Showing papers in "Asia Pacific Journal of Clinical Nutrition in 2008"

Nutrition education: linking research, theory, and practice.

Abstract: The increase in obesity and chronic diseases such as diabetes and heart disease worldwide reflects the complex interactions of biology, personal behaviour and environment. Consequently there has been a greater recognition of the importance of nutrition education. An analysis of the evidence from 300+ studies shows that nutrition education is more likely to be effective when it focuses on behaviour/ action (rather than knowledge only) and systematically links theory, research and practice. There are three essential components to nutrition education: 1. A motivational component, where the goal is to increase awareness and enhance motivation by addressing beliefs, attitudes through effective communication strategies. 2. An action component, where the goal is to facilitate people's ability to take action through goal setting and cognitive self-regulation skills. 3. An environmental component, where nutrition educators work with policymakers and others to promote environmental supports for action. Each component needs to be based on appropriate theory and research. The procedure for program design can use the logic model: Inputs are the resources needed as well as the needs analysis process. The outputs are the activities within the three components of nutrition education described above. Here the behavioural focus is selected and theory and research are used to design appropriate educational strategies to achieve the targeted behaviours. The outcomes are the short, medium or long-term impacts of the nutrition program. These are evaluated through the use of appropriate designs and instruments. Nutrition education programs that link research, theory, and practice are more likely to be effective.

How to Define Obesity? Evidence-based Multiple Action Points for Public Awareness, Screening, and Treatment: an Extension of Asian-Pacific Recommendations

Abstract: Metabolic risks are greater in Asians than Caucasians at a given body mass index (BMI). It is generally accepted that the BMI cut-off points for defining overweight and obesity should be lower for Asians. However, the percent body fat at a given BMI and metabolic responses to fatness vary among the different ethnic groups in Asia. Therefore, roughly even-spaced multiple action points (i.e., BMIs of 23, 25, 27.5, 30, 32.5, 35 and 37.5) have been advocated for managing obesity in Asians. We propose here evidence-based ethnicity-specific action points for public awareness, screening, and treatment that take into consideration sensitivity, specificity, and positive/negative predictive values for cardiovascular disease and/or metabolic syndromes, which are the most preva-lent adverse consequences of obesity.

The omega-6/omega-3 fatty acid ratio, genetic variation, and cardiovascular disease.

Abstract: A high omega-6/omega-3 ratio, as is found in today's Western diets, promotes the pathogenesis of many chronic diseases, including cardiovascular disease. Increased dietary intake of linoleic acid (LA) leads to oxidation of low-density lipoprotein (LDL), platelet aggregation, and interferes with the incorporation of essential fatty acids (EFA) in cell membrane phopholipids. Both omega-6 and omega-3 fatty acids influence gene expression. Omega-3 fatty acids have strong anti-inflammatory effects, suppress interleukin 1 beta (IL-1 beta), tumor necrosis factor-alpha (TNF alpha) and interleukin-6 (IL-6), whereas omega-6 fatty acids tend to be pro-inflammatory. Because inflammation is at the base of many chronic diseases, including coronary heart disease, dietary intake of omega-3 fatty acids plays an important role in the manifestation of disease, particularly in persons with genetic variation, as for example in individuals with genetic variants at the 5-lipoxygenase (5-LO). Increased dietary arachidonic acid (AA) significantly enhances the apparent atherogenic effect of genotype, whereas increased dietary intake of omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) blunts this effect. The diet-gene interaction further suggests that dietary omega-6 fatty acids promote, whereas marine omega-3 fatty acids EPA and DHA inhibit leukotriene-mediated inflammation that leads to atherosclerosis in this subpopulation.

Epidemiology of metabolic syndrome in Asia.

Abstract: Metabolic syndrome (MS) is a rising disease entity characterized by a clustering of metabolic conditions. Although prevalence of obesity as defined by the World Health Organization (WHO) is relatively low in Asia compared to western countries, metabolic syndrome is growing into a significant public health problem. Comparative studies indicate that metabolic responses to obesity may be greater in South and East Asians than their western counterparts at given Body Mass Indexes (BMIs). Higher percentage body fat in Asians at given BMIs and over-responsiveness to obesity may in part explain the phenomenon for which the underlying causes are not clear. Furthermore, aborigines may be at an even greater MS risk. The metabolic syndrome definition itself as well as whether it should be defined are controversial. The National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) gives equal weight to each component disorder, while the International Diabetes Federation (IDF) takes central obesity as a pre-requisite. Both criteria adopt ethnic-specific cut-off points for waist circumference. Asian data favour the new NCEP-ATP III definition, as individuals that were selected through the NCEP criteria but disregarded by the IDF criteria had similar Framingham cardiovascular disease risk scores to those picked by both definitions. Prospective data show that the metabolic syndrome not only increases the risk of coronary artery disease but also cerebrovascular disease in Asians. Macronutrient composition and the quality of the diet are associated with the risk of metabolic syndrome. More research is needed to relate diet and metabolic syndrome in Asians.

The role of eicosanoids in the brain.

Abstract: The brain contains two main polyunsaturated fatty acids (PUFA), arachidonic acid (AA) and docosahexaenoic acid (DHA). These PUFA are located almost exclusively in the sn2-position of phosphoglycerides which are found in the neural cell membranes. Liberation of these PUFA from the phosphoglycerides occurs via the action of specific phospholipases (PLA2). Free AA can be metabolised by cyclooxygenases to prostaglandins and thromboxane, while both AA and DHA can be metabolised by lipoxygenases to form hydroxy derivatives and leukotrienes. AA is also metabolised to lipoxins via the 5-lipoxygenase pathway. The eicosanoids formed play important roles in neural function including sleep induction (PGD2), long term potentiation, spatial learning and synaptic plasticity (PGE2), resolution of inflammation (lipoxins) and anti-inflammatory and neuroprotective bioactivity (dihydroxy-docosatriene, neuroprotectin D1, formed from DHA). COX-inhibitors have been shown to reduce oxidative stress and cognitive impairment. Additionally, drugs which are used to treat depression have been shown to reduce the turnover of AA to PGE2 in the brain. Diets deficient in omega 3 PUFA lead to reduced DHA in the brain and increased turnover of AA to eicosanoids, an effect which is overcome by restoring the omega 3 PUFA to the diet. In neural trauma and neurodegenerative diseases, there is a dramatic rise in the levels of AA-derived eicosanoids. In contrast, DHA-derived compounds can prevent neuroinflammation. Clearly, the eicosanoids are very important for the normal functioning of the brain, while the PUFA themselves are important in membrane structure and function.

Traditional Indian spices and their health significance.

Abstract: India has been recognized all over the world for spices and medicinal plants. Both exhibit a wide range of physiological and pharmacological properties. Current biomedical efforts are focused on their scientific merits, to provide science-based evidence for the traditional uses and to develop either functional foods or nutraceuticals. The Indian traditional medical systems use turmeric for wound healing, rheumatic disorders, gastrointestinal symptoms, deworming, rhinitis and as a cosmetic. Studies in India have explored its anti-inflammatory, cholekinetic and anti-oxidant potentials with the recent investigations focusing on its preventive effect on precarcinogenic, anti-inflammatory and anti atherosclerotic effects in biological systems both under in vitro and in vivo conditions in animals and humans. Both turmeric and curcumin were found to increase detoxifying enzymes, prevent DNA damage, improve DNA repair, decrease mutations and tumour formation and exhibit antioxidative potential in animals. Limited clinical studies suggest that turmeric can significantly impact excretion of mutagens in urine in smokers and regress precancerous palatal lesions. It reduces DNA adducts and micronuclei in oral epithelial cells. It prevents formation of nitroso compounds both in vivo and in vitro. It delays induced cataract in diabetes and reduces hyperlipidemia in obese rats. Recently several molecular targets have been identified for therapeutic / preventive effects of turmeric. Fenugreek seeds, a rich source of soluble fiber used in Indian cuisine reduces blood glucose and lipids and can be used as a food adjuvant in diabetes. Similarly garlic, onions, and ginger have been found to modulate favourably the process of carcinogenesis.

Childhood obesity in Asian Indians: a burgeoning cause of insulin resistance, diabetes and sub-clinical inflammation.

Abstract: Recent data indicate a rise in obesity both in children and adolescents in developing countries. The overall prevalence of overweight/obesity in urban children in New Delhi has shown an increase from 16% in 2002 to about 24% in 2006-2007. Our recent data show that the prevalence among adolescent children was 29% in private schools and 11.3% in government funded schools. While India already has highest number of patients with type 2 diabetes mellitus (T2DM) globally, rapid rise of obesity in children is the prime reason for increasing insulin resistance, the metabolic syndrome, dyslipidemia, polycystic ovarian syndrome and raised levels of C-reactive protein. Excess body fat, thick truncal subcutaneous fat, and abdominal adiposity are important predisposing factors for development of insulin resistance in Asian Indian children. As compared to other ethnic groups, children with ancestral origin in South Asia manifest adiposity, insulin resistance and metabolic perturbations earlier in life and these derangements are of higher magnitude than white Caucasian children. Since the metabolic syndrome and obesity track into adulthood, these clinical entities need to be recognized early for effective prevention of T2DM and coronary heart disease. Therapeutic lifestyle changes, maintenance of high levels of physical activity and normal weight are most important prevention strategies. Both high-risk surveillance and costeffective population intervention programs are urgently needed. In this context, we have launched one of the largest program (“MARG”, The Path) to curb childhood obesity in India.

Phytochemical Composition of Nuts

Abstract: Observational studies suggest nut consumption is inversely associated with the incidence of cardiovascular disease and cancer. In addition to being rich in several vitamins and minerals, unsaturated fatty acids, and fiber, tree nuts and peanuts contain numerous phytochemicals that may contribute to promoting health and reducing the risk of chronic disease. While many of these bioactive constituents remain to be fully identified and characterized, broad classes include carotenoids, phenols, and phytosterols. Phytosterols in nuts range from 95-280 mg/100 g. alpha- and beta-Carotene, beta-cryptoxanthin, lutein, and zeaxanthin are found in microg/100 g amounts in some nuts but at 1-3 mg/100 g in pistachios and none at all in Brazils, macadamias, and peanuts. Phenols, including phenolic acids, flavonoids, and stilbenes, are present in nuts. Walnuts are particularly rich in total phenols with 1625 mg gallic acid equivalents/100 g. The stilbene resveratrol is found in peanuts and pistachios at 84 and 115 microg/100 g, respectively. The flavonoid content of nuts as provided in USDA Database for the Flavonoid Content of Selected Foods, lists totals in pecans at 34, almonds at 15, and pistachios and hazelnuts at 12 mg/100 g. Proanthocyanidins are found in almonds, cashews, hazelnuts, pecans, pistachios, peanuts, and walnuts, with concentrations varying from 9-494 mg/100 g. Nut phytochemicals have been associated with numerous bioactivities known to affect the initiation and progression of several pathogenic processes. However, as complete phytochemical profiles are lacking for most nuts, information is limited regarding their bioavailability and metabolism, so further research on this topic is warranted.

Seaweed carotenoid, fucoxanthin, as a multi-functional nutrient.

Abstract: Fucoxanthin has a unique structure including an unusual allenic bond and 5, 6-monoepoxide in its molecule. We found that abdominal white adipose tissue (WAT) weights of rats and mice fed fucoxanthin were significantly lower than those fed a control diet. The daily intake of fucoxanthin in mice also caused a significant reductions of body weight. Clear signals of uncoupling protein 1 (UCP1) and its mRNA were detected by Western and Northern blot analyses in abdominal WAT in mice fed fucoxanthin, although there is little expression of UCP1 in WAT in mice fed a control diet. UCP1 expression in WAT by fucoxanthin intake leads to oxidation of fatty acids and heat production in WAT mitochondria. Substrate oxidation can directly reduce WAT in animals. Fucoxanthin intake also significantly reduced blood glucose and plasma insulin. Furthermore, feeding fucoxanthin significantly increased the level of hepatic docosahexaenoic acid (DHA), a most important n-3 functional polyunsaturated fatty acid in biological systems. These multi-functionalities of fucoxanthin indicate that it is an important bioactive carotenoid that is should be beneficial for the prevention of the metabolic syndrome.

L-Theanine, a Natural Constituent in Tea, and Its Effect on Mental State

Abstract: Tea is the most widely consumed beverage in the world after water. Tea is known to be a rich source of flavonoid antioxidants. However tea also contains a unique amino acid, L-theanine that may modulate aspects of brain function in humans. Evidence from human electroencephalograph (EEG) studies show that it has a direct effect on the brain (Juneja et al. Trends in Food Science & Tech 1999;10;199-204). L-theanine significantly increases activity in the alpha frequency band which indicates that it relaxes the mind without inducing drowsiness. However, this effect has only been established at higher doses than that typically found in a cup of black tea (approximately 20mg). The aim of the current research was to establish this effect at more realistic dietary levels. EEG was measured in healthy, young participants at baseline and 45, 60, 75, 90 and 105 minutes after ingestion of 50mg L-theanine (n=16) or placebo (n=19). Participants were resting with their eyes closed during EEG recording. There was a greater increase in alpha activity across time in the L-theanine condition (relative to placebo (p+0.05). A second study replicated this effect in participants engaged in passive activity. These data indicate that L-theanine, at realistic dietary levels, has a significant effect on the general state of mental alertness or arousal. Furthermore, alpha activity is known to play an important role in critical aspects of attention, and further research is therefore focussed on understanding the effect of L-theanine on attentional processes.

Dynamic shifts in Chinese eating behaviors.

Abstract: The purpose of the study is to examine the dynamic eating behaviors of the Chinese people, focusing on snacking and the choice of cooking methods, and to identify the influences of socioeconomic factors on these eating behaviors. Data for this study were from the China Health and Nutrition Survey (CHNS). There were 12808 subjects, older than two years (y), from the 1991 and 11527 from the 2004 surveys respectively. Logistic regressions of pooled data were performed to evaluate how socioeconomic status (SES) was associated with two eating behaviors: snacking and consuming excessive amounts of fried foods. Simulation techniques were used to clarify the effects of the results that included significant interaction terms. Results showed that the rapid shift in the food and nutrient profile of the Chinese population is accompanied by equally profound changes in meal and cooking patterns. Snacking behavior is beginning to emerge and there are shifts away from the steaming and boiling of food to the, less healthy, frying of food. Income is positively associated with the consumption of both snacks and excessive fried food. Urban residents are also more likely to snack and to consume excessive amounts of fried foods than rural residents. These findings indicate that eating behaviors are beginning to change rapidly toward less healthy options in China. SES plays a vital role in the early stages of the eating behavior transition in China. Future health promotion programs targeting the higher-SES population will exert far-reaching effects on the improvement of health status in this group.

NF-κB and Nrf2 as Potential Chemopreventive Targets of Some Anti-Inflammatory and Antioxidative Phytonutrients with Anti-Inflammatory and Antioxidative Activities

Abstract: Chemoprevention refers to the use of defined non-toxic chemical regimens to inhibit, reverse or retard the process of multi-stage carcinogenesis that involves multiple signal transduction events. A new horizon in chemoprevention research is the recent discovery of molecular links between inflammation and cancer. Components of the cell signaling network, especially those that converge on the ubiquitous eukaryotic redox-sensitive transcription factor, nuclear factor-kappa B (NF-kappa B), have been implicated in the pathogenesis of many inflammation-associated disorders. A wide variety of chemopreventive and chemoprotective phytochemicals and phytonutrients can alter or correct undesired cellular functions caused by abnormal pro-inflammatory signal transmissions, mediated by NF-kappaB. Modulation of cellular signaling involved in chronic inflammatory responses, induced by anti-inflammatory agents, hence provides a rational and pragmatic strategy in molecular target-based chemoprevention and cytoprotection. Induction of phase-2 detoxifying or antioxidant genes represents an important cellular defence in response to oxidative and electrophilic insults. Nuclear transcription factor erythroid 2p45 (NF-E2)-related factor 2 (Nrf2) plays a crucial role in regulating phase-2 detoxifying/antioxidant gene induction. Many antioxidants derived from dietary and medicinal plants have been found to activate this particular redox-sensitive transcription factor, thereby potentiating the cellular antioxidant or detoxification capacity.

Content and distribution of flavonoids among 91 edible plant species.

Abstract: Flavonoid contents as aglycones (for quercetin, kaempherol, isorhamnetin, luteolin and apigenin) were reported for 115 edible plants (91 species). Plant materials mostly originated in tropical zones were grown and harvested from AVRDC, Taiwan. Acid extraction and HPLC were used as analytical methods. Total flavonoid contents ranged from 0 to 254 mg/100g fresh weight. About 75% of samples were found to contain flavonoids ＞ 0.5 mg/100g with the group mean 33 ± 48 mg/100g. Data for only 30 samples (20 species) in this study are also available (measured as raw vegetables) in the USDA flavonoid database. This study can expand the flavonoid database and contribute to measurement of flavonoid intake, especially for populations consuming tropical and underutilized vegetables.

Phytochemicals of foods, beverages and fruit vinegars: chemistry and health effects.

Abstract: Plant-based foods and food ingredients provide a wide range of phytochemicals and antioxidants that render their beneficial health effects through a number of mechanisms. The presence of phenolics in different plant materials and beverages depends on the source material which dictates the type and quantity present. In addition, processing of raw materials, including fermentation, may alter the chemical nature and efficacy of their phenolic constituents. While vinegar has traditionally been used for food preservation and as a seasoning, more recently, fruit vinegars with different sensory characteristics have appeared in the marketplace. In addition to acetic acid, fruit vinegars often contain citric, malic, lactic, and tartaric acids and may also include phenolics, some of which are produced as a result of fermentaion. The beneficial health effects of fruit vinegars may in part be related to the process-induced changes in their phenolics and generation of new antioxidative phenolics during fermentation.

In vitro screening of relative bioaccessibility of carotenoids from foods

Abstract: Carotenoids are lipophilic pigments in plant foods that are of particular interest as precursors of vitamin A, a nutrient required for vision, cell differentiation, and the immune system. In order to mediate such activities, carotenoids and their metabolites must be absorbed for delivery to tissues. Unlike many other dietary lipids, the efficiency of carotenoid absorption is typically inefficient, being affected by food matrix, style of processing, other dietary components, and nutritional and physiological status. Thus, reliable prediction of carotenoid bioavailability is problematic. We have developed a relatively simple and cost effective procedure to study the potential bioavailability, i.e., the bioaccessibility, of carotenoids. The method involves simulated oral, gastric and small intestinal digestion of test samples to access the efficiency of incorporation into micelles, an obligatory step for absorption of lipophilic compounds. The model can be further expanded by adding micelles generated during small intestinal phase of digestion to monolayers of Caco-2 human intestinal epithelial cells to investigate apical uptake, cellular metabolism and transepithelial transport of carotenoids. Recent work by Borel and associates has demonstrated that the relative bioaccessibility of carotenoids observed in vitro is highly correlated with in vivo observations and results from bioavailability trials with human subjects. Results from recent studies using the in vitro model to screen relative bioaccessibility of β-carotene in various cultivars of cassava, impact of amount and types of fatty acyl groups in triglycerides on micellarization of carotenoids, and the mechanism of digestion and intestinal cell uptake of xanthophyll esters are presented.

Vegetable flavonoids and cardiovascular disease.

Abstract: Studies have suggested that dietary flavonoids are helpful in the prevention of atherosclerosis and cardiovascular disease. Antioxidant activity should be noted as underlying mechanism of their health impact in the vascular system, as atherosclerosis is closely related to oxidative events such as oxidized LDL accumulation in the macrophages. Vegetables contain a variety of flavonoids, such as flavonols, flavones and anthocyanidins. We focused on quercetin (3,3',4',5,7- pentahydroxyflavone), a major flavonoid in onion, and its anti-atherosclerotic effect was examined from the aspect of the bioavailability and translocation to the target site. Although quercetin exists as its glucoside form in onion, it is metabolized into several glucuronides and/or sulfate conjugates with or without methylation during its intestinal absorption. We found that these metabolites circulating in the human blood stream were mostly localized in plasma albumin fraction, but not LDL fraction. Onion consumption failed to enhance the antioxidant activity of plasma fraction against LDL oxidation, indicating that the level of quercetin metabolites bound to albumin is insufficient to exert the antioxidative effect in vivo. In contrast, we discovered that quercetin metabolites accumulate in the aorta tissue and exerted their antioxidant activity, when rabbits were fed with quercetin glucoside and high cholesterol diet. Furthermore, quercetin metabolites were detected in human atherosclerotic aorta exclusively. These imply that quercetin metabolites are incorporated into the atherosclerotic region and act as complementary antioxidants, when oxidative stress is loaded in the vascular system. It is likely that plasma albumin is a carrier for translocation of quercetin metabolites to vascular target.

Prevalence of overweight and obesity amongst school children in Delhi, India.

Abstract: Obesity has emerged as an epidemic worldwide. The present study was conducted to assess the prevalence of overweight and obesity amongst children in the age group of 5-18 years belonging to low, middle and high income group in National Capital Territory NCT of Delhi. A total of 16,595 children (LIG 5087, MIG 5134 and HIG 6368) were covered in the present study. Overweight and obesity were assessed using Body Mass Index (BMI) and Triceps Skin Fold Thickness (TSFT) utilizing age and sex specific cut off points. Considering the BMI cut off points, the prevalence of obesity and overweight in Low Income Group (LIG) school children was 0.1 and 2.7 percent respectively, amongst Middle Income Group (MIG) school children it was 0.6 and 6.5 percent and in High Income Group (HIG) school children was 6.8 and 15.3 percent respectively (p<0001). With regard to the TSFT criteria, the prevalence of obesity and overweight in LIG school children was 1.2 and 2.4 percent, amongst MIG school children it was 2.5 and 4.9 percent and in children belonging to HIG schools was 9.3 and 13.1 percent respectively (p<0.001). The present study documented that the prevalence of overweight and obesity was higher in the HIG children as compared to the MIG and the LIG for all age groups, highlighting the possible role of change in the dietary pattern and physical activities with increase in income levels.

Dietary sources of aldose reductase inhibitors: prospects for alleviating diabetic complications

Abstract: Activation of polyol pathway due to increased aldose reductase activity is one of the several mechanisms that have been implicated in the development of various secondary complications of diabetes. Though numerous synthetic aldose reductase inhibitors have been tested, these have not been very successful clinically. Therefore, a number of common plant/ natural products used in Indian culinary have been evaluated for their aldose reductase inhibitory potential in the present study. The aqueous extracts of 22 plant-derived materials were prepared and evaluated for the inhibitory property against rat lens and human recombinant aldose reductase. Specificity of these extracts towards aldose reductase was established by testing their ability to inhibit a closely related enzyme viz, aldehyde reductase. The ex vivo incubation of erythrocytes in high glucose containing medium was used to underscore the significance in terms of prevention of intracellular sorbitol accumulation. Among the 22 dietary sources tested, 10 showed considerable inhibitory potential against both rat lens and human recombinant aldose reductase. Prominent inhibitory property was found in spinach, cumin, fennel, lemon, basil and black pepper with an approximate IC50 of 0.2 mg/mL with an excellent selectivity towards aldose reductase. As against this, 10 to 20 times higher concentrations were required for 50% inhibition of aldehyde reductase. Reduction in the accumulation of intracellular sorbitol by the dietary extracts further substantiated their in vivo efficacy. The findings reported here indicate the scope of adapting life-style modifications in the form of inclusion of certain common sources in the diet for the management of diabetic complications.

The application of medium-chain fatty acids: edible oil with a suppressing effect on body fat accumulation.

Abstract: The bulk of fatty acids found in our diets consists of long-chain fatty acids (LCFA), which are molecules containing 12 or more carbon atoms. In contrast, medium-chain fatty acids (MCFA) are composed of 8-10 carbon atoms, and are found in palm kernel oil, among other types of foods. MCFA have attracted attention as being part of a healthy diet, because they are absorbed directly into the portal vein, transported rapidly to the liver for β-oxidation, and thus increase diet-induced thermogenesis. In contrast, long-chain triacylglycerols are absorbed via the intestinal lymphatic ducts and transported by chylomicrons through the thoracic duct into the systemic circulation. Because medium-chain triacylglycerols (MCT) containing solely MCFA have a few disadvantages when used for deep frying, we have developed a new kind of triacylglycerol product: medium- and long-chain triacylglycerol (MLCT). MLCT is produced by lipase-catalyzed enzymatic transesterification. Long-term clinical trials have demonstrated that MLCT and MCT result in less body fat accumulation in humans. MLCT oil has been approved as FOSHU (Food for Specified Health Use) for use as cooking oil with a suppressing effect on body fat accumulation.

Anticancer Effects of Diallyl Trisulfide Derived from Garlic

Abstract: Alk(en)yl sulfides are characteristic flavor components of garlic. Several lines of epidemiological study indicate that the risk of a certain cancer can be prevented by consumption of garlic. In this manuscript, we examined the anticancer property of garlic-derived alk(en)yl sulfides, and the molecular basis especially for diallyl trisulfide which is a major constituent of the garlic oil. Alk(en)yl sulfides with different numbers of sulfur atom (i.e., mono-, di-, and trisulfide) were synthesized and purified (＞99%). The anticancer activity of the alk(en)yl sulfides was primarily examined using human colon cancer cells HCT-15 and DLD-1. The growth of the cells was significantly suppressed by diallyl trisulfide, but neither diallyl monosulfide nor diallyl disulfide showed such an effect. The number of cells arrested at G2/M phase, the cells with a sub-G1 DNA content, and the cells with caspase- 3 activity were dramatically increased by diallyl trisulfide treatment. Diallyl trisulfide disrupted microtubule network formation of the cells, and microtubule fragments could be seen at the interphase. There was a specific oxidative modification of cysteine residues Cys12β and Cys354β, forming S-allylmercaptocysteines in the tubulin molecule. These results suggest that diallyl trisulfide is responsible, at least in part, for the epidemiologically proven anticancer effect for garlic eaters.

Double burden of malnutrition: the Vietnamese perspective.

Abstract: In addition to the burden of undernutrition, many recent studies in Vietnam demonstrate that overweight/obesity and a number of nutritionally- related chronic diseases (NRCD) (hypertension, diabetes, cardio-vascular diseases) are on the rise at an alarming rate. This could be the result of dietary and life style changes. The double burden of malnutrition (DBM) - a typical phenomenon during nutrition transition in developing countries, has been clearly reported in our country. Controlling nutritional deficiencies and newly emerging nutrition problems to reduce the double burden of malnutrition in Vietnam requires comprehensive and appropriate measures as set out in the National Nutrition Strategy 2001 - 2010, as well as a greater research effort on transitional nutrition.

Prevalence of malnutrition in free living elderly people in Iran: a cross-sectional study.

Abstract: Introduction: The elderly are a particularly vulnerable group. Malnutrition is common and increases an old person’s vulnerability to disease. We determine the prevalence of malnutrition in free living elderly people and its relationship with nutritional status and some ocioeconomic conditions. Methods: Nutritional status and its relationship with socioeconomic conditions were evaluated using Mini Nutritional Assessment in free-living elderly people (n=1962 using cluster sampling, 917 male/1045 female, aged＞60). Results: Among the population, 42.7% were well nourished, 12.0% malnourished and 45.3% at risk of malnutrition. There was more malnutrition in females compared to males (13% vs. 10.8%; p＜0.001), rural than urban (14.8% vs. 9.9%; p＜0.001), non educated than educated (13.3% vs 6.9%; p＜0.001), lonely than living with family (17.5% vs. 10.3%; p＜0.001), unemployed than employed (13.3% vs. 6.3%; p＜0.05), elderly on income support (Behsisty charity) compared with elderly on retirement salary, (41.7% vs. 3.3%; p＜0.05). Total Mini Nutritional Assessment scores correlated significantly with length of education, age, waist circumference, and body mass index (r =0.426, -0.142, 0.355 and 0.269 respectively). Conclusion: This study revealed a 12% malnutrition prevalence in this elderly group, with higher percentages in special socioeconomic conditions. Health care providers need to be aware of this problem and its scope. These results reinforce the need to screen, monitor and support elderly people.

To what extent can food-based approaches improve micronutrient status?

Abstract: The main dietary sources of micronutrients are animal source foods, fruits, vegetables and legumes. Animal source foods are the only source of some micronutrients and the main dietary source of others. Micronutrient status and child development are improved by animal source food interventions in populations that habitually consume low amounts. Of particular concern is the high global prevalence of vitamin B12 depletion, which is associated with low animal source food intake. Some fruits and vegetables can supply vitamin A requirements even with the lower amounts of fat typically consumed in many countries. However, plant source foods are unlikely to supply enough iron, zinc and vitamin B12, even if strategies such as consuming ascorbic-acid rich foods to increase iron absorption are adopted. Identification of mineral-rich varieties of cereals and legumes may improve the future situation. Complementary foods for infants and young children are unlikely to meet micronutrient requirements, especially for iron and zinc, unless they are fortified. Other strategies to improve micronutrient status, such as fortification and supplementation, have limitations and should not replace food-based strategies. Moreover, food-based strategies will improve dietary quality in general and are consistent with the global need to lower the risk of chronic disease and overweight.

Obesity prevalence and time trend among youngsters in China, 1982-2002

Abstract: Purpose of present study is to describe the prevalence and trend of overweight and obesity, as well as its coexistence 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 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.

Validity and reproducibility of a semi-quantitative food frequency questionnaire for use among pregnant women in rural China.

Abstract: A longitudinal study was conducted to validate a 68-item semi-quantitative food-frequency questionnaire (FFQ) for assessing nutrient intake among pregnant women in rural China. The interview administrated FFQs were conducted at the start of the third trimester (FFQ1) and repeated three months later prior to delivery (FFQ2), and compared with six repeated 24-hour recalls collected between the FFQs. From June to September 2004, 125 women at 23 to 26 weeks of gestation were recruited into the study in two rural counties in Shaanxi province, China. Pearson correlation coefficients for crude nutrients assessed by FFQ1 and FFQ2 had a mean of 0.46, and ranged from 0.31 for thiamin to 0.61 for fat. Pearson correlation coefficients estimated by FFQ2 and 24-hour recalls had a mean of 0.62 for all nutrients, and ranged from 0.53 for cholesterol and carotene to 0.70 for alpha-vitamin E and potassium. De-attenuated coefficients had a mean of 0.69 for all nutrients, and ranged from 0.58 for cholesterol to 0.77 for alpha- vitamin E. Bland-Altman plots revealed significant relationships between the difference and the average of the two methods with larger differences at higher average intakes. On average, 74% of participants were classified into the same or adjacent nutrient intake quintiles, while 1% were grossly misclassified to opposite quintiles. In conclusion, this FFQ has adequate reproducibility and validity for most nutrients but would benefit from the addition of wheat porridge to ensure it is suitable for assessing dietary intake in pregnant women in rural China.

Sociocultural factors relating to Tongans' and Indigenous Fijians' patterns of eating, physical activity and body size.

Abstract: This paper reviews literature between 1974 and 2007 that addresses the impact of sociocultural factors on reported patterns of eating, physical activity (activity) and body size of Tongans and indigenous Fijians (Fijians) in their countries of origin. There have been changes in diet (more imported and fewer traditional foods), activity (reduced, especially in urban settings), residence (rural-urban shift) and body size (increased obesity and at a younger age). The prevalence of overweight/obesity in Tongans and Fijians has increased rapidly over the last two decades and remains among the highest in the world (>80% in Tonga; >40% in Fiji), with more females reported to be obese than males. The few studies that investigated sociocultural influences on patterns of eating, activity and/or body size in this population have examined the impact of hierarchical organisation, rank and status (sex, seniority), values (respect, care, co-operation) and/or role expectations. It is important to examine how sociocultural factors influence eating, activity and body size in order to i) establish factors that promote or protect against obesity, ii) inform culturally-appropriate interventions to promote healthy lifestyles and body size, and iii) halt the obesity epidemic, especially in cultural groups with a high prevalence of obesity. There is an urgent need for more systematic investigations of key sociocultural factors, whilst taking into account the complex interplay between sociocultural factors, behaviours and other influences (historical; socioeconomic; policy; external global influences; physical environment).

Cancer prevention by tea and tea polyphenols

Abstract: The inhibition of tumorigenesis by tea extracts and tea polyphenols has been demonstrated in different animal models, including those for cancer of the skin, lung, oral cavity, esophagus, stomach, small intestine, colon, bladder, liver, pancrease, prostate, and mammary glands. Caffeine is also active in inhibition of tumorigenesis on the skin, lung, and perhaps other organs. In spite of many in vitro and in vivo studies, the molecular mechanisms for the cancer preventive actions of these compounds are not clearly known. The relationship between tea consumption and cancer risk has not been conclusively demonstrated, and the relationship may become more clear if we consider the effects of specific types of tea, at defined doses, in populations with certain dietary patterns or genetic polymorphisms. Human intervention trials and large prospective studies are needed to further assess the cancer preventive activities of tea constituents.

Development of food frequency questionnaires and a nutrient database for the Prospective Urban and Rural Epidemiological (PURE) pilot study in South India: methodological issues.

Abstract: Purpose: To develop Food Frequency Questionnaires (FFQs) and nutrient databases for urban and rural Indian populations with diverse dietary habits for the PURE (Prospective Urban and Rural Epidemiological) pilot study. Procedure: 24 hour dietary recalls were obtained from 84 rural and 60 urban subjects. From a comprehensive food list, separate FFQs were developed for the two groups. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. The FFQs were piloted in 80 urban and 77 rural subjects. Separately for each group, a stepwise regression method was used to identify foods contributing to a cumulative 90 % of variance to total energy intake. Nutrient and food group intakes were compared using an independent t-test. Main Findings: The urban and the rural FFQs contained 129 and 102 foods respectively, of which 82 foods were common to both. Fourteen urban foods and eight rural foods explained a cumulative 90% of variance for total energy intake. Daily intakes for most nutrients and food groups were two to three fold higher in the urban than in the rural group. Conclusions: In Indian populations with diverse dietary habits, using standard methods to develop separate FFQs can capture dietary intakes adequately. To develop nutrient databases, substitution of local food composition tables with data from other sources using standard methods to match foods can be adopted.

Health benefits of a natural carotenoid rich oil: a proposed mechanism of protection against ischaemia/ reperfusion injury

Abstract: Numerous studies have reported the protective properties of carotenoid supplementation against skin and eye associated diseases. However, conflicting data concerning the efficacy of β-carotene in the pathogenesis of cancers and cardiovascular disease exist. It has been shown that β-carotene is an effective antioxidant on its own or in combination with other antioxidants. Red palm oil (RPO) is a potent anti-oxidant rich oil which consists of carotenoids, tocopherols, tocotrienols and lycopenes as well as lipid fractions such as squalene, saturated and unsaturated fatty acids (which maximize absorption of these anti-oxidants) and Co-enzyme Q10. α and β-carotene account for more than 90% of the total carotene in RPO. It is known that ischaemia/reperfusion-induced injury causes an imbalance in oxygen supply which can lead to oxidative stress in the heart. It has been shown that the mitogen-activated protein kinases (MAPKs), PKB/Akt and the NO-cGMP all play vital roles in ischaemia/reperfusion injury in the heart. Therefore, our review mainly focuses on the signaling pathways involved in functional recovery induced by a natural carotenoid oil after ischaemia/reperfusion injury.

Alcohol consumption and risk of type 2 diabetes mellitus in Japanese: a systematic review.

Abstract: Objective: To evaluate the association between alcohol consumption and the risk for type 2 diabetes (DM) in Japanese. Methods: We searched the MEDLINE data base with the key words 'alcohol intake' (or 'alcohol consumption') and 'Japanese' cross-linked with 'diabetes mellitus' (or 'impaired glucose tolerance'). The reports we sought were restricted to prospective cohort studies, randomized controlled trials, meta-analyses and systematic reviews. Computerized and hand searches were conducted in June 2007. Results: Seven prospective cohort studies were adopted. We previously reported that in lean Japanese men (BMI ≤22.0 kg/m^2), moderate to heavy alcohol intake is a risk factor for diabetes. One study found heavy alcohol intake to be associated with an increased risk in low-BMI men while moderate alcohol intake was associated with a reduced risk in higher-BMI men. Another study suggested daily alcohol consumption to be a risk factor in low-BMI participants, while being protective in middle-BMI participants. Yet another study demonstrated a U-shaped association between alcohol consumption and the risk of diabetes in men. Three other studies, which did not divide the subjects in terms of BMI values, indicated alcohol intake to be an increased risk for diabetes, two being in men and one being in women, respectively. Conclusion: For a large number of Japanese men who have relatively low BMI, alcohol intake is an established risk factor for diabetes.