Body mass index and risk of diabetes mellitus in the Asia-Pacific region
Author:Asia Pacific Cohort Studies Collaboration
Keywords:Body mass index, obesity, diabetes mellitus, Asia
Abstract:Few prospective data from the Asia Pacific region are available relating body mass index to the risk of diabetes. Our objective was to provide reliable age, sex and region specific estimates of the associations between body mass index and diabetes. Twenty-seven cohort studies from Asia, New Zealand and Australia, including 154,989 participants, contributed 1,244,793 person-years of follow-up. Outcome data included a combination of incidence of diabetes (based on blood glucose measurements) and fatal diabetes events. Hazard ratios were calculated from Cox models, stratified by sex and cohort, and adjusted for age at risk and smoking. During follow-up (mean = 8 years), 75 fatal diabetes events and 242 new cases of diabetes were documented. There were continuous positive associations between baseline body mass index and risk of diabetes with each 2 kg/m2 lower body mass index associated with a 27% (23-30%) lower risk of diabetes. The associations were stronger in younger age groups, and regional comparisons demonstrated slightly stronger associations in Asian than in Australasian cohorts (P = 0.04). This overview provides evidence of a strong continuous association between body mass index and diabetes in the Asia Pacific region. The results indicate considerable potential for reduction in incidence of diabetes with population-wide lowering of body mass index in this region.
Asia Pac J Clin Nutr. 2006;15(2):127-133.doi:
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Dietary patterns and metabolic syndrome - a review of epidemiologic evidence
Author:Amanda J Baxter BAppSc (Hons), Terry Coyne PhD and
Keywords:metabolic syndrome, X syndrome, literature, review, diet, diet quality, dietary patterns
Abstract:Metabolic syndrome is associated with increased risk of coronary heart disease and type 2 diabetes, and appears
to be widely prevalent in both developed and developing countries. While lifestyle modification is
recommended for management of the syndrome, the dietary pattern most beneficial for patients is yet to be
ascertained. Original research papers from the Medline database were examined for dietary patterns that may
be associated with the syndrome. Three large-scale epidemiological studies were found fitting our criteria.
Dietary patterns high in fruit and vegetable content were generally found to be associated with lower prevalence
of metabolic syndrome. Diet patterns with high meat intake were frequently associated with components of
metabolic syndrome, particularly impaired glucose tolerance. High dairy intake was generally associated with
reduced risk for components of metabolic syndrome with some inconsistency in the literature regarding risk of
obesity. Minimally processed cereals appeared to be associated with decreased risk of metabolic syndrome,
while highly processed cereals with high glycaemic index are associated with higher risk. Fried foodswere
noticeably absent from any dietary pattern associated with decreased prevalence of metabolic syndrome.The
conclusion of this review is that no individual dietary component could be considered wholly responsible for
the association of diet with metabolic syndrome. Rather it is the overall quality of the diet that appears to offer
protection against lifestyle disease such as metabolic syndrome. Further research is required into conditions,
such as overweight and obesity, which may influence the effect of diet on the development of metabolic
syndrome.
Asia Pac J Clin Nutr. 2006;15(2):134-142.doi:
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Natural products and anti-inflammatory activity
Author:Gaofeng Yuan MSc Mark L WahlqvistMD Guoqing He PhD
Keywords:inflammation, anti-inflammatory activity, natural products, anti-inflammatory food, pain, migraine, arthritis, asthma, chronic colitis, inflammatory based diseases
Abstract:The aim of this review paper was to summarise some commonly available natural products and their antiinflammatory activity. We have collected data from MEDLINE, Current Contents and scientific journals,
which included 92 publications. There are numerous natural products detailed in this literature; however we
have summarized a few of the most commonly available and potent ones. In this paper, the natural products
with anti-inflammatory activity including curcumin,parthenolide, cucurbitacins, 1,8-cineole, pseudopterosins,
lyprinol, bromelain, flavonoids, saponins, marine sponge natural products and Boswellia serrata gum resin
were reviewed. Natural products play a significant role in human health in relation to the prevention and
treatment of inflammatory conditions. Further studies are being conducted to investigate the mechanism of
action, metabolism, safety and long term side effect of these natural products, as well as interactions between
these natural products with food and drug components.
Asia Pac J Clin Nutr. 2006;15(2):143-152.doi:
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The KOJACH food frequency questionnaire for Chaoshan, China: development and description
Author:Li Ke PhD, Toshiro TakezakiPhD, Song Feng-YanMS, Y
Keywords:nutrients,weighed diet records, contribution analysis, multiple regression analysis
Abstract:This paper aims to develop a data-based Semi-Quantitative Food Frequency Questionnaire (SQFFQ) covering
both urban and rural areas in the Chaoshan region of Guangdong Province, China, for the investigation of
relationships between food intake and lifestyle-related diseases among middle-aged Chinese. We recruited 417
subjects from the general population and performed an assessment of the diet, using a 3-day weighed dietary
record survey. We employed contribution analysis (CA) and multiple regression analysis (MRA) to select food
items covering up to a 90% contribution and a 0.90 R
2
, respectively. The total number of food items consumed
was 523 (443 in the urban and 417 in the rural population) and the intake of 29 nutrients was calculated
according to the actual consumption by foods/recipes. The CA selected 233, 194 and 183 foods/recipes for the
combined, the urban and the rural areas, respectively, and then 196, 157 and 160 were chosen by the MRA.
Finally, 125 foods/recipes were selected for the final questionnaire. The frequencies were classified into eight
categories and standard portion sizes were also calculated. For adoption of the area-specific SQFFQ, Validity
and reproducibility tests are now planned to determine how the combined SQFFQ performs in actual
assessment of disease risk and benefit.
Asia Pac J Clin Nutr. 2006;15(2):153-160.doi:
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Reproducibility and validity of a Chinese food frequency questionnaire used in Taiwan
Author:Meei-Shyuan Lee DrPH, Wen-Harn Pan PhD, Kai-Li Liu
Keywords:Chinese Food-frequency questionnaire, Taiwan, diet record, reproducibility, validity, ratio of within- to between-person variation
Abstract:A 64-item Chinese food frequency questionnaire (FFQ)combined with open questions on types of staples and
cooking oil most frequently consumed was designed for a prospective study in Taiwan to appraise participants’
usual intake. We examined its reproducibility and validity. The form was administered three times atthreemonth intervals by face-to-face interview to 83 senior college students majoring in nutrition, in order to recall
their usual dietary intake over the past six months. They also completed five-day (includes both weekends) diet
records (DR) after each interview. Averaged intake levels of most nutrients assessed by the three FFQswere
slightly higher than those of 15-day DR. Intraclass correlation coefficients for nutrient intakes assessed by three
FFQs three months apart ranged from 0.37 for saturated fat to 0.82 for alcohol (average: 0.52). Averaged
Pearson correlation coefficients between the unadjusted and energy-adjusted nutrient intakes measured by DR
and by the third FFQ (which asked about diet duringthe six months encompassing the diet records) were0.40
and 0.35, respectively, not including vitamins A and C. These correlations were higher (average: 0.47)after
adjusting for the daily variation of the diet records. On average, 50% subjects were correctly classified into the
same tertiles by both methods; 11% of the subjects were misclassified to extreme categories. These data indicate
that this FFQ for Chinese-speaking people in Taiwan is reproducible and provides a useful measure of intake for
many nutrients over a six-month period.
Asia Pac J Clin Nutr. 2006;15(2):161-169.doi:
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Item non-responses in mailed food frequency questionnaires in a Korean male cancer cohort study
Author:Younjhin Ahn PhD, Hee Young PaikScD and Yoon-Ok Ah
Keywords:cross classification, food frequency questionnaire (FFQ), item non-response, cancer cohortstudy, Korea
Abstract:Item non-responses are frequently encountered in mailed food frequency questionnaires (FFQs) in
epidemiological studies. The effects of item non-responses in a FFQ on presumed nutrient intake and subject
classifications were examined in this study of a male cancer cohort in Korea. A semi-quantitative FFQ was
developed and mailed to adult males aged between 40and 59 in Seoul. Among the 14,533 cohort participants,
7,647 subjects who fully completed the FFQ initially and 216 subjects who completed the frequency missing
items at resurvey were compared. When item non-responses were treated as not eaten, the average nutrient
intakes of this group were significantly lower thanboth the average intake of subjects who fully completed at
the initial survey and the average intake of those who completed at the resurvey. Increases in nutrient intakes
during resurvey were substantively proportional to the number of items originally omitted. Cross classifications
of item non-response subjects by nutrient intake after the initial survey and after resurvey showed
misclassification towards lower quantile. Moreover, distribution of ‘never or seldom’ answer of resurvey group
was similar to initial complete group. These results indicate that treating item non-responses as not eaten
introduces bias when estimating nutrient intakes orwhen classifying subjects on the basis of nutrientintakes.
More study is required to determine how best to treat non-response items in FFQ.
Asia Pac J Clin Nutr. 2006;15(2):170-177.doi:
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An Aboriginal-driven program to prevent, control and manage nutrition-related “lifestyle” diseases including diabetes
Author:Michael Gracey AO,MD,PhD,FRACP,FAAP(Hon), Ernie
Keywords:Australian Aborigines, overweight, obesity, diabetes, cardiovascular disease
Abstract:Type 2 diabetes and other nutrition-related so-called “lifestyle” diseases, including obesity, and cardiovascular
and chronic renal disease, are very prevalent in Australian Aboriginal people and contribute to their high rates
of chronic illness and premature mortality. An Aboriginal-driven, community-based health protection, health
promotion and improved disease detection, management and care program was introduced in four remote,
discrete communities in the far north of Western Australia (WA) in order to attempt to prevent these disorders
through community-based lifestyle modification. More energetic screening for early risk factors is involved as
well as early dietary and exercise interventions and medical treatment, when indicated. Distinctive features of
this program include its Aboriginal initiatives and perspectives, committed partnerships between the
communities, the Unity of First People of Australiaof Australia (UFPA) and its carers, the communities’ health
care providers, external clinical specialists, other external agencies and a locally-operated point-of-care (POC)
pathology testing capability that is conducted by local and UFPA personnel. The POC component is quality
managed by Flinders University. These features have ensured the viability of the program in three of the
communities; the other one decided not to continue with the program despite risks of serious long-termhealth
consequences. The pre-program prevalence of diabetes in screened adults was almost 40% and in adults aged
≥35 years was almost 60%. After several months of the program’s operation, there have been positive changes
in knowledge about food, nutrition, exercise and disease and altered attitudes and behaviours related to dietary
and exercise patterns. There have also been improvements in weight control and in pathology test results
relevant to the risk of subsequent development of diabetes and cardiovascular disease.
Asia Pac J Clin Nutr. 2006;15(2):178-188.doi:
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Anthropometric, metabolic and dietary fatty acids profiles in lean and obese diabetic Asian Indian subjects
Author:Arnab Ghosh PhD
Keywords:obesity, central obesity, dietary fatty acids, lipids, diabetes, Asians, India
Abstract:The present study was aimed to study anthropometric, metabolic and dietary fatty acids profiles among 200
(Group I: lean control, N= 80; Group II: lean diabetic, N= 70 and Group III: obese diabetic, N= 50) Asian
Indians (aged 30 years and above) living in the eastern part of India. Anthropometric [height, weight,waist
(WC) and hip circumference] metabolic [total cholesterol (TC), triglyceride (TG), high (HDL), low density
lipoprotein (LDL) and fasting plasma glucose (FPG)]and dietary profiles were collected from each participant.
Body mass index (BMI), waist-hip ratio (WHR) and conicity index (CI) were subsequently computed from
anthropometric measures. An open-ended 24 h food recall proforma consisting of three sections and in local
language was used to collect nutrient information from each participant. Daily intake of nutrients including
saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) were estimated by adding
all the foodstuffs consumed on weekly and monthly basis. One-way ANOVA with Scheffe’s post-hoc test
revealed that Group I has significantly lower mean than both Group II and Group III for age, WC, WHR, CI,
TC, TG, LDL, FPG and total carbohydrates; Group I has significantly lower mean than Group II only for HDL
and Group I has significantly lower mean than GroupIII only for BMI, total proteins and total fats. On the
other hand, Group I has significantly greater mean than both Group II and Group III for UFA/SFA,
MUFA/SFA and PUFA/SFA whereas Group I has significantly lower mean than Group III only for trans fatty
acids and Erucic acid. Pearson’s partial correlation (controlling age and sex) analysis showed that the ratios of
unsaturated fatty acids and saturated fatty acids had significant negative association with lipids, lipoprotein and
fasting glucose. Discriminant analysis revealed that overall 86.2% of all cases were correctly (positively)
classified in three groups using fatty acids and their ratios. In conclusion, it seems reasonable to argue that
dietary management including dietary guidelines would be useful to retard the growing incidence of diabetes in
Indian population.
Asia Pac J Clin Nutr. 2006;15(2):189-195.doi:
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Parental overweight as an indicator of childhood overweight: how sensitive?
Author:Kayoung Lee PhD, Eun-Ryoung KwonPhD, Tae-Jin ParkM
Keywords:BMI, parent, children, overweight, sensitivity, specificity, Korea
Abstract:This study determined the sensitivity and specificity of parental overweight from self-reported height and
weight to identify families with overweight school age children. A cross sectional study was conductedamong
3059 parents and their children (1558 boys and 1501girls) aged 7-12 years in five primary schools of Busan,
Korea. BMI was calculated from parental reported height and weight and from children’s measured height and
weight. Parents were considered overweight when their BMI was >25 kg/m
2
(WHO, 2000). Children were
considered overweight when their BMI was >95th percentile (CDC, 2000). Prevalence of overweight was
calculated and logistic regressions were performed.The sensitivity and specificity of parental overweight were
calculated. A total of 26% (805/3059) parents wereoverweight. Of the families with one overweight parent,
15% (N= 109) had an overweight child. When both parentswere overweight, 17% (N= 9) had an overweight
child. After adjusting for child’s age and gender, parental education, family income, and spouse’s BMI as
required, the odds of having an overweight child were 2.5 [1.8, 3.3] for one overweight parent, and 3.2 [1.4,
7.1] for both overweight parents. While the sensitivity of one overweight parent to identify families with
overweight school age children was 44%, specificity was 75%. The presence of both overweight parents
provided a 3% sensitivity and 98% specificity for the identification of an overweight school age child.
Although parental overweight was obtained from self-reported weight and height in Busan (Korea), it is a
practical indicator to identify families with an overweight school age child, it has poor sensitivity.
Asia Pac J Clin Nutr. 2006;15(2):196-200.doi:
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Body image differences among Malay, Samoan, and Australian women
Author:Andrew J McDowell PhDand Malcolm J BondPhD
Keywords:body image, body mass index, cross-cultural comparison, diet, exercise
Abstract:Comparisons of body attitudes and associated behaviours were undertaken using Malay, Samoan, and
Australian female students. The general goal of theresearch was to determine the degree to which the observed
pattern of attitudes and behaviours was attributable to culture. The specific analyses comprised an examination
of group differences using standard measures that included the Body Attitudes Questionnaire, the Three-Factor
Eating Questionnaire and detailed questions concerning the use of diet and exercise as weight control
strategies. The main findings concerned a number ofcultural differences, particularly in relation to diet and
exercise, that were evident even with the effect ofbody mass index held constant. These results are interpreted
in terms of the efficacy of entrenched cultural beliefs in protecting against introduced, more dominant, cultural
values. The Australian sample exhibited the most negative body image, although there was some evidencethat
Malays and Samoans were influenced by Western ideals of weight and shape. It is proposed that to fully
understand the differential meaning of negative body image across cultures and the potential impact of
westernisation, both within-group and between-groupdifferences in body size need to be acknowledged.
Asia Pac J Clin Nutr. 2006;15(2):201-207.doi:
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Differences in nutrient intakes and physical activity levels of Japanese and Australian Caucasian males living in Australia and Japanese males living in Japan
Author:Masaharu Kagawa PhD, Yoko Saito MHSE, Deborah Kerr
Keywords:nutrient intakes, energy contribution, physical activity, Japanese males, Australia
Abstract:The aim of the study was to determine the nutritional status and nutrient intakes of young Japanese males living
in Australia and compared with Japanese males living in Japan and Australian Caucasian males. Four-day
dietary records were obtained from 65 Japanese living in Australia (JA), 81 Japanese living in Japan (JJ), and
70 Australian Caucasian males (AA) aged 18-30 years old, together with body composition and physical
activity level assessments using anthropometry and the questionnaire. Australian males were significantly taller
and heavier than the Japanese counterparts and also showed a greater percent body fat (%BF) and heightcorrected sum of skinfolds compared with Japanese males living in Japan (%BF: JJ = 16.6 ± 5.2, AA = 18.7 ±
5.6; height corrected sum of skinfolds: JJ = 78.8 ±37.3, AA = 96.0 ± 39.5) (P <0.05). A greater proportion of
Australian Caucasian males (98.6%) were involved in vigorous physical exercise than Japanese males (JA =
72.3%; JJ = 85.2%). The JA group consumed a greater amount of energy from protein and fat sources as well
as greater calcium, iron, dietary fibre and niacin equivalents intakes than the JJ group (P <0.05). The results
suggest that Japanese males living in Australia consumed more energy-dense westernised diet than Japanese
males living in Japan. Because of lower physical activity level than Australian males, consumption of energydense diet may increase the risk of weight gain among Japanese males who stay in Australia for a long-term.
Asia Pac J Clin Nutr. 2006;15(2):208-216.doi:
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Physical activity and nutritional status of Brazilian children of low socioeconomic status: undernutrition and overweight
Author:Paulo Roberto dos Santos Amorim PhD , Ricardo Camp
Keywords:child, physical activity, nutritional status, obesity, overweight, socioeconomic factors, Brazil
Abstract:The aim of this study was to analyse the level of habitual physical activity (HPA) and nutritional status of
children attending selected public schools in Brazil. The sample comprised 1719 participants who ranged in
age from 11 to 14 yrs with 861 females (F) aged 12.7±1.0yr and 858 males (M) aged 12.7±1.0yr. The short
form of the International Physical Activity Questionnaire (IPAQ) was used to measure HPA. Nutritional status
was assessed using the body mass index (BMI). Statistical analyses included ANOVA followed by the post-hoc
Tukey-test (P < 0.05) which showed a statistically significant difference between M and F in time spent in
moderate intensity physical activity. F completed more moderate intensity physical activity than M whereas
time in vigorous physical activities was higher in M than F. Analyses of BMI and IPAQ categorical scoreusing
Pearson product moment correlations with subsequentFisher Z transformation showed values of Z = 0.49 for
females and Z = 0.44 for males, indicating a low relationship between these variables. HPA levels showed
93.7% of the M and 91.1% of the F were at least minimally active. According to BMI values, 7.3% of the
cohort was underweight; 83.0% normal weight; 8.3% overweight and 1.3% obese. These results demand
attention, particularly for children at the lower end of nutritional status and HPA levels due to the potential
negative impact on their growth and development. Atthe other end of the nutritional spectrum, one needs to be
concerned regarding the levels of excess body weight, mainly considering the poor region in which the children
live.
Asia Pac J Clin Nutr. 2006;15(2):217-223.doi:
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Diet composition and body mass index in Tehranian adults
Author:Parvin Mirmiran PhD, Ahmad EsmaillzadehPhDand Fere
Keywords:carbohydrate, fat, protein, macronutrients, obesity, BMI, Tehran Lipid and Glucose Study, Iran
Abstract:Human studies investigating the relationship between macronutrients intake and obesity, have failed toachieve
consistent findings. This study was undertaken to assess the relationship between macronutrients intake and
body mass index in a group of Tehranians. From 15005 participants of the Tehran Lipid and Glucose Study,
1290 subjects aged over 10 years (565 males and 725 females) were selected randomly for dietary survey.
Anthropometric indices were measured according to standard protocols and BMI was calculated. Dietary data
were collected by trained interviewers using two non-consecutive 24-hour dietary recalls. Data on smoking
habits, educational level and physical activity were compiled. Under- and over-reporting of energy intake were
defined as EI: BMR<1.35 and >=2.4, respectively. Calorie-adjusted amounts of macronutrients were calculated
by the residual method, following which energy intakes from all calorie-adjusted macronutrients were
simultaneously included in the multiple regression models controlling for age, physical activity, educational
level and smoking and mutual effects of macronutrients. Total energy intake was not included to avoid
collinearity. BMI increased with age in either gender. Controlling for confounding variables, energy intake
from fat was positively associated with BMI in malesin the 10-18, 19-24, 25-50 and 51+ year age categories
(β=0.06, 0.13, 0.33, 0.48, P<0.05 for all, respectively) and females in the 19-24, 25-50 and 51+ age categories
(β=0.17, 0.43, 0.52, P<0.05 for all, respectively). This relationship remained after excluding misreporters
(β=0.06, 0.15, 0.36, 0.50 for males and β= 0.21, 0.46, 0.54 for females in the correspondingage categories,
respectively). The correlation of fat intake to BMI was not significant in younger females (10-18 year). No
association was seen between energy intake from protein and carbohydrate with BMI in subjects before and
after exclusion of misreporters. In conclusion, energy from fat was found to be independently and positively
associated with obesity in adults. No other association was observed between energy from protein and
carbohydrate with BMI.
Asia Pac J Clin Nutr. 2006;15(2):224-230.doi:
>>Abstract
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Skinfold thickness, body fat percentage and body mass index in obese and non-obese Indian boys
Author:Satipati Chatterjee PhD, Pratima Chatterjee PhDand
Keywords: obesity, skinfolds, BMI, %fat, boys, India
Abstract:Childhood obesity is presently increasing worldwide and has created enormous concern for researchers
working in the field of obesity related diseases with special interest in child health and development. Selected
anthropometric measurements including stature, body mass, and skinfolds are globally accepted sensitive
indicators of growth patterns and health status of a child. The present study was therefore aimed not only at
evaluating the body mass index (BMI), skinfolds, body fat percentage (%fat) in obese school going boysof
West Bengal, India, but also aimed to compare these data with their non-obese counterparts. Ten to sixteen
year old obese boys (N = 158) were separated from their non-obese counterparts using the age-wise
international cut-off points of BMI. Skinfolds were measured using skinfold calipers, BMI and %fat were
calculated from standard equations. Body mass, BMI, skinfolds and %fat were significantly (P <0.001)
higher for the sample of obese boys when compared to their non-obese counterparts. The obese group also
showed progressive age-wise increments in all recorded anthropometric parameters. Stature (cm) showedno
significant inter-group variation except in the 10 year age group (P<0.001). All data for the non-obese group
were comparable with other national and international studies, but those collected for the obese groupcould
not feasibly be compared because the availability of data on obese children is limited. Current data and
prediction equations will not only serve as a reference standard, but also be of vital clinical importance in
order to identify or categorize obese boys, and to take preventative steps to minimise serious health problems
that appear during the later part of life.
Asia Pac J Clin Nutr. 2006;15(2):231-235.doi:
>>Abstract
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Prevalence of obesity, overweight and underweight in a Hong Kong community: the United Christian Nethersole Community Health Service (UCNCHS) primary health care program 1996-1997
Author:Gary TC Ko FRCPI and Joyce SF Tang FRACGP
Keywords:body mass index, obesity, overweight, underweight, Hong Kong Chinese
Abstract:The aim of this cross-sectional observation study was to assess thoroughly the body mass index (BMI) profile
in Hong Kong Chinese and report all categories of BMI cutoff points as suggested by the World Health
Organization (WHO). A cohort of 17242 subjects (4822 men and 12420 women) aged 15 or above from the
community of Hong Kong presenting themselves voluntarily from April 1996 to August 1997 for primary
health assessment at the Three Health Centers of theUnited Christian Nethersole Community Health Service
(UCNCHS). The mean age (±SD) was 51.0 ±16.2 years (range 15-96 years, median 49.6 years).The mean
BMI of the 17242 subjects was 23.5 ±3.3 kg/m
2
in men and 23.0 ±3.7 kg/m
2
in women. The BMI peaked at
age 30 to 50 years in men and 50 to 70 years in women. The age-standardized prevalence of BMI ≥30 kg/m
2
or
≥25 kg/m
2
in Hong Kong Chinese was 3.0% in men and 3.2% in women, and 29.1% in men and 21.3% in
women, respectively. For underweight, 35.9% and 27.8% of women and 27.5% and 10.3% of men aged 15-20
and 20-30 years, respectively, had BMI <18.5 kg/m
2
. In conclusion, a significant proportion of Hong Kong
Chinese had a BMI ≥25 kg/m
2
. Among Hong Kong Chinese aged <30 years, the prevalence of underweight was
also high.
Asia Pac J Clin Nutr. 2006;15(2):236-241.doi:
>>Abstract
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Are energy drinks contributing to the obesity epidemic?
Author:Elaine Rush PhD, Stephanie Schulz BAppSc, Vladimir
Keywords:lipogenesis, caffeine, sucrose, carbonated beverage, fat oxidation, carbohydrate oxidation
Abstract:The consumption of energy drinks containing sucrose and caffeine is increasing worldwide. Ten healthy
women aged 18 to 22 years and fasted overnight wererandomly allocated to a standardised dose of sucrose
either as an “energy “ drink (containing sucrose and caffeine) or lemonade on the first day and then crossed
over to the alternative drink on a second day. For thirty minutes before and thirty minutes after drinking
oxygen consumption and carbon dioxide production were measured in the resting subject breath-by-breathby
indirect calorimetry and the rates of carbohydrate and fat oxidation calculated. Energy drink consumption
apparently caused increased carbohydrate oxidation (P = 0.004) and reduced lipid oxidation (P = 0.004)
compared to lemonade. The longer term effects of combined caffeine and sucrose intake, particularly in
sedentary individuals, on metabolism and body fatness needs further examination.
Asia Pac J Clin Nutr. 2006;15(2):242-244.doi:
>>Abstract
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Fruits and vegetables, 5+ a day: are we getting the message across?
Author:Pauline AL Ashfield-Watt PhD
Keywords:fruits, vegetables, health promotion, nutrition survey, social marketing
Abstract:Fruit and vegetables have important health promoting properties. The 5+ a day programme aims to promote
awareness of the need to eat more of these foods. This paper presents and discusses the results of two surveys
designed to determine the success of the 5+ a day programme across New Zealand. Household surveys were
carried out by a marketing research company in 1999and 2000. The 1999 questionnaire focused on awareness
and understanding of the 5+ a day campaign. The 2000 questionnaire focused on attitudes to health andon
intakes of fruits and vegetables. Data were collected from households nationwide (1999 survey N= 200, 2000
survey N = 520). Spontaneous consumer awareness of messages promoting the need to eat more fruit and
vegetables was high. Seventy-one percent of all respondents identified the 5 servings a day message from the
5+ a day logo regardless of whether they had seen it before. The meaning of the hand in the logo was less clear
with only 2.5% identifying the ‘serving size’ element of the logo. Fruit and vegetable intakes of respondents
were influenced by demographic factors: gender, ethnicity, education and occupation (all P ≤0.05). Positive
attitude towards the relationship between fruit, vegetables and health was influenced by similar factors and in
turn affected fruit and vegetable intakes. The 5+ a day message is well recognised and understood. Portion
size is less well understood. The 5+ a day messagepromotes positive attitudes towards healthy eatingwhich
are associated with healthier eating habits, but some groups within society may need further attention.
Asia Pac J Clin Nutr. 2006;15(2):245-252.doi:
>>Abstract
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Drinking tea is associated with lower plasma total homocysteine in older women
Author:Jonathan M Hodgson PhD, Amanda DevinePhD, Ian B Pu
Keywords:tea, polyphenols, homocysteine, folate,women
Abstract:Dietary polyphenols are suggested to elevate plasmatotal homocysteine concentration (tHcy). Althoughtea is
rich in polyphenols, it has been associated with lower tHcy, which may be due to its folate content. Our aims
were to investigate relationships of tea intake and4-O-methylgallic acid (4OMGA) – a biomarker of exposure
to tea-derived polyphenols – with tHcy in older women. In a cross-sectional study of 232 women over 70years
of age, we measured tHcy, tea intake, 24 h urinary excretion of 4OMGA, and red cell folate. Tea intake and
4OMGA excretion were inversely related to tHcy. Tea intake (>2 cups) and 4OMGA excretion above the
median were associated with lower tHcy by ~1mmol/L (P <0.01). Red cell folate was not associated with tea
intake or 4OMGA excretion. The observed lower tHcy in women with higher tea intake is consistent in
direction and magnitude with previous epidemiological studies, but any mechanisms remain unclear.
Asia Pac J Clin Nutr. 2006;15(2):253-258.doi:
>>Abstract
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Concordance of diets and eating practices in a rural Guatemalan setting with the cancer prevention recommendations of the World Cancer Research Fund: estimates from existing dietary intake
Author:Roxana Valdes-Ramos PhD, Ines CervantesPhD, I
Keywords:Total energy intake, cancer prevention, chronic disease epidemiology, nutritional epidemiology, food frequency questionnaire, dietary guidelines,Guatemala
Abstract:To evaluate concordance of eating practices in a rural Guatemalan setting with the 14-point cancer prevention
recommendations of the World Cancer Research Fund/American Institute for Cancer Research. Two-hundred
sixty nine food-frequency questionnaires based on the Willett model were analysed with respect to concordance
with the recommendations, aimed at constraining intakes of: fat, sugar, salt, red meat and alcoholic beverages
within specific ranges; restricting nutritional supplements’ use for the express purpose of avoiding cancer;
maximizing the consumption of: edible plants, especially fruits, vegetables, cereals, tubers and legumes;
achieving dietary variety and nutrient adequacy; avoiding high-temperature cooking, and exposure to food
additives, pesticides and residues; adequately preserving perishable and fungal-prone foods; maintaining
normal body composition and regular levels of physical activity. The study was conducted in the county seat
and three hamlets from the rural province of Santa Rosa. 214 females and 55 males were evaluated. Daily food
servings of plant origin varied from 18.2 to 99.1% (74.6 ± 10.7%). The guidelines' criteria were met by more
than 80% for total fat, red meat, ethanol, fruits and vegetables, cereals-tubers-legumes, sugar and nutritional
adequacy, whereas 80% concordance was not met for nutritional supplements, and dietary variety. The other
variables could not be evaluated. Concordance with national standards for micronutrient intake was not
achieved most frequently for calcium, riboflavin, and iron. Guatemalan cuisine and diet in this ruralsetting has
features of a cancer-protective diet, but complementary actions must be taken, within the social and economic
realities of the region.
Asia Pac J Clin Nutr. 2006;15(2):259-266.doi:
>>Abstract
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Lactagogue effects of Torbangun, a Bataknese traditional cuisine
Author:Rizal Damanik DVM, MRepSc, PhD , Mark L Wahlqvist
Keywords:Coleus amboinicus Lour, Torbangun, lactagogue, Bataknese Simalungun, traditional cuisine,Indonesia
Abstract:Coleus amboinicusLour (CA) has been used as a breast milk stimulant (a lactagogue) by Bataknese people in
Indonesia for hundreds of years. However, the traditional use of CA is not well documented, and scientific
evidence is limited to establish CA as a lactagogue.This investigation was conducted to elucidate the effect of
traditional use of CA during the first month of lactation on quantity and quality of the breast milk. The results
collected from the study show that CA supplementation increased breast milk production without
compromising the nutritional quality of the breast milk. Lactating women receiving CA supplementation had a
65% increase in milk volume during the last two weeks of supplementation (from Day 14 to Day 28). This
increase was greater than that of lactating women receiving Molocco+B12™ tablets (10%) or Fenugreek seeds
(20%). The residual effects of CA supplementation were seen even after the supplementation had ended for
one month. Results of the present study confirmed the belief and the practice amongst the Bataknese people
that CA can be used as a lactagogue in humans, and the use of CA might be suitable for lactating women in
general.
Asia Pac J Clin Nutr. 2006;15(2):267-274.doi:
>>Abstract
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Phytochemical intakes of the Fijian population
Author:Jimaima Lako PhD, Naiyana Wattanapenpaiboon PhD, M
Keywords:phytochemicals, flavonoids, carotenoids, anthocyanins, polyphenols, food intake, Fijians, Fiji
Abstract:The dietary intakes of major phytochemicals in Fijian population were estimated from the consumption of 90
plant foods reported in five major surveys conducted in Fiji from 1952 to 2001. These surveys includedthe
Naduri Longitudinal study, for which food intake data were collected on four occasions in 1952, 1953, 1963
and 1994), the 1982 and 1993 National Nutritional Surveys, the 1996 Suva-Nausori Corridor cross-sectional
study, the 1999 Verata cross-sectional study, and the 2001 Fiji Food Choice study. It was found that the
Fijian population generally had low intakes of total phenols (275 mg/day), and total flavonoids (17.5
mg/day), but high intake of total carotenoids (20 mg/day), in comparisons with the intakes of other
populations reported in literature. It has been speculated that the change of eating patterns resulting in the
low intakes of phytochemicals may have partly contributed to the increase in the nutritionally chronicdisease
morbidity and mortality among the Fijians. It is further recommended that the traditional Fijian foodpatterns
with high fruits and vegetables should be revived, and the consumption of sweet potato leaves and drumstick
leaves, both of which were rich in phytochemicals, should be promoted.
Asia Pac J Clin Nutr. 2006;15(2):275-285.doi:
>>Abstract
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