Lean meat and heart health
Author:Duo Li PhD , Sirithon Siriamornpun PhD, Mark L Wah
Keywords:nuts, meat, heart disease, CHD risk factors, LDL cholesterol, saturated fat, polyunsaturated fatty acids
Abstract:The general health message to the publicabout meat consumption is both confusing and misleading. It is stated
that meat is not good for health because meat is rich infat and cholesterol and high intakes are associated with
increased blood cholesterol levels and coronary heart disease (CHD). This paper reviewed 54 studies from the
literature in relation to red meat consumption and CHD risk factors. Substantial evidence from recent studies
shows that lean red meat trimmed of visible fat does not raise total blood cholesterol and LDL-cholesterol
levels. Dietary intake of total and saturated fat mainly comes from fast foods, snack foods, oils, spreads, other
processed foods and the visible fat of meat, rather than leanmeat. In fact, lean red meat is low in saturated fat,
and if consumed in a diet low in SFA is associated with reductions in LDL-cholesterol in both healthy and
hypercholesterolemia subjects. Lean red meat consumption has no effect on in vivoand ex vivoproduction of
thromboxane and prostacyclin or the activity of haemostaticfactors. Lean red meat is also a good source of
protein, omega-3 fatty acids, vitamin B12
, niacin, zinc and iron. In conclusion,lean red meat, trimmed of visible
fat, which is consumed in a diet low in saturated fat does not increase cardiovascular risk factors (plasma
cholesterol levels or thrombotic risk factors).
Asia Pac J Clin Nutr. 2005;14(2):113-119.doi:
>>Abstract
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Enhancing health benefits of berries through phenolic antioxidant enrichment: focus on cranberry
Author:Dhiraj A VattemPhD, Reza Ghaedian PhD and Kalidas
Keywords: antioxidant activity, antimicrobial activity, free radical scavenging, cranberry, fruit phytochemicals, phenolic antioxidant, synergy, solid-state bioprocessing
Abstract:Emerging epidemiological evidence is increasingly pointing to the beneficial effects of fruits and vegetables in
managing chronic and infectious diseases. These beneficial effects are now suggested to be due to the
constituent phenolic phytochemicals having antioxidant activity. Cranberry like other fruits is also rich in
phenolic phytochemicals such as phenolic acids, flavonoids and ellagic acid. Consumption of cranberry has
been historically been linked to lower incidences of urinary tract infections and has now been shown to have a
capacity to inhibit peptic ulcer-associated bacterium, Helicobacter pylori. Isolated compounds from cranberry
have also been shown to reduce the risk of cardiovascular diseases. Recent evidence suggests the ability of
phytochemical components in whole foods in being more effective in protectively supporting human health
than compared to isolated individual phenolic phytochemicals. This implies thatthe profile of phenolic
phytochemicals determines the functionality of the whole food as a result of synergistic interaction of
constituent phenolic phytochemicals. Solid state bioprocessing using food grade fungi common in Asian food
cultures as well as cranberry phenolic synergies through the addition of functional biphenyls such as ellagic
acid and rosmarinic acid along with processed fruit extracts have helped to advance these concepts. These
strategies could be further explored to enrich cranberry and cranberry products with functional phytochemicals
and further improve their functionality for enhancing health benefits.
Asia Pac J Clin Nutr. 2005;14(2):120-130.doi:
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Increases in plasma lycopene concentration after consumption of tomatoes cooked with olive oil
Author:Jeanette M Fielding PhD, Kevin G Rowley PhD, Pauli
Keywords: antioxidant, lycopene, tomatoes, olive oil, cuisine, bioavailability, Mediterranean cuisine
Abstract:Lycopene is the main carotenoid in tomatoes and it has been hypothesised to be responsible for reducing the
risk of some cancers and heart disease. The cooking of tomatoes with olive oil is a characteristic combination in
the Southern Mediterranean diet. Previous studies haveshown that the absorption of lycopene is greater from
processed tomatoes than fresh tomatoes, since the processing breaks down the tomato cell matrix and makes
the lycopene more available. The aim of the present study was to determine whether consumption of diced
tomatoes cooked with olive oil resulted in higher plasma lycopene concentrations than consumption of diced
tomatoes cooked without olive oil. Plasma lycopene concentrations were measured after 5 days on a low
lycopene diet and again after a five-day dietary intervention, in healthy subjects, who consumed one meal per
day of tomatoes (470 g) cooked with or without extra virgin olive oil (25 ml olive oil). There was an 82%
increase in plasma trans-lycopene (P< 0.001) and a 40% in cis-lycopene (P= 0.002) concentrations in the 11
subjects who consumed tomatoes cooked in olive oil. There was no significant change in trans-lycopene
(P=0.684) and a 15% increase in cis-lycopene (P= 0.007) concentrations in 12 subjects consuming tomatoes
cooked without olive oil. We conclude that the addition of olive oil to diced tomatoes during cooking greatly
increases the absorption of lycopene. The results highlight the importance of cuisine (i.e how a food is
prepared and consumed) in determining the bioavailability of dietary carotenoids such as lycopene.
Asia Pac J Clin Nutr. 2005;14(2):131-136.doi:
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Dietary vitamin A may be a cardiovascular risk factor in a Saudi population
Author:Eman M Alissa BSC , Suhad M BahjriBSC, PhD, Nabeel
Keywords:vitamins A, C, and E, coronary disease, risk factors, lipid peroxides, dietary antioxidant vitamin intake, oxidative stress, coronary atherosclerosis, Saudi Arabia, Jeddah
Abstract:Traditional risk factors do not appear to explain fully the variation in the incidence of the cardiovascular
diseases (CVD). Epidemiological studies have not been entirely consistent with regard to the relationship
between antioxidant vitamin intake and CVD and there appears to be little data on this relationship in nonCaucasian populations. This study aimed to investigate the dietary intake ofvitamin A, C, and vitamin E, and
carotenoids, serum concentrations of vitamin E and A and indices of lipid peroxidation were measured in male
Saudi patients with established CVD and age-matched controls. We assessed the dietary intakes of vitamins A,
C, and E and carotenoids, by a food frequency questionnaire. Serum vitamins A and E concentrations were
measured by HPLC, in 130 Saudi malesubjects with established CVD, and 130 age-matched controls. We also
determined serum lipid profiles (total cholesterol, triglycerides, HDL-C, LDL-C), lipoprotein (a), oxidized
LDL, and serum lipid peroxide concentrations. Diabetes mellitus (P<0.0001), a positive smoking habit
(P<0.0001) and hypertension (P<0.05) were more prevalent among CVD patients. Levels of dietary vitamin E
and A were also significantly higher among cases. In conditional logistic regression analysis, the most
significant characteristics differentiating CVD patients from controls were diabetes mellitus (Odds ratio 2.49,
CI 1.42-4.37, P<0.001), total fat intake (Odds ratio 1.02, CI 1.01-1.03, P<0.01), serum vitamin A (Odds ratio
0.72, CI 0.53-0.99, P<0.05), and the vitamin A/total fat intakeratio (Odds ratio 1.04, CI 1.01-1.06, P<0.01). In
a Saudi population, smoking habit and hypertension were significantly more common among patients with
CVD. Multivariate analysis showed that dietary total fat and vitamin A and the presence of diabetes mellitus
were independent coronary risk factors. This is the first report of a potentially deleterious effect of dietary
vitamin A in a non-Caucasian population. However it ispossible that unidentified residual confounding factors
may account for this finding.
Asia Pac J Clin Nutr. 2005;14(2):137-144.doi:
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Anti-diabetic and anti-hypertensive potential of sprouted and solid-state bioprocessed soybean
Author:Patrick McCue MS, Young-In Kwon MS and Kalidas Sh
Keywords:alpha amylase, alpha glucosidase, angiotensin I-converting enzyme, soybean, Rhizopus, Lentinus, hyperglycemia, hypertension, diabetes, obesity
Abstract:Long-term type 2 diabetes can lead to numerous biological complications, such as hypertension and cardiovascular disease. Key enzymes involved in the enzymatic breakdown of complex carbohydrates, pancreatic
α-amylase and intestinal α-glucosidase, have been targeted as potential avenues for modulation of type 2
diabetes-associated post-prandial hyperglycemia through mild inhibition of their enzymatic activities so as to
decrease meal-derived glucose absorption. Further, inhibition of hypertension-linked angiotensin I-converting
enzyme (ACE) was targeted as a potential approach for modulation of diabetes-linked hypertension. Watersoluble extracts of soybean optimized for phenolic content via sprouting or bioprocessing by dietary fungus
(Rhizopus oligosporus, Lentinus edodes) were investigated for inhibitory activity against porcine pancreatic α-amylase (PPA), yeast α-glucosidase, and rabbit lung ACE in vitro. PPA was allowed to react with each
phenolic-optimized extract and the derivatized enzyme-phytochemical mixtures obtained were characterized
for residual amylase activity. α-Glucosidase and ACE activities were determined in the presence of each
phenolic-optimized extract. All of the soybean extracts possessed marked anti-amylase activity, with extracts
of R. oligosporus-bioprocessed soybean having the strongest inhibitory activity, but only slight anti-glucosidase
activity. The anti-amylase activity of each extract seemed associated with extract antioxidant activity. Antienzyme activity was slightly associated with total soluble phenolic content per se, but seemed more associated
to the length of sprouting or bioprocessing of the soybean substrate. Short-term sprouting or bioprocessing
seemed to improve anti-amylase activity, while long-term sprouting or bioprocessing seemed to aid antiglucosidase activity. While ACE activity was strongly inhibited by all of the soybean extracts (44-97%), only
sprouting was found to increase this inhibition and bioprocessing of soybean with L. edodesdecreased
inhibitory activity of soybean extract. The results suggest that sprouting and dietary fungal bioprocessing of
soybean improve the anti-diabetic potential of soybean extracts, potentially through modulation of the phenolic
profile of the extract, and further suggest that enzyme inhibitory activity may be linked to phenolic antioxidant
mobilization during spouting and/ or bioprocessing. The significance of food-grade, plant-based enzyme
inhibitors for modulation of carbohydrate breakdown and control of glycemicindex of foods in the context of
preventing hyperglycemia and diabetes mellitus complications such as hypertension in the long-term is
hypothesized and discussed.
Asia Pac J Clin Nutr. 2005;14(2):145-152.doi:
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Antioxidant properties of Momordica Charantia(bitter gourd) seeds on Streptozotocin induced diabetic rats
Author:Dhanasekar Sathishsekar MScand Sorimuthu Subramani
Keywords:Momordica charantia, bitter gourd seeds, streptozotocin, diabetes, antioxidant enzymes
Abstract:The aim of the present study is to investigate the antioxidant activities of the aqueous extract of seeds of two
varieties, namely a country and hybrid variety of Momordica charantia(MCSEt1 and MCSEt2) respectively in
streptozotocin induced diabetic rats. Oral administration of both the seed extracts at a concentration of 150 mg/kg
b.w for 30 days showed a significant decrease in fasting blood glucose, hepatic and renal thiobarbituric acid reactive
substances and hydroperoxides. The treatment also resulted in a significant increase in reduced glutathione,
superoxide dismutase, catalase, glutathione peroxidase and glutathione-s-transferase in the liver and kidney of
diabetic rats. The results clearly suggest that seeds of Momordica charantiatreated group may effectively
normalize the impaired antioxidant status in streptozotocin induced-diabetes than the glibenclamide treated groups.
The extract exerted rapid protective effects against lipid peroxidation by scavenging of free radicals there by
reducing the risk of diabetic complications. The effect was more pronounced in MCSEt1 compared to MCSEt2.
Asia Pac J Clin Nutr. 2005;14(2):153-158.doi:
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Sources of household salt in South Africa
Author:Pieter L Jooste PhD
Keywords:iodine, salt, household salt, socio-economic status, South Africa
Abstract:Marketing of non-iodized salt through unconventional distribution channels isone of the factors weakening the
national salt iodization program in South Africa. The aim of this study was therefore to quantify the various
sources of household salt, and to relate this information to socio-economic status. Questionnaire information
was collected by personal interview during home visits from a multistage, cluster, probability sample of 2164
adults representative of the adult population. Nationally 77.7% of households obtained their table salt from the
typical food shops distributing iodized salt. However, in the nine different provinces between 8 and 37.3% of
households used unconventional sources, distributing mainly non-iodized salt, to obtain their household salt.
These alternative sources include distributors of agricultural salt, small general dealer shops called spaza shops,
in peri-urban and rural townships, street vendors and salt saches placed inthe packaging of maize meal bags.
Countrywide around 30% of low socio-economic households obtained their salt from unconventional sources
compared to less than 5% in high socio-economic households, emphasizing the vulnerability of low socioeconomic groups to the use of non-iodized salt. Intervention strategies should mobilize all role players
involved in unconventional marketing channels of household salt to provide only iodized salt to consumers, as
required by law.
Asia Pac J Clin Nutr. 2005;14(2):159-162.doi:
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Diet quality status of most Tehranian adults needs improvement
Author:Leila Azadbakht MSc, Parvin Mirmiran MSc, Firoozeh
Keywords:diet quality, food groups, Healthy Eating Index (HEI), Tehranian adults, Iran
Abstract:The healthy eating index (HEI) was developed to trackthe quality of diets in different societies. The
aim of this study was to determine the HEI score of Tehranian adults. This study, conducted within
the framework of Tehran Lipid and Glucose Study (TLGS), was a part of a dietary intake assessment carried out in 819 cases aged 19 and over. Dietary intake was assessed with two 24-hour
recalls. HEI was calculated based on 9 components. The HEI score was categorized into three
groups: less than 45 (poor diet), between 45-72 (needs improvement) and more than 72 (good diet).
The mean score of HEI was 65.8 ± 9.6 in men and 65.9 ± 8.6 in women. The results showed that the
number of servings of food groups in those with good diet was significantly higher than the two
other groups (P<0.05). The percentage of observationsfailing to meet the estimated average
requirements (EAR) in the poor diet group (HEI<45) was higher than the other diet groups for most
of the nutrients. Diets were categorized into: needs improvement (74%); good (23%); and poor
(3%). Since the majority of the sample needed to improve their diet, this suggests that nutrition
intervention may be needed.
Asia Pac J Clin Nutr. 2005;14(2):163-168.doi:
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High prevalence of overweight and obesity in women of Islamshahr, Iran
Author:Gity Sotoudeh PhD, Shahla Khosravi MS, Farahnaz Kh
Keywords:obesity, overweight, women, BMI, WHR, Islamshahr, Iran
Abstract:This study determined the prevalence of overweight, overall and central obesity in female adolescents and
women and their possible association with marital status, occupation, literacy, parity, daily meal and snack
consumption. The study was a cross-sectional, randomsurvey of households. Rural and urban areas of
Islamshahr district in Iran were selected and 1003 female adolescents and women aged 10-65 years were
studied. The frequency of overweight and obesity were similar in rural and urban areas. On the basis of body
mass index (BMI), more than 19% of adolescents were overweight or at risk of it and 66.8% of adult females
were overweight or obese. Frequency of central obesity [waist to hip ratio (WHR) ≥0.85] was 35.7% in all
females. The mean BMI was significantly higher in married women and in women with less than 8 years of
formal education. The mean WHR was significantly higher in women with less than 8 years of education or
with more than 6 parity female adults. In addition, the mean BMIs and WHRs were significantly higher in
women without any daily snack consumption. Overweight and obesity was very common in adult females of
Islam shahr thus prevention of overweight and obesity through a healthy diet and increased physical activity
should now be an important priority area.
Asia Pac J Clin Nutr. 2005;14(2):169-172.doi:
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Folic acid fortified milk increases blood folate and lowers homocysteine concentration in women of childbearing age
Author:Timothy J Green PhD, C Murray Skeaff PhD, Jennifer
Keywords:folic acid, milk, NTD, fortification, red blood cell folate, plasma folate, homocysteine, women
Abstract:Daily consumption of 400 µg folic acid prior to conception and during early pregnancy is recommended for the
prevention of neural tube defects (NTD). Strategies to increase folic acid consumption include supplements
and fortified foods. Milk is consumed by women and can be fortified with folic acidbut little is known about
the effect of fortified milk on blood folate concentration in women of childbearing age. The objective of this
study was to determine whether daily consumption of milk fortified with 375µg folic acid increases blood
folate and lowers homocysteine concentrations in women of childbearing age. Seventy-three non-pregnant
women (aged 18-47 y) were randomized to receive either75 g/d of a fortified or unfortified (control) milk
powder for 12 weeks. Women who consumed the folic acid fortified milk had mean (95% CI) red blood cell
and plasma folate con-centrations that were 539 nmol/L (436, 641) and 35 nmol/L (30, 41) higher, respectively,
than in the control group. Women drinking fortified milk had a 14% lower mean plasma homocysteine
concentration at week 12 than women consuming the control milk. Daily consumption of fortified milk powder
providing 375µg folic acid increases blood folate and lowers homocysteine concentrations over 12 weeks in
women of childbearing age. Daily consumption of fortified milk would be expected to reduce NTD risk.
Asia Pac J Clin Nutr. 2005;14(2):173-178.doi:
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Maternal total homocysteine concentration and neonatal size in India
Author:Chittaranjan S YajnikMD FRCP, Swapna S Deshpande M
Keywords:total-Homocysteine, vitamin B12, folate, neonatal size, India
Abstract:The smallness of Indian babies is ascribed to small maternal size and their chronic under nutrition.
Micronutrient nutrition of the mother may be particularly important. We investigated the relationship between
maternal circulating concentrations of total homocysteine (tHcy), vitamin B12 and folate and offspring size at
birth. Mothers of full term small for gestation age babies (SGA, gestation and sex specific birth weight <10
th
centile, N = 30) and mothers of appropriate for gestational age babies (AGA, >10
th
centile, N = 50) were
compared for their body size, plasma tHcy, vitamin B12 and red cell folate concentration at 28week gestation.
Mothers of SGA babies were lighter and shorter than those of AGA babies (P <0.05, both) and had higher
plasma tHcy concentration (P<0.01). Total homocysteine concentrations were inversely related to plasma
vitamin B12 and red cell folate concentrations (r = ~ -0.5, P <0.01, both). Seventy percent of the women had a
low vitamin B12 status (plasma vitamin B12 <150 pmol/L) but none were folate deficient (red cell folate <283
nmol/L). Higher maternal plasma tHcy concentration was significantly associated with lower offspring birth
weight (r=-0.28, P<0.05 adjusting for maternal height, weight, gestation at delivery and the baby’s gender), this
effect was reduced by adjustment for red cell folate concentration. We conclude that maternal vitamin B12
deficiency reflected in plasma tHcy concentration contributes to small size of Indian babies.
Asia Pac J Clin Nutr. 2005;14(2):179-181.doi:
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Management of chylothorax and chylopericardium in pediatric patients: experiences at Siriraj Hospital, Bangkok
Author:Narumon Densupsoontorn MD, Pipop Jirapinyo MD, Ren
Keywords: chylothorax, chylopericardium, total parenteral nutrition, MCT-rich diet, pediatric, Bangkok, Thailand
Abstract:Chylothorax and chylopericardium are rare conditions occurring in infants and children. Both may be traumatic
or nontraumatic in origin. We reviewed our experiences with the management of sixteen pediatric cases (10
males, 6 females; 11 days to 14-years old) of chylothorax and chylopericardium from 1997 to 2003. There were
fifteen cases of chylothorax (9 left, 2 right, 4 bilateral)and two cases of chylopericardium (1 isolated and 1
associated with chylothorax), and their incidences ofoccurrence after cardiothoracic surgery were 0.89% and
0.12%, respectively. Of the fifteen cases occurring after cardiothoracic surgery, thirteen patients had corrective
or palliative surgery for complex congenital heart disease, and two patients had removal of thymolipoma and
neuroblastoma, respectively. Included also in this review was an 11-day old preterm infant with hydrops fetalis
and congenital heart disease who developed chylothorax. Characteristics of chylous effusion included a
presence of whitish opaque fluid in the pleural cavity and the pericardial cavity, having a triglyceride content
ranging from 59 to 1689 mg/dl which was higher than a plasma triglyceride, a protein content of 2.4 to 7.4 g/dl,
and a presence of lymphocyte predominance. The average latent period for diagnosis of chylothorax or
chylopericardium was 13 days (range 3 -30). All patients were treated primarily with nutritional modification
using medium-chain triglycerides (MCT) instead of long-chain triglycerides in their diet; and only a few cases
needed bowel rest with total parenteral nutrition (TPN). Twelve patients completely responded to a MCT-rich
diet; two cases resolved after switching to TPN and another case needed surgery for ligation of lymphatic
vessels around the thymus gland. The mean duration of lymph drainage was 12.1 days (range 3-29) and the
average length of time of continued conservative treatment (MCT-rich diet and TPN) was 29.8 days (range 18 -47). Fourteen patients (87.25%) had good outcome, i.e. resolution from chylothorax or chylopericardium and
return to normal diet. Two of the fourteen patients developed severe infections; one was diagnosed with
suspected bacterial endocarditis and the other had candidemia. However, both responded well to antibacterial
and antifungal drugs, respectively. One case succeeded after surgery. A case that had low compliance with
dietary recommendations and required repeated placement of drainage devices died due to infection with
enterococcal septicemia. Early and good compliance with MCT-rich diet is essential for achieving a favorable
outcome in the management of chylothorax and chylopericardium in children.
Asia Pac J Clin Nutr. 2005;14(2):182-187.doi:
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Protein-energy malnutrition and soil-transmitted helminthiases among Orang Asli children in Selangor, Malaysia
Author:Hesham MS Al-MekhlafiMSc, M AzlinMB, BCH, BAO, U N
Keywords:protein-energy malnutrition in children, underweight, stunting, soil-transmitted helminthiases, intestinal parasitic infections, ascariasis, trichuriasis, hookworm infection, giardiasis, Orang Asli, Aborigine, Selangor, Malaysia
Abstract:This study aims to determine the prevalence of protein-energy malnutrition and its association with soiltransmitted helminthiases in Orang Asli (Aborigine) children in Selangor, Malaysia. The results obtained from
368 children aged 2-15 years showed that the overall prevalence of mild and significant underweight was
32.1% and 56.5% respectively. The prevalence of mild stunting was 25.6% while another 61.3% had
significant stunting. The overall prevalence of mild and significant wasting was 39.0% and 19.5% respectively.
The overall prevalence of ascariasis, trichuriasis and hookworm infection were 61.9%, 98.2% and 37.0%
respectively and of these 18.9%, 23.5%and 2.5% of the children had severe infection of the respective
helminthes. The overall prevalence of giardiasis was 24.9%. The present study vividly shows that stunting and
underweight are highly prevalent among Orang Asli children and therefore of concern in this community. In
this population intestinal parasitic infections, especially severe trichuriasis and giardiasis, were identified as the
main predictors of stunting and wasting respectively, in addition to age between 2 to 6 years.
Asia Pac J Clin Nutr. 2005;14(2):188-194.doi:
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Recurrent D-lactic acidosis in a child with short bowel syndrome
Author:Maneerat Puwanant MD, Ladda Mo-Suwan MD and Sakda
Keywords:lactic acidosis, short bowel syndrome
Abstract:D-lactic acidosis is a rare complication in children with short bowel syndrome. It results from fermentation of
dietary carbohydrate by luminal bacteria in the small bowel caused by bacterial overgrowth. We present the
case of a 14-year-old boy who had been diagnosed with short bowel syndrome from surgical treatment of
midgut volvulus five years previously. His nutritional status was maintained by total parenteral nutrition and
enteral feeding as tolerated. During hospitalization, episodic confusion and hyperpnea developed. The investigation showed severe metabolic acidosiswith serum bicarbonate of 9 mmol/L and a wide anion gap. The serum
D-lactic acid was 11.21 mmol/L. There was no evidence of renal or hepatic failure. Therefore, D-lactic acidosis
from enteral carbohydrate overload was diagnosed. The treatment was correction of metabolic acidosis by
sodium bicarbonate infusion and carbohydrate restriction. The results of the therapy were satisfactory. Early
detection and appropriate treatment is necessary to avoid morbidity and mortality following this complication
of short bowel syndrome.
Asia Pac J Clin Nutr. 2005;14(2):195-198.doi:
>>Abstract
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