Asia Pacific Clinical Nutrition Society Award for 2009
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Asia Pac J Clin Nutr. 2009;18(1):i.doi:
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Serum antioxidants and age-related macular degeneration among older Japanese
Author:Takehiro Michikawa MD, Susumu Ishida MD, Yuji Nish
Keywords:serum antioxidants, Age-related Macular Degeneration (AMD), diet, aged, Japan
Abstract:From the perspective of human nutrition, the prevention of age-related macular degeneration (AMD) through
diet control is feasible and desirable. We investigatedthe relationship between serum antioxidants and AMD in
the community-dwelling older Japanese eating a typical Japanese diet. In thisstudy, 722 subjects aged 65 years
or older (297 males and 425 females) who had gradable fundus photographs were included. The subjects were
divided into three groups of early or late AMD ornon-maculopathy. Serum antioxidants (alpha-, gammatocopherols, retinol, beta-cryptoxanthin, alpha-, beta-carotenes, lycopene, and lutein and zeaxanthin) were measured with high-performance liquid chromatography. To clarify the combined effect as the group of the antioxidants, we defined the carotene family (alpha-, beta-carotenes and lycopene) and carotenoid family (betacryptoxanthin, alpha-, beta-carotenes, lycopene, lutein and zeaxanthin). Tertiles of each serum antioxidant were
obtained and the prevalence of early or late AMD was compared with univariate or multivariate analysis. The
overall prevalence of early AMD was 4.4% (95% confidence interval: 3.1-6.2) and late AMD was 1.1% (0.5-2.2).
Only alpha-tocopherol and beta-cryptoxanthin were related to late AMD as single antioxidants. On the other
hand, the carotene and carotenoid families as a combination of antioxidants were protectively associated with
late AMD. No relationship was found between serum antioxidants and early AMD. Our findings support the hypothesis that a combination of serum antioxidants obtained from the traditional Japanese diet is protective for
late AMD, but not for early AMD.
Asia Pac J Clin Nutr. 2009;18(1):1-7.doi:
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Lentil-based high protein diet is comparable to animalbased diet in respect to nitrogen absorption and nitrogen balance in malnourished children recovering from shigellosis
Author:Md Iqbal Hossain DCH, M Munirul Islam PhD, M Abdul
Keywords:lentil-based high protein diet, animal-based high protein diet, nitrogen absorption, nitrogen balance, malnutrition
Abstract:Previous studies showed better absorption of protein and catch-up growth with animal-based high protein (15%
energy from protein) diets (AP) than plant-based diets. This study compared the intake and absorption ofnutrients from a lentil-based high protein (15% energy from protein) diet (LenP), AP, and a low protein (7.5% energy
from protein) diet (LP). A total of 31 moderately malnourished 24 to 59 month old children convalescing from
shigellosis were randomised to these three diets: LenP (n=11), AP (n=9) and LP (n=11). After two weeks adaptation with the respective diets, a 72-hour metabolic balance study was performed. The children’s baseline characteristics were comparable among the groups (one exception:children of LP group were less stunted). The costs
of 1,000 kcal from LenP, AP and LP diets were 0.15, 0.75 and 0.11 US dollar, respectively. Average daily energy intake (115-119 kcal/kg/d), coefficients of carbohydrate (89-91%), fat (80-90%), and energy (87-89%) absorption were similar in all groups. Mean±SD coefficient of nitrogen absorption (%) and nitrogen balance
(g/kg/day) were 81±6 and 0.35±0.21 in LenP, 82±5 and 0.36±0.08 in AP, and 73±4 and 0.13±0.06 in LP groups,
respectively (for both the nitrogen absorption and balance comparisons: LenP vs. AP, p>0.05; LenP vs. LP,
p<0.05; AP vs. LP, p<0.05). The results showed higher absorption ofnitrogen and its balance from high protein
diets whether derived from lentil or animal source, which may enhance tissue protein deposition. A lentil-based
high protein diet, which is less expensive, may be useful for nutritional rehabilitation of moderately malnourished children.
Asia Pac J Clin Nutr. 2009;18(1):8-14.doi:
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Stunting and zinc deficiency among primary school children in rural areas with low soil zinc concentrations in Jiangsu Province, China
Author:Yu Qin MSc, Alida Melse-Boonstra PhD, Jinkou Zhao
Keywords:zinc deficiency, stunting, anaemia, children, China
Abstract:Objective: To assess stunting and zinc deficiency among primary school children in north rural area of Jiangsu
Province with low soil zinc concentrations, eastern partof China. Methods: Two data collection rounds were
conducted. In the first data collection round, 2268 primary school children aged 6-9 years were included by cluster sampling from three counties with low soil zinc concentrations. Anthropometric measures were assessed and
stunting was defined as a z-score of height-for-age (HAZ) below -2 according to the WHO new Growth Standards in 2006. For the second data collection round, the county with the highest prevalence of stunting was selected. From this county, 297 children aged 6-9 years were recruited by cluster sampling. Anthropometric measures, serum and hair zinc, and haemoglobin were measured at this stage. Results: The total prevalence of stunting (HAZ < -2) and mild stunting (-2 ≤HAZ< -1) was 4.7% and 22.8% respectively, and Huaián had the highest
prevalence of stunting (8.1%) among the three counties. In Huaián County the prevalence of zinc deficiency
based on serum zinc concentration, hair zinc concentration, and both was 0.7%, 15.2% and 15.3%, respectively,
and 32.3% of subjects were anaemic. Boys had a higher prevalence of zinc deficiency than girls (19.1 vs. 10.5%,
p< 0.05), whereas the prevalence of anaemia in boys was lower than that in girls (28.2 vs. 37.3%, p= 0.07).
Conclusion: Stunting and zinc deficiency were not highly prevalent among primary school children in rural
counties with low soil zinc concentrations of Jiangsu Province.
Asia Pac J Clin Nutr. 2009;18(1):15-21.doi:
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Mental retardation is associated with plasma omega-3 fatty acid levels and the omega-3/omega-6 ratio in children
Author:Yasmin H Neggers DrPH, Eun-Kyung Kim PhD, Ju-Mi So
Keywords:plasma omega-6 fatty acids, omega-3 fatty acids, docosahexanoic acid, mental retardation, children
Abstract:There is evidence that alteration in plasma fatty acid composition may play a role in certain neurological disorders. This case control study was conducted to evaluate the association between plasma fatty acid levels and
mental retardation in Korean children. Plasma phospholipid fatty acids, plasma lipids, dietary fatty acids and selected nutrients were measured in 31 mentally retarded boys (mean age 9.93 ±1.5 yrs) and matched controls. Total plasma omega-3 fatty acids (Σω3), docosahexaenoic acid (DHA) and high density lipoprotein (HDL) concentrations were significantly lower and the Σomega-6/Σomega-3 ratio was significantly higher in cases than in controls. The odds in favor of mental retardation increased by 69 % for each unit increase in the Σomega-6/
Σomega-3 ratio (adjusted odds ratio = 1.69, 95% CI= 1.25-2.29). Significant variation in plasma Σomega-3 and
the Σomega-6/ Σomega-3 ratio was explained by mental retardation and plasma HDL concentrations (45% and
37 % respectively). There was a significant inverse association between plasma DHA and mental retardation.
For each unit increase in plasma DHA, odds of mental retardation decreased by 74 %. There was no significant
difference in either total dietary fat or fatty acids intakes between cases and controls. The energy intake of cases
was significantly higher than the controls. These results suggest that proportion of plasma Σomega-3 fatty acids,
particularly, DHA, and the Σomega-6/ Σomega-3 ratio are associated with mental retardation in children in this
study.
Asia Pac J Clin Nutr. 2009;18(1):22-28.doi:
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Serum vitamin D status of Korean postmenopausal women during the winter months
Author:Eun Sil Lee MD， Jihyun Ahn MD and Hyoung Moo Park
Keywords:vitamin D status, Korea, postmenopausal women, winter, vitamin D supplements
Abstract:Objective: To determine the vitamin D status of Korean postmenopausal women during the winter months according to the intake of vitamin D supplements. Design: Cross sectional study of serum 25(OH)D levels according to the intake of vitamin D supplements in postmenopausal women. Method: Between November 2006 and
February 2007, 254 postmenopausal women who visited our menopausal clinic for hormone therapy or osteoporosis medication were recruited. Serum 25(OH)D levels were measuredwith a radioimmunoassay kit and the results were compared among groups thatwere classified according to the intake amount of vitamin D supplements. Results: The mean serum 25(OH)D level was 83.3 ±32.8 nmol/L and it increased as the intake amount of
vitamin D supplements increased. The mean serum 25(OH)D level was notsignificantly different between
groups 1 (no vitamin D supplements) and 2 (daily 100-300 IU supplements). However, the mean serum
25(OH)D level was significantly higher in group 3 (daily 400 IU supplements) than in group1. While the mean
value of group 4 (daily 600 IU) was notsignificantly different from that ofgroup 3, it was significantly lower
than that of group 5 (daily 800-900 IU). Conclusion: Vitamin D supplementation is highly effective in improving
vitamin D status and the vitamin D status in this study population was improved considerably when compared to
previous studies. Therefore, it is concluded that the prevalence of vitamin D insufficiency should be re-evaluated
in postmenopausal women in most countries including Korea.
Asia Pac J Clin Nutr. 2009;18(1):29-33.doi:
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Iodine status and thyroid function of pregnant, lactating women and infants (0-1 yr) residing in areas with an effective Universal Salt Iodization program
Author:Yanling Wang PhD, Zhongliang Zhang MS, Pengfei Ge
Keywords:iodine nutrition, iodized salt, thyroid hormone, urine iodine concentration, milk iodine concentration
Abstract:Objective: To assess the iodine nutrition and thyroid function of pregnant women, lactating women and infants
residing in areas where the Universal Salt Iodization program is in place. Methods: Pregnant women,lactating
womenand infants were selected randomly in the regions where iodized salt coverage rate is more than 90%
since 2000. Urine iodine levels of pregnant woman, lactating woman and infants, milk iodine of lactating woman,
thyroid-stimulating hormone (TSH) and free T4 of women were tested respectively. Results: Median Urinary Iodine (MUI) of infants, three groups of pregnant women (first, second and third trimester) and two groups lactating women (breastfeeding less than or more than six months) were 233, 174, 180, 147, 126 and 145 μg/L, respectively. Median milk iodine of lactating women was 163 μg/L. Percentage of milk iodine < 150 μg/L of early
lactating women was 40% less than that of late lactating women (p < 0.01).There was a positive correlation between urine iodine of infants and milkiodine of lactating women (r = 0.526, p = 0.000). T4 of two women were
above or below the reference range. Total 15.4% women’s TSH were abnormal. Most of these women’s urinary
iodine were lower than 150 μg/L. Conclusion: Iodine status of most of the target population for Universal Salt
Iodization program is adequate, but iodine deficiency stillexisted in some. To assure every new life’s brain not
be damaged by iodine deficiency, iodine status of targeted populations should be monitored and supplements
provided according to the monitoring outcomes.
Asia Pac J Clin Nutr. 2009;18(1):34-40.doi:
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Micronutrient status in anemic and non-anemic Chinese women in the third trimester of pregnancy
Author:Ai-Guo Ma MD, Evert G Schouten MD, Yu Wang MD, Ron
Keywords:anemia, pregnancy, micronutrient, vitamin, iron
Abstract:Background: Anemia is a major nutrition related problem inChina. In addition to iron deficiency this may be
due to deficiencies of other micronutrients. Objective: To describe the micronutrient status of anemic and nonanemic pregnant women in China. Subjects and Methods: 734 clinically normal pregnant women in the third
trimester aged 20-35, were randomly recruited from the population of pregnant women regularly receiving pregnant examination in community medical centers. Serum concentrationsof vitamins A, B12 and C, iron and zinc
status parameters, and vitamin B2in urine were determined. Subjects were categorized according to the presence
or absence of anemia and compared according to micronutrient status. Results: Serum concentrations of iron and
micronutrients were significantly lower in anemic women than non-anemic women: serum iron 909 µg/L versus
1109 µg/L, ferritin 13.8 µg/L versus 19.6 µg/L, vitamin C 308.9 µg/L versus 388.1 µg/dL, and retinol 50.0
µg/dL versus 59.3 µg/dL. Zinc concentrations were also lower in anemic women. Subnormal serum iron (<700
µg/L) and iron depletion (ferritin <12 µg/L) were 39.7% and 52.6%, significantly more frequent in anemic than
23.9% and 35.0% in non-anemic subjects, as were subnormal vitamin A and ascorbic acid. Subnormal vitamin
B2and B12were frequent in both anemic and non-anemic groups. Conclusion: Subnormal concentrations of iron
and micronutrients in combination may contribute to thissituation. Further studies on food-based or supplementbased approaches trying to increase intake of iron and certain vitamins are warranted to decrease anemia in
pregnant Chinese women in the third trimester.
Asia Pac J Clin Nutr. 2009;18(1):41-47.doi:
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Nutritional status among postmenopausal osteoporotic women in North West of Iran
Author:Jalal Hejazi MSc, Javad Mohtadinia, Sousan Kolahi
Keywords:osteoporosis, postmenopausal, nutritional status, bone density, calcium
Abstract:Background: Osteoporosis is a multifactorial disease and one of the most important modifiable factors in the development and maintenance of bone mass is nutrition. Objective: The aim of this study was to determine the nutritional status among osteoporotic postmenopausal women in north west of Iran and compare intake of several
nutrients important in terms of bone health with the standard values (DRIs). Design: Bone mineral density of the
left proximal femur, the lumbar spine and total hip were measured using dual-energy X-ray absorptiometry.
Ninety-seven postmenopausal osteoporotic women were studied. A validated food frequency questionnaire was
used to determine food habits and 24-h recall was used to estimate average energy and nutrient intakes. Results:
The mean t-score for bone mineral density (BMD) of LS, FN and total hip were -3.15 ± 0.73, -1.93 ± 0.86 and -1.92 ± 0.88, respectively. The percentages of participantsreceiving adequate intake of calcium, vitamin D and
vitamin K were 7.2%, 3.1% and 42.3%, respectively. The mean phosphate to calcium ratio was 1.6 ± 0.87. BMD
of femoral neck and total hip was correlated inversely with the amount of energy obtained from fat and positively with energy intake. Among micronutrients studied, calcium was positively correlated with BMD of total
hip. Conclusion: Most of the postmenopausal osteoporotic women in north west of Iran have a considerable deficiency in terms of energy and some micronutrients such as calcium, vitamin D and magnesium, which can be
deleterious for bone health.
Asia Pac J Clin Nutr. 2009;18(1):48-53.doi:
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Nutritional risk, malnutrition (undernutrition), overweight, obesity and nutrition support among hospitalized patients in Beijing teaching hospitals
Author:Xiaokun Liang PhD, Zhu-Ming Jiang MD, Marie T Nola
Keywords:Nutritional Risk Screening 2002 (NRS 2002), nutritional risk in hospitalized patient, malnutrition (undernutrition) in hospitalized patient, overweight in hospitalized patient, obesity in hospitalized patient
Abstract:The purpose of this study was to test the suitability of Nutritional Risk Screening 2002 (NRS 2002) among hospitalized patients and to determine the prevalence of nutritional risk, undernutrition, overweight, obesity, nutritional support and the changes of nutritional risk from admission to discharge or over a two-week period. A prospective descriptive design was used to describe patients’data collected at three Beijing teaching hospitals. A total number of 1500 consecutive patients, who met the inclusion criteria on admission and provided informed
consent, were enrolled. The NRS 2002 was completed by 97.7% of all patients in this study. The overall prevalence of nutritional risk was 27.3%, the prevalence of undernutrition, overweight and obesity was 9.2%, 34.8%,
and 10.2%, respectively at admission. Only 24.9% of patients who were at nutritional risk received nutritional
support while 6% of non-risk patients received nutritional support. The overall prevalence of nutritional risk
changed from 27.3% to 31.9% (p < 0.05), and the prevalence of undernutrition, overweight and obesity changed
from 9.2% to 11.7% (p < 0.05), from 34.8% to 31.8% (p > 0.05) and from 10.2% to 8.6% (p > 0.05), respectively during hospitalization. Nutritional Risk Screening 2002 was a feasible nutritional risk screening tool in selected Beijing teaching hospitals. The prevalence of nutritional risk observed was nearly 30%. Inappropriate use
of nutritional support was observed in hospitalized patients. The prevalence of nutritional risk increased in surgical patients during hospitalization.
Asia Pac J Clin Nutr. 2009;18(1):54-62.doi:
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Current and future costs of cancer, heart disease and stroke attributable to obesity in Australia – a comparison of two birth cohorts
Author:Robert J Aitken BEc, Margaret A Allman-Farinelli P
Keywords:obesity, health costs, cancer, stroke, coronary heart disease
Abstract:The obesity epidemic appears set to worsen the morbidity and mortality from leading causes of death in Australia – ischaemic heart disease, stroke and obesity-related cancers. The aim of this study was to compare hospital
separations, deaths and direct health costs for middle-aged adults (45 to 54 years) in 2004/05 with those attaining
age 45 to 54 years in 2024/25 who were born into an obesogenic environment. Using data from National Health
Surveys, prevalence of obesity in 2004/05 was calculated for those born in 1950/51-59/60 and four scenarios
were considered to project rates in 2024/25 for those born in 1970/71-79/80: an age-cohort model; a linear trend
model; a steady state where rates increase to equal those ofthe older birth cohort at the same age; and a best case
where rates remain at 2004/05 levels. Population attributable fractions were calculated by gender and disease using relative risks of disease from the literature, and applied to hospital separations, deaths, and direct health system costs data to estimate the proportion of each attributable to obesity. In 2024/25 the projected number of hospitalizations of 45 to 54 year olds due to the diseases of interest could be more than halved, over 200 lives rescued and $51.5 million (in 2004/05 dollars) saved if further gains in obesity in the younger birth cohort are
halted. Instead, if the worst case scenario is realized there will be a morethan doubling in costs (in 2004/05 dollars) compared with those born in 1950/51-59/60.
Asia Pac J Clin Nutr. 2009;18(1):63-70.doi:
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The repeatability of self reported physical activity patterns in rural South India
Author:Mario Vaz MD, Ankalmadagu Venkatasubbareddy Bharat
Keywords:Physical activity, methods, rural, India, questionnaire
Abstract:The objective of this study was to develop a physical activity assessment questionnaire for use in poorly educated and low socio-economic rural communities in developing countries and assess the repeatability of the
measurements over a one-year duration. Physical Activity Level, as a composite measure of daily physical activity (PAL = estimated 24 hour energy expenditure / estimated basal metabolic rate) was derived from the semipictorial, interviewer based questionnaire assessing physical activity over the previous 1 week. PAL of both men
and women was unchanged across the different seasons of the year. Correlations between the first physical activity questionnaire and the mean of at least 4 questionnaires administered during the course of one year were generally high (males: PAL ‘r’ = 0.69, individual domains ‘r’ between 0.57 and 0.82; females: PAL ‘r’ = 0.7, individual domains ‘r’ between 0.41 and 0.76, all p< 0.05). Within- individual % coefficient variations (CV) across
4 physical activity questionnaires werelow for sleep duration and PAL (< 14%) but high for the other domains
of physical activity (77-100%). The data, at least in this community, suggestthat while within-individual variations in specific domains of physicalactivity may be considerable, the questionnaire that we designed can rank
individuals in terms of their PAL or individual domains ofphysical activity fairly consistently. A single physical
activity assessment using this instrument may therefore be adequate to rank individuals.
Asia Pac J Clin Nutr. 2009;18(1):71-75.doi:
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Food frequency questionnaire is a valid tool in the nutritional assessment of Brazilian women of diverse ethnicity
Author:Junko Ishihara PhD, Motoki Iwasaki PhD, Claudia Mi
Keywords:FFQ, ethnicity, reproducibility, validity, nutritional assessment
Abstract:The objective of this study was to validate a food frequency questionnaire (FFQ) used to estimate energy and selected nutrient intake in a Brazilian population with various ethnic backgrounds. Validity of intake estimated using the FFQ was tested among 55 Brazilian women, namely 26 Caucasians, 15 of Japanese descent, and 14 others. The FFQ was originally developed for use in a case-control study of breast cancerconducted in São Paulo.
Dietary records (DRs) recorded in two seasons were used as references. Intake of energy and 24 nutrients were
calculated using the USDA and Japanese food composition tables. Validity and reproducibility were evaluated
using Spearman’s correlation coefficients. Results showed that intake of chicken/poultry, eggs and legumes were
overestimated by the FFQ compared to the DR, whereas that of pork and fat was underestimated. Further, intake
of folate, fiber and isoflavones was overestimated by the FFQ whereas that of energy, fat, carbohydrate alphacarotene and lycopene was underestimated. Energy-adjusted correlation coefficients between nutrient intakes estimated with the FFQ and DR were high for isoflavones (0.76), calcium (0.50), and vitamin C (0.49). In contrast,
validity varied from moderately high to low for energy and other nutrients. In conclusion, validity of the FFQ for
estimation of the intake of selectednutrients among Brazilian women withvaried ethnic background was moderately high.
Asia Pac J Clin Nutr. 2009;18(1):76-80.doi:
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Hyperuricemia and the metabolic syndrome in Hangzhou
Author:Zhenzhen Cai MSc, Xiaofeng Xu MD, Xiangming Wu MD,
Keywords:uric acid, the metabolic syndrome, correlation, Hangzhou, China
Abstract:The aim of this study was to investigate prevalences of hyperuricemia and the metabolic syndrome (MS) in the
Hangzhou population, and the relationship between serum uric acid and the MS. A cross-sectional study was
conducted among 4155 subjects (2614 men and 1541 women) aged20-80 years, recruited through a health check
program in Hangzhou, China. Biochemical and haematological parameters were measured by standard methods.
The diagnosis of the MS is made when three or four of the following criteria are met: 1) body mess index (BMI)
≥25; 2) systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg; 3) fasting triacyglycerol ≥
1.7 mmol/L (150 mg/dL), high density lipoprotein cholesterol (HDL-C) < 0.9 mmol/L (35 mg/dL) in men and
<1.0 mmol/L (39 mg/dL) in women; 4) fasting glucose ≥6.1 mmol/L (109 mg/dL). Hyperuricemia is defined by
cut-off values of > 420 µmol/L for men and > 360 µmol/Lfor women. Prevalences were 16.9% (N=702) for hyperuricemia and 8.4% (N=349) for the MS. Serum uric acid concentration was significantly higher in males than
in females (p<0.0001), and significantly higher in subjects with obesity, dyslipidemia and hypertension compared with those without. In the partial correlation analysis, after controlling for gender, age and creatinine, serum uric acid concentration was significantly positively correlated with BMI (r=0.301, p<0.0001), systolic blood
pressure (r=0.151, p<0.0001), diastolic blood pressure (r=0.168, p<0.0001), total cholesterol (r=0.144, p<0.0001)
and triacyglycerol (r=0.234, p<0.0001). Results suggest that increased serum uric acid concentration is associated with an increased prevalence of metabolic disorders such as obesity, dyslipidemia and hypertension in the
Hangzhou population.
Asia Pac J Clin Nutr. 2009;18(1):81-87.doi:
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Understanding the differences in obesity among working adults between Taiwan and China
Author:Satoru ShimokawaPhD, Hung-Hao ChangPhD and Per Pin
Keywords: obesity, socioeconomic factors, adults, Taiwan, China
Abstract:Objective: To investigate the difference in the prevalence of obesity and the associations between the risk of
obesity and socioeconomic factors with regard to working adults in China and Taiwan. Data: the 2000 China
Health and Nutrition Survey and the 2001 National HealthInterview Survey in Taiwan, which contains information from 20-60-year-old working adults in China (3,067 men and 2,998 women) and Taiwan (6,475 men and
6,341 women). Method: Variables were converted to cross-economy comparable forms, and the estimated prevalence of obesity across socioeconomic groups was compared between China and Taiwan. Probit models were
used to examine the associations between socioeconomic factors and the probability of being obese. Results: In
China, the prevalence of obesity was higher in the higher income, more educated, and more sedentary occupation groups, while it was higher in the lower income and less educated groups in Taiwan. Also, our results indicate that occupational types rather than income and education levels are more significantly associated with the
probability of being obese in China, whereas income and education levels rather than occupational types are
more significantly associated with the probability of being obese in Taiwan. These findings may indicate that,
when an economy becomes more developed, the association between obesity risk and income and education levels becomes more significant and negative especially among women, while the association between obesity risk
and occupational types decreases especially among men.
Asia Pac J Clin Nutr. 2009;18(1):88-95.doi:
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Effects of masticatory movement on cranial bone mass and micromorphology of osteocytes and osteoblasts in developing rats
Author:Toshikazu Kawakami MS, Sadafumi Takise PhD, Takafu
Keywords:masticatory movement, cranial bone density, osteocytes, osteoblasts, bone lacunae, DMP-1
Abstract:In order to evaluate the influence of masticatory movement on cranial bone mineral density (BMD) and osteocyte and osteoblast micromorphology, weconducted a study in rats fed with solid feed (n=10) and powdered
feed (n=10). Cranial BMD was measured by dual X-ray absorptiometry (DXA). Osteocyte morphology was
evaluated by light microscopy. In addition, some of the tissue was treated with EDTA-KOH to digest the bone
matrix and prepare osteocyte samples. Micromorphology of the osteocytes was examined by scanning electron
microscopy (SEM). Bone mineral content (BMC) was significantly higher in the solid feed group (1.86 ± 0.11 g)
than in the powdered feed group (1.63 ± 0.09 g) (p< 0.05). In the solid feed group, the maximum masseter muscle tension when crushing solid feed was 305 ± 46.0 N. Immunohistochemical staining with DMP-1 showed
greater positive localization of DMP-1 in bone lacunae in the solid feed group than in the powdered feed group.
On examination of cranial bonesections by SEM, the lacunar area was significantly larger in the solid feed
group (0.64 ± 0.08 μm
2
) than in the powdered feed group(0.43 ± 0.10 μm
2
) (p< 0.01). In the solid feed group,
adjacent osteocytes were connected through cytoplasmic branches and reticular cell processes to form a 3-dimensional structure. In the powdered feed group, connecting osteocyte processes weresparser. Results suggest
that masticatory movement stimulates mediator substances involved in dynamic interactions between osteocytes,
increases cranial bone mass during the developmental period and influences osteoblast, osteocyte, and lacunar
micromorphology.
Asia Pac J Clin Nutr. 2009;18(1):96-104.doi:
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Obesity criteria for identifying metabolic risks
Author:Jin-wen WangMD, Da-yi HuMD, Yi-hong SunMD, Jia-hon
Keywords:obesity, waist circumference, metabolic risk factors, ROC curve analysis, Chinese
Abstract:Criteria of obesity in the Chinese population with multiple metabolic risk factors remains unclear. The objective
was to determine the best anthropometrical measurements with regard to the metabolic syndrome (MetS) and to
propose optimal cut-off values. Between April and August, 2007, 3,704 men and 6,392 women aged 18-85 years
were recruited from four communitycenters. Medical examinations included measurement of weight, height,
waist circumference (WC), hip circumference, fasting blood triglycerides(TG), high-density lipoprotein cholesterol (HDL-C), glucose concentrations, and blood pressure (BP). Bodymass index (BMI), waist to hip ratio
(WHR), WC and waist to stature ratio (WSR) were calculated. Four metabolic risk factors were examined: 1)
high BP; 2) high levels of TG; 3) low levels of HDL-C; 4) impaired glucose tolerance. The relationships between studied indices and risk factors were analyzed using partial correlation analyses, analysis of variance
(ANOVA), linear regression, and Receiver Operator Characteristic (ROC) curve analysis. The optimal cut-off
values of each obesity index were calculated using ROC analysis respectively. All obesity indices were positively associated with metabolic risk factors. Area under curve (AUC) of WC was the largest for ≥2 risk factors
after adjustment for age in both genders. Optimal cut-off points for WC were 89 cm inmen, and 80.5cm, 82.5cm,
and 89.5cm in < 40-yr, 40-60-yr, and > 60-yr women respectively. Waist circumference is best associated with
metabolic risk factors among the studied indices in Chinese adults. Indices of abdominal obesity for older age
groups tend to be higher than younger age groups in women.
Asia Pac J Clin Nutr. 2009;18(1):105-113.doi:
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Sustainability of lifestyle changes following an intensive lifestyle intervention in insulin resistant adults: followup at 2-years
Author:Kelly S Dale PhD, Jim I Mann PhD, Kirsten A McAule
Keywords:Weight maintenance, insulin resistance, obesity, diet, physical activity
Abstract:The objective of this study was to determine whether overweight insulin resistant individuals who lost weight
and improved cardiovascular risk factors during a 4-month lifestyle intervention could sustain these lifestyle
changes in the long-term. Seventy-nine insulin resistant adults were randomised to a control group or either a
modest or intensive lifestyle intervention group for 4-months. Thereafter the two intervention groups were combined and all participants were followed-up at 8, 12 and 24 months. Anthropometry, blood pressure, fasting glucose, lipids, insulin and aerobic fitness were measured and dietary intake was assessed. An interview was conducted to determine factors which participants perceived facilitated or hindered maintenance of healthy lifestyle
habits. Seventy-two (91.1%), sixty-nine(87.3%) and sixty-two (78.5%) participants were retained at 8, 12 and
24-month respectively. At 4-months the adjusted difference in weight between the modest and control groups
was -3.4 kg (95% CI -5.4, -1.3) p=0.002 and intensive and control groups was -4.7 kg (-6.9, -2.4) p=0.0001 respectively. At 2-years there were no significant differences for weight when the initial 3 groups were compared
or when the combined intervention group was compared with the control group. At 2-years, 64% of participants
reported that more frequent follow-up would have helped them to maintain healthy lifestyle habits. Even intensive counselling for 4-months with 4-monthly and then yearly monitoring were not enough for maintaining lifestyle changes sufficient to sustain weight loss. More frequent monitoring for an indefinite period was perceived
by two-thirds of participants as necessary for them to maintain their initial lifestyle changes.
Asia Pac J Clin Nutr. 2009;18(1):114-120.doi:
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Effects of supplementation with multivitamin and mineral on blood pressure and C-reactive protein in obese Chinese women with increased cardiovascular disease risk
Author:Cheng Wang PhD, Ying Li PhD, Kun Zhu PhD, Yan-Mei
Keywords:obesity, blood pressure, C-reactive protein,multivitamin and mineral supplementation, Chinese women
Abstract:Objective: To investigate the effect of supplementation with multivitamin and mineral on blood pressure and Creactive protein (CRP) in obese women with increased cardiovascular disease risk as having hypertension, hyperglycemia or hyperlipemia. Subjects and Methods: 128 obese Chinese women aged 18-55 years with increased
cardiovascular disease risk participated in a 26-week randomized, double-blind, placebo-controlled trial. Subjects were randomized to four groups, and received either one tablet of high-dose multivitamin and mineral supplement (MMS), or one tablet of low-dose MMS (Low MMS), or calcium 162 mg (Calcium) or identical placebo (Placebo) daily during the study. Diastolic blood pressure (DBP), systolic blood pressure (SBP) and serum
concentrations of CRP were measured at baseline and end-trial. Results: At baseline, the subjects had an average
age of 42.0±7.1 years and BMI of 30.9±2.8 kg/m
2
. There were no significant differences between the four
groups in baseline characteristics. One hundred and seventeen subjects completed the study. After 26-week supplementation, both SBP and DBP were significantly lower in the MMS group compared to the placebo group (p
< 0.05). There was also a non-significant trend of lower DBP at 26-week in the MMS and calcium groups compared to baseline (p< 0.08). At 26-week, the MMS group also had significantly lower serum concentrations of
CRP compared with that of baseline and the placebo group (p< 0.05). Conclusions: Our results showed that
supplementation with adequate multivitamin and mineral supplement could reduce blood pressure and serum
CRP in obese women with increased cardiovascular disease risk.
Asia Pac J Clin Nutr. 2009;18(1):121-130.doi:
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Prevalence of the metabolic syndrome and its influencing factors among adolescent girls in Mashhad, Iran
Author:Naghmeh-Zahra Mirhosseini MSc, Noor Aini Mohd Yuso
Keywords:metabolic syndrome, adolescent girl, obesity, prevalence, diet
Abstract:Introduction: This study sought to determine the prevalence of the metabolic syndrome, one of the major publichealth challenges worldwide, and itsinfluencing factors among 15 to 17 years old adolescent girls in Mashhad,
Iran. Methods: A total of 622 high school adolescents participated in a cross-sectional study. A self-administered
questionnaire was used to assess socio-demographic characteristics and dietary habits. Anthropometric assessments, blood pressure measurement and biochemical assessment were done.Results: Applying BMI Z-score for
age and gender (WHO 2007), 14.6 % and 3.4 % of subjects were classified as overweight and obese, respectively. Enlarged WC (> 80 cm) was seen in 9.5% of subjects. The prevalence of combined hypertension was
6.1% which was increased by the severity of obesity. A total of 24.5% of subjects had hypertriglyceridemia and
57% of them had low level of HDL-cholesterol. Hyperglycemia was present in16.7% of subjects. Based on the
NCEP ATP III (2001) criteria, the prevalence of the metabolic syndrome was 6.5% and increased to 45.1% in
obese subjects. Increasing BMI or WC, led to significant increment in the number of metabolic syndrome features (p< 0.001). High socioeconomic statusof family, medical history of parents and dietary habits especially
high consumption of carbohydrates were influencing factors in the prevalence of the metabolic syndrome. Conclusion: Approximately 6.5% of all and 45% of obese subjects met the criteria for the metabolic syndrome. Dietary habits especially carbohydrate consumption, socioeconomic status of family and medical history of parents
can be influential factors in the prevalence of the metabolic syndrome.
Asia Pac J Clin Nutr. 2009;18(1):131-136.doi:
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Symposium on Diet, Nutrition and Immunity
Author:Rodolfo F Florentino MD PhD
Keywords:Diet, immune system, micro- and macronutrients, pro- and pre-biotics, Asian foods
Abstract:The symposium on Diet, Nutrition and Immunity held in Singapore on April,2008, reviewed the current scientific information on the development of the immune system particularly in infancy and the role of diet, exercise
and aging on immunocompetence, together with the molecular processes involved. The importance of specific
nutrients particularly zinc and iron, vitamins D and E and long-chain polyunsaturated fatty acids on enhancing
immunity, as well as the significance of maintaining a healthy microbiota in the gut leading to the concept of
pro- and pre-biotics was discussed. Of interest was the presentation ofstudies on some common Asian foods
such as soybeans, wolfberry, and mushroom that may have application in the prevention and treatment of disease
involving inflammatory responses.
Asia Pac J Clin Nutr. 2009;18(1):137-142.doi:
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Book Review and Future Events
Author:
Keywords:
Abstract:
Asia Pac J Clin Nutr. 2009;18(1):143.doi:
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