Asia Pacific Journal of Clinical Nutrition (ASIA PAC J CLIN NUTR )

Publisher: Asia Pacific Clinical Nutrition Society; Australasian Clinical Nutrition Society; Asia Pacific Public Health Nutrition Association; International Union of Nutritional Sciences, Blackwell Publishing


Asia Pacific Journal of Clinical Nutrition is a peer reviewed journal published for the Asia Pacific Clinical Nutrition Society.The aims of the Asia Pacific Clinical Nutrition Society (APCNS) are to promote the education and training of clinical nutritionists in the region and to enhance the practice of human nutrition and related disciplines in their application to health and the prevention of disease.Asia Pacific Journal of Clinical Nutrition publishes original research reports, short communications reviews, and letters to the editors. Letters to the editors may take several forms: they may be very short articles (500 words) containing new material, case reports, or comments on previous papers or on other topics of current interest. News, book reviews and other items may also be included.

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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: We examined coffee consumption patterns over the past decade among Korean adults. This study was based on seven different cross-sectional data from the Korean National Health and Nutrition Examination Survey (KNHANES) between 2001 and 2011 (17,367 men and 23,591 women aged 19-103 y, mean 48.1 y). Information on frequency and type of coffee consumption was derived from frequency questionnaires or 24-hour recalls. For the study period, the prevalence of daily coffee consumption increased by 20.3% (from 54.6 to 65.7%; p<0.001). For those who consumed 2 or more cups of coffee daily, it dramatically increased by 48.8% (from 29.1 to 43.3%; p<0.001). The instant coffee mix was consumed the most frequently by Korean adults, and it was on the increasing trend among people who were middle aged or older (>=40 y), while it was on the slowdown in young men or on the declining trend in young women. Brewed coffee consumption had an increasing trend by all age groups in recent years. Especially, there was a rapid increase in brewed coffee consumption among young women (strongly) and young men. The instant coffee mix that contains non-dairy creamer and/or sugar still takes up a significant portion of coffee consumption in Korea, which may result in weight gain and insulin resistance, and potential benefits of coffee may be offset. Given high prevalence of coffee consumption in Korea, nutrition education should be conducted to help people (especially the elderly) to make healthy coffee drinking habits.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):691-702.
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    ABSTRACT: Background and aim: Glycated hemoglobin (HbA1c) assessment is basic to diabetes management. Little is done to describe the whole spectrum of the trajectory, its related temporal patterns of metabolic indices, and comorbidities. Methods and Results: This was a longitudinal study. In the Diabetes Management through Integrated Delivery System project in Taiwan, enrollees had diabetes, but no major comorbidities. They were randomized into intensive or conventional education (health, diet and exercise) groups. HbA1c was classified by a groupbased trajectory model on the basis of repeated six-monthly measurements. We analyzed data from 1091 subjects who had at least two measurements on HbA1c. HbA1c exhibited three distinct ranges of low (42-53 mmol/mol), intermediate (64-75 mmol/mol) and high (97 mmol/mol), all of which persisted for 4.5 years regardless of receiving intensive education or not. Temporal changes and a time-group interaction were found for triglycerides, total cholesterol, HDL-C and LDL-C. The high trajectory was associated with the major co-morbidities of retinopathy, nephropathy, neuropathy, stroke, hypoglycemia, and ketoacidosis. Patients in the intensive education group (62.4%), which were equally distributed in the three trajectories, had significantly lower HbA1cs (-0.14%= -1.5 mmol/mol, p=0.026). The intermediate trajectory patients with intensive education had HbA1cs higher than the low trajectory patients with conventional education (β=0.189, p=0.033). Though not significant, a similar pattern was found for DM education in the high group (β=0.223, p=0.154). Conclusions: Novel strategies beyond current education and pharmacotherapeutic regimens are needed to lower HbA1c at least 11 mmol/mol for the high HbA1c group to minimize comorbidities.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):592-606.
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    ABSTRACT: Elderly Greek-born Australians (GA) consistently show lower rates of all-cause and CVD mortality compared with Australian-born. Paradoxically, however, this is in spite of a higher prevalence of CVD risk factors. This paper reviews the findings from the Food Habits in Later Life (FHILL) study, other studies on Greek migrants to Australia and clinical studies investigating dietary mechanisms which may explain the "morbidity mortality paradox". The FHILL study collected data between 1988 and 1991 on diet, health and psycho-social variables on 818 people aged 70 and over from Sweden, Greece, Australia (Greeks and Anglo-Celts), Japan and were followed up for 5-7 years to determine survival status. The FHILL study was the first to develop a score which captured the key features of a traditional plant-based Mediterranean diet pattern (MDPS). A higher score improved overall survival in both Greek and non-Greek elderly reducing the risk of death by 50% after 5-7 years. Of the 5 cohorts studied, elderly GA had the lowest risk of death, even though they had the highest rates of obesity and other CVD risk factors (developed in the early years of migration with the introduction of energy dense foods). GA appeared to be "getting away" with these CVD risk factors because of their continued adherence in old age to a Mediterranean diet, especially legumes. We propose that the Mediterranean diet may, in part, be operating to reduce the risk of death and attenuate established CVD risk factors in GA by beneficially altering the gut microbiome and its metabolites.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):532-544.
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    ABSTRACT: Background: Cambodia is among the 28 worst countries globally with the highest rates of childhood malnutrition. The aim of the assessment was to apply published evidence associating malnutrition and a variety of functional consequences to project economic implications of this high rate of childhood malnutrition. Such information is vital to advocate for appropriate programs and action plan to reduce malnutrition (from severe stunting to micronutrient deficiencies). Methods: This exercise used a "consequence model" to apply these "coefficients of loss" established in the global scientific literature to Cambodia health, demographic and economic data to develop a national estimation of the economic losses link to malnutrition. Results: The impact of the indicators of malnutrition analysed represent a burden to the national economy of Cambodia estimated at more than $400 million annually -2.5% of GDP. Micronutrient deficiencies suggest deficits in the quality of the diet - representing a national burden of more than $200 million annually while breastfeeding behaviours account for 6% of the burden. 57% of the losses emerge from indicators measured in children, while 43% of losses are from indicators independent of childhood measurements - indicators of maternal behaviour along with maternal and adult nutrition. Conclusions: Given the low cost of interventions and the high baseline losses, investment in nutrition programs in Cambodia is likely to offer high returns and attractive benefit cost ratios. Since nearly half the losses are determined prior to the birth of the child, this has implications for targeting and timing of programs.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):524-531.
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    ABSTRACT: Asian regions have been suffering from growing double burden of nutritional health problems, such as undernutrition and chronic diseases. National nutrition survey plays an essential role in helping to improve both national and global health and reduce health disparities. The aim of this review was to compile and present the information on current national nutrition surveys conducted in Asian countries and suggest relevant issues in implementation of national nutrition surveys. Fifteen countries in Asia have conducted national nutrition surveys to collect data on nutrition and health status of the population. The information on national nutrition survey of each country was obtained from government documents, international organizations, survey website of governmental agencies, and publications, including journal articles, books, reports, and brochures. The national nutrition survey of each country has different variables and procedures. Variables of the surveys include sociodemographic and lifestyle variables; foods and beverages intake, dietary habits, and food security of individual or household; and health indicators, such as anthropometric and biochemical variables. The surveys have focused on collecting data about nutritional health status in children aged under five years and women of reproductive ages, nutrition intake adequacy and prevalence of obesity and chronic diseases for all individuals. To measure nutrition and health status of Asian populations accurately, improvement of current dietary assessment methods with various diet evaluation tools is necessary. The information organized in this review is important for researchers, policy makers, public health program developers, educators, and consumers in improving national and global health.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):514-523.
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    ABSTRACT: Background: Iodine content in table salt was adjusted from 30-50 mg/kg to 21-39 mg/kg from March of 2012 in Henan Province, China. The vulnerable population may be at risk of iodine deficiency. Objectives: To determine whether the iodine intake was sufficient in vulnerable populations and to investigate what factors may be associated with iodine status in these vulnerable populations in Henan Province, China. Methods: A cross-sectional survey was conducted in 17 cities in Henan Province, China, from April 2012 to December 2012 to assess the iodine status in vulnerable populations, including women of reproductive-age (n=2648), pregnant women (n=39684), lactating women (n=6859), infants <2 years of age (n=16481), and children aged 8-10 years (n=3198). Questionnaires (n=4865) related to demographic and dietary factors were collected from the investigated women to identify factors that were related to iodine intake and iodine status. Results: The median urinary iodine concentrations (mUICs) were 205 μg/L, 198 μg/L, 167 μg/L, 205 μg/L and 200 μg/L, respectively, in reproductiveage, pregnant and lactating women, infants <2 years of age and children aged 8-10 years. Higher income, and consuming more poultry and fish in the diet had positive impact on UIC levels. Low salt intake, consuming more rice and vegetables in the diet were negative factors for UIC. Conclusions: Iodine status of the vulnerable populations was generally adequate in Henan Province, China, according to WHO criteria. But the mUICs were slightly above the adequate level in reproductive-age women and children aged 8-10 years. It's important to monitor the iodine status in vulnerable populations after the adjustment on iodine content in table salt.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):626-633.
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    ABSTRACT: Background: Probiotics are microbial supplements that have shown efficacy in a wide range of applications. To assess the safety and effects of enteral probiotics in critically ill neonates. Methods: A double-blind, randomized controlled trial was conducted in 100 full-term infants with critical illness according to scores of neonatal acute physiology. Fifty neonatal intensive care patients were randomly assigned to receive probiotics three times daily after birth for 8 days, and fifty patients were not given probiotics, but who received a placebo. The incidence of sepsis, multiple organ dysfunction syndrome (MODS), nosocomial pneumonia, and necrotizing enterocolitis were recorded. The prognosis of probiotic treatment was determined based on the rate of recovery and hospital days. Serum IgA, IgG, and IgM concentrations were measured on days 4 and 8. Results: Infants in the probiotics group showed a significantly reduced rate of nosocomial pneumonia (18% versus 36%) and multiple organ dysfunction syndrome (6% versus 16%) compared with the placebo group (p<0.05). Significant results were demonstrated in favour of the probiotics for days of hospital stay (13±3.5 d versus 15.8±5.3 d) (p<0.05). However, there were no significant differences in the occurrence of sepsis, necrotizing enterocolitis, and recovery rate. Patients given probiotics had significantly greater levels of IgA than those in the placebo group (p<0.05). No serious adverse effects in the study population were noted. Conclusions: Supplements of probiotics to critically ill neonates could enhance immune activity, decrease occurrence of nosocomial pneumonia and MODS, and reduce days in hospital.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):575-580.
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    ABSTRACT: Food affordability and quality can influence food choice. This research explores the impact of geographic factors on food pricing and quality in Western Australia (WA). A Healthy Food Access Basket (HFAB) was cost and a visual and descriptive quality assessment of 13 commonly consumed fresh produce items was conducted in-store on a representative sample of 144 food grocery stores. The WA retail environment in 2010 had 447 grocery stores servicing 2.9 million people: 38% of stores the two major chains (Coles® Supermarkets Australia and Woolworths ® Limited) in population dense areas, 50% were smaller independently owned stores (Independent Grocers Association®) in regional areas as well, and 12% Indigenous community stores in very remote areas. The HFAB cost 24% (p<0.0001) more in very remote areas than the major city with fruit (32%, p<0.0001), vegetables (26.1%, p<0.0005) and dairy (40%, p<0.0001) higher. Higher price did not correlate with higher quality with only 80% of very remote stores meeting all criteria for fresh produce compared with 93% in Perth. About 30% of very remote stores did not meet quality criteria for bananas, green beans, lettuce, and tomatoes. With increasing geographic isolation, most foods cost more and the quality of fresh produce was lower. Food affordability and quality may deter healthier food choice in geographically isolated communities. Improving affordability and quality of nutritious foods in remote communities may positively impact food choices, improve food security and prevent diet-sensitive chronic disease. Policy makers should consider influencing agriculture, trade, commerce, transport, freight, and modifying local food economies.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):703-713.
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    ABSTRACT: Many studies have demonstrated the efficacy of folic acid (FA) supplementation in prevention of neural tube defects (NTDs), although the extent of NTDs varies among individuals of different races and ethnic origin. China is a multi-ethnic country with no standard practice for FA-fortified food. Milk is consumed by women, but little is known about the effects of milk on folate concentration in maternal blood and neonatal umbilical cord blood in Han and Mongolian women after stopping taking the supplement for a month and five month, respectively. The objective of this study was to determine whether only daily consumption of liquid milk can increase the blood folate concentration in pregnant women and whether there are differences in blood folate concentrations between Han and Mongolian women after cessation of FA supplementation. Of the 4052 women enrolled in the parallel group design study. Three thousand five hundred and twenty-six women had confirmed pregnancies and were randomized to receive liquid milk or not until delivery. Women who consumed the liquid milk had significantly increased serum folate concentrations at 16 and 32 weeks of gestation as well as cord blood at birth compared to control groups in both ethnic groups. Infants born to women drinking milk also had better the term birth weight and height, which may be related to the increased concentration of folate. In conclusion, daily consumption of milk can increase the serum folate concentration in pregnant Han and Mongolian women in China (differences in the efficacy of FA and milk supplementation) and may enhance birth outcomes.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):567-574.
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    ABSTRACT: Minimally invasive esophagectomy has recently become popular after the laparoscopic technique was developed. However, the postoperative energy expenditure in patients undergoing this procedure has not been evaluated. Therefore, we hypothesized that postoperative resting energy expenditure (REE) following minimally invasive esophagectomy is lower than that estimated using the Harris-Benedict equation. Fifteen patients who underwent esophagectomy by thoracoscopy in the prone position were analyzed. After esophagectomy, an indirect calorimeter measured the energy expenditure during ventilation in the ICU. These values and the estimated basal energy expenditure values were compared using the paired t test. The mean age was 66±10 years and mean duration of ventilator use in the ICU was 697±70 mins. The acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores at the time of ICU admission were 13±4 and 2±1, respectively. The average temperature, heart rate, and respiratory rate during ventilation were 36.2±0.6°C, 67±9 beats/min, and 12±2/min, respectively. The average REE during ventilation was 985±167 kcal/day (18.1±3.4 kcal/kg/day). The estimated REE was 1191±159 kcal/day. The average REE measured using the indirect calorimeter during ventilation was significantly lower than the estimated REE (83±10% of the estimated REE, p<0.001). In conclusion, the REE measured by an indirect calorimeter after minimally invasive esophagectomy at early postoperative stage under sedation was significantly lower than the REE estimated using the Harris-Benedict equation.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):555-559.
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    ABSTRACT: Background: Clinical practice guidelines recommend objective nutritional assessments in managing chronic kidney disease (CKD) patients but were developed while referencing to a North-American population. Specific recommendations for assessing muscle mass were suggested (mid-arm circumference, MAC; corrected mid-arm muscle area, cAMA; mid-arm muscle circumference, MAMC). This study aimed to assess correlation and association of these assessments with dietary protein intake in a multi-ethnic Asian population of healthy and CKD patients. Methods: We analyzed 24-hour urine collections of selected participants to estimate total protein intake (TPI; g/day). Ideal body weight (IDW; kg) was calculated and muscle assessments conducted. Analyses involved correlation and linear regression, taking significance at p<0.05. Results: There were 232 stable CKD patients and 103 healthy participants comprising of 51.0% male, 38.5% Chinese, 29.6% Malay, 23.6% Indian, and 8.4% others. The mean TPI was 58.9±18.4 g/day in healthy participants and 53.6±19.4 g/day in CKD patients. When normalized to ideal body weight, TPI-IDW (g/kg/day) was similar in healthy and CKD participants. Overall, TPI was associated with MAC (r=0.372, p<0.001), cAMA (r=0.337, p<0.001), and MAMC (r=0.351, p<0.001). TPI-IDW was also associated with MAC (r=0.304, p<0.001), cAMA (r=0.202, p<0.001), and MAMC (r=0.200, p<0.001) but not for TPI normalized to actual body weight. When examined separately, TPI was associated with MAC, cAMA, and MAMC in both CKD and healthy participants, but was associated with TPI-IDW only in CKD patients. Conclusion: Total protein intake was associated with muscle assessments in all participants. TPI normalized to IDW should only be used in CKD patients.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):619-625.
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    ABSTRACT: It is important to identify patients who are at risk of malnutrition upon hospital admission as malnutrition results in poor outcomes such as longer length of hospital stay, readmission, hospitalisation cost and mortality. The aim of this study was to determine the prognostic validity of 3-Minute Nutrition Screening (3-MinNS) in predicting hospital outcomes in patients admitted to an acute tertiary hospital through a list of diagnosis-related groups (DRG). In this study, 818 adult patients were screened for risk of malnutrition using 3-MinNS within 24 hours of admission. Mortality data was collected from the National Registry with other hospitalisation outcomes retrieved from electronic hospital records. The results were adjusted for age, gender and ethnicity, and matched for DRG. Patients identified to be at risk of malnutrition (37%) using 3-MinNS had significant positive association with longer length of hospital stay (6.6±7.1 days vs 4.5±5.5 days, p<0.001), higher hospitalisation cost (S$4540±7190 vs S$3630±4961, p<0.001) and increased mortality rate at 1 year (27.8% vs 3.9%), 2 years (33.8% vs 7.2%) and 3 years (39.1% vs 10.5%); p<0.001 for all. The 3-MinNS is able to predict clinical outcomes and can be used to screen newly admitted patients for nutrition risk so that appropriate nutrition assessment and early nutritional intervention can be initiated.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):560-566.
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    ABSTRACT: The WHO recommends exclusive breastfeeding during the first 6 mo of life; however, deviations from this recommendation are widespread. The objective of the current study was to evaluate exclusive and predominant breastfeeding rates, as defined by the WHO, in a cross-sectional sample of Guatemalan children using retrospective records on the temporal pattern of introducing foods and beverages before 6 mo. Mothers of 150 infants, aged 6 to 23 mo, attending a public health clinic were interviewed about early life feeding practices with a structured questionnaire. In addition, the plausibility of the reported offering of liquids and foods, other than breast milk, since birth was checked against reported current feeding practices. We observed that estimated exclusive breastfeeding was rare with 14% of infants receiving exclusive breastfeeding for 5 mo, and only 9% for the recommended 6 mo. The proportion of infants with predominant breastfeeding, which allows certain liquids such as water, juices and ritual fluids, was 33% through 5 mo and 23% through 6 mo. One-quarter of mothers (n=38) reported implausible answers concerning age-of-introduction of liquids and foods. Nevertheless, retrospective reports at up to 2 y give credible outcomes for estimations of feeding pattern at 6 mo of age. Our findings match the findings of other studies conducted in Guatemala. Overall adherence to the WHO guidelines for feeding in the first semester of infancy was much less than ideal and in need of strengthening.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):634-640.
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    ABSTRACT: Financial restraints and poverty lead to poor diets and poor health outcomes. Limited research shows that socioeconomic status is related to home availability of certain foods. However, studies in this area have used different socio-economic indicators, which may not equally influence eating-related behaviors. Using multiple indicators of socio-economic status may provide a more accurate picture of these relationships. The aim of this study was to investigate whether several socio-economic indicators are independently associated with home availability of selected foods known to influence chronic disease risk in 50 year olds from Canterbury, New Zealand, participating in the CHALICE study. Participants were selected randomly from health research extracts from Canterbury. Data from 216 participants (110 females, 106 males) were included. The presence (but not quantity) of foods/beverages in the home was measured by a validated home food inventory. Linear regression analyses were performed for the following home food inventory scores: fruit, vegetables, lower fat dairy, obesogenic foods and sweetened beverages with household income, standard of living and education using multivariate models. Higher household income and standard of living were individually associated with a 2% to 3% higher fruit and vegetables (3 to 5 types/forms) and total food scores (6 to 9 types/forms) (p<0.03). Higher education level was associated with a 2.5% increase in fruit and vegetables score (4 types/forms) and an 8% decrease in sweetened beverages score (0.4 beverages) (p<0.02). These results suggest that using only one measure of socio-economic status cannot accurately capture the effects of social inequalities in food availability. Those experiencing the most social disadvantage had a lesser availability of fruit and vegetables which may be detrimental to good health.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):714-722.
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    ABSTRACT: In order to sustain life during the occurrence of a natural disaster, it is vital to ensure that people's intake of water and food is adequate (prioritizing first energy, then protein and water-soluble vitamins). Infants, pregnant women, patients, and the elderly are particularly vulnerable to insufficiencies in food intake, even if they are provided with the same quantity of food as others, and providing them with dietary and nutritional support becomes a high priority as their insufficient intake of energy and protein becomes long term. It is necessary to have a system in place for identifying those who are vulnerable and in need of support and providing them with the items (food) and nutritional care that they require. Eating is equivalent to living, and if the vulnerable themselves recognize the importance of food and nutrition, this will help improve the nutritional situation of the entire population. It is recommended that measures be taken in non-emergency periods such as stockpiling food for special dietary uses.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):505-513.
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    ABSTRACT: Purpose: This study explored the relationship between adolescents' emotional intelligence and the tendency to develop an eating disorder. Methods: Senior high school students in Taiwan were recruited for the study. A 3- part anonymous questionnaire measured demographic information, body weight satisfaction, and expectation of body weight. Students also completed the Adolescent Emotional Intelligence Scale and the Eating Disorders Attitude- 26 Test (EAT-26). Height and weight were also measured. Results: The mean of EAT-26 score was 8.66±7.36, and 8.6% students were at high risk to develop eating disorders. Gender, body weight, body dissatisfaction and the expected body shape were significantly related to disturbed eating attitudes and behaviours. Scores of EAT-26 were positively correlated with emotional perception, emotional expression, and emotional application. Conclusions: Disturbed eating behaviours exist among adolescents in Taiwan, and these behaviours may be related to emotional intelligence. However further studies with larger samples are needed.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):651-659.
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    ABSTRACT: Background and Objectives: Cognitive impairment develops with pre-diabetes and dementia is a complication of diabetes. Natural products like turmeric and cinnamon may ameliorate the underlying pathogenesis. Methods: People >=60 years (n=48) with newly-recognised untreated pre-diabetes were randomised to a double-blind metabolic study of placebo, turmeric (1 g), cinnamon (2 g) or both (1 g & 2 g respectively), ingested at a white bread (119 g) breakfast. Observations were made over 6 hours for pre- and post-working memory (WM), glycaemic and insulin responses and biomarkers of Alzheimer's disease (AD)(0, 2, 4 and 6 hours): amyloid precursor protein (APP), γ-secretase subunits presenilin-1 (PS1), presenilin-2 (PS2), and glycogen synthase kinase (GSK-3β). Differences between natural product users and non-users were determined by Students t and chi square tests; and between pre-test and post-test WM by Wilcoxon signed rank tests. Interaction between turmeric and cinnamon was tested by 2-way ANOVA. Multivariable linear regression (MLR) took account of BMI, glycaemia, insulin and AD biomarkers in the WM responses to turmeric and cinnamon. Results: No interaction between turmeric and cinnamon was detected. WM increased from 2.6 to 2.9 out of 3.0 (p=0.05) with turmeric, but was unchanged with cinnamon. WM improvement was inversely associated with insulin resistance (r=-0.418, p<0.01), but not with AD biomarkers. With MLR, the WM responses to turmeric were best predicted with an R2 of 34.5%; and with significant turmeric, BMI and insulin/glucose AUC beta-coefficients. Conclusions: Co-ingestion of turmeric with white bread increases working memory independent of body fatness, glycaemia, insulin, or AD biomarkers.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):581-591.
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    ABSTRACT: Objective: Childhood obesity is tracked to adulthood at a high rate. However, longitudinal studies of obesity in early childhood remain limited. This study aimed at tracking young obese children back to birth in comparison with normal-weight children, and investigating the relationship with parental obesity. Methods: A total of 2,678 (1,353 boys) young children attending kindergarten or nursery school in Nara Prefecture, Japan, were enrolled. The present heights and weights of children and parents were obtained by a questionnaire, and children's heights and weights at birth, 1.5, and 3.5 years were obtained from mother-child health notebooks. Using body mass index (BMI), child and parental obesity were defined as >=90th percentile based on the reference values for Japanese children and >=25 (kg/m²), respectively. Results: The overall prevalence of obesity at birth was 10.2%, and decreased to 5.6% at 5 years. In the retrospective tracking, obese children at 5 years exhibited significantly higher weight Z-scores and BMI percentiles consistently from birth than in normal-weight children. The increased velocity of weight gain as judged by their Z-score during three periods; birth-1.5, 1.5-3.5, and 3.5-5 years were significantly associated with an increased risk for the obesity at 5 years of age. Only maternal obesity was found to be associated with daughters' obesity in the analysis of association of parents-children obesity. Conclusions: It is important to manage body weight from early infancy for reducing the occurrence of obesity at 5 years. Where there is maternal obesity, greater attention may be required, especially for daughters.
    Asia Pacific Journal of Clinical Nutrition 12/2014; 23(4):641-650.