Determining the predictive equation for height from ulna length in the Vietnamese Population
Author:Ana Bonell, Nguyen Nguyen Huyen, Vu Dinh Phu, Hei
Keywords:height, ulna length, anthropometric, predict, Vietnamese
Abstract:Background and Objectives: Height is an essential measurement in clinical medicine. It allows the calculation of body mass index, ideal body weight, basic energy requirements and tidal volumes. In many patient groups, such as the critically ill, height cannot be measured easily and surrogate anthropometric measures are used. Regression equations estimating height are specific to ethnicity. To develop the regression equation for Vietnamese men and women to predict height from ulna length and so improve prescription of life-saving treatment in the intensive care units. Methods and Study Design: A cross-sectional survey of patients and relatives at the National Hospital for Tropical Diseases was undertaken. Ulna length, standing height and weight were measured. The first two thirds of participants’ data, stratified by sex and age, were allocated to a model training group, the subsequent participants entered the validation group. Linear regression equations were calculated for the model group by sex, then applied to the validation group and assessed for precision. Other international equations were also compared. Results: 498 males and 496 females were recruited. There was good correlation between ulna length and height in those aged 21-64, r =0.66, p <0.001 in males and females. The regression equations were: male: height = 85.61 + (3.16 x ulna length), female: height = 85.80 + (2.97 x ulna length). Equations from other populations were less accurate. Conclusions: The regression equations calculated for men and women aged 21-64 showed good correlation and can be used to predict height in those where direct measurement is impossible.
Asia Pac J Clin Nutr. 2017;26(6):982-986.doi: 10.6133/apjcn.012017.01
>>Abstract
>> Download PDF
Validation of summer and winter ELISA measurements of serum
25-hydroxyvitamin D concentrations in Mongolia
Author:Sabri Bromage, Daria Tselmen, Gary Bradwin, Michael F Holick, Davaasaambuu Ganmaa
Keywords:vitamin D, 25(OH)D, IDS ELISA, DiaSorin LIAISON, Mongolia
Abstract:Background and Objectives: Assay cost, quality, and availability pose challenges for vitamin D
surveys in limited resource settings. This study aimed to validate an inexpensive vitamin D assay
(ELISA) under real-world conditions in Mongolia, the northernmost developing country, to
characterize the assay’s usefulness and inform the design of epidemiologic studies in similar
regions. Methods and Study Design: We collected paired summer and winter serum samples
from 120 men and women (aged 20-57 years) in urban and rural Mongolia, analyzed each
sample for 25(OH)D concentration using both Immunodiagnostic Systems ELISA and DiaSorin
LIAISON 25(OH)D TOTAL, and compared the assays using multiple statistics. LIAISON was
itself validated by participation in the DEQAS program. Results: Correlation and agreement
between assays were higher in summer (Pearson’s correlation=0.60, Spearman’s rank
correlation=0.67, Lin’s concordance correlation=0.56) than winter (rP=0.37, rS=0.43, rC=0.33),
although ELISA less accurately assigned subjects to sufficiency categories in summer (percent
agreement=44%) than winter (58%), during the latter of which most subjects were deficient
([25(OH)D] categories used: >75 nmol/L (optimal), 50-75 nmol/L (adequate), 25-50 nmol/L
(inadequate), <25 nmol/L (deficient)). Compared with LIAISON, ELISA tended to indicate
higher vitamin D status in both seasons (mean paired difference: 7.0 nmol/L (95%CI: 3.5-10.5)
in summer, 5.2 nmol/L (95%CI: 2.9-7.5) in winter). Conclusions: ELISA proved useful for
measuring and ranking subjects’ vitamin D status in Mongolia during summer, but levels were
too low in winter to sensitively discriminate between subjects, and ELISA overestimated status
in both seasons. These findings have implications for the timing and interpretation, respectively,
of vitamin D surveys in highly deficient populations.
Asia Pac J Clin Nutr. 2017;26(6):987-993.doi: 10.6133/apjcn.122016.02
>>Abstract
>> Download PDF
Validity of the Malnutrition Universal Screening Tool (MUST) in Australian hospitalized acutely unwell elderly patients
Author:Yogesh Sharma, Campbell Thompson, Billingsley Kaambwa, Rashmi Shahi, Michelle Miller
Keywords:PGSGA, EQ5D, Hospital length of stay, Weight loss, Anthropometric
Abstract:Background and Objectives: In the present study, we aimed to validate the Malnutrition Universal Screening Tool (MUST) for nutritional screening in acutely unwell elderly patients
against a reference assessment tool – Patient-Generated Subjective Global Assessment (PG-SGA). Methods and Study Design: One hundred and thirty two patients, who are participants in an ongoing randomized control trial looking into the cost-effectiveness of
extended ambulatory nutrition intervention in patients discharged from acute care, contributed data for this study. In addition to performance of MUST and PG-SGA the following nutritional parameters were measured: weight loss >5% in previous 3-6 months, handgrip strength, triceps skinfold thickness, Mid-arm Circumference, Mid-arm Muscle
circumference (MAMC). Quality of life was determined using the EuroQoL Questionnaire (EQ-5D 5 level). Sensitivity, specificity, predictive values and concordance were calculated to validate MUST against PG-SGA. Results: MUST when compared to PG-SGA gave a sensitivity of 69.7%, specificity of 75.8%, positive predictive value of 75.4%, negative
predictive value of 70.1% and kappa statistics showed 72.7% agreement (k=0.49) for detecting malnutrition. The MUST score had significant inverse correlation with body mass index, Triceps skinfold thickness and Mid-arm muscle circumference but not with Handgrip strength. Malnourished patients (PG-SGA class B/C) were found to have a significantly
worse QoL. Conclusion: This is the first study to demonstrate that MUST can be confidently administered with respect to validity in acutely unwell general medicine elderly patients to
detect malnutrition. In this study, significant weight loss in the preceding 3-6 months also seems to have validity, almost comparable to MUST, for predicting the risk of malnutrition.
Further research is needed to verify this finding, as a single item may be more feasible to complete than an instrument consisting of two or more items.
Asia Pac J Clin Nutr. 2017;26(6):994-1000.doi: 10.6133/apjcn.022017.15
>>Abstract
>> Download PDF
Simple method to estimate daily sodium intake during measurement of dialysis adequacy in chronic peritoneal dialysis patients
Author:So Mi Kim, Eun Kyoung Lee, Shin Sook Kang, Soon Mi
Keywords:dietary sodium intake, peritoneal dialysis, peritoneal sodium removal, urinary sodium removal, dialysis adequacy
Abstract:Background and Objectives: Restriction of dietary sodium intake for peritoneal dialysis (PD) patients is recommended, but there is limited information on the measurement and monitoring of sodium intake. We have developed a simple method to estimate daily sodium intake during the measurement of dialysis adequacy in PD patients. Methods and Study Design: A total of 83 PD patients were enrolled in the study. The patients were divided into two groups based on residual renal function (RRF). We measured total sodium removal and estimated daily sodium intake using dietary recall for one day, during the assessment of dialysis adequacy. Results: There were 39 patients in the RRF(−) group and 44 in the RRF(+) group. In both groups, and all patients, there were significant positive correlations between sodium intake and total sodium removal: RRF(−) group, r=0.598; RRF(+) group, r=0.577; total patients, r=0.595. There were linear relationships between dietary sodium intake and total sodium removal in both groups: RRF(−) group, sodium intake (mg/d) = 19.3 × peritoneal sodium removal (mEq/d) + 211;RRF(+) group, sodium intake (mg/d) = 15.4 × total sodium removal (mEq/d) + 609. All PD patients, sodium intake (mg/d) = 15.6 × total sodium removal (mEq/d) + 646. Conclusions: The measurement of total sodium removal during the assessment of dialysis adequacy could be an effective and simple method to estimate dietary sodium intake in PD patients. A dietary intake of 2,000 mg of sodium corresponds to a total sodium removal of approximately 87 mEq/d.
Asia Pac J Clin Nutr. 2017;26(6):1001-1006.doi: 10.6133/apjcn.012017.03
>>Abstract
>> Download PDF
Appropriate nutritional management in patients with impaired mastication and those with mild dysphagia:
a multicenter study of the usefulness of novel foods processed and softened by enzymes
Author:Takashi Higashiguchi, Akihiro Ito, Hirofumi Nishiyama, Takashi Shigematsu, Atsuko Ishikawa, Hiroyuki Kato, Shohei Iijima, Nobuyuki Kikuchi
Keywords:dysphagia, intake, modified diet, satisfaction, taste
Abstract:Objectives: Our aim was to investigate the safety of iEAT (a food that is softened by heat and enzyme homogeneous permeation) and iEAT-affected nutrition parameters, e.g., nutrition intake (calculated from the consumption rate in patients with impaired mastication and those with mild dysphagia). Methods and Study Design: A multicenter, randomized, cross-over study of iEAT was conducted in 50 patients (mean age 77.0±11.0 years) with dysphagia due to Occasional aspiration (4 points on the Dysphagia Severity Scale [DSS]) or Oral problems (5 points) randomly assigned to the study diet (iEAT) or its opposite (the modified traditional [control] diet) for 1 week and then switched for 1 week to the opposing diet. Intake of energy, protein, lipid, carbohydrate, and sodium were evaluated along with questionnaire-assessed levels of satisfaction. Results: The mean intake was significantly lower for the study diet, whereas the intakes of energy, protein, carbohydrate on day 1, intake of protein on day 7, and body weight on day 7 were significantly higher for the study diet. We found no between-group differences in hematologic and blood biochemistry parameters, no diet-related adverse events, greater satisfaction with the appearance of the study diet (p<0.001), and comparable levels of satisfaction with ease of eating, ease of swallowing, and taste for both diets. Conclusions: iEAT was provided to patients with mild dysphagia as safely as a blender diet or other diets usually provided at each study site, and can serve as an efficient nutrition source.
Asia Pac J Clin Nutr. 2017;26(6):1007-1015.doi: 10.6133/apjcn.122016.01
>>Abstract
>> Download PDF
Energy intake in the first week in an emergency intensive care unit may not influence clinical outcomes in critically ill, overweight Japanese patients
Author:Satomi Ichimaru, Maren Sono, Ryutaro Seo, Koichi A
Keywords:critical illness, body mass index, obesity, overweight, energy intake
Abstract:Background and Objectives: The American Society for Parenteral and Enteral Nutrition recommends hypocaloric feeding for critically ill patients with a BMI of ≥30.0 kg/m2. However, the cut-off value of obesity in Japan is BMI >25.0kg/m2, due to the higher prevalence of type 2 diabetes mellitus, and cardiovascular risk factors, even at a lower BMI than in Western populations. Thus, the optimal energy intake for critically ill, overweight Asian patients is unknown. Methods and Study Design: A retrospective chart review was conducted in patients with BMI of ≥25.0 kg/m2 in an emergency intensive care unit (EICU). Patients were categorized into two groups by average daily energy intake during the first week in the EICU, with Group A at <50% of requirement and Group B at ≥50%. Results: A total of 72 patients with a median BMI of 27.5kg/m2 were included in the study. No significant differences between the groups were observed for all-cause mortality, ICU-free days, or length of hospital stay. The number of ventilator-free days (VFDs) was significantly higher in Group A than Group B (20.0 [15.5-24.5] vs 17.0 [2.0-21.0] days; p=0.042). On multiple adjusted analysis, however, we found that %energy intake/requirement was not independently associated with VFDs (regression coefficient=0.019; 95% confidence interval, −0.115–0.076). Conclusions: Energy intake in the first week in the EICU did not influence clinical outcomes in critically ill, overweight Japanese patients. Confirmation of these results in larger, randomized trials is required.
Asia Pac J Clin Nutr. 2017;26(6):1016-1020.doi: 10.6133/apjcn.022017.01
>>Abstract
>> Download PDF
Pharmacoeconomics of parenteral nutrition in surgical and critically ill patients receiving structured triglycerides in China
Author:Guo Hao Wu, Alexandra Ehm, Marco Bellone, Lorenzo
Keywords:lipid emulsion, parenteral nutrition, intensive care unit, cost-effectiveness
Abstract:Background and Objectives: A prior meta-analysis showed favorable effects of parenteral structured triglyceride (STG) lipid emulsions on metabolic outcomes in surgical and critically ill patients compared with mixed medium-chain and long-chain triglycerides (MCT/LCT) emulsions. Limited data on clinical outcomes precluded a pharmacoeconomic analysis. We performed an updated meta-analysis of studies evaluating the effect of STGs and mixed MCT/LCTs in surgical and critically ill patients and developed a cost model to compare overall costs in Chinese hospitals. Methods and Study Design: We searched Medline, Embase, Wanfang Data, the China Hospital Knowledge Database, and Google Scholar for clinical trials comparing STGs to mixed MCT/LCTs in surgical and/or critically ill adults published between October 10, 2013 and September 19, 2015. Newly identified studies were pooled with studies from the prior meta-analysis and an updated meta-analysis was performed using RevMan® version 5.3. A deterministic simulation model based on cost data from Chinese hospitals was used to compare the effects of STGs and mixed MCT/LCT’s on hospital costs. Results: The systematic literature search identified six new clinical trials, resulting in a total of 27 studies that were included in the updated meta-analysis. Statistically significant differences favoring STGs were observed for cumulative nitrogen balance, pre-albumin and albumin concentrations, plasma triglycerides, and liver enzymes. STGs were also associated with a significant reduction in the length of hospital stay (mean difference, −1.45 days; 95% confidence interval [CI], −2.48 to −0.43; p=0.005) compared with mixed MCT/LCTs. Cost analysis demonstrated a net cost benefit of ¥675 for STGs compared with mixed MCT/LCT emulsions. Conclusions: STGs are associated with improvements in metabolic function and reduced length of hospital stay in surgical and critically ill patients compared with mixed MCT/LCT emulsions. Cost analysis based on cost data from Chinese hospitals showed a corresponding cost benefit
Asia Pac J Clin Nutr. 2017;26(6):1021-1031.doi: 10.6133/apjcn.022017.04
>>Abstract
>> Download PDF
Parenteral nutrition combined with enteral feeding improves the outcome of cancer patients
Author:Pei-Chun Chao, Cheau-Feng Lin, Hui-Ju Chuang
Keywords:performance status (PS) scale, enteral nutrition (EN), total parenteral nutrition (TPN), oncology, modified Glasgow Prognostic Score (mGPS)
Abstract:Background and Objective: This study investigated whether total parenteral nutrition combined with enteral nutrition is associated with improved biochemical and clinical outcomes in cancer patients with gastrointestinal dysfunction. Methods and Study Design: From January to December 2014, the clinical data of 68 patients in a cancer ward were retrospectively collected, and these patients were classified into two groups according to nutrition delivery, through parenteral nutrition, combined with enteral nutrition more (group A) or less (group B) than 250 kcal/day. The following variables were analyzed: the route and percentage of nutritional support, total caloric intake, age, gender, body weight, body mass index, diagnosis at admission, complications of intestinal failure, modified Glasgow Prognostic Score, co-morbidities, duration of total parenteral nutrition support, performance status scale, and plasma nutritional markers. Results: A significant difference was observed between the two groups in functional capacity, including the Karnofsky index, World Health Organization/Eastern Cooperative Oncology Group score, body-weight loss, and serum albumin levels. However, no significant difference was observed in the modified Glasgow Prognostic Score. Conclusions: Cancer patients receiving total parenteral nutrition who were fed enterally more than 250 kcal/d exhibited more favorable clinical outcomes than those who were fed enterally less than 250 kcal/d. Enteral nutrition should be considered for these severely ill patients.
Asia Pac J Clin Nutr. 2017;26(6):1032-1038.doi: 10.6133/apjcn.012017.06
>>Abstract
>> Download PDF
Peanut butter increase the bioavailability and bioconversion of kale β-carotene to vitamin A
Author:Tawanda Muzhingi, Kyung-Jin Yeum, Odilia Bermudez,
Keywords: kale, vitamin A, carotenoids, deuterium, peanut butter
Abstract:Background and Objectives: Kale is a rich source of provitamin A- β-carotene. This study used intrinsically labeled kale [2H9] β-carotene to determine the effect of peanut butter on the bioconversion of kale β-carotene to vitamin A in preschool children. Methods and Study Design: Preschool children (n=37; age 12-36 mo) were randomly assigned to 50 g cooked kale (1.5 mg β-carotene content) with either 33 g peanut butter (PBG) or with 16 g lard (LG) and a reference dose of 1 mg [13C10] retinyl acetate capsule. Blood samples were processed to serum and analyzed by Negative Chemical Ionization-Gas Chromatography Mass Spectrometry (NCI-GCMS) for the enrichments of [2H] retinol from kale [2H9] β-carotene and [13C10] retinol from reference dose. Results: The area under curves (AUCs) of molar enrichment at days 1, 2, 3, 6, 15, and 21 after the labeled doses was 56.3±10.5 and 84.8±16.2 (nmole) for [2H] retinol from LG and PBG kale [2H9] β-carotene, respectively. The AUC of [13C10] retinol from reference dose was 432.6±54.9 (LG) and 560.3±156.7 (nmole) (PBG), respectively. The calculated βcarotene conversion factors were 13.4±3.1 and 11.0±3.9 to 1 (p>0.05) by weight for LG and PBG, respectively. Conclusions: This study showed that peanut butter enhances the vitamin A value of kale.
Asia Pac J Clin Nutr. 2017;26(6):1039-1047.doi: 10.6133/apjcn.112016.03
>>Abstract
>> Download PDF
Energy restriction combined with green coffee bean extract affects serum adipocytokines and the body composition in obese women
Author:Fatemeh Haidari, Mehnoosh Samadi, Majid Mohammadsh
Keywords:adipocytokine, body composition, chlorogenic acid, lipid profile, obesity
Abstract:Background and Objectives: Obesity has become a public health problem and is a cause of some preventable illnesses. Among several methods for treating obesity, the use of food supplements is highly common. A commonly used food supplement is green coffee bean extract. The objective of this study was to evaluate the efficacy of green coffee bean extract combined with an energy-restricted diet on the body composition and serum adipocytokines in obese women. Methods and Study Design: In this randomised clinical trial, 64 obese women aged 20–45 years were selected and divided into two groups: an intervention group (receiving 400 mg green coffee bean extract for 8 weeks) and control group (receiving placebo). All participants were on an energy-restricted diet. The body composition, leptin, adiponectin, lipid profile, free fatty acids (FFAs), and fasting blood sugar were compared between the two groups. Results: We observed significant reductions in the body weight, body mass and fat mass indices, and waist-to-hip circumference ratio in both groups; however, the decrease was higher in the intervention group. Moreover, serum total cholesterol, low-density lipoprotein, leptin, and plasma free fatty acids significantly decreased in the intervention group (p<0.05) after adjustment for energy and fibre intake. The serum adiponectin concentration significantly increased in the intervention group (p<0.05). Conclusions: Green coffee bean extract combined with an energy-restricted diet affects fat accumulation and lipid metabolism and is thus an inexpensive method for weight control in obese people
Asia Pac J Clin Nutr. 2017;26(6):1048-1054.doi: 10.6133/apjcn.022017.03
>>Abstract
>> Download PDF
Portion controlled ready-to-eat meal replacement is associated with short term weight loss: a randomised controlled trial
Author:Rebecca Kuriyan, Deepa P Lokesh , Ninoshka D’Souza
Keywords:weight loss, meal replacement, portion control, ready to eat cereal, Indian women
Abstract:Background and Objectives: Strategies to prevent and treat overweight/obesity are urgently needed. This study assessed the effect of a short-term intake of ready-to-eat cereal on body weight and waist circumference of overweight/obese individuals in comparison to a control group. Methods and Study Design: A randomized, controlled 2-arm trial was carried out on 101 overweight/obese (Body Mass Index – 29.2±2.4 kg/m2) females aged 18 to 44 years, at St. John’s Medical College Hospital. The intervention group received a low fat, ready to eat cereal, replacing two meals/day for two weeks. The control group was provided with standard dietary guidelines for weight loss and energy requirements for both groups were calculated similarly. Anthropometric, dietary, appetite and health status assessments were carried out at baseline and at the end of two weeks. Results: At the end of two weeks, the mean reductions in body weight and waist circumference were significantly greater in the intervention group, -0.53 kg; 95% CI (-0.86 to -0.19) for body weight and -1.39 cm; 95% CI (-1.78, -0.99) for waist circumference. The intervention group had a significantly higher increase in dietary intakes of certain vitamins, fiber and sugar, and significantly higher reductions in total and polyunsaturated fats and sodium intakes, as compared to the control group (p≤0.05). No significant differences were observed between the groups, in change of appetite, health and perception scales. Conclusions: Portion controlled, ready to eat cereal could be effective for shortterm weight loss, with some improvements in the nutrient intake profile. However, studies of longer duration are needed.
Asia Pac J Clin Nutr. 2017;26(6):1055-1065.doi: 10.6133/apjcn.022017.07
>>Abstract
>> Download PDF
Compressed food with added functional oligopeptides improves performance during military endurance training
Author:Zhi-Qiang Zheng, Zhan-Hui Geng, Jia-Xi Liu, Shun-Tang Guo
Keywords:compressed food, maltooligosaccharide, soy oligopeptide, exercise performance, endurance training
Abstract:Background and Objectives: Oligosaccharide or oligopeptide supplementation may have a significant impact on endurance performance. This study evaluated the effects of adding maltooligosaccharides (MO) or soy oligopeptides (SO) to compressed food (CF) on the physical response of soldiers to daily military training. Methods and Study Design: Twelve soldiers were randomized to four diet groups: regular meals, CF, CFMO, and CFSO (crossover design). They participated in exercise tests including 90 minutes running at 55-65% VO2max and exhaustive running. Heart rates, rating of perceived exertion (RPE), and blood and urine samples were collected during exercise and recovery. Results: The recovery heart rates were significantly lower with the CFMO diet compared with the other diets. Compared with all other diets, blood glucose levels were higher, post-exercise blood lactate levels were lower, and lactate clearance during recovery was higher with the CFMO diet, followed by the CFSO diet. Post-exercise levels of erythrocytes and hematocrit were significantly higher with the CFSO diet. Post-exercise urine specific gravity was lower with the CFMO diet and urine pH was decreased with the CFSO diet. Blood urea nitrogen (BUN) and uric acid (UA) were significantly higher with the CFSO diet than with the other diets. There was no significant difference in skeletal and cardiac muscle injury indices and RPE among diets. Conclusions: CFMO led to better heart rate recovery, improved and maintained blood glucose levels, and increased removal of blood lactate. CFSO accelerated removal of blood lactate during recovery, maintained oxygen supply, and increased fluid retention.
Asia Pac J Clin Nutr. 2017;26(6):1066-1075.doi: 10.6133/apjcn.122016.06
>>Abstract
>> Download PDF
High prevalence of vitamin B-12 insufficiency in patients with
Crohn’s disease
Author:Misora Ao, Hidemi Tsuji, Kenichiro Shide, Yuki Kosaka, Akari Noda, Nobuya Inagaki, Hiroshi Nakase, Kiyoshi Tanaka
Keywords:vitamin B-12, homocysteine, Crohn’s disease, malabsorption, vitamin
Abstract:Background and Objectives: In Crohn’s disease (CD), belonging to inflammatory bowel disease, the small intestine is involved in most cases. Most frequently affected is the distal
ileum, where vitamin B-12 is specifically absorbed. Therefore, malabsorption of vitamin B-12 is quite likely to occur in patients with CD. In this study, we have studied the vitamin B-12 status in CD patients. Methods and Study Design: Forty eight patients with CD were evaluated for their food intake, and circulating concentrations of vitamin B-12, folic acid, and
homocysteine (Hcy) as a sensitive marker for the insufficiency of these vitamins and a risk factor of atherosclerosis. Results: Plasma Hcy concentration was significantly correlated with
serum vitamin B-12 concentration alone, and 60.4 % of the subjects had hyperhomocysteinemia. Receiver Operating Characteristics (ROC) analysis showed that serum concentration of vitamin B-12, but not folic acid, predicted hyperhomocysteinemia. Their intake of vitamin B-12 was much higher than the Japanese RDA, but not correlated with blood concentrations of vitamin B-12 or Hcy, probably due to malabsorption. Discussion: Vitamin B-12 insufficiency and hyperhomocysteinemia were highly prevalent in CD patients. Recently, the significance of extra-intestinal complications of CD has been increasingly recognized, and our finding is likely to be of clinical importance.
Asia Pac J Clin Nutr. 2017;26(6):1076-1081.doi: 10.6133/apjcn.022017.13
>>Abstract
>> Download PDF
Association between complement component C3 and body composition: a possible obesity inflammatory biomarker for insulin resistance
Author:Hayder A Al-Domi, Reem M Al Haj Ahmad
Keywords:ASP, BIA, HOMA-IR, proinflammatory, complement system
Abstract:Background and Objectives: The C3 complement component (C3) is increasingly recognized as a cardiometabolic risk factor. We aimed to examine the role of C3 in insulin resistance (IR) and its association with adiposity. Methods and Study Design: Sixty-seven obese (18-35 years) participants were matched with normal weight participants from the University of Jordan. BMI, waist-hip ratio (WHpR), and waist-height ratio (WHtR) were calculated. Body percent fat mass (%FM) was determined using the bioelectrical impedance analysis. C3, insulin, and glucose serum concentrations were measured. IR was assessed by the homeostasis model assessment of IR (HOMA-IR). Results: Serum concentrations of C3 and IR were significantly higher in the obese group than that in the normal body weight, regardless of gender (women: 1.2±0.08 and men: 1.2±0.08 vs women: 0.88±0.07 and men: 0.94±0.05, p<0.01; women: 3.6±0.34 and men: 3.9±0.43 vs women: 1.7±0.12 and men: 2.0±0.24, respectively; p<0.001). After adjustment for the potential confounders, BMI, waist circumference, WHtR and %FM were correlated positively with C3 (r=0.44; 0.42; 0.47; 0.43, respectively; p<0.001), and with IR (r=0.67; 0.61; 0.59; 0.59, respectively; p<0.001). C3 was correlated with IR (r=0.35, p<0.001). In linear regression analysis, C3 was not associated with IR independent of BMI (p>0.05). Conclusions: C3 may be a marker of chronic inflammatory process independently underlying IR obese individuals regardless of gender, which may have a role in the progression of IR during obesity.
Asia Pac J Clin Nutr. 2017;26(6):1082-1087.doi: 10.6133/apjcn.012017.02
>>Abstract
>> Download PDF
Reconfirmation of improved tolerance to a new amino acid-based formula by infants with cow’s milk protein allergy
Author:Pipop Jirapinyo, Narumon Densupsoontorn, Channagan Kangwanpornsiri, Renu Wongarn, Hathaichanok Tirapongporn, Kwanjai Chotipanang, Phakkanan Phuangphan
Keywords:amino acid-based formula, corn glucose polymer, cow’s milk protein allergy,
Abstract:Background and Objectives: Reasons for intolerance to commercial amino acid-based formulas (cAAF) in infants diagnosed with cow’s milk protein allergy (CMA) remain unknown. We assume that minute amounts of proteins, presenting in the glucose polymers derived from corn starch (cGPs), can elicit the intolerance to the cAAFs observed in some infants with CMA. By replacing cGPs with glucose polymers derived from rice starch (rGPs), a new amino acid-based (nAAF) formula has been shown to be better tolerated than an existing cAAF. This study was carried out to corroborate the superiority of nAAF over a different
commercially available cAAF. Methods and Study Design: Infants with CMA aged less than 4 months underwent a double-blind, placebo-controlled food challenge. They consumed each of the 2 test formulas for 14 days before switching to the other one. Following the 28-day challenge period, infants consumed the tolerated formula for 4 weeks as an at-home open challenge. Results: Out of 36 infants who completed the study, 18 were intolerant to the cAAF,
seven of whom (38.8%) were also intolerant to the nAAF. Eleven of the 18 infants who were intolerant to the cAAF tolerated the nAAF (p˂0.01). Conclusion: This study reconfirms that substitution of rGPS for cGPs in the amino acid-based formula improves tolerance of young infants with CMA.
Asia Pac J Clin Nutr. 2017;26(6):1088-1091.doi: 10.6133/apjcn.022017.14
>>Abstract
>> Download PDF
Dietary intake of heme iron and body iron status are associated with the risk of gestational diabetes mellitus: a systematic review and meta-analysis
Author:Lu Zhao, Jia Lian, Jishun Tian, Ye Shen, Zhiguang
Keywords: pregnancy, diabetes mellitus, heme iron, nonheme iron, supplemental iron
Abstract:Background and Objectives: Some potential role of iron overload in the development of diabetes mellitus have been suggested. Our study aimed to systematically assess the association between the risk of gestational diabetes mellitus (GDM) and iron intakes/body iron status. Methods and Study Design: PubMed and Web of Science were searched for relevant articles. Relative risks (RR) of GDM in relation to dietary iron intakes and body iron stores were pooled with the random-effects model. Weighted mean differences of iron blood markers between GDM and non-GDM individuals were also analyzed. Results: Twenty-five studies were included in the qualitative analysis, and 23 studies with 29,378 participants and 3,034 GDM patients were included in the quantitative analysis. Dietary intake of heme iron was significantly associated with GDM risk (RR=1.65, 95% CI: 1.28 to 2.12), and the pooled RR for each 1mg/day increment of heme iron intake was 1.38 (95% CI: 1.19 to 1.61). No association between GDM and the intakes of nonheme iron, total iron, or supplemental iron was detected. Body iron stores, as represented by serum ferritin level, were correlated with GDM risk (RR=1.64, 95% CI: 1.27 to 2.11). Moreover, the concentrations of both serum ferritin and serum iron were increased in GDM patients, compared with non-GDM individuals. Conclusions: Increased dietary intake of heme iron and body iron status are positively associated with the risk of GDM development in pregnant women. Future studies are warranted to better understand the role of iron in GDM development.
Asia Pac J Clin Nutr. 2017;26(6):1092-1106.doi: 10.6133/apjcn.022017.09
>>Abstract
>> Download PDF
Screening for nutritional risk in hospitalized children with liver disease
Author:Tiantian Song, Ying Mu, Xue Gong, Wenyan Ma, Li Li
Keywords: children, liver disease, nutritional risk screening, malnutrition, nutritional support
Abstract:Background and Objectives: Malnutrition is a major contributor to morbidity and mortality from pediatric liver disease. We investigated the prevalence of both malnutrition and high nutritional risk in hospitalized children with liver disease as well as the rate of in-hospital nutritional support. Methods and Study Design: A total of 2,874 hospitalized children and adolescents with liver disease aged 1 to 17 years (inclusive) were enrolled. Malnutrition was screened by anthropometric measures (height-for-age, weight-for-height, weight-for-age, and BMIfor-age z-scores). The Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) was used to evaluate nutritional risk status. Nutrition markers in blood, rate of nutritional support, length of hospital stay, and hospital fees were compared among nutritional risk groups. Results: The overall prevalence of malnutrition was 38.6%. About 20.0% of children had high nutritional risk, and prevalence of malnutrition was markedly greater in the high nutritional risk group compared with the moderate risk group (67.9% vs 31.3%). Serum albumin and prealbumin differed significantly between high and moderate risk groups (p<0.001). Only 8.9% of children with high nutritional risk and 3.5% with moderate nutritional risk received nutrition support during hospitalization. Children with high nutritional risk had longer hospital stays and greater hospital costs (p<0.001). Conclusions: The prevalence of malnutrition is high in children with liver disease. High nutritional risk is also prevalent at admission. Albumin and prealbumin are sensitive markers for distinguishing nutritional risk groups. High nutritional risk prolongs length of stay and increases hospital costs. The nutritional support rate is still low and requires standardization.
Asia Pac J Clin Nutr. 2017;26(6):1107-1112.doi: 10.6133/apjcn.022017.06
>>Abstract
>> Download PDF
Qualitative study of eating habits in Bruneian primary school children
Author:Tajidah Talip, Rajiah Serudin, Salmah Noor, Nik Tu
Keywords:eating habits, childhood obesity, qualitative design, school health, Brunei
Abstract:Background and Objectives: Childhood obesity is a serious public health issue globally and poor eating habits are an important contributing factor. This study aimed to explore the perceptions, practices and attitudes towards healthy eating in Bruneian primary school children. Methods and Study Design: A qualitative study was conducted among 40 subjects involving 18 children (aged 9-10 years old), 12 parents and 10 teachers, who were recruited from two primary schools using convenience sampling. Five focus group discussion sessions were conducted, and recorded discussions were translated. The transcripts were entered into NVivo10 and thematic analysis was conducted. Results: All participants had differing perceptions of the term ‘healthy eating’. Children reported ‘healthy eating’ by identifying foods or food groups they perceived as healthy and unhealthy. Only a few mentioned fruits and vegetables as essential to a healthy diet. Parents mainly perceived ‘healthy eating’ as consuming ‘any quality food’ that contains ‘vitamins and minerals’. Teachers described a healthy diet as including balanced and varied dietary practices, having breakfast and eating regularly at the right, set times. They also associated eating healthily with traditional, home-grown and home-cooked food. All participants had positive attitudes towards healthy eating, however most children demonstrated unhealthy eating habits and frequently consumed unhealthy foods. Conclusions: The Bruneian primary school children reported better knowledge despite having poor healthy eating habits. The factors influencing participants eating behavior included food preferences, familial factors (parental style and parenting knowledge), food accessibility and availability, time constraints, as well as convenience. These factors hindered them from adopting healthy eating practices
Asia Pac J Clin Nutr. 2017;26(6):1113-1118.doi: 10.6133/apjcn.022017.02
>>Abstract
>> Download PDF
Screening for inadequate dietary vitamin B-12 intake in South
Asian women using a nutrient-specific, semi-quantitative food
frequency questionnaire
Author:Gael Janine Mearns, Elaine Carolyn Rush
Keywords: food frequency questionnaire, vitamin B-12 deficiency, South Asian women, serum B-12, holotranscobalamin
Abstract:Background and Objectives: A high prevalence of vitamin B-12 (B-12) deficiency among
young women of South Asian origin predisposes to significant health risks for these women
and their future offspring. Vegetarian or low-meat based dietary practices contribute to B-12
deficiency. This study validated a nutrient-specific, semi-quantitative food frequency
questionnaire, developed to estimate dietary B-12 intake (B12FFQ) in South Asian women.
Methods and Study Design: The B12FFQ was developed, then tested in 60 apparently
healthy South Asian women aged 18-50 years, living in Auckland, New Zealand. Participants
recalled the frequency and quantity of vitamin B-12-containing foods consumed in the
preceding three months. Pearson’s correlations measured the associations between dietary B-
12 intake and B-12 biomarkers (serum B-12 and holotranscobalamin [holoTC]). Likelihood
of B12 insufficiency was calculated for vegetarian and non-vegetarian dietary practices.
Results: The B12FFQ was a valid measure of dietary B-12 intake - supported by moderate
positive associations with serum B-12 (r=0.50, p<0.001, 95% CI [0.28, 0.67]) and holoTC
(r=0.55, p<0.001, 95% CI [0.34, 0.71]). A dietary B-12 intake of less than 2.4 µg/day
increased the likelihood of serum B-12 (X2 (1)=11.79, p=0.001) or holoTC (X2 (1)=6.33,
p=0.012) insufficiency. A dietary B-12 intake of less than the recommended dietary
allowance (2.4 µg/day), occurred in 61% (n=20/33) of participants with vegetarian and 22%
(n=6/27) with non-vegetarian dietary practices. Conclusions: The B12FFQ provides a valid
estimate of dietary B-12 intake. This easily administered food frequency questionnaire has
the potential to identify low dietary B-12 intake as a contributor to B-12 depletion or
deficiency.
Asia Pac J Clin Nutr. 2017;26(6):1119-1124.doi: 10.6133/apjcn.112016.06
>>Abstract
>> Download PDF
Snack and beverage consumption and preferences in a sample of Chinese children-Are they influenced by advertising?
Author:Peng Liu, Yang Yu, Lesley King, Mu Li
Keywords:snack, beverages, noncore foods, television advertisement, children
Abstract:Background and Objectives: The consumption of unhealthy snack and beverages can lead to childhood obesity, which has become a major concern globally. Television food advertisements may influence children's snack and beverages preferences. This article aims to explore children's snack and beverage consumption habits; examine the extent of television advertising for noncore (energy-dense, nutrient poor) snack and beverages; and assess the influence of television advertising on children's snack and beverages preferences in Harbin, China. Methods and Study Design: The study consisted of two components, a recall survey on the snack and beverage consumption and preferences of 9-11 years old school children; and recording snack and beverage advertisements on three popular television channels. Odds Ratio (OR) was used to estimate the likelihood of children selecting particular snack and beverages as their top three choices according to whether their preferences were influenced by television advertisements. Results: The majority of children consumed non-core snacks (100%) and beverages (80%) in the four weeks prior to the survey. Nearly 40% of television food advertisements were for non-core snacks and beverages. Non-core snacks (OR of 1.13) and non-core beverages (OR of 1.23) were more likely chosen as children's top three snack/beverage choices, particularly, "puffed food and tubers" snack and carbonated beverages (OR of 1.31 and 1.45, respectively). Conclusions: The snack and beverage preferences appeared to be influenced by television advertisements in this sample of Chinese children, highlighting the potential health and nutritional value of policy to reduce advertising of non-core foods in China.
Asia Pac J Clin Nutr. 2017;26(6):1125-1132.doi: 10.6133/apjcn.012017.04
>>Abstract
>> Download PDF
Dietary sodium reduction in New Zealand: influence of the Tick label
Author:Sherry X Ning, Louise A Mainvil, Rachel K Thomson, Rachael M McLean
Keywords:food industry, New Zealand, sodium dietary, food labelling, cardiovascular disease
Abstract:Background and Objectives: The Tick programme of the National Heart Foundation (NHF) is the longest standing voluntary front of pack signpost nutrition logo in New Zealand. It provides a platform for collaboration with the food industry to encourage development of healthier products. This study evaluated the impact of the Tick programme on sodium in processed food. Methods and Study Design: Fifty-two Tick programme products from food categories known to contribute substantially to sodium intake were identified. Sales volumes (kg) from January 2011 to December 2013 were multiplied by changes in sodium content over that time, producing an estimate of programme impact. Five semi-structured interviews with industry representatives were conducted, to look at other influences for sodium reduction, and themes identified through methods of thematic analysis. Results: Over the period, the Tick programme influenced food companies to remove approximately 16 tonnes of salt through the reformulation and formulation of 52 Tick-approved breakfast cereals, edible oil spreads, cooking sauces and processed poultry products. Other factors influencing sodium reduction reported by company representatives included increased consumer and industry interest in healthier product nutrition profiles and other sodium reduction programmes targeting reformulation/formulation. Conclusions: The Tick remains a credible and well-recognized brand and may provide a competitive edge for participating food manufacturers in the current market. The Tick programme is effective in influencing industry to reduce sodium in processed foods in New Zealand. The combined impact of the Tick and other NHF programmes has the potential to reduce population sodium intake and improve health outcomes.
Asia Pac J Clin Nutr. 2017;26(6):1133-1138.doi: 10.6133/apjcn.032017.06
>>Abstract
>> Download PDF
Comprehensive school-based intervention to control overweight and obesity in China: a cluster randomized controlled trial
Author:Haiquan Xu, Yanping Li, Qian Zhang, Xiaoqi Hu, Ail
Keywords:childhood obesity, comprehensive intervention, physical activity, nutrition, lipids
Abstract:Background and Objectives: With prevalence of childhood obesity increasing rapidly, developing of effective and sustainable intervention strategies is becoming more and more important for the prevention of childhood obesity in China. A trial was developed to evaluate the effect of comprehensive school-based intervention on childhood obesity. Methods and Study Design: A multi-center cluster randomized controlled trial was conducted among urban children (n=9,867) aged 6-13 years in 38 primary schools from six large cities. Comprehensive intervention, nutrition education and physical activity interventions were carried out among children. Nutrition education was also targeted towards teachers, parents and health workers in intervention schools. The program was implemented for 2 semesters from May 2009 to May 2010. Results: The combined prevalence of overweight and obesity increased by 1.5 percent (22.7% vs 24.2%, p<0.001) in control group while 0.2 percent in comprehensive intervention group (23.6% vs 23.8%, p=0.954) after intervention (p=0.067). The effect was significantly stronger among girls than boys (-1.4% vs -0.9%, p=0.028). A significant intervention effect was found on BMI for -0.3 kg/m2 (95% confidence interval (CI): -0.4, -0.2; p<0.001), BMI z scores for -0.14 (95% CI: -0.18, -0.11; p<0.001)，body fat for -0.8 percent (95% CI: -0.9, -0.6; p<0.001), waist circumference for -0.5 cm (95% CI: -0.6, -0.3; p<0.001), blood serum glucose for -0.20 mmol/L (95% CI: -0.24, -0.16; p<0.001) and cholesterol for -0.32 mmol/L (95% CI: -0.34, -0.30; p<0.001). Conclusions: We observed moderately significant effects on combined prevalence of overweight and obesity, BMI, BMI z scores, waist circumference, percentage body fat, glucose and lipid for a comprehensive school-based intervention of childhood obesity in China.
Asia Pac J Clin Nutr. 2017;26(6):1139-1151.doi: 10.6133/apjcn.112016.05
>>Abstract
>> Download PDF
Association between rice intake and all-cause mortality among Chinese adults: findings from the Jiangsu Nutrition Study
Author:Zumin Shi, Shiqi Zhen, Lu Qi, Yijing Zhou, Anne W Taylor
Keywords:rice intake, mortality, Chinese, cohort study, epidemiology
Abstract:Backgrounds and Objectives: The few studies that have assessed the association between rice intake and mortality have generated inconsistent results. We assessed whether rice intake was associated with cardiovascular disease (CVD) mortality, cancer mortality and all-cause mortality in a prospective cohort of the Chinese population. Methods and Study Design: We prospectively studied 2832 adults aged 20 years and above with a mean follow up of 10 years. Rice intake was measured by a 3-day weighed food record (WFR) in 2002. Hazard ratios (HRs) and 95%CI were calculated by competing risks regression (CVD and cancer mortality) and Cox proportional hazards analysis (all-cause mortality). Results: We documented 184 deaths (including 70 CVD deaths and 63 cancer deaths) during 27,742 person-years of follow-up. No association between rice intake and all-cause mortality was found. After adjusting for sociodemographic and lifestyle factors as well as energy and fat intake, HRs for CVD mortality across tertiles of rice intake were 1.00, 0.47(95% CI 0.25-0.87), and 0.49(95% CI 0.21-1.13) (p for trend 0.049). Conclusion: There was no association between rice intake and all-cause mortality.
Asia Pac J Clin Nutr. 2017;26(6):1152-1157.doi: 10.6133/apjcn.012017.05
>>Abstract
>> Download PDF
Dietary patterns and sleep parameters in a cohort of community
dwelling Australian men
Author:Yingting Cao, Anne W Taylor, Gary Wittert, Robert Adams, Zumin Shi
Keywords:dietary patterns, polysomnography, sleep onset latency, apnoea hypopnea index, men
Abstract:Background: Emerging evidence suggests potential effects of nutrients/foods on sleep
parameters. However, no studies have addressed the complex interactions among
nutrients/foods and relate them to sleep outcomes. Objective: To investigate the
associations between dietary patterns and sleep parameters (polysomnography (PSG)
measured and self-reported sleep symptoms) in a large sample of community dwelling men in
South Australia. Methods: Cross-sectional analysis was conducted of participants in the
Men Androgen Inflammation Lifestyle Environment and Stress cohort enrolled in a sleep
sub-study (n=784, age 35-80 years). Dietary intake was measured by a validated food
frequency questionnaire. Dietary patterns were identified by factor analysis. Sleep was
assessed by an overnight home PSG and self-reported questionnaires. Results: Two factors
were obtained by factor analysis: Factor 1 was characterised by high intakes of vegetables,
fruits, and legumes and factor 2 was characterised by processed meat, snacks, red meat and
take-away foods. Three categories of the dietary patterns were defined (prudent, mixed and
western) through classification of the sample according to the actual consumption higher or
lower of each factor. The prudent (factor 1 dominant) and mixed dietary patterns were
inversely associated with sleep onset, compared with the western dietary pattern (factor 2
dominant) (β=-6.34 (95% CI-1.11, -11.57), β=-4.34 (95% CI-8.34, -0.34) respectively)). The
association was only significant with the prudent dietary pattern after multiple comparison
adjustment. No associations were found with between dietary patterns and other sleep
outcomes. Conclusions: The prudent dietary pattern was associated with a faster sleep onset,
which may provide a solution for sleep management.
Asia Pac J Clin Nutr. 2017;26(6):1158-1169.doi: 10.6133/apjcn.122016.03
>>Abstract
>> Download PDF
A single-nucleotide polymorphism in transferrin is
associated with soluble transferrin receptor levels in Chinese
adolescents
Author:Wei Piao, Li Wang, Ting Zhang, Zhen Wang, Shaofang Shangguan, Jing Sun, Junsheng Huo
Keywords:single-nucleotide polymorphism, hepcidin, serum ferritin, soluble transferrin receptor, Chinese adolescents
Abstract:Background and Objective: Associations between genetic variants in the hepcidin regulation
pathway and iron status have been reported in previous studies. Most of these studies were
conducted in populations of European descent and relatively few studies have been conducted in
Chinese populations. In this study, we evaluated associations between single-nucleotide
polymorphisms (SNPs) in the hepcidin regulation pathway and the levels of serum ferritin (SF)
and soluble transferrin receptor (sTfR) in Chinese adolescents. Methods and Study Design: In
total, 692 students from rural boarding schools were selected from six cities in China. The
participants were divided into case and control groups according to criteria for SF and sTfR.
Furthermore, 33 SNPs in TMPRSS6, TF, TFR2, BMP2, BMP4, HJV, CYBRD1, HFE, IL6, PCSK7,
HAMP, KIAA1468, and SRPRB were selected. Associations between the genetic variants and SF
or sTfR were detected. Results: For SF, rs4820268 in TMPRSS6 was associated with an SF <25
ng/mL status. Carriers of the G/G genotype of rs4820268 exhibited significantly lower SF levels
than A allele carriers did (p = 0.047). For sTfR, rs1880669 in TF, rs4901474 in BMP4, and
rs7536827 in HJV were significantly associated with an sTfR ≥4.4 mg/L status. However, in
general linear model analysis, after adjustment for age, sex, and location, only rs1880669
exhibited a stable association with higher sTfR levels (p=0.032). Conclusion: We found
rs4820268, in TMPRSS6 that was associated with a low SF level, as previously reported, and a
new association between 1880669 in TF and sTfR.
Asia Pac J Clin Nutr. 2017;26(6):1170-1178.doi: 10.6133/apjcn.112016.04
>>Abstract
>> Download PDF
