Improved α-amylase and Helicobacter pylori inhibition by fenugreek extracts derived via solid-state bioconversion using Rhizopus oligosporus
Author:Reena Randhir PhDand Kalidas Shetty PhD
Keywords:fenugreek, α-amylase inhibition, type 2 diabetes, solid-state bioconversion (SSB), Rhizopus oligosporus, β-glucosidase, phenolics, antioxidant activity, L-DOPA (levo-dihydroxy phenylalanine), superoxide dismutase, antioxidant protection factor, Helicobact
Abstract:The present research investigated the enrichment of fenugreek (Trigonella foenum graceum) seed substrate with
phenolic antioxidants and L-DOPA via fungal-based solid-state bioconversion (SSB) system. This approach using food grade fungus Rhizopus oligosporus,was chosen because it has been demonstrated to be effective in
other seed and food substrates for improving health-relevant functionality and has long history of use for food
processing in Asia. The protein content and β-glucosidase activity of the substrate which reflects fungal growth,
increased with incubation time in conjunction with enhanced phenolic content and also suggested its possible involvement in phenolic mobilization. The antioxidant activity assayed by β-carotene bleaching and DPPH free
radical scavenging methods both indicated high activity during early growth stage (days 4-6) followed by reduced activity during later growth stage (days 8-20). A direct association between higher phenolic contents during early growth stage (days 4-6) and antioxidant activity suggested a link to mobilization of polymeric and hydrophobic phenolic forms. The L-DOPA content of the fenugreek extract fluctuated during the course of bioconversion with higher levels during days 6-10 (1.5-1.7 mg/g DW). The SSB process substantially improved the in
vitroporcine α-amylase inhibition activity by 75 % on day 4 which correlated to higher levels of total phenolics
and related antioxidant activity of the extracts. The high α-amylase inhibitory activityalso coincided with high
L-DOPA content on day 6. These results have implicationsfor diet-based diabetes management. The same bioconversion stage had Helicobacter pylori inhibitory activity, which has implications for ulcer management.
Asia Pac J Clin Nutr. 2007;16(3):382-392.doi:
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Recycled palm oil is better than soy oil in maintaining bone properties in a menopausal syndrome model of ovariectomized rat
Author:Ahmad Nazrun Shuid MBBCh, PhD, Loh Hong Chuan BSc,
Keywords:palm oil, vitamin E, heated frying oils, ovariectomy, bone histomorphometry
Abstract:Palm oil is shown to have antioxidant, anticancer and cholesterol lowering effects. It is resistant to oxidation
when heated compared to other frying oils such as soy oil. When a frying oil is heated repeatedly, it forms toxic
degradation products, such as aldehydes which when consumed, may be absorbed into the systemic circulation.
We have studied the effects of taking soy or palm oil that were mixed with rat chow on the bone histomorphometric parameters of ovariectomised rats. Female Sprague-Dawley rats were divided into eight groups: (1)
normal control group; (2) ovariectomised-control group; (3) ovariectomised and fresh soy oil; (4) ovariectomised and soy oil heated once; (5) ovariectomised and soy oil heated five times; (6) ovariectomised and fresh
palm oil; (7) ovariectomised and palm oil heated once; (8) ovariectomised and palm oil heated five times. These
oils were mixed with rat chow at weight ratio of 15:100 and were given to the rats daily for six months. Ovariectomy had caused negative effects on the bone histomorphometric parameters. Ingestion of both fresh and onceheated oils, were able to offer protections against the negative effects of ovariectomy, but these protections were
lost when the oils were heated five times. Soy oil that was heated five times actually worsens the histomorphometric parameters of ovariectomised rats. Therefore, it may be better for postmenopausal who are at risk of
osteoporosis to use palm oil as frying oil especially if they practice recycling of frying oils.
Asia Pac J Clin Nutr. 2007;16(3):393-402.doi:
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High prevalence of goiter in an iodine replete area: do thyroid auto-antibodies play a role?
Author:Mahin Hashemipour MD, Masoud Amini MD, Ashraf Amin
Keywords:goiter, antithyroid antibody, thyroidperoxidaseantibody, thyroglobulin antibody, autoimmune thyroid disease
Abstract:Introduction:Despite long standing iodine supplementation in Iran the prevalence of goiter remains high in
some areas. This may suggest that causes other than iodine deficiency, such as autoimmune thyroid diseases,
should also be considered. We therefore assessed the prevalence of anti-thyroid antibodies in children living in an
inland area in Iran and correlated these findings with prevalence of goiter within this region.
Methods: In a cross-sectional study, 1948 students were selected by multistage random cluster sampling from the
108 primary schools (age, 7-13 year-old) of the urban and rural areas of Semirom. After obtaining written consent
from their parents, the children were examined by endocrinologists for goiter grading. Grade 2 goitrous children
(108 cases) were compared with non-goitrous children (111children as control group) for anti-thyroid antibodies.
Results: Overall, 36.7% of 1948 students had goiter. The mean urinary iodine excretion level was 1.49±0.7
µmol/L. This was within normal limits. Of 219 children studied, 4.3% presented with subclinical hypothyroidism,
and 7.3% had positive anti-thyroid antibodies. There was non-significant difference of positive thyroperoxidase
antibody (anti-TPO) (Odds Ratio= 3.2, p= 0.13) but significant difference of anti Tg between goitrous and non
goitrous children (Odds Ratio: 5.6, 95% CI: 1.18-26.0, p: 0.015).
Conclusion: This study suggests that autoimmunity may be oneof the mechanisms responsible for goiter persistence after iodine replenishment in thisiodine deficient region, but the role of other factors should also be considered.
Asia Pac J Clin Nutr. 2007;16(3):403-410.doi:
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Four week supplementationwith mixed fruit and vegetable juice concentrates increased protective serum antioxidants and folate and decreased plasma homocysteine in Japanese subjects
Author:Akira Kawashima MD, PhD, Takeo Madarame MD, PhD, H
Keywords:fruits, vegetables, antioxidants, folate, homocysteine, carotenoids, smokers
Abstract:Fruit and vegetable consumption has beeninversely associated with the risk of chronic diseases including cancer
and cardiovascular disease, with the beneficial effects attributed to a variety of protective antioxidants, carotenoids and phytonutrients. The objective of the present study was to determine the effect of supplementation with
dehydrated concentrates from mixed fruit and vegetable juices (Juice Plus+®) on serum antioxidant and folate
status, plasma homocysteine levels and markers for oxidative stress and DNA damage. Japanese subjects (n=60;
age 27.8 yrs; BMI 22.1) were recruited to participate in a double-blind placebo controlled study and were randomized into 2 groups of 30, matched for sex, age, BMI and smoking status (39 males, 22 smokers; 21 females,
13 smokers). Subjects were given encapsulated supplements containing mixed fruit and vegetable juice concentrates or a matching placebo for 28 days, with blood and urine samples collected at baseline, day 14 and day 28
for analytical testing. Compared with the placebo, 28 day supplementation significantly increased the concentration of serum beta-carotene 528% (p<0.0001), lycopene 80.2% (p<0.0005), and alpha tocopherol 39.5%
(p<0.0001). Serum folate increased 174.3% (p<0.0001) and correlated with a decrease in plasma homocysteine of
-19.9% (p<0.03). Compared with baseline, measures of oxidative stress decreased with serum lipid peroxides declining -10.5% (p<0.02) and urine 8OHdG decreasing -21.1% (p<0.02). Evaluation of data from smokers only
(n=17) after 28 days of active supplementation showed comparable changes. Conclusion: In the absence of dietary modification, supplementation with the fruit and vegetable juice concentrate capsules proved to be a highly
bioavailable source of phytonutrients. Important antioxidants were elevated to desirable levels associated with
decreased risk of disease while markers of oxidative stress were reduced, and folate status improved with a concomitant decrease in homocysteine, and these benefits occurred to a similar extent in smokers when compared to
non-smokers.
Asia Pac J Clin Nutr. 2007;16(3):411-421.doi:
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Effects of gamma-tocopherol supplementation on thrombotic risk factors
Author:Indu Singh MSc, Alan H Turner MSc , Andrew J Sincl
Keywords:gamma tocopherol, platelets, lipids, CRP, thrombotic risk factors
Abstract:Objective: The antioxidant activity of vitamin E isderived primarily from alpha-tocopherol (α-T) and gammatocopherol (γ-T). Results of epidemiological studies have demonstrated an inverse relationship between vitamin
E intake and coronary disease. However,the results of clinical trials using α-T are equivocal. We determined the
effect of 5 weeks of 100 mg/d or 200 mg/d γ-T supplementation on thrombotic markers such as platelet reactivity, lipid profile and the inflammation marker C-reactive protein (CRP).
Methods and results: Fourteen healthy subjects consumed 100 mg/day while 13 consumed 200 mg/d of γ-T and
12 received placebo (soybean capsules with less than 5 mg/d γ-T) in a double-blinded parallel study design. Fasting pre and post dose blood samples were analysed. Blood γ-T concentrations increased significantly (p<0.05)
relative to dose during the intervention period. Both groups receiving active ingredients showed significantly
lower platelet activation after supplementation (p<0.05). Subjects consuming 100 mg/d γ-T had significantly decreased LDL cholesterol, platelet aggregation and mean platelet volume (MPV) (p<0.05). Little effect of γ-T was
observed on other parameters.
Conclusions: These data suggest that γ-T supplementation may have a permissive role in decreasing the risk of
thrombotic events by improving lipid profile and reducing platelet activity.
Asia Pac J Clin Nutr. 2007;16(3):422-428.doi:
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The effect of n–3 PUFA/γ-cyclodextrin complex on serum lipids in healthy volunteers - a randomized, placebo-controlled, double-blind trial
Author:Koji Kobayashi MS, Kei Hamazaki MD, PhD, Shuntaro
Keywords:EPA, n–3 polyunsaturated fatty acids, γ-cyclodextrin, fatty acid composition, triglycerides
Abstract:Objectives:This study was carried out to examine whether serum triglyceride concentrations were decreased by
administration of n–3 polyunsaturated fatty acid (PUFA)/γ-cyclodextrin (γ-CD) complex-containing capsules as
reported previously with n–3 PUFA without γ-CD.
Study Design:A placebo-controlled double-blind study with healthy subjects (n=35) and hypertriglyceridemic
subjects (n=7) of 35-66 years of age was performed. The subjects were randomized to a group (n–3 group) supplemented with n–3 PUFA/γ-CD-containing capsules (660 mg EPA + 280 mg DHA/day) or a control group supplemented with capsules containing essentially no n–3 PUFA for 8 weeks with stratification by sex, age, and serum triglyceride levels in a double blind manner. Fasting blood samples were obtained at the start of administration and 4 and 8 weeks afterward.
Results:EPA concentrations in the total phospholipid fraction of red blood cells increased significantly in all
subjects in the n–3 group, whereas no changes were seen in the control group. Triglyceride levels were significantly decreased (–17%) in the n–3 group compared with the control group at week 8. The following serum lipids did not significantly change over time: total-cholesterol, low-density lipoprotein-cholesterol and high-density
lipoprotein-cholesterol. Only two subjects in the n–3 groupguessed at the end of the study that their capsules
were active.
Conclusion: n–3 PUFA/γ-CD complex lowered triglyceride levels in normal and slightly hypertriglyceridemic
subjects. There was a possibility that γ-CD might at least partly cover the smell and aftertaste of fish oil.
Asia Pac J Clin Nutr. 2007;16(3):429-434.doi:
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The effect of early nutritional supplementation with a mixture of probiotic, prebiotic, fiber and micronutrients in infants with acute diarrhea in Indonesia
Author:Rina Agustina MD, MSc, Widjaja Lukito MD,PhD, Agus
Keywords:acute diarrhea, dietary fiber, Lactobacillus rhamnosus, micronutrients, probiotic, prebiotic, Jakarta
Abstract:A randomized double blind clinical trial was conducted to assess the efficacy of a special infant formula containing Lactobacillus rhamnosusLMG P-22799 (probiotic: 5 x 10
8
CFU/100mL), inulin (prebiotic: 0.15
g/100mL), dietary fiber (soy polysaccharides: 0.2 g/100mL)and increased amounts of zinc+iron (+0.4 and +0.6
mg/100mL, respectively) as active ingredients for the early dietary management of 58 Indonesian well-nourished
male infants aged 3-12 months suffering from acute diarrhea with moderate dehydration. After adequate oral rehydration, the patients were randomly assigned to receive either a low lactose infantformula supplemented with
added precooked rice (1.5 g/100mL) with the above active ingredients (study group) or a low lactose infant formula with added precooked rice without the above active ingredient supplement (control group). No antibiotic,
anti-secretory drug or antiemetic was given at all. Both study and control groups showed similar outcomes for
weight gain and stool weight. The duration of diarrhea was significantly shorter in the study group than in the
control group (1.63 versus 2.45 days; p<0.05; for the study and control group,respectively). No treatment failure
or other side effects were observed during the course ofthe study. The present study supports the evidence for
the efficacy of a special anti-diarrhea infant formula containing probiotic, prebiotic, fiber and iron+zinc after oral
rehydration by shortening the duration of infantile diarrhea in developing countries. However, from the results of
our study we cannot discern the individual contribution ofthe active ingredients and also not whether they may
act independent from each other or in a synergistic way.
Asia Pac J Clin Nutr. 2007;16(3):435-442.doi:
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The validity of the World Health Organisation’s obesity body mass index criteria in a Turkish population: a hospital-based study
Author:Emre Bozkirli MD, Melek Eda Ertorer MD, Okan Bakin
Keywords:obesity, body mass index, body fat percent, bioelectrical impedance analysis, dual energy X-ray absorptiometry, Turkey
Abstract:Our aim was to determine the relationship between body fat percentage (BF%) and body mass index (BMI) and
to evaluate the validity of World Health Organisation’s BMI cut-off values for obesity. Adult out-patients (n=909,
249 men, 660 women), mean age; 40.5 ± 14.1 years were included. According to WHO’s BMI criteria, 440 subjects were obese (79 men, 361 women). The BF% of participants were measured using a bioelectrical impedance
analysis (BIA) system (TANITA). Randomly selected 30 patients were also subjected to the dual-energy X-ray
absorptiometry (DEXA) procedure for evaluation of the validity of TANITA measurements. The BF% results obtained by DEXA and TANITA revealed good correlation (r =0.952, p= 0.382). There was a positive correlation
between BF% and BMI (p<0.001) for both methods. Cut-off valuesfor BMI were calculated as 28.0 kg/m
2
for
women, 28.2 kg/m
2
for men, if obesity was defined as BF ≥25% in men, ≥35% in women according to WHO’s
criteria. Using the new cut-off values, the frequency of obesity increased up to 33.9% in our group. The increase
was more pronounced in men (67.1% vs 26.6%).The WHO cut-off values underestimated the frequency of obesity in this population. Further studies are warranted for different ethnic groups.
Asia Pac J Clin Nutr. 2007;16(3):443-447.doi:
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Food security, selection, and healthy eating in a Pacific Community in Auckland New Zealand
Author:Elaine Rush PhD, Naita Puniani MAppSc, Neil Snowli
Keywords:food security, obesity, Pacific, energy density, diet, costs
Abstract:When an infant is brought home to the family, it is often a time of emotional, economic and physical stress due
to the extra demands placed on parents. Household food security means “access at all times to enough and nutritionally appropriate food to provide the energy and nutrients needed to maintain an active and healthy life”.
Questions about food security were asked of 1376 Pacific Island mothers (as part of the Pacific Island Family
Study) approximately six weeks after the birth of their baby. Due to lack of money food sometimes ran out in
39.8% of households and in a further 3.8% food often ran out. Variety of foods was limited by lack of money in
39.3%. Foods that were still bought when money was limited included bread (97%),milk (95%), meat and
chicken (91%), vegetables and fruit (83%), rice or pasta (82%), breakfast cereals (69%), fish or shellfish (50%)
and biscuits or chips (44%). Alcohol (1%), soft drinks(11%), ice cream (12%) and fruit juice (21%) were the
least often bought. Energy density (MJ/kg) and nutrient-density of typical foods limited by lack of money were
analysed. Rice, bread and fatty meats provided the most calories per dollar and fruit and vegetables the least.
The best protein-value for money was from minced beef, chicken and tinned tuna and the most fibre-rich foods
included baked beans and mixed vegetables. Food security is a major problem for Pacific families. The environment of food availability, choice and cost requires attention to help close the health gap.
Asia Pac J Clin Nutr. 2007;16(3):448-454.doi:
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Effect of purple sweet potato leaf consumption on the modulation of the antioxidative status in basketball players during training
Author:Wen-Hsin Chang MSc, Chiao-Ming Chen MSc, Shene-Pin
Keywords:purple sweet potato leaves, polyphenols, basketball, training, antioxidative status
Abstract:The aim of this study was to evaluatethe effect of purple sweetpotato leaves (PSPLs) consumption on antioxidative status and its modulation of that status in basketballplayers during training period. Fifteen elite basketball
players were enrolled in this study. The seven-week study consisted of a run-in (week 1), PSPLs diet (daily consumption of 200 g PSPLs) (weeks 2, 3), washout (weeks 4, 5), and control diet (low polyphenol, with the amount
of carotenoids adjusted to the same level as that of PSPLs) (weeks 6, 7). Blood and urine samples were taken for
biochemical analysis. Compared with the control group, the results showed that PSPLs consumption led to a significant increase of plasma polyphenol concentration and vitamin E and C levels. Low density lipoprotein (LDL)
lag time was significantly longer in the PSPLs group.A significant decrease of urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) was noted; however, there was no significant change in plasma glutathione (GSH), total antioxidant status (TAS) and malondialdehyde + 4-hydroxy-2(E)-nonenal level after consuming the PSPLs
diet. In conclusion, consumption of PSPLs diet for 2 weeks may reduce lipid and DNA oxidation that can modulate the antioxidative status of basketball players during training period.
Asia Pac J Clin Nutr. 2007;16(3):455-461.doi:
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Rising trends in BMI of Saudi adolescents: evidence from three national cross sectional studies
Author:Hazzaa M Al-HazzaaPhD, FACSM
Keywords:body mass index, obesity, overweight, childhood, adolescence, Saudi Arabia
Abstract:Objective:To examine the trends in body mass index (BMI) of Saudi male adolescents between 1988 and 1996.
Methods:The data set came from three major population-based cross sectional studies. They all involve nationally representative samples and were conducted between 1988 and 1996. BMI was calculated from body height
and mass and plotted at the 50
th
and 90
th
percentiles.
Results:BMI of Saudi adolescents progressively increased at both 50
th
and 90
th
percentiles between 1988 and
1996. The increases in BMI during the eight-year period ranged from 9.6 to 10.8% at the 50
th
percentiles and
from 10.9 to 13.9% at the 90
th
percentiles. At ages 15-18 years, the yearly increase in median BMI from 1988 to
1996 averaged 0.246 kg/m
2
.
Conclusion:The rising trends in BMI between 1988 and 1996 are indication of increasing obesity among Saudi
male adolescents. More attention to the promotion of healthy nutrition and physical activity throughout childhood and adolescence is required.
Asia Pac J Clin Nutr. 2007;16(3):462-466.doi:
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Milk consumption is a risk factor for prostate cancer in Western countries: evidence from cohort studies
Author:Li-Qiang Qin PhD, Jia-Ying Xu SM, Pei-Yu Wang PhD
Keywords: milk, dairy products, prostatecancer, meta-analysis, cohort study, oriental populations
Abstract:We have previously found a positive association between milk consumption and prostate cancer risk using metaanalysis to analyze published case-control studies. In the present study, further meta-analysis was conducted to
estimate the summary relative risk (RR) between the consumption of milk and dairy products and prostate cancer
from cohort studies published between 1966- 2006. We found 18 relevant articles and 13 independent studies
were available for our analysis. The summary RR was 1.13 (95% confidence interval = 1.02-1.24) when comparing the highest with the lowest quantile of consumption.The summary RRs by study stratification showed a positive association. A dose-response relationship was identified when combining the studies that partitioned the consumption by quintiles. We also evaluated the effects of some limitations, such as dairy classification, prostate
cancer stages and publication bias, in the present study. These findings, together with the previous study, suggest
that the consumption of milk and dairy products increases the risk of prostate cancer. This isbiologically plausible since milk contains considerable amounts of fat, hormones, and calcium that are associated with prostate cancer risk.
Asia Pac J Clin Nutr. 2007;16(3):467-476.doi:
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Intake of vitamin A-rich foods and lung cancer risk in Taiwan: with special reference to garland chrysanthemum and sweet potato leaf consumption
Author:Yi-Ru Jin MS, Meei-Shyuan Lee DrPH, Jang-Hwa Lee M
Keywords:lung cancer, case-control study, vitamin A, garland chrysanthemum, and sweet potato leaves
Abstract:A case-control study was conducted to investigate the association between the consumption of local common
foods that are rich in vitamin A and the risk of lung cancer in Taiwan. A total of 301 incident lung cancer cases,
602 hospital controls, and 602 neighborhood controls were recruited. The consumption of 13 food items and vitamin supplements was estimated by use of a food frequency questionnaire. The conditional logistic regression
models were used to estimate the adjusted odds ratios (AOR) and 95% confidence intervals (CI) for lung cancer
risk with each control group as reference by adjustmentof covariates. A reduced risk for lung cancer was found
to be associated with increased intakes of vitamin A, α-carotene, and β-carotene from 13 food items. More servings of vegetables (AOR for the highest versus the lowest quartile = 0.67-0.70, 95% CI = 0.42-1.08, plinear trend
=
0.04), garland chrysanthemum (AOR for the highest versusthe lowest tertile = 0.58-0.74, 95% CI = 0.37-1.14,
plinear trend ≤0.04) and sweet potato leaves (AOR for the highest versus the lowest tertile = 0.43-0.65, 95% CI =
0.28-0.96, plinear trend ≤0.03) were associated with the reduced risk for lung cancer. In conclusion, higher consumption of vitamin A-rich vegetables, especially garland chrysanthemum and sweet potato leaves might provide
potential protection from lung cancer.
Asia Pac J Clin Nutr. 2007;16(3):477-488.doi:
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Short-term effectiveness of an individual counseling program for impaired fasting glucose and mild type 2 diabetes in Japan: a multi-center randomized control trial
Author:Makoto Watanabe MD, Akira Okayama MD, Kazuaki Shim
Keywords:randomized controlled trial, health education, program evaluation, hyperglycemia, public health
Abstract:The aim of this study is to evaluate the short-term effectiveness of our individual-based counseling program and
tools among individuals in ordinary Japanese communities with impaired fasting glucose (IFG) and mild type 2
diabetes. A total of 233 eligible participants (age 30-69 years) in 14 localstudy centers wererandomly assigned
to an intervention group (INT, N=119) and a control group (CONT, N=114). During the 4-month intervention,
the INT received 4 individual counseling sessions and one reminder on lifestyle modification. The CONT received only an explanation of blood testresults and general information on diabetes. Baseline characteristics did
not differ significantly between groups. Percentages of participants with desirable changes in glycemic level and
weight were significantly higher in INT than CONT: fasting plasma glucose reduction of more than 10 mg/dL
(39% in INT vs. 26% in CONT, p=0.045), hemoglobinA1
c reduction greater than 0.3% (14% vs. 4%, p=0.01),
and weight reduction of more than 4 kg (13% vs. 4%, p=0.025). Decreases in total energy intake and percentage
of heavy alcohol drinkers (more than 46 g/day) were significantly greater in INT than CONT. The increase in
percentages of participants who engaged in leisure time physical activity more than 12 times per month was significantly greaterin INT than CONT. Our program resulted in life style modification and glycemic level improvement in the short-term among individuals with IFG and mild type 2 diabetes. Results indicated that the program was sufficiently effective and feasible for implementation in ordinary communities.
Asia Pac J Clin Nutr. 2007;16(3):489-497.doi:
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Tocotrienol levels in adipose tissue of benign and malignant breast lumps in patients in Malaysia
Author:Kalanithi Nesaretnam PhD, Patricia Alison Gomez MD
Keywords:tocotrienols, tocopherols, adipose tissue, fatty acid composition, malignant and benign lumps
Abstract:Data on dietary exposure to vitamin E by plasma or adipose tissue concentrations of α-tocopherol (α-T) in observational studies have failed to provideconsistent support for the idea that α-T provides women with any protection from breast cancer. In contrast, studies indicate that α, γ, and δ-tocotrienols but not α-T have potent antiproliferative effects in human breast cancer cells. Our aim was to investigate whether there was a difference in
tocopherol and tocotrienol concentrations in malignantand benign adipose tissue, in a Malaysian population
consuming predominantly a palm oil diet. The study was undertaken using fatty acid levels in breast adipose tissue as a biomarker of qualitative dietary intake of fatty acids. The major fattyacids in breast adipose tissue of
patients (benign and malignant) were oleic acid (45-46%), palmitic (28-29%) and linoleic (11-12%). No differences were evident in the fatty acid composition of the two groups. There was a significant difference (p=0.006)
in the total tocotrienol levels between malignant (13.7 ± 6.0 µg/g) and benign (20±6.0 µg/g) adipose tissue samples. However, no significant differences were seen in the total tocopherol levels (p=0.42) in the two groups. The
study reveals that dietary intake influences adipose tissue fatty acid levels and that adipose tissue is a dynamic
reservoir of fat soluble nutrients. The higher adipose tissue concentrations of tocotrienols in benign patients provide support for the idea that tocotrienols may provide protection against breast cancer.
Asia Pac J Clin Nutr. 2007;16(3):498-504.doi:
>>Abstract
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Multiple micronutrient fortification of salt and its effect on cognition in Chennai school children
Author:Malavika Vinod Kumar PhD and Srinivasa Rajagopalan
Keywords:child nutrition, India, multiple micronutrients, salt fortification, iron, vitamin A, B complex vitamins, cognition
Abstract:Aim:To test the efficacy of a multiple micronutrient fortified salt in improving the micronutrient status and
health of school children and its effect on cognition.
Methods:A salt fortified with multiple micronutrients was developed containing chelated ferrous sulphate,
microencapsulated vitamin A, B1,B2, B6, B12, folic acid, niacin, calcium pantothenate and iodine. The efficacy
of the fortified salt was assessed in 7-11 year old schoolchildren in Chennai, India. In the experimental group
(N=63), the food in the school kitchen was cooked with the fortified salt for a periodof one year. The control
group (N=66) consisted of day scholars who did not eat at the school. Hemoglobin, red blood cell count, hematocrit, serum vitamin A, urinary iodine and prevalence ofangular stomatitis were measured at baseline and at the
end of the study after one year. A battery of 7 memory tests (The personal information test, the Mann-Suiter Visual memory screen for objects, The digit span forward test, The digit span backward test, The delayed response
test, The Benton Visual Retention Test and The Cattells retentivity test), one test for attention and concentration
(Letter cancellation test) and one test for intelligence (Raven’s coloured progressive matrices) were administered
to all the children at baseline and endline.
Results:There was a significant (p<0.05) improvement in the experimentalgroup in hemoglobin, red cell count,
urinary iodine and serum vitamin A whereas in the control group there was a statistically significant decline
(p<0.05) in hemoglobin, hematocrit, red cell count and urinary iodine. Angular stomatitis was eliminated from
baseline 30.4% in the experimental group whereas it increased from 3.25% to 25.5% in the control group. In 4
tests out of the 7 memory tests and in the letter cancellation test for attention, the mean increment in scores in the
experimental group is significantly more (p<0.05) than the control group. There was no significant improvement
in overall intelligence as seen in the Ravens progressive matrices betweenthe experimental and control groups.
Conclusion:The study shows that the multiple micronutrient fortified salt is effective in improving multiple micronutrient status and cognition in children.
Asia Pac J Clin Nutr. 2007;16(3):505-511.doi:
>>Abstract
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Determinants of child malnutrition during the 1999 economic crisis in selected poor areas of Indonesia
Author:Saptawati Bardosono MD PhD, Soemilah Sastroamidjoj
Keywords:crisis, poverty, economy, recent-onset malnutrition (wasting), chronic malnutrition (stunting and anaemia), determinants, under-five children, Jakarta, Banggai, Alor-Rote
Abstract:There is empirical evidence at the national level that suggests the 1999 Indonesian economic crisis impact was
very heterogeneous both between urban and rural areas and across regions. A cross sectional study of the nutritional status of children and its determinants was performed in urban poor areas of Jakarta, and rural areas of
Banggai in Central Sulawesi, and Alor-Rote in East Nusa Tenggara. Two-stage cluster sampling was used to obtain 1078 households with under-five children in the urban poor area of Jakarta, and 262 and 631 households
with under-five children each for the rural areas of Banggai and Alor-Rote, respectively. Data collection for both
studies was performed from January 1999 to June 2001. The study shows that wasting affected more children in
the urban poor areas of Jakarta than in the other study areas. On the other hand, stunting and anemia were significantly more severe among children 6-59 months of age inthe rural area of Alor-Rote compared to the other
study areas. The high prevalence of infectious diseases was significantly related to the higher prevalence of
wasting in the study areas of Jakarta and Banggai, and also significantly related to the higher prevalence of stunting and anemia in the study area of Alor-Rote. To avert this kind of health impact of a economic downturn, there
is a need to improve the nutritional and health status of under-five children and their mothers through the existing health care system, provide basic health services and improvethe capacity of health staff across Indonesia as
part of the decentralization process.
Asia Pac J Clin Nutr. 2007;16(3):512-526.doi:
>>Abstract
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Anemia in pregnancy in Malaysia: a cross-sectional survey
Author:Jamaiyah Haniff MPH, MD, Anita Das MPH, MBBS, Lim
Keywords:anemia, pregnancy, prevalence, haemoglobin, grandmultiparity
Abstract:Anemia is the most prevalent nutritional deficiency during pregnancy. Except for a study conducted 10 years ago
in Kelantan, Malaysia’s available statistics are based onisolated small urban maternity hospital studies from the
1980s. There was therefore, a need for a large study at national level to estimate the magnitude of the problem in
the country as well as to understand its epidemiology. This multi-center, cross-sectional study was conducted
from February to March 2005, to assess the prevalence of anemia. Multistage stratified random sampling technique was used and 59 Ministry of Health (MOH) primary health care clinics were selected. Our final dataset
consisted of 1,072 antenatal mothers from 56 clinics. The overall prevalence of anemia in this population was 35
% (SE 0.02) if the cut off level is 11 g/dL and 11 % (SE 0.03) if the cut-off level is 10 g/dL. The majority was of
the mild type. The prevalence was higher in the teenage group, Indians followed by Malays and Chinese being
the least, grandmultiparas, the third trimester and from urban residence. After multiple linear regression analysis,
only gestational age remained significant. These findings are useful for our Maternal Health program planners
and implementers to target and evaluate interventions. Work is in progress for outcomes and cost-effectiveness
studies to best tackle this problem. In conclusion, the prevalence of anemia is 35% and mostly of the mild type
and more prevalent in the Indian and Malays.
Asia Pac J Clin Nutr. 2007;16(3):527-536.doi:
>>Abstract
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Influences on maternal and child nutrition in the highlands of the northern Lao PDR
Author:Wendy Holmes MB BS MSc (CH) Lond, Damian Hoy BAppS
Keywords:nutrition, Lao PDR, Laos, mother, child, qualitative study
Abstract:In two remote northern provinces of the Lao People’s Democratic Republic, provincial and district teams were
trained and subsequently conducted a qualitative study using a participatory approach to investigate people’s
knowledge, attitudes, beliefs and practices in relation towomen’s and children’s nutrition. Using focus group
discussions, key informant interviews, and structured observation, the teams found that certain nutrition behaviours, including food taboos, may contribute to the high prevalence of child malnutrition and micronutrient deficiencies in these northern provinces. Ethnic groups gavedetails of nutrition-related beliefs and practices; the
teams found that many of these are likely to be amenable to change through relatively low-cost nutrition promotion informed by these findings. In particular, barriers to exclusive breastfeeding, food taboos and hygiene behaviour could be addressed. The study also demonstrated that with appropriate training, supervision and support,
local teams are able to plan and conduct a large-scale qualitative study.
Asia Pac J Clin Nutr. 2007;16(3):537-545.doi:
>>Abstract
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Determinants of blood pressure among Indonesian elderly individuals who are of normal and over-weight: a cross sectional study in an urban population
Author:Sudijanto Kamso PhD, Johanna S.P. Rumawas MD, Widj
Keywords: Obesity, fat intake, sodium, potassium, calcium, physical activity, blood pressure, Jakarta
Abstract:Cardiovascular disease has become the first cause of death in Indonesia. The highest morbidity is found in the
aged, and among cardiovascular disorders or diseases, the prevalence of hypertension is the highest. Many studies of the relationship between nutritional factors and hypertension have been conducted, especially with reference to the metabolic syndrome, but studies to understand determinants of blood pressure in Indonesia are lacking. There is an urgent need to gather information about various blood pressure risk factors in Indonesian elderly,
which will allow policy makers to provide appropriate intervention programs.The primary purpose of this study
was to investigate various determinants of blood pressure in Indonesian elderly who differed in body composition. A cross sectional study was undertaken in Jakarta on 556 elderly using multistage random sampling. Data
were collected through interview using structured questionnaires, anthropometric measurements, biochemical
blood analysis, and blood pressure measurements. Daily nutrient intake was analyzed using the World Food 2
Dietary Assessment Program. General Linear Model and Multiple linear regression analysis were performed to
determine determinants of systolic and diastolic blood pressure. Monounsaturated fatty acid, saturated fatty acid,
and sodium intake, plasma total cholesterol level, the ratio of total cholesterol to HDL-cholesterol and a sport
Index were determinants of blood pressure in the normal weight elderly individuals, while potassium intake, calcium intake and BMI were determinants of bloodpressure in the overweight elderly individuals.
Asia Pac J Clin Nutr. 2007;16(3):546-553.doi:
>>Abstract
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Effects of continuous enteral L-Arginine in a rat model of the short bowel syndrome
Author:Xiaohua Jiang MD, Weiming Zhu MD, Ning Li MD , Li
Keywords:short bowel syndrome, adaptation, intestine, L-arginine, enteral nutrition
Abstract:The objective of this study was to evaluate whether continuous enteral supplementation of L-arginine can stimulate intestinal adaptation in a rat model of short bowel syndrome (SBS). Male Sprague-Dawley rats were randomly divided into three groups of 10 each: Sham ratsunderwent bowel transaction and received continuous enteral nutrition (Control group, Con group), SBS rats underwent 75% small bowel resection and received continuous enteral nutrition (SB group), and SBS rats underwent 75% bowel resection and received continuous enteral
nutrition supplemented with L-arginine (300mg/Kg/d) (SB-Arg group). Fat absorbability, plasma free fatty acids,
parameters of intestinal adaptation, enterocyte proliferation and apoptosis were determined on day 15after operation. After massive small bowel resection, rats had significant bowel adaptation. Compared with SB untreated rats,
SB rats supplemented with L-argininedemonstrated a significant increase in fat absorbability, plasma level of
free fatty acids, ileal mucosal weight and DNA content, jejunal and ileal mucosal protein content, jejunal and ileal
villus length, crypt depth and mucosal thickness. L-argininesupplementation increased enterocyte proliferation,
while decreasing enterocyte apoptosis.We suggest that after massive small bowel resection, continuous enteral
supplementation of L-arginine can stimulate intestinal adaptation. L-arginine may bea trophic factor to stimulate
intestinal adaptation in rats of SBS.
Asia Pac J Clin Nutr. 2007;16(3):554-560.doi:
>>Abstract
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A national study on the prevalence of obesity among 16,127 Malaysians
Author:Lekhraj Rampal MBBS, MPH, DrPH, Sanjay Rampal MBBS
Keywords:prevalence, obesity, ethnicity, Malaysia
Abstract:A population-based cross-sectional study was conducted in all states of Malaysia withthe aim to determine the
prevalence of obesity among Malaysians aged fifteen years and above and factors associated. A stratified twostage cluster sampling design with proportional allocation was used. Trained interviewers using a standardized
protocol obtained the weight and height measurements and other relevant information. Subjects with a body
mass index ≥30 kg/m
2
were labelled as obese. The results show that the overall national prevalence of obesity
among Malaysians aged 15 years old and above was 11.7% (95% CI = 11.1 - 12.4%). The prevalence of obesity
was significantly higher in females (13.8%) as compared to 9.6% in males (p< 0.0001). Prevalence of obesity
was highest amongst the Malays (13.6%) and Indians (13.5%) followed by the indigenous group of “Sarawak
Bumiputra” (10.8%) and the Chinese (8.5%). The indigenousgroup of “Sabah Bumiputra” had the lowest prevalence of 7.3%. These differences are statistically significant (p< 0.0001). Logistic regression analysis results
show that there was a significant association between obesity and age, gender, ethnicity urban/rural status and
smoking status. The prevalence ofobesity amongst those aged ≥18 years old has markedly increased by 280%
since the last National Health and Morbidity Survey in 1996. Conclusion: The overall prevalence of obesity in
Malaysia is very high as compared to1996. There is an urgent need for a comprehensive integrated populationbased intervention program to ameliorate the growing problem of obesity in Malaysians.
Asia Pac J Clin Nutr. 2007;16(3):561-566.doi:
>>Abstract
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Comparisons of attitudes and practices between obese and normal weight women in Taiwan
Author:Shene-Pin Hu PhD, Tzu-Yin Chiang MS, Sung-Ling Yeh
Keywords:weight-related attitudes, food and beveragepractices, normal-weight, obese people, women Chinese
Abstract:This study was designed to obtain baseline data regarding self-reported body image, attitudes toward overweight
people, and dietary behaviors of normal-weight and obese women in Taiwan. Fifty obese women (BMI ≧27)
and age-matched normal-weight women participated in thisstudy. Written questionnaires were used for data collection.Simple frequency and t-test were used to analyze data. In general, the majority of normal-weight women
perceived themselves as being heavier than their actual body weight. The normal-weight group had more high
inaccurate images of their bodies than that of the obese group (72% vs. 24%). Obese and normal-weight women
had similar attitudes to overweight people, but some of their attitudes showed significant differences. Obese
women would prefer to consume more fried foods and drink sugar-containing foods than would normal-weight
women (p< 0.05). Education about accurate perceptions of what is normal weight for women and adopting energy-diluted foods for obese women is needed in the future.
Asia Pac J Clin Nutr. 2007;16(3):567-571.doi:
>>Abstract
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Prevalence of overweight and obesity and its associated factors in aboriginal Taiwanese: findings from the 2001 National Health Interview Survey in Taiwan
Author:Ching-Sung Ho PhD and Alan C Tsai PhD
Keywords:aborigines, obesity, anthropometrics, lifestyle, Taiwan
Abstract:The study was undertaken to assess the prevalence of obesity in Taiwanese aborigines and to identify the associated factors. Data for this study were from the “2001 National Health Interview Survey (NHIS)” that conducted
in-home, face-to-face, interviews on 6,592 households (26,658 persons) of a national probability sample in Taiwan. Aborigine-dense mountainous areas are over-sampled. BMI values were used to indicateobesity status.
Logistic regression analyses were usedto determine the significance of the association of the variables with the
obesity status. Results showed that approximately 10.5% of aboriginal men and 14.5% of women compared to
4.1% and 3.5% of their non-aboriginal counterparts wereobese (BMI > 30). An additional 45.1% of aboriginal
men and 33.3% of women compared to 27.6% and 17.7% of their non-aboriginal counterparts were overweight
(BMI 25-30). Regression analyses revealed few associations with increased risk of obesity in the aborigines.
However, the aborigines and non-aborigines were distinctly different from each other in socio-economic status,
lifestyle, environmental factors and attitude toward obesity. Results indicate that obesity is more prevalent
among the aborigines but the causal reasons are not apparent. The public health authorities should develop more
culturally appropriate community-based intervention strategies to promote the health of the aborigines.
Asia Pac J Clin Nutr. 2007;16(3):572-579.doi:
>>Abstract
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Anti-obesity drug use before professional treatment in Taiwan
Author:Tsan-Hon Liou MD, Chih-Hsing Wu MD, Hsu-Chen Chien
Keywords:Orlistat, sibutramine, dietary supplement, off-label drugs, drug utilization
Abstract:Between July 2004 and June 2005, a cross-sectional study was performed to determine the prevalence and patterns of anti-obesity medicine use among subjects seeking obesity treatmentin Taiwan. Eighteen obesity outpatient clinics were selected via a random stratified sampling method and 1,060first-visit clients (791 females and
269 males) aged above 18 years were enrolled and then completed a self-administered questionnaire. The prevalence of anti-obesity medicine use was 50.8%; more females than male usedanti-obesitymedicines (53.6% vs.
42.4%). Of the 1,060 subjects, 17.1% had used orlistat, 21.1% had taken sibutramine, and 18.3% had utilized unproven drugs such as cocktail therapy and other anti-obesity drugs. Furthermore, 23.6% and 22.4% of subjects
indicated that they concurrently used Chinese herbal preparations and dietary supplements, respectively. Logistic
regression analyses demonstrated thatthe odds ratio (OR) for anti-obesity medicine use was substantially higher
in females (OR, 1.9; 95% CI, 1.3-2.6), those aged 18-24 years (OR, 1.6; 95% CI, 1.0-2.6), those with a body mass
index (BMI) >35 kg/m
2
(OR, 3.4; 95% CI, 2.1-5.7) and respondents concurrently using Chinese herbal preparations (OR, 1.7; 95% CI, 1.2-2.4) and dietary supplements (OR, 2.2; 95% CI, 1.6-3.1). In conclusion, the prevalence of anti-obesity drugs use is high among Taiwanese adults before they seek obesity treatment. Young, obese
females, and those who had taken Chinese herbal preparations/dietary supplements had a high likelihood to report
using anti-obesity medicines. Use ofunproven weight-loss drugs is common and warrants further investigation.
Asia Pac J Clin Nutr. 2007;16(3):580-586.doi:
>>Abstract
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