Iron status and dietary intake of Chinese pregnant women with anaemia in the third trimester
Author:Aiguo Ma MD, Xuecun Chen MD, Mingci Zheng PhD, Yu
Keywords:anaemia, China, ferritin, iron, pregnancy, Qingdao, soluble transferrin receptor, vitamins
Abstract:Anaemia in pregnancy is a major public health problem in China. Anaemia in pregnant women may be related
to dietary intake of nutrients. To examine the relationship between iron status and dietary nutrients, a crosssectional study in pregnant women was carried out. The intake of foods and food ingredients were surveyed by
using 24-h dietary recall. Blood haemoglobin, haematocrit, serum iron, serum ferritin, transferrin and soluble
transferrin receptor were measured in 1189 clinically normal pregnant women in the third trimester of
pregnancy. The results showed that the average daily intake of rice and wheat was 504.2 g in the anaemia group
and 468.6 g in the normal group. Carbohydrates accounted for 63.69% and 63.09% of energy in the anaemia and
normal groups, respectively. Intake of fat was very low; 18.38% of energy in anaemia group and 19.23% of
energy in normal group. Soybean intake was 109.4 g/day and 63.6 g/day in the anaemia and normal groups,
respectively (P< 0.001). There were lower intakes of green vegetables (172.1 g/day) and fruits (154.9 g/day) in
the anaemia group than in the normal group (246.2 g/day green vegetables (P< 0.001) and 196.4 g/day fruit
(P< 0.001)). Intakes of retinol and ascorbic acid were much lower in the anaemia than in the normal group
(P< 0.001). In the anaemia group, vitamin A intake was only 54.76% of the Chinese recommended daily
allowance (RDA) and ascorbic acid intake was 53.35% of the Chinese RDA. Intake of total vitamin E was
14.55 mg/day in the anaemia group compared with 17.35 mg/day in the normal group (P< 0.016). Moreover,
intake of iron in pregnant women with anaemia was slightly lower than that in the normal group. Comparison of
iron status between the anaemia and normal groups found serum iron in women with anaemia at 0.89 µg/L,
which was significantly lower than 1.09 µg/L in the normal group (P< 0.001). There were lower average values
of ferritin (14.70 µg/L) and transferrin (3.34 g/L) in the anaemia group than in the normal group (20.40 µg/L
ferritin (P< 0.001) and 3.44 g/L transferrin (P< 0.001)). Soluble transferrin receptor was significantly higher
(32.90 nmol/L) in the anaemia than in the normal group (23.58 nmol/L; P< 0.001). The results of this study
indicate that anaemia might be attributed to a low iron intake, a low intake of enhancers of iron absorption and
a high intake of inhibitors of iron absorption from a traditional Chinese diet rich in grains.
Asia Pac J Clin Nutr. 2002;11(3):171-175.doi:
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Faecal bulking efficacy of Australasian breakfast cereals
Author:John A Monro BSc(Hons), PhD
Keywords: breakfast cereals, dietary fibre, faecal bulk, wheat bran equivalents
Abstract:Faecal bulk may play an important role in preventing a range of disorders of the large bowel, but as yet there is
little information available on the relative faecal bulking capacities of various foods. Breakfast cereals are often
promoted as a good source of potential bulk for ‘inner health’ because they provide dietary fibre, but their
relative abilities to provide faecal bulk per se have not been described. The faecal bulking efficacy of 28
representative Australasian breakfast cereals was therefore measured. A rat model developed for the purpose,
and shown to give similar responses as humans to cereal fibres, was used to measure faecal bulking efficacy as
increases in fully hydrated faecal weight/100 g diet, based on precise measurements of food intake, faecal dry
matter output and faecal water-holding capacity (g water held without stress/g faecal dry matter). Compared to a
baseline diet containing 50% sucrose, increments in hydrated faecal weight due to 50% breakfast cereal ranged
from slightly negative (Cornflakes, –2 g/100 g diet) to about 80 g/100 g diet (San Bran). Most breakfast cereals
increased hydrated faecal weight by between 10 and 20 g/100 g diet from a baseline of 21 ± 1.5 g/100 g diet, but
four products containing high levels of wheat bran had an exceptionally large impact on hydrated faecal weight
(increment >20 g/100 g diet), and the changes resulted more from relative changes in dry matter output than in
faecal water retention/gram. However, as faecal water retention was about 2.5 g water/g faecal dry matter on
average, increases in dry matter represented large increases in faecal water load. Faecal bulking indices (FBI)
for most of the breakfast cereals were less than 20 (wheat bran = 100). The content of wheat bran equivalents
for faecal bulk (WBE
fb)
) in the breakfast cereals was calculated from FBI. Most breakfast cereals contributed,
per serve, less than 10% of a theoretical daily reference value for faecal bulk (DRV
fb= 63 WBEfb/day), which
was based on data from human clinical trials and dietary fibre recommendations. Based on the WBEfb
contribution/serving that would be required to meet the DRV
fb
from the number of servings of dietary fibre
sources in the CSIRO 12345+ food and nutrition plan, the results suggest that although some high bran
breakfast cereals may contribute substantially to, and many are reasonable sources of, faecal bulk, for most of
them, one or two servings at breakfast cannot be relied on to effectively redress shortfalls in faecal bulk
elsewhere in the diet.
Asia Pac J Clin Nutr. 2002;11(3):176-185.doi:
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Zinc and iron status during pregnancy of Filipino women
Author:Nynke de Jong PhD, Aurora B Ampong Romano MD, MPHa
Keywords: anaemia, birthweight, haemoglobin, hair, iron, Philippines, pregnancy, Zamboanga del Sur, zinc
Abstract:Low birthweight is associated with maternal anaemia and, in some circumstances, with low iron and zinc status,
but this relationship has not been investigated in the Philippines. In this study, we assessed the prevalence of
anaemia and suboptimal iron and zinc status in pregnant women from three geographical regions (mountain,
coast, city) of Zamboanga del Sur province at 24 weeks (n= 305), and again at 36 weeks (n= 127), gestation.
At 24 weeks, 34% were anaemic (i.e., haemoglobin < 105 g/L) from all causes, of whom only 14% had
concomitant low serum ferritin values (i.e., < 12 µg/L). The presence of infection was low, based on both
elevated white blood cell count (> 11×10
9
/L; 19%) and serum C-reactive protein (> 15 mg/L; 3%). Of the
women surveyed, 20% were iron depleted but not anaemic, and 15% were zinc deficient (i.e., serum zinc
< 7.1 µmol/L). The mean (± SD) birthweight of the infants (n= 250) was 3074 g ± 408 g, of whom 5% were of
low birthweight (< 2500 g). No differences existed for biochemical indices or birthweight among the three
regions, or between women consuming maize or rice-based diets. Women with low haemoglobin (P= 0.05) and
low serum zinc (P= 0.14) values at 24 weeks gestation had infants with lower birthweights than those with
values ≥105 g/L and ≥7.1 µmol/L, respectively. However, in the multivariate model, the contribution of
maternal haemoglobin to the variance in birthweight at 24 weeks gestation was non-significant, although modest
for serum zinc. Anaemia and/or suboptimal zinc status during pregnancy may be related to low birthweight in
the Philippines, and their aetiology deserves further study.
Asia Pac J Clin Nutr. 2002;11(3):186-193.doi:
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Tocotrienols are needed for normal bone calcification in growing female rats
Author:Mohamed Norazlina PhD, SoelaimanIma-Nirwana MBBS,
Keywords:α-tocopherol, bone calcium, female rat, palm vitamin E, tocotrienol, vitamin E deficiency
Abstract:In this study the effects of vitamin E deficiency and supplementation on bone calcification were determined
using 4-month-old female Sprague-Dawley rats. The rats weighed between 180 and 200 g. The study was
divided in three parts. In experiment 1 the rats were given normal rat chow (RC, control group), a vitamin E
deficient (VED) diet or a 50% vitamin E deficient (50%VED) diet. In experiment 2 the rats were given VED
supplemented with 30 mg/kg palm vitamin E (PVE30), 60 mg/kg palm vitamin E (PVE60) or 30 mg/kg pure
α-tocopherol (ATF). In experiment 3 the rats were fed RC and given the same supplements as in experiment 2.
The treatment lasted 8 months. Vitamin E derived from palm oil contained a mixture of ATF and tocotrienols.
Rats on the VED and 50%VED diets had lower bone calcium content in the left femur compared to the RC group
(91.6 ±13.3 mg and 118.3 ±26.0 mg cf. 165.7 ±15.2 mg; P< 0.05) and L5 vertebra (28.3 ±4.0 mg and
39.5 ±6.2 mg compared with 51.4 ±5.8 mg; P< 0.05). Supplementing the VED group with PVE60 improved
bone calcification in the left femur (133.6 ±5.0 mg compared with 91.6 ±13.3 mg; P< 0.05) and L5 vertebra
(41.3 ±3.3 mg compared with 28.3 ±4.0 mg; P < 0.05) while supplementation with PVE30 improved bone
calcium content in the L5 vertebra (35.6 ±3.1 mg compared with 28.3 ±4.0 mg; P< 0.05). However, supplementation with ATF did not change the lumbar and femoral bone calcium content compared to the VED group.
Supplementing the RC group with PVE30, PVE60 or ATF did not cause any significant changes in bone calcium
content. In conclusion, vitamin E deficiency impaired bone calcification. Supplementation with the higher dose
of palm vitamin E improved bone calcium content, but supplementation with pure ATF alone did not. This effect
may be attributed to the tocotrienol content of palm vitamin E. Therefore, tocotrienols play an important role in
bone calcification.
Asia Pac J Clin Nutr. 2002;11(3):194-199.doi:
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Association between overweight or obesity and household income and parental body mass index in Australian youth: analysis of the Australian National Nutrition Survey, 1995
Author:Zaimin Wang BMed, MMed,MPS Food Nutr, Carla M Patt
Keywords:Australia, body mass index, nutrition survey, obesity, overweight, school children
Abstract:This study is a secondary data analysis based on the 1995 Australian National Nutrition Survey (NNS).
A random subsample of 1581 school children aged 7–15 years old from the NNS was studied. The results show
the prevalence of overweight, obesity and combined overweight and obesity was 10.6–20.9%, 3.7–7.2% and
15.6–25.7%, respectively. The odds ratio of overweight or obese boys with highest household income was
significantly smaller than those with the lowest household income. The proportion of combined overweight and
obesity in children whose parents were overweight or obese was significantly greater compared with those
whose parents were not. The trend of increasing prevalence of overweight or obesity among children with
increasing parental body mass index (BMI) was significant after adjusting for age except the trend of father’s
BMI for boys. This study provided baseline data on the recent prevalence of overweight or obesity of Australian
school children using new international absolute BMI cut-off points. It indicated that young school girls
(7–9 years) were more likely to be overweight or obese compared with boys, the prevalence rates of overweight
or obesity in older boys (13–15 year) was significantly greater than in other age groups while in girls it was the
opposite. The boys with lowest household income ($0–17 500) were more likely to be overweight or obese
compared with those with the highest household income (greater than $67 500). Having parents especially
mothers who were overweight or obese may increase the risk of children being overweight or obese.
Asia Pac J Clin Nutr. 2002;11(3):200-205.doi:
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Antioxidant effect ofPhaseolus vulgarisin streptozotocin-induced diabetic rats
Author:Subramanian Venkateswaran MPhiland Leelavinothan P
Keywords:aqueous extract, enzymic antioxidants, Phaseolus vulgaris, streptozotocin-induced diabetes
Abstract:The antioxidant effect of an aqueous extract of Phaseolus vulgarispods, an indigenous plant used in Ayurvedic
medicine in India, was studied in rats with streptozotocin-induced diabetes. Oral administration of Phaseolus
vulgaris pod extract (PPEt; 200 mg/kg body weight) for 45 days resulted in a significant reduction in
thiobarbituric acid reactive substances and hydroperoxides. The extract also causes a significant increase
in reduced glutathione, superoxide dismutase, catalase, glutathione peroxidase and glutathione-S-transferase in
the liver and kidneys of rats with streptozotocin-induced diabetes. These results clearly show the antioxidant
property of PPEt. The effect of PPEt at 200 mg/kg body weight was more effective than glibenclamide.
Asia Pac J Clin Nutr. 2002;11(3):206-209.doi:
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Cross-sectional study of diet and risk factors for metabolic diseases in a Ghanaian population in Sydney, Australia
Author:Ashraf Saleh M Nutr Sc, Soumela Amanatidis MPH,Di
Keywords:Australia, cholesterol, diabetes, diet, Ghana, hypertension, lifestyle, metabolic risk factors, migration, obesity, Sydney
Abstract:Ethnic groups in affluent environments experience higher rates of metabolic diseases than their native
counterparts. Our objective was to determine the prevalence of metabolic risk factors in Ghanaians in Sydney,
and to investigate the relationship with dietary and lifestyle factors. Cross-sectional design with anthropometry,
blood pressure, plasma lipids, glucose and insulin concentrations were measured on two occasions on each
subject. Dietary information was obtained by three 24-h dietary recalls. Adults (45 male, 35 female) were
recruited from a local association in Sydney, Australia. Overweight was observed in a large proportion of
subjects (71% and 66% of men and women, respectively), with 18% of men and 26% of women classified as
obese. Abdominal overweight was seen in 63% and 74% of men and women, respectively. Abdominal obesity
was seen in 20% of men and 49% of women. Hypertension was detected in 40% of men and 17% of women,
16% of men and 6% of women were diagnosed with definite hypertension. Seventy-one per cent of men and
29% of women were classified as hypercholesterolaemic and 67% of men and 23% of women had elevated lowdensity lipoprotein cholesterol. In men, low high-density lipoprotein cholesterol and hypertriacylglycerolaemia
affected 18% and 13%, respectively. Fasting hyperinsulinaemia was observed in 14% and 9% of men and
women, respectively. The majority of subjects (73%) sustained one or more metabolic risk factors. Dietary fat
contributed 33% and 35% of total energy intake in men and women, respectively, saturated fat contributing 11%
in both sexes. A high prevalence of overweight, diabetes, hypertension and dyslipidaemia exists in this
population, particularly in men, highlighting the need for intervention.
Asia Pac J Clin Nutr. 2002;11(3):210-216.doi:
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Glycaemic glucose equivalent: combining carbohydrate content, quantity and glycaemic index of foods for precision in glycaemia management
Author:John A Monro PhD
Keywords:carbohydrate, diabetes mellitus, food intake, glycaemia, glycaemic glucose equivalents, glycaemic index, relative glycaemic impact
Abstract:The glycaemic index (GI) is the blood glucose response to carbohydrate in a food as a percentage of the response
to an equal weight of glucose. Because GI is a percentage, it is not related quantitatively to food intakes, and
because it is based on equi-carbohydrate comparisons, GI-based exchanges for control of glycaemia should be
restricted to foods providing equal carbohydrate doses. To overcome these limitations of GI, the glycaemic
glucose equivalent (GGE), the weight of glucose having the same glycaemic impact as a given weight of food,
is proposed as a practical measure of relative glycaemic impact. To illustrate the differences between GGE
and GI in quantitative management of postprandial glycaemia, published values for carbohydrate content, GI
and serving size of foods in the food groupings, breads, breakfast cereals, pulses, fruit and vegetables, were used
to determine the GGE content per equal weight and per serving of foods. Food rankings and classifications for
exchanges based on GGE content were compared with those based on GI. In all of the food groupings analysed,
values for relative glycaemic impact (as GGE per 100 g food and per serving) within each of the categories, low,
medium and high GI, were too scattered for GI to be a reliable indicator of the glycaemic impact of any given
food. Correlations between GI and GGE content per serving were highest in food groupings of similar
carbohydrate content and serving size, including breads (r= 0.73) and breakfast cereals (r= 0.8), but low in
more varied groups including pulses (r= 0.66), fruit (r= 0.48) and vegetables (r= 0.28). Because of the noncorrespondence of GI and GGE content, food rankings by GI did not agree with rankings by GGE content, and
placement of foods in GI-based food exchange categories was often not appropriate for managing glycaemia.
Effects of meal composition and food intake on relative glycaemic impact could be represented by GGE content,
but not by GI. Because GGE is not restricted to equicarbohydrate comparisons, and is a function of food
quantity, GGE may be applied, irrespective of food or meal composition and weight, and in a number of
approaches to the management of glycaemia. Accurate control of postprandial glycaemia should therefore be
achievable using GGE because they address the need to combine GI with carbohydrate dose in diets of varying
composition and intake, to obtain a realistic indication of relative glycaemic impact.
Asia Pac J Clin Nutr. 2002;11(3):217-225.doi:
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Green tea catechin improves microsomal phospholipase A2 activity and the arachidonic acid cascade system in the kidney of diabetic rats
Author:Soon-Jae Rhee PhD, Jeong-Hwa Choi PhD and Mo Ra Pa
Keywords:antithrombogenic, diabetes, green tea catechin, lipid peroxidation, phospholipase A 2
Abstract:The purpose of this study was to investigate the effects of green tea catechin on the microsomal phospholipase
A2
activity and arachidonic acid cascade in the kidneys of streptozotocin-induced diabetic rats. Sprague-Dawley
male rats weighing 100 ±10 g were assigned randomly to one normal and three streptozotocin-induced diabetic
groups. The diabetic groups were the DM-0C group (n= 10), fed a catechin-free diet, the DM-0.25C group
(n= 10), fed a 0.25 g catechin per 100 g diet, and the DM-0.5C group (n= 10), fed a 0.5 g catechin per 100 g
diet. The kidney microsomal phospholipase A
2
activity was higher in the diabetic groups than in the normal
group, while it was lower in the DM-0.25C and DM-0.5C groups than in the DM-0C group. The percentage of
phosphatidylcholine hydrolysed in the kidney microsomes was not significantly different between any of the
four groups. The percentage of phosphatidylethanolamine hydrolysed in the kidney microsomes was progressively higher in the DM-0.5C, DM-0.25C and DM-0C groups, respectively, compared to the normal group. The
formation of thromboxane A
2
was significantly higher while the formation of prostacyclin was lower in kidney
microsomes of the streptozotocin-induced diabetic groups compared with the normal group, but this condition
was improved by catechin supplementation. Kidney microsomal vitamin E concentrations were progressively
lower in the DM-0.5C, DM-0.25C, and DM-0C groups, respectively, compared to the normal group. The kidney
thiobarbituric acid reactive substance (TBARS) contents became higher in the DM-0C and DM-0.25C groups as
compared with the normal group, whereas the DM-0.5C group did not differ from the normal group. Kidney
function appears to be improved by green tea catechin supplementation due to its antithrombus action, which in
turn controls the arachidonic acid cascade system.
Asia Pac J Clin Nutr. 2002;11(3):226-231.doi:
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Effects of green tea catechin on prostaglandin synthesis of renal glomerular and renal dysfunction in streptozotocin-induced diabetic rats
Author:Soon-Jae Rhee PhD, Mi-Ji Kim PhD and Oh-Gye Kwag P
Keywords:antithrombotic activity, diabetes, green tea catechin, renal dysfunction, renal glomerulus
Abstract:The purpose of the present study was to investigate the effects of green tea catechin on prostaglandin synthesis
of renal glomerular and renal dysfunction in rats with streptozotocin–induced diabetes. Sprague-Dawley rats
weighing 100 ±10 g were randomly assigned to one normal group and three groups with streptozotocin-induced
diabetes. The diabetic groups were classified to a catechin-free diet (DM group), a 0.25% catechin diet (DM-0.25C group) and a 0.5% catechin diet (DM-0.5C group) according to the levels of catechin supplement in their
diet. The animals were maintained on an experimental diet for 4 weeks. At this point, they were injected with
streptozotocin to induce diabetes. They were killed on the sixth day. The catechin supplementation groups (DM-0.25C, DM-0.5C groups) showed a decrease in thromboxane A
2
synthesis but an increase in prostacyclin
synthesis, compared to the DM group. The ratio of prostacyclin/thromboxane A
2
was 53.3% and 38.1% lower in
the DM and DM-0.25C groups, respectively, than in the normal group. The ratio in the DM-0.5C group did not
differ from that in the normal group. The glomerular filtration rate in catechin feeding groups (DM-0.25C and
DM-0.5C groups) was maintained at the normal level. The urinary β2-microglobulin content in the DM-0.5C
group was significantly lower than that in the normal group. On the sixth day after induction of diabetes, the
urinary microalbumin content in the DM, DM-0.25C and DM-0.5C groups had increased 5.40, 4.02, 3.87 times,
respectively, compared with the normal group. In conclusion, kidney function appears to be improved by green
tea catechin supplementation due to its antithrombotic action, which in turn controls the arachidonic acid
cascade system.
Asia Pac J Clin Nutr. 2002;11(3):232-236.doi:
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Selective feeding centres in refugee settings: evaluation framework protocol
Author:Andre MN Renzaho BNutr,BDiet,MPH
Keywords:evaluation, feeding programs, malnutrition, refugees
Abstract:Selective feeding programs are centres for the treatment of persons suffering from acute malnutrition. Unlike
chronic malnutrition, acute malnutrition reflects recent problems. In a crisis situation, wasting is preferred above
other indicators because it is sensitive to rapid change, indicates present change, can be used to monitor the
impact of interventions and is a good predictor of immediate mortality risk. This paper reviews the current
approach being used in the field to evaluate the effectiveness of feeding programs. There is no comprehensive
evaluation framework in place to assess the impact of feeding programs on mortality due to malnutrition. Some
loose outcome measures, such as the number of children enrolled in a feeding centre, are being used to
determine if a feeding centre should continue. In addition, malnutrition prevalence and crude mortality rates
determined through nutritional and mortality surveys are used to assess the impact of feeding programs. This
procedure does not take into account potential confounding factors that impact on malnutrition prevalence,
including access to non-relief foods and the general food ration. Therefore, one could not confidently say that
the reduction of malnutrition prevalence is a result of feeding programs. This paper presents an alternative
approach to evaluating feeding centres.
Asia Pac J Clin Nutr. 2002;11(3):237-245.doi:
>>Abstract
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