HPV-induced recurrent laryngeal papillomatosis: rationale for adjuvant fatty acid therapy
Author:Louise Louw PhDand André Claassen MMed FCORL
Keywords:Benign tumors, laryngeal papillomatosis, therapeutic rationale, adjuvant fatty acid therapy, nutritional immunomodulation
Abstract:The course of human papilloma virus (HPV)-induced recurrent laryngeal papillomatosis (RLP) is variable and
unpredictable. Some patients experience spontaneous remission, while others suffer from aggressive growth
with dire consequences. Unfortunately, HPV DNA can persist in mucosa after treatment and can be reactivated
under immunosuppressive conditions. For this reason, these benign tumors are notoriously recurrent. Better understanding of lipid-driven signaling pathways during tumorigenesis and immune responses in RLP patients can
contribute to improve therapeutic approaches in an attempt to obviate this disease. Based on a mountain of evidence in the literature that concerns the immunomodulatory potential of certain FAs, it is clear that there is a rationale for adjuvant FA therapy (concurrent application) in the management of RLP. Of particular importance
for immune surveillance is that the Th1 pathway in RLP is down-regulated and it is advocated that conjugated
linoleic acid (CLA) and eicosapentaenoic acid (EPA) have the ability to restore the Th1/Th2 balance. Therefore,
it is proposed that adjuvant FA therapy with CLA and EPA must be included in the therapeutical regime of RLP,
since they are considered excellent anti-viral and anti-tumor agents to improve immune conditions and disease
outcome. Immunocompetence plays a pivotal role in the clinical course of RLP and, hence, a new direction with
adjuvant FA therapy may be the key to prevent recurrence of this disease.
Asia Pac J Clin Nutr. 2008;17(2):187-193.doi:
>>Abstract
>> Download PDF
Vitamins, minerals and race performance in ultra-endurance runners – Deutschlandlauf 2006
Author:Beat Knechtle MD, Patrizia Knechtle, Ingo Schulze
Keywords:ultra running - supplementation - nutrition - ergogenic aids - exercise
Abstract:We investigated the effect ofpre-race intake of vitamins and minerals, in the form of supplementation, before a
multi-stage ultra-endurance run and their effect on raceperformance. At the Deutschlandlauf 2006 in Germany,
where athletes had to run across Germany from the north(Kap Arkona - Rügen) to the south (Lörrach) over
1,200 km within 17 consecutive stages, twenty male ultra runners (46.2 ± 9.6 years, 71.8 ± 5.2 kg, 179 ± 6 cm,
BMI 22.5 ± 1.9 kg/m
2
) completed a questionnaire about their intake of vitamin and mineral supplements in the
four weeks before the race. Race performance of athletes with- and athletes without regular intake of these supplements were compared. In the four weeks before the run, nine runners (45%) ingested vitamin- and twelve athletes (60%) mineral supplements. Athletes with an intake of vitamins (152.8 ± 14.1 h versus160.6 ± 14.6 h, p>
0.05) and minerals (151.6 ± 14.5 h versus 165.3 ± 10.8 h, p> 0.05) finished the race no faster than athletes without an intake of vitamins and minerals. We concluded that in the Deutschlandlauf 2006 of over 1,200 km within
17 consecutive stages, athletes with a regular intake of vitamin and mineral supplements in the four weeks before
the race finished the competition no faster than athletes without an intake of vitamins and minerals.
Asia Pac J Clin Nutr. 2008;17(2):194-198.doi:
>>Abstract
>> Download PDF
Nutritional status of adults participating in ambulatory rehabilitation
Author:Supreet Kaur BSc MNutDiet, Michelle D Miller BSc M
Keywords:ambulatory rehabilitation, older, malnutrition, quality of life, appetite
Abstract:Aims:To assess the overall nutritional status of older adults participating in ambulatory rehabilitation and determine its association with relevant outcomes including physical function and quality of life. Design:Crosssectional. Setting:Ambulatory rehabilitation service in the Southern region of Adelaide, Australia. Subjects:A
total of 229 participants recruited as part of a RCT between June 2005 and June 2006, stroke (n=83), elective orthopedic procedure (n=44) and other medical condition (n=102). Methods:Nutritional status was measured using Mini Nutritional Assessment (MNA), Simplified Nutrition Appetite Questionnaire (SNAQ) and Body Mass
Index. Functional performance was assessed using the ModifiedBarthel Index (MBI) and quality of life was
measured using the Short Form-36 (SF-36). Results: Sixty-three percent of participants were malnourished or at
risk of malnutrition according to the MNA and a third had a risk of ≥5% weight loss in the subsequent six
months, according to the SNAQ. Participants with a diagnosis other thanstroke or elective orthopedic procedure
were the most vulnerable, with 53% (n=74/140) classified as at risk of malnutrition or malnourished and a longer
length of stay in hospital. Functional performance was no different for participants assessed as at risk of malnutrition or malnourished compared to the well nourished, but the SF-36 mental component score was significantly
higher for those who were well nourished (p=0.003). Conclusion:Findings emphasise the magnitude of the
malnutrition problem in ambulatory rehabilitation settings. Further research is required to evaluate the resource
implications against expected benefits of providing nutrition interventions at this point.
Asia Pac J Clin Nutr. 2008;17(2):199-207.doi:
>>Abstract
>> Download PDF
Effects of social determinants on food choice and skipping meals among Turkish adolescents
Author:Meral Turk Soyer, Isil Ergin and Safak Taner Gurso
Keywords:Adolescent, food choice, skipping meals, meal pattern, social determinant
Abstract:Purpose: To present data that contributes to understanding factors that influence food choice and skipping meals
in adolescents. Methods: A cross sectional study is carried in selected high schools in Bornova. Study sample
compromises of 527 students chosen randomly by class from a population of 2410 first year in high school students. Self-administered questionnaires containing sociodemographic determinants, self reported weight and
height, food choices and meal patterns were used.Findings:A psychosocial factor that affects almost all of the
students is the “taste and sensory perception of food”. The second noticable factor isthe “health and nutritious
value of food”. The time conserved and the convenience in the preparation of food is one of the lifestyle factors
that affect more than half of the students. The cost ofthe food was also found to have an effect. Among the third
group of factors categorized as “media”, the leading factor is advertisement, effective in one third of the students.
Among boys and girls, there was no statistical difference in the type of meal skipped.Living in Izmir for more
than 10 years compared to less than ten years, being in a nuclear family to extended family, and belonging to the
“owner” social class to “wage laborer” class also do not statistically differ with regard to skipping meals. However, the mother’s and father’s education level and having a working mother are associated with skipping meals.
Conclusions: These results provide important evidence to support opportunities to positively influence the adoption of healthful eating.
Asia Pac J Clin Nutr. 2008;17(2):208-215.doi:
>>Abstract
>> Download PDF
Diet and obesity among Chamorro and Filipino adults on Guam
Author:Rachael T Leon Guerrero PhD RD, Yvette C Paulino M
Keywords:Guam, energy density, obesity, Chamorro, Filipino
Abstract:The purpose of this study was to compare the body mass index (BMI) and dietary intakes of Chamorro (n=66)
and Filipino (n=61) adults, ages 25-65 years, living in Guam. Participants were recruited via community-based
sampling; however, recruitment was targeted to ensure approximately equal numbers from each ethnic group,
equal numbers of men and women within each ethnic group, and proportional representation of the main geographic areas of the island. In addition, subjects were recruited and stratified based on the 2000 Guam Census
Data to assure proportional distribution by age. Dietary energy density (ED) was calculated as kcal/g and compared by gender, ethnicity, and obesity status. Mean BMI for Chamorros was significantly higher than for Filipinos, and a significantly higher proportion of Chamorros (49%) were obese compared to Filipinos (20%).
Chamorros reported higher ED than Filipinos (1.9 kcal/gversus 1.6 kcal/g), although the difference was significant among males only. Non-obese subjects had a lower ED than obese subjects (1.9 versus 2.3 kcal/g). Overweight and obese subjects both reported a significantly higher % energy consumed as sugar-sweetened beverages than healthy weight subjects (8% and 9% versus 3%). Differences in ED may contribute to differences in
obesity rates between Chamorros and Filipinos in Guam, particularly among men, and lowering ED may be an
appropriate goal for nutrition interventions.
Asia Pac J Clin Nutr. 2008;17(2):216-222.doi:
>>Abstract
>> Download PDF
Comparisons between anthropometric indices for predicting the metabolic syndrome in Japanese
Author:Masayuki KatoMD PhD, Yoshihiko TakahashiMD PhD, Ma
Keywords:metabolic syndrome, waist circumference, waist/hip ratio, waist/height ratio, body-mass index
Abstract:Aims: Most definitions of the metabolic syndrome (MS) employ waist circumference as an indicator of central
obesity. However, several reports, mainly from Asia, argue that other indices, for example the waist/height ratio,
are superior to waist circumference for identifying subjects with cardiovascular risk factors. We therefore investigated correlations between the predictive power of several anthropometric indices and risk factor accumulation
(RFA) defined by the existence of two or more disorders among hypertension, dyslipidemia (high triglycerides
and/or low levels of high density lipoprotein cholesterol) and fasting hyperglycemia; each of which is a component of MS.Methods: We conducted a cross-sectional analysis using data from a part of the Japan Public
Health Center-based Cohort. A total of 315 men and 314women, 51 to 70 years of age were examined for variables including waist and hip circumferences, blood pressure, fasting plasma glucose and lipids at an annual
health check-up.Results: The prevalence of RFA increased almost linearly in parallel with increasing waist circumference up to 95 cm. Receiver operating characteristic analysis demonstrated that waist circumference was
better than waist/ height ratio, waist/hip ratio and BMI at predicting RFA; but the differences were not statistically significant. However, even in the case of waist circumference, no clear cut-off point yields sufficiently
high sensitivity and specificity simultaneously.Conclusions: The predictive power of waist circumference was
not inferior to those of other indices. Therefore, waist circumference is practically the most convenient measure
for predicting MS because of its simplicity.
Asia Pac J Clin Nutr. 2008;17(2):223-228.doi:
>>Abstract
>> Download PDF
How useful is waist circumference for assessment of abdominal obesity in Korean pre-menopausal women during weight loss?
Author:Mi-Ja Hwang OMD, Won-Suk Chung OMD, Dympna Gallagh
Keywords:abdominal fat, Dual energy x-ray absorptiometry, obesity, waist circumference, fat distribution
Abstract:Asian women are known to have a larger amount of abdominal fat (AF) for the same level of BMI compared
with Caucasian and African-American women. This study was aimed todetermine whether waist circumference
(WC) could be useful as an index of AF compared with AF measured by dual energy x-ray absorptiometry
(DXA) before and after a weight-loss program in Asian women. Thirty-eight healthy, pre-menopausal obese Korean women (body fat percent > 30%) were enrolled and followed during a 6-week weight-loss program including herbal formula, calorie restriction, and exercise. Anthropometry and DXA measurements were performed before and after weight-loss. A specific region of interest(ROI, L2-iliac crest) by DXA was correlated with anthropometry at baseline: WC (γ= 0.91) > BMI (γ= 0.87) > Waist-Height ratio (WHtR, γ= 0.82) > WHR (γ=
0.46); and after weight loss: BMI (γ= 0.88) > WC (γ= 0.84) > WHtR (γ= 0.82), all p< 0.01. The change in
DXA ROI showed a reasonable correlation with change in anthropometry: BMI (γ= 0 .63, p< 0.01) > WC (γ=
0.39, p< 0.05) > WHtR (γ= 0.37, p< 0.05). A stepwise multiple regression analysis revealed that 83% of the
variance in DXA derived AF was explained by WC at baseline, WC and BMI at follow-up, respectively. This
study suggests that WC could be a good predictor of AF for Korean pre-menopausal women.
Asia Pac J Clin Nutr. 2008;17(2):229-234.doi:
>>Abstract
>> Download PDF
Energy expenditure and energy intake in 10-12 years obese and non-obese Chinese children in a Guangzhou boarding school
Author:Cai-Xia Zhang MD, Yu-Ming Chen MD PhD, Wei-Qing Ch
Keywords:obesity, children, energy intake, energy expenditure, Chinese Guangzhou
Abstract:Objective: The objective of this study was to observe the variation of energy intake and energy expenditure in
the obese Chinese children. Methods: Basic metabolic rate was measured by using open-circuit indirect calorimetry in 54 obese children and 60 non-obese children aged 10-12 years in a full- time boarding school in
Guangzhou suburb, China. Total energy expenditure was estimated by using a factorial method.Dietary intake
was surveyed by the weighed inventory method. Physical activity was determined using a 2-day activity diary.
Results:Univariate analysis showed that basic metabolic rate was significantly higher (p<0.05) in obese children
than in non-obese ones, but the significant difference disappeared after controlling for fat free mass and fat mass.
Energy intake and total energy expenditure were significantly higher (p<0.05) in obese than in non-obese children. Obese children spent more time in sleeping and light physical activity, but less time in moderate physical
activity and vigorous physical activity than non-obese children (p<0.05). Conclusions: Compared to non-obese
children, both energy intake and expenditure were higher in obese Chinese children. It appears that an area for
preventive strategies may be to encourage increased physical activity expenditure in this age group.
Asia Pac J Clin Nutr. 2008;17(2):235-242.doi:
>>Abstract
>> Download PDF
Partial breastfeeding protects Bedouin infants from infection and morbidity: prospective cohort study
Author:Natalya Bilenko MD MPH, Rohini Ghosh PhD, Amalia L
Keywords:Bedouin, Breastfeeding, Enteric pathogens, Gastroenteritis, Primary health care
Abstract:The benefits of exclusive breastfeeding for health in infants have been widely described. The goal of this study
was to determine whether partial breastfeeding has protective effects against enteric infection and associated
morbidity in population where early addition of supplementation is common. In this prospective study 238 Bedouin infants were followed from birth to age 18 months. Exclusive breastfeeding was protective against infection
and morbidity at ages 0 to 3 months. In the age range of 4 to 6 months, partial versus non breastfeeding was associated with lower rates of infection with Cryptosporidium spp (Odds Ratio OR 0.34, 95% confidence interval
CI 0.18; 0.65), andCampylobacter spp (OR 0.58, CI 0.35; 0.98), lower rates ofear infections (OR 0.47, CI 0.24;
0.90) and of asthma (OR 0.33, CI 0.13; 0.81). In older children (10-12 month age range) partial breastfeeding as
compared to none, protected against infections with Cryptosporidium spp (OR 0.57, CI 0.36; 0.91) and Giardia
lamblia(OR 0.92, CI 0.85; 0.99). In Bedouins, and possibly in other populations, even partial breastfeeding, especially at ages 4 to 6 months offers protection against infection. Thus, encouraging mothers to continue to at
least partially breastfeed past age 3 months may help reduce infections and morbidity in infants.
Asia Pac J Clin Nutr. 2008;17(2):243-249.doi:
>>Abstract
>> Download PDF
A comparative intervention trial on fish sauce fortified with NaFe-EDTA and FeSO4+citrate in iron deficiency anemic school children in Kampot, Cambodia
Author:Philippe Longfils MD, Didier Monchy MD, Heike Wein
Keywords:NaFe-EDTA, FeSO4+citrate, iron fortification, fish sauce, efficacy, safety
Abstract:Background: Inhabitants of agrarian villages of rural Cambodia suffer from high prevalences of iron deficiency and
anemia in the context of a monotonous diet. Objective: To compare the efficacy and safety of placebo Khmer fish
sauce to that of 10 mL of fish sauce containing 10 mg of iron, added to daily school meals either as NaFe-EDTA or as
FeSO4+
citrate. Methods: 140 students aged 6-21 years were enrolled in a double-blinded, placebo-controlled intervention trial. They were randomly allocated to one of three treatment groups, and followed for 21 weeks during
which 114 school meals seasoned with 10 mL of fish sauce were consumed by each participant. Changes in the concentrations of hemoglobin (hb), serum ferritin (SF), and C-reactive protein (CRP) and in body weight and standing
height were determined. Prevalences of vomiting, diarrhea,and acute respiratory infections were monitored weekly.
Results: Both iron-fortified fish sauces increased hb and SF concentrations significantly as compared to placebo. No
significant differences were observed between FeSO4
+citrate and NaFe-EDTA fortification, regarding mitigation of
iron-deficiency anemia (IDA) or regarding CRP, growth, infections, or side-effects. Conclusions: Iron-fortified
Khmer fish sauce added to Khmer food is a suitable vehicle for iron fortification inchildren and adolescents.
FeSO4
+citrate and NaFe-EDTA show equivalent efficacy and safety.
Asia Pac J Clin Nutr. 2008;17(2):250-257.doi:
>>Abstract
>> Download PDF
The effects of docosahexaenoic acid-rich fish oil on behavior, school attendance rate and malaria infection in school children – a double-blind, randomized, placebo-controlled trial in Lampung, Indonesia
Author:Kei Hamazaki MD PhD, Din Syafruddin MD PhD, Insan
Keywords:behavior, fatty acid composition of red blood cells, fish oil, intervention study, malaria, school attendance rate
Abstract:Background: There are only a very limited number of reports of intervention studies on the effects of fish oil on
behavior in normal school children. Objective: To observe the effects of fish oil on behavior and school attendance rates in school children. Design: Fourth to sixth graders (mostly 9-12years of age) of an elementary
school in Lampung Province, Indonesia,were randomly divided into either a docosahexaenoic acid (DHA)
group (n=116) or a control group (n=117) in a double-blind manner. The subjects in the DHA group took 6 fish
oil capsules per day (0.65g DHA and 0.10g eicosapentaenoic acid (EPA)/day) for 3 months. Controls took soybean oil capsules. Two questionnaires were administered and blood was taken at the start and end of the study.
Two questionnaires were administered at the start and end of the study: Hostility-Aggression Questionnaire for
Children (HAQ-C) and Barratt Impulsiveness Scale, version 11 (BIS-11), for measurement of aggression and
impulsivity, respectively. Attendance was recorded during the study period. Outcomes: The concentrations of
DHA and EPA in the phospholipid fraction in red blood cells were significantly increased in the DHA group.
Behavior checked with HAQ-C or BIS-11 did not show any differences between groups. However, the odds ratio
of inability to attend school regularly during the study period was 0.40 (95%CI: 0.23-0.71) in the DHA group
compared with controls (p=0.002). Conclusions: DHA-rich fish oil may improve the school attendance rate of
children in Lampung, Indonesia
Asia Pac J Clin Nutr. 2008;17(2):258-263.doi:
>>Abstract
>> Download PDF
Effect of iron fortification of nursery complementary food on iron status of infants in the DPRKorea
Author:HuiYong Rim MD, SuHuan Kim MD, ByongChel Sim MD, H
Keywords:iron status, iron deficiency anemia (IDA), iron fortification, infant, nursery food
Abstract:The aim of this study was to determine the iron status of infants who consumed porridge cooked in water with
added ferrous sulphate. A total of 234 infants, aged 6~12 months, were recruited from 36 nurseries in the Democratic Peoples Republic of Korea (DPRK North Korea) and randomly divided into iron (Fe) and placebo
groups. At baseline, almost half the children had Hb<110 g/L and no significant differences between the two
groups were found with regard to hemoglobin concentration and anemia prevalence. The Fe group received rice
porridge fortified with 10 mg of iron (as ferrous sulfate) per day, added to the water in which the rice was
cooked and the placebo group non-fortified cereal for 6 months. After which, the hemoglobin (Hb), serum ferritin (SF) and packed cell volume (PCV) were measured and it was found that the proportion of children with
anemia (Hb<110 g/L) was lower (24.3% v 48.1% p< 0.01), the Hb levels (117.6 g/L v 109.8 g/L p<0.001) and
serum ferritin were higher (40.7 v 26.8 mcg/L p<0.001); and iron deficiencyanemia (Hb<110 g/L, SF<12
mcg/L) was lower in the Fe group (3% v 22% p<0.001) when compared to the placebo group. Ferrous sulphate,
added to the water in which rice was cooked, lowered the prevalence of iron deficiency anemia of infants in the
DPRK with no adverse reactions. Thissimple fortification would be suitable as a nationwide program in the
DPRK and other countries with large infant nurseries.
Asia Pac J Clin Nutr. 2008;17(2):264-269.doi:
>>Abstract
>> Download PDF
Nutrient intake risk factors of osteoporosis in postmenopausal women
Author:Jeongseon Kim PhD, Sun-Young Lim MPH and Joo-Hak K
Keywords:nutrient, diet, osteoporosis, menopause, risk
Abstract:This study was conducted to assess the association between dietary nutrient intake and osteoporosis risk in postmenopausal women. Bone mineral density was measured at the lumbar spine by dual-energy X-ray absorptiometry and a structured questionnaire was administered by a trained interviewer, which included information on sociodemographics, medical and reproductive history, and dietary intake. The study sample included 134 osteoporotic and 137 non-osteoporotic subjects between the ages of52 and 68. Nutrient variables were classified into
tertiles. Odds ratios and 95% confidence intervals (CI) were calculated which compared the highest tertile with
the lowest tertile as a reference group. Odds ratios for osteoporosis were 1.47 (95% CI: 1.03 – 2.05) for total protein, 1.62 (95% CI: 0.51 – 3.92) for animal protein, and 2.98 (95% CI: 1.42 – 4.23) for sodium. Odds ratios for
osteoporosis in the highest tertile were: 0.42 (95% CI: 0.23 – 0.83) for vegetable protein, 0.72 (95% CI: 0.51 –
0.90) for Ca, and 0.65 (95% CI: 0.49 – 0.88) for Fe, relative to the respective lowest tertile. These findings suggest that adequate nutrient intake may be important for prevention of osteoporosisin postmenopausal women.
Asia Pac J Clin Nutr. 2008;17(2):270-275.doi:
>>Abstract
>> Download PDF
Serum zinc levels amongst pregnant women in a rural block of Haryana state, India
Author:Priyali Pathak PhD, Umesh Kapil MD, Sada Nand Dwiv
Keywords:Serum zinc levels, zinc deficiency, pregnant women, pregnancy, rural India
Abstract:Introduction: Zinc deficiency is wide spread in developing countries. Its deficiency during pregnancy has been
documented to be associated with growth retardation,congenital abnormalities, and low birth weight. Limited
community based data is available on the serum zinc levels during pregnancy from Haryana State, India. Hence
the present study was undertaken. Methods: A community based cross sectional study was conducted amongst
283 pregnant women with gestational age of 28 weeks or more. Each pregnant woman was inquired about her age,
obstetric profile, socio-economic status, and other demographic parametersby utilizing a pre-tested semistructured questionnaire. Blood from the antecubital vein was drawn to assess the serum zinc levels utilizing the
atomic absorption spectrophotometer. Nutrient intake was assessed by the standard 24-hr dietary recall method.
Statistical tests were applied to the data collected. Results: Mean serum zinc level was 61.1 ± 16.6 µg/dL. Almost
64.6% of the women had zinc deficiency. The dietary data revealed that 58.9 % of the women were consuming
calories less that 75% of the recommended, indicating an overall poor food intake. Dietary zinc intake revealed
that 86.2 % of the women were consuming less than 50%of the recommended (15 mg). A high prevalence of
zinc deficiency (64.6%) was found amongst the pregnant women possibly due to the low dietary intake of zinc.
There is a need to undertake multi-centric studies in variousparts of the country to assess the serum zinc levels,
magnitude of zinc deficiency and factors leading to zinc deficiency amongst pregnant women in India.
Asia Pac J Clin Nutr. 2008;17(2):276-279.doi:
>>Abstract
>> Download PDF
Dietary supplementation by older adults in Japan
Author:Fumi Hirayama MPH, Andy H Lee PhD, Colin W Binns M
Keywords:dietary supplement, older adults, prevalence, Japan
Abstract:This study documented the prevalence and pattern of dietary supplements usage among older adults in Japan.
Persons aged 55-75 years residing in middle and southern Japan were recruited and interviewed face-to-face on
their use of dietary supplements. Among the 572 (355 male and 217 female) participants from 10 prefectures,
45.8% took supplements on a weekly ordaily basis, the prevalence was higher for women (52.5%) than men
(41.7%). Many types of miscellaneous supplements were consumed. The most popular supplement was vinegar
for both men (11.0%) and women (15.2%), followed by energy drink (8.5%) for men, and multivitamin (8.5%)
for men and vitamin C (8.3%) for women. The findings suggested an increasing trend of dietary supplementation
by Japanese older adults when compared to previous studies.
Asia Pac J Clin Nutr. 2008;17(2):280-284.doi:
>>Abstract
>> Download PDF
Prevalence of malnutrition in free living elderly people in Iran: a cross-sectional study
Author:Maliheh Aliabadi MSc, Masood Kimiagar PhD, Majid G
Keywords:Free living elderly people, nutritional status, socioeconomic conditions (SEC), Body mass index (BMI)
Abstract:Introduction:The elderly are a particularly vulnerable group. Malnutrition is common and increases an old person’s vulnerability to disease. We determine the prevalence of malnutrition in free living elderly people and its
relationship with nutritional status and some ocioeconomic conditions. Methods:Nutritional status and its relationship with socioeconomic conditions were evaluated using Mini Nutritional Assessment in free-living elderly
people (n=1962 using cluster sampling,917 male/1045 female, aged>60). Results:Among the population,
42.7% were well nourished, 12.0% malnourished and 45.3% at risk of malnutrition. There was more malnutrition in females compared to males (13% vs. 10.8%; p<0.001), rural than urban (14.8% vs. 9.9%; p<0.001), non
educated than educated (13.3% vs 6.9%; p<0.001), lonely than living with family (17.5% vs. 10.3%; p<0.001),
unemployed than employed (13.3% vs. 6.3%; p<0.05), elderly on income support (Behsisty charity) compared
with elderly on retirement salary, (41.7% vs. 3.3%; p<0.05). Total Mini Nutritional Assessment scores correlated
significantly with length of education,age, waist circumference, and body mass index (r =0.426, -0.142, 0.355
and 0.269 respectively). Conclusion:This study revealed a 12% malnutrition prevalence in this elderly group,
with higher percentages in special socioeconomic conditions. Health care providers need to be aware of this
problem and its scope. These results reinforce the need to screen, monitor and support elderly people.
Asia Pac J Clin Nutr. 2008;17(2):285-289.doi:
>>Abstract
>> Download PDF
The relevance of the Heart Foundation of Australia’s dietary recommendations for adult Australians: a comparison of views of general practitioners, cardiologists and dietitians
Author:Sylvia Pomeroy PhDand Anthony Worsley PhD
Keywords:General practitioners, Cardiologists, Dietitians, Food based dietary recommendations, Food selection recommendations
Abstract:Purpose: To compare the views of general practitioners, cardiologists and dietitians about the relevance of the
Heart Foundation of Australia’s dietary recommendations for adult cardiac patients. Basic procedures: Quantitative-cross sectional study. Postal questionnaires wereself-completed by 248 Victorian general practitioners
(30% response), 189 Australia-wide cardiologists (47% response) and 180 Victorian dietitians (45% response).
Responses were represented as percentages and analyses of variance were conducted to explore the impact of the
independent variables: age, work status and gender on the dependent variable: dietary recommendation.Main
findings: Approximately half of the recommendations were viewed as stronglyimportant to implement; these
related to lean meats, limiting takeaways and cakes/biscuits, and adjusting energy intake. Others of importance
were eating fruits, vegetables and fish. However, most of these goals were seen as difficult to achieve. Dietitians
appeared to share responses of doctors, except for greater importance of eating fruit and vegetables and a greater
difficulty in limiting cakes and biscuits. There was a high level of agreement among the three groups (mean 87%)
about patients having difficulty implementing adjusting energy intake. Conclusions: There is agreement
amongst these professionals that many of the recommendations lack importance, specifically those pertaining to
unsaturated oils, low fat dairy products, cholesterol rich foods, intake of legumes and grains and the restriction of
salt. This may reflect a need for further nutrition education.
Asia Pac J Clin Nutr. 2008;17(2):290-296.doi:
>>Abstract
>> Download PDF
Assessing physical activity in an Asian country: Low energy expenditure and exercise frequency among adults in Taiwan
Author:Jackson Pui Man Wai PhD, Chi Pang Wen MD DrPH, Hui
Keywords: Exercise, Kilocalorie, Leisure-time physical activity, Prevalence
Abstract:Leisure-time physical activity (LTPA) has been closely related to health improvement. The under-appreciation
for energy output by nutritionists stems in part from limited data expressed in caloric equivalent. We converted
the frequency, duration, and intensity of LTPA, reported from 15,390 adults in the Taiwan National Health Interview Survey 2001, into kilocalories (kcal). Half of Taiwanese adults admit to noLTPA. Women, lower education or income, younger age, smokers and chewers of betel quid; exercised significantly less than their counterparts. Less than 1/5 (18.9%) of the population in Taiwan was physically active at ≥750 kcal/week, and only 1/7
(13.9%) reached a more desirable goal of ≥1,000 kcal/week, compared with 1/3 in the U.S. The most disconcerting finding was the Taiwan unique U-shaped prevalencefor males, with the 25-44 age group being the least
active, ≥65 age group being the most active; and S-shaped for females, lowest at age 18-24 years and highest at
the two older groups (45-64 and ≥65 years). LTPA was under-appreciated, particularly among the most productive work force (25-44-year group), who exercised with a prevalence only 1/4 of their U.S. counterparts. Expressing LTPA in kcal makes direct comparison easier. Invoking a goal of ≥750 kcal/week for Asians, attainable
by exercising 4 hours/week, can facilitate nutritionists in assessing LTPA adequacy. Currently, 4/5 of adults in
Taiwan failed to reach this goal. Recognizing the concept of cumulative energy expenditure, in contrast to disciplined daily work for 5 or more days, will encourage the infrequent exercisers such as “weekend warriors” to
continue with their activities.
Asia Pac J Clin Nutr. 2008;17(2):297-308.doi:
>>Abstract
>> Download PDF
A participatory assessment of dietary patterns and food behavior in Pohnpei, Federated States of Micronesia
Author:Allison Corsi MPH, Lois Englberger PhD, Rafael Flo
Keywords:Micronesia, dietary patterns, type 2 diabetes, obesity, nutrition transition
Abstract:Non-communicable diseases are escalating rapidly within the Pacific region, including Pohnpei, Federated States
of Micronesia. A shift in dietary patterns from indigenous, high fiber, healthy local food to energy-dense, imported food with low nutritional value, and increased sedentary lifestyles are expediting this process. Essential to
counteract this trend is an understanding of how people make food decisions. This participatory assessment utilized a quantitative and qualitative approach to capture diet patterns and knowledge, attitudes, beliefs and practices of food consumption. A structured 7–day food frequency questionnaire (FFQ) was used to quantify the diets of 293 adult Pohnpeian women attending an island-wide education/disability screening program. An ethnographic approach, including in-depth interviews, informal focus groups and observations documented food behavior practices and contributed to the design of the FFQ. Of those responding to the FFQ, 96% reported eating
rice frequently (3-7 days/week) whereas 75% reported eating locally grown carbohydrate foods frequently. Factors associated with culture change, including availability, affordability, convenience, and status of food items
were found to determine food decisions. Food-based, culturally sensitive and innovative strategies that utilize existing resources are required to promote local food production and consumption. Prevention programs with an information, education and communication (IEC) approach are needed to provide accurate and available health
and nutrition knowledge and to increase the demand for local foods. Behavior modification requires the continued collaboration of the national, state, and community organizations that partnered on this research to strategize
programs in order to target individual food choices and to transform the environment to support these decisions.
Asia Pac J Clin Nutr. 2008;17(2):309-316.doi:
>>Abstract
>> Download PDF
The extent and nature of “health messages” in magazine food advertising in Australia
Author:Sandra C Jones MBA MAssessEval MPH PhD, Kelly L An
Keywords:health claims, health messages, food standards, advertising, magazines
Abstract:Objective: To quantify the extent and nature of healthy eating messages Australian consumers are currently exposed to through magazine advertising. Method: Analysisof healthy eating messages in advertisements found in
the top 30 Australian magazines between January and June 2005 was conducted. Advertisements were analysed
and classified by source, subject, food category, food type, food occasion, type of claim and disease type. Results: A total of 1,040 advertisements were identified which contained a healthy eating message; after removing
duplicates, 390 advertisements were analysed. Culinary and women’s magazines contained the greatest number
of healthy eating messages. The most frequently occurring food category utilising a health message in an advertisement was dairy and dairy substitutes (71/390), closely followed by fruit and fruit juice (70/390). Overall, 31
advertisements referred to a specific disease, health problem, or risk factor and the most commonly mentioned
were heart disease/heart-attack (12) cancer (seven) and diabetes (five). Conclusions: Majority of healthy eating
messages currently advertised are by manufacturers, double thatof retailers, with non-commercial sources representing only 2%. Processed foods werethe most commonly advertised food form which contained a healthy eating message, this is of concern given the generally low nutritional value of these foods. Overall, there are a large
number of advertisements in Australian magazines that contain healthy eating messages that may have the potential to communicate to consumers that there are health benefits associated with the consumption of certain foods.
Implications: Future research to assess the accuracy of the information in such advertisements, and to examine
consumer interpretations of these health message are important.
Asia Pac J Clin Nutr. 2008;17(2):317-324.doi:
>>Abstract
>> Download PDF
Association between C677T/MTHFR genotype and homocysteine concentration in a Kazakh population
Author:Ainur Akilzhanova MD PhD, Noboru Takamura MD PhD,
Keywords:folate, homocysteine, Kazakh, 5,10-methylenetetrahydrofolate reductase
Abstract:We recently suggested that due to insufficient intake of vegetables, low folate status and mild homocysteinemia
might exist in the Kazakh population. To clarify the determinants of homocysteine concentrations among this
population, we determined concentrations of serum folate, albumin, creatinine, vitamin B12
, and the C677T/
MTHFRgenotype in 110 Kazakh individuals and compared these with plasma total homocysteine. In Kazakh,
after adjustment for age and sex, folate was correlated with plasma total homocysteine, whereas concentrations
in those with the TTgenotype was almost twice as high as in those with the CCand CTgenotypes (19.7±1.8
mol/L vs. 10.7±0.5 mol/L, p<0.001). Our results suggest that the C677T/MTHFRgenotype is associated with
homocysteine concentrations in this population and this association might be affected by other factors, such as
folate status.
Asia Pac J Clin Nutr. 2008;17(2):325-329.doi:
>>Abstract
>> Download PDF
High plasma homocysteine is associated with the risk of coronary artery disease independent of methylenetetrahydrofolate reductase 677C→T genotypes
Author:Ping-Ting Lin PhD, Men-Chung Huang PhD, Bor-Jen Le
Keywords:methylenetetrahydrofolate reductase, gene polymorphism, homocysteine, B-vitamins, coronary artery disease
Abstract:Hyperhomocysteinemia is an independentrisk factor for coronary artery disease (CAD). The aim of this study
was to investigate the relations between the methylenetetrafolate reductase (MTHFR) 677C →T genotypes, Bvitamins (folate, vitamin B-12 and B-6), homocysteine and the risk of CAD. In this case-control study, patients
who were identified by cardiac catheterization as having at least 50% stenosisof one major coronary artery were
assigned to the case group (n= 121). Healthy individuals with normal blood biochemical values were assigned to
the control group (n = 155). Healthy subjects were matched to case subjects for age. The concentrations of
plasma homocysteine, serum folate, vitamin B-12, plasma pyridoxal 5’- phosphate (PLP) and MTHFR677C→T
gene polymorphism were obtained. The T-allele carriers had significantly higher plasma homocysteine concentration compared to subjects with the 677CC genotype. The MTHFR677C→T genotypes were associated with
plasma homocysteine after adjusting for various potential risk factors in the case and pooled groups. The
MTHFRgenotypes were found to have no associations with the risk of CAD.However, plasma homocysteine (≥
12.5 μmol/L) (OR, 3.49; 95% CI, 1.23 – 9.88) had a significant association with increased risk of CAD even after additionally adjusted folate status. High plasma homocysteine concentration had a direct effect on the risk of
CAD independent of MTHFR677C→T genotypes.
Asia Pac J Clin Nutr. 2008;17(2):330-338.doi:
>>Abstract
>> Download PDF
Body mass index (BMI) as a major factor in the incidence of the metabolic syndrome and its constituents in unaffected Taiwanese from 1998 to 2002
Author:Feng-Yu Yang MPH, Mark L Wahlqvist MD, Meei-Shyuan
Keywords:BMI, incidence, metabolic syndrome, metabolic abnormalities, Taiwan
Abstract:A large health screening program in Taiwan with members who have periodic checks provides an opportunity to
track individuals who are healthy at baseline for the emergence of the metabolic syndrome (MS) and its component disorders. The syndrome comprised abdominal obesity assessed by waist circumference, high fasting serum
glucose (FSG), high triglyceride (TG), low high density lipoprotein-cholesterol (HDL-C) and high blood pressure. A cohort of 9,785 adults (4,707 men and 5,078 women), aged 19 to 84 years, who were free from the MS at
baseline were followed for 4 years from 1998 to 2002. Using Asian criteria for abdominal obesity and reducing
the threshold for FSG from ≥110 mg/dL to ≥100 mg/dL, the incidence of MS during the 4-year follow up in the
MJ Health Screening Center Study inTaiwan was 12.7% (17.5% for men and 8.3% for women). The incidence
of the MS in men exceeded that for women up until 50-59 years and then this gender was reversed in the older
age groups pointing to pre-menopausal protection in women.The most evident manifestations of the incident of
metabolic abnormalities were high FSG, high blood pressure and high TG, particularly in post-menopausal
women. Baseline body mass index and age were the most significant predictors of MS for both men and women,
with cigarette smoking significantly predictive in men. Incident information should inform preventive and intervention strategies in Taiwanese, both Chinese and Indigenous, more effectively thanMS and its component disorder prevalences.
Asia Pac J Clin Nutr. 2008;17(2):339-351.doi:
>>Abstract
>> Download PDF
HPV-induced recurrent laryngeal papillomatosis: dietary fatty acid and micronutrient intakes
Author:Louise Louw PhD 1 and Corina Walsh PhD
Keywords:Papillomatosis, fatty acids, micronutrients, immunodeficiency, immunonutrition
Abstract:Human papilloma virus (HPV)-induced recurrent laryngeal papillomatosis (RLP) is a chronic debilitating disease
often encountered among children of poor socio-economic South African groups. There are a few studies and
limited evidence as to what extent nutrition may contribute to this disease. To our knowledge this is the first
study that gives an account of dietary FA and micronutrient intakes in RLP patients, according to food frequency
questionnaires. The dietary FA profile revealed an excessive linoleic acid (LA) intake syndrome and is also
marked by high palmitic acid (PA), oleic acid (OA) and SFA intakes. Research revealed that enhanced LA and
PA drive, respectively, mitogenetic stimuli and apoptotic resistance during tumorigenesis, whist SFAs are associated with lipid rafts, the Th1 immune response and immunosuppression. Low folateintake, a risk for HPVinfection, and low Zn intake, detrimental for lipid metabolism and immunocompetence,occurred in, respectively,
70 % and 20% RLP patients. The poor correlations that werefound in RLP patients between essential fatty acids
(EFAs) and micronutrients, namely, Mg, Zn and Se, involved in lipid metabolism and immuneresponses, need
proper clarification. Overall, it is plausible that the diet (poor nutrition), a shift in lipid metabolism caused by
HPV- infection, environmental smoke and oxidative stress, as well as extra-esophageal acid reflux with secondary inflammation in the larynx are co-factors in the etiology of laryngeal papillomatosis, and that immunocomprised patients are subjected to recurrence. It is imperative to ensure that children with RLP receive proper nutrition and follow a healthy lifestyle to prevent disease recurrence after treatment.
Asia Pac J Clin Nutr. 2008;17(2):352-357.doi:
>>Abstract
>> Download PDF
