A community-based approach to lean body mass and appendicular skeletal muscle mass prediction using body circumferences in community-dwelling elderly in Taiwan
Author:Kuei-Yu Chien, Shu-Chen Chen, Chiao-Nan Chen, Hsiu-Hua Wang, Wen-Sheng Zhou, Lee-Hwa Chen
Keywords:appendicular, elderly, nutrition assessment, the regression formula, aging
Abstract:Background and Objectives: To develop and validate the prediction equations for lean body mass (LBM) and appendicular skeletal muscle mass (ASM) using body circumference measurements of community-dwelling adults older than 50 years old. Methods and Study Design: Four hundred and ninety-eight community-dwelling adults older than 50 years old were recruited for this study. Participants were randomly assigned to a development group (DG, n=332) and validation group (VG, n=166). Lean body mass and ASM were assessed using dual-energy x-ray absorptiometry along with the anthropometric parameters. The Pearson correlation coefficient was used to examine the associations between ASM, LBM and anthropometric parameters in the DG. Prediction equations for LBM and ASM were established from DG data using multiple regression analyses. Paired t-test and Bland-Altman test were used to validate the equations in the VG. Results: Forearm circumference had the highest correlation with LBM and ASM. The developed prediction models were: LBM (kg) = 27.479 + 0.726 * weight (kg) - 3.383 * gender (male = 1, female = 2) - 0.672 * BMI + 0.514 * forearm circumference (cm) - 0.245 * hip circumference (cm)(r2=0.90); ASM (kg) = -4.287 + 0.202 * weight (kg) - 0.166 * hip circumference (cm) - 1.484 * gender (male = 1, female = 2) + 0.173 * calf circumference (cm) + 0.096 * height + 0.243 * forearm circumference (cm)(r2=0.85). Conclusions: Prediction equations using only a measuring tape provide accurate, inexpensive, practical methods to assess LBM and ASM in Asians older than 50 years old.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0013
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Socioeconomic correlates of adherence to mineral intake recommendations among pregnant women in north China: Findings from a cross-sectional study
Author:Kaipeng Wang, Ying Xie, Dandan Wang, Nicholas J. Bishop, Erica M Tooker, Zengning Li
Keywords:mineral intake, pregnancy, China, socioeconomic status, women
Abstract:Background and Objectives: The purpose of the present study is to examine the socioeconomic correlates of adherence to minimum mineral intake recommended by the Chinese Dietary Guidelines during each trimester of pregnancy among Chinese women. Methods and Study Design: A total of 567 pregnant women with foetal age of 6 – 12 weeks were recruited from nine community health centres and three hospitals. Cross-sectional survey data were collected using structured interviews and questionnaires. Mineral intake was calculated from food consumption reported on 24-hour dietary reviews using the Chinese Food Composition Metrics. Logistic regression models were estimated to assess the relationship between sociodemographic factors and adherence to mineral intake recommendations for each trimester. Results: Significant predictors of adherence to mineral intake recommendations include: (1) age (zinc: OR=1.09, p<0.05; copper: OR=1.11, p<0.05), having bachelor’s degree (copper: OR=2.23, p<0.05; phosphorus: OR=2.23, p<0.01), and household income ≥5,000RMB (potassium: OR=2.51, p<0.001; phosphorus: OR=1.91, p<0.05) during the first trimester, (2) being employed (zinc: OR=0.54, p<0.001; selenium: OR=0.53, p<0.05) and household income ≥5,000 RMB (zinc: OR=1.86, p<0.05) during the second trimester, and (3) husband/partner with associate degree or vocational school education (selenium: OR=3.26, p<0.01) and household income of 3,000–4,999 RMB (potassium: OR=1.71, p<0.05; zinc: OR=1.48, p<0.05) during the third trimester. Conclusions: To our knowledge, this is the first study that examines the relationship between socioeconomic factors and mineral intake among Chinese pregnant women at three trimesters. Findings highlights the importance of considering individuals’ socioeconomic status to develop personalized interventions to prevent undernutrition among this population.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0017
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Association between dairy consumption and prevalence of obesity
in adult population of northeast China: an internet-based
cross-sectional study
Author:Xiao-yun Song, Rui Li, Lin Guo, Pan-pan Guo, Meng Zhang, Ren-nan Feng
Keywords:dairy product, milk, yogurt, obesity, abdominal obesity
Abstract:Background and Objectives: Dairy has been shown to reduce the risk of obesity in many epidemiological studies. However, few studies have been fully conducted in China in this respect. We aimed to investigate the association between dairy consumption and prevalence of obesity in an adult Chinese population. Methods and Study Design: A cross-sectional study was performed in an adult population of 5598 in northeast China, aged ≥18. Intakes of dairy products were obtained by internet-based dietary questionnaire for the Chinese (IDQC). The associations between total and individual dairy consumption and prevalence of overall and abdominal obesity were examined by logistic regression. Sex stratification was performed. Results: A total of 3871 participants, including 1700 men and 2171 women, were eligible for analysis. Men who consumed ≥100 g/day of yogurt had lower risks of abdominal obesity(multivariate-adjusted OR=0.41; 95% CI: 0.24-0.70) than men who did not consume yogurt. Women who consumed ≥200 g/day of milk had lower risks of overall obesity (multivariate adjusted OR=0.47; 95% CI: 0.24-0.91) than women who did not consume milk. Conclusions: Increased dairy consumption was associated with lower risk of obesity in adult population in northeast China. Further studies are needed to confirm these observational findings and explain the observed gender-specific difference.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0015
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Association between food liking and the dietary quality in Australian young adults
Author:Uracha Wanich, Lynn Riddell, Sara Cicerale, Mohammadreza Mohebbi, Dhoungsiri Sayompark, Djin Gie Liem, Russell SJ Keast
Keywords:food liking, dietary quality, young adult
Abstract:Background and Objectives: An individual’s liking for food maybe associated with food consumption. This study investigates the association between food liking and dietary quality in Australian young adults. Methods and Study Design: Food liking and food frequency data were collected via an online Food Liking Questionnaire (FLQ) and Food Frequency Questionnaire (FFQ). Food liking scores were calculated for groupings of foods. FFQ Food intake data was used to calculate diet quality using a 13 item Dietary Guideline Index (DGI). The relationship between food liking and DGI was assessed using linear regression models and the difference was assessed using an independent sample t-test and One-way ANOVA. Results: Data were available from n=2,535 participants (BMI=24 (SD 3.74), age=21.9 (SD 5.05) years, female=77.1%). Liking for grains, vegetables, fruits, dairy, plant-based protein, was weakly positively associated with diet quality. Liking for animal-based protein, fat and oil, sweet food, and salty food, was weakly negatively associated with diet quality. Liking for grains, vegetables, fruits, dairy, plant-based protein and healthy foods increased across increasing DGI tertiles, and liking for animal-based protein, fat and oil, sweet food, salty food and discretionary foods decreased across increasing DGI tertiles. Conclusions: The results were logical with increased liking for healthy or discretionary foods linked with increased consumption of those foods. The results reinforce the strategy to introduce a variety of healthy food groups early in life to initiate flavour-nutrient learning and increase liking for healthy foods.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0022
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Vitamin D and liver cancer risk: a meta-analysis of prospective studies
Author:Xiao-fei Guo, Ting Zhao, Jian-min Han, Shan Li, Duo Li
Keywords:vitamin D, liver cancer, prospective study, meta-analysis, dose-response analysis
Abstract:Background and Objectives: The association between circulating vitamin D and liver cancer risk has been controversial on the basis of epidemiological studies. The aim of this study was to quantitatively evaluate this association with prospective studies. Methods and Study Design: A systematic literature search was implemented in PubMed and Scopus databases up to June 2019. Using a random-effects model, the multivariate-adjusted relative risks (RRs) with corresponding 95% confidence interval (CI) were pooled for the highest versus lowest category. Trend estimation was conducted with a two-stage dose-response meta-analysis. Results: Six independent prospective studies (992 liver cancer events and 60,811 participants) were included for data synthesis. The summary estimate showed that a higher circulating vitamin D was associated with lower risk of liver cancer (Summary RR=0.78; 95% CI: 0.63, 0.95; I2=53.6%, p=0.035). Dose-response analysis indicated that liver cancer was associated with 8% (95%CI: 0.89, 0.95) lower risk with a 10 nmol/L increment of circulating vitamin D concentration. Conclusions: The present study provides substantial evidence that a higher concentration of circulating vitamin D would have conferred protection against liver cancer.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0023
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Clinical nutrition knowledge, attitude and practice of medical interns in Shanghai: contributory factors
Author:Min Zong, Yan-Qiu Chen, Xia Liu, Hua Xie, Mei-Fang Zhang, Jian-Qin Sun
Keywords:knowledge score, attitude score, practice score, frequency of accessing nutrition information, method of accessing nutrition information
Abstract:Background and Objectives: To provide a questionnaire, with Shanghai medical interns as respondents, analyzing knowledge (K), attitude (A), and practice (P) in relation to clinical nutrition, and to explore factors that could affect KAP scores. Methods and Study Design: The cross- sectional study used 330 interns from Shanghai medical universities responding to general material data questionnaires and KAP questionnaires on clinical nutrition. Results: The mean KAP score was 210.26±25.9 (X±SD), and the score for each part of the KAP questionnaire was just within the threshold for qualified. Multivariate analysis showed that the factors influencing the proportion of excellent scores for K were preventive medicine major (OR=3.45, p<0.001), senior intern (OR=2.52, p=0.002), and tertiary intern hospital (OR=2.31, p=0.006). The only factor influencing the proportion of excellent scores for P was accessing nutritional information one to three times per week (OR=3.95, p=0.011). Nutrition course had no relation to any scores of K, A, P. Conclusions: The mean scores of overall KAP and the individual K, A, P were all categorized as qualified. The P score was the lowest and only influenced by how frequently information was accessed. In summary, nutrition knowledge and regular practical training gained from intern hospital could be a better way to enable senior interns to quickly and competently address patient nutrition problems at the commencement of their careers.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0011
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Reduced crying and favourable stool characteristics in Chinese infants formula-fed fat-based milk
Author:Xiao Yang Sheng, Vanitha Buthmanaban, Marlotte Marianne Vonk, Anouk Leonie Feitsma, Panam Parikh
Keywords:crying, stool consistency, stool color, infant, milk fat, gut comfort
Abstract:Background and Objectives: Chinese infants consuming four different commercially available infant formulas were evaluated on gut comfort and stool consistency parameters. Methods and Study Design: Gut comfort characteristics were evaluated during a 7-day cross-sectional observational study in 409 healthy, term, exclusively formula-fed infants via questionnaires and fecal parameters. Results: The stool consistency and color scores were different between the infants consuming one of the four commercially-available infant formulas including different fat sources, i.e. one milk fat-based (IF1), two structured vegetable fat-based (IF2 and IF4) and one palm oil-free vegetable blend (IF3). The scoring pattern showed more ‘soft-formed’ stools for IF1-consuming infants compared to infants consuming IF2, IF3 or IF4. In addition, a lower amount of green feces was observed in combination with an increase in golden-colored feces for IF1-consuming infants compared to the other groups. Furthermore, IF1-consuming infants reported less fussy/crying time during the night and less gut discomfort. Infants consuming milk fat-based IF1 showed significantly lower fatty acid soaps compared to palm-oil free IF3-fed infants. Conclusions: Infants consuming milk fat-based IF1 experienced less gut discomfort compared to infants consuming other commercially-available infant formula. Lower fecal fatty acid soap levels, fussy/crying time during the night and gut discomfort were observed. These findings contribute to current understanding of the association between lipid structure and gut comfort parameters. However, the suggested benefits noted cannot be fully linked to the effect of fat blend differences since formulas differ in ingredient-sourcing and processing. Future research should confirm the added benefit of milk fat-based infant formulas to improve gut comfort parameters.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0019
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Serum total iron-binding capacity and iron status in patients with non–dialysis-dependent chronic kidney disease: a cross-sectional study in Vietnam
Author:Le Viet Thang, Nguyen Trung Kien, Nguyen Van Hung, Truong Quy Kien, Nguyen Huu Dung, Nguyen Duy Toan, Pham Quoc Toan, Hoang Trung Vinh, Vu Xuan Nghia, Tomoko Usui
Keywords:anemia, CKD, ferritin, TIBC, transferrin saturation
Abstract:Background and Objectives: We performed this study to evaluate serum iron and ferritin concentrations, serum total iron-binding capacity (TIBC), and proportion of overall iron deficiency among patients with non–dialysis-dependent chronic kidney disease (ND-CKD). Methods and Study Design: A hospital-based cross-sectional observational study was conducted on 175 adult patients with stage 3–5 chronic kidney disease (CKD) by using 51 healthy age–sex-matched Vietnamese adults as the control group. We next examined the prevalence of anemia and determined the serum iron and ferritin concentrations and TIBC. Anemia in CKD was defined as hemoglobin levels <13 g/dL in men and <12 g/dL in women. Transferrin saturation (TSAT, %) was calculated as (serum iron x 100)/TIBC. Functional iron deficiency was defined as serum ferritin >100 ng/mL and TSAT <20%, and absolute iron deficiency was defined as serum ferritin <100 ng/mL and TSAT <20%. Overall iron deficiency was defined as the presence of either absolute or functional iron deficiency. Results: Anemia prevalence in our study was approximately 88.6% with a mean hemoglobin concentration of 9.71±2.26 g/dL. The median serum TIBC was lower in the CKD group (50.4 µmol/L) than in the control group (66.0 µmol/L; p<0.001). The proportion of overall iron deficiency was 44.0%. TIBC had a diagnostic value for overall iron deficiency (area under the ROC curve=0.814; p<0.001). Conclusions: Anemia and iron deficiency are common in Vietnamese patients with ND-CKD. TIBC had diagnostic value for overall iron deficiency.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0007
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Nutrition program selection in acute ischemic stroke patients with GI hemorrhage
Author:Xiaoyan Zeng, Junhong Chen, Zhihua Sun, Heng Zeng, Junyan Xue, Yingjie Zhang, Gang Liu, Xiaojing Huang
Keywords:gastrointestinal haemorrhage, nutrition therapy, stroke
Abstract:Background and Objectives: The severity of neurologic impairment is significantly associated with gastrointestinal (GI) hemorrhage. Therefore, the aim of this study was to compare the effect of two nutritional interventions in acute ischemic stroke patients with GI hemorrhage. Methods and Study Design: We retrospectively studied consecutive ischemic stroke patients with GI hemorrhage from January 2014 to December 2018. They were stratified into two programs of nutritional therapy after GI hemorrhage: moderate feeding (more than 70% optimal caloric uptake, 50-100 mL/h) and trophic feeding (16-25% of the target energy expenditure, 25 kcal/kg per day, 10-30 mL/h) with supplemental parenteral nutrition. Results: The group receiving moderate feeding included 30 patients, and the group receiving trophic feeding and supplemental parenteral nutrition included 32 patients. There was no statistically significant difference between the two groups in the baseline characteristics of the patients. Mortality, Glasgow Coma Scale (GCS) score at discharge, and Glasgow Outcome Scale (GOS) score 3 months after discharge were compared between the two groups. In the moderate feeding group, the overall mortality was significantly lower than in the trophic feeding and supplemental parenteral nutrition group (p<0.05). Conscious state and neurological severity were assessed by the GCS score before discharge, and the score was higher in the moderate feeding group than in the other group (p<0.05). The GOS score 3 months after discharge was higher in the moderate feeding group than in the trophic feeding and supplemental parenteral nutrition group (p<0.05). These three items showed that moderate feeding led to a better prognosis: lower occurrence of mortality, higher GCS score at discharge, and higher GOS score 3 months after discharge. Conclusions: This study showed that moderate feeding had a much more profound effect on the outcomes than trophic feeding and supplemental parenteral nutrition, as it was associated with lower mortality, higher GCS score at discharge, and higher GOS score 3 months after discharge.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0008
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Physical activity and sedentary behaviour during pregnancy are associated with gestational weight gain in Vietnamese women
Author:Anh Vo Van Ha MPH1,2, Yun Zhao, Ngoc Minh Pham, Cong Luat Nguyen, Phung Thi Hoang Nguyen, Tan Khac Chu, Colin W Binns, Andy H Lee
Keywords:gestational weight gain, pregnancy, physical activity, sedentary behaviour, Vietnam
Abstract:Background and Objectives: Gestational weight gain is known to impact maternal and child health outcomes. Energy intake and energy expenditure are major components of clinical nutrition in relation to weight gain during pregnancy. The study was to determine the association of physical activity and sitting time during pregnancy with gestational weight gain in Vietnamese women. Methods and Study Design: A multicentre prospective cohort study was conducted in Vietnam from 2015 to 2017. A total of 1873 women with a singleton pregnancy were included. Physical activity and sitting exposures during pregnancy were determined using an interviewer-administered validated questionnaire. Multiple regression analysis was performed to assess physical activity and sitting time in relation to gestational weight gain, adjusting for the confounding effects of maternal characteristics and total energy intake during pregnancy. Results: The mean weight gain was 12.9 (Standard deviation 4.1) kg throughout pregnancy. Pregnant women with prolonged sitting time gained an average of 0.6 kg more weight (p=0.016 for highest versus lowest tertiles). Conversely, women who were physically active, in terms of having higher tertiles of total physical activity, moderate-to-vigorous-intensity, household/caregiving activities, and occupational physical activity, experienced significantly less gestational weight gain (p<0.05 for highest versus lowest tertiles). Conclusions: Inverse associations were found between gestational weight gain and physical activity (i.e. intensities and several domains), whereas gestational weight gain tended to increase with longer sitting time. Therefore, being physically active and less sedentary is important to regulate weight gain during pregnancy.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0018
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Regulobiosis: a regulatory and food system-sensitive role for fungal symbionts in human evolution and ecobiology
Author:Ju-Sheng Zheng, Mark L Wahlqvist
Keywords:fungi, mycobiome, regulobiosis, symbionts, human ecobiology
Abstract:The role of microbiomes in human biology and health are being extensively investigated, yet how the fungal community or mycobiome contributes to an integral microbiome is unclear and probably underestimated. We review the roles of fungi from the perspectives of their functionality in human biology, their cross-kingdom talk with other human microbial organisms, their dependence on diet and their involvement in human health and diseases. We hypothesize that members of the fungal community may interact as necessary symbionts with members of other human microbiome communities, and play a key role in human biology, yet to be fully understood. We propose further that “regulobiosis”, whereby fungi play a regulatory role in human ecobiology, is operative in humans as probably obtains in other forms of life. Fungally-dependent regulobiosis would characterise, at first, microbiomes which include, but are not limited to, bacteria, archaea, and viruses; then, their human host; and, next, provide ecological connectedness
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0002
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Impaired glucose tolerance among adolescents with low birth weight history: the Tanjungsari cohort study in Indonesia
Author:Hikmat Permana, Ria Bandiara, Stefanie Yuliana Usman, Evan Susandi, Aly Diana, Augusta YL Arifin, Bachti Alisjahbana
Keywords:adolescents aged 12-14, birth weight, body mass index, insulin resistance, impaired glucose tolerance
Abstract:Background and Objectives: Diabetes prevalence has been increasing overtime in Indonesia along with its complications and morbidities. Diabetes prevention program is still a challenge. Previous study concluded poor intrauterine nutritional status, low birth weight (LBW), and nutrition status early in life were risk factors for impaired glucose tolerance (IGT) or type 2 diabetes mellitus in adulthood. This study aimed to evaluate the association between both LBW and intrauterine growth restriction (IUGR) with IGT in adolescents. Methods and Study Design: Total of 536 subjects from Tanjungsari Cohort Study were included in this study. Subjects were in their early adolescence age (12-14 years). Anthropometric data were collected and IGT was determined by using 2-hour postprandial plasma glucose level, then it was assessed based on their birth weight and intrauterine nutritional status. Results: Subjects with LBW history were shorter, had lower body weight and body mass index (p<0.05, respectively). The proportion of IGT is significantly higher among subject with LBW (RR 1.692 [1.079–2.653]). There was no difference on proportion of IGT among subjects with IUGR compared with subjects who were not IUGR or born preterm (p=0.286). Multiple regression analysis showed the effect of LBW remain independent after adjusted with sex and socioeconomic variables (RR 1.650 [1.054–2.584]). Conclusions: Significant association was found between LBW and IGT in comparison to those who were born with normal birth weight. Hence, diabetes should be prevented as early as possible, even since in the pregnancy.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0016
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Thyroglobulin can be a functional biomarker of iodine deficiency, thyroid nodules, and goiter in Chinese pregnant women
Author:Min Gao, Yanting Chen, Ying Zhang, Hao Sun, Qi Zhang, Wen Chen, Wei Wang, Jun Shen, Yuangui Cheng, Wanqi Zhang
Keywords:thyroglobulin, iodine status, pregnant women, biomarker, thyroid disease
Abstract:Background and Objectives: Thyroglobulin (Tg) is considered a sensitive indicator of iodine status for children and adults, but its usefulness for pregnant women is unknown. The aim of this study was attempting to explore the relationship between Tg and iodine status and the association between elevated Tg and thyroid diseases. Methods and Study Design: A total of 2163 pregnant women were recruited in this study. The ratio of urine iodine concentration and urine creatinine concentration (UI/Cr) was measured in spot urine samples. Serum thyroid hormones and thyroglobulin were measured. Thyroid nodules and thyroid volume were diagnosed by ultrasound. Results: The geometric mean of serum Tg was significantly higher in the UI/Cr <100 μg/g group (10.94 [2.47] μg/L) and the UI/Cr >500 μg/g group (11.48 [2.35] μg/L) than in the 150–249 μg/g group (9.64 [2.32] μg/L). The generalized linear model analysis showed that Serum log(10) Tg concentration was much higher in the UI/Cr <100 μg/g group (β=0.052, p=0.026) than in the 150–249 μg/g group. Multivariate logistic regression models demonstrated that elevated Tg may be a risk factor for both goiter (OR=8.30) and thyroid nodules (OR=2.73). Conclusions: Pregnant women with UI/Cr <100 μg/g have a higher Tg, and those with elevated Tg concentrations have a higher risk of thyroid nodules and goiter. Tg can be a functional biomarker of iodine deficient, thyroid nodules and goiter.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0004
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Prolonged preoperative fasting and prognosis in critically ill gastrointestinal surgery patients
Author:Gang Zhou, Fengxue Zhu, Youzhong An, Lixia Qin, Jie Lv, Xiujuan Zhao, Jiawei Shen
Keywords:fasting, gastrointestinal surgery, elective surgery, myocardial injury, reoperation
Abstract:Background and Objectives: This study aimed to assess the influence of prolonged preoperative fasting on prognosis in elective surgery. Methods and Study Design: A retrospective, controlled study involving patients admitted to our surgical intensive care unit who underwent a gastrointestinal operation under general anesthesia. Patients were divided into regular preoperative fasting time (n=57) and prolonged preoperative fasting time (n=73) groups. Clinical data were collected including patients’ demographics, intraoperative and postoperative operation time, volume of blood loss, intensive care unit stay, hospital stay, postoperative complications and other factors. Results: Patients in the regular preoperative fasting time group had less duration of mechanical ventilation support after surgery [245 (177, 450) min vs 315 (210, 812) min (p=0.021)] and the postoperative myocardial injuries (myocardial injury 2 cases vs 11 cases, p=0.038) and reoperation percentages (reoperation 0 cases vs 7 cases, p=0.044) were lower compared to the prolonged preoperative fasting time group. In addition, patients in the regular preoperative fasting time group presented with a significantly shorter period of postoperative fasting time [6.0 (5.0, 8.0) vs 8.0 (6.0, 13.0), p=0.005]. Conclusions: Prolonged preoperative fasting time led to unfavorable outcomes after gastrointestinal operations. Thus, reducing preoperative fasting time is likely to accelerate postoperative recovery in gastrointestinal surgery patients.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0006
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Late-night-dinner deteriorates postprandial glucose and insulin whereas consuming dinner dividedly ameliorates them in patients with type 2 diabetes: A randomized crossover clinical trial
Author:Saeko Imai, Yuuki Saito, Shizuo Kajiyama, Ayasa Nitta, Takashi Miyawaki, Shinya Matsumoto, Neiko Ozasa, Shintaro Kajiyama, Yoshitaka Hashimoto, Michiaki Fukui
Keywords:diet, postprandial glucose, insulin, dinner, meal timing, diabetes
Abstract:Background and Objectives: The aims of this study is to explore the acute effect of consuming dinner at different timing on postprandial glucose and hormone in patients with type 2 diabetes. Methods and Study Design: Eight patients (age 70.8±1.9 years, HbA1c 7.6±0.6 %, BMI 23.3±3.2, mean±SD) were randomly assigned in this crossover study. Patients consumed the test meals of dinner at 18:00 on the first day, and dinner at 21:00 or divided dinner (vegetable and rice at 18:00 and vegetable and the main dish at 21:00) on the second or third day. Postprandial glucose, insulin, glucagon, free fatty acid (FFA), active glucagon-like peptide-1 (GLP-1), and active glucose-dependent insulinotropic polypeptide (GIP) concentration after dinner were evaluated. Results: Both incremental area under the curve (IAUC) 2h for glucose and insulin were higher in dinner at 21:00 than those in dinner at 18:00 (IAUC glucose: 449±83 vs 216±43 mmol/L×min, p<0.01, IAUC insulin:772±104 vs 527±107 μU/mL × min, p<0.01, mean ± SEM). However, in divided dinner both IAUC 4h for glucose and insulin tended to be lower than those of dinner at 21:00 (IAUC glucose: 269±76 mmol/L × min, p=0.070, IAUC insulin: 552±114 μU/mL × min, p=0.070). IAUC of active GLP-1 and active GIP demonstrated no difference among different dinner regimen. Conclusions: Consuming late-night-dinner (21:00) deteriorates postprandial glucose and insulin compared with those of early-evening-dinner (18:00) whereas consuming dinner dividedly ameliorates them.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0010
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Dietary diversity and all-cause mortality among Chinese adults aged 65 or older: a community-based cohort study
Author:Liyuan Tao, Zheng Xie, Tao Huang
Keywords:dietary diversity, mortality, elderly, oldest old, Cox proportion hazard model
Abstract:Background and Objectives: To evaluate the association between dietary diversity and all-cause mortality in older adults. Methods and Study Design: 17,949 community-based elderly participants aged ≥65 years in China were included in this cohort study. The baseline consumption frequencies of nine food groups (meat, vegetables, fish, eggs, fruits, legumes, milk, tea, and nuts) were recorded, and the dietary diversity score (0–9) was calculated. Survival status and death date were collected during follow-up. Cox proportional-hazards models were used to assess the association between dietary diversity and all-cause mortality. Results: We identified 8445 death events over 57,685 person-years of follow-up. Compared with participants in the lowest dietary diversity score group (score 0–1), higher dietary diversity scores were associated with lower mortality risk in univariate models. After adjusting for potential confounders, participants in the higher dietary diversity score group had a 9%–30% lower risk in all-cause mortality (p trend <0.001) compared with those in the lowest dietary diversity score group. The inverse relationship between dietary diversity score and all-cause mortality was also significant in four food groups (vegetables, fish, fruits, and nuts). Similar results were observed in sensitivity analyses. Conclusions: Our study showed that dietary diversity was inversely associated with all-cause mortality in the Chinese elderly, especially in the oldest old and men. Therefore, increasing dietary diversity may reduce mortality rates in the older population, and tailored interventions for improving dietary diversity are required to benefit health and survival in them.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0020
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The association of blood pressure with estimated urinary sodium, potassium excretion and their ratio in hypertensive, normotensive, and hypotensive Chinese adults
Author:Ying Li, Lu Yin, Yaguang Peng, Xiaoyun Liu, Xia Cao, Yaqin Wang, Pingting Yang, Xiaohui Li, and Zhiheng Chen
Keywords:systolic blood pressure, diastolic blood pressure, estimated urinary sodium excretion, estimated urinary potassium excretion
Abstract:Background and Objectives: Low sodium and high potassium intake is reported to be a risk of hypertension. However, it is uncertain whether these associations can be generalized to those without hypertension. This study is to evaluate the associations of systolic and diastolic blood pressure (SBP and DBP, respectively) with estimated urinary sodium excretion (eUNaE), estimated urinary potassium excretion (eUKE) and their ratio (Na/K ratio) among hypertensive, normotensive, and hypotensive Chinese individuals. Methods and Study Design: A large institution-based cross-sectional study was conducted at the Third Xiangya Hospital, Changsha between August 2017 and November 2018. Spot urine samples were collected to test urinary sodium, potassium, and creatinine excretions for each participant. The Kawasaki formula was used to estimate 24-hour urinary sodium and potassium excretions. Results: A total of 26,363 eligible subjects were used to analyze the associations of blood pressure with eUNaE, eUKE, and their ratio. 27.3% (n=7,201) of participants were diagnosed with hypertension, 5.4% (n=1,427) were diagnosed with hypotension, and the remaining of 17,735 participants were normotensive. A significant increase in SBP and DBP was related to the Na/K ratio increase in hypertensive and normotensive subgroups (all ptrend<0.01), but the association was not significant for DBP among hypotensive individuals (ptrend=0.58). Stronger associations of SBP with the Na/K ratio were observed in older people pinteraction<0.01) and females (pinteraction<0.0001), but the same trend was not observed for DBP (pinteraction=0.10 and 0.88, respectively). Conclusions: High potassium and low sodium intake were further confirmed to reduce blood pressure in hypotensive, normotensive, and hypertensive individuals.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0014
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Double burden of malnutrition in urbanized settled Tibetan communities on the Tibetan Plateau
Author:Wen Peng, Shulin Wang, Shuang Han, Xiaodong Su, Lei Zhao
Keywords:double burden of malnutrition, undernutrition; obesity, Tibetan, urbanization
Abstract:Background and Objectives: A previous pilot study revealed stunted children and obese adults in urbanized settled Tibetan communities. A survey with a representative population in selected communities was conducted to test the preliminary findings. Methods and Study Design: A cross-sectional study on the nutritional status involving 504 children (244 boys and 260 girls, 5-16 y) and 927 adults (422 men and 505 women, 18-90 y) was conducted in communities, with anthropometric parameters measured. The z-scores for height (HAZ) and BMI (BAZ) in children were calculated according to WHO 2007 reference. Results: The children showed a double burden of both under- and over-nutrition. The prevalence of under-nutrition in children was high – stunting (HAZ <-2) 10.7%, underweight (BAZ <-2) 9.5%, combined prevalence of stunting and underweight 19.4%. The rate of over-nutrition was also alarming – obesity 12.7% (BAZ >2). The mean value of HAZ (-0.45±1.41) was lower than, whereas that of BAZ (0.05±1.76) was comparable to, the WHO reference. No significant differences were found in under- or over-nutrition between genders. Specifically, 8.9% of children demonstrated both short stature (HAZ <-1) and overweight (BAZ >1). By contrast, community adults showed almost a one-way direction tilted towards over-nutrition – overweight 61.4% (BMI ≥24 kg/m2), obesity 30.1% (BMI ≥28 kg/m2), and central obesity 62.0% (waist circumference, men ≥85 cm, women ≥80 cm). Women were marginally more likely to be obese than men (p=0.061). Conclusions: The co-existence of under- and over-nutrition in the community may have reflected the suboptimal early life nutrition and the obesogenic environment afterwards. Potential determinants need to be explored for future interventions.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0021
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Leisure-time physical activity and milk intake synergistically reduce the risk of pathoglycemia: a cross-sectional study in adults in Beijing, China
Author:Xiaona Na, Zhu Zhu, Yangyang Chen, Haizhen He, Guirong Zhou, Jing Zhou, Ting Zhang, Guoliang Zhuang, Aiping Liu
Keywords:synergistic associations, leisure-time physical activity, the frequency of milk intake, pathoglycemia, impaired fasting glucose
Abstract:Background and Objectives: To evaluate the synergistic and individual associations of leisure-time physical activity (LTPA) intensity and the frequency of milk intake in adulthood with newly diagnosed pathoglycemia. Pathoglycemia comprised impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM). Methods and Study Design: This cross-sectional study of 3977 adults was conducted in Mentougou District, Beijing, China. After excluding ineligible individuals or those with missing data, 2977 participants were included in the final analysis. Data on LTPA, milk intake, and other demographic characteristics were obtained through previously designed questionnaires. Newly diagnosed pathoglycemia was determined based on fasting plasma glucose (FPG) concentration. Results: Among all participants, 21.4% had newly diagnosed pathoglycemia, 9.9% engaged in moderate to vigorous leisure-time physical activity (MVLTPA), and 63.7% drank milk more than once weekly. Relative to those who engaged in low-intensity LTPA and drank milk less than once weekly, those who engaged in MVLTPA (OR: 0.584, 95%CI: 0.410-0.810) and drank milk more than once weekly (OR: 0.734, 95% CI: 0.614-0.878) had a lower risk of pathoglycemia; this association was greater when both variables interacted (OR: 0.446, 95% CI: 0.287-0.669). Conclusions: MVLTPA and enough frequency of milk intake synergistically decreased the risk of pathoglycemia. A future interventional study including both factors should be performed.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0024
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Economic value of nutritional support methods in gastrointestinal cancer: a quantitative meta-analysis
Author:Mingwei Zhu, Wei Chen, Hua Jiang, Sainan Zhu, Jingyong Xu, Wenlei Bao, Yan Dang, Michael Yao-Hsien Wang
Keywords:nutritional support, economic value, parenteral nutrition, enteral nutrition, meta-analysis
Abstract:Background and Objectives: Multiple studies of the relative economic value of different nutritional support methods for patients with gastrointestinal cancer have provided inconsistent results. Methods and Study Design: The PUBMED and EMBASE databases were systematically searched through September 30, 2018to identify latent studies of the benefits of parenteral nutrition (PN), enteral nutrition (EN) orconventional intervention (CI) in gastrointestinal cancer patients. A fixed-effects model or random-effects model was applied depending on the heterogeneity of the studies. Statistical analysis was conducted using R software. A total of 728 studies were reviewed, and 21 studies published from 1998 to 2018 were included in the final analysis. Results: The results showed that the hospitalization expenditure of the EN group was 3938 RMB less than that of the PN group. Similarly, the EN group had a shorter length of hospitalization than the PN and CI groups. The infection rate was lower in the EN group (12%) than in the PN group (16%) and CI group (20%). Subgroup analysis showed that gastrointestinal cancer patients who received oral nutritional supplements had the lowest infection rate (11%) after surgery. Conclusions: EN, especially oral nutritional supplements, has a positive economic impact on patients with gastrointestinal cancer, based on reductions in the post-operative infection rate, length of hospitalization, and hospitalization expenditure.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0012
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Effect of early enteral nutrition on the incidence of acute acalculous cholecystitis among trauma patients
Author:Ye Rim Chang, Jung Ho Yun, Seok Ho Choi, Ye Seob Jee
Keywords:enteral nutrition, trauma, acute acalculous cholecystitis, effect, critically ill
Abstract:Background and Objectives: Acute acalculous cholecystitis (AAC) often occurs in critically ill patients, especially in those that have experienced trauma, surgery, shock, and prolonged fasting. Early enteral nutrition has been shown to significantly reduce morbidity and mortality compared to other nutritional support strategies. The purpose of this study was to evaluate the effect of early enteral nutrition on the incidence of AAC among trauma patients. Methods and Study Design: Multi-strategy nutritional protocol was implemented in the intensive care unit (ICU) in 2016 for early enteral nutrition and proper nutritional support. The traumatized critically-ill patients without volitional intake who were admitted to ICU between 2015 and 2017 were included. Basic characteristics, duration of fasting, and the incidence of percutaneous cholecystostomy (PC) due to AAC were analyzed according to the year. Results: Enteral nutrition was indicated in 552 trauma patients (28.2%). The mean duration of fasting was shortened from 6.5 days in 2015 to 5.4 days in 2017 (p=0.202). The incidence of PC was significantly decreased from 2015 to 2017 [6/171 (3.5%) vs. 6/204 (2.9%) vs. 0/177 (0%), p=0.023]. The provision of central parenteral nutrition (p=0.001) and fasting over 7 days (p=0.014) proved to be a risk factor of AAC. Conclusions: This study showed that the incidence of PC due to AAC was decreased significantly after the implementation of a nutritional protocol among traumatized critically ill patients. Early enteral nutrition may be effective in reducing the AAC among trauma patients who are at high risk of AAC.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0005
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Benefit risk and cost ratios in sustainable food and health policy: changing and challenging trajectories
Author:Mark L Wahlqvist
Keywords:climate change, food systems, health systems, risk offsets, livelihoods, liveability Units nutritional economics
Abstract:As climate change gathers momentum, the emphases on each of benefit, risk and cost will alter. That we are ecologi-cal beings whose health and wellbeing are ecosystem -dependent, must be the underpinning framework for risk management. This will be a problematic risk communication challenge. Previously desirable food and food pattern recommendations will be tempered by substantial sustainability, availability, safety, affordability, equity and ethical considerations. Future workforces will need to ensure basic livelihoods (food, water, shelter, clothing, healthcare, education, communication, essential transport, resource management and effective governance) and with risk mini-misation. Cost appraisal will have less to do with monetisation and more to do with resource management in ac-cordance with equity and ethical principles. Communities could adopt Liveability Units (LU) for community-based transactions, the currency of a more sustainable future, encouraging and enabling food and health system viability.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0001
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Consumption patterns of sweetened condensed milk in the diet of young Indonesian children and its potential nutritional health consequences
Author:Mohammad Juffrie, Ratu Ayu Dewi Sartika, Roy Alexander
Sparringa, Lindawati Wibowo, Widjaja Lukito
Keywords:sweetened condensed milk, sugar-sweetened beverages, young children, metabolic disorders, health
outcomes
Abstract:This critical review is intended to analyse the existing studies on the consumption patterns of sweetened condensed milk in the diet of young Indonesian children and its potential nutritional health consequences. Considering its lim-ited nutritional value and high sugar content, sweetened condensed milk (SCM) should not be administered to young children (1-3 years old) with the goal of promoting their growth and development. However, such false prac-tice has been reported in mostly urban studies among the underprivileged population. Conclusive scientific evidence is also still lacking regarding the health risks of long-term SCM consumption by young Indonesian children at early ages, as no study has focused on this specific topic. Nevertheless, inadequate understanding of SCM, its consump-tion patterns, and its long-term effects on health among young Indonesian children have been implicated in public confusion on the topic. Ongoing disparities that exist between regulation, industrial practices, and product adver-tisement have led to poor understanding in communities, which, to a considerable extent, has contributed to difficul-ties in segregating data on the consumption of SCM and its related products. Analogous to sugar-sweetened bever-ages, limited SCM consumption can be recommended when appropriately implemented with active monitoring and evaluation of product advertisements and product labeling, enforcement of regulations, and provision of effective customer education.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0003
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Effects of flaxseed supplementation on functional
constipation and quality of life in a Chinese popula-tion: a randomized trial
Author:Jianqin Sun, Huijing Bai, Jianxia Ma, Ruiyu Zhang, Hua Xie, Yanmei Zhang, Mingquan Guo, Jianfeng Yao
Keywords:flaxseed, lactulose, Chinese, functional constipation
Abstract:Background and Objectives: This prospective, randomized, controlled study aimed to evaluate the effects of flax-seed supplementation on functional constipation and quality of life in adult men and women in China. Methods and Study Design: 90 subjects with functional constipation diagnosed by the Rome IV criteria were enrolled. Subjects were randomly assigned to receive either 50 g/day flaxseed flour with meals (n=60) or 15 mL/day of a lactulose so-lution on an empty stomach (n=30) every morning for 4 weeks. Wexner constipation scores, stool consistency ac-cording to the Bristol Stool Form Scale, and bowel habits (frequency of bowel movements/week, the time spent on defecation) were the primary outcomes. The change in Patient Assessment of Constipation Quality of Life score was the secondary outcome. Results: After 4 weeks, the bowel habits in both groups were significantly improved. The median Wexner constipation score decreased from 14 to 6.5 in the flaxseed group (p<0.001) and from 15 to 9 in the lactulose group (p<0.001). The median defecation frequency per week increased significantly (2 to 7 for flax-seed and 2 to 6 for lactulose, p<0.001 for both groups). The Patient Assessment of Constipation Quality of Life score decreased significantly (−1.34 and −0.66 for flaxseed and lactulose, respectively; p<0.001 for both groups). Conclusions: Flaxseed flour is somewhat more effective at increasing defecation frequency than lactulose, improv-ing bowel movements and promoting life quality of subjects with chronic functional constipation in the Chinese population.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0009
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Reproducibility and construct validity of a food
frequency questionnaire for assessing dietary intake in rural and urban Asian Indian adults
Author:Vasudevan Sudha, Ranjit Mohan Anjana, Parthasarathy Vijaya-lakshmi, Nagarajan Lakshmipriya, Natarajan Kalpana, Rajagopal Gayathri, Rahavan Durga Priyadarshini, Hutgikar Madhav Malini,
Chandrasekaran Anitha, Mohan Deepa, Sekar Sathish Raj, Kumar
Parthiban, Rajappan Ramakrishnan, Gunasekaran Geetha, Kamala Krishnaswamy, Ranjit Unnikrishnan, Viswanathan Mohan
Keywords:food frequency questionnaire, reproducibility, validity, biomarkers, serum lipid
Abstract:Background and Objectives: To evaluate the reproducibility and construct validity of the Madras Diabetes Re-search Foundation FFQ (MDRF-FFQ) with biomarkers for its use in epidemiological settings in India. Methods and Study Design: The MDRF-FFQ was administered to 500 participants representing rural and urban areas of 10 Indian states, twice at an interval of 12 months. Reproducibility was assessed using intra cluster correlation coef-ficients (ICC). Construct validity of carbohydrate and fat intake was assessed using baseline serum lipids by regres-sion analysis. Results: Reproducibility as measured by ICC was 0.50-0.77 for saturated fatty acids (SFA) and en-ergy in urban and 0.61-0.72 for protein and SFA in rural areas. The ICC for food groups was 0.53-0.77 for whole grains, fruits and vegetables in urban and 0.50-0.89 for animal foods and whole grains in rural areas. After adjust-ing for potential confounders, carbohydrate intake was positively associated with serum triglycerides (TG) (β [SE]: +2.3 [0.72] mg/dL; p=0.002) and inversely with high density lipoprotein cholesterol (HDL) (β [SE]:-0.48 [0.12], p<0.001), while dietary fat and SFA (% Energy) were positively associated with HDL, low density lipoprotein (LDL) and total cholesterol and inversely with TG. Conclusions: The MDRF-FFQ can be considered as a reliable and valid tool to measure the long-term dietary exposure in respect of macronutrient intakes in Indian populations despite diverse dietary practices.
Asia Pac J Clin Nutr. 2020;29(1):.doi: 10.6133/apjcn.202003_29(1).0025
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