Supplementary feeding in programmes in developing countries: lessons of the eighties. Part 1: Findings of the report
Author:Hossein Ghassemi
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Abstract:This extensive report reviews the important lessons learned during the 1980s on supplementary food distribution for the vulnerable groups in developing countries. These lessons may be useful in making such programs a more cost-effective option in narrowing the food/nutrient gap in intake among the program beneficiaries. This report follows a similar report published at the end of the 1970s by the author and George Beaton for UNICEF. The primary focus in the study has been the food distribution among young children, particularly school children, and also in pregnant and lactating women. The data have been gathered through a comprehensive search of the literature, official reports and documents from several United Nations agencies, aid agencies, national and international institutions. As well as original research papers on theoretical and applied issues, reports on design and evaluation of specific programs in over 20 countries are studied. Consideration of programme design examines objectives, nutrient/food gap, poverty reduction, malnutrition, mother and child feeding practices, foods, ration sizes, leakages, targeting, coverage, integration of feeding and health care. Potential and measured benefits are considered in the light of the reports published at the end of the 1970s and consequent analysis of work up until the end of the 1980s. Programme costs are documented. In a discussion on context and input, the functional significance of mild and moderate malnutrition is considered, together with diet and physical activity. The author offers some thoughts on future directions and highlights the need for further research.
Asia Pac J Clin Nutr. 1992;1(3):131-152.doi:
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Determination of tocotrienol and tocopherol isomers at physiological concentrations by HPLC in Caucasian and Japanese women
Author:Che Sam Lo, Mark L Wahlqvist, Yoshimitsu Horie,Nai
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Abstract:A sensitive, specific and simple method for simultaneous evaluation of tocopherol and tocotrienol isomers in human serum by normal phase HPLC with a fluorescence detector has been developed. Tocopherol and tocotrienol isomers are measurable in physiological concentration in human serum by this method. There is no significant difference in serum alpha- and beta-tocopherols and alpha-, gamma-, and delta-tocotrienols between Caucasian and Japanese subjects. However, serum gamma- and delta-tocopherol concentrations in Japanese women are significantly higher than in Caucasian women.
Asia Pac J Clin Nutr. 1992;1(3):153-158.doi:
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Trends and dietary implications of some chronic non-communicable diseases in peninsular Malaysia
Author:Geok Lin Khor, Chong-Ying Gan
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Abstract:Non-communicable diseases with dietary implications, ischaemic heart disease, diabetes mellitus and cancers of the breast and colon are discussed in relation to their prevalence and mortality rates in peninsular Malaysia during the past few decades. The mortality rate due to diseases of the circulatory system has more than doubled since 1970, deaths due to ischaemic heart disease being the major cause. The prevalence of diabetes mellitus has risen from 0.65% in 1960 to about 4% currently. The mortality risk for both ischaemic heart disease and diabetes is highest in the Indian compared to Malay and Chinese populations. The Chinese show the highest mortality rate for cancers of the breast and colon. This could reflect, partly, because more people especially in the urban areas are seeking treatment and improved diagnosis. Empirical dietary data indicate an increase in the prevalence of hypercholesterolaemia among urban adults and overweight among urban and rural adults. Aggregate data from food balance sheets indicate increased availability of energy intake from fats and oils, sugar, and animal products, with concomitant decline in available energy from plant products. Continued public health education on the important linkage between diet and disease is called for.
Asia Pac J Clin Nutr. 1992;1(3):159-168.doi:
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The effects of soluble dietary fibre from the Thai herb, sweet basil seed, on human body composition
Author:Preeya Leelahagul, Supanee Putadechakum, Vichai Ta
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Abstract:Twenty obese patients, two males and 18 females, with a mean (± SEM) age of 41.7± 3.2 years and body mass index (BMI) of 31.8± 3.8 kg/m2, were enrolled in a 16-week study to evaluate the usefulness and limitations of treatment with a sweet basil seed (Ocimum canum, Sims) extract. For 16-week (wk0-wk16), they were instructed to reduce their usual energy intake. After baseline observations for 4 weeks, for 12 wk (wk4-wkl6), patients were asked to ingest 2 g of sweet basil seed extract, swollen with 240 ml of water, before lunch and supper (4 g/day). Sixteen patients commenced extract use at wk4. On the basis of their ability to ingest more or less than 50% of the extract, they were categorized into high dose (n= 10) and low dose (n=6) users. In high dose users, there were a significant decrease in BMI by the 4th week of treatment which was maintained at the 8th and 12th weeks of treatment, but skinfold thickness measurements for fat did not decrease. There may, therefore, have been a reduction in total body water. Further support for this view was provided by an observed increase in serum total protein concentration at the 12th week of intervention. That the distribution of water may have changed was suggested by an increase in upper arm muscle circumference (UAMC). For low dose users, on the other hand, their body fat increased at wk8 as indicated by both BMI and skinfold thickness measurements, suggesting that supplement use gave a sense of false security. Apart from the change in serum total protein in the high dose group, no significant effect was observed on lipid, renal or electrolyte status, although fasting glucose rose within the normal range. This investigation demonstrated the importance of direct measures of body fatness, as opposed to those implied from weight-height relationships in the evaluation of management strategies for obesity.
Asia Pac J Clin Nutr. 1992;1(3):169-174.doi:
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Promotion of healing by orally administered glutamine in elemental diet after small intestinal injury by X-ray radiation
Author:Takuzo Nambu, Tadao Bamba, Shiro Hosoda
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Abstract:Glutamine was administered orally to rats with damaged small intestinal mucosa as the result of injury by X-ray radiation at 10 Gy to the abdomen. The healing effects of glutamine on the injured mucosa were studied serially from the day of radiation (Day 0) to Day 4. The rats received two types of isocaloric elemental diet, Gln( + ) containing 2% glutamine and Gln( - ) containing no glutamine, by paired feeding. From Day 2 to Day 4, the wet weight, protein content, and DNA content of the jejunal mucosa were significantly greater in the Gln(+) than in the Gln(-) group. On Day 3, when the damage of the intestinal mucosa was the severest, the crypt cell production rate in the jejunum was significantly higher in the Gln(+) than in the Gln(-) group. The permeability of the intestinal mucosa to 51CrEDTA, administered to the rat stomach through an oro-gastric tube, remained significantly lower in the Gln( + ) group . Light microscopic findings showed that oedema in the lamina propria mucosae of jejunum and fusion of jejunal villi were milder in the Gln(+) group on Day 4. when the mucosal mass began to recover. The arterial and portal blood glutamine concentration, and glutamine extraction by the gut from arterial blood and phosphate-dependent glutaminase activity in the jejunal mucosa, were higher in the Gln(+) than in the Gln(--) group. Ornithine decarboxylase activity was increased in both the jejunum and the ileum from Day 3, but no difference was observed between the two groups. These findings suggest that, after X-ray radiation injury of the intestinal mucosa, the oral administration of the elemental diet containing 2% glutamine improved glutamine metabolism of the body, promoted the proliferation of jejunal epithelium, accelerated the recovery of the mucosal mass and the morphology of villi, and then contributed to maintaining the barrier function of the intestine from an early stage after the injury.
Asia Pac J Clin Nutr. 1992;1(3):175-182.doi:
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Options in obesity management
Author:Mark L Wahlqvist
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Abstract:The management of obesity requires acknowledgment of its heterogeneity. This derives from differences in pathogenesis, in genetic and psychological background. in physical activity. in food intake, and in aspects of lifestyle like cigarette smoking; as well as in degree, fat distribution. stability, and in consequences and associated disease. Pivotal to management is an appreciation that negative energy, balance can be achieved at various levels of energy intake. depending on physical activity or on the degree of inefficiency of energy utilization. Reduced food intake can help people start with reduction in body fatness and is sometimes necessary for extended periods. but in the long run, an emphasis on increased levels of physical activity is preferred. Management endpoints need careful consideration since a great deal can be done to help the obese without necessarily changing weight. It is important to document changes in body fat and its distribution particularly by way of abdominal girth. Setting other healthful endpoints. such as food intake itself, self-esteem, physical fitness, risk profile for non-communicable disease, and self-care, are equally important. Management options -- social, behavioural, exercise, pharmacotherapeutics and surgical - can be considered singly, sequentially or in combination. There are risks of management and these will include social, psychological (sense of failure and alteration in body image), economic nutritional and physical (eg injury), and the more specific side-effects of pharmacotherapeutics and of surgery. Finally, the prevention of obesity requires the early detection of risk, eg the emergence of abdominal fatness with little change in total body fatness, and attention to health education, regular physical activity and the use of food with little fat.
Asia Pac J Clin Nutr. 1992;1(3):183-190.doi:
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Book Review: Nutrition in developmental transition in South-East Asia
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Asia Pac J Clin Nutr. 1992;1(3):191.doi:
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