Econutrition, brown and beige fat tissue and obesity
Author:Kelei Li, Chunxiao Liu, Mark L Wahlqvist, Duo Li
Keywords:diet, brown fat tissue, energy metabolism, obesity, overweight
Abstract:Background and Objectives: Obesity is caused by excessive fat accumulation or abnormal fat distribution and has become one of the biggest health challenges worldwide. Considering the high thermogenic ability of brown
fat tissue (BAT) and the plasticity of fat tissue, to induce the browning of white fat tissue (WAT), so increasing BAT activity provides an attractive option for the prevention and resolution of obesity. The aim of the present narrative review was to understand the relationship between diet, BAT, and obesity. Methods and Study Design:
PubMed and Embase databases were searched to identify eligible studies. Results: Although cold exposure has long been known to be effective in the browning of WAT and activation of BAT, it is societally impractical for
everyday body weight management aside from the tolerance of ambient temperature. An alternative is to identify specific dietary components with similar effects to cold exposure on BAT. Current evidence indicates that capsaicin and capsinoids, catechins, curcumin, quercetin, berberine, lipoic acid, polyunsaturated fatty acids, royal jelly, and some natural sweeteners are effective promoters of WAT browning, increase BAT activity and improve obesity related traits. However, only capsaicin, capsinoids, and catechins have demonstrated efficacy in clinical trials.
Evidence for effects of curcumin, quercetin, berberine, lipoic acid, polyunsaturated fatty acids, royal jelly and natural sweeteners on BAT have only been observed in animal or in vitro studies, with clinical trials awaited for verification. Conclusions: Several dietary components can induce WAT browning and activate BAT, offering potential targets for obesity prevention and management.
Asia Pac J Clin Nutr. 2020;29(4):668-680.doi: 10.6133/apjcn.202012_29(4).0001
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Dietary camellia (Camellia oleifera Abel) seed oil in
traditional Chinese cooking for high-risk cardiovascular
disease: A three-arm double-blind randomized
controlled feeding trial protocol
Author:Min-Yu Wu, Ju-Sheng Zheng, Li-Rong Shen
Keywords:Camellia seed oil, cardiovascular risk factors, three-arm double-blind randomized controlled feeding trial,
traditional Chinese cooking, high risk of cardiovascular disease
Abstract:Background and Objectives: As the Chinese economy has developed, dietary patterns have modernized, thereby increasing the incidence of chronic diseases such as cardiovascular disease (CVD). Many observational studies
have shown that the Mediterranean diet based on olive oil is associated with a decreased incidence of CVD. This article aims to study the possible effects of dietary models by using three edible oils: olive oil, camellia seed oil (CSO), and soybean oil. CSO has a fatty acid composition similar to that olive oil and is unique in China, and soybean oil is a dietary oil used in traditional Chinese cooking. Methods and Study Design: This intervention is designed based on a three-arm double-blind randomized controlled feeding trial. Three dietary models are established according to traditional Chinese cooking methods, each using one of the three plant edible oils mentioned above as a leading factor. Participants will be randomly assigned to each group and provided with a designated
diet for 3 months. Results: The study population is planned to be women with a high risk of CVD and aged between 35 and 69 years. Weight and other CVD-related factors are treated as primary and secondary outcomes, respectively. Conclusions: This trial may inform dietary nutrition policies to a certain extent, especially concerning traditional Chinese cooking methods, for weight control and the improvement of cardiovascular-related risk factors in women with a high risk of CVD.
Asia Pac J Clin Nutr. 2020;29(4):751-762.doi: 10.6133/apjcn.202012_29(4).0010
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Associations between anthropometric parameters (body
mass index, waist circumference and waist to hip ratio) and newly diagnosed hyperuricemia in adults in Qingdao, China: A cross-sectional study
Author:Yun-yun Wang, Lin Li, Jing Cui, Fan Yin, Fan Yang,Dong-min Yuan, Hua-lei Xin, Lei Zhang, Wei-guo Gao, Jian-ping Sun
Keywords:hyperuricemia, body mass index, waist circumference, waist-to-hip ratio, obesity
Abstract:Background and Objectives: To evaluate the association between anthropometric parameter of obesity and newly diagnosed hyperuricemia (HUA) in a general Chinese population. Methods and Study Design: A population-based cross-sectional survey included 9 615 participants (3777 men and 5838 women) aged 35-74 years in 2006 and 2009 in Qingdao, China. The multivariate linear regression was used to assess the linear associations
between anthropometric parameter of obesity [body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)] and serum uric acid. The logistic regression model was performed to estimate the associations between BMI, WC, WHR and newly diagnosed HUA. Results: The prevalence of newly diagnosed HUA was higher in men than in women (19.46% vs 11.34%, p<0.05). Multivariate liner regression showed that BMI, WC
and WHR were positively correlated with serum uric acid. Multivariate logistic regression revealed that being overweight [men, odds ratios (OR): 1.69, 95% confidence intervals (95% CI): 1.37-2.08; women, OR: 1.67, 95%
CI: 1.34-2.09] and obese (men, OR: 3.01, 95% CI: 2.38-3.79; women, OR: 2.91, 95% CI: 2.31-3.67) were significantly associated with a higher risk of newly diagnosed HUA. Abdominal obesity (WC: men, OR: 2.26, 95% CI:
1.88-2.73; women, OR: 1.96, 95% CI: 1.61-2.39; WHR: men, OR: 1.91, 95% CI: 1.61-2.26; women, OR: 1.39, 95% CI: 1.16-1.67) were associated with an increased risk of newly diagnosed HUA. Conclusions: This study
demonstrated that BMI, WC and WHR were positively correlated with serum uric acid in both genders. Meanwhile, overweight, obese and abdominal obesity were associated with increased risk of newly diagnosed HUA.
Asia Pac J Clin Nutr. 2020;29(4):763-770.doi: 10.6133/apjcn.202012_29(4).0011
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Association of dietary diversity with uterine fibroids among urban premenopausal women in Shijiazhuang, China: A cross-sectional study
Author:Meiqi Zhou, Yijing Zhai, Cuiju Wang, Tian Liu, Su Tian
Keywords:uterine fibroids, premenopausal women, dietary diversity score, plant-based food variety score, Prime Diet Quality Score
Abstract:Background and Objectives: Uterine fibroids (UFs) are the most common neoplasm affecting reproductive-age women. The purpose of the present study is to explore the association between dietary diversity and risk of UFs in
a cross-sectional study of urban premenopausal women. Methods and Study Design: A total of 248 urban premenopausal women with age of 20-45 were recruited in 3 randomly chosen hospitals in Shijiazhuang, China. Dietary
diversity was assessed from food frequency intake data using dietary diversity score (DDS), Prime Diet Quality Score (PDQS) and food variety score (FVS). UFs were diagnosed by the methods of ultrasound, pelvic exam, or surgery. Binary logistic regression was used to estimate the relationship between dietary diversity and risk of UFs.
Results: 37 of the study subjects (14.9%) had UFs. Participants with a low education level and single marital statusparticipants had a lower DDS and PDQS, respectively. After adjustment for confounding factors, a higher DDS 24 was associated with decreased UF risk (OR=0.22, 95% CI=0.05–1.01). Similar trends were observed for the plantbased FVS (ptrend=0.025). Carrot (OR=0.04, 95% CI=0.00–0.48) and kiwi fruit (OR=0.03, 95% CI=0.00–0.47)
were also inversely associated with risk of UFs after adjustment for confounding factors. Conclusions: Multifarious food groups and the increase of variety of plant-based food, especially carrot and kiwi fruit, may be associated with the lower risk of UFs; they may play an important role in inhibiting the formation of UFs.
Asia Pac J Clin Nutr. 2020;29(4):771-781.doi: 10.6133/apjcn.202012_29(4).0012
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Community and individual iodine status assessment in premenopausal women in Shanxi, China: Repeated spot urine versus 24-hour urine
Author:Xiaomin Jia, Jie Liu, Wenwen Gu, Peng Zhang, Wendi Liu, Hong Zhu, Xiaotong Liu, Maocheng Sang, Jiawen Ding, Zhongna Sang
Keywords:iodine intake, repeated spot urine samples, UIC, 24h-UIE, individual iodine assessment
Abstract:Background and Objectives: Urinary iodine is an essential index of iodine nutrition evaluation. To establish the number of repeated spot urine collections necessary to reflect individual iodine status over 2 months and assess its feasibility to serve as an independent indicator of individual iodine status. Methods and Study Design: We performed a longitudinal, 2-months study from May to June in 2015 of 23 apparently healthy Chinese women aged 18 to 44 (32±9) y. Spot urine samples were collected on any two days of the week, and 24-h urine samples were collected once every 6 days. Results: 368 spot urine and 230 24-h urine samples were analysed. The median urinary iodine concentration (UIC) was 140.5 (75.2, 246.9) μg/L. The estimated 24-h urinary iodine excretion (24-h UIE) values from spot urine samples and measured 24-h UIE values from 24-h urine samples were
348±240 μg/24h and 330±216 μg/24h (p=0.003), respectively. Irrespective of the urinary iodine method, the intra-individual coefficient of variation (CV%) was lower than the inter-individual CV%. Bland-Altman analysis
revealed differences between spot urine and 24-h urine. When the precision ranges with 95% confidence were ±15%, ±20%, ±25% or 30%, the number of an individual’s spot urine samples required were 30, 16, 11 or 8, respectively. Conclusions: Repeated spot urine is not a feasible way to assess recent individual iodine intake. The development of a multi-indicator system could provide an acceptable individual evaluation index of iodine status.
Asia Pac J Clin Nutr. 2020;29(4):782-788.doi: 10.6133/apjcn.202012_29(4).0013
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Thyroid structure, function and iodine status by pregnancy trimester in Harbin, China
Author:Min Guo, Ze Yu, Jinlai Yao, Huaiqiu Cai, Xiaohui Shao, Xiaoqiu Dong
Keywords:pregnancy, thyroid, structure, function, urine iodine concentration
Abstract:Background and Objectives: Thyroid disease in pregnancy can have devastating effect on the fetus. In Harbin, China, there is insufficient knowledge about the incidence of and contributing factors to thyroid disease in pregnancy. This study investigates whether urine iodine concentration (UIC), as a proxy for iodine intake, affects the
thyroid structure and/or function during each trimester. Methods and Study Design: Data of 24000 pre-pregnant women were collected from January 2017 to August 2019. Serum thyroid hormone levels were measured, and
thyroid ultrasonography was performed. If thyroid ultrasonography and thyroid function findings were normal before pregnancy and were abnormal after pregnancy, the current gestational age was recorded and the UIC was
measured. Finally, a total of 500 participants were included in the study. Results: There were significant differences in the incidence of abnormal thyroid structure and function between trimester groups (p<0.05). Thyroid
nodular lesions were the most common abnormal ultrasound finding, and positive thyroid peroxide antibodies (TPOAb) were the most common abnormal thyroid function test results. There were significant differences in the
median UIC between trimester groups (p<0.001); the median UIC decreased with increasing gestational age. The incidence of abnormal thyroid structure or function was not significantly different across UIC groups (p>0.05).Conclusions: In women from Harbin, thyroid structural or functional abnormalities commonly occur in the second and third trimesters of pregnancy. Thyroid nodular lesions and positive TPOAb are the commonest thyroid abnormalities. The median UIC significantly declines with increasing gestational age. Pregnant women in Harbin have iodine-deficient states.
Asia Pac J Clin Nutr. 2020;29(4):789-794.doi: 10.6133/apjcn.202012_29(4).0014
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Birth anthropometry from a tertiary care hospital in Sri Lanka: Differs from the WHO growth standards
Author:Marianne Nishani Lucas, Pulani Lanerolle, Upul Senarath, Andrew Peter Hills, Vithanage Pujitha Wickramasinghe
Keywords:birth anthropometry, WHO growth standards, Sri Lanka, infant nutrition, parental height
Abstract:Background and Objectives: The nutritional status of infants is assessed using the WHO growth references, based on the Multicenter Growth Reference Study (MGRS) in many countries including Sri Lanka. Birth parameters define infant growth curves. The aim of this study was to compare the birth anthropometric data of a healthy population of babies born in Colombo, Sri Lanka with the WHO MGRS birth data and determine its suitability
for assessment of growth in this population. Methods and Study Design: Birth data were obtained as part of a study on longitudinal infant body composition from birth to 2 years from 2015-2019. Healthy babies, born to
non-smoking mothers, >18 years old, with a singleton pregnancy at term, living in the study area and intending to breastfeed, were recruited. The Ethical Review Committee of the Faculty of Medicine, University of Colombo,
approved the study. Results: Compared to WHO data, the mean birth weight (2.9±0.4 kg), length (48.2±2.7 cm) and head circumference (33.6±1.2 cm) of our study population (n=337) was significantly lower with a left shift in the z score distribution. This was despite similar background characteristics except for significantly lower income (USD 200) and lower maternal (154.2±9.0 cm) and paternal height (165±11.6 cm) in our study population. A significant change in birth parameters was only seen with maternal height when disaggregated. Conclusions: WHO birth parameters were significantly higher and underestimated the growth of healthy babies in Sri Lanka.
Asia Pac J Clin Nutr. 2020;29(4):795-802.doi: 10.6133/apjcn.202012_29(4).0015
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Dynamic changes in blood amino acid concentrations in preterm infants in different nutritional periods
Author:Danyang Liu, Li Wang, Haiqing Shen, Lianshu Han, Ying Wang, Zhenjuan He
Keywords:preterm infant, nutrition, amino acid, mass spectrometry, metabolism
Abstract:Background and Objectives: Neonatal nutrition is critical for the growth and development of preterm infants. Dynamic changes in the amino acid profiles in preterm infants of different gestational ages and in different nutritional periods were investigated. Methods and Study Design: Premature infants who received parenteral nutrition support after birth were enrolled and divided into four groups based on their gestational ages. Blood samples
were collected as a dried blood spot before nutritional support, and in the total parenteral nutrition, partial parenteral nutrition, and total enteral nutrition periods. Amino acid concentrations were detected in the samples by liquid chromatography tandem mass spectrometry and compared between the different nutritional periods and gestational ages. Results: Samples from 124 premature infants were statistically analyzed. Concentrations of all amino acids, except glutamine, were statistically different at distinct nutritional periods. Threonine and aspartic acid concentrations gradually increased, while valine, methionine, phenylalanine, and glycine concentrations gradually decreased with the transition from TPN to TEN. At different gestational ages, significant differences were observed in the concentrations of seven amino acids only in the PPN period but not in the others. Conclusions: The concentrations of amino acids in preterm infants vary with nutritional period.
Asia Pac J Clin Nutr. 2020;29(4):803-812.doi: 10.6133/apjcn.202012_29(4).0016
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Association between milk consumption and the nutritional status of poor rural Chinese students in 2016
Author:Xiaofan Zhang, Li Li, Juan Xu, Peipei Xu, Titi Yang, Qian Gan, Hui Pan, Xiaoqi Hu, Wei Cao, Qian Zhang
Keywords:milk consumption, poor rural areas, student nutrition improvement, China, nutritional status
Abstract:Background and Objectives: Milk promotes the growth of children’s height. However, the relationship between milk consumption and anemia or obesity remain unclear. We explored the association between milk consumption
and the nutritional status of poor rural Chinese students, including anemia, height, weight, malnutrition, and overweight/obesity. Methods and Study Design: A total of 22,315 students aged 8–16 years were recruited. The frequency of milk consumption and other information were investigated using the questionnaire. Students’ morning fasting height, weight, and whole-blood hemoglobin were measured. The children were classified as malnutrition, normal weight, and overweight/obesity according to their age-specific height and BMI. Multivariate linear and multiple logistic regression were used to analyze the association between milk consumption and nutritional status. Results: In total, 10.6% of students drank milk at least once a day. Compared to students who drank milk <1 time/week, The heights and weights of students who consumed milk 1–3 times/week, 4–6 times/week, and at least once per day were 0.8, 0.9, and 1.3 cm greater and 0.8, 0.6, and 1.0 kg heavier. Students who drank milk at least once a day (OR=0.817), and 1–3 times/week (OR=0.868) had a significantly lower prevalence of malnutrition. Students who drank milk 4–6 times/week (OR=0.472) had a significantly lower prevalence of anemia. However, no significant association was identified between milk consumption and overweight/obesity. Conclusions: Frequent consumption of milk was associated with these students having a lower risk of malnutrition and anemia, being taller, and being heavier.
Asia Pac J Clin Nutr. 2020;29(4):813-820.doi: 10.6133/apjcn.202012_29(4).0017
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Association between dietary pattern and the risk of type
2 diabetes mellitus in Zhejiang Province, China: A case-control study
Author:Mei Fang, Zhe-Fang Hu, Li-Jun Feng
Keywords:nutrient intake, type 2 diabetes mellitus, case-control study, nutrition education, life quality
Abstract:Background and Objectives: Diet is a modifiable risk factor of T2DM with the potential to improve the patients’ quality of life. The diet–diabetes relationship has received considerable attention in past decades. This
study describes dietary intake of nutrients in a matched case-control study of adults with and without T2DM. Methods and Study Design: Dietary nutrient intake was evaluated by semi-quantitative FFQ and biochemical
indexes were studied in enrolled 207 participants with T2DM (diabetes group) and 215 healthy participants (control group). The t-test of two independent-sample and chi-square test were used to compare data by age and other characters. Exploratory factor analysis was used for dietary pattern analysis. Logistic regression analysis were used to test the effect of different dietary patterns and dietary intakes on the risk of T2DM. Results: The blood glucose, triglyceride and low-density lipoprotein cholesterol levels were significantly higher in the diabetes group
(p<0.05). Three major dietary patterns were identified, “High-salt and high-fat”, “Traditional Chinese” and “Western” dietary patterns. With or without adjustment, highest quintile of high-salt and high-fat dietary pattern showed a significantly higher risk of T2DM than the lowest quintile. (OR=2.08, 95%CI: 1.24, 3.49, OR=1.70,
95%CI: 0.98, 2.54, OR=1.67, 95%CI: 0.97, 2.51). Conclusions: Individuals with a high-fat and high-salt dietary pattern had an increased risk of T2DM. These findings offered further insights into the dietary structure of T2DM patients. These findings put nutrition education at the center for T2DM patient management. Further follow-up study is needed to assess the dynamic changes of nutrient-metabolism association.
Asia Pac J Clin Nutr. 2020;29(4):821-826.doi: 10.6133/apjcn.202012_29(4).0018
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Dietary and serum selenium in coronary heart disease and all-cause mortality: An international perspective
Author:Baoming Xie, Jinhuan Wang, Jingyuan Zhang,Miaomiao Chen
Keywords: dietary selenium, serum selenium, coronary heart disease, all-cause mortality, NHANES
Abstract:Background and Objectives: The objective of this study was to explore the associations of dietary selenium and serum selenium concentration with coronary heart disease (CHD) prevalence and all-cause mortality among participants in United States. Methods and Study Design: Using data collected from the National Health and Nutrition Examination Survey (NHANES) 1999–2006, 17867 individuals were included. Logistic regression analyses were used to explore the associations between dietary selenium intake and serum selenium concentration and prevalent of CHD. Multivariable Cox regression was used to identify the association between dietary selenium intake and all-cause mortality. The nonlinear relationships were assessed using generalized additive models. Results: A U-shaped association between dietary intake of selenium and all-cause mortality was observed. Compared with the lowest quartile, the second quartile of dietary intake of selenium was inversely associated with all-cause mortality (Hazard ratio [HR]: 0.802, 95% confidence interval [CI]: 0.658, 0.977, p=0.029). There was no evidence of association between dietary selenium intake and CHD risk (Odds ratio [OR]: 1.001, 95% CI: 0.999, 1.003, p=0.206). Furthermore, serum selenium concentration was negatively associated with CHD risk (OR: 0.989, 95% CI: 0.981, 0.997, p=0.006). Comparing with the lowest quartile, participants with the highest serum selenium concentration had a statistically significant decreased prevalence of CHD, with OR (95% CI) of 0.417 (0.259, 0.669) (p<0.001). The smoothing curve also showed a non-linear relationship between serum selenium and risk of CHD. Conclusions:
This analysis suggested that a higher serum selenium concentration was associated with reduced risk of CHD, and that the relationship was non-linear. In addition, an appropriate dietary selenium intake might reduce all-cause mortality.
Asia Pac J Clin Nutr. 2020;29(4):827-838.doi: 10.6133/apjcn.202012_29(4).0019
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Enteral nutrition bibliometry from 2010 to 2019
Author:Xiaolin Li, Li Wang, Bin Zhao, Dan Mei, Jiandong Jiang
Keywords:enteral nutrition, bibliometry, visualization analysis, developing trends, research hotspots
Abstract:Background and Objectives: This study aimed to describe and analyze the research outputs on enteral nutrition, which is the administration of food through the gastrointestinal tract for nutrition maintenance. Methods and
Study Design: We searched the Web of Science Core Collection database for original publications on enteral nutrition research from 2010 to 2019. HistCite and VOSviewer software were used for analysis and visualization of
the publication outputs, journals, institutions, keywords, cocitations, and collaborations among authors in different countries or regions. Results: A total of 963 relevant articles were included. The number of publications in
2010 and 2019 were 68 and 139, respectively. Nutrition in Clinical Practice and the Journal of Parenteral and Enteral Nutrition had the highest number of publications and cocitations (76, 7.89%; 2058), respectively. The
United States and China were the top contributors, accounting for 24.1% and 22.3% of the total articles, respectively. Andrew S. Day and Stephen A. McClave were core researchers in this field. Primary authors collaborated
closely. Enteral nutrition, parenteral nutrition, and support were the three most common keywords. The top 10 cocited references concerned administering early enteral nutrition therapy in acutely ill patients and patients with acute Crohn’s disease. Crohn’s disease, acute pancreatitis, upper gastrointestinal malignancy, and other surgical diseases were among the research hotspots. Conclusions: Our findings can help researchers identify notable research trends and clinically relevant articles. New catheterization technologies are a future research direction.
Asia Pac J Clin Nutr. 2020;29(4):681-689.doi: 10.6133/apjcn.202012_29(4).0002
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Correlation of serum vitamin D with lipid profiles in middle-aged and elderly Chinese individuals
Author:Conghui Guan, Songbo Fu, Donghu Zhen, Xuehong Li, Jinglei Niu, Jianguo Cheng, Nan Zhao, Jinjin Liu, Hongtao Yin, Xulei Tang
Keywords:Vitamin D deficiency, lipid profiles, cross-sectional study, atherosclerotic cardiovascular disease, northwest China
Abstract:Background and Objectives: Deficiency of vitamin D has been associated with various health conditions. The purpose of this study was to evaluate the associations between the serum 25OHD concentration and lipid profiles
in Chinese individuals. Methods and Study Design: Serum 25OHD and lipid profiles were obtained for a cross sectional sample of 10100 individuals aged 40-75 years from Lanzhou city, which is located in western China.
Linear-by-linear association, partial correlation analysis and multiple logistic regression analysis were used to evaluate associations between serum 25OHD concentration and lipid profiles. Results: 10038 subjects aged 40-75 years were included in the study. The 25OHD deficient and insufficient groups had higher TC, LDL-C and TG when compared to the optimal group. The dyslipidemia rates of vitamin D deficiency, insufficiency, and sufficiency groups were 45.4%, 41.6%, 38.8%, respectively. The prevalence rates of dyslipidemia, high cholesterol,
high LDL-C, hypertriglyceridemia and mixed type hyperlipidemia exhibited decline trend in vitamin D deficiency, insufficiency and sufficiency groups. The correlation coefficients in between TC and 25OHD, LDL-C and
25OHD, TG and 25OHD were -0.033, -0.022, -0.044, respectively. Low 25OHD levels were associated with the risk of onset of dyslipidemia [OR 1.225 (95% CI 1.075-1.397), p=0.002] in the logistical regression analyses.
Conclusions: Deficient serum 25OHD is associated with higher TC, LDL-C, and TG in middle-aged and elderly Chinese individuals. These findings suggest that low 25OHD levels observationally is simply a marker for elevated atherogenic lipoproteins and question a role for vitamin D supplementation in the prevention of cardiovascular disease.
Asia Pac J Clin Nutr. 2020;29(4):839-845.doi: 10.6133/apjcn.202012_29(4).0020
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Total folate, natural folate and synthetic folic acid intake associations with adult depressive symptoms
Author:Liwen Zheng, Xiaohui Yu, Wenjie Jiang, Dongfeng Zhang
Keywords:depressive symptoms, folate, NHANES, synthetic folic acid, natural folate
Abstract:Background and Objectives: In the United States, synthetic folic acid has become an important source of folate in the era of mandatory folic acid fortification. This study aimed to evaluate the associations between total folate, natural folate and synthetic folic acid intakes and depressive symptoms among US adults. Methods and Study Design: Cross-sectional data was collected from the National Health and Nutrition Examination Survey
(NHANES) 2007-2016. Dietary data were obtained through two 24-h dietary recall interviews. Depressive symptoms were detected by PHQ-9 (Patient Health Questionnaire-9), participants whose depression scores over 10
points were diagnosed as depressive symptoms. Weighted logistic regressions were used to analyze the associations between different forms of folate and depressive symptoms. Results: Among 19244 participants included in
this study, 9.2% of them met the definition of depressive symptoms. In fully adjusted models, total folate intake and natural folate intake were inversely associated with depressive symptoms respectively, while synthetic folic acid was not. The multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were 0.69 (0.54-0.89), 0.51 (0.39-0.68) for the highest versus lowest quartile of total folate and natural folate intake, respectively. We also found two L-shaped dose-response curves among total folate intake, natural folate intake with depressive symptoms, respectively. Conclusions: Total folate intake, natural folate intake may be inversely associated with depressive symptoms among US adults, while the association was not significant between synthetic folic acid and depressive symptoms.
Asia Pac J Clin Nutr. 2020;29(4):846-855.doi: 10.6133/apjcn.202012_29(4).0021
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Weight and cardiometabolic risk among adolescents in Agano city, Japan: NICE EVIDENCE Study-Agano 1
Author:Sakiko Yoshizawa Morikawa, Kazuya Fujihara, Yasunaga Takeda, Mariko Hatta, Chika Horikawa, Masahiro Ishizawa, Masahiko Yamamoto, Tomonobu Shiraishi, Hajime Ishiguro, Takaho Yamada MD, Yohei Ogawa, Hirohito Sone
Keywords:overweight, underweight, blood pressure, lipids, glycated hemoglobin A1c
Abstract:Background and Objectives: Pediatric obesity is associated with clustered cardiometabolic risk and the future incidence of cardiovascular disease. However, few studies have determined the effect of pediatric obesity in Asia, where obesity is less common than in Western countries. We aimed to clarify whether weight status including underweight and slightly overweight is associated with metabolic risk factors in Japanese adolescents. Methods
and Study Design: We performed a cross-sectional analysis of 2241 adolescents aged 13–14 years. Participants were classified as underweight, normal weight, slightly overweight, overweight, or obese according to the International Obesity Task Force. The clustered cardiometabolic risk (Z-CMR) was estimated by summing standardized sex-specific Z scores of mean arterial pressure (MAP), non-high-density lipoprotein cholesterol (non-HDLC), and HbA1c. Results: Linear regression analysis showed that MAP, non-HDL-C, and Z-CMR were higher in the slightly overweight, overweight, and obese groups than in the normal weight group after adjusting for confounders. Compared with the normal weight group, the slightly overweight, overweight, and obese groups had higher prevalence of high BP [odds ratios (ORs): 1.38 (95% CI, 1.03, 1.85); 2.63 (1.77, 3.91); and 2.39 (1.57, 3.64), respectively]. Compared with the normal weight group, underweight boys, but not girls, had a lower prevalence of high Z-CMR [OR=0.20 (0.05, 0.84)]. Conclusions: Adolescents classified as slightly overweight had higher levels of BP, serum lipids, and clustered cardiometabolic risk than those classified as normal weight. This
observation showed significant associations between weight status and cardiometabolic risk factors during adolescence even in East Asians.
Asia Pac J Clin Nutr. 2020;29(4):856-866.doi: 10.6133/apjcn.202012_29(4).0022
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Food consumption and mild cognitive impairment in Qingdao rural elderly: A cross-sectional study
Author:Rui Xu, Tianlin Gao, Jing Cai, Huaqi Zhang, Huaqi Zhang, Han Zhou, Kunxiang Ding, Lei Chen, Feng Zhong, Aiguo
Keywords:diet, food habits, mild cognitive impairment, elderly, cross-sectional study
Abstract:Background and Objectives: Diet plays a crucial role in cognition. Mild cognitive impairment has a high prevalence in rural elderly people. However, few studies have investigated the relationship between diet and mild cognitive impairment among rural elderly people in China. The study evaluated the association between diet and the risk of mild cognitive impairment among them. Methods and Study Design: In this cross-sectional study, we enrolled 1262 participants (≥65 years) living in rural Qingdao, China. Cognitive function was assessed using the Mini-Mental State Examination, and dietary consumption was measured using a food frequency questionnaire.Logistic regression models were used to assess the associations. Results: In all, 315 (25%) participants had mild
cognitive impairment. The weekly frequency of food consumption was lower in the mild cognitive impairment group than in the no mild cognitive impairment group. After adjusting for covariates, compared with participants who consumed never/less than once a week, daily consumption of coarse cereals (OR: 0.64, 95% CI: 0.44-0.91), potatoes (OR: 0.54, 95% CI: 0.34-0.87), fruits (OR: 0.49, 95% CI: 0.35-0.69), livestock and poultry meat (OR: 0.66, 95% CI: 0.44-0.99), eggs (OR: 0.67, 95% CI: 0.47-0.97), and nuts (OR: 0.47, 95% CI: 0.28-0.80) was inversely associated with mild cognitive impairment (all p<0.05). Conclusions: Higher dietary diversity and more frequent consumption of coarse cereals, potatoes, fruits, livestock and poultry meat, eggs, and nuts were associated with a lower risk of mild cognitive impairment. Elderly people should develop healthy dietary habits to prevent or delay cognitive decline.
Asia Pac J Clin Nutr. 2020;29(4):867-875.doi: 10.6133/apjcn.202012_29(4).0023
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Development of a tool for food literacy assessment for
young adults: findings from a Korean validation study
Author:Yeseul Na, Mi Sook Cho
Keywords:food literacy, tool development, factor analysis, food choice, dietary behavior
Abstract:Background and Objectives: There is little research on the development and validation of measurement tools to evaluate integrative concepts of food literacy; however, this is a growing research area. Methods and Study Design: A food literacy measurement tool for young Korean adults was developed in three phases: (1) tool development and content validation using the Delphi method (2) pilot testing (n=108) and (3) confirmatory study (n=435) and internal consistency using Cronbach’s α and the test-retest for reliability. p<0.05 was considered statistically significant. Results: Feedback from the Delphi rounds resulted in modification and rewording of nine items, yielding 105 items with acceptable content validity ratio (CVR). Exploratory factor analysis (EFA) revealed an eight-factor construct: food and nutrition knowledge, food safety, food systems, sociocultural context, food skill, food choice, self-efficacy, and food resource management. Confirmatory factor analysis (CFA) indicated that the validated tool met the acceptable indices of basic psychometric standards, and internal consistency was satisfactory for all subscales (Cronbach’s α >0.70). Conclusions: A validated food literacy assessment tool
for young Korean adults was developed.
Asia Pac J Clin Nutr. 2020;29(4):876-882.doi: 10.6133/apjcn.202012_29(4).0024
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Takeaway food in Chengdu, Sichuan province, China: Composition and nutritional value
Author:Jianwei Ren, Xinyue Luo, Xuan Zhao, Weiqing Yang, Mingqi Yang, Yan Wang,Wenjia Wang, XiaoLi Zou,Ping Yuan
Keywords:takeaway meals, nutritional value, nutritional composition, China, nutritional evaluation
Abstract:Background and Objectives: The popularity of takeaway has caused health problems. To analyse the basic nutrients and composition of popular takeaway meals in Chengdu, China. Methods and Study Design: We randomly collected 105 takeaway meals from takeaway platforms. The quality of ingredients such as grains, vegetables, and meat were assessed and weighed. The samples were then homogenised, and the nutrients were detected
following the AOAC Official Methods of Analysis. Results: Compared with Chinese and US dietary reference intakes, the average energy, protein, salt, fat, vitamin, and available carbohydrate contents exceeded dietary recommendations for one takeaway meal. By contrast, the whole grain, vegetable, fruit, dairy product, egg, mineral, and dietary fibre contents were insufficient. Food compositions and basic nutrients differed among takeaway meals prepared with various cooking methods and meats. Fried rice had the lowest nutritional value. The fried dish set meal had high energy density. The nutrient content of poultry takeaway meals was more balanced compared with other meals assessed, and salt and fat were excessive in mixed meat meals. In addition, meatless takeaway meals tended to have high fat content because of excess vegetable oil added for better taste. Conclusions: Takeaway meals should have lower contents of energy, fat, carbohydrate, and salt and higher contents of whole grains, vegetables, fruits, dairy products, and eggs. Attention should be paid to the high energy density of the fried dish set meal to prevent resultant health problems such as obesity. Consumers, takeaway outlets, and government agencies need to work together to address the health problems.
Asia Pac J Clin Nutr. 2020;29(4):883-898.doi: 10.6133/apjcn.202012_29(4).0025
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Long-term impact of fistula status on growth and
anemia in infants with congenital anorectal
malformations
Author:Zhongmin Gao, Benjuan Ying, Lin Kong, Yongfang Liu
Keywords:congenital anorectal malformation, growth, infant, anemia
Abstract:Background and Objectives: To evaluate the impacts of fistula status over 12 months on growth and development and anemia in infants with anorectal malformation (ARM) and to analyze the effects of comorbidities.
Methods and Study Design: The ARM group included infants who suffered from ARM and underwent three operations including colostomy, anoplasty (group A) and fistula closure (group B). The normal group included infants aged approximately 6 months and 12 months who were classified as groups C and D. A 24-h dietary recall questionnaire was completed by the guardians of all the participants. Data on height, weight, hemoglobin (Hb) level and comorbidities were extracted from electronic medical records. Then, we compared the impacts of the 12-month fistula status on growth and development and anemia among the infants. Results: In total, 47 patients
in the ARM group and 100 infants in the normal group were included. The height-for-age z-score (HAZ) was lower in group A than in group B. Compared with those in group D, weight, height, the HAZ and the weight-forage z-score (WAZ) were lower in group B. The incidence of anemia was higher in the ARM group than in the normal group. Conclusions: Patients with ARM are at risk for growth problems and anemia. The long-term impacts of fistula status on infant length presented earlier than those associated with other physical indicators. Compared to infants with urogenital comorbidities, those with congenital heart disease (CHD) seemed to be more prone to growth disorders and anemia.
Asia Pac J Clin Nutr. 2020;29(4):690-695.doi: 10.6133/apjcn.202012_29(4).0003
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Efficacy of ursodeoxycholic acid in nonalcoholic fatty
liver disease: An updated meta-analysis of randomized
controlled trials
Author:Wenyue Zhang, Yao Tang, Juan Huang, Huaidong Hu
Keywords:ursodeoxycholic acid, nonalcoholic fatty liver, alanine aminotransferase, meta-analysis, randomized
controlled trial
Abstract:Background and Objectives: The role of ursodeoxycholic acid (UDCA) in Nonalcoholic fatty liver disease (NAFLD) is not well-defined. In this meta-analysis, we analyzed the efficacy of UDCA for the treatment of NAFLD. Methods and Study Design: We searched the Web of Science, Pubmed, Embase and Cochrane library databases for relevant studies published before September 1, 2019. The randomized controlled trials (RCTs) that investigated the effectiveness of UDCA in NAFLD were selected and examined by Stata (version 12.0). Results: The forest plot displayed that UDCA treatment can significantly decrease the ALT (alanine aminotransferase) levels (p=0.007). Further, its’ significant role in subgroup analyses (p=0.003 in people from Europe, p=0.001 in people older than 50 years and p=0.008 in longer duration). Conclusions: Although UDCA treatment was found beneficial in ALT-lowering, future meta-analysis will be required to fully confirm and validate the efficacy of UDCA in NAFL.
Asia Pac J Clin Nutr. 2020;29(4):696-705.doi: 10.6133/apjcn.202012_29(4).0004
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Nutritional statuses before and after chemotherapy
predict the prognosis of Chinese patients after
gastrectomy for gastric cancer
Author:Ping Wu, Renjia Du, Yun Yu, Feiyang Tao, Xiaosong
Keywords:nutritional status, gastric cancer, surgery, adjuvant chemotherapy, prognosis
Abstract:Background and Objectives: Nutritional parameters may predict the prognosis of patients with gastric cancer. This study investigated whether changes in nutritional parameters before and after chemotherapy were associated
with survival among patients who underwent gastrectomy for gastric cancer. Methods and Study Design: We retrospectively reviewed data from 77 Chinese patients who had undergone gastrectomy for stage III gastric cancer at a single center. Laboratory data from before and after chemotherapy were collected regarding peripheral albumin, prealbumin, total protein, hemoglobin, and total cholesterol concentrations. The prognostic nutritional index (PNI) values were calculated and compared before and after chemotherapy. The relationships between survival and the pre-chemotherapy and post-chemotherapy nutritional statuses were evaluated. Results: Among the 77 patients, survival was associated with the staging, the pre-chemotherapy PNI values, and the postchemotherapy body mass index (BMI) values. Significantly better overall survival was associated with a high pre-chemotherapy PNI value (hazard ratio [HR]: 0.485, 95% confidence interval (CI): 0.255–0.920) and a normal post-chemotherapy BMI value (HR: 0.475, 95% CI: 0.249–0.907). Even better survival was associated with the
co-existence of a high pre-chemotherapy PNI value and a normal post-chemotherapy BMI value (vs. one or more abnormal parameter, HR: 0.337, 95% CI: 0.167–0.679). Conclusions: Chinese patients who underwent gastrectomy for gastric cancer had nutritional statuses that deteriorated after adjuvant chemotherapy. High prechemotherapy PNI values and normal post-chemotherapy BMI values were associated with better survival outcomes. Thus, low pre-chemotherapy PNI values and/or low post-chemotherapy BMI values may predict poor outcomes among these patients.
Asia Pac J Clin Nutr. 2020;29(4):706-711.doi: 10.6133/apjcn.202012_29(4).0005
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Association of nutritional status with osteoporosis,
sarcopenia, and cognitive impairment in patients on
hemodialysis
Author:Heeryong Lee, Kipyo Kim, Jeongmyung Ahn, Dong Ryeo Lee, Jin Ho Lee, Seun Deuk Hwang
Keywords:malnutrition, sarcopenia, osteoporosis, hemodialysis, cognitive impairment
Abstract:Background and Objectives: Inadequate nutrition in patients on hemodialysis causes various complications. This study aimed to investigate the association between nutritional status and risk of osteoporosis, sarcopenia, and cognitive impairment in patients on hemodialysis. Methods and Study Design: We enrolled 131 older patients on maintenance hemodialysis. Geriatric Nutrition Risk Index (GNRI) was used to assess nutritional status. Patients were divided into quartile groups according to the GNRI. Dual-energy X-ray absorptiometry, bioimpedance analysis and handgrip strength measurement, and the Korean version of the Montreal Cognitive Assessment were used to assess osteoporosis, sarcopenia, and cognitive impairment, respectively. Biochemical laboratory tests were also
performed before mid-week hemodialysis session. Results: Patients from higher GNRI quartiles had a lower prevalence of osteoporosis and sarcopenia. Cognitive impairment was not associated with any GNRI quartile. In the multivariable models, longer dialysis periods (OR 1.696, 95% CI 1.053-2.729, p=0.030) and higher intact parathyroid hormone levels (OR 3.136, 95% CI 1.781-5.518, p<0.001) were significantly associated with osteoporosis risk.
GNRI quartile 2 (OR 0.064, 95% CI 0.005-0.883, compared to quartile 1, p=0.040) and higher hemoglobin A1c levels (OR 3.728, 95% CI 1.033-86.4, p=0.043) were associated with a higher sarcopenia risk. Lower hemoglobin
levels (OR 0.585, 95% CI 0.360-0.950, p=0.030) were associated with a higher risk of cognitive impairment. Conclusions: In patients on hemodialysis, inadequate nutrition was associated with the risk of osteoporosis and sarcopenia, but not cognitive impairment. Proper nutritional assessment and management in these patients could prevent
complications related to bone and muscle loss.
Asia Pac J Clin Nutr. 2020;29(4):712-723.doi: 10.6133/apjcn.202012_29(4).0006
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Sarcopenia associated with 90-day readmission and
overall survival after abdominal trauma
Author:Fengchan Xi, Shanjun Tan, Tao Gao, Weiwei Ding,Yuqing Song, Jie Yang, Weiqin , Wenkui Yu
Keywords: sarcopenia, skeletal muscle index, readmissions, trauma
Abstract:Background and Objectives: It is widely recognized that sarcopenia increases postoperative complications in trauma patients. However, the effects on prognosis remain unclear. This study aimed to evaluate the impact of sarcopenia on 90-day readmission and overall survival (OS) in abdominal trauma patients. Methods and Study Design: 485 consecutive patients who underwent abdominal surgery after trauma in our institution were enrolled.
Sarcopenia was diagnosed with low muscle mass and low muscle strength-handgrip. Multivariate logistic regression analysis was performed to identify factors that contributed to 90-day readmission and OS. Cox logistic regression analysis was used to assess the relationship between sarcopenia and OS. Results: Sarcopenia was present in 120 of 485 patients (24.7%) with abdominal trauma within one week after admission based on the diagnostic cut-off values (40.9 cm2/m2for men and 36.8 cm2/m2 for women). 90-day readmission was significantly higher in the sarcopenia group (p=0.019), and OS lower in the sarcopenia group (p=0.025). Sarcopenia was an independent predictor of 90-day readmission [odds ratio (OR): 5.34, 95% confidence interval (CI): 2.52-11.3].
Conclusions: Sarcopenia was associated with high 90-day readmission and low OS in abdominal trauma patients, and it was an independent risk factor for 90-day readmission.
Asia Pac J Clin Nutr. 2020;29(4):724-731.doi: 10.6133/apjcn.202012_29(4).0007
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Effect of zinc and vitamin A supplementation on
immune responses in Indonesian pre-schoolers
Author:Martha Irene Kartasurya, Geoffrey C Marks, Faruk Ahmed,Hertanto W Subagio,Mohammad Zen Rahfiludin
Keywords:zinc, vitamin A, supplementation, immune response, preschool children
Abstract:Background and Objectives: Vitamin A and zinc are interrelated, but the effects of zinc on vitamin A supplementation on morbidity are inconsistent and not well understood. We investigated the effects of zinc and vitamin
A supplementation on immune responses in Indonesian pre-schoolers. Methods and Study Design: In a twostage study design, 826 children (2-5year old) were randomly assigned to receive daily zinc supplement (10 mg) or placebo for 4 months. At 2 months, both groups received a 200,000 IU vitamin A capsules through national vitamin A program. Data were collected at baseline, two and four months, resulting in 4 groups for comparisons:
– no zinc no vitamin A (Placebo), zinc only, vitamin A only, and zinc plus vitamin A. Hair, blood and saliva samples were collected to measure hair zinc and serum retinol (vitamin A) concentration, ex-vivo IFN-γ, serum
IgG and salivary IgA from 81 children selected randomly from each group. Results: At baseline, there were no differences between treatment groups. Zinc supplementation increased ex-vivo IFN-γ production, greatest
amongst boys, younger (<3.5 years), normal weight and children with low baseline retinol concentration. Vitamin A supplementation increased IFN-γ only in those with low baseline retinol, with no effect on serum IgG and salivary IgA. After vitamin A supplementation, zinc had an effect on salivary IgA among younger and underweight children. Conclusions: Zinc supplementation increased IFN-γ (cellular immune responses) and modified the effect of vitamin A supplementation on salivary IgA (mucosal innate immune response) in younger and underweight children.
Asia Pac J Clin Nutr. 2020;29(4):732-742.doi: 10.6133/apjcn.202012_29(4).0008
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The benefits of a novel chicken-based oral nutritional
supplement for older adults: A double-blind randomized
controlled trial
Author:Prasert Assantachai, Pipop Jirapinyo,Narumon Densupsoontorn, Somboon Intalapaporn, Wichai Chatthanawaree, Weerasak Muangpaisan, Chalobol Chalermsri, Patumporn Suraarunsumrit, Titima Wongviriyawong, Napaporn Pengsorn, Angkana Jongsawadipatana, Dujpratana Pisalsarakij, Suthipol Udompunturak
Keywords:chicken-based, oral nutritional supplement, older adults, gait speed, bone marker
Abstract:Background and Objectives: A considerable proportion of older adults are lactose intolerant. The aim of this study was to investigate the clinical safety, efficacy, and tolerability of a chicken-based oral nutritional supplement (ONS). Methods and Study Design: Double-blind randomized controlled trial. Subjects in the intervention group received chicken-based ONS, and those in the control group received a similarly flavored oral fluid placebo. All subjects were followed-up every two months for a total of 6 months. Results: Thirty-eight older adults aged ≥70 years were recruited. The mean age and BMI were 81.5±5.6 years and 19.6±2.5 kg/m2. At the end of this trial, there was no statistically significant change in sarcopenia-related variables in the intervention group. However, the higher-level physical activity (PA) group within the intervention group had a significantly improved usual gait speed (UGS) compared to the lower-level PA group (p=0.04). The adjusted mean differences in UGS between the high and low level PA groups in the intervention and placebo groups were 0.149 m/sec and 0.083 m/sec, respectively. Significant difference was observed for changes in two bone markers between the intervention and placebo groups. Conclusions: The chicken-based ONS evaluated in this study was well-tolerated. No improvement of sarcopenia-related components was shown by the study ONS. Up to nearly an 80% increase in adjusted mean difference in UGS between the high and low level PA groups was observed in the nutritional intervention group compared to the zero-protein calorie placebo group. Significant improvement in age-related bone resorption was the earliest advantage of taking our ONS.
Asia Pac J Clin Nutr. 2020;29(4):743-750.doi: 10.6133/apjcn.202012_29(4).0009
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