Securing food from field to table: what can we do?
Author:Duo Li PhD and Mark L Wahlqvist MD FRACP FAFPHM FA
Keywords:ecosytems, FIHS network, agriculture, health systems, food systems
Abstract:Food security has emerged as one of the most pressing socio-economic and health issues of our time. While the
formal processes of international and national governance are short-changing the need for action, an increasing
number of professional science-based organisations are rallying to reduce the presence and risks of food
insecurity. Examples are the Food in Health Security Network (FIHS) for the Asia Pacific region and the
‘Healthy Agriculture, Healthy Nutrition, Healthy People’ initiative of the World Council on Genetics, Nutrition
and Fitness for Health. The common denominator is the threat to ecosytems which are intrinsic to food and
health systems. To increase their prospects for sustainability and health promotion, coordinated partnerships
between agriculture and health as well as other sectors are imperative
Asia Pac J Clin Nutr. 2011;20(2):149-150.doi:
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Action Plan for a Healthy Agriculture, Healthy Nutrition, Healthy People
Author:Artemis P Simopoulos, Ole Faergeman, Peter G Bourn
Keywords:
Abstract:
Asia Pac J Clin Nutr. 2011;20(2):151-153.doi:
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Enteral nutrition is superior to total parenteral nutrition for pancreatic cancer patients who underwent pancreaticoduodenectomy
Author:Changli Liu MS, Zhi Du PhD, Cheng Lou PhD, Chenxua
Keywords:EN, TPN, pancreaticoduodenectomy, biochemical parameter, complication
Abstract:Objective: To determine the effects of total parenteral nutrition (TPN) and enteral nutrition (EN) on biochemical
and clinical outcomes in pancreatic cancer patients who underwent pancreaticoduodenectomy. Methods: From
the year 2006 to 2008, 60 patients who underwent pancreaticoduodenectomy in Tianjin Third Central Hospital
were enrolled in this study. They were randomly divided into the EN group and the TPN group. The biochemical
and clinical parameters were recorded and analyzed between the two groups. Results:There was no significant
difference in the nutritional status, liver and kidney function, and blood glucose levels between the TPN and EN
groups on the preoperative day, the 1
st
and 3
rd
postoperative days. However, on the 7
th
postoperative day, there
was significant difference between the two groups in 24 h urinary nitrogen, serum levels of, total protein (TP),
transferrin (TF), alanine aminotransferase (ALT), aspartate aminotransferase(AST), alkaline phosphatase (ALP),
and γ-glutamyl transpeptadase (GGT), blood urea nitrogen (BUN) and creatinine (Cr). On the 14
th
postoperative
day, there was a significant difference between the two groupsin terms of urinary levels of 24 h nitrogen, TP, TF,
retinol binding protein, ALT, AST, ALP, GGT, total bilirubin, direct bilirubin, BUN, Cr, and glucose. The incidence of delayed gastric emptying inthe EN and TPN groups was 0% and 20%, respectively. Moreover, the incidence of pancreatic fistulas and hemorrhages in the EN group were 3.6% and 3.6%, versus 26.7% and 30% in
the TPN group, respectively. Conclusions: EN is better than TPN for pancreatic cancer patients who received
pancreaticoduodenectomy.
Asia Pac J Clin Nutr. 2011;20(2):154-160.doi:
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A simple meal plan of ‘eating vegetables before carbohydrate’ was more effective for achieving glycemic control than an exchange–based meal plan in Japanese patients with type 2 diabetes
Author:Saeko Imai PhD,Mikuko Matsuda MA,Goji Hasegawa MD,
Keywords: type 2 diabetes, dietary interventions, glycemic control, vegetables, carbohydrate
Abstract:This study aimed to determine whether educating diabetic patients to ‘eat vegetables before carbohydrate’ was as
effective on long-term glycemic control as a traditional exchange-based meal plan. To test this hypothesis, we
carried out a randomized, controlled trial in patients with type 2 diabetes that compared changes in HbA1c as the
primary outcome. A total of 101 patients were stratified according to sex, age, BMI, duration of diabetes, and
HbA1c, and then randomized to receive instructions to eateither vegetables before carbohydrate (VBC, n=69) or
an exchange-based meal plan (EXB, n=32). The impact of the two plans on glycemic control was compared over
24 months of follow-up. Significant improvements in HbA1c over 24 months were observed in both groups
(VBC, 8.3 to 6.8% vs EXB, 8.2 to 7.3%). HbA1c levels were significantly lower in the VBC group than in the
EXB group after 6, 9, 12 and 24 months of the study.Both groups exhibited similar improvements in dietary
practices with respect to intake ofcarbohydrate, fats and sweets, while the VBC group had a significant increase
in consumption of green vegetables and a significant decrease in fruit consumption. A simple meal plan of ‘eating vegetables before carbohydrate’ achieved better glycemic control than an exchange-based meal plan in Japanese patients with type 2 diabetes over a 24-month period.
Asia Pac J Clin Nutr. 2011;20(2):161-168.doi:
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Effect of kiwifruit consumption on sleep quality in adults with sleep problems
Author:Hsiao-Han Lin MS, Pei-Shan Tsai PhD, Su-Chen Fang
Keywords:insomnia, sleep disorders, kiwifruit, antioxidants, sleep quality
Abstract:Numerous studies have revealed that kiwifruit contains many medicinally usefulcompounds, among which antioxidants and serotonin may be beneficial in the treatment of the sleep disorders. The aim of this study was to
evaluate the effects of kiwifruit on sleep patterns, including sleep onset, duration, and quality. In this study, we
applied a free-living, self-controlled diet design. Twenty-four subjects (2 males, 22 females) 20 to 55 years of
age consumed 2 kiwifruits 1 hour before bedtime nightlyfor 4 weeks. The Chinese version of the Pittsburgh
Sleep Quality Index (CPSQI), a 3-day sleep diary, and the Actigraph sleep/activity logger watch were used to assess the subjective and objective parameters of sleep quality, including time to bed, time of sleep onset, waking
time after sleep onset, time of getting up, total sleep time, and self-reported sleep quality and sleep onset latency,
waking time after sleep onset, total sleep time, and sleep efficiency before and after the intervention. After 4
weeks of kiwifruit consumption, the subjective CPSQI score, waking time after sleep onset, and sleep onset latency were significantly decreased (42.4%, 28.9%, and 35.4%, respectively). Total sleep time and sleep efficiency were significantly increased (13.4% and 5.41%, respectively). Kiwifruit consumption may improve sleep
onset, duration, and efficiency in adults with self-reported sleep disturbances. Further investigation of the sleeppromoting properties of kiwifruit may be warranted.
Asia Pac J Clin Nutr. 2011;20(2):169-174.doi:
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Testing the acceptability of liquid fish oil in older adults
Author:Alison Yaxley BSc(Hons), Michelle D Miller PhD, Ro
Keywords:fish oils, older adults, acceptability, taste, adverse effects
Abstract:Inflammatory conditions likely to benefit from fish oil therapy are prevalent in older adults however acceptability in
this group is uncertain. This study aimed to assess the palatability of a range of liquid fish oil concentrations, the
frequency and extent of side effects, and to summarise any effects on adherence to fish oil therapy in older adults.
One hundred patients (≥60 years) completed a randomised, single-blind palatability study, conducted in two
parts. In part one, 50 subjects, blinded to random sample order, consumed multiple liquid fish oil samples
(2x10%, 40% and 100%). In part two, 50 subjects tasted one concentration, or 100% extra light olive oil (control). Pleasantness of taste was scored on a 5-point Likertscale. Side effects were recorded 24-hr post-tasting.
Results of part one showed that 9/50 participants reported increasingly unpleasant taste with increasing fish oil
concentration. 14/50 reported unpleasant taste for 100% fish oil vs 7/50 for 10%. 14/50 reported side effects
which would not affect compliance with therapy. For part two, 1/12 reported unpleasant taste for 100% vs 0/13
for 10% fish oil or control. 4/50 reported side effects and 2/4 indicated these would prevent ongoing fish oil
therapy. The authors conclude that taste itself is not a deterrent to fish oil therapy. Furthermore, reported adverse
effects may not be a true reaction to fish oil, or dissuade patients from compliance. Liquid fish oil supplements
are acceptable to older adults, therefore should be investigated as a therapy for geriatric conditions.
Asia Pac J Clin Nutr. 2011;20(2):175-179.doi:
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Secular changes in growth among Japanese children over 100 years (1900-2000)
Author:Masaharu Kagawa PhD, Yasuaki Tahara PhD, Kazuhiko
Keywords:secular change, Japan, children, height, BMI
Abstract:Human growth is associated with complex interactionsbetween genetic and environmental factors. While research has reported increased body size and body mass index (BMI) of Japanese children, few studies have compared the magnitude of increments ingrowth before and after World War II (WW II) and also considered other
social and economical events that may have influenced the growth of children. The current study assessed the
secular change in growth in Japanese children and adolescents aged between 6 and 17 years using data from the
School Health Statistics Survey conducted between 1900 and 2000 with consideration of key social changes during the 20th Century. Over the 100-year period, Japanese boys had height and weight increments of 1.0-2.0 cm
per decade and 0.4-1.7 kg per decade whereas girls had rates of 1.1-1.9 cm and 0.4-1.5 kg per decade, respectively. The rates of height increment were significantly (p<0.05) different between pre-, during and post-WW II
periods. While Japanese children were considerably larger in 2000 compared to 1900, increments between 1950
and 1960 reflected catch-up growth to restore physical size seen in children prior to WW II. The increments in
body size continued after 1960 with greatest changes seen across the pubertal years.While increments in BMI
were evident in most age groups, the BMI of 17-year-old girls was consistent over the 100 years. Results clarified secular changes in growth in Japanese school children across the 20th Century and possible factors contributing to these changes.
Asia Pac J Clin Nutr. 2011;20(2):180-189.doi:
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Coconut oil is associated with a beneficial lipid profile in pre-menopausal women in the Philippines
Author:Alan B Feranil PhD, Paulita L Duazo BS, Christophe
Keywords:cholesterol, cardiovascular disease, nutrition, saturated fat, nutrition transition
Abstract:Coconut oil is a common edible oil in many countries, and there is mixed evidence for its effects on lipid profiles
and cardiovascular disease risk. Here we examine the association between coconut oil consumption and lipid
profiles in a cohort of 1,839 Filipino women (age 35-69 years) participating in the Cebu Longitudinal Health and
Nutrition Survey, a community based study in MetropolitanCebu. Coconut oil intake was estimated using the
mean of two 24-hour dietary recalls (9.5±8.9 grams). Lipid profiles were measured in morning plasma samples
collected after an overnight fast. Linear regression models were used to estimate the association between coconut
oil intake and each plasma lipid outcome after adjusting for total energy intake, age, body mass index (BMI),
number of pregnancies, education, menopausal status, household assets and urban residency. Dietary coconut oil
intake was positively associated with high density lipoprotein cholesterol especially among pre-menopausal
women, suggesting that coconut oil intake is associated with beneficial lipid profiles. Coconut oil consumption
was not significantly associated with low density lipoprotein cholesterol or triglyceride values. The relationship
of coconut oil to cholesterol profiles needs further study in populations in which coconut oil consumption is
common.
Asia Pac J Clin Nutr. 2011;20(2):190-195.doi:
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Survey on eating disorders related thoughts, behaviors and dietary intake in female junior high school students in Taiwan
Author:Mei-Rong Tsai RN, Yu-Jhen Chang MS, Pei-Ju Lien MS
Keywords: eating disorders, body image, EAT-26, body shape-related teasing, female junior high school students
Abstract:OBJECTIVE: The purpose of this study was to investigate body weight satisfaction, eating attitudes and dietary
intake related to eating disorders of female juniorhigh school students in Taiwan. METHODS: In a crosssectional survey, 835 female junior high school students participated inthis study. The questionnaire items included respondents’ demographic information as well as weight and body image concerns. Developmental and
attitudinal scales such as the body shape-related teasing scale, Pubertal Development Scale, Eating Attitudes
Test-26 (EAT-26) and 24-hour dietary recall were also used to collect data. Data were analyzed using a Student’s ttest, chi-square test and logistic regression. RESULTS: Disturbed eating attitudes and behaviors were
found in 10.4 % of participants (measured by EAT-26≥20). The multivariate logistic regressions showed that
disturbed eating attitudes and behaviors were associated with weight/shape-related teasing experiences and dissatisfaction with body weight. The reported intakes of energy, protein, fat, carbohydrate,cholesterol, zinc and vitamins B-6, B-12, were significantly lower in participants with disturbed eating patterns than in participants
without disturbed eating. Conversely, participants with disturbed eating patterns had higher dietary and crude fiber intake than participates without disturbed eating. CONCLUSION: Disturbed eating behaviors exist among
female adolescents in Taiwan, and these behaviors jeopardize their necessary dietary intake requirements. More
research using the EAT-26 asa measure to predict the quality and quantity of food intake among female adolescents warrants further study.
Asia Pac J Clin Nutr. 2011;20(2):196-205.doi:
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Nutritional adequacy of energy restricted diets for young obese women
Author:Helen O’Connor PhD, Zahra Munas BSc Nutrition (Hon
Keywords:iron, zinc, nutritional requirements, obesity, overweight
Abstract:Aim: Energy restricted meal plans may compromise nutrient intake. This study used diet modelling to assess the
nutritional adequacy of energy restricted meal plans designed for weight management in young obese women.
Methods: Diet modelling of 6000 kJ/d animal protein based meal plans was performed using Australian nutrient
databases with adequacy compared to the AustralianNutrient Reference Values (NRVs) for women (19-30
years). One diet plan was based on the higher carbohydrate(HC) version of the Australian Guide to Healthy Eating for women 19-60 years. An alternative higher protein (HP) plan was adapted from the CSIRO Total Wellbeing Diet. Vegan and lacto-ovo versions of these plans were also modelled and compared to the appropriate vegetarian NRVs. Results: Both animal protein diets met the estimated average requirement (EAR) or adequate intake (AI) for all nutrients analysed. The recommended dietary intake (RDI) was also satisfied, except for iron.
HC met 75±30% and HP 81±31% of the iron RDI when red meat and iron fortified cereal were both included
three days a week, and remained below the RDI even when red meat was increased to seven days. Iron for the
modified vegan (57±5% HC; 66±4% HP) and lacto-ovo (48±6% HC; 59±7% HP) plans was below the RDI and
zinc below the EAR for the vegan (76±8% HC; 84±9% HP) plans. Conclusion: The 6000 kJ/d animal protein
meal plans met the RDI for all nutrients except iron. Iron and zinc failed to meet the vegetarian RDI and EAR
respectively for the vegan plans.
Asia Pac J Clin Nutr. 2011;20(2):206-211.doi:
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Attitudes toward pregnancy related changes and self-judged dieting behavior
Author:Hidemi Takimoto MD, Chisako Mitsuishi MD, Noriko K
Keywords:pregnancy, weight gain, diet, health knowledge, attitude to health
Abstract:Adequate weight gain in pregnancy is essential for the health of the mother and developing fetus. However, a
woman’s self-beliefs regarding body shape and weight gain may become a driving force toward unnecessary dietary restriction during pregnancy. In order to assess the current status of self-beliefs, attitudes toward pregnancy
related changes, and dieting behavior in pregnant women, a questionnaire survey was conducted at a prenatal
clinic in Tokyo. A self-administered questionnaire was distributed to 500 women and 248 women responded
with eligible data. Nearly all respondents (91.5%) stated that they knew their own weight gain targets. Thirtyfour women (13.7%) reported dieting before being pregnant, and 88 women (35.5%) reported current dieting.
Seventy-eight of the current dieters were doing so based on self-judgment, and only fifteen were following a dietician’s advice. The majority of the respondents (69.0%) believed that smaller babies would help a smooth delivery. From multivariable logistic regression analysis, the odds ratio (OR) for current self-judged dieting was
significant in women who had dieted before pregnancy (OR: 4.67, 95% confidence intervals (CI): 2.10-10.4),
and those who desired smaller babies for a smooth delivery (OR: 2.73, 95% CI: 1.35-5.52). Obstetricians, midwives, and dieticians should be aware ofprevious dieting history and self-beliefs in pregnant women, in order to
give professional advice about the importance of adequate weight gains.
Asia Pac J Clin Nutr. 2011;20(2):212-219.doi:
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Relation of plasma somatostatin levels with malondialdehyde in hyperlipidemic patients
Author:Rui-li Yang PhD, Wu Li PhD, Peng YueMS, Yong-Hui S
Keywords:somatostatin, insulin resistance, oxidative stress, malondialdehyde, hyperlipidemia
Abstract:Somatostatin (SST) may protect organism from overnutrition-induced insulinresistance and oxidative stress by
inhibiting pancreatic endocrine and exocrine secretion, gastrointestinal digestion and absorption. Many studies
clearly show its release becomes perturbed in diabetes and obesity. Therefore, in the present study we first aimed
to investigate whether or not plasma somatostatin level was different in patients with hyperlipidemia and normolipidemic controls. We also assessed the relationship between plasma somatostatin levels with atherosclerotic
index (AI) and malondialdehyde (MDA) in non-diabetic dyslipidemicpatients. Subjectswith hyperlipidemia
have insulin resistance and high levels of oxidative stress. Median somatostatin (57.2±19.2 vs 68.0±21.9 pg/mL;
p<0.05) levels were lower in hyperlipidemic than in normolipidemic subjects. Significant inverse relationships
between SST level and AI (r=–0.21, p< 0.05), or MDA (r=–0.31, p<0.01) were observed. These results suggest
a possible protective role of endogenous SST, at least on hyperlipidemia and atherosclerosis that are attributed to
excess energy intake and physical inactivity. Of course these preliminary results should be supported by prospective studies.
Asia Pac J Clin Nutr. 2011;20(2):220-224.doi:
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Design and sample characteristics of the 2005-2008 Nutrition and Health Survey in Taiwan
Author:Su-Hao Tu PhD, Cheng Chen BS, Yao-Te Hsieh MS, Hsi
Keywords:Nutrition and Health Survey in Taiwan (NAHSIT) 2005-2008, sample design, response rates, weighting, Computer Assistant Personal Interview (CAPI)
Abstract:The Nutrition and Health Survey in Taiwan (NAHSIT) 2005-2008 was funded by the Department of Health to
provide continued assessment of healthand nutrition of the people in Taiwan. This household survey collected
data from children aged less than 6 years and adults aged 19 years and above, and adopted a three-stage stratified,
clustered sampling scheme similar to that used in the NAHSIT 1993-1996. Four samples were produced. One
sample with five geographical strata was selected for inference to the whole of Taiwan, while the other three
samples, including Hakka, Penghu and mountainous areas were produced for inference to each cultural stratum.
A total of 6,189 household interviews and 3,670 health examinations were completed. Interview data included
household information, socio-demographics, 24-hour dietary recall, food frequency and habits, dietary and nutritional knowledge, attitudes and behaviors, physical activity, medical history and bone health. Health exam data
included anthropometry, blood pressure, physical fitness, bone density, as well as blood and urine collection. Response rate for the household interview was 65%. Of these household interviews, 59% participated in the health
exam. Only in a few age subgroups were there significant differences in sex, age, education, or ethnicity distribution between respondents and non-respondents. For the health exam, certain significant differences between
participants and non-participants were mostly observed in those aged 19-64 years. The results of this survey will
be of benefit to researchers, policy makers and the public to understand and improve the nutrition and health
status of pre-school children and adults in Taiwan.
Asia Pac J Clin Nutr. 2011;20(2):225-237.doi:
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Diet and health trends in Taiwan: comparison of two nutrition and health surveys from 1993-1996 and 2005-2008
Author:Wen-Harn Pan PhD, Hsing-Juan Wu MS, Chih-Jung Yeh
Keywords:metabolic syndrome, anemia, health indices, 24-hour recall, food frequency
Abstract:The availability of new food choices has increased dramatically in recent times, whilst increasingly sedentary
lifestyles have reduced calorie intakerequirements. The present study uses24 hour dietary recall data, and biochemical and anthropometric measurements from the 1993-1996 and 2005-2008 Nutrition and Health Surveys in
Taiwan (NAHSIT) to investigate trends in dietary habits, and cardiovascular and metabolic disease markers in
Taiwanese persons aged 19 years and above. We found thatdietary habits in Taiwan are changing, particularly
in regards to intakes of cakes and sweets, and sugary drinks. Energy intakes in young people have increased, and
combined with an increasingly sedentary lifestyle, this may have led to the increase in obesity and associated
metabolic diseases. Large increases in the prevalence of the metabolic syndrome, diabetes, hypertriglyceridemia
and gout have been observed. Fortunately, some positive dietary and behavioral changes have also been observed; including an increased avoidance of products madefrom animal fats and oils’ and a concomitant increase
in the use of vegetable oil. Intakes of fruit and vegetables, soy products, fish, whole grains, nuts and seeds have
also increased; and intakes of red meat, carbohydrates and sodium containing foods have decreased. These positive dietary changes could explain the lack of large changes in the prevalence of hypertension and hypercholesterolemia, and the decrease in prevalence of hyperuricemia. Intake of dairy products remains low, and continues
to be an important dietary issue in Taiwan.
Asia Pac J Clin Nutr. 2011;20(2):238-250.doi:
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Trends in nutrient and dietary intake among adults and the elderly: from NAHSIT 1993-1996 to 2005-2008
Author:Shin-Jiuan Wu MS, Wen-Harn Pan PhD, Nai-Hua Yeh MS
Keywords: 24-hour recall, dietary intake, food sources,nutrients, Nutrition and Health Survey in Taiwan (NAHSIT)
Abstract:The aim of this study was to investigate trends in nutrients and sources of dietary intake for Taiwanese people
from the Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996 to 2005-2008. Twenty-four hour dietary
recall data were obtained from the 2005-2008 NAHSIT. The results showed that intake of cereals and grains, and
dietary fiber has decreased, whereas intake of carbohydrate rich convenience foods has increased. As a result,
10-20 g of dietary fat is now obtained from carbohydrate rich foods. A greater proportion of Taiwanese are
choosing low-fat meat products, however, excessive intake of meat by men and women aged 19 to 64 years is
resulting in excessive intakes of protein, cholesterol and saturated fat. Men and women aged 19 to 30 years had
insufficient intakes of fruit and vegetables. Consumption of fruit, dairy/products, and nuts was low in all age
groups. We recommend strengthening public nutrition education and changing diet related environment to improve dietary quality and food group distributions. Issues of concern include excessive intakes of energy and the
soybean/fish/meat/eggs food group in all subjects, high amount of processed foods and refined-carbohydrate rich
foods in men aged 19 to 64 years and women aged 19-30 years, as well as intakes below the DRI for a variety of
nutrients in elderly persons.
Asia Pac J Clin Nutr. 2011;20(2):251-265.doi:
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Trends and Nutritional Status for Magnesium in Taiwan from NAHSIT 1993 to 2008
Author:Jui-Line Wang PhD, Yao-Lin Weng PhD, Wen-Harn Pan
Keywords:nutrition and health survey in Taiwan (NAHSIT), nutrition status of magnesium, magnesium intake, blood magnesium, urinary magnesium/creatinine ratio
Abstract:Data from nationwide population-based nutrition surveys in Taiwan wereused to investigate trends and nutritional status for magnesium from 1993 to 2008. Dietary magnesium intake was estimated from 24-hour dietary
recalls. Serum and urinary magnesium were also measured. In Nutrition and Health Survey in Taiwan (NAHSIT)
2005-2008, average magnesium intake was 305 mg and 259 mgfor adult males and females, respectively, which
is equivalent to 82-85% of relevant Taiwanese Dietary Reference Intakes (DRIs). After correcting intraindividual variation, 74-81% of adult subjects’ dietary magnesium was estimated as sub-optimal. Mean serum
magnesium concentration was 0.866 mmol/L and 0.861 mmol/L for the males and females, respectively. The
prevalence of low serum magnesium(<0.8 mmol/L) was 12.3% and 23.7% for the males and females, respectively. There was positive association among dietary magnesium, blood magnesium, and urinary magnesium/creatinine ratio. From NAHSIT 1993-1996 to NAHSIT2005-2008, dietary magnesium significantly increased (p<0.05), the blood magnesium and urinary magnesium/creatinine ratio decreased (p<0.05). The findings
suggest that the relationships between dietary magnesium and biochemical markers among different nutrition
and health surveys are not straightforward and need to be further clarified.
Asia Pac J Clin Nutr. 2011;20(2):266-274.doi:
>>Abstract
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Trends in folate status in the Taiwanese population aged 19 years and older from the Nutrition and Health Survey in Taiwan 1993-1996 to 2005-2008
Author:Kuan-Ju Chen PhD, Wen-Harn Pan PhD, Yi-Chin Lin Ph
Keywords:folate status, NAHSIT, nutrition survey, homocysteine, hyperhomocysteinemia
Abstract:To investigate ten year trends in folate status in Taiwanese aged ≥19 yrs by three Nutrition and Health Survey in
Taiwan (NAHSIT) in 1993-1996, 1999-2000 and 2005-2008. Women had higher blood folate levels than men in
all three surveys. The prevalence of folate deficiency (5.2% <3 ng/mL) and insufficiency (34.1% ≤6 ng/mL) in
men was highest in 2005-2008. Adults aged 19-30 yrs had the lowest blood levels and the highest prevalence of
deficiency (8.1% in men; 3.5% in women) and insufficiency (48.6% in men; 25% in women) as compared to
other age groups in 2005-2008. Folate insufficiency rate inthose aged 31-44 yrs was twice as high in men and
three times as high in women in 2005-2008 compared to 1993-1996. In the elderly, folate insufficiency rate
(28%) in 2005-2008 was not higher than that of 1993-1996, although it was higher than that found in 1999-2000
(18.4%). Men aged ≥80 yrs had the poorest folate status in 2005-2008, and men were twice as likely to have inadequate status as women. Plasma homocysteine (Hcy) levels were higherin older men than older women in
both surveys. The elderly had significantly higher plasma tHcy in 2005-2008 compared to the 1999-2000 survey.
Dark green vegetables and fruit intake frequency in young adults (19-30 yrs) was the lowest among all age
groups. This study suggests that folate status in Taiwan has not improved during the past fifteen years, and has
worsened in the young population.
Asia Pac J Clin Nutr. 2011;20(2):275-282.doi:
>>Abstract
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Bone mineral density in adults in Taiwan: results of the Nutrition and Health Survey in Taiwan 2005-2008 (NAHSIT 2005-2008)
Author:Yi-Chin Lin PhD, Wen-Harn Pan PhD
Keywords:NAHSIT, bone mineral density, osteoporosis, lumbar spine, femoral neck
Abstract:Osteoporosis is one of the most prevalent global healthproblems in the elderly. A nationwide representative
sample of 1121 adult subjects, aged 19years and older, were scanned by a dual-energy X-ray absorptiometry in
the third survey year of Nutrition and Health Survey in Taiwan 2005-2008. There was an apparent gender difference in the trend of bone mineral density (BMD) with age.In males, the decrease in BMD with age at lumbar
spine and at femoral neck were statistically significant in those younger than 50 years, whereas the decrease in
BMD at forearm was significant only inthose aged 50 years and older (β= -0.005, p<0.0001). In females there
was a significant negative correlation between BMD at femoral neck and age (β= -0.004, p<0.0001). In the 236
subjects aged 50 years and older, the prevalence rates ofosteoporosis were 4.3% at lumbar spine, 12.0% at
femoral neck, and 11.6% at forearm in males, and 12.6% at lumbar spine, 18.1% at femoral neck, and 25.0% at
forearm in females, respectively. The prevalence rates of osteoporosis at any site were 23.9% in males and
38.3% in females, respectively. The prevalence rates of low bone mass at lumbar spine, femoral neck, and forearm were 28.8%, 57.5%, and 22.7% in males and 34.7%, 45.9%, and 26.1% in females, respectively. Effective
measures to maintain bone health and/or to reduce excessive bone loss may be important in the prevention of osteoporotic fractures in Taiwanese adults.
Asia Pac J Clin Nutr. 2011;20(2):283-291.doi:
>>Abstract
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Time trend of obesity, the metabolic syndrome and related dietary pattern in Taiwan: from NAHSIT 1993-1996 to NAHSIT 2005-2008
Author:Chih-Jung Yeh PhD, Hsing-Yi Chang PhD, Wen-Harn Pa
Keywords:obesity, metabolic syndrome, prevalence, dietary pattern, reduced rank regression
Abstract:Obesity and the metabolic syndrome (MetS) are challenging public health issues as globesity popularizes. The
present study illustrates the trend of obesity and MetS for the last 12 years in Taiwan based on the analysis of
Nutrition and Health Survey in Taiwan. Between the two surveys, a large growth on MetS prevalence was observed, from 13.6% to 25.5%. In NAHSIT 2005-2008, the prevalence of MetS in females exceeded that of males
in people older than the age of 45. With regard to regional differences, the growing prevalence of obesity and the
metabolic syndromes alleviated in the northern area level one, the most urbanized and dense area. Prevalence of
obesity and MetS in Hakka, central, and southern areas increased rapidly. Aboriginal areas had the highest
prevalence, which increased modestly. Prevalence of MetS rose fastamong males, but much slower among females. Comparing the Taiwanese data with other countries, obesity prevalence in Taiwan was higher than in
many of Asian countries, but less than in the West. The prevalence of MetS in Taiwanese females reached levels
close to that of the West. Reduced rank regression analysis was used to extract a risk reducing dietary pattern in
women, featured by not only more vegetables, fruit, lean meat, and fish, but also some specific Taiwanese dietary items including mushrooms, seaweed, and soybean. No apparent increase in intake of certain healthy foods
including lean meat, milk, dark-green vegetables, and fruit in the last 12 years, challenges future strategies to
promote health.
Asia Pac J Clin Nutr. 2011;20(2):292-300.doi:
>>Abstract
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Trends in hyperuricemia and gout prevalence: Nutrition and Health Survey in Taiwan from 1993-1996 to 2005-2008
Author:Shao-Yuan Chuang PhD, Shu-chen Lee MS, Yao-Te Hsie
Keywords:uric acid, dietary patterns, trend, national survey, reduced rank regression
Abstract:Hyperuricemia is a recognized risk factor for cardiovascular disease. This study investigated trends in uric acid
levels, hyperuricemia and gout among adults in Taiwan from 1993-1996 to 2005-2008, using data collection
from, Nutrition and health surveys in Taiwan (NAHSIT) conducted in 1993-1996 and 2005-2008. Information
on food frequency, medical history, physical measures and fasting blood parameters were analyzed. Mean uric
acid levels decreased between 1993-1996 and 2005-2008 in both genders (6.77 vs 6.59 mg/dL in men and 5.33
vs 4.97 mg/dL in women) and the prevalence of hyperuricemia declined from 25.3% to 22.0% in men (p<0.0001)
and from 16.7% to 9.7% in women (p<0.0001). However, the prevalence of gout (self-reported) increased
(4.74% vs 8.21% in men and 2.19% vs 2.33% in women, p<0.0001). Reduced rank regression was used to identify dietary patterns that explained significant amounts ofvariance in uric acid. Frequency of consumption of
lean meat, soy products and soymilk, milk, eggs, vegetables, carrots, mushrooms, fruit and coffee were negatively associated with hyperuricemia, whereas consumption of organ meats, bamboo shoots, and soft drinks were
positively associated with hyperuricemia. The dietary factor score (DFS) composed of the frequency of above
food items decreased from -5.40 to -6.00 between the two surveys (p<0.0001). In conclusion, uric acid levels and
prevalence of hyperuricemia both declined, whilstself-reported gout increased between 1993-1996 and 2005-2008. Changes in dietary patterns may inpart explain the decrease in uric acid levels between the two national
surveys.
Asia Pac J Clin Nutr. 2011;20(2):301-308.doi:
>>Abstract
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2005-2008 Nutrition and Health Survey in Taiwan: the nutrition knowledge, attitude and behavior of 19–64 years old adults
Author:Wei Lin PhD, Chi-Ming Hang PhD, Hsiao-Chi Yang PhD
Keywords: nutrition knowledge, attitude, behavior, adults, NAHSIT
Abstract:The purpose of this study is to understand nutrition knowledge, attitude, and behaviorin Taiwanese adults. Results indicated that adults’ knowledgeon “relationship between diet and disease” and “comparison of foods in
terms of specific nutrients” is acceptable. However, they lack knowledge on “daily serving requirements” and
“weight and weight loss”. Although they recognize the importance of nutrition, nutrition was not the major concern of food selection. Significant differences were found among gender and age groups. Females of most age
groups are better than males in many aspects of nutrition knowledge, attitude and behavior except emotional and
external eating behavior. Young (age 19–30) and prime (age31–44) adults have better knowledge than that of
middle adults (age 45–64), while prime adults hold a more positive attitude than youngadults. As for nutrition
behavior, prime and middle adults are better than young adults. Nutrition knowledge and attitude of adults in urban areas is generally better than those in suburban and remote areas. However, adults in urban areas perform
“emotional and external cued eating” more frequently than those in suburban and remote areas. There are significantly positive correlations among nutrition knowledge, attitude and behavior; and attitude has stronger correlation (r=0.42) with behavior than knowledge does (r=0.27). Therefore, to achieve desirable eating behaviors,
the adult nutrition education program should include knowledge of what constitutes a balanceddiet and what
constitutes being overweight. Proper strategies to enhance the behavioral motivation of healthy food selection
must also not be neglected.
Asia Pac J Clin Nutr. 2011;20(2):309-318.doi:
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Use of supplements by Taiwanese adults aged 19-44 during 2005-2008
Author:Jia-Rong Lin EdD, Yi-Shin Lin MS, Mei-Ding Kao MS,
Keywords:supplements, 19-44 year old adults, gender, multivitamins and minerals, nutrient intakes from supplements
Abstract:The aim of the study was to understand the use of supplements in Taiwan. Data used in this study came from the
2005-2008 Nutrition and Health Survey in Taiwan. The total sample available for analysis of supplement use included 973 adults (485 men and 488 women), aged 19-44 years.Survey data were weighted to adjust for the survey design effect and to make the sample nationally representative. Our results showed that 33.2% of Taiwanese
adults aged 19-44 took supplements (26.6% of men and 40.0% of women). Gender was the only demographic
factor found to be associated with the total number of supplement types taken. Men were more likely to take only one supplement. In contrast, women were 2.6 times more likely than men to take two or more supplements.
The most commonly taken supplements by adults were multivitamins and minerals (35.8%), followed by vitamin
B group (20.6%) and calcium (9.3%). We found that in both men and women, nutrient intakes from supplements
exceeded DRIs for vitamins A, D, E, B-1, B-2, B-6, B-12, pantothenic acid and biotin. Men were more likely
than women to take excess iron. Women were more likely than men to take excess vitamin C and niacin. Our
study results may be used by government agencies to develop policies regarding supplement use in Taiwan.
Asia Pac J Clin Nutr. 2011;20(2):319-326.doi:
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Dietary supplements usage among elderly Taiwanese during 2005-2008
Author:Shih-Ying Chen PhD, Jia-Rong Lin PhD, Tzu-Hsiu Che
Keywords:dietary supplements, the elderly, Nutrition and Health Survey in Taiwan (NAHSIT 2005-2008), consumption practices, dietary reference intakes (DRIs)
Abstract:This study describes dietary supplement consumption practices among the Taiwanese population over the age of
65. Data for the analyses were derived from the 2005-2008 Nutrition and Health Survey in Taiwan. Data from a
total of 914 participants (456 men and 458 women) was collected in the study to delineate patterns of supplement usage. The results indicated that the percentage of individuals taking supplements was 45.7% for men and
52.2% for women. There were no significant differences in supplement use by gender, age group, geographic
stratum, current employment status, household monthly income, self-reported health status or marital status, except for higher education and adequate perceived financial resources. Half of both men and women chose to take
only one supplement. In addition, as the number of supplements taken increased, the number of people decreased.
The elderly with higher education levels were more likely to take two kinds of supplements. The top five supplements consumed from highest to lowest were: glucosamine, multivitamins and minerals, calcium, fish oil and
vitamin B complex. The major reason for supplements use for men was to supplement an unbalanced diet, and
that for women was to prevent joint degeneration. The mainfactor influencing choice of supplements in the elderly was receiving the supplement as a gift from another person. Note that mean intakes of vitamins A, C, E, B-1,
B-2, B-6, B-12, biotin, niacin, and pantothenic acid from supplementsover-exceeded DRIs in Taiwan.
Asia Pac J Clin Nutr. 2011;20(2):327-336.doi:
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Practice to introduce complementary foods to infants in Taiwan – changes from 1997 to 2008
Author:Jia-Rong Lin EdD, Min-Su Tzeng DrPH, Mei-Ding Kao
Keywords:complementary foods, caregiver, encountered problem, nutrition knowledge, infant
Abstract:The purpose of the study was to understand present infantcomplementary foods eating and compare trends over
the past 10 years in Taiwan. We investigated the methods used to introduce infants to complementary foods, difficulties encountered, sources of information and the principle caregiver’s knowledge about infant feeding. This
study focused on findings from the 2005-2008 Nutrition and Health Survey in Taiwan (NAHSIT) and compared
with those from the 1997-1999 Child NAHSIT. Interviews inboth surveys were carried out by trained interviewers. In 2005-2008 survey, 50% of infants aged 7-12 months had started eating baby cereals or juice at age 4-6 months as recommended. The proportions of infants aged 10-12 months who were introduced to particular
complementary foods at recommended periods varied from biscuits (51.1%) to tofu (1.1%). The proportions
were higher in 2005-2008 than in 1997-1999 for only 3 items.In both survey, more than 80% of mothers were
the one who made the decision to introduce their children to complementary foods. More than 75% of caregivers
fed baby cereals to their babies from milk bottles. In 2005-2008, the most commonly encountered problem was
that the child wouldn’t eat. Nutrition knowledge of the caregivers have improved since 1999, but still needs fostering. The timing to introduce complementary foods become later than ten years ago. Whether the delay will affect the normal dietary intakes of children after one yearof age needs attention. The government should not only
promote breastfeeding, but also reevaluate current evidence-based recommendation on complementary food introduction time.
Asia Pac J Clin Nutr. 2011;20(2):337-345.doi:
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Obituary for Professor Prasong Tienboon (1952-2011)
Author:Dr Prasong Tienboon (July 31st, 1952-May 23rd, 201
Keywords:
Abstract:
Asia Pac J Clin Nutr. 2011;20(2):i.doi:
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