Asia Pacific Clinical Nutrition Society 2002 Award
Author:
Keywords:
Abstract:
Asia Pac J Clin Nutr. 2002;11(2):87.doi:
>>Abstract
>> Download PDF
Ocular manifestation of vitamin A deficiency among Orang Asli (Aborigine) children in Malaysia
Author:Nor F Ngah MS(Ophthal), Norhayati Moktar PhD, Noor
Keywords:luxometer reading, Malaysia, night blindness, Orang Asli, Perak, vitamin A deficiency, xerophthalmia
Abstract:This study determined the prevalence of ocular manifestation of vitamin A deficiency in Orang Asli (Aborigine)
children. Night blindness was found in 16.0% of the children, conjunctiva xerosis in 57.3%, Bitot’s spot in
2.8%, corneal xerosis in 0.5% and corneal scars in 5.6%. These findings show that history of night blindness
had sensitivity, specificity and predictive value (positive) of 47.2, 98.1 and 96.2%, respectively, compared with
the standard diagnosis procedure using luxometer readings.
Asia Pac J Clin Nutr. 2002;11(2):88-91.doi:
>>Abstract
>> Download PDF
Simultaneous analysis of retinol, β-carotene and tocopherol levels in serum of Vietnamese populations with different incomes
Author:Nguyen Thi Minh Kieu MD, Kidokoro Yurie BS, Nguye
Keywords:β-carotene, Can Gio district, fat-soluble vitamin, Ho Chi Minh City, retinol, tocopherol, Vietnam
Abstract:In this study, we clarified the status of the fat-soluble vitamins retinol and tocopherol, as well as β-carotene, as
antioxidants in the prevention of cardiovascular disease in middle-aged Vietnamese populations with different
incomes. In order to measure simultaneously the serum concentrations of retinol, β-carotene and tocopherol, we
carried out high-performance liquid chromatography analysis with three separate detectors. The analytical
method was modified, omitting the saponification process, and used a multi-evaporating system with dry ice.
This allowed the analysis to proceed more rapidly, use a small amount of serum (40 µL) and be free of hexane
contamination to the environment. The analyses reflected an adequate status of vitamin A (serum
retinol = 20 µg/dL), but inadequate status of β-carotene and vitamin E (serum β-carotene < 40 µg/dL; serum
tocopherol < 600 µg/dL) in all three Vietnamese populations. As large numbers of Vietnamese subjects were
observed with very low serum concentrations of β-carotene and tocopherol, higher consumptions of green and
yellow vegetables, fruits, vegetable oils and other foods rich in vitamin E are recommended for these
Vietnamese populations.
Asia Pac J Clin Nutr. 2002;11(2):92-97.doi:
>>Abstract
>> Download PDF
Socioeconomic status and the prevalence of coronary heart disease risk factors
Author:Kanala KR Reddy PhD,FICN, Alahari P Rao PhD and Th
Keywords: Andhra Pradesh, coronary heart disease, India, lipid profile, physical activity, socioeconomic status, Tirupati
Abstract:South Asian countries have a high prevalence of coronary heart disease (CHD) in line with their economic
development. India, in particular, has a high burden of CHD. Hence, the aim of the present study was to assess
the prevalence of CHD risk factors in a semiurban population of Andhra Pradesh, India, in different
socioeconomic status (SES) groups. Information was collected on socioeconomic status, physical activity,
cigarette smoking, body mass, blood pressure (BP) and serum lipid profiles among a healthy sample of 440 men
and 210 women with an age range of 20–70 years. Mean levels of serum cholesterol (SC), high density
lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC) and skinfold ratio were found to
be higher among women, whereas triglycerides (TG), systolic BP and diastolic BP were higher in men. No
statistically significant differences in body mass index (BMI) or pulse rate were observed between the sexes. In
men, a significant positive rank correlation (rho =P< 0.05) was observed between SES and SC, TG, systolic
and diastolic BP, pulse rate and BMI, but in women, the same trend was found only with SC, TG, skinfold ratio
and age. The prevalence (age standardized to the world population of Segi, 95% CI) of obesity was 14.37%
(11.06–17.68), hypertension 13.13% (9.11–17.15), hypercholesterolemia 18.56% (13.88–23.24),
hypertriglyceridemia 45.98% (36.47–55.49) and low HDLC 31.01% (24.25–37.77). In both sexes, the
prevalence of hypercholesterolemia, hypertriglyceridemia and sedentary life style increased among higher SES
groups (P< 0.05). Also, an increase in the level of social class was positively associated with mean levels of
serum cholesterol and triglycerides in both men and women. The results demonstrate that higher SES groups
have greater prevalence of CHD risk factors than lower SES groups. Preventive measures are required to reduce
the risk factors among higher SES groups.
Asia Pac J Clin Nutr. 2002;11(2):98-103.doi:
>>Abstract
>> Download PDF
Influence of fish consumption on the distribution of serum cholesterol in lipoprotein fractions: comparative study among fish-consuming and non-fish-consuming populations
Author:Gandham BulliyyaPhD
Keywords:cardiovascular disease risk factors, fish consumption, India, long-chain n-3 polyunsaturated fatty acids, serum lipoprotein lipids, Tirupati
Abstract:The objective of this study was to investigate serum lipoprotein levels in order to assess cardiovascular disease
(CVD) risk factors between fish-consuming populations and non-fish-consuming populations, as it has been
speculated that fish intake reduces CVD risk. A representative sample of one thousand subjects (529 men and
471 women) were selected, with ages ranging from 20 to 70 years, from 40 villages belonging to fishconsuming (500) or non-fish-consuming (500) populations. Serum lipoprotein lipids such as total cholesterol
(TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were
analysed biochemically using standard procedures. The ratios of TC : HDL-C and LDL-C : HDL-C were
computed. Mean values of serum LDL-C and the ratios of LDL-C : HDL-C and TC : HDL-C were significantly
lower and HDL-C levels were higher in fish-consumers than in non-fish-consumers. The concentrations of HDL-C
decreased with increasing age, while the reverse was true for LDL-C and for the LDL-C : HDL-C and
TC : HDL-C ratios. There were significant sex differences for certain age groups in both of the population
groups. The 5th, 50th and 95th percentile cut-off values for these parameters were lower in fish-consumers than
in non-fish-consumers. The prevalence of individuals at risk of CVD because of low HDL-C (<35 mg/dL), high
LDL-C (>130 mg/dL) and their atherogenic ratios (LDL-C : HDL-C > 3.5 and TC : HDL-C > 4.5) was
significantly greater in non-fish-consumers. This study highlights that the fish-consuming population had a
lower atherogenic risk than the non-fish-consuming population. The intake of fish may have substantial
implications for public health and health economy by decreasing the risk of CVD. However, more studies are
warranted to better define the mechanisms of cardioprotection by dietary fish and fish oils.
Asia Pac J Clin Nutr. 2002;11(2):104-111.doi:
>>Abstract
>> Download PDF
Serum fatty acids, lipoprotein (a) and apolipoprotein profiles of middle-aged men and women in South Vietnam
Author:Nguyen Thi Minh Kieu MD, Etsuko Yasugi PhD, Nguyen
Keywords:apolipoprotein, Can Gio district, cardiovascular disease, fatty acid composition, Ho Chi Minh City, lipoprotein (a), Vietnamese
Abstract:In Vietnam, increasing fat consumption is a trend recognized recently in urban areas. To obtain a reasonable
nutrition status and prevent cardiovascular disease (CVD), it is necessary to obtain information on habitual fat
intake and biochemical parameters as risk factors for CVD in Vietnamese populations. Therefore, from the
analysis of serum fatty acid composition, fat consumption patterns in Vietnamese populations in South Vietnam,
with different incomes, are discussed in this study. In addition, some risk factors for premature CVD, serum
lipoprotein (a) and apolipoprotein concentrations are also assessed in these Vietnamese populations. The study
was carried out in men and women aged 40–59 in three different districts: urban (n= 100), suburban (n= 98)
and rural (n= 98). The results of serum fatty acid composition analysis reflected differences in quality fat intake
among the three populations. The urban population was estimated to consume more vegetable oil but less fish
than their rural counterparts. Although serum lipoprotein (a) and apolipoprotein B levels were below the ranges
associated with atherogenesis, ongoing attention to dietary fat intake for the prevention of CVD in Vietnamese
populations is required.
Asia Pac J Clin Nutr. 2002;11(2):112-116.doi:
>>Abstract
>> Download PDF
Effects of haemoglobin and serum ferritin on cognitive function in school children
Author:Rassamee Sungthong MD, Ladda Mo-suwan MD and Viras
Keywords:cognitive function, educational achievement, Hat Yai, IQ, iron deficiency, iron status, school performance, Songkhla, Thailand
Abstract:The association between iron deficiency anaemia and cognitive function impairment has been widely reported in
young children, but whether the impairment is a result of iron deficiency per se or a combination of iron
deficiency and anaemia, and how these conditions interact, is still questionable. Four hundred and twenty-seven
school children from two schools in socioeconomically deprived communities were selected in southern
Thailand. Iron status was determined by haemoglobin and serum ferritin concentrations. Cognitive function in
this study was measured by IQ test and school performance, including Thai language and mathematics scores,
using z-scores based on distributions within the same grade and school. Data on demography and socioeconomic status were collected by questionnaire answered by the parents. Linear regression models were used
to investigate the effect of anaemia and iron deficiency, reflected by haemoglobin and serum ferritin
concentration, on cognitive function and school performance. We found that cognitive function increased with
increased haemoglobin concentration in children with iron deficiency, but did not change with haemoglobin
concentration in children with normal serum ferritin level. Children with iron deficiency anaemia had
consistently the poorest cognitive function (IQ, 74.6 points; Thai language score, 0.3 SD below average; and
mathematics score, 0.5 SD below average). Children with non-anaemic iron deficiency but with high
haemoglobin levels had significantly high cognitive function (IQ, 86.5 points; Thai language score, 0.8 SD
above average; and mathematics score, 1.1 SD above average). This study found a dose–response relationship
between haemoglobin and cognitive function in children with iron deficiency, whereas no similar evidence was
found in iron sufficient children.
Asia Pac J Clin Nutr. 2002;11(2):117-122.doi:
>>Abstract
>> Download PDF
Therapeutic effects of NaFeEDTA-fortified soy sauce in anaemic children in China
Author:Junsheng Huo PhD, Jing Sun BSc, Hong Miao MSc, B
Keywords:China, food fortification, Henan, iron deficiency anaemia, NaFeEDTA, soy sauce
Abstract:The therapeutic effects of NaFeEDTA-fortified soy sauce on anaemic students were investigated. Three hundred
and four iron-deficient anaemic school children (11–17 years) were randomly assigned to three treatment
groups: control group (consuming non-fortified soy sauce), low-NaFeEDTA group (consuming fortified soy
sauce, providing 5 mg Fe/day) and high-NaFeEDTA group (consuming fortified soy sauce, providing 20 mg
Fe/day). Blood haemoglobin (Hb) levels were determined before and after 1 month, 2 months and 3 months of
intervention. In addition, serum iron (SI), serum ferritin (SF), free erythrocytic porphyrin (FEP), total iron
binding capability (TIBC) and transferritin (TF) were measured before and after consumption of soy sauce for
3 months. The results obtained herein show that the parameters measured were not changed remarkably within
the 3-month intervention in the control group (P< 0.05). However, increased Hb, SI, SF and TF levels and
decreased TIBC and FEP levels were observed in both the high-NaFeEDTA group (P< 0.01) and the lowNaFeEDTA group (P< 0.05). The effectiveness of iron intervention in the low-NaFeEDTA group and highNaFeEDTA group had no statistical significance after 3 months. It was concluded that nutritional intervention
for anaemic students using NaFeEDTA-fortified soy sauce could play a positive role in the improvement of iron
status and control of anaemia.
Asia Pac J Clin Nutr. 2002;11(2):123-127.doi:
>>Abstract
>> Download PDF
Sources of dietary iron in urban and provincial 4-year-old children in Iran
Author:Fatemeh V ZohouriBSc, MSc, PhDand Andrew J Rugg-Gu
Keywords:children, diet, Fars province, food sources, Iran, iron
Abstract:Iron-deficiency anaemia is prevalent in childhood, especially in developing countries. Nutritional deficiency is
one of the main causes of iron-deficiency anaemia, although absorption varies considerably between different
dietary items. Information on the sources of iron in young children is limited. A study was therefore undertaken
to investigate the different dietary sources of iron in 151 healthy children aged 4 years who were selected from
two districts of Fars province, Iran. Two 3-day dietary diaries with pre- and post-interview were used to record
the dietary intake of the children. Food and drinks were categorised into four groups (animal, plant, drinks and
other) to measure the relative importance of different sources of iron. Sixty-eight percent of the children
completed the 3-day dietary diaries in both summer and winter. The results showed no statistically significant
differences in total daily iron intake between the two seasons or between genders. However, the difference in the
total daily iron intake between children in the city and the provincial district was significant: 7.73±1.75 mg/day
and 10.33±2.9 mg/day, respectively (P< 0.001). About 75 and 60% of iron intake came from plant sources in
the provincial district and city, respectively. The three most important sources of iron for children of the
provincial district were bread (51%), fruit and vegetables (12%) and meat (7%). This pattern was also observed
for children living in the city, but with different percentages: 27%, 16% and 16%, respectively. In conclusion,
total iron intakes were similar to those recorded in European countries, but little of the intake came from animal
sources and substantial differences between city and provincial children were recorded.
Asia Pac J Clin Nutr. 2002;11(2):128-132.doi:
>>Abstract
>> Download PDF
Socioeconomic profile and nutritional status of children in rubber smallholdings
Author:Zamaliah Mohd Marjan MSc, Mirnalini Kandiah PhD,
Keywords: anthropometry, children, income level, Johor, Kedah, Kelantan, Malaysia, Perak, rubber smallholdings, socioeconomic
Abstract:This paper will present the socioeconomic profile and nutritional status of children aged 1–6 years in the rubber
smallholdings of Peninsula Malaysia. A total of 323 households were involved in this study. The
sociodemographic data were obtained through interviews with heads of households using a set of
questionnaires. Anthropometric measurements were taken from 506 children aged 1–6 years from these
households. The weight and height of the children were compared with the reference values of the National
Center for Health Statistics (NCHS) and the nutritional status was classified based on the recommendations of
WHO. The average age of the fathers was 39.9±8.6 years and 34.4±7.0 years for the mothers. The mean
household size was 6.67±2.27. The majority (49.7%) of the heads of households received 4–6 years of formal
education and 7.9% received no formal education. Based on the monthly per capita income, 24.0% were found
to be in the hardcore poor category, 38.3% fall into the poor category and 37.7% in the above poverty income
group. The prevalence of stunting and underweight among children between the ages of 1–6 years were highest
among children from the hardcore poor, followed by the poor category and above the poverty line income
group. Wasting was present in all income groups, with a prevalence of 4.2% found among the hardcore poor,
9.4% among the poor group and 8.4% in the above poverty income group. The Pearson Product Moment
Correlation showed significant relationships between household total income and height-for-age (r = 0.131,
P= 0.05) and weight-for-age (r= 0.127, P= 0.05). There were also significant correlations between monthly
per capita income with height-for-age (r= 0.16, P< 0.01) and weight-for-age (r= 0.13, P< 0.05). The acreage
of land utilised was correlated with height-for-age (r= 0.11, P< 0.05), weight-for-age (r= 0.17, P< 0.05) and
weight-for-height (r = 0.16, P< 0.05). However, stepwise multiple regression analysis indicated that the
predictor of height-for-age was monthly per capita income (R2
= 0.03, P< 0.01) and acreage of land utilised
was a predictor for weight-for-age (R2
= 0.03, P< 0.01) and weight-for-height (R2
= 0.01, P< 0.01). Because
income and acreage of land utilised have been shown to be associated with nutritional status, it is recommended
that intervention programs that focus on generation of income and diversification of land utilisation should be
undertaken. A multidiscipline approach involving the family, community and government agencies should be
applied to any type of intervention program.
Asia Pac J Clin Nutr. 2002;11(2):133-141.doi:
>>Abstract
>> Download PDF
Dietary calcium intake in postmenopausal Malaysian women: comparison between the food frequency questionnaire and three-day food records
Author:WSS Chee MSc, AR Suriah1PhD, Y Zaitun PhD, SP Chan
Keywords:calcium, China, diet, food frequency questionnaire, food records, Malaysia, menopause, women
Abstract:The objective of this study was to compare the dietary calcium intakes assessed by a quantitative food frequency
questionnaire (FFQ) and the three-day food record method in 230 Chinese postmenopausal women aged
50–65 years in Kuala Lumpur. The results showed that the mean calcium intake from the dietary records was
447 ± 168 mg/day and 499 ± 211 mg/day from the FFQ. The mean difference in intake by the two methods
was 51.3 mg (95% CI = – 30.8 – 77.9; SD = 181.2, P> 0.05), which did not differ significantly from zero.
Pearson’s correlation coefficient of 0.56 was obtained between the two methods. Ninety-five percent of the
individuals classified by food records fell into the same or within-one-quartile category when classified by FFQ.
Forty-eight percent were classified into the same quartile by both methods. No subjects were grossly
misclassified by the FFQ. The FFQ correctly identified subjects with calcium intakes below the Malaysian
recommended daily allowance (450 mg/day) with 60% specificity and with 92% specificity for women
consuming less than 800 mg calcium/day. In conclusion, the FFQ developed was a useful, rapid clinical tool for
assessing calcium intake and identifying postmenopausal Chinese women with low calcium intakes in Malaysia.
Asia Pac J Clin Nutr. 2002;11(2):142-146.doi:
>>Abstract
>> Download PDF
Assessment of a rapid method for assessing adequacy of calcium intake
Author:J Hilary Green PhD, Chris L Booth BScand Richard L
Keywords:calcium, diet recall, food intake, New Zealand
Abstract:The purpose of this study was to assess the agreement between the 24 h diet recall and a short 17-item 24 h food
intake recall in assessing calcium intake. The calcium intakes of 21 women over the age of 50 were assessed by
both methods on four occasions. The mean calcium intakes were similar using both methods, being
1034 ± 398 mg/day by 24 h diet recall and 822 ± 412 mg/day (SD) by 17-item 24 h food intake recall. The
17-item 24 h food intake recall tended to underestimate calcium intake compared with the 24 h diet recall, with
the limits of agreement being between –1197 and –727 below and 370 and 682 mg/day above 24 h diet recall
values over the four assessments. The 17-item 24 h food intake recall identified 8% more women with
inadequate calcium intakes than the 24 h diet recall method did. Although there is poor agreement in calcium
intake between the 24 h diet recall method and the 17-item 24 h food intake recall, the latter provides a quick
and simple means for assessing extremes of calcium intake and whether day to day calcium intake is adequate.
Asia Pac J Clin Nutr. 2002;11(2):147-150.doi:
>>Abstract
>> Download PDF
Gastrointestinal tolerance of a new infant milk formula in healthy infants: multicenter study conducted in Taiwan
Author:Nancy Chen MS, RD, Pedro A Alarcon MD, PhD, Gail M
Keywords:human milk, infant formula, stool consistency, stool frequency, Taiwan
Abstract:The objective of this study was to test whether the gastrointestinal tolerance of a new infant formula equalled or
exceeded the tolerance of other milk-based infant formulas, and to compare the tolerance of the new formula to
that of human milk. This prospective, observational, multicenter, open-label study was conducted in Taiwan.
Healthy, full-term infants aged 28–98 days were enrolled on their current feeding regimen (no treatment
assigned). Feeding regimens included human milk (HM), a new infant formula (NF, Similac Advance®), other
marketed infant formulas (OF, mainly Enfalac® or S-26®), HM + NF and HM + OF. Data for stool frequency,
stool consistency and gastrointestinal intolerance symptoms were recorded in study diaries by parents for a
period of two weeks. Gastrointestinal tolerance was evaluated in 967 infants, of whom 481 (49.7%) received
NF, 312 (32.2%) received OF, 101 (10.4%) received HM + NF, 41 (4.2%) received HM + OF and 32 (3.3%)
received HM. Infants fed HM only had softer and more frequent stools than those who received NF only or OF
only (P< 0.001). Infants fed NF only had softer stools than those fed OF only (P< 0.001), including those fed
either Enfalac® or S-26® (P< 0.001). There were no significant differences between feeding groups for the
incidence of general intolerance, spit-up or flatulence. All feeding regimens were well tolerated. We thereby
concluded that NF is well tolerated in healthy infants and results in stool consistencies that more closely
resemble those of infants fed human milk than those of infants fed other formulas.
Asia Pac J Clin Nutr. 2002;11(2):151-156.doi:
>>Abstract
>> Download PDF
Effect of Cassia auriculataleaf extract on lipids in rats with alcoholic liver injury
Author:Rajagopal Senthil Kumar MSc, Manickam Ponmozhi MSc
Keywords:alcohol, Cassia auriculata, hepatotoxicity, hypolipidemia, India
Abstract:We studied the effect of administering Cassia auriculataleaf extract to rats with experimentally induced liver
damage. Hepatotoxicity was induced by administering 9.875 g/kg bodyweight ethanol for 30 days by
intragastric intubation. C. auriculataleaf extract was administered at a dose of 250 mg/kg bodyweight daily in
one group and 500 mg/kg bodyweight daily in another group of alcohol-treated rats. All rats were fed with
standard pellets. The control rats were also given isocaloric glucose solution. The average bodyweight gain was
significantly lower in alcohol-treated rats, but improved on supplementation with C. auriculataleaf extract.
Alcohol supplementation significantly elevated the cholesterol, phospholipid and triglyceride concentration in
the liver, brain, kidney and intestine, as compared with those of the normal control rats. Treatment with C.
auriculata leaf extract and alcohol significantly lowered the tissue lipid levels to almost normal levels.
Microscopic examination of alcohol-treated rat liver showed inflammatory cell infiltrates and fatty changes,
which were reversed on treatment with C. auriculataleaf extract. Similarly, alcohol-treated rat brain
demonstrated spongiosis, which was markedly reduced on treatment with C. auriculata. In conclusion, this
study shows that treatment with C. auriculata leaf extract has a lipid-lowering effect in rats with experimentally
induced, alcohol-related liver damage. This is associated with a reversal of steatosis in the liver and of
spongiosis in the brain. The mechanism of C. auriculata leaf extract lipid-lowering potential is unclear.
Asia Pac J Clin Nutr. 2002;11(2):157-163.doi:
>>Abstract
>> Download PDF
Kiwifruit promotes laxation in the elderly
Author:Elaine C Rush PhD, Meena Patel BSc, Lindsay D Pla
Keywords:constipation, controlled trial, elderly, human, kiwifruit, laxation
Abstract:Numerous anecdotal reports have suggested that kiwifruit (Actinidia deliciosa) has laxative effects. This could
be an acceptable dietary supplement, especially for elderly people who often present with constipation. We
wished to obtain objective evidence as to whether or not kiwifruit eaten regularly could promote laxation in
elderly people. Thirty-eight healthy adults of age > 60 years consumed their normal diet, with or without one
kiwifruit per 30 kg bodyweight for three weeks, followed by a 3-week crossover period. Daily records were
taken on frequency of defecation and characteristics of the stools. Kiwifruit significantly enhanced all tested
measures of laxation in these adults. The regular use of kiwifruit appeared to lead to a bulkier and softer stool,
as well as more frequent stool production. Kiwifruit as a natural remedy appears palatable to most of the
population and provides improved laxation for elderly individuals who are otherwise healthy. It is likely that a
number of factors in the whole fruit are involved, but the nature of the stools suggest fibre is important. This
study provides evidence of the potential for improvement in bowel function, health and well-being through
changes in diet.
Asia Pac J Clin Nutr. 2002;11(2):164-168.doi:
>>Abstract
>> Download PDF
Seminar on nutrition labelling and health claims: scientific substantiation and opportunities for harmonization
Author:E-Siong Tee, PhD
Keywords:
Abstract:
Asia Pac J Clin Nutr. 2002;11(2):S65-S67.doi:
>>Abstract
>> Download PDF
Nutrition labelling: purpose, scientific issues and challenges
Author:Annoek WEM Van den Wijngaart MSc
Keywords:CODEX Alimentarius Commission, nutrition claims, nutrition labelling
Abstract:Nutrition labels describe the nutrient content of a food and are intended to guide the consumer in food selection.
The nutrition information provided must be selected on the basis of consistency with dietary recommendations.
Selection of the specific nutrients or food components to be listed should further take into account label space,
the analytical feasibility of measuring the particular nutritional component within the food matrix, and the
relative costs of such analyses. Nutrition information provided on labels should be truthful and not mislead
consumers. At the same time, labelling regulations should provide incentives to manufacturers to develop
products that promote public health and assist consumers in following dietary recommendations. It is likely that
in many countries, there would be some segments of the population that would benefit from information about
the composition of foods. In these cases, countries should consider the need to provide for appropriate labelling
and its presentation relative to existing guidelines and approaches. As nutrition-labelling efforts have evolved,
different approaches and legal requirements have been established. These create difficulties in developing and
harmonizing nutrition information listings, which have broad international applications. For these reasons, the
Codex Guidelines on Nutrition Labeling play an important role to provide guidance to member countries when
they want to develop or update their national regulations and to encourage harmonization of national standards
with international standards. These Guidelines are based on the principle that no food should be described or
presented in a manner that is false, misleading or deceptive. The Guidelines include provisions for voluntary
nutrient declaration, calculation and presentation of nutrient information. The Guidelines on Claims establish
general principles to be followed and leave the definition of specific claims to national regulations. Definitions
are provided for a number of claims (nutrient content, comparative claims, nutrient function claims) as well as
general requirements concerning consumer information in relation with claims. Nutrition labelling by itself
cannot solve nutrition problems. It should be seen as one of the elements of nutrition policy and should be
envisaged in the larger perspective of consumer education, which in its turn is part of an overall development
policy. Exchange of information at the regional and subregional level is important, as each country can learn
from the experience of others and regional co-ordination and co-operation can be developed.
Asia Pac J Clin Nutr. 2002;11(2):S68-S71.doi:
>>Abstract
>> Download PDF
Nutrition labelling: perspectives of a bi-national agency for Australia and New Zealand
Author:Margaret A Curran, BSc(Hons)
Keywords:Australia, food standards, labelling, New Zealand, nutrition
Abstract:Australia New Zealand Food Authority (ANZFA) is a bi-national government agency forming a partnership
between all of Australia’s States and Territories and the New Zealand government. Australia New Zealand Food
Authority employs scientific, legal policy, communication and administrative staff in our Australia and New
Zealand offices. Prior to 1991 each of Australia’s States and Territories had their own food standards; however,
in 1991 Commonwealth legislation was introduced to consolidate responsibility for developing food standards
in one specialist agency and to ensure the uniformity of Standards across all States and Territories in Australia.
This was extended to New Zealand in 1995 when we became a bi-national agency following the signing of a
Treaty between Australia and New Zealand to develop joint food standards for both countries. Australia New
Zealand Food Authority’s objectives in setting food standards are to: protect public health and safety; provide
adequate information to enable consumers to make informed choices; and prevent misleading or deceptive
conduct. Health Ministers have recently approved a new Joint Food Standards Code for Australia and New
Zealand. This is the result of over 6 year’s work and many rounds of public consultation. The new Code has had
extensive input from government agencies, industry and consumers. In drafting the new code our emphasis has
been on making decisions based on sound science and the most up-to-date information available. We also
recognized the need for Standards to be practical in not imposing unnecessary costs on food manufacturers with
an inevitable flow on effect to consumer prices. The Joint Code will replace both the existing Australian Food
Standards Code and the New Zealand Food Regulations after a 2-year transition period. During the development
of the Joint Code a wide range of matters were considered in relation to labelling. Amongst these were
consumer needs, costs to industry, voluntary versus mandatory, enforcement issues, relationship to advertising
and exemptions. A number of features of the new Code relate specifically to labelling and include: warning and
advisory statements; ingredients lists; date marking; directions for use and storage; nutrition information;
legibility requirements; and percentage labelling. One of the key features of the Joint Code is the requirement
for most packaged foods to bear a nutrition information panel (NIP). Information must be presented on the
amount of fat, saturated fat, protein, energy, carbohydrates, sugars and sodium. For the majority of foods the
label is the first and only source of information regarding the nutritional content of food purchased. Mandatory
nutrition labelling will ensure that consumers are provided with key nutritional information about foods. Single
ingredient produce such as fruit and vegetables, and some other foods such as spices, tea and coffee will be
exempt. The new requirements will give consumers more nutritional information to allow product comparison.
All products will be required to provide information on these nutrients on both a per 100 g basis and in terms of
an average serving. In addition to the mandatory nutrient declarations NIP are also required to carry additional
data for any substance for which a nutrition claim is made. During the 2-year transition period to December
2002 ANZFA will be working with industry, enforcement agencies and consumers to help to ensure that there is
a smooth transition to the Joint Food Standards Code.
Asia Pac J Clin Nutr. 2002;11(2):S72-S76.doi:
>>Abstract
>> Download PDF
Nutrition labelling: European Union and United Kingdom perspectives
Author:Eva Hurt MA
Keywords:European Union, nutrition labelling
Abstract:The growing public interest in the relationship between diet and health and increasing public health problems in
Europe were among the determining factors which led the European Commission to propose harmonized
legislation on nutrition labelling. The Directive which was adopted in 1990 primarily aimed at providing
information which helps consumers to make an informed choice and assist action in the area of nutrition
education for the public. The provisions of the Directive are voluntary but become obligatory if the
manufacturer decides to make a ‘nutritional claim’. Where nutrition labelling is applicable, the information may
be given in two formats: group 1, energy value and the amounts of protein, carbohydrate and fat (‘Big 4’); or
group 2, energy value and the amounts of protein, carbohydrate, sugars, fat, saturates, fibre and sodium
(‘Big 8’). A claim for one of the following sugar, saturated fat, fibre or sodium automatically triggers group 2
information. Additional information can be provided on the amounts of starch, polyols, mono-unsaturates, poly
unsaturates, cholesterol and any of the vitamins or minerals. The nutrition information must be given per 100 g
or 100 mL of food but may also be declared per quantified serving of food, or per portion where the number of
portions is indicated on the label. The information must be presented together in one place in tabular form. A
revision of the Nutrition Labelling Directive is due and will address issues such as the voluntary character of the
legislation, the amount of information given and its presentation, legibility and consumer understanding.
Asia Pac J Clin Nutr. 2002;11(2):S77-S79.doi:
>>Abstract
>> Download PDF
Current status of nutrition labelling and claims in the South-East Asian region: are we in harmony?
Author:E-Siong Tee PhD, Suryani Tamin BSc,SRD,Rosmulyati
Keywords:food regulations, health claims, nutrition claims, nutrition labelling
Abstract:This review includes the situation of nutrition labelling and claims in six countries in South-East Asia: Brunei,
Indonesia, Malaysia, Philippines, Singapore and Thailand. With the exception of Malaysia, there is no
mandatory nutrition labelling requirements for foods in these countries except for special categories of foods
and when nutritional claims are made for fortified or enriched foods. Nevertheless, several food manufacturers,
especially multinationals, do voluntarily label the nutritional content of a number of food products. There is,
therefore, increasing interest among authorities in countries in the region to start formulating regulations for
nutrition labelling for a wider variety of foods. Malaysia has proposed new regulations to make it mandatory to
label a number of foodstuffs with the four core nutrients, protein, carbohydrate, fat and energy. Other countries
have preferred to start with voluntary labelling by the manufacturers, but have spelt out the requirements for this
voluntary labelling. The format and requirements for nutrition labelling differ widely for countries in the region.
Some countries, such as Malaysia, closely follow the Codex guidelines on nutrition labelling in terms of format,
components to be included and mode of expression. Other countries, such as the Philippines and Thailand, have
drafted nutrition labelling regulations very similar to those of the Nutrition Labeling and Education Act (NLEA)
of the United States. Nutrition and health claims are also not specifically permitted under food regulations that
were enacted before 1998. However, various food products on the market have been carrying a variety of
nutrition and health claims. There is concern that without proper regulations, the food industry may not be
certain as to what claims can be made. Excessive and misleading claims made by irresponsible manufacturers
would only serve to confuse and mislead the consumer. In recent years, there has been efforts in countries in the
region to enact regulations on nutrition claims. Recently enacted regulations or amendments to existing
regulations of almost all the countries reviewed have included provisions for nutrition claims. Malaysia is in the
process of gazetting regulations to clearly stipulate the permitted nutrition claims and the conditions required to
make these claims along the guidelines of Codex Alimentarius Commission. Only two countries in the region
permit health claims to be made – Indonesia and Philippines. Other countries in the region are following
developments in Codex and examining the need for allowing these claims. There are more differences than
similarities in the regulations on nutrition labelling and claims among countries in the South-East Asian region
as no previous efforts have been made to address these. Hopefully, through this first regional meeting, countries
can initiate closer interaction, with a view to working towards greater harmonization of nutrition labelling and
health claims in the region.
Asia Pac J Clin Nutr. 2002;11(2):S80-S86.doi:
>>Abstract
>> Download PDF
Biomarkers, yesterday, today and tomorrow: the basis for health claims
Author:DCK Roberts, PhD
Keywords:foods, genomics, health claims, microarray technology, nutrients, proteomics
Abstract:The development of useful and accurate biomarkers for predicting outcomes of food based interventions is
becoming more and more important, given the emphasis being placed on ingredients in foods contributing to
disease risk reduction and optimal health promotion. With the human genome now laid bare, opportunities
abound to barcode individuals with their risk profiles. The massive increase in DNA sequence information
together with the development of new technologies such as genomics, proteomics and bioinformatics, has
resulted in a much greater capacity to determine individual risk profiles. Screening for biomarkers at the gene or
protein expression level using microarray technology has the potential to identify new biomarkers for disease
diagnosis. Whether these techniques will enable a better understanding of food–gene interactions to permit
health claims rather than better therapeutic treatment (at high economic cost) remains to be demonstrated.
Asia Pac J Clin Nutr. 2002;11(2):S87-S89.doi:
>>Abstract
>> Download PDF
Newly established regulation in Japan: foods with health claims
Author:Toshio Shimizu PhD
Keywords:food with nutrient function claims, foods with health claims, FOSHU, functional food
Abstract:The Japanese government enacted a new regulatory system called ‘Foods with health claims’ in April 2001,
which consists of ‘Foods for Specified Health Use’ (FOSHU) and ‘Foods with Nutrient Function Claims’
(FNFC). The FOSHU was set up by the Ministry of Health and Welfare in 1991 to approve descriptions on a
label regarding an effect of food on the human body. It was enacted as a part of ‘food for specified dietary use’
under the Nutrition Improvement Law. There are three important requirements for FOSHU approval. The first is
scientific evidence of the efficacy, including clinical testing. The second is safety for consumption. The third is
analytical determination of the effective component. At present there are 293 items approved as FOSHU. Most
of the descriptions of foods under the FOSHU system are similar to the category of enhanced function claims of
Codex. Under FNFC, 12 vitamins (vitamin A, B1, B2, B6, B12, C, E, D, biotin, pantothenic acid, folic acid, and
niacin) and two minerals (calcium and iron) are standardized. These claims are similar to the nutrient function
claims approved by Codex in 1997. It is desirable that the Japanese administration and the food industry
cooperate with ASEAN countries to work together in the development and promotion of nutrition and health
claims on foods.
Asia Pac J Clin Nutr. 2002;11(2):S94-S96.doi:
>>Abstract
>> Download PDF
