional study among 883 participants from 6 representative general public hospitals was conducted during April and May 2016. Participants were considered malnourished if they were classified using Subjective Global Assessment (SGA) as malnourished (B or C) or with BMI < 18.5kg/m2. Demographic and socio-economic status characteristics were measured using interviewer-administered questionnaires. Sampling weights for the number of participants in each hospital were calculated to account for the difference in the stratified cluster sampling design. Logistic regression was used to examine the association of malnutrition with potential risk factors. Results: The prevalence of underweight (BMI <18.5 kg/m2) and hospital malnutrition (B/C on SGA or BMI <18.5 kg/m2) in acute care setting was 14.0% and 34.1%. The prevalence was higher in participants over 80 years old (49.7%), attending a Level 1 hospital (37.1%), with an oncology (46.5%) or pulmonary (43.6%) diagnosis. The risk of being malnourished was statistically significantly higher among participants who were living in poverty (OR:1.6), were living in marginal poverty (OR:1.3), did not work in the last six months (OR:1.7), had a length of stay over 10 days (OR:1.6) and were admitted via emergency (OR:1.5). Conclusions: Hospital malnutrition is a significant health problem in Ho Chi Minh City. Socio-economic status and pre-admission underweight were significant risk factors besides other clinical risk factors. Improvement of nutrition and dietetics services is crucial to optimize patient outcomes.
Asia Pac J Clin Nutr. 2018;27(5):986-995.doi: 10.6133/apjcn.042018.07
>>Abstract
>> Download PDF
Prognostic nutritional index relevance in chemoradiotherapy for advanced oral cavity, oropharyngeal and hypopharyngeal cancer
Author:Pei-Hung Chang, Jason Chia-Hsun Hsieh, Kun-Yun Yeh, Eric Yen-Chao Chen, Shih-Wei Yang, Jen-Seng Huang, Chien-Hong Lai, Tsung-Han Wu, Yen-Min Huang, Yueh-Shih Chang, Wen-Chi Chou, Cheng-Hsu Wang
Keywords:prognostic nutritional index, head and neck cancer, chemoradiotherapy, toxicities, malnutrition
Abstract:Background and Objectives: This study was designed to evaluate the impact of the prognostic nutritional index (PNI) on treatment-related toxicities and tolerance in patients with advanced head and neck cancers who were undergoing concurrent chemoradiotherapy (CCRT). Methods and Study Design: We retrospectively analyzed and compared the clinical characteristic, toxicities and survival of 143 patients with stage III, IVA, and IVB head and neck cancer who were treated with CCRT according to their PNI between 2007 and 2010. Results: Low PNI was correlated with T classification and advanced tumor stage. Patients with low PNI were less likely to tolerate CCRT, required tube feeding support more frequently and had higher percentages of grade 3/4 hematological toxicities, sepsis and toxic death. Conclusions: Pretreatment PNI predicts treatment-tolerance and toxicity in patients with advanced head and neck cancer undergoing CCRT.
Asia Pac J Clin Nutr. 2018;27(5):996-1001.doi: 10.6133/apjcn.032018.04
>>Abstract
>> Download PDF
HDL subfraction changes with a low-fat, plant-based Complete Health Improvement Program (CHIP)
Author:Lillian M Kent, Ross S Grant, Greg Watts, Darren P Morton, Paul M Rankin, Ewan J Ward
Keywords: HDL subfractions, CHIP, diet, CVD risk, behaviour
Abstract:Background and Objectives: Low HDL concentrations are considered an important risk factor for cardiovascular disease. Interventions promoting a low-fat, plant-based eating pattern appear to reduce CVD risk while paradoxically also reducing HDL concentrations. Recent studies show HDL to comprise a range of subfractions, but the role these play in ameliorating the risk of CVD is unclear. The purpose of this study was to characterize changes in HDL subfractions in participants where HDL decreased following the CHIP intervention which promotes a low-fat, plant-based diet, with physical activity. Methods and Study Design: Individuals (n=22; mean age=55.4±16.3 years; 45.5% men, 54.5% women) participating in a CHIP intervention were assessed at baseline and 30 days for changes in BMI, blood pressure, lipid profile, (including large-, intermediate- and small-HDL subfractions) and fasting glucose. Results: HDL significantly decreased (10.6%, p<0.001) together with BMI (2.5%, p=0.028), systolic blood pressure (7.1%, p=-0.005), total cholesterol (9.5%, p=0.002), LDL (11.2%, p=0.007) and fasting glucose (8.2%, p=0.028). Triglycerides did not significantly change. Physical activity (22.7%, p=0.016) and consumption of whole plant-foods (13.9%, p=0.003) significantly increased, while non-plant (energy and animal) foods decreased (43.1%, p=0.009). Large-, intermediate- and small-HDL decreased (-10.0%, p=0.003; -8.3%, p=0.013 and 22%, p=0.005, respectively). Conclusions: This paper discusses specific changes in HDL subfractions when overall-HDL decreases as a response to low fat, whole-food, plant-based eating and exercise. Additional research is required to elucidate the reasons through which behavioural therapies remodel the HDL particle and how this impacts the functional properties of HDL and CVD risk.
Asia Pac J Clin Nutr. 2018;27(5):1002-1009.doi: 10.6133/apjcn.052018.05
>>Abstract
>> Download PDF
Prolonged effectiveness of 12-month exercise-plus-diet intervention in Japanese adults at risk of impaired glucose or lipid metabolism
Author:Tomoko Nishida, Kiyoshi Shimaoka, Shigeki Tsuzuku, Kazumasa Igura, Hisataka Sakakibara
Keywords:intervention study, diet, exercise, prolonged effects, Japanese adults
Abstract:Background and Objectives: To investigate the prolonged effects of a 12-month exerciseplus-diet intervention in Japanese adults at risk of impaired glucose or lipid metabolism. Methods and Study Design: A total of 180 participants were randomly divided into an intervention group (n=94), and a control group (n=86). An exercise-plus-diet intervention was conducted on the intervention group for 12 months. The effects were evaluated by questionnaire, physical examinations, and blood tests at baseline, 3 months, 12 months (the end of intervention), and 24 months (one year after the end of intervention). The control group took only the same examinations as the intervention group. Results: At the end of the 12-month intervention, body weight, waist circumference, fasting glucose, HbA1c, triglycerides, and LDL-cholesterol were improved in the intervention group compared to the control group (all p<0.05). One year after the end of the intervention, body weight, waist circumference, fasting glucose, triglycerides, and LDL-cholesterol were still decreased in the intervention group compared to the control group (all p<0.05), especially among nonoverweight participants. Among overweight persons, only body weight in the intervention group was lower than the control group. The personal behaviours of physical activity and diet in the intervention group were also improved. Conclusions: The 12-month exercise-plusdiet programs were found to be effective in improving glucose and lipid metabolism, as well as personal behaviour one year after completion of the intervention.
Asia Pac J Clin Nutr. 2018;27(5):1010-1017.doi: 10.6133/apjcn.052018.06
>>Abstract
>> Download PDF
Dietary education with customised dishware and food supplements can reduce frailty and improve mental well-being in elderly people: a single-blind randomized controlled study
Author:Szu-Yun Wu, Li-Lin Hsu, Chih-Cheng Hsu, Tsung-Jen Hsieh, Shin-Chang Su, Ya-Wen Peng, Tsam-Ming Guo, Yaw-Wen Kang, Wen-Harn Pan
Keywords:frailty, nutrition education, customised dishware, Daily Food Guide, multiple dietary components
Abstract:Background and Objectives: The elderly population is increasing rapidly worldwide, and frailty is a common geriatric syndrome. Comprehensive dietary management strategies may have beneficial effects on frailty prevention and reversal. This 3-month single-blind, paralleled, randomized controlled trial compared the effects of micronutrients and/or protein supplements, and a personalised diet on frailty status in elderly individuals. Methods and Study Design: Between 2014 and 2015, 40 prefrail or frail subjects aged ≥65 years were recruited at Miaoli General Hospital, Taiwan. Of these, 37 completed the study, and 36 were included in the analysis. Participants were randomly assigned to one of four treatment groups: (1) the control (2) multiple micronutrient supplements, (3) multiple micronutrients plus isolated soy protein supplement, and (4) individualised nutrition education with customised dishware and food supplements (mixed nuts and skimmed milk powder). Dietary intake, protein biomarkers, frailty score, and geriatric depression score were assessed. Results: Individualised nutrition education with customised dishware and food supplements significantly increased the participants’ intake of vegetables, dairy, and nuts, in addition to increasing the concentration of urinary urea nitrogen. It yielded a significant reduction in frailty score (p<0.05) and a borderline reduction (p=0.063) in geriatric depression score. No significant beneficial changes were observed for the other two intervention groups. Conclusions: Our study indicated that a dietary approach with easy-to-comprehend dishware and food supplements to optimize the distribution of the consumption of six food groups improved frailty status and, potentially, psychological well-being in elderly people
Asia Pac J Clin Nutr. 2018;27(5):1018-1030.doi: 10.6133/apjcn.032018.02
>>Abstract
>> Download PDF
Pro-and prebiotic effects on oxidative stress and inflammatory markers in non-alcoholic fatty liver disease
Author:Leila Javadi, Manouchehr Khoshbaten, Abdolrasoul Safaiyan, Mostafa Gha-vami, Mehran Mesgari Abbasi, Bahram Pourghassem Gargari
Keywords:prebiotic, probiotic, oxidative stress, inflammatory markers, liver diseases
Abstract:Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is related to inflammation and oxidative stress. Probiotics and prebiotics are considered anti-inflammatory and antioxidative factors. In this study, we evaluated the effects of probiotic and/or prebiotic on oxidative stress and inflamma-tory markers in patients with NAFLD. Methods and Study Design: Seventy-five NAFLD subjects were divided into four groups. The first group received a pro-biotic capsule of Bifidobacterium longum (B.L) and Lactobacillus acidophilus (L.A) (2 × 107 CFU/day), the second group received prebiotic (10g/day inulin), the third group received pro-biotic and prebiotic, and the fourth group received placebo, for three months. Anthropometric, inflammatory and oxidative/anti-oxidative indices were measured in all patients before and after the intervention. Results: We showed that consumption of pro- and/or prebiotic compared to placebo is able to significantly decrease body weight, body mass index, waist and hip circumferences, tumour necrosis factor-α and increase serum levels of total antioxidant capacity in patients with NAFLD (p<0.01). There were not any significant differences between probiotic, prebiotic and co-administration of them on the mentioned parameters. Co-administration of pro- and prebiotic caused significant decrease of high-sensitive C-reactive protein (hs-CRP) compared to the placebo and other groups (p<0.01). Interlekin-6 and malondialdehyde were not significantly different among groups at the end of study. Conclusions: Probiotic or/and prebiotic supplementation can be effective for improvement of some anthropometric, inflammatory and oxidative indices in patients with NAFLD. Co-administration of pro- and prebiotic is more effective than probiotic and prebiotic alone in modifying hs-CRP in patients with NAFLD.
Asia Pac J Clin Nutr. 2018;27(5):1031-1039.doi: 10.6133/apjcn.042018.05
>>Abstract
>> Download PDF
The influence of diet and behaviour on metabolic syndrome and the prevalence of metabolic syndrome according to different definitions in west China
Author:Xinyin Xu, Xianping Wu, Ying Deng, Kui Ji, Yichong Li, Xiaohua Liang, Xiaofang Chen, Jing Zeng, Zhuo Wang, Guanghui Yi, Jinyao Chen and Lishi Zhang
Keywords:sedentary, smoking, dietary, prevalence and influencing factors, metabolic syndrome
Abstract:Background and Objectives: This study investigated the updated prevalence of metabolic syndrome among adults in West China and the influence of diet and behaviour on metabolic syndrome. Methods and Study Design: A cross-sectional survey was conducted from 20132014, and multi-stage stratified clustering sampling was applied in 12 counties of Sichuan province. Data regarding metabolic syndrome and style risk factors were collected through interviewer-administered questionnaires, and physical measurements were recorded following a standardized protocol. Logistic regression models were used to explore the association between metabolic syndrome and its risk factors. Results: A total of 7,131 adults participated. The prevalence of metabolic syndrome was 16.9% and 23.8% according to the International Diabetes Federation criteria and the consensus definition, respectively. The International Diabetes Federation criteria failed to identify 28.8% of the participants identified by the consensus definition. The odds ratios (ORs) of suffering from Metabolic syndrome in people eating pork every week compared with at lower frequencies, people eating more than 100 g of red meat/day, people with more sedentary behaviour per day, and people consuming at least 20 cigarettes/day were 1.76 (1.09-2.84), 1.28 (1.01-1.62), 1.03 (0.99-1.07), and 1.46 (1.121.92), respectively, according to the consensus definition, and 1.51 (1.09-2.10), 1.4 (1.141.72), 1.07 (1.02-1.13), and 1.5 (1.16-1.94), respectively, based on the International Diabetes Federation criteria. Conclusions: The International Diabetes Federation criteria were less sensitive in identifying metabolic syndrome than the consensus definition. More sedentary behaviour, smoking ≥20 cigarettes per day, and a higher frequency of pork intake increased the risk of metabolic syndrome in this study.
Asia Pac J Clin Nutr. 2018;27(5):1040-1047.doi: 10.6133/apjcn.122017.06
>>Abstract
>> Download PDF
Dietary pattern and its association with blood pressure and blood lipid profiles among Japanese adults in the 2012 Japan National Health and Nutrition Survey
Author:Nay Chi Htun, Hitomi Suga, Shino Imai, Wakana Shimizu, Kazuko Ishikawa-Takata, Hidemi Takimoto
Keywords:dietary pattern, blood pressure, blood lipid profiles, Japanese, National Health and Nutrition Survey
Abstract:Background and Objectives: Little is known about the association between dietary patterns and cardiovascular disease risk factors among Japanese adults based on nationally representative data. This study aimed to explore the association between dietary patterns and hypertension or blood lipid profiles among Japanese people. Methods and Study Design: De-identified Japan National Health and Nutrition Survey (NHNS) 2012 data with a total of 8721 subjects (3524 men and 5197 women) aged 40-74 years were used. Dietary patterns were derived by principal component analysis (PCA). Generalized linear models and multivariate logistic regression analysis were used to assess the relationship between dietary patterns and blood pressure or lipid profiles. Results: We identified four dietary patterns: (a) traditional Japanese, (b) bread-dairy, (c) meat-fat, and (d) noodle patterns. Among these, the traditional Japanese pattern was significantly related to lower blood pressure, lower low-density lipoprotein (LDL)-cholesterol in men and lower high-density lipoprotein (HDL)-cholesterol in women. Bread-dairy pattern was associated with high total cholesterol in women and higher LDL cholesterol in both men and women. Noodle pattern was associated with higher total cholesterol and HDL-cholesterol in men. No significant association was observed between meat-fat pattern and blood pressure or lipid profiles. Conclusions: Our study showed that the traditional Japanese pattern with high intake of miso, soy-sauce, vegetables, beans, potatoes and mushroom conferred benefits on blood pressure. Our findings have indicated clearly that it is possible to provide useful information on healthy dietary pattern for health promotion from the one-day dietary records of the NHNS.
Asia Pac J Clin Nutr. 2018;27(5):1048-1061.doi: 10.6133/apjcn.072018.04
>>Abstract
>> Download PDF
Association between bone mineral density, muscle volume, walking ability, and geriatric nutritional risk index in hemodialysis patients
Author:Hiroyuki Tominaga, Manei Oku, Yoshiya Arishima, Toru Ikeda, Yasuhiro Ishidou, Satoshi Nagano, Masato Minami, Akio Ido, Setsuro Komiya, Takao Setoguchi
Keywords:hemodialysis, lean mass index (LMI), geriatric nutritional risk index (GNRI), bone mineral density (BMD), sarcopenia
Abstract:Background and Objectives: Hemodialysis patients are at risk for bone loss and sarcopenia, characterized by reduced muscle mass and limited mobility/function. Osteoporosis and sarcopenia both increase the risk of hospitalization and death in affected individuals. Malnutrition also occurs as a complication of hemodialysis and has been identified as a risk factor for osteoporosis and sarcopenia. In this study, we examined the relationship between osteoporosis, muscle volume, walking ability, and malnutrition in hemodialysis patients. Methods and Study Design: Forty-five hemodialysis patients were evaluated. Bone mineral density (BMD) and muscle volume were measured by dual-energy X-ray absorptiometry. Muscle volume and strength were evaluated using lean mass index (LMI), handgrip strength, and walking ability. The time required for a patient to walk 10 meters was measured to evaluate walking ability. The geriatric nutritional risk index (GNRI) was used to assess malnutrition. Results: Multiple linear regression analysis showed that older age, female sex, lower LMI, and higher total type I procollagen N-terminal propeptide were correlated with lower BMD of lumbar spine. Higher age and lower LMI were correlated with lower BMD of the femoral neck. Female sex and lower GNRI were correlated with lower LMI. Longer duration of hemodialysis was correlated with lower walking ability. Conclusions: Our findings suggest that muscle preservation is required to maintain both lumbar spine and femoral neck BMD. Similarly, nutritional management is necessary to maintain BMD via preservation of muscle volume. Complementary nutritional therapies are needed to improve osteoporosis and sarcopenia in high-risk hemodialysis patients
Asia Pac J Clin Nutr. 2018;27(5):1062-1066.doi: 10.6133/apjcn.052018.03
>>Abstract
>> Download PDF
Untargeted metabolomics approach (UPLC-Q-TOF-MS) explores the biomarkers of serum and urine in overweight/obese young men
Author:Hai-Tao Yu, Xiao-Yi Fu, Bin Xu, Li-li Zuo, Hong-Bo Ma, Shu-Ran Wang
Keywords:overweight/obese, metabolomics, biomarkers, serum, urine, microbiomics
Abstract:Background and Objectives: Obesity is linked to metabolic diseases characterized by insulin resistance, such as diabetes and cardiovascular disease. In this study, we investigated the metabolic disorders of uncomplicated obesity to identify early alterations in biological systems. Methods and Study Design: Metabolic differences between overweight/obese (n=36) and normal-weight (n=35) young Chinese men without known metabolic disorders were assessed. Metabolic profiling of the serum and urine was performed using ultraperformance liquid-chromatography quadrupole-time-of-flight mass spectrometry (UPLC-QTOF-MS). Partial least squares discriminant analysis (PLS-DA) was undertaken to reveal and classify the differences between the two groups. Results: Compared to normal-weight men, obese men had higher levels of the serum metabolites phenylalanine, Phe-Phe, and Ltryptophan were greater increased, whereas those of p-cresol sulfate and p-cresol were less with obesity. Urinary metabolites phenylacetamide, L-glutamine, phenylacetylglutamine, indoxyl sulfate, p-cresol, and p-cresol sulfate were greater in obese men. Conclusions: These findings indicate that disorders involving aromatic amino acids and the tricarboxylic acid cycle (TCA) have microbiomic involvement in the uncomplicated phase of obesity
Asia Pac J Clin Nutr. 2018;27(5):1067-1076.doi: 10.6133/apjcn.052018.07
>>Abstract
>> Download PDF
Effect of increasing protein content at the evening meal followed by exercise on overnight nocturnal total energy expenditure, fat and carbohydrate oxidation in healthy young Indian men
Author:Rose Babu, Rebecca Kuriyan, Tinku Thomas, Sucharita S, Anura V Kurpad
Keywords:exercise, protein meal, fat oxidation, energy expenditure, indirect calorimetry
Abstract:Background and Objectives: Indians are more prone to develop diabetes at a younger age, with normal BMI, and this might partly be due to their higher body fat content. Increase in fat mass in the body might be because of the reduction in fat oxidizing capability. Given the fact that Indians consume high carbohydrate diets, effective fat oxidation is likely to be delayed. Simple preventive weight loss strategies like exercise or change in diet regimen are needed to reduce their body fat. This study investigated the effect of exercise with a high protein dinner on overnight thermogenesis and fat oxidation. Methods and Study Design: Nine healthy normal subjects aged 18 – 30 years participated in randomised cross over study. They underwent 6 sessions of overnight whole body indirect calorimetry on separate nights with the following experimental conditions: (i) standard (habitual) meal (ii) standard meal with exercise (iii) 20% protein meal (iv) 20% protein meal with exercise (v) 50% protein meal and (vi) 50% protein meal with exercise. Oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured overnight, from which energy expenditure, non-protein respiratory quotient (RQ), and fat oxidation were estimated. Results: The estimated marginal means of fat oxidation and energy expenditure were significantly different for protocols with exercise compared to those without exercise (p=0.02). There was no acute effect of protein on nocturnal fat or carbohydrate oxidation, with or without exercise. Conclusions: Post-dinner exercise increase nocturnal fat oxidation and energy expenditure in young active Indian men.
Asia Pac J Clin Nutr. 2018;27(5):1077-1083.doi: 10.6133/apjcn.052018.04
>>Abstract
>> Download PDF
Several problem nutrients are identified in the complementary diet of 6 to 11 month old breastfed children in Western Guatemala
Author:Marieke Vossenaar, Ilse van Beusekom, Jeniece Alvey, Colleen M. Doak, Noel W. Solomons
Keywords:breastmilk, complementary feeding, infant feeding, micronutrient intake, Guatemala
Abstract:Background and Objectives: The failure of infants in developing countries to meet nutrient intake recommendations is well documented. The objective of this study was to assess the nutritional adequacy and identify problem nutrients of the diets of Guatemalan infants with continued breastfeeding. Methods and Study Design: A single previous-day dietary recall was collected from a convenience sample of mothers of 94 infants aged 6-11 mo attending a public health clinic in the urban area of Quetzaltenango, Guatemala. Energy and nutrient content of complementary feeding (CF) and breastmilk, modelled by subtracting estimated energy intakes from CF from energy requirements, were calculated and nutrient adequacy of the diet was assessed. Nutrient densities and critical nutrient densities of CF were computed to identify “problem nutrients” and main food sources of these nutrients were identified. Results: Complementary diets were adequate for protein, but inadequate for pantothenic acid and vitamins C, A, D, E, and K, as well as calcium, iron and zinc. In the worst-case scenario, i.e. for small girls with limited energy allowances, riboflavin, niacin, vitamin B6 and magnesium were identified as “problem nutrients” as well. Formula milk, cow milk and Incaparina® were main food sources of “problem nutrients”. Conclusions: The intake of micronutrients during the first six months of the recommend CF period in Guatemala has a number of notable inadequacies, but the gaps are narrower than traditionally reported for this age group in low-income settings.
Asia Pac J Clin Nutr. 2018;27(5):1084-1094.doi: 10.6133/apjcn.042018.08
>>Abstract
>> Download PDF
A dietary and nutritional status survey among young children in five big cities of China
Author:Tao Li, Jacques G Bindels, Shuaiming Zhang, Zangwen Tan, Ni Jia, Aihua Liu, Zonghan Zhu, Yaohua Dai
Keywords:nutrition, complementary foods, breastfeeding, dietary recall, China
Abstract:Background and Objectives: To investigate the dietary patterns and nutritional status of young children living in urban environments in China. Methods and Study Design: A crosssectional study was conducted of 750 children aged 6 - 35 months living in 5 large cities in China. The survey methodology included a physical examination, blood hemoglobin measurements and a 24 hour dietary recall questionnaire. Results: The educational level of participant mothers was high (79% had attended college or university or higher), which may not be fully representative across all areas of urban China. Overall anthropometric nutritional status indicators were within acceptable ranges based on national recommendations, and there was no evidence of severe micronutrient deficiencies. However, we identified three significant nutritional issues that warrant attention: 1.) Later than optimal introduction and low-intake of animal-based iron-containing foods into the diet, and a need for greater inclusion of vitamin B-1 rich foods among 12-35 month old children. 2.) Presence of significant rates of anemia in 6 - 11 and 12 - 23 month old children. 3.) An increased risk of overweight/obesity. Conclusions: Since food availability and affordability are no longer major issues in the well developed parts of urban China, achieving further improvements in the diet and nutrition of young children in these environments is likely require more specific education to parents and other significant carers such as grandparents. The relatively high educational level and socio-economic status of the population group is likely to facilitate the uptake of such measures in this population group.
Asia Pac J Clin Nutr. 2018;27(5):1095-1105.doi: 10.6133/apjcn.122017.01
>>Abstract
>> Download PDF
Analysis of dietary trends in Chinese adolescents
from 1991 to 2011
Author:Alice Yunzi L Yu, Nancy López-Olmedo, Barry M Popkin
Keywords:nutrition transition, China, adolescents, dietary trends, urbanicity
Abstract:Background and Objectives: To examine temporal trends in dietary energy, fat, carbohydrate, protein, sodium and potassium intake of Chinese adolescents aged 12 – 17 years by sex and urbanicity, using data from the China Health and Nutrition Survey. Methods and Study Design: Individual level, consecutive 3 – day 24-hour recalls were analyzed from survey years 1991 (n=504), 2000 (n=665), and 2011 (n=267) from nine provinces representing a range of geography, economic development, and health indicators in China. Linear multivariable regression models were conducted to predict mean intakes of energy, macronutrients, sodium, and potassium. Models were adjusted for age, per capita income, parental education, region, and family size. Results: From 1991 to 2011, total energy consumption decreased among both sexes and all urbanicity groups (p<0.05). Sodium intake decreased in all sex and urbanicity groups except the high urbanicity group, which was the only group to show significant change in potassium intake (p<0.05). Sodium-potassium ratios decreased overall and across both sexes (p<0.05). However, the major observed shift was a structural change from carbohydrates to fat and protein. Both sexes showed decrease in carbohydrate-derived energy (p<0.05). Proportion of fat-derived energy increased in female, and proportion of protein-derived energy increased in male adolescents, as well as the low and high urbanicity groups (p<0.01). Conclusions: This suggests Chinese adolescents are transitioning to a low carbohydrate diet. Urbanicity appears to play a role in sodium, potassium and protein intake. Improvements of sodium-potassium ratios are primarily due to decreased sodium intake and require further reduction efforts.
Asia Pac J Clin Nutr. 2018;27(5):1106-1119.doi: 10.6133/apjcn.042018.02
>>Abstract
>> Download PDF
Dietary patterns among Japanese adults: findings from the National Health and Nutrition Survey, 2012
Author:Emiko Okada, Kunihiko Takahashi, Hidemi Takimoto, Saeka Takabayashi, Tomoko Kishi, Tohru Koba yashi, Koshi Nakamura, Shigekazu Ukawa, Mieko Nakamura, Satoshi Sasaki, Akiko Tamakoshi
Keywords:dietary patterns, dietary habits, factor analysis, National Health and Nutrition Survey, Japanese
Abstract:Background and Objectives: Recent studies have analyzed dietary patterns to assess overall dietary habits, but there have been no studies of dietary patterns among the contemporary Japanese population nationwide. The objective of this study was to identify dietary patterns based on consumption of food items among Japanese adults, and to examine whether these dietary patterns were associated with nutrient intake, demographic characteristics, and lifestyle factors. Methods and Study Design: The study population included 25,754 Japanese adults aged 20 years and older registered in the nationwide National Health and Nutrition Survey database in 2012. Dietary patterns were analyzed by factor analysis of 29 food items from the dietary intake survey and household-based semi-weighed dietary records. Results: Five dietary patterns were identified: high-bread and low-rice, high-meat and low-fish, vegetable, wheat-based food, and noodle and alcohol patterns. The lowest quartile of factor scores for high-meat and low-fish, wheat-based food, and noodle and alcohol patterns had higher nutrient intakes, and the highest quartile of factor scores for the vegetable pattern had a higher nutrient intake overall (all p<0.01). Dietary pattern scores were associated with demographic and lifestyle factors such as sex, age, region, smoking status, and alcohol intake. Conclusions: Five major dietary patterns among Japanese adults were identified by factor analysis. Dietary pattern scores were associated with differences in nutrient intakes and demographic and lifestyle factors. These patterns were further used for examining the association between Japanese diets and health outcomes.
Asia Pac J Clin Nutr. 2018;27(5):1120-1130.doi: 10.6133/apjcn.042018.06
>>Abstract
>> Download PDF
Association between metabolic syndrome and coffee
consumption in the Korean population by gender: a
cross-sectional study in Korea
Author:Jeong-Hyeon Kim, Yong Soon Park, Hyoeun Kim,
Keywords: coffee, dose-response relationship, healthy lifestyle, KNHANES,
metabolic syndrome X
Abstract:Background and Objectives: We conducted this cross-sectional study to identify the
association between coffee consumption and risk of metabolic syndrome (MetS) in the
Korean population. Methods and Study Design: Subjects aged 30–79 years in the Fifth
Korea National Health and Nutrition Examination Survey conducted in 2010 and 2011
were included (n=8,246). The self-reported frequency of coffee consumption was classified
as non-drinker, <1, 1, 2, and ≥3 cups/day. Results: The MetS prevalence was 33.6% in
men (n=1,149) and 26.1% in women (n=1,388). Among women, the level of coffee
consumption was inversely associated with MetS and each component (p for trend 0.002
for abdominal obesity and <0.001 for others). The dose-response inverse association
remained significant between coffee consumption and MetS, high triglyceride, and low
high-density lipoprotein cholesterol (p for trend 0.001, 0.009, and <0.001, respectively;
adjusted for age and body mass index). Compared with women who did not consume
coffee, the adjusted odds ratio (OR) for MetS was 0.57 (95% CI, 0.38–0.86) for women
who consumed ≥3 cups per day (p for trend 0.002). Among women, excluding those
receiving medical treatments for hypertension, diabetes, and dyslipidemia, a significantly
lower OR for MetS (0.53, 95% CI 0.31–0.93) was observed with coffee consumption ≥3
cups, and the dose-response inverse association remained significant (p for trend 0.008). In
men, there were no significant associations between coffee consumption and MetS.
Conclusion: In conclusion, coffee consumption is associated with a lower risk of MetS
among Korean women. There was a dose-response inverse relationship between coffee
consumption and the prevalence of MetS in Korean women.
Asia Pac J Clin Nutr. 2018;27(5):1131-1140.doi: 10.6133/apjcn.022018.04
>>Abstract
>> Download PDF
Acne Vulgaris and its association with dietary intake: a Malaysian perspective
Author:Thiribura Sundra Sumathi Suppiah, Thavin Kumar Mathana Sundram, Eugenie Sin Sing Tan, Chew Kek Lee, Normina Ahmad Bustami, Chung Keat Tan
Keywords:Acne vulgaris, diet, dairy products, chocolate, comprehensive acne severity scale (CASS)
Abstract:Background and Objectives: Acne vulgaris is a common skin condition among adolescents and young adults. Its relationship with the dietary intake is highly debatable and equivocal. This study aimed to identify the association between acne vulgaris and dietary intake among Malaysians. Methods and Study Design: A case-control study was conducted involving 57 acne vulgaris patients and 57 age-, gender- and ethnicity-matched controls. All participants were aged 14 and above. The Comprehensive Acne Severity Scale (CASS) was used to categorise patients (grades 2 to 5) and controls (grades 0 to 1). Information such as the demographics, family history, smoking habits and dietary intake were collected using a self-administered questionnaire. Results: In the patient arm, the gender ratio of male to female was 1.5:1. 43 patients (75.4%) had a family history of acne vulgaris. No significant association was found for acne in patients with a history of smoking. Milk consumption was significantly higher in patients (63.2%, n=36) versus controls (43.9%, n=25), (OR =2.19, p<0.05). In addition, chocolate consumption was also significantly higher in patients (43.9%, n=25) versus controls (24.6%, n=14), (OR=2.4, p<0.05). No significant association was found with the intakes of sweets, potatoes, chips, nuts, yoghurt, ice-cream or carbonated drinks. Conclusions: Dietary intake of milk and chocolate may play a role in acne vulgaris. Prospective cohort and intervention studies are recommended to explore whether a causal relationship might obtain.
Asia Pac J Clin Nutr. 2018;27(5):1141-1145.doi: 10.6133/apjcn.072018.01
>>Abstract
>> Download PDF
Fast food consumption alongside socioeconomic status, stress, exercise, and sleep duration are associated with menstrual irregularities in Korean adolescents: Korea National Health and Nutrition Examination Survey 2009–2013
Author:Hee-Sook Lim, Tae-Hee Kim, Hae-Hyeog Lee, Yoon-Hyung Park, Bo-Ra Lee, Yoo-Jin Park, Yeon-Suk Kim
Keywords:adolescent, diet, life habit, menstruation, nutrition surveys
Abstract:Background and Objectives: Menstrual irregularities in adolescents are a concern because they are considered a subjective indicator of poor physical and reproductive health. Menstrual regularity is associated with many genetic and mental health factors, and lifestyle changes can markedly influence an individual’s level of menstrual regularity. Therefore, we investigated associations between lifestyle factors and menstrual irregularities in Korean adolescents by analyzing data collected from the Korea National Health and Nutrition Examination Survey from 2009 to 2013. Methods and Study Design: A total of 463 female adolescents aged 15–18 years participated in this study; they were divided into two groups based on their menstrual regularity. We assessed the between-group differences in relation to lifestyle-related factors, fast food consumption, and diet quality. Results: The frequencies of consumption of soda, coffee, and fried foods were significantly higher in the irregular menstruation group. However, the nutritional quality index was not significantly different between the two groups. Logistic regression analysis revealed that younger age at menarche (odds ratio [OR]=0.69, 95% confidence interval [CI]=0.54–0.88), higher family income (OR=0.37, 95% CI=0.15–0.91), lack of exercise (OR=10.42, 95% CI=2.73–39.8), and high stress levels (OR=4.18, 95% CI=1.02–17.12) were associated with menstrual irregularity, whereas sufficient sleep (OR=0.49, 95% CI=0.39–0.60) and low frequency of eating out accounted for menstrual regularity. Conclusions: Lifestyle factors and stress levels influence menstrual regularity in Korean adolescents. Appropriate and accessible education on lifestyle management is required.
Asia Pac J Clin Nutr. 2018;27(5):1146-1154.doi: 10.6133/apjcn.032018.03
>>Abstract
>> Download PDF
Results of a long-term follow-up evaluation of an Australian adult nutrition education program
Author:Simone Pettigrew, Michelle I. Jongenelis, Nicole Biagioni, Iain S Pratt, Sarah Moore
Keywords:Australia, nutrition education, adults, longitudinal, evaluation
Abstract:Background and Objectives: To assess persistence of improvements in nutrition-related attitudes and behaviours 2-4 years after attending an adult nutrition education program (FOODcents). Methods and Study Design: A link to an online survey was sent to 407 past FOODcents participants. The survey replicated items included in previous FOODcents evaluation surveys. In total, 87 responses were received (response rate 21%). Analyses were conducted on matched responses across 3 time points: pre, post, and follow-up. Results: Improvements since baseline were maintained in confidence to buy healthy foods on a budget and a range of dietary behaviours (e.g., increased consumption of vegetables, legumes, and wholegrain products; greater use of the nutrition information available on food packages; and decreased consumption of soft drinks). There were two primary areas in which improvements were not maintained over time: reported intake of fruit and frequency of consumption of fast food. Conclusions: The results suggest that adult nutrition education can be effective in encouraging individuals to alter their food shopping processes and modify their diets. The tendency for some behavioural outcomes to be worse at follow-up than at baseline indicates that marketplace factors such as food promotion and availability may be influencing these specific dietary behaviours. This rare longitudinal study of the effects of adult nutrition education shows that this form of intervention has the potential to produce lasting improvements in attitudes and behaviours. However, such programs cannot be expected to produce large and lasting effects without support from population-level nutrition policies and programs that address macro-environmental factors that influence dietary behaviours.
Asia Pac J Clin Nutr. 2018;27(5):1155-1159.doi: 10.6133/apjcn.052018.02
>>Abstract
>> Download PDF