June 2000 - Volume 9 Issue 2

Asia Pacific Clinical Nutrition Society 2000 Award

61 / Asia Pacific Clinical Nutrition Society 2000 Award
AkiraOkada
Asia Pacific Journal of Clinical Nutrition
Volume 9Issue 2Page 61 - June 2000
Asia Pacific Clinical Nutrition Society 2000 Award
Akira Okada, MD, PhD

Original Articles

62 / Serum fatty acids, lipoprotein(a) and apolipoprotein composition of rural, suburban and urban populations in North Vietnam
NGUYEN THI MINHKIEU, ETSUKOYASUGI, DO THI KIMLIEN, NGUYEN THI LANANH, TRAN THANHDO, HA HUYKHOI, TOSHIMIKIDO, KAZUOKONDO, HIROSHIGEITAKURA, NGUYEN VANCHUYEN, SHIGERUYAMAMOTO, MIEKOOSHIMA
Asia Pacific Journal of Clinical Nutrition
Volume 9Issue 2Page 62 - June 2000
ORIGINAL ARTICLE
Serum fatty acids, lipoprotein(a) and apolipoprotein composition of rural, suburban and urban populations in North Vietnam
Nguyen Thi Minh Kieu MD1, Etsuko Yasugi PhD1, Do Thi Kim Lien MD, PhD2, Nguyen Thi Lan Anh MD2, Tran Thanh Do Bs2 Ha Huy Khoi MD, PhD2, Toshimi Kido BS3, Kazuo Kondo MD, PhD3, Hiroshige Itakura MD, PhD3, Nguyen Van Chuyen PhD4, Shigeru Yamamoto PhD5 and Mieko Oshima PhD1
This study was conducted to investigate the concentrations of serum fatty acids, lipoprotein(a) and apolipoprotein of three populations in North Vietnam: rural area with low income (n = 101), suburban with average income (n = 97), and urban with high income (n = 95). The results showed the suburban and urban populations had higher fat intake than the rural. The fat intake in quality was different in these three populations. The suburban had the highest consumption of fatty foods rich in n-6 polyunsaturated fatty acid (PUFA). The rural consumed more fatty foods rich in monounsaturated fatty acid (MUFA), but less fatty foods rich in n-3 PUFA than the two other populations. The high index of thrombogenicity (IT) of the Vietnamese diet may result from their low intake of fish and vegetable oils. Risk factors for premature cardiovascular disease (CVD) assessed by serum lipoprotein(a) and apolipoprotein levels were not observed in all three populations. However, coronary heart disease (CHD) and stroke are problems that should be monitored because the increase of CVD morbidity has been reported in Vietnamese people. From a nutritional point of view, the increase of fish and vegetable oils consumption is necessary for the prevention of CVD and CHD in these Vietnamese populations.
67 / Concurrent management of postprandial glycaemia and nutrient intake using glycaemic glucose equivalents, food composition data and computer-assisted meal design
JOHN AMONRO, MIKEWILLIAMS
Asia Pacific Journal of Clinical Nutrition
Volume 9Issue 2Page 67 - June 2000
ORIGINAL ARTICLE
Concurrent management of postprandial glycaemia and nutrient intake using glycaemic glucose equivalents, food composition data and computer-assisted meal design
John A Monro BSc(Hons), PhD1 and Mike Williams BSc(Hons), AACS2
A computer system, called SERVE-NZ Nutririon Management System, for use in diabetes management, addresses the problem of concurrently controlling postprandial glycaemic response and nutrient intake in meals containing a number of foods, is described. It converts the weight and relative glycaemic potency of each food to its content of glycaemic glucose equivalents (GGE) - the amount of glucose theoretically inducing the same blood glucose response as would the specified quantity of food. Glycaemic glucose equivalents in a meal can be simply obtained by adding the GGE content of all foods in the meal to give a figure for the maximal glycaemic impact of the meal. Glycaemic glucose equivalents may be calculated using food composition databases that include available carbohydrate, common standard measure weights and glycaemic index values. If GGE is treated as a nutrient, an output of the total nutrient profile of a food or meal, and its glycaemic impact as GGE, can be obtained simultaneously. Application of a nutritional software system incorporating GGE values to management of glycaemic loadings and nutrient intakes over five meals within a day is demonstrated. The system may be a useful aid in self-management of glycaemia, as it will identify quantities of foods that can be consumed without exceeding the predetermined glucose tolerances of individuals. The graphical presentation of GGE and nutrient composition of meals may be a useful visual aid in educating clients with diabetes. The GGE values on food labels would provide easily understood guidance, not obtained from glycaemic index values, to the maximum number of items or quantity of a food that an individual should eat at a time. In its present basic form the calculation of GGE is most likely to slightly overestimate glycaemic impact, so it presents a worst-case prediction.
74 / Faecal bulking index: A physiological basis for dietary management of bulk in the distal colon
JOHN AMONRO
Asia Pacific Journal of Clinical Nutrition
Volume 9Issue 2Page 74 - June 2000
ORIGINAL ARTICLE
Faecal bulking index: A physiological basis for dietary management of bulk in the distal colon
John A Monro, BSc(Hons), PhD, MA
Bulk in the distal colon provides protection against a range of large bowel disorders, but a simple standardized measure of the relative bulking efficacy of foods, for use in dietary management of distal colonic bulk, has not been available. This paper describes a faecal bulking index (FBI) for standardized measurement of the relative colonic bulking efficacy of foods relative to a reference material. Faecal bulking index is defined as the mass of fully rehydrated faecal matter accumulated by the distal colon per gram of a food consumed, as a percentage of the matter accumulated from the same weight of a reference food. The FBI of foods was measured after feeding adult rats at moderate levels by partially or completely replacing sucrose in a baseline diet already containing mixed dietary fiber. Faeces were collected, dried, weighed, allowed to imbibe water until fully rehydrated, reweighed and their mass and water holding capacity measured. The FBI was calculated as the increase over baseline in rehydrated faecal mass induced by a test food as a percentage of the increase due to wheat bran (reference). The FBI values were measured for 69 diets including breakfast cereals, breads and other bakery products, fruits, vegetables, food ingredients and polysaccharides. Values for most foods ranged between almost zero for some starch-based foods to about 50 for wheat bran-enriched breakfast cereals, but laxatives based on fermentation-resistant hydrated polysaccharide had FBI values well in excess of 100 (FBI for psyllium = 500). The FBI values allow foods to be ranked according to their faecal bulking efficacy on an equal edible weight basis. They can also be used to calculate the bulking action of any amount of food in terms of equivalents to a reference material such as wheat bran. Wheat bran equivalents allow the cumulative intake of potential distal colonic bulk to be monitored for single foods or mixed meals, and shortfalls to be quantified for dietary modification or supplementation. Measures such as FBI or wheat bran equivalents would prove more useful than dietary fiber in controlling 'functional foods' promoted as effective bulking agents.
82 / Evaluation of nutritional status among a group of young Chinese adults in Kuala Lumpur, Malaysia
NORIMAHKARIM, SWLEONG
Asia Pacific Journal of Clinical Nutrition
Volume 9Issue 2Page 82 - June 2000
ORIGINAL ARTICLE
Evaluation of nutritional status among a group of young Chinese adults in Kuala Lumpur, Malaysia
Norimah Karim, PhD and SW Leong, BSc
A nutritional status study was carried out among a group of young Chinese adults, aged between 19 and 25, in Kuala Lumpur, Malaysia. Subjects comprised 108 young adults (55 women, 53 men) who were students at two institutes of higher learning. Physical characteristics were evaluated by anthropometric measurements while food intake was determined with a 3-day food record. Blood cholesterol and triglyceride were assessed using the Reflotron analyser. Birthweight was obtained from birth certificates or by proxy. The results showed that the mean body mass index (BMI) for men and women was 21.4 ± 3.3 and 20.0 ± 2.0, respectively, indicating normal weight. Further analysis of BMI classification demonstrated that 28% of men and 39% of women were underweight, 11% of men and 2% of women were overweight while 2% of men were obese. Mean waist-to-hip ratio showed that the subjects had a low risk of developing cardiovascular disease (0.72 ± 0.03 women; 0.81 ± 0.05 men). Mean energy intake was 8841 ± 1756 kJ per day for men and 6426 ± 1567 kJ per day for women. Closer analysis of energy intake of the subjects showed that 86% of men and 91% of women were consuming below the Malaysian recommendation for energy. Nutrients found to be deficient in at least one third of women were calcium, vitamin A, niacin and iron. Mean cholesterol intake in the diet was 278.7 ± 108.7 mg in men and 207.0 ± 82.5 mg in women and there was a significant difference between genders. Blood cholesterol and triglyceride levels were 3.88 ± 0.76 mmol/L and 1.08 ± 0.33 mmol/L, respectively in men, while these levels were lower in women, 3.87 ± 0.80 mmol/L for cholesterol and 0.99 ± 0.29 mmol/L for triglyceride. A general trend of higher mean blood cholesterol and triglyceride levels was shown in adults who were born with lower birthweights.
87 / Implications of diet and nutrition for growth and prevalence of anaemia in rural preschool-aged children in Shandong Province, China
ZAIMINWANG, CARLA MPATTERSON, BRIANOLDENBURG
Asia Pacific Journal of Clinical Nutrition
Volume 9Issue 2Page 87 - June 2000
ORIGINAL ARTICLE
Implications of diet and nutrition for growth and prevalence of anaemia in rural preschool-aged children in Shandong Province, China
Zaimin Wang, BMed, MMed, MPS FoodNutri, PhD, MA1, Carla M Patterson, MSc, PhD2 Brian Oldenburg, MSc, MPsych, PhD2
A nutrition surveillance and nutritional improvement programme through nutrition field worker training, nutrition education and encouraging the utilization of home gardens was undertaken among rural preschool-aged children in the four counties of Linshu, Caoxin, Zoucheng and Yucheng in Shandong Province in China from 1990 to 1995. A baseline survey was conducted in 1990. This included physical and biochemical measurements being taken on 3474 children aged 0-5 years and dietary household surveys being taken on a random subsample of 312 children. The baseline survey showed that the average height and weight of the subjects was lower than the World Health Organization (WHO) standard with the prevalence of stunting, underweight and wasting being 24.2, 12.5 and 2.1%, respectively (using the Z scores -2 as the cut-off point). The prevalence of anaemia was 61.9% (using haemoglobin (HB) 110 g/L as the cut-off point). The range of mean intakes of protein and energy was, respectively, 54.0-67.2% and 56.4-68.4% of the Chinese recommended dietary allowance (RDA) depending on the age group. Mean calcium intake was less than 30% of the RDA for all age groups and the mean intakes of ascorbic acid, niacin, retinol and riboflavin were between 30.6 and 96.1% of the RDA. Nutrition education and nutrition field worker training were the key components of the intervention phase that followed the baseline survey. Over 5 years, 531 nutrition field workers were trained, 1200 parents joined in nutrition classes and approximately 8000 villagers received basic nutrition information. The latter included promotion of breast-feeding, identification of sources of appropriate foods for weaning, and also for the prevention and treatment of common nutritional deficiencies. Home gardens for fruit, vegetable and livestock were also encouraged. The evaluation survey of the project was conducted in 1995 among 2728 0-5-year-old children. The results indicated that the nutritional status of preschool-aged children had improved greatly. The prevalence of stunting and underweight was reduced by 37.8 and 21.3%, respectively, while there was no significant change in the prevalence of wasting. The average rate of anaemia decreased by 79.6% in 1995.
93 / Prediction of percentage body fat from anthropometry and bioelectrical impedance in Singaporean and Beijing Chinese
PAULDEURENBERG, MABELDEURENBERG-YAP, JINGZHONGWANG, FU POLIN, GORDONSCHMIDT
Asia Pacific Journal of Clinical Nutrition
Volume 9Issue 2Page 93 - June 2000
ORIGINAL ARTICLE
Prediction of percentage body fat from anthropometry and bioelectrical impedance in Singaporean and Beijing Chinese
Paul Deurenberg PhD1,5, Mabel Deurenberg-Yap MSc2, Jingzhong Wang BSc3, Fu Po Lin MSc2 and Gordon Schmidt PhD4
Body composition was measured in 205 male and female Beijing Chinese and in 148 male and female Singaporean Chinese, age 34 (mean) (range 18-68) years and body mass index (BMI) 22.3 (15.9-38.5) kg/m 2. In Beijing Siri's two-compartment model based on densitometry was used as a reference technique and in Singapore Siri's three-compartment model based on densitometry and deuterium oxide dilution was used. In addition, body composition was predicted using equations based on anthropometry and bioelectrical impedance developed in Caucasian populations. Percentage body fat (BF%) predicted from BMI was systematically underestimated by about 1% in Beijing Chinese and by about 3.5% in Singaporean Chinese. The difference in bias (measured minus predicted BF%) between the two population groups could be explained by differences in frame size. The Durnin and Womersley equations for BF% based on skinfold thickness predicted BF% in the male and female Chinese groups adequately, with only a slight (less than 1% body fat) and not significant bias. The prediction of BF% based on the waist circumference (Lean's formula) resulted in an unbiased estimate of BF% in females (bias about 1% body fat), whereas in males the formula systematically underestimated BF% by 3.5-5%. Bioelectrical impedance underestimated BF% systematically by 3%, in males and females to about the same extent. The bias of all prediction formulas was positively correlated with the level of body fatness and, except for impedance, also negatively correlated with age. The negative association of the bias with age indicates that the age-related increase in body fatness is lower in Chinese than in Caucasians. It can be concluded of the studied prediction techniques that only the skinfold methodology using the equations of Durnin and Womersley give valid mean estimates for both Chinese males and females. The other techniques require the development of population-specific prediction formula.
99 / Assessment of iodine deficiency disorders in Meerut district, Uttar Pradesh
UMESHKAPIL, JAI VIRSINGH, MONICATANDON, PRIYALIPATHAK, CHARANSINGH, RAKESHYADAV
Asia Pacific Journal of Clinical Nutrition
Volume 9Issue 2Page 99 - June 2000
ORIGINAL ARTICLE
Assessment of iodine deficiency disorders in Meerut district, Uttar Pradesh
Umesh Kapil, MD1, Jai Vir Singh, MD2, Monica Tandon, MSc1, Priyali Pathak, MSc1, Charan Singh, MD3 and Rakesh Yadav, MA1
Iodine deficiency disorders (IDD) are an important public health problem in India. Meerut district, Uttar Pradesh, is a known IDD endemic area. A study conducted in 1986 reported a total goitre rate of 24.9% in the entire population of Meerut district. During 1990-97 intensive efforts were taken by the Uttar Pradesh Government to ensure universal availability of iodized salt to the population. No survey has been conducted since 1997 on the status of iodine deficiency in the Meerut district. Hence, the present study was conducted in order to assess the prevalence of IDD and to estimate the iodine content of salt consumed in the households of Meerut district, Uttar Pradesh. The 30 cluster sampling methodology and indicators for assessment of IDD as recommended by the joint WHO/UNICEF/ICCIDD (World Health Organization/United Nations Children's Fund/International Council for the Control of Iodine Deficiency Disorders) Consultation in full was utilized for the survey. A confidence level of 95%, relative precision of 10% and design effect of three were considered in the calculation of the sample size. The prevalence of goitre at the time of survey was estimated to be 15%. A total of 6485 school children in the 6-10 years age group were selected using probability proportionate to size cluster sampling methodology. A total goitre prevalence rate of 11.6% was found in the district. It was observed that 5.4, 2.9 and 19.9% of the children had urinary excretion levels of < 2.0, 2.0-4.9, and 5.0-9.9 g/dL, respectively. The median urinary iodine excretion of the children studied was found to be 15.0 g/dL. Fifty-three percent of the children studied consumed salt with an iodine content of less than 15 p.p.m., which was below the stipulated level (15 p.p.m.). The study showed that the population is in a transition phase from iodine deficient (as revealed by total goitre rate) to iodine sufficient (as revealed by median urinary iodine excretion of 15.0 g/dL). There is a need to further strengthen the existing monitoring system for the quality of iodized salt in the district in order to achieve the elimination of IDD.
102 / Nutritional and anthropometric assessment of a sample of pregnant women and young children in Palau
REBECCA SPOBOCIK, GMHEATHCOTE, JBSPIERS, CTOTTO
Asia Pacific Journal of Clinical Nutrition
Volume 9Issue 2Page 102 - June 2000
ORIGINAL ARTICLE
Nutritional and anthropometric assessment of a sample of pregnant women and young children in Palau
Rebecca S Pobocik, PhD, RD1 GM Heathcote, PhD2 JB Spiers, MS, RN, CS, FNP3 and CT Otto, MHA4
This study examines the diet and body constitution of a small sample of pregnant women, n = 27, and children, n = 32, enrolled in the Maternal and Child Health program at the Public Health/Community Health Center in Koror, Palau. Twenty-four hour diet recalls were collected from both groups, 17 anthropometric and body composition measurements were made on the women and a range of body measurements from height to a full battery of 28 measures were obtained from the children. Diets were found to be low in energy, calcium and zinc. Women consume micronutrients primarily from fish, traditional starches, vegetables and fruits, while children rely more on fortified grain products and milk. The energy distribution is higher in protein and fat and lower in carbohydrate than earlier reports of adult Palauans. A significant minority of the women (27%) have body fat or body mass index profiles indicative of clinically significant obesity or energy storage deficit, both problematic in terms of pregnancy outcomes. While sample sizes of infant and young child cohorts are very small, our findings indicate that a relatively high proportion of these younger children, have experienced inadequate growth and development This is especially true of females, among whom stunting (height deficients) and especially wasting (weight and arm circumference deficits) were in greater evidence.