Asia Pacific Journal of Clinical Nutrition

Published by Wiley
Online ISSN: 1440-6047
Publications
Article
Several studies have shown that high protein meals and foods are more satiating than high carbohydrate or high fat meals when assessed by subjective ratings of satiety. Few of these studies were able to control for potentially confounding variables. Test meals differ widely in physical and sensory properties so it cannot be concluded that it is protein conferring these effects. When sensory properties are controlled up to 10-30% more calories are eaten at a subsequent meal with a high carbohydrate liquid meal than a high protein liquid meal with no difference in protein sources or BMI status. Weight loss studies examining the metabolic effects of isocaloric high protein energy restricted diets with high carbohydrate structured diets have not shown differences in kilojoule intake and weight loss despite expected satiety differences. Such studies do not allow the effects of increased satiety attributable to protein to be expressed as the dietary protocols have required all foods to be consumed. However, several longer term studies have noted improvements in body composition on a higher protein pattern despite similar weight loss. An interaction between protein intake and exercise on improved lean mass retention has also been observed. Studies comparing ad libitun high protein diets to high carbohydrate diets have usually shown greater weight loss on the high protein pattern and that enhanced satiety was the most important factor in the weight loss.
 
Article
A survey was conducted to monitor the current status of iodine deficiency disorders in children aged 6-12 years and women aged 15-44 years in Bangladesh as measured by goitre prevalence and urinary iodine excretion. Conducted between September 2004 and March 2005, the survey followed a stratified multistage cluster sampling design to provide nationally representative data, with self-weighted rural-urban disaggregation. A total of 7233 children and 6408 women were examined for goitre and 4848 urine samples (2447 from children and 2401 from women) were analyzed for iodine. In addition, 5321 household salt samples were analyzed for iodine. In children, the total goitre rate (TGR) was 6.2%, compared to 49.9% in 1993 and the TGR among women was 11.7%, while in 1993 it was 55.6%. Prevalence of iodine deficiency (Urinary Iodine Excretion <100 microg/L) was 33.8% in children and 38.6% in women (compared to 71.0% and 70.2%, respectively in 1993). Iodine nutrition status in urban areas was considerably better than in rural areas. There was a clear inverse relationship between iodine deficiency and the coverage of households using adequately iodized salt (> or =15 ppm). The findings of the survey revealed that Bangladesh has achieved a commendable progress in reducing goitre rates and iodine deficiency among children and women ever since the universal salt iodization programme was instituted 10 years ago. However, physiological iodine deficiency still persists among more than one-third of children and women, which points to the need for all stakeholders to redouble their efforts in achieving universal salt iodization.
 
Article
Evolutionary pressures have probably amplified the mechanisms for minimizing the impact of environmental factors through compensatory maternal mechanisms. Nevertheless, experimentally there are clear long-term programming effects of manipulations to the maternal diet on the likelihood of neural-tube defects associated with folate deficiency The fat/lean ratios of the newborn, and subsequent development, seem to be linked to amino acid or folate supply. An altered balance in the hypothalamic-pituitary-adrenal axis, which experimentally has profound effects on brain development, is induced by low-protein maternal diets. Such diets are linked to a reduced pancreatic capacity for insulin production and to an altered hepatic architecture, with a change in the control of glucose metabolism. Human studies suggest that what happens in pregnancy is modified by the child's diet in the first months of life. Low birthweight is linked to early stunting, and predisposes to abdominal obesity and metabolic syndrome in later life. Metabolic syndrome amplifies the risks of diabetes, hypertension, coronary heart disease and probably some cancers. Mothers with gestational diabetes are themselves prone to early type 2 diabetes and produce heavier babies prone to childhood obesity and adolescent type 2 diabetes. There is increasing evidence of an intergenerational effect, with big babies being prone to excess weight gain, which then, in girls, predisposes them to diabetes in pregnancy, which, in turn, promotes an accelerating cycle of early diabetes in subsequent generations. Essential fatty acids and fat soluble vitamins are important, but we need early interventions and monitoring systems to justify coherent policies.
 
Article
The metabolic syndrome is related to increased risk of developing cardiovascular disease and type 2 diabetes. Adiponectin is an adipocyte-secreted protein with insulin-sensitizing and anti-atherogenic properties. The aims of this study were to evaluate adiponectin levels and biochemical parameters in metabolic-syndrome subjects and healthy controls. The study also sought to identify links between two polymorphisms, -11377C>G (rs266729) and +45T>G (rs2241766) of the adiponectin gene, in relation to adiponectin levels and the metabolic syndrome. Three hundres and thirty-two Thai volunteers: 164 metabolic-syndrome subjects and 168 healthy control subjects were investigated. The adiponectin and HDL-C levels of the metabolic-syndrome group were significantly lower than the control group (p<0.001). Decreased concentration of adiponectin was associated with -11377C>G polymorphism (p<0.001); this polymorphism was significantly more frequent in the metabolic syndrome group than in the control group (p<0.001). However, +45T>G polymorphism of the adiponectin gene was found not to be related to adiponectin level or metabolic syndrome. Therefore, -11377C>G polymorphism was related to the metabolic syndrome susceptibility, and this polymorphism impacted on circulating adiponectin concentrations among Thais.
 
Article
This study evaluated the nutritional status of residents in the Riyadh nursing home, using anthropometric and haematological measurements. All male residents (N=84; age range 24-80 years) in the Riyadh nursing home were included in the study. Weight, height, body mass index, triceps skin fold thickness, and mid-arm muscle circumference were measured. Furthermore, serum concentrations of albumin, haemoglobin and haematocrit were measured. About 13% of adult residents and 11% of elderly residents were considered to be underweight (body mass index <18.5 kg/m(2)). From estimations of fat mass in the periphery, using triceps skin fold thickness, it appears that the elderly residents had significantly lower fat mass compared to the adult residents (P <0.05). The results showed that more than 40% of residents had low mid-arm muscle circumference (<22.3 cm). Serum albumin concentration was significantly lower in the elderly group than in the adult group (P<0.01). No significant difference was found in haematocrit level between the adult and elderly residents. Within the adult group, about 38% of residents had low haemoglobin level (<12 mg/dl), and this proportion was even higher, about 55%, in elderly residents. Based on body mass index or albumin to determine the prevalence of malnutrition among residents, the results have shown that the prevalence of undernourished residents was not higher than the prevalence of undernourished nursing-home residents reported in other studies. The percentage of elderly residents with anaemia was appreciable. Thus, undernourished and anemic residents should have special dietary and medical attention. Early detection of malnutrition upon admission would lead to early intervention and thus to reduced complications and medical-treatment costs. Staff working in nursing homes should be aware of the nutritional guidelines for health and disease.
 
Article
The aim of this study was to investigate the hypolipidemic effect of the total flavonoids from mulberry leaves (MTF) in hyperlipidemic mice. The total flavonoids have been isolated from mulberry (Morus alba L.) leaves and purified by macroporous resins. After that, the content of MTF is 581.7 mg g-1 in dried product. The hypolipidemic effect of MTF has been evaluated in triton WR-1339 (400 mg kg-1) induced hyperlipidemic mice. The beneficial effects of MTF on serum lipid levels are more significant at 12h post MTF administration than at 6h. The levels of TG, TC and LDL-C were remarkably reduced to 388, 257 and 189 mg 100 ml-1 in MTF (30 mg kg-1) and triton WR-1339 treated mice, compared with 540, 464 and 299 mg 100 ml-1, respectively, in group treated by triton WR-1339 only. The ratios of HDL-C/TC and HDL-C/LDL-C were increased to 0.42 and 0.57 post MTF (30 mg kg-1) administration, whereas these two ratios at the low levels of 0.33 and 0.52, respectively, in the reference group. These findings support a serum a lipid-favourable activity for mulberry leaf flavonoids.
 
Article
The frequency of lactase persistence varies widely in human populations. Study showed that the T allele of a C/T transition 13910bp upstream from exon 1 of lactase gene (LCT) was completely associated with lactase persistence in a Finnish population. To evaluate if the frequency of -13910T allele was in concordance with the lactase persistence in northern Chinese populations, in this study, we used Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) to detect the lactase -13910T allelic frequency in 5 northern Chinese populations for the first time. Results showed that the T allele frequency was low in these populations and that it did not match the lactase persistence phenotype in these populations. Therefore the -13910T allelic frequency can not serve as a predictor of the lactase persistence in these populations and this suggests the existence of other possible mechanisms of lactose tolerance in Chinese populations.
 
Article
Our aim has been to construct a portable prototype instrument for measuring the whole body composition in vivo of growing lambs in terms of fat. protein and water by determining the mass of carbon, nitrogen and oxygen present. A small and compact sealed tube neutron generator which has the capability of exploiting the associated particle time-of-flight technique has been used for prompt gamma 14 MeV neutron activation analysis of C, N and O. This technique allows only gamma rays generated by neutron reactions within a defined volume to be recorded and offers a superior signal-to-noise ratio over existing prompt gamma neutron activation techniques. Based on the results obtained from irradiating a 41.4 kg meat phantom, we anticipate that an instrument comprising the neutron generator and four 15 x 15 x 45 cm Nal(TI) gamma ray detectors can be assembled to determine in vivo, protein, fat and water with precisions of 4.1, 5.4 and 1.2% (CV), respectively, within a 15 min scan. The radiation dose delivered would be ~0.03 mSv.
 
Article
Sialic acid (N-acetylneuraminic acid), a component of gangliosides and sialylglycoproteins, may be a conditional nutrient in early life because endogenous synthesis is limited. The aim of this study was to investigate the metabolic fate of intravenously administrated N-acetylneuraminic acid-6-14C (sialic acid) in piglets. Three-day-old male domestic piglets (Sus scrofa) were injected via the jugular vein with 5 microCi (11-12 x 10(6) cpm) of N-acetylneuraminic acid-6-14C (specific activity of 55 mCi/mmol). Blood samples were collected at regular intervals over the next 120 min. The organs were then removed and the urine collected for determination of residual radioactivity. Within 2 min of injection, 80% of the activity was removed from the blood and by 120 min the remaining activity approached 8%. At 120 min, the brain contained significantly more radioactivity (cpm/g tissue) than the liver, pancreas, heart and spleen, but less than the kidneys. Within the brain, the percentage of total injected activity was highest in the cerebrum (0.175 +/-0.008) followed by the cerebellum (0.0295 +/-0.006, p=0.00006) and the thalamus (0.029 +/- 0.006, p =0.00003). An exogenous source of sialic acid is capable of crossing the blood-brain barrier and being taken up into various tissues. The findings suggest that dietary sources of sialic acid may contribute to early brain development in newborn mammals.
 
Article
The aim of this study was to evaluate the use of the [14C]-sodium bicarbonate/urea technique to measure the change in total energy expenditure after weight loss and a period of weight maintenance. Eleven healthy subjects (6 men and 5 women aged 50 +/- 3 yrs, BMI 34.1 +/-2.1 kg/ m2, body fat 38.7 +/-3%) underwent 8 weeks of energy restriction using a combination of "Modifast" formula and one small meal per day (approximately 3.3 MJ/day). For an additional 2 weeks, subjects resumed a solid food diet that contained enough energy to stabilize body weight at the newly reduced level. Body composition, total energy expenditure (TEE), resting energy expenditure (REE) and the thermic effect of a 2.7 MJ test meal (TEF) were measured at both weeks 0 and 10. At week 10 as compared to week 0, body weight decreased by 12.2+/-1.6 kg (12.5%)(P<0.001). Total fat and lean mass decreased by 8.4+/-1.0 kg (20.4%) and 3.8+/-0.7 kg (6.7%), respectively (P< 0.001). REE decreased by 500+/-128 kJ/day (5.6+/-1.3%)(P<0.002). Decreases in the TEE (0.18 +/-;3.7%)and TEF(1.4+/-0.9%) were not significant. In conclusion, although [14C]-sodium bicarbonate/urea was well tolerated and did not interfere with normal daily activities, it did not have sufficient sensitivity to accurately measure weight loss induced changes in TEE in the range of 0.1-10%.
 
Article
The aim of this study was to evaluate the utility of the [(14)C]-sodium bicarbonate/urea technique to detect physical activity-induced increases in total energy expenditure in free-living healthy men. Thirteen healthy males aged 34.1 +/- 11.7 yrs with body mass index 24.1 +/- 3.1 kg/m(2) were studied on three separate occasions, during which [(14)C]-bicarbonate was infused over 48-hours and urine was collected during the second 24-hours. On three separate occasions and in random order, subjects either remained sedentary, or performed a bout of physical activity on an electro-magnetically braked cycle ergometer sufficient to increase energy expenditure by 7% or 11% above predicted sedentary total energy expenditure. Urine samples were analyzed to evaluate the amount of [(14)C]-bicarbonate incorporated into urinary urea, thereby reflecting the amount of CO(2) produced per day, and upon conversion, the number of kilojoules of energy expended in 24-hours. All 13 subjects successfully completed the two physical activity treatments and there were no adverse events. As measured by the [(14)C]-urea assay, mean total energy expenditure values were not significantly different between sedentary activity (17902 +/- 905 kJ/day), the physical activity treatment designed to increase TEE by 7% (17701 +/- 594 kJ/day) and the physical activity treatment designed to increase TEE by 11% (18538 +/- 485 kJ/day) (P=0.668). In conclusion, although the [(14)C]-sodium bicarbonate/urea technique was well tolerated and did not interfere with normal daily activities, it was not able to accurately measure physical activity-induced increases in EE in the range of 7-11% above predicted sedentary total energy expenditure.
 
Article
We have previously found a positive association between milk consumption and prostate cancer risk using meta-analysis to analyze published case-control studies. In the present study, further meta-analysis was conducted to estimate the summary relative risk (RR) between the consumption of milk and dairy products and prostate cancer from cohort studies published between 1966- 2006. We found 18 relevant articles and 13 independent studies were available for our analysis. The summary RR was 1.13 (95% confidence interval = 1.02-1.24) when comparing the highest with the lowest quantile of consumption. The summary RRs by study stratification showed a positive association. A dose-response relationship was identified when combining the studies that partitioned the consumption by quintiles. We also evaluated the effects of some limitations, such as dairy classification, prostate cancer stages and publication bias, in the present study. These findings, together with the previous study, suggest that the consumption of milk and dairy products increases the risk of prostate cancer. This is biologically plausible since milk contains considerable amounts of fat, hormones, and calcium that are associated with prostate cancer risk.
 
Article
6239 children aged 7 to 16 years, attending 22 primary and secondary schools in Kuala Lumpur, Malaysia, were screened using a self report questionnaire, with their heights and weights measured using a digital electronic SECA beam balance. The selection was done by a two staged stratified random sampling from a total of 226 schools in Kuala Lumpur. The racial distribution was 56.7% Malays, 33.8% Chinese and 8.1% Indians; 3.6% (n:222) of the children were identified as obese and 6% (n:373) identified as overweight. The definitions of obese and overweight were computed using growth charts of the National Centre for Health Statistics (NCHS) from the median of the reference population. There were no significant differences amongst the 3 major ethnic groups in the obese group. The differences were significant in the overweight group with the Indians most overweight, followed by the Chinese and the Malays.
 
Article
Unlabelled: A population-based cross-sectional study was conducted in all states of Malaysia with the aim to determine the prevalence of obesity among Malaysians aged fifteen years and above and factors associated. A stratified two-stage cluster sampling design with proportional allocation was used. Trained interviewers using a standardized protocol obtained the weight and height measurements and other relevant information. Subjects with a body mass index >= 30 kg/m2 were labelled as obese. The results show that the overall national prevalence of obesity among Malaysians aged 15 years old and above was 11.7% (95% CI = 11.1 - 12.4%). The prevalence of obesity was significantly higher in females (13.8%) as compared to 9.6% in males (p< 0.0001). Prevalence of obesity was highest amongst the Malays (13.6%) and Indians (13.5%) followed by the indigenous group of "Sarawak Bumiputra" (10.8%) and the Chinese (8.5%). The indigenous group of "Sabah Bumiputra" had the lowest prevalence of 7.3%. These differences are statistically significant (p< 0.0001). Logistic regression analysis results show that there was a significant association between obesity and age, gender, ethnicity urban/rural status and smoking status. The prevalence of obesity amongst those aged >= 18 years old has markedly increased by 280% since the last National Health and Morbidity Survey in 1996. Conclusion: The overall prevalence of obesity in Malaysia is very high as compared to 1996. There is an urgent need for a comprehensive integrated population-based intervention program to ameliorate the growing problem of obesity in Malaysians.
 
Article
Objectives: to describe the trend in gender disparities of overweight/obesity and underweight, as well as height, among Chinese adolescents. Methods: the study is based on population-based data from annual health checks of approximately 7,000 students finishing high school each year between 2004-2011. Height and weight were measured. Overweight/obesity and underweight were defined using International Obesity Task Force (IOTF) criteria. School level socioeconomic status (SES) was constructed based on real-estate prices near each school. Results: there was a slight increase in the prevalence of obesity between 2004 and 2011; 3.7% to 4.7% in boys and 1.1% to 1.5% in girls. The prevalence of overweight was quite stable in both genders (boys: 12%-15%; girls: 7%-10%). In most years, the prevalence of underweight was above 10%. The prevalence of underweight in girls born after 1991 increased dramatically. However, the opposite trend was seen in boys. School SES was positively associated with overweight and inversely associated with underweight among boys. There was a significant increase in height in both genders. Height and BMI was positively associated in boys but this relation was inversely associated in girls. Conclusion: between 2004 and 2011, the prevalence of overweight/obesity was plateauing among adolescents finishing high school. A substantial increase in the prevalence of underweight was observed among girls born after 1991 but this seemed to be positively associated with high SES.
 
Article
Residents from high level (nursing homes) and low-level care facilities (hostel) being served the three common diet texture modifications (full diet, soft-minced diet and pureed diet) were assessed. Individual plate waste was estimated at three meals on one day. Fifty-six males and 156 females, mean age 82.9+/-9.5 (SD) years, of which 139 lived in nursing homes (NH) and 76 in hostels (H) were included. Mean total energy served from meals was 5.3 MJ/day, 5.1 to 5.6 MJ/day, 95% confidence intervals (CI), in NH which was less than in H, 5.9 MJ/day (CI 5.6 to 6.2 MJ/day) (P=0.007). Protein and calcium intakes were lower in NH, 44.5g (CI 41.5 to 47.5g), 359.0mg (CI 333.2 to 384.8mg), versus 50.5g (CI 46.6 to 54.3g), 480.5mg (CI 444.3 to 516.7mg) in H (P=0.017, P<0.001 respectively). There was no difference in nutrient/energy ratios, except for protein/energy, which was higher in NH 11.7 (CI 11.3 to 12.2) than in H 9.8 (CI 9.4 to 10.3) (P<0.001). Ability to self-feed had no significant effect on nutrient intakes in NH. The self fed group (N=63) had the following nutrient intakes: energy 4.0 MJ (CI 3.6 to 4.3 MJ), protein 44.6g (CI 40.3 to 48.9g), calcium 356.9mg (CI 316.3 to 397.4mg), fibre 14.9g (CI 13.2 to 16.5g). The assisted group (N=64) had the following nutrient intakes: energy 3.9MJ (CI 3.6 to 4.2MJ), protein 46.0g (CI 40.7 to 49.6), calcium 361.9mg (CI 327.8 to 396.1mg), fibre 14.9g (CI 13.2 to 16.1g). Of NH classified as eating impaired, 36% received no assistance with feeding and had lower intakes of protein 37.8g (CI 33.0 to 42.1g) compared to those receiving some assistance 46.1g (CI 41.3 to 50.9g) (P=0.026). Reduced energy intake accounted for the differences in nutrient intakes between nursing homes and hostels, except for protein. Strategies to effectively monitor nutrient intakes and to identify those with eating impairment are required in order to ensure adequate nutrition of residents in nursing homes and hostels.
 
Article
Information on nutritional adequacy and inadequacy of dietary patterns is useful when making practical dietary recommendations. We examined nutritional inadequacy of dietary patterns among 3756 Japanese female dietetic students aged 18-20 years. Diet was assessed with a validated self-administered diet history questionnaire (DHQ). Dietary patterns were determined from intakes of 33 food groups summarized from 147 foods assessed with DHQ, by cluster analysis. Nutritional inadequacy for the selected 21 nutrients in each dietary pattern was examined using the reference values given in the Dietary Reference Intakes for the Japanese (DRIs) as the gold standard. Four dietary patterns identified were labeled 'fish and vegetables' (n=697), 'meat and eggs' (n=1008), 'rice' (n=1041), and 'bread and confectionaries' (n=1010) patterns. The 'fish and vegetables' pattern, characterized by high intakes of vegetables, potatoes, pulses, fruits, fish, and dairy products, showed significantly the lowest percentage of subjects with inadequate intakes for 15 nutrients, except for the highest prevalence in sodium. In contrast, 'bread and confectionaries' pattern, characterized by high intakes of bread, confectionaries, and soft drinks, showed the highest prevalence of inadequate intakes for nine nutrients. The median number of nutrients not meeting the DRIs as a marker of overall nutritional inadequacy was five in 'fish and vegetables' pattern. It was significantly lower than nine both in 'meat and eggs' and 'rice', and 10 in 'bread and confectionaries' patterns (p<0.001). A dietary pattern high in vegetables, fruits, fish, and some others showed better profile of nutritional adequacy except for sodium in young Japanese women.
 
Article
Preoperative 12.6% oral carbohydrate loading is an element of the Enhanced Recovery After Surgery (ERAS) protocol aimed at alleviating postoperative insulin resistance; however, in Japan, beverages with 18% carbohydrate content are generally used for preoperative carbohydrate loading. We investigated the effect of 18% carbohydrate loading on alleviating insulin resistance. Six healthy volunteers participated in this crossover-randomized study and were segregated into 2 groups: volunteers in the carbohydrate-loading group (group A) who fasted from after 9 pm and ingested 375 mL of a beverage containing 18% carbohydrate (ArginaidWaterTM; Nestle, Tokyo, Japan) between 9 pm and 12 pm, and 250 mL of the same liquid at 6:30 am. Volunteers in control group (group B) drank only water. At 8:30 am, a hyperinsulinemic normoglycemic clamp was initiated. Glucose infusion rate (GIR) and levels of ketone bodies and cytokines (IL-1β, IL-6, and TNF-α) before clamping were evaluated. p<0.05 was considered statistically significant. Levels of blood glucose, insulin, and cytokines at the start of the clamp were similar in both the groups. The GIR in group A was significantly higher than that in group B (11.5±2.4 vs 6.2±2.2 mg/kg/min, p=0.005), while blood ketone body levels were significantly lower in group A (22±4 vs 124±119 μmol/L, p=0.04). Preoperative 18% carbohydrate loading could prevent the decrease in insulin sensitivity and suppress catabolism in healthy volunteers. Thus, carbohydrate loading with a beverage with 18% carbohydrate content might contribute to improvements in perioperative management.
 
Article
We previously reported that a novel alkylphospholipid type antitumor agent edelfosine (ET-18-O-CH3 ; 1-O-octadecyl-2-O-methyl-glycero-3-phosphocholine) induced apoptosis in human breast epithelial cells transfected with the H-ras oncogene (MCF10A-ras) which was causally linked to cyclooxygenase-2 (COX-2) up-regulation and production of 15-deoxy-Delta 12,14-prostaglandins J2 (15d-PGJ2). ET-18-O-CH3 treatment also enhanced the production of prostaglandin E2 (PGE2), a major COX-2 product. In this study, we found that ET-18-O-CH3 treatment resulted in elevated mRNA expression of the PGE2 receptor subunit, EP2 receptor. Exogenously added PGE2 inhibited the growth of MCF10A-ras cells and induced proteolytic cleavage of caspase 3. ET-18-O-CH3 also inhibited constitutive activation of ERK1/2, p38 MAPK, and Akt/protein kinase B, which was blunted by a selective COX-2 inhibitor SC58635. In addition, ET-18-O-CH3 inhibited DNA binding activity of NF-kappa B in MCF10A-ras cells, and this was again attenuated by SC58635. Based on these findings, it is likely that ET-18-O-CH3 inactivates ERK1/2, Akt, and NF-kappaB signaling via COX-2 induction in MCF10A-ras cells, thereby inducing apoptosis of these cells.
 
Beer making during Cook's three voyages, 1768-1780
Article
The custom of allowing British seamen the regular use of fermented liquor is an old one. Ale was a standard article of the sea ration as early as the fourteenth century. By the late eighteenth century, beer was considered to be at once a food (a staple beverage and essential part of the sea diet), a luxury (helping to ameliorate the hardship and irregularity of sea life) and a medicine (conducive to health at sea). In particular, beer and its precursors, wort and malt, were administered with the aim of preventing and curing scurvy. This paper examines the use of malt and beer during late eighteenth century British sea voyages, particularly their use as antiscorbutic agents, focusing on James Cook's three voyages during the period 1768-1780. Cook administered sweet wort (an infusion of malt), beer (prepared from an experimental, concentrated malt extract), and spruce beer (prepared mainly from molasses), among many other items, in his attempts to prevent and to cure scurvy. Despite the inconclusive nature of his own experiments, he reported favourably after his second voyage (1772-1775) on the use of wort as an antiscorbutic sea medicine (for which purpose it is now known to be useless). Cook thereby lent credibility to erroneous medical theories about scurvy, helping to perpetuate the use of ineffective treatments and to delay the discovery of a cure for the disorder.
 
Article
Objective. To develop an optically scannable food frequency questionnaire (FFQ), 'The Melbourne FFQ', suitable for classifying Australian-, Greek- and Italian-born individuals into quantiles of intake for a range of foods and nutrients. The FFQ would provide the primary measure of dietary exposure in a prospective cohort study. Design. The FFQ was modelled on that used for the (US) Nurses' Health Study. Food items were chosen on the basis of their relative contribution to the intake of a range of nutrients computed from weighed food records. Setting. Metropolitan Melbourne, Australia, a city of 3 million people, of whom 75.5% were born in Australia, 2.7% were born in Italy and 1.7% were born in Greece. Participants. Weighed Food Survey (1987-1989): A volunteer sample of 810 healthy middle-aged (40-69 years) men and women of whom 35% were born in Greece, 33% were born in Italy, and 32% were born in Australia. Melbourne Collaborative Cohort Study (1990-1993): A volunteer sample of 17 949 healthy men and women aged between 40 and 69 years of whom 61% were born in Australia, 21% were born in Italy and 17% were born in Greece. Results. A 121 item FFQ was developed, together with a customized nutrient database. The optical scanning format was generally well received with the majority of subjects requiring no assistance. The FFQ appeared to overestimate the consumption of fruit and vegetables. Conclusions. The Melbourne FFQ provides a convenient method of measuring habitual dietary intake in a large population setting. A separate study is required to assess how well the instrument characterizes diet at the level of the individual.
 
Article
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 in those 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 higher in 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.
 
Article
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.
 
Article
The purpose of this study is to understand nutrition knowledge, attitude, and behavior in Taiwanese adults. Results indicated that adults' knowledge on '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 (age 31-44) adults have better knowledge than that of middle adults (age 45-64), while prime adults hold a more positive attitude than young adults. 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 balanced diet and what constitutes being overweight. Proper strategies to enhance the behavioral motivation of healthy food selection must also not be neglected.
 
Article
Human growth is associated with complex interactions between 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 in growth 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.
 
Main dishes of different ethnic groups in Tanzania. 
Main dishes of different ethnic groups in Uganda. 
Article
Knowledge of traditional African foods and food habits has been, and continues to be, systematically extirpated. With the primary intent of collating data for our online collection documenting traditional African foods and food habits (available at: www.healthyeatingclub.com/Africa/), we reviewed the Oltersdorf Collection, 75 observational investigations conducted throughout East Africa (i.e. Tanzania, Kenya, and Uganda) between the 1930s and 1960s as compiled by the Max Planck Nutrition Research Unit, formerly located in Bumbuli, Tanzania. Data were categorized as follows: (1) food availability, (2) chemical composition, (3) staple foods (i.e. native crops, cereals, legumes, roots and tubers, vegetables, fruits, spices, oils and fats, beverages, and animal foods), (4) food preparation and culture, and (5) nutrient intake and health status indicators. Many of the traditional foods identified, including millet, sorghum, various legumes, root and tubers, green leafy vegetables, plant oils and wild meats have known health benefits. Food preparatory practices during this period, including boiling and occasional roasting are superior to current practices which favor frying and deep-frying. Overall, our review and data extraction provide reason to believe that a diversified diet was possible for the people of East Africa during this period (1930s-1960s). There is a wealth of knowledge pertaining to traditional East African foods and food habits within the Oltersdorf Collection. These data are currently available via our online collection. Future efforts should contribute to collating and honing knowledge of traditional foods and food habits within this region, and indeed throughout the rest of Africa. Preserving and disseminating this knowledge may be crucial for abating projected trends for non-communicable diseases and malnutrition in Africa and abroad.
 
Article
During 1948, scientists (an anthropologist, a nutritionist and a plant ecologist) of the American-Australian Scientific Expedition to Arnhem Land observed the daily activities of families of nomadic Aborigines in the monsoonal climate of Groote Eylandt, Bickerton Island, Port Bradshaw, Yirrkala and Oenpelli, Northern Territory. The close relationship between the hunter-gatherers and the marine and terrestrial landscape is described at Hemple Bay in Port Langdon, north-eastern Groote Eylandt. Food-gathering from both land and sea was followed hourly to assess the nutritional value of 'bush tucker' in comparison with that of natives eating freshly picked fruit and vegetables grown in the garden of the Umbakumba Settlement. The ecological distributions of food plants used by the Aborigines, together with their seasonality, determined the migratory pattern of the hunter-gatherers throughout the year. With only a few exceptions, the diets which were seen at the four camps in Arnhem Land were well-balanced and provided amounts of most nutrients comparable with the recommended international dietary allowances. Seasonal and regional variations in food supply were a constant problem to these nomadic people.
 
Article
Consumption figures for 15 major commodities (cereals, wheat, rice, maize, potato, pulses, olive oil, other vegetable oils, vegetables, fruits, wine, meats, animal fats, milk + products, and fish + seafood) were collected from FAO Food Balance Sheets during the 1960s (1961-1969) and late 1990s (1995-1999). For some nutritionists the "model Mediterranean diet" is the Italian or Greek diet of the 1960s, for others the concept of Mediterranean countries is more general. Analysis shows: (1) In the 1960s, Australia consumed more meat, milk, animal fat than Italy or Greece and less cereals, wheat, pulses, olive oil, vegetables, fruits and wine. (2) In the 1960s, Australia's olive oil, vegetables, fruits and wine consumption were within the range for all 18 Mediterranean countries (i.e. Spain, France, Italy, Malta, Croatia, Bosnia, Albania, Greece, Cyprus, Turkey, Syria, Lebanon, Israel, Egypt, Libya, Tunisia, Algeria and Morocco). (3) In the 1990s, food consumptions have evolved; Australia's wine and milk consumption is now similar to Italy and Greece; consumption of wheat, olive oil, vegetables, fruits and fish are lower; consumption of potato, pulses, other vegetable oils and meat are higher than Italy or Greece. (4) Australia's consumption of the 15 commodities is within the range of all Mediterranean countries in the late 1990s, except wheat consumption was lower.
 
Article
The purpose of this study was to determine trends in body physique among Tongan adults, between the late 1970s and the 2000s. Two areas were studied: Kolofo'ou town (as an urban area) and 'Uiha village (as a rural area). Measurements of body weight and height were taken 4 times for all residents in both areas in 1977/79, 1983, 1990, and 2001. The number of the subjects in 1977/1979, 1983, 1990, 2001 were 130, 138, 102, 71 in the urban area and 92, 89, 90, 66 in the rural area respectively. The mean body mass index (BMI, kg/m2) values of males in the rural area increased significantly, from 28.0 kg/m2 in 1977 to 31.0 kg/m2 in 2001 (p=0.001); in females, mean BMI values were 30.6 kg/m2 in 1977 and 33.3 kg/m2 in 2001, this change was not statistically significant. However, the BMI values did not significantly change in males or females in the urban area. The proportion of rural males with a BMI>or=30 kg/m2 had increased from 24.5% in 1977 to 55.5% in 2001 (p=0.012). Although the mean BMI values for males and females were higher in the urban area than in the rural area until 1990, the differences between the two areas were not observed in 2001, due to an increase of BMI in the rural area. Changes of the mean BMI values in the rural and urban areas studied, between the late 1970s and 2000s, were 10% and 4%, respectively.
 
Article
Although the prevalence of overweight and obesity in Australia has increased during the past 30 years, little is known about the dietary and behavioural antecedents of body mass index (BMI). We examined changes in mean BMI, diet, and other lifestyle behaviours between 1976 and 2005 and described the cross-sectional associations between these factors and BMI. A series of biennial biomedical surveys by Sydney Adventist Hospital from 1976 to 2005 allowed examination of BMI trends, while the selection of three surveys enabled detailed examination of likely dietary and lifestyle associations. Subjects included in this study were: 384 men and 338 women in 1976; 160 men and 146 women in 1978; 166 men and 141 women in 1980; 164 men and 142 women in 1982; 177 men and 13 women in 1984; 239 men and 227 women in 1986; 210 men and 225 women in 1988; 165 men and 148 women in 1990; 138 men and 167 women in 1992 and 270 men and 62 women in 2005. Height and weight were measured by hospital staff. Mean BMI increased in the early 1990s. Salt, coffee, cola, alcohol and meat consumption, dieting to lose weight and eating between meals were positively associated with BMI while physical activity, food variety, large breakfasts and consumption of spreads were negatively associated. Food consumption and daily activities have important associations with BMI, though their specific associations differ by sex. "Affluent" lifestyle patterns appear to contribute to higher BMI, while a more "prudent" lifestyle seems to protect from such increases.
 
Article
In order to assess secular trends in growth of the Vietnamese population following a period of rapid economic growth, a follow-up study on physical growth and nutritional status of adults was carried out in a rural section of the Red River delta, Vietnam 30 years after the original study. The initial study in 1976 found that average height and weight of Vietnamese adults was similar to data collected by French experts Huard and Bigot in 1938. Hence, no noticeable secular trends were observed in almost 40 years. However, the 2006 follow-up study revealed a positive secular trend in growth of adults, aged 16-60 years. The average increased rate in height of males was up to 1.1 cm/decade in the age group 26-40 years and up to 2.7 cm/decade in the age group 16-25 years. Nutritional status, as indicated by body mass index, increased in both sexes and in all age groups between 1976 and 2006.were observed. In 2006, average dietary intake of fat and animal protein was higher than that found in 1976. The percentage of energy from fat in the diet increased from 6% in 1976 to 16% in 2006. This study shows that Vietnam is entering the nutrition transition period.
 
Article
The aim of the study was to investigate the secular changes in size at birth of Vietnamese newborns, and to determine the relationship between size at birth of the infants and nutritional status of their parents. Length, weight, mid upper arm circumference and head circumference of 586 newborns from the two maternity houses Hoan Kiem and Hai Ba Trung in Hanoi, Vietnam were measured. Information on socioeconomic conditions, health status, weight, and height of the parents were also obtained. There was a significant increase of birth weight (190 g,P=0.008; T-test) and length (1.3 cm, P=0.001; T-test) of Vietnamese newborns compared to those of newborns of the 1980's (1980-1984). There was a positive secular trend in parent's height and weight after a period of one and a half decades (height and weight increase of mothers: 2.6 kg and 1.9 cm, respectively; height and weight increase of fathers: 4.5 kg and 1.6 cm, respectively). The data showed that the birth weight of infants in the Capital of Vietnam have caught up with those of infants from richer societies in the Northern hemisphere.
 
Number and percentage of participants in sex and age groups by survey
Stunting 1 proportion (%) among overweight and obese 2 youngsters
Article
Unlabelled: Purpose of present study is to describe the prevalence and trend of overweight and obesity, as well as its co-existence with stunting, among youngsters in China, from 1982 to 2002. Data from children 7-17 years of age from three cross-sectional national surveys: "1982 China National Nutrition Survey" (5,334 boys and 4,793 girls), "1992 China National Nutrition Survey" (8,048 boys and 7,453 girls) and "2002 China National Nutrition and Health Survey" (23,242 boys and 21,638 girls) were used in this study. Overweight and obesity were defined according to age, sex and specific BMI cut-off points from the International Obesity Task Force, while stunting was defined as height-for-age below -2 standard deviation from the NCHS/WHO reference median value. Results: Overweight prevalence of Chinese youngsters was 1.2%, 3.7% and 4.4%, while the obesity prevalence was 0.2%, 0.9% and 0.9% in 1982, 1992 and 2002, respectively. Both the overweight and obesity prevalence and their increment were higher among boys in urban areas. In 1982, 28.4% of overweight and 69.6% of obese youngsters were stunted, this decreased to 22.0% and 46.4% in 1992, and then to 5.7% and 7.7% in 2002, respectively. Conclusion: The prevalence of overweight and obesity in Chinese youngsters were low in 1982. There has been a rapid increase since then. If this trend continues, overweight will soon reach epidemic proportions. Stunting among overweight and obese youngsters decreased dramatically at the same time.
 
Article
Dietary patterns were assessed in a prospective study of cardiovascular disease (CVD) risk factors in four Chinese populations: Beijing urban (BJ-U) and rural (BJ-R), Guangzhou urban (GZ-U) and rural (GZ-R). A total of 10,076 men and women 35-54 years old were surveyed in 1983-84 and resurveyed in 1987-88. Dietary data were obtained in a subsample of about 10% (n=169 BJ-U, 178 BJ-R, 198 GZ-U, 230 GZ-R). Three 24-hr recalls were collected on each participant in each survey. Comparison of mean intakes in the two periods showed increases in meat, poultry, fish (except GZ-R), eggs (rural only), milk (except BJ-R) and alcoholic beverages. The largest shifts were in meat intake (29%-39%), alcoholic beverages (71%-104%) and fats in the urban samples (33%-35%). These changes are reflected in increased mean intakes of animal protein, fat, saturated fatty acids (SFA) and higher Keys scores. Mean total fat intake now exceeds the PRC recommended range of 20-25% of energy in three of the four samples. During this period BMI increased in all samples especially among men (3% - 6%). These surveys, conducted during a period of rapid economic development in China, show that such changes promote shifts in dietary patterns and energy balance towards increased risk of cardiovascular disease.
 
Article
Background - Various trends in dietary intake have been reported. However, validity of self-reported intake is variable, and trends could be confounded by validity, if not taken into account. Objective - To determine trends in body weight, macronutrient and energy intake (EI), physical activity, and energy expenditure in acceptable- and under-reporting female university students. Design - Analysis of four-day intake (weighed) and physical activity (timesheets) records from 887 female university students enrolled in a human nutrition unit. Records were collected annually between 1988 and 2003. Physical activity level (PAL) and energy expenditure (EE) were determined using a factorial method. Subjects with an EI:EE ratio <0.76 were classified as under-reporters (UR). The remainder were classified as acceptable reporters (AR). Outcomes - There was a significant increase in prevalence of under-reporting between 1988 and 2003 (P<0.01). Body weight, EE, protein intake (both g/day and as a percentage of energy) and carbohydrate (CHO) intake (g/day) increased during this time in AR (n=480) and UR (n=407), and in the whole group (n=887). Percentage (%) of energy from fat decreased in all three groups (P<0.01-0.001). Over the same period, PAL increased (P<0.01) and fat intake (g/day) decreased (P<0.001) in the whole group and in UR (P<0.05-0.001), but did not change in AR. Energy intake increased in both UR (P<0.05) and AR (P<0.01) but did not change in the whole group. Conclusion - Prevalence of under-reporting increased between 1988 and 2003. Increased body weight, EE, and protein and CHO intake, and decreased %fat energy were not affected by dietary validity. Other trends either varied between UR and AR (increased PAL and decreased % fat energy), or were confounded by combining UR and AR into one group (EI).
 
Article
The cardiovascular risk prevalence of 935 adult Chinese living in Chauzhou, Meizhou, and Xinhui cities of Guangdong Province, China, is reported. The three communities are geographically separated, and represent the three major dialect group in Guangdong Province (Teochew, Hakka and Cantonese respectively) which are also the major donor populations of overseas Chinese to Australia and South East Asia. Taking into account historical data, the conventional cardiovascular risk factor prevalence of these combined communities in China as a whole is on the increase and approaches or even exceeds that in Western Society. However, the three communities are not very alike in their prevalences of individual conventional cardiovascular risk factors, notably for hyperlipidaemia (most prevalent in Chauzhou), hypertension (most prevalent in Chauzhou men at 12.4% and least in Meizhou women 5.0%) and cigarette smoking (most prevalent in Xinhui men at 72.7% and least in Xinhui women, 0%). They are similar in stature, body weight, BMI, and waist-to-hip ratio, with very low prevalences of overweight/obesity, or abdominal obesity. An understanding of the contributors to sub-ethnic difference in cardiovascular risk should emerge with further study of these Chinese populations.
 
Article
Reduction in childhood malnutrition in Vietnam between 1990 and 2004 was assessed using data from 5 national surveys. The prevalence of malnutrition, including stunting, declined significantly for underweight from 45% in 1990 to 26.6% in 2004. While the average reduction was 1.3% per year in the period from 1990 to 2000, it was 1.8% per year in the period from 2000 to 2004. The prevalence of stunting declined from 56.5% in 1990 to 30.7% in 2004, with an average reduction of 2% per year in the period from 1990 to 2000 and 1.5% per year in the period from 2000 to 2004. There were clear differences in the decrease in malnutrition prevalence between urban, rural and mountainous areas, the reduction being highest in the urban regions and lowest in the mountainous areas. Regression analysis showed that the nutrition status of the child is positively related to better household living conditions and to the educational level of the father, but not the mother. Stunting is higher in children whose parents are farmers and higher in households with more children. Stunting prevalence is lower in households with safe water access and hygienic toilets. In future , the dramatic reduction is childhood malnutrition as seen in the period 1990 to 2004 might not continue. More comprehensive apptoaches will be needed to lower childhood malnutrition in Vietnam further.
 
Article
By early next century a majority of deaths in the countries classed as 'developing' will be due to chronic non-communicable diseases (NCDs). Such countries must now seek to counter the rise of NCDs while continuing the fight against traditional killers. 'Lifestyles'--socially sustained styles of living viewed in their material aspect--are major determinants of most diseases that vary markedly across cultures and through time, not just of those NCDs that typically increase with socio-economic modernization. Earlier phases of socio-economic development also brought with them adverse as well as beneficial effects on health. Living in cities greatly increased the transmissibility of infection but has since been made compatible with good health. The 'lifestyle diseases' associated with socio-economic modernization pose difficult public health challenges: they often arise from the otherwise welcome 'first fruits of affluence' and there is typically a long delay between the behaviours involved and their health effects. Major efforts may be required, over several decades, to first contain adverse trends and then to encourage favourable trends. The first task may be to help build constituencies for action by documenting and publicizing the likely health impact of the elements of lifestyle involved. In most industrialized countries, earlier adverse trends in the NCDs have been either reversed (heart attack, traffic injuries) or contained (lung cancer) in the last 2 decades, showing that such health costs are not a price that must inevitably be paid for by the other benefits of modernization.
 
Article
This study investigates the dynamic shifts in snacking behaviors and patterns in China. Using four waves (1991, 2004, 2006, and 2009) from the China Health and Nutrition Survey (CHNS), with full socioeconomic and demographic data and 3-day, 24-hour dietary recall data, 45,402 individuals age two and older were studied. Multiple logistic regressions were performed to examine the association of social-demographic factors on snacking behaviors. Results show that snacking prevalence, frequency of daily snacking occasions, and percentage of total daily energy intake (EI) from snacks increased significantly across all ages between 1991 and 2009, with a dramatic increase after 2004. Snacking was much more prevalent among children and higher-income, urban, and educated populations over time. Evening was the preferred snacking occasion, and the proportion of total daily EI from snacks varied between 4.1% and 12.3% for all snackers. Fruits, grains, and beverages were the most popular snacks and the highest contributors to snacking EI over all age groups. A marked transition from a tradition of two or three meals per day toward meals combined with snacks is underway. Further research is needed to develop a better understanding of the nutritional implications of Chinese snacking behaviors.
 
Article
This study examined the trends in snacking behaviours and eating food-prepared-outside-the-home (FPOH) by Chinese children and adolescents using data from the China Health and Nutrition Survey. The sample consisted of 3223 subjects aged 6-18 in 1991 and 2836 in 1997. Three days of 24hr recall dietary data and per capita income (deflated to 1989) was used. The percentage of Chinese children having snacking behaviours was significantly differentiated according to the income level while percentage of eating FPOH increased in middle and high income groups. Snacking contributed about 8% of the energy intake (EI) for snackers, compared with over 15% from FPOH for those who ate FPOH. Fruit was a major component of snacking: snacks based on fruit intake almost doubled over the study period as did snacks based on soft drink consumption. Animal source food consumption was a key component of FPOH and its intake also increased.
 
Article
Based on information gathered in the l992 Chinese national nutrition survey, the energy consumption on average is about adequate for the whole population. Dietary protein and fat have increased, and now provide 11.8% and 22.0%, respectively, of the total dietary energy. The adequacy of nutrient intake, expressed as percentages of RDA, is higher for urban populations than for rural, and higher for high income groups than for low income groups. Child growth has improved substantially compared to ten years ago. However, there are still 32.6% of preschool children with stunted growth and 17.7% are underweight. Rural children have a higher incidence of chronic energy deficiency (CED) than their urban counterparts. The improvement in children's growth and the increase of overweight adults are in line with the country's overall food production and the average food consumption of the population. The difference between urban and rural nutritional status deserves more attention.
 
Article
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.
 
Article
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 of variance 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, whilst self-reported gout increased between 1993-1996 and 2005-2008. Changes in dietary patterns may in part explain the decrease in uric acid levels between the two national surveys.
 
Article
The availability of new food choices has increased dramatically in recent times, whilst increasingly sedentary lifestyles have reduced calorie intake requirements. The present study uses 24 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 that dietary 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 made from 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.
 
Article
Data from nationwide population-based nutrition surveys in Taiwan were used 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 mg for adult males and females, respectively, which is equivalent to 82-85% of relevant Taiwanese Dietary Reference Intakes (DRIs). After correcting intra-individual 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 NAHSIT 2005-2008, 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.
 
Article
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 fast among 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.
 
Article
The aim of this cross-sectional observation study was to assess thoroughly the body mass index (BMI) profile in Hong Kong Chinese and report all categories of BMI cutoff points as suggested by the World Health Organization (WHO). A cohort of 17,242 subjects (4822 men and 12420 women) aged 15 or above from the community of Hong Kong presenting themselves voluntarily from April 1996 to August 1997 for primary health assessment at the Three Health Centers of the United Christian Nethersole Community Health Service (UCNCHS). The mean age (+/- SD) was 51.0 +/- 16.2 years (range 15-96 years, median 49.6 years). The mean BMI of the 17,242 subjects was 23.5 +/- 3.3 kg/m2 in men and 23.0 +/- 3.7 kg/m2 in women. The BMI peaked at age 30 to 50 years in men and 50 to 70 years in women. The age-standardized prevalence of BMI > or = 30 kg/m2 or > or = 25 kg/m2 in Hong Kong Chinese was 3.0% in men and 3.2% in women, and 29.1% in men and 21.3% in women, respectively. For underweight, 35.9% and 27.8% of women and 27.5% and 10.3% of men aged 15-20 and 20-30 years, respectively, had BMI < 18.5 kg/m2. In conclusion, a significant proportion of Hong Kong Chinese had a BMI > or = 25 kg/m2. Among Hong Kong Chinese aged < 30 years, the prevalence of underweight was also high.
 
Article
The purpose of the study was to understand present infant complementary 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 in both 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 year of age needs attention. The government should not only promote breastfeeding, but also reevaluate current evidence-based recommendation on complementary food introduction time.
 
Distribution of energy intake of Jakartan elderly.
Distribution of energy intake of Semarang elderly.
Differences in food intakes between Jakarta and Semarang elderly
Article
The Nutrient and Metabolic Study of Indonesian Elderly (NUMSIE) was conducted in part to identify differences in eating patterns and in food and energy intakes between elderly people residing in urban metropolitan Jakarta (JAK) and in urban non-metropolitan Semarang (SEM) in order to investigate the prevalence of food and energy deficiencies. Data on food intake were collected from 212 JAK elderly and 238 SEM elderly aged 60 years and over using a quantitative food frequency questionnaire (FFQ). Although most of the elderly lived with their families or extended families, a large proportion of the subjects were eating alone, especially in the SEM sample. Jakartan elderly had significantly higher intakes of most food groups, except for added sugar and cow's milk. Total food intake of JAK subjects was also significantly higher (p<0.0001) than that of SEM subjects. The ratio of plant to animal food was lower among SEM elderly due principally to their higher intake of milk. Thirty percent of both JAK and SEM elderly consumed less than the recommended amounts of cereals, followed by vegetables and fruits (10%, 47% JAK; 22%, 75% SEM, respectively). Finally, it was found that the range of daily energy intakes was higher in JAK (1251-2079 kcal) than in SEM (939-1579 kcal). This suggests that SEM elderly were more likely to be energy deficient than were JAK elderly. While the results of this study indicate that food and energy intakes may be inadequate in Indonesian elderly, especially in non-metropolitan areas, more analyses are required to ascertain the true prevalence of malnutrition in this age group using anthropometric and blood measurements.
 
Article
A large health screening program in Taiwan with members who have periodic checks provides an opportunity to track individuals who are healthy at baseline for the emergence of the metabolic syndrome (MS) and its component disorders. The syndrome comprised abdominal obesity assessed by waist circumference, high fasting serum glucose (FSG), high triglyceride (TG), low high density lipoprotein-cholesterol (HDL-C) and high blood pressure. A cohort of 9,785 adults (4,707 men and 5,078 women), aged 19 to 84 years, who were free from the MS at baseline were followed for 4 years from 1998 to 2002. Using Asian criteria for abdominal obesity and reducing the threshold for FSG from >or=110 mg/dL to >or=100 mg/dL, the incidence of MS during the 4-year follow up in the MJ Health Screening Center Study in Taiwan was 12.7% (17.5% for men and 8.3% for women). The incidence of the MS in men exceeded that for women up until 50-59 years and then this gender was reversed in the older age groups pointing to pre-menopausal protection in women. The most evident manifestations of the incident of metabolic abnormalities were high FSG, high blood pressure and high TG, particularly in post-menopausal women. Baseline body mass index and age were the most significant predictors of MS for both men and women, with cigarette smoking significantly predictive in men. Incident information should inform preventive and intervention strategies in Taiwanese, both Chinese and Indigenous, more effectively than MS and its component disorder prevalences.
 
Top-cited authors
Paul Deurenberg
  • National University of Singapore; Wageningen University Netherlands
Mabel Yap
  • Ministry of Health, Singapore
Elaine Carolyn Rush
  • Auckland University of Technology
Artemis Simopoulos
  • Center for Genetics Nutrition and Health
Geok Lin Khor
  • Universiti Putra Malaysia