Asia Pacific Clinical Nutrition Society 2000 Award
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Asia Pac J Clin Nutr. 2000;9(2):61.doi:
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Serum fatty acids, lipoprotein(a) and apolipoprotein composition of rural, suburban and urban populations in North Vietnam
Author:Nguyen Thi Minh Kieu MD, Etsuko Yasugi PhD, Do Thi
Keywords:apolipoprotein, cardiovascular disease, dietary pattern, fatty acid, fat consumption, lipoprotein(a)
Abstract:This study was conducted to investigate the concentrations of serum fatty acids, lipoprotein(a) and
apolipoprotein of three populations in North Vietnam: rural area with low income (n= 101), suburban with
average income (n= 97), and urban with high income (n= 95). The results showed the suburban and urban
populations had higher fat intake than the rural. The fat intake in quality was different in these three
populations. The suburban had the highest consumption of fatty foods rich in n-6 polyunsaturated fatty acid
(PUFA). The rural consumed more fatty foods rich in monounsaturated fatty acid (MUFA), but less fatty foods
rich in n-3 PUFA than the two other populations. The high index of thrombogenicity (IT) of the Vietnamese diet
may result from their low intake of fish and vegetable oils. Risk factors for premature cardiovascular disease
(CVD) assessed by serum lipoprotein(a) and apolipoprotein levels were not observed in all three populations.
However, coronary heart disease (CHD) and stroke are problems that should be monitored because the increase
of CVD morbidity has been reported in Vietnamese people. From a nutritional point of view, the increase of fish
and vegetable oils consumption is necessary for the prevention of CVD and CHD in these Vietnamese
populations.
Asia Pac J Clin Nutr. 2000;9(2):62-66.doi:
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Concurrent management of postprandial glycaemia and nutrient intake using glycaemic glucose equivalents, food composition data and computer-assisted meal design
Author:John A Monro BSc(Hons), PhD and Mike Williams BSc
Keywords:carbohydrate, diabetes, food composition data, glycaemia, glycaemic glucose equivalents, nutrition software
Abstract:A computer system, called SERVE-NZ Nutririon Management System, for use in diabetes management,
addresses the problem of concurrently controlling postprandial glycaemic response and nutrient intake in meals
containing a number of foods, is described. It converts the weight and relative glycaemic potency of each food
to its content of glycaemic glucose equivalents (GGE) – the amount of glucose theoretically inducing the same
blood glucose response as would the specified quantity of food. Glycaemic glucose equivalents in a meal can be
simply obtained by adding the GGE content of all foods in the meal to give a figure for the maximal glycaemic
impact of the meal. Glycaemic glucose equivalents may be calculated using food composition databases that
include available carbohydrate, common standard measure weights and glycaemic index values. If GGE is
treated as a nutrient, an output of the total nutrient profile of a food or meal, and its glycaemic impact as GGE,
can be obtained simultaneously. Application of a nutritional software system incorporating GGE values to
management of glycaemic loadings and nutrient intakes over five meals within a day is demonstrated. The
system may be a useful aid in self-management of glycaemia, as it will identify quantities of foods that can be
consumed without exceeding the predetermined glucose tolerances of individuals. The graphical presentation of
GGE and nutrient composition of meals may be a useful visual aid in educating clients with diabetes. The GGE
values on food labels would provide easily understood guidance, not obtained from glycaemic index values, to
the maximum number of items or quantity of a food that an individual should eat at a time. In its present basic
form the calculation of GGE is most likely to slightly overestimate glycaemic impact, so it presents a worst-case
prediction.
Asia Pac J Clin Nutr. 2000;9(2):67-73.doi:
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Faecal bulking index: A physiological basis for dietary management of bulk in the distal colon
Author:John A Monro BSc(Hons), PhD, MA
Keywords:distal colon, faecal bulk, water-holding capacity, wheat bran equivalents
Abstract:Bulk in the distal colon provides protection against a range of large bowel disorders, but a simple standardized
measure of the relative bulking efficacy of foods, for use in dietary management of distal colonic bulk, has not
been available. This paper describes a faecal bulking index (FBI) for standardized measurement of the relative
colonic bulking efficacy of foods relative to a reference material. Faecal bulking index is defined as the mass of
fully rehydrated faecal matter accumulated by the distal colon per gram of a food consumed, as a percentage of
the matter accumulated from the same weight of a reference food. The FBI of foods was measured after feeding
adult rats at moderate levels by partially or completely replacing sucrose in a baseline diet already containing
mixed dietary fiber. Faeces were collected, dried, weighed, allowed to imbibe water until fully rehydrated,
reweighed and their mass and water holding capacity measured. The FBI was calculated as the increase over
baseline in rehydrated faecal mass induced by a test food as a percentage of the increase due to wheat bran
(reference). The FBI values were measured for 69 diets including breakfast cereals, breads and other bakery
products, fruits, vegetables, food ingredients and polysaccharides. Values for most foods ranged between almost
zero for some starch-based foods to about 50 for wheat bran-enriched breakfast cereals, but laxatives based on
fermentation-resistant hydrated polysaccharide had FBI values well in excess of 100 (FBI for psyllium = 500).
The FBI values allow foods to be ranked according to their faecal bulking efficacy on an equal edible weight
basis. They can also be used to calculate the bulking action of any amount of food in terms of equivalents to a
reference material such as wheat bran. Wheat bran equivalents allow the cumulative intake of potential distal
colonic bulk to be monitored for single foods or mixed meals, and shortfalls to be quantified for dietary
modification or supplementation. Measures such as FBI or wheat bran equivalents would prove more useful
than dietary fiber in controlling ‘functional foods’ promoted as effective bulking agents.
Asia Pac J Clin Nutr. 2000;9(2):74-81.doi:
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Evaluation of nutritional status among a group of young Chinese adults in Kuala Lumpur, Malaysia
Author:Norimah Karim PhDand SW Leong BSc
Keywords:body mass index, nutritional status, young Chinese adults in Malaysia
Abstract:A nutritional status study was carried out among a group of young Chinese adults, aged between 19 and 25, in
Kuala Lumpur, Malaysia. Subjects comprised 108 young adults (55 women, 53 men) who were students at two
institutes of higher learning. Physical characteristics were evaluated by anthropometric measurements while
food intake was determined with a 3-day food record. Blood cholesterol and triglyceride were assessed using
the Reflotron analyser. Birthweight was obtained from birth certificates or by proxy. The results showed that the
mean body mass index (BMI) for men and women was 21.4 ± 3.3 and 20.0 ± 2.0, respectively, indicating
normal weight. Further analysis of BMI classification demonstrated that 28% of men and 39% of women were
underweight, 11% of men and 2% of women were overweight while 2% of men were obese. Mean waist-to-hip
ratio showed that the subjects had a low risk of developing cardiovascular disease (0.72 ± 0.03 women; 0.81 ±
0.05 men). Mean energy intake was 8841 ± 1756 kJ per day for men and 6426 ± 1567 kJ per day for women.
Closer analysis of energy intake of the subjects showed that 86% of men and 91% of women were consuming
below the Malaysian recommendation for energy. Nutrients found to be deficient in at least one third of women
were calcium, vitamin A, niacin and iron. Mean cholesterol intake in the diet was 278.7 ± 108.7 mg in men and
207.0 ± 82.5 mg in women and there was a significant difference between genders. Blood cholesterol and
triglyceride levels were 3.88 ± 0.76 mmol/L and 1.08 ± 0.33 mmol/L, respectively in men, while these levels
were lower in women, 3.87 ± 0.80 mmol/L for cholesterol and 0.99 ± 0.29 mmol/L for triglyceride. A general
trend of higher mean blood cholesterol and triglyceride levels was shown in adults who were born with lower
birthweights.
Asia Pac J Clin Nutr. 2000;9(2):82-86.doi:
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Implications of diet and nutrition for growth and prevalence of anaemia in rural preschool-aged children in Shandong Province, China
Author:Zaimin Wang BMed, MMed, MPS FoodNutri, Carla M Pat
Keywords:anaemia, China, growth, nutrition education, nutrition improvement, nutrition surveillance, preschool children
Abstract:A nutrition surveillance and nutritional improvement programme through nutrition field worker training,
nutrition education and encouraging the utilization of home gardens was undertaken among rural preschoolaged children in the four counties of Linshu, Caoxin, Zoucheng and Yucheng in Shandong Province in China
from 1990 to 1995. A baseline survey was conducted in 1990. This included physical and biochemical
measurements being taken on 3474 children aged 0–5 years and dietary household surveys being taken on a
random subsample of 312 children. The baseline survey showed that the average height and weight of the
subjects was lower than the World Health Organization (WHO) standard with the prevalence of stunting,
underweight and wasting being 24.2, 12.5 and 2.1%, respectively (using the Zscores ≤–2 as the cut-off point).
The prevalence of anaemia was 61.9% (using haemoglobin (HB)≤110 g/L as the cut-off point). The range of
mean intakes of protein and energy was, respectively, 54.0–67.2% and 56.4–68.4% of the Chinese
recommended dietary allowance (RDA) depending on the age group. Mean calcium intake was less than 30% of
the RDA for all age groups and the mean intakes of ascorbic acid, niacin, retinol and riboflavin were between
30.6 and 96.1% of the RDA. Nutrition education and nutrition field worker training were the key components of
the intervention phase that followed the baseline survey. Over 5 years, 531 nutrition field workers were trained,
1200 parents joined in nutrition classes and approximately 8000 villagers received basic nutrition information.
The latter included promotion of breast-feeding, identification of sources of appropriate foods for weaning, and
also for the prevention and treatment of common nutritional deficiencies. Home gardens for fruit, vegetable and
livestock were also encouraged. The evaluation survey of the project was conducted in 1995 among 2728 0–5-year-old children. The results indicated that the nutritional status of preschool-aged children had improved
greatly. The prevalence of stunting and underweight was reduced by 37.8 and 21.3%, respectively, while there
was no significant change in the prevalence of wasting. The average rate of anaemia decreased by 79.6% in
1995.
Asia Pac J Clin Nutr. 2000;9(2):87-92.doi:
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Prediction of percentage body fat from anthropometry and bioelectrical impedance in Singaporean and Beijing Chinese
Author:Paul Deurenberg PhD, Mabel Deurenberg-Yap MSc, Ji
Keywords:anthropometry and bioelectrical impedance, body composition, body mass index, percentage body fat
Abstract:Body composition was measured in 205 male and female Beijing Chinese and in 148 male and female
Singaporean Chinese, age 34 (mean) (range 18–68) years and body mass index (BMI) 22.3 (15.9–38.5) kg/m2
.
In Beijing Siri’s two-compartment model based on densitometry was used as a reference technique and in
Singapore Siri’s three-compartment model based on densitometry and deuterium oxide dilution was used. In
addition, body composition was predicted using equations based on anthropometry and bioelectrical impedance
developed in Caucasian populations. Percentage body fat (BF%) predicted from BMI was systematically
underestimated by about 1% in Beijing Chinese and by about 3.5% in Singaporean Chinese. The difference in
bias (measured minus predicted BF%) between the two population groups could be explained by differences in
frame size. The Durnin and Womersley equations for BF% based on skinfold thickness predicted BF% in the
male and female Chinese groups adequately, with only a slight (less than 1% body fat) and not significant bias.
The prediction of BF% based on the waist circumference (Lean’s formula) resulted in an unbiased estimate of
BF% in females (bias about 1% body fat), whereas in males the formula systematically underestimated BF% by
3.5–5%. Bioelectrical impedance underestimated BF% systematically by 3%, in males and females to about the
same extent. The bias of all prediction formulas was positively correlated with the level of body fatness and,
except for impedance, also negatively correlated with age. The negative association of the bias with age
indicates that the age-related increase in body fatness is lower in Chinese than in Caucasians. It can be
concluded of the studied prediction techniques that only the skinfold methodology using the equations of
Durnin and Womersley give valid mean estimates for both Chinese males and females. The other techniques
require the development of population-specific prediction formula.
Asia Pac J Clin Nutr. 2000;9(2):93-98.doi:
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Assessment of iodine deficiency disorders in Meerut district, Uttar Pradesh
Author:Umesh Kapil MD, Jai Vir Singh MD, Monica Tandon M
Keywords:excretion levels, goitre, iodine deficiency disorders, iodized salt, urinary iodine
Abstract:Iodine deficiency disorders (IDD) are an important public health problem in India. Meerut district, Uttar
Pradesh, is a known IDD endemic area. A study conducted in 1986 reported a total goitre rate of 24.9% in the
entire population of Meerut district. During 1990–97 intensive efforts were taken by the Uttar Pradesh
Government to ensure universal availability of iodized salt to the population. No survey has been conducted
since 1997 on the status of iodine deficiency in the Meerut district. Hence, the present study was conducted in
order to assess the prevalence of IDD and to estimate the iodine content of salt consumed in the households of
Meerut district, Uttar Pradesh. The 30 cluster sampling methodology and indicators for assessment of IDD as
recommended by the joint WHO/UNICEF/ICCIDD (World Health Organization/United Nations Children’s
Fund/International Council for the Control of Iodine Deficiency Disorders) Consultation in full was utilized for
the survey. A confidence level of 95%, relative precision of 10% and design effect of three were considered in
the calculation of the sample size. The prevalence of goitre at the time of survey was estimated to be 15%. A
total of 6485 school children in the 6–10 years age group were selected using probability proportionate to size
cluster sampling methodology. A total goitre prevalence rate of 11.6% was found in the district. It was observed
that 5.4, 2.9 and 19.9% of the children had urinary excretion levels of < 2.0, 2.0–4.9, and 5.0–9.9 µg/dL,
respectively. The median urinary iodine excretion of the children studied was found to be 15.0 µg/dL. Fiftythree percent of the children studied consumed salt with an iodine content of less than 15 p.p.m., which was
below the stipulated level (15 p.p.m.). The study showed that the population is in a transition phase from iodine
deficient (as revealed by total goitre rate) to iodine sufficient (as revealed by median urinary iodine excretion of
15.0 µg/dL). There is a need to further strengthen the existing monitoring system for the quality of iodized salt
in the district in order to achieve the elimination of IDD.
Asia Pac J Clin Nutr. 2000;9(2):99-101.doi:
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Nutritional and anthropometric assessment of a sample of pregnant women and young children in Palau
Author:Rebecca S Pobocik PhD, RD, GM Heathcote PhD, JB Sp
Keywords:anthropometry, diet and nutrition, Palau, pregnant women, young children
Abstract:This study examines the diet and body constitution of a small sample of pregnant women, n= 27, and children,
n= 32, enrolled in the Maternal and Child Health program at the Public Health/Community Health Center in
Koror, Palau. Twenty-four hour diet recalls were collected from both groups, 17 anthropometric and body
composition measurements were made on the women and a range of body measurements from height to a full
battery of 28 measures were obtained from the children. Diets were found to be low in energy, calcium and zinc.
Women consume micronutrients primarily from fish, traditional starches, vegetables and fruits, while children
rely more on fortified grain products and milk. The energy distribution is higher in protein and fat and lower in
carbohydrate than earlier reports of adult Palauans. A significant minority of the women (27%) have body fat or
body mass index profiles indicative of clinically significant obesity or energy storage deficit, both problematic
in terms of pregnancy outcomes. While sample sizes of infant and young child cohorts are very small, our
findings indicate that a relatively high proportion of these younger children, have experienced inadequate
growth and development This is especially true of females, among whom stunting (height deficients) and
especially wasting (weight and arm circumference deficits) were in greater evidence.
Asia Pac J Clin Nutr. 2000;9(2):102-114.doi:
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Nutritional assessment of rural villages and estates in peninsular Malaysia: Total blood cholesterol values in children, adolescents and adults
Author:Tony Ng Kock Wai PhD, Khor Geok Lin PhD, Tee E Sio
Keywords:adolescents, adults, children, cholesterol, Malaysia
Abstract:The present study is unique in the Malaysian context on two counts; first, it employs for the first time a
functional group approach (groups based on occupational or economic activity) in the assessment of community
nutritional status. Second, the study provides on a nationwide-sampling basis, information on total blood
cholesterol (TC) levels in rural children (7.0–12.9 years; n= 1921) and adolescents (13.0–17.9 years; n= 753)
which were hitherto unavailable. Total blood cholesterol measurements were performed on 7184 subjects
ranging from 7 to 75-years-old (males = 3151; females = 4033) from households in 69 rural villages and seven
estates in peninsular Malaysia, which were based on selected multistage random sampling according to the
household’s involvement in the following economic activities: rice farming, rubber smallholding, coconut
smallholding, fishing and employment in estates. In all functional groups, TC values increased with age and
there was a distinct gender effect, namely females had higher TC values than males throughout the age spectrum
analyzed. Mean TC levels for children and adolescents were in the range 3.85–4.37 mmol/L, rising markedly
during adulthood to an overall mean of 4.91 ± 1.13 mmol/L for men and 5.17 ± 1.11 mmol/L for women. In
adults (³18.0 years), there was marked disparity in mean TC values among the functional groups; males and
females from rice households had the lowest mean TC values (4.58 and 4.99 mmol/L, respectively). Individuals
at ‘high risk’ (TC > 6.20 mmol/L) averaged 16.0% in women and 11.6% in men, with women from the fishing,
rubber and coconut households particularly affected (17.1–21.1%). When compared to earlier rural TC data
reported for closely similar rural communities in the peninsula, the present findings suggest a
‘hypercholesterolemic shift’ approximating 0.39 mmol/L (15 mg/dL) in the adult population; however, this was
not apparent in the children and adolescents from these rural communities.
Asia Pac J Clin Nutr. 2000;9(2):115-121.doi:
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Food intakes and habits of rural elderly Malays
Author:Suzana Shahar PhD, Jane Earl and MScand Suriah A
Keywords: dietary habits, elderly, food intakes
Abstract:A cross-sectional nutritional survey was carried out on 350 elderly Malays aged 60 and above from 11 randomly
selected villages in a rural area on the east coast of Malaysia. The findings indicated that the mean intakes of
energy and of all of the nutrients investigated were below the Malaysian Recommended Dietary Allowances,
except for protein and vitamin C. With respect to dietary habits, almost all of the subjects reported that they had
breakfast (99.3%), lunch (97.9%) and dinner (90.4%) daily or almost daily (5–6 times/week). However,
approximately half of the subjects, especially women, had particular beliefs and prohibitions about specific
foods. Most of the subjects usually ate their meals at home, particularly dinner, with 99.3% always having
dinner in their own home. Thus, although the rural elderly Malays studied had regular meal intakes, the dietary
intake was inadequate. There is a need to plan community-based intervention programmes in order to prevent
the subsequent consequences of malnutrition that lead to increased morbidity and mortality.
Asia Pac J Clin Nutr. 2000;9(2):122-129.doi:
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Isolation of Bifidobacteria infantis and its antagonistic activity against ETEC 0157 and Salmonella typhimurium S-285 in weaning foods
Author:Rokiah Mohd Yusof, Formuzul Haque, Maznah Ismail a
Keywords: antagonistic, Bifidobacteria infantis, pathogen, probiotic, Salmonella typhimurium, weaning food
Abstract:Probiotic organism Bifidobacteriawas isolated from the faeces of breast-fed infants at Universiti Putra
Malaysia. Trypticase phytone peptone yeast extract agar (TPY) was used as a selective media for the isolation.
Morphological examination of the isolates indicated that Bifidobacteriawas Gram-positive rods in nature,
curved with characteristics of V and Y shapes. The organisms were non-catalase producing, non-nitrate
reducing, non-motile, had an absence of indole and were unable to liquify gelatin. The ratios of acetic and lactic
acids were determined using high performance liquid chromatography (HPLC). Using carbohydrate
fermentation profile test API-CH-50 kits, 20 Bifidobacteriastrains had been identified: they were the species of
Bifidobacteria infantisand two different sub-species, mainly infantis and lacentis. Based on a wide zone of
inhibition, three suitable strains of B. infantis, Bifi-11, Bifi-19 and Bifi-20, were tested in weaning foods for
antimicrobial activity towards two human pathogens: E. coli-0157 (World Health Organization) and Salmonella
typhimurium S-285. The pH, titratable acidity of weaning foods and total colony count for Bifidobacteria,
enteropathogenicEscherichia coli and S. typhimuriumwere recorded at 3-h intervals for 30 h. It was found that
after 9 h of incubation of weaning foods, the pH declined to <3.6 from pH 6.0, whereas titratable acidity
increased from 0.026 to 0.08%. It was indicated that Bifidobacteriainhibited E. colibetter than did
S typhimuriumdue to low pH. After 24 h of incubation, approximately 98% of E. coliwas inhibited by
Bifidobacteria.It is suggested that the inhibitory effect of Bifidobacteriastrains in weaning foods towards the
growth of enteropathogenic E. coliand S. typhimuriumwas solely due to low pH and the production of volatile
acid components by the organism.
Asia Pac J Clin Nutr. 2000;9(2):130-135.doi:
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Garlic exerts hepatoprotective effects during 4-nitroquinoline 1-oxide-induced oral carcinogenesis in rats
Author:Seetharaman Balasenthil M Philand Siddavaram Nagin
Keywords:antioxidants, chemoprevention, garlic, glutathione, lipid peroxidation, liver, 4-nitroquinoline 1-oxide, oral cancer
Abstract:The modifying effects of garlic (Allium sativumLinn.) on hepatic lipid peroxidation and antioxidant status
during 4-nitroquinoline 1-oxide (4NQO)-induced oral carcinogenesis were investigated in male Wistar rats.
Enhanced lipid peroxidation in the liver of tumour-bearing animals was accompanied by significant decreases in
the activities of glutathione peroxidase (GPx), glutathione S-transferase (GST) and reduced glutathione (GSH)
levels. Administration of aqueous garlic extract significantly lowered lipid peroxidation and enhanced the levels
of hepatic antioxidants and detoxifying enzymes. The results of the present study suggest that garlic exerts its
hepatoprotective effects by influencing hepatic biotransformation enzymes and antioxidants.
Asia Pac J Clin Nutr. 2000;9(2):136-138.doi:
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Bedside monitoring of nutritional metabolism in the persistent vegetative state
Author:Kazuhiko Kudoh MD, PhD,Hideo Yamada MD,Shigeru Ish
Keywords:energy measurement, enteral nutrition, persistent vegetative state
Abstract:The basal metabolism and daily energy consumption of eight cases of the persistent vegetative state were low.
Some received excessive energy and inappropriate essential nutrient infusions.
Asia Pac J Clin Nutr. 2000;9(2):139-140.doi:
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Overview: Dietary fat and atherosclerosis
Author:David Kritchevsky PhD
Keywords: atherosclerosis, cholesterolemia, dietary fat
Abstract:Research on the effects of dietary fat on cholesterolemia and coronary risk began with comparisons of the
amount and type of fat (saturated vs unsaturated). It then became clear that not all fatty acids had similar
cholesterolemic effects and equations were derived which gave different weights to saturated and unsaturated
fatty acids. We now find that the triglyceride structure also plays a role in cholesterolemia as suggested by the
studies of Kritchevsky and Tepper in rabbits and McGandy et al.in human subjects.
Asia Pac J Clin Nutr. 2000;9(2):141-145.doi:
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Lipids and immunology
Author:Michihiro Sugano PhD, Tamiho Koga PhD and Kogi Y
Keywords:chemical mediators, cytokines, food allergy, immunoglobulins, polyunsaturated fatty acids
Abstract:Dietary fat plays an important regulatory role in the pathogenesis of a range of immune reactions. In food
allergies, especially in type I allergic reactions, dietary fat can modulate the development of clinical symptoms
through influencing the production of immunoglobulins (Ig), cytokines and chemical mediators. In general,
polyunsaturated fatty acids (PUFA) of the n-3 family in relation to those of the n-6 family reduce the production
of eicosanoids and hence, mitigate hypersensitivity. In this context, it is interesting that conjugated derivatives
of linoleic acid (CLA) reduce the production of eicosanoids and regulate the production of Ig in a manner
favourable to the prevention of allergic reactions. Transmonoene fatty acid (that is, elaidic acid), in relation to
cismonoenoic fatty acid (that is, oleic acid), also behaves as an anti-allergic agent through interfering with the
desaturation of linoleic acid. The information available indicates that different dietary fats influence differently
the immune indices related to food allergic reaction. The effects appeared to be readily modified by the
combination of food components, including dietary fats. Thus, an appropriate combination of a specific fat or
fatty acid may be one approach to the regulation of allergic reaction.
Asia Pac J Clin Nutr. 2000;9(2):146-152.doi:
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